bluuebunny/crossref_metadata_2025 huggingface dataset:
Meta-analysis of gene expression profiles in breast cancer: toward a unified understanding of breast cancer subtyping and prognosis signatures
Authors: Wirapati Pratyaksha , Sotiriou Christos , Kunkel Susanne , Farmer Pierre , Pradervand Sylvain , Haibe-Kains Benjamin , Desmedt Christine , Ignatiadis Michail , Sengstag Thierry , Schütz Frédéric , Goldstein Darlene R , Piccart Martine , Delorenzi Mauro
Published: July 2008

Introduction

Breast cancer subtyping and prognosis have been studied extensively by gene expression profiling, resulting in disparate signatures with little overlap in their constituent genes. Although a previous study demonstrated a prognostic concordance among gene expression signatures, it was limited to only one dataset and did not fully elucidate how the different genes were related to one another nor did it examine the contribution of well-known biological processes of breast cancer tumorigenesis to their prognostic performance.

Method

To address the above issues and to further validate these initial findings, we performed the largest meta-analysis of publicly available breast cancer gene expression and clinical data, which are comprised of 2,833 breast tumors. Gene coexpression modules of three key biological processes in breast cancer (namely, proliferation, estrogen receptor [ER], and HER2 signaling) were used to dissect the role of constituent genes of nine prognostic signatures.

Results

Using a meta-analytical approach, we consolidated the signatures associated with ER signaling, ERBB2 amplification, and proliferation. Previously published expression-based nomenclature of breast cancer 'intrinsic' subtypes can be mapped to the three modules, namely, the ER-/HER2- (basal-like), the HER2+ (HER2-like), and the low- and high-proliferation ER+/HER2- subtypes (luminal A and B). We showed that all nine prognostic signatures exhibited a similar prognostic performance in the entire dataset. Their prognostic abilities are due mostly to the detection of proliferation activity. Although ER- status (basal-like) and ERBB2+ expression status correspond to bad outcome, they seem to act through elevated expression of proliferation genes and thus contain only indirect information about prognosis. Clinical variables measuring the extent of tumor progression, such as tumor size and nodal status, still add independent prognostic information to proliferation genes.

Conclusion

This meta-analysis unifies various results of previous gene expression studies in breast cancer. It reveals connections between traditional prognostic factors, expression-based subtyping, and prognostic signatures, highlighting the important role of proliferation in breast cancer prognosis.
Reliability of diagnostic coding in intensive care patients
Authors: Misset Benoît , Nakache Didier , Vesin Aurélien , Darmon Mickael , Garrouste-Orgeas Maïté , Mourvillier Bruno , Adrie Christophe , Pease Sébastian , de Beauregard Marie-Aliette Costa , Goldgran-Toledano Dany , Métais Elisabeth , Timsit Jean-François ,   The Outcomerea Database Investigators
Published: July 2008

Introduction

Administrative coding of medical diagnoses in intensive care unit (ICU) patients is mandatory in order to create databases for use in epidemiological and economic studies. We assessed the reliability of coding between different ICU physicians.

Method

One hundred medical records selected randomly from 29,393 cases collected between 1998 and 2004 in the French multicenter Outcomerea ICU database were studied. Each record was sent to two senior physicians from independent ICUs who recoded the diagnoses using the International Statistical Classification of Diseases and Related Health Problems: Tenth Revision (ICD-10) after being trained according to guidelines developed by two French national intensive care medicine societies: the French Society of Intensive Care Medicine (SRLF) and the French Society of Anesthesiology and Intensive Care Medicine (SFAR). These codes were then compared with the original codes, which had been selected by the physician treating the patient. A specific comparison was done for the diagnoses of septicemia and shock (codes derived from A41 and R57, respectively).

Results

The ICU physicians coded an average of 4.6 ± 3.0 (range 1 to 32) diagnoses per patient, with little agreement between the three coders. The primary diagnosis was matched by both external coders in 34% (95% confidence interval (CI) 25% to 43%) of cases, by only one in 35% (95% CI 26% to 44%) of cases, and by neither in 31% (95% CI 22% to 40%) of cases. Only 18% (95% CI 16% to 20%) of all codes were selected by all three coders. Similar results were obtained for the diagnoses of septicemia and/or shock.

Conclusion

In a multicenter database designed primarily for epidemiological and cohort studies in ICU patients, the coding of medical diagnoses varied between different observers. This could limit the interpretation and validity of research and epidemiological programs using diagnoses as inclusion criteria.
Non-pharmacological management of antipsychotic-induced weight gain: Systematic review and meta-analysis of randomised controlled trials
Authors: Álvarez-Jiménez Mario , Hetrick Sarah E. , González-Blanch César , Gleeson John F. , McGorry Patrick D.
Published: July 2008

Background

Antipsychotic-induced weight gain is a major concern in the treatment of psychosis. The efficacy of non-pharmacological interventions as well as the optimal intervention approach for this side-effect remain unclear.

Aims

To determine the effectiveness of non-pharmacological interventions and specific treatment approaches to control antipsychotic-induced weight gain in patients with firstepisode or chronic schizophrenia.

Method

Systematic review and meta-analysis of randomised controlled trials.

Results

Ten trials were included in the meta-analysis. Adjunctive non-pharmacological interventions, either individual or group interventions, or cognitive-behavioural therapy as well as nutritional counselling were effective in reducing or attenuating antipsychotic-induced weight gain compared with treatment as usual, with treatment effects maintained over follow-up.

Conclusions

Non-pharmacological weight-management interventions should be a priority, particularly during the early stages of antipsychotic treatment. Preventive approaches have the potential to be more effective, acceptable, cost-efficient and beneficial.
Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual
Authors: Killackey Eóin , Jackson Henry J. , McGorry Patrick D.
Published: July 2008

Background

Unemployment is a major problem for people with first-episode psychosis and schizophrenia. This has repercussions for the economy, social functioning and illness prognosis.

Aims

To examine whether a vocational intervention - individual placement and support (IPS) - which has been found to be beneficial in populations with chronic schizophrenia, was a useful intervention for those with first-episode psychosis.

Method

A total of 41 people with first-episode psychosis were randomised to receive either 6 months of IPS + treatment as usual (TAU) (n=20) or TAU alone (n=21).

Results

The IPS group had significantly better outcomes on level of employment (13 v. 2, P<0.001), hours worked per week (median 38 v. 22.5, P=0.006), jobs acquired (23 v. 3) and longevity of employment (median 5 weeks v. 0, P=0.021). The IPS group also significantly reduced their reliance on welfare benefits.

Conclusions

Individual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.
Competence of psychiatric clinicians in interpreting electrocardiograms and QT intervals: can they do this? Does it matter?
Authors: Solomons Luke , Treloar Adrian , Noronha Ryan
Published: July 2008

Aims and Method

We assessed the abilities of trainee and consultant psychiatrists in reading and interpreting electrocardiograms (ECGs) and QT intervals using a questionnaire and standardised ECG.

Results

Only 5% of our sample of trainee and consultant psychiatrists could correctly indicate a QTc interval. Performances on other measures, such as rate were also poor, with senior house officers performing better than consultants.

Clinical Implications

The increased awareness of problems caused by antipsychotics has not been reflected in improved knowledge of ECGs among psychiatrists. Machines do not reliably calculate QT intervals. We therefore urge better training and understanding of ECGs for psychiatrists.
Blinded Independent Central Review of Progression-Free Survival in Phase III Clinical Trials: Important Design Element or Unnecessary Expense?
Authors: Dodd Lori E. , Korn Edward L. , Freidlin Boris , Jaffe C. Carl , Rubinstein Lawrence V. , Dancey Janet , Mooney Margaret M.
Published: July 2008

Progression-free survival is an important end point in advanced disease settings. Blinded independent central review (BICR) of progression in randomized clinical trials has been advocated to control bias that might result from errors in progression assessments. However, although BICR lessens some potential biases, it does not remove all biases from evaluations of treatment effectiveness. In fact, as typically conducted, BICRs may introduce bias because of informative censoring, which results from having to censor unconfirmed locally determined progressions. In this article, we discuss the rationale for BICR and different ways of implementing independent review. We discuss the limitations of these approaches and review published trials that report implementing BICR. We demonstrate the existence of informative censoring using data from a randomized phase II trial. We conclude that double-blinded trials with consistent application of measurement criteria are the best means of ensuring unbiased trial results. When such designs are not practical, BICR is not recommended as a general strategy for reducing bias. However, BICR may be useful as an auditing tool to assess the reliability of marginally positive results.
Applying thermoelasticity to study stress relief and crack propagation in aluminium specimens patched with composite material
Authors: Moutrille M-P , Balandraud X , Grédiac M , Derrien K , Baptiste D
Published: July 2008

The context of the study is the preventive reinforcement of aluminium structures with bonded composite patches. The paper deals with stress relief in the substrate under tensile loading, as well as crack propagation in the adhesive during fatigue tests. For this purpose, temperature measurements are performed through the thickness of the specimen using an infrared camera. The procedure provides two types of information. First, thermoelasticity is used to study the relief in the aluminium substrate during cyclic loading: stress distribution, global relief, and progressive load transfer zone. Second, the study allows the tracking of patch disbond and characterization of mode-II crack propagation in the adhesive. A Paris law is determined for the design of bonded composite patches subjected to tensile fatigue loading.
When Rational Sellers Face Nonrational Buyers: Evidence from Herding on eBay
Authors: Simonsohn Uri , Ariely Dan
Published: July 2008

People often observe others' decisions before deciding themselves. Using eBay data for DVD auctions we explore the consequences of neglecting nonsalient information when making such inferences. We show that bidders herd into auctions with more existing bids, even if these are a signal of no-longer-available lower starting prices rather than of higher quality. Bidders bidding a given dollar amount are less likely to win low starting price auctions, and pay more for them when they do win. Experienced bidders are less likely to bid on low starting price auctions. Remarkably, the seller side of the market is in equilibrium, because expected revenues are nearly identical for high and low starting prices.
Innovation Contests, Open Innovation, and Multiagent Problem Solving
Authors: Terwiesch Christian , Xu Yi
Published: July 2008

In an innovation contest, a firm (the seeker) facing an innovation-related problem (e.g., a technical R&D problem) posts this problem to a population of independent agents (the solvers) and then provides an award to the agent that generated the best solution. In this paper, we analyze the interaction between a seeker and a set of solvers. Prior research in economics suggests that having many solvers work on an innovation problem will lead to a lower equilibrium effort for each solver, which is undesirable from the perspective of the seeker. In contrast, we establish that the seeker can benefit from a larger solver population because he obtains a more diverse set of solutions, which mitigates and sometimes outweighs the effect of the solvers' underinvestment in effort. We demonstrate that the inefficiency of the innovation contest resulting from the solvers' underinvestment can further be reduced by changing the award structure from a fixed-price award to a performance-contingent award. Finally, we compare the quality of the solutions and seeker profits with the case of an internal innovation process. This allows us to predict which types of products and which cost structures will be the most likely to benefit from the contest approach to innovation.
Diversity in Resource Consumption Patterns and Robustness of Costing Systems to Errors
Authors: Labro Eva , Vanhoucke Mario
Published: July 2008

Practitioners and academics hypothesize that when there is high diversity in resource consumption patterns, costing systems are more sensitive to errors. Given that firms' resources to enhance costing accuracy are typically constrained, it is argued that costing system refinement efforts should be focused on such cases, where they are likely to be most effective. However, little guidance is available on how to identify those situations where costing system refinement efforts (such as introducing an activity-based costing system) are likely to pay off most in terms of increased accuracy. Further, to our knowledge, the existing guidance provided by this high diversity rule of thumb has never been empirically tested. Using a simulation method, we address these issues in this paper. Specifically, we model various aspects, and degrees, of diversity in the resource consumption patterns to be reflected by the costing system and find that more diversity in resource consumption patterns only leads to increased costing system sensitivity to errors for some of the aspects of diversity studied. We also identify situations in which allocating costing system refinement resources to cases characterized by high diversity in resource consumption patterns is detrimental to improved accuracy.
Emergence of Ethical Issues During Strategic Change Implementation
Authors: Sonenshein Scott
Published: July 2008

Using qualitative data from a Fortune 500 company undergoing a strategic change, I describe the emergence of three ethical issues and build a theory to explain how this emergence unfolds. I find that some employees reframe the meaning of strategic issues as involving ethical implications because of trigger points, ambiguity, and the use of an available employee welfare frame. These employees take the meaning of strategic issues and reinterpret them as either leading to harmful consequences or the violation of a right. I conclude by discussing the theoretical implications for business ethics and sensemaking research, and the practical implications for responding to ethical issues.
Managing Complexity and Unforeseeable Uncertainty in Startup Companies: An Empirical Study
Authors: Sommer Svenja C. , Loch Christoph H. , Dong Jing
Published: July 2008

Novel startup companies often face not only risk, but also unforeseeable uncertainty (the inability to recognize and articulate all relevant variables affecting performance). The literature recognizes that established risk planning methods are very powerful when the nature of risks is well understood, but that they are insufficient for managing unforeseeable uncertainty. For this case, two fundamental approaches have been identified: trial-and-error learning, or actively searching for information and repeatedly changing the goals and course of action as new information emerges, and selectionism, or pursuing several approaches in parallel to see ex post what works best. Based on a sample of 58 startups in Shanghai, we test predictions from prior literature on the circumstances under which selectionism or trial-and-error learning leads to higher performance. We find that the best approach depends on a combination of uncertainty and complexity of the startup: risk planning is sufficient when both are low; trial-and-error learning promises the highest potential when unforeseeable uncertainty is high, and selectionism is preferred when both unforeseeable uncertainty and complexity are high, provided that the choice of the best trial can be delayed until its true market performance can be assessed.
Gems from the Ashes: Capability Creation and Transformation in Internal Corporate Venturing
Authors: Keil Thomas , McGrath Rita Gunther , Tukiainen Taina
Published: July 2008

Our longitudinal study of the entire population of internal corporate ventures within a large European electronics manufacturer finds that the conventional focus in the corporate venturing literature to evaluate ventures based on business growth and financial performance may be misguided. Instead, we found that ventures are temporary conduits for capability development and play a primary role in launching the founding stage of new capability life cycles. Ventures' main contribution was often to transfer valuable capabilities to other ventures or the firm's existing business units. The benefit from investing in ventures was therefore largely independent of their commercial success. Furthermore, estimation of success rates proved highly sensitive to the stage of the ventures at which sampling began. These findings suggest the need to reconceptualize the notion of early stage ventures and their success. We further found that the venturing process can be conceptualized as a nested system of simultaneous selection at both the venture and the capability level. We show that these selection processes are distinct yet operate in a coevolutionary way and are amenable to proactive management.
Accuracy of hand-held ultrasound scanning in detecting meniscal tears
Authors: Shetty A. A. , Tindall A. J. , James K. D. , Relwani J. , Fernando K. W.
Published: July 2008

The diagnosis of a meniscal tear may require MRI, which is costly. Ultrasonography has been used to image the meniscus, but there are no reliable data on its accuracy. We performed a prospective study investigating the sensitivity and specificity of ultrasonography in comparison with MRI; the final outcome was determined at arthroscopy. The study included 35 patients with a mean age of 47 years (14 to 73).

There was a sensitivity of 86.4% (95% confidence interval (CI) 75 to 97.7), a specificity of 69.2% (95% CI 53.7 to 84.7), a positive predictive value of 82.6% (95% CI 70 to 95.2) and a negative predictive value of 75% (95% CI 60.7 to 81.1) for ultrasonography. This compared favourably with a sensitivity of 86.4% (95% CI 75 to 97.7), a specificity of 100.0%, a positive predictive value of 100.0% and a negative predictive value of 81.3% (95% CI 74.7 to 87.9) for MRI.

Given that the sensitivity matched that of MRI we feel that ultrasonography can reasonably be applied to confirm the clinical diagnosis before undertaking arthroscopy. However, the lower specificity suggests that there is still a need to improve the technique to reduce the number of false-positive diagnoses and thus to avoid unnecessary arthroscopy.
Multilevel modelling: Beyond the basic applications
Authors: Wright Daniel B. , London Kamala
Published: July 2008

Over the last 30 years statistical algorithms have been developed to analyse datasets that have a hierarchical/multilevel structure. Particularly within developmental and educational psychology these techniques have become common where the sample has an obvious hierarchical structure, like pupils nested within a classroom. We describe two areas beyond the basic applications of multilevel modelling that are important to psychology: modelling the covariance structure in longitudinal designs and using generalized linear multilevel modelling as an alternative to methods from signal detection theory (SDT). Detailed code for all analyses is described using packages for the freeware R.
Hip Fractures in Institutionalized Elderly People: Incidence Rates and Excess Mortality
Authors: Rapp Kilian , Becker Clemens , Lamb Sarah E , Icks Andrea , Klenk Jochen
Published: July 2008

It is assumed that nursing homes are the setting with the highest incidence of hip fractures. This observation is, however, based on very little data. The aim of this study was to analyze hip fracture rates and the associated excess mortality in a large nursing home population. A cohort of >69,000 women and men newly admitted to German nursing homes were used to calculate sex- and age-specific incidence rates of hip fractures. To calculate excess mortality, a retrospective cohort study was conducted. To each patient with a hip fracture (n = 4342), four residents without hip fracture (n = 17,368) were matched by sex, age, and level of care (measure for the need of care). Hazard regression models were applied. During 91,850 person-years, 4342 hip fractures were observed. The crude incidence rates for hip fractures were 50.8/1000 person-years in women and 32.7/1000 person-years in men. The incidence rates increased with increasing age categories and were highest in the first months after admission to the nursing home. Increasing care need reduced the risk of hip fracture. Mortality in patients with a hip fracture was increased (women: hazard rate ratio for the first 3 mo after fracture, 1.72; 95% CI, 1.59–1.86; men: hazard ratio, 2.14; 95% CI, 1.80–2.53), but excess mortality was limited to the first months after injury. Data are presented for hip fracture rates and excess mortality after a hip fracture. Our results have implications on the timing and the allocation of specific measures for hip fracture prevention.
Impaired Energetic Metabolism After Central Leptin Signaling Leads to Massive Appendicular Bone Loss in Hindlimb-Suspended Rats
Authors: Martin Aline , David Valentin , Vico Laurence , Thomas Thierry
Published: July 2008

We previously showed in rats that the leptin effects on bone were dose dependent. Positive effects were observed when serum leptin concentration was in a physiological range. In contrast, important increases in serum leptin levels led to negative effects on bone formation similar to those reported after intracerebroventricular leptin administration in mice. To clarify whether leptin effects on bone depend on administration route and/or animal model, female rats were hindlimb unloaded or not and treated either with intracerebroventricular infusion of leptin or vehicle for 14 days. By increasing cerebrospinal fluid (CSF) leptin concentration, intracerebroventricular infusion of leptin significantly reduced food intake and consequently body weight, abdominal fat, and lean mass of the animals. Leptin infusion inhibited bone elongation over the 14 days and blunted cortical bone thickening at the femoral diaphysis site. Interestingly, leptin effects were site dependent in the cancellous bone envelopes, because tibia metaphysis BMD was lower and lumbar spine BMD was higher under intracerebroventricular leptin. Treated groups showed reduced bone remodeling independently of hindlimb unloading. Multiple downstream pathways were implicated in the mediation of these negative leptin effects on bone including not only stimulation of the sympathetic nervous system but also a decrease in somatotropic axis activity. Therefore, the intracerebroventricular leptin-induced bone loss could be largely related to the concurrent alteration of energetic and metabolic status. In summary, our study supports the hypothesis of a concentration-dependent balance between peripheral and central control of leptin on bone.
Partnerships with Complementary Professional-scientific and Service-delivery Organisations: The Future Direction for the Australian Association for Cognitive and Behaviour Therapy
Authors: Murphy Gregory C.
Published: July 2008

A brief historical analysis of AACBT's development and current performance suggests that the Association has suffered a loss of environmental support over the last decade. Selected examples of strategies used by other organisations to react to environmental change are presented as initiatives that offer potential for the Association to use in re-establishing itself as a major professional–scientific organisation.
The Effect of an Optimism and Lifeskills Program on Depressive Symptoms in Preadolescence
Authors: Quayle Diane , Dziurawiec Suzanne , Roberts Clare , Kane Robert , Ebsworthy Greg
Published: July 2008

Depression is a serious mental health problem, affecting more young people than ever before. This research reports on the short-term effectiveness of an Optimism and Lifeskills Program for preventing depression in preadolescents. A randomised, controlled trial was conducted with students about to make their transition to high school, in a private girls school. Self-report questionnaires were used to assess the program's effect on depressive and lonely symptoms, attributional style and self-worth, in a sample of 47 grade 7 girls at posttest and 6-month follow-up. Results showed fewer depressive symptoms and more positive self-worth in the intervention group compared to the control group at 6-month follow-up. This research indicates that depression prevention programs can be effective in the short-term and can provide valuable skills to young people making their transition to high school. Implementation issues and suggestions for further research on primary prevention for mental health in schools are discussed.
Intellectual Disability and Anxiety in Children: A Group-based Parent Skills-training Intervention
Authors: Ciechomski Lisa D. , Jackson Kylie L. , Tonge Bruce J. , King Neville J. , Heyne David A.
Published: July 2008

Anxiety is a highly prevalent problem with various manifestations in young children, especially those with an intellectual disability. Many parents of children with disabilities also experience a wide range of health problems, including anxiety, stress and depression. Very few group-based programs for parents of disabled children have been evaluated, and none of the existing research studies specifically address child or parental anxiety. Given the success of cognitive-behavioural interventions for anxious children without disabilities, it is logical that these interventions be applied to anxious intellectually disabled children. This paper presents a rationale for a new parent training-based early intervention program, targeting anxiety in this population of young people.
Three Versus Six Sessions of Computer-aided Vicarious Exposure Treatment for Spider Phobia
Authors: Fraser Jacqui , Kirkby Kenneth C. , Daniels Brett , Gilroy Lisa , Montgomery Iain M.
Published: July 2008

Thirty participants diagnosed with specific phobia (spiders) were randomly allocated to receive a treatment dose of either three or six 45-minute sessions of a computer-aided vicarious exposure (CAVE) for spider phobia. Phobic symptom severity was measured at pretreatment, posttreatment and at one-month follow-up on a range of subjective and behavioural measures. Results showed that participants in both groups improved significantly across the majority of outcome measures from pre- to posttreatment and pretreatment to follow-up assessment. There were no significant differences between the three- and six-session groups. Process measures indicated that the six-session treatment group performed approximately twice as much vicarious exposure, however, competence on the program was reached by the end of three sessions. These results suggest that rehearsal of CAVE, beyond the level at which skill learning is consolidated, is not of therapeutic value. Further research is required to ascertain whether other forms of dosage effect may operate in computer-delivered behaviour therapy. For example, delivery of a wider range, rather than amount, of CAVE scenarios, or the delivery of a hierarchy of exposure stimuli on the screen, without a vicarious component, may show a dose-response relationship.
Identifying Crosscultural Differences in the Effectiveness of an Information and Free Child Seat Rental Program
Authors: Sibley Chris G. , Hunt Maree , Harper David N.
Published: July 2008

Porirua (a suburb in Wellington, New Zealand) is a problem area for child restraint use and has been targeted by a variety of government-initiated, and largely ineffective, traffic safety campaigns in recent years (e.g., Gouldsbury, 1999). The present study attempted to increase child restraint use in cars at two Porirua Kindergartens, one predominantly Pacific Nations (Kindergarten A), and the other predominantly New Zealand European (Kindergarten B), by providing parents with information packages and vouchers for free child seat rental. An increase in correct child seat use was not observed at either kindergarten, although all unrestrained children observed during baseline at the predominantly New Zealand European kindergarten changed to wearing seat belts after the intervention. This finding suggests that income limitations per se are not the primary factor maintaining child seat non-use. Discussion focuses on the contradictory findings provided by both previous survey and observational research on the effect of ethnicity and income on child seat use. Potential crosscultural differences in the existence and salience of verbal community effects that may maintain child seat use through the avoidance of social punishment contingencies from other parents within the kindergarten are considered as one possible explanation for the present findings.
Learning How To Be A Good Sport: An Intervention Aimed at Increasing Sportsperson-like Behaviour
Authors: Mohr Caroline
Published: July 2008

This paper describes the use of cognitive-behavioural therapy to assist a very experienced Special Olympics tennis player control his unacceptable on-court behaviour. In 10 weekly sessions he was taught to relax both on and off court, change his gloomy self statements and negative predications of his future behaviour, analyse and learn three essential elements of good sporting behaviour and practised these skills under low stress conditions. He assisted in the writing of a book, which described all the stages of his therapy, and he looked at the book often between therapy sessions. At an interstate championship held 3 months later the player won all his early matches but lost in the final series. However he was able to practise relaxation skills and positive self-statements, and perform all the elements of good sporting behaviour.
Work, Women and Their Beliefs
Authors: O'Kelly Monica
Published: July 2008

Many women now juggle the multiple roles of wife, mother, home maker, and paid worker. Although their behaviours may have changed, many of these women still adhere to traditional beliefs about their roles, which may predispose them to conflict and stress. Questionnaires were sent to all women working at a large urban teaching hospital in metropolitan Melbourne in a study to explore, among other factors, the relationship between occupational status, education level, and women's beliefs. Of the 2562 questionnaires sent out 974 (44%) were completed and returned, 422 of the questionnaires were completed by women who were living with a male partner and children. Multivariant analyses of variance were performed on the data. Results indicated a relationship between occupational status and adherence to traditional beliefs. Blue collar women had the most traditional beliefs followed by clerical women, then nurses. Managerial women and professional women had the least traditional beliefs. A similar relationship was found between level of education and beliefs; women with lower levels of education adhered to more traditional beliefs than women with higher education levels. It is possible that, as a result of adherence to traditional beliefs, women who are blue-collar workers and those with lower levels of education may be more predisposed to stress than other women when juggling their multiple roles.
Career Versus Motherhood? A Case Study Describing a Cognitive-existential Approach to the Dilemma
Authors: Dingle Genevieve
Published: July 2008

The present paper reports a case study concerning a professional woman in her 30s, who presented to the Occupational Health department of a metropolitan hospital with work stress stemming from accelerating work demands and marital problems related to the decision about whether to start a family or continue her career. No clinical diagnosis was warranted; however, Maslach Burnout Inventory Scores indicated a high degree of emotional exhaustion and moderate levels of depersonalisation, offset by a high sense of personal accomplishment in her work role. The client also demonstrated severe stress and moderate depression on the Depression-Anxiety-Stress Scale (DASS-21). The case was conceptualised from a combined cognitive-existential perspective. The woman's cognitions about her work, relationship, and prospective motherhood roles were identified, as well as underlying existential issues such as finding a meaning in life and a fear of being alone and unloved. Eight sessions of therapy incorporated components of cognitive and existential therapies, aimed at managing stress and improving marital adjustment. Posttreatment results showed substantial reductions in all the measures of distress, while personal accomplishment remained high. The woman and her husband decided to defer starting a family until other issues had been addressed.
Integrating Cognitive-behavioural and Interpersonal Approaches in a Group Program for the Eating Disorders: Measuring Effectiveness in a Naturalistic Setting
Authors: Crafti Naomi A.
Published: July 2008

A group treatment program, designed for post-adolescent women with a range of eating problems, was developed, implemented, evaluated and then transported to a different treatment setting to test its effectiveness. The treatment program was aimed at overcoming some of the difficulties traditionally associated with clinical trial treatment protocols. In particular, the inclusion of sub-clinical and comorbid clients, the integration of two empirically validated theoretical approaches (cognitive-behavioural therapy and interpersonal therapy), and the implementation of the program in both a generalist outpatient clinic staffed by postgraduate counselling students and a hospital specialist clinic, enabled treatment outcome to be assessed under more naturalistic conditions. Twenty-eight women (Mean age = 33 years), met in six small groups at the University clinic, and completed the 10-week group program, which incorporated both cognitive-behavioural and interpersonal components. Outcome was determined by measures of behaviour change, changes in eating psychopathology and measures of general psychopathology. In addition, treatment generalisability was assessed by running the group program in an alternative setting, with an additional 12 clients, led by two clinically trained therapists. Group data indicated improvement on most outcome measures at both posttreatment and follow-up, for treated clients (in both settings) relative to a waiting-list control group. The variables which were most affected by treatment, however, were not necessarily those specifically targeted by the intervention. The results demonstrate the need to gather empirical data on psychotherapy as it is actually practiced, with a broad range of clients, therapists and using integrated treatment approaches.
Where are the Women in End-of-Life Research?
Authors: Allen Felicity
Published: July 2008

This article reviews research on attitudes towards, and the practice of, hastening death. The central aim of this review is to elucidate what is known about the role played by gender in shaping the behaviours of people in the diverse roles of healthcare provider, carer, and patient. It is concluded that, on the whole, researchers have neglected to acknowledge gender differences in the experience of dying. Also lacking is carefully conducted research which is contextualised so that the dying person is better understood as a member of society rather than an isolated individual.
Insights into Women's Experiences of Hospital Stays: Perceived Control, Powerlessness and Satisfaction
Authors: Polimeni Anne-Maree , Moore Susan
Published: July 2008

Understanding the psychosocial experiences of women as hospital patients is an important step in assessing the relationship to healthy outcomes of patients' perceived experiences of power and control in hospital. Accordingly, the aims of this study of 124 adult women were (a) to document women's psychosocial experiences during a hospital stay, and (b) to develop and psychometrically evaluate a scale to measure perceived control over treatment, management and daily routine during a hospital stay (Perceived Control in Hospital Scale; PCHS). Women who had experienced a hospital stay of at least one night were surveyed. The qualitative section of the study involved thematic analysis of the written or oral comments of 10 women concerning psychosocial aspects of their hospital experience. Results indicated that the PCHS comprised three factors describing patients' perceptions of their hospital stay: Respect/Communication, Lack of Dignity, and Day-to-Day Control. The survey results showed that although the majority of the women were satisfied with the psychosocial aspects of being an in-patient, there was a substantial core of perceived powerlessness. A significant proportion of women indicated that they either felt “not listened to”, experienced loss of dignity, or experienced unnecessary loss of day-to-day control.
The Relative Contributions of Negative Cognitions and Self-efficacy to Severity of Panic Attacks in Panic Disorder
Authors: Richards Jeffrey C. , Richardson Vanessa , Pier Ciaran
Published: July 2008

The aim of this study was to determine the degree to which fearful and catastrophic cognitions, and self-efficacy for managing panic predicted various panic attack characteristics in panic disorder. The cognitive variables consisted of anxiety sensitivity, the frequency of fearful agoraphobic cognitions and measures of catastrophic misinterpretation of symptoms. The panic parameters were number and severity of panic symptoms, distress associated with panic attacks, worry about future panics, duration of panic disorder, and life interference due to panic disorder. These variables were measured in 40 people with panic disorder, 31 of whom also had significant agoraphobia. The frequency of fearful agoraphobic cognitions was the strongest predictor of panic attack symptomatology, predicting number of symptoms, symptom severity and degree of anticipatory fear of panic. Catastrophic misinterpretation of symptoms and anxiety sensitivity did not independently predict any panic parameters. Only self-efficacy for managing the rapid build-up of panic symptoms was specifically related to panic severity. The results therefore suggest that cognitive behaviour therapy for panic symptoms in panic disorder should reduce fearful cognitions rather than focus on panic coping strategies. The results offer little support for the contribution of the expectancy or catastrophic misinterpretation theories to the maintenance of panic disorder.
Depression, Anxiety and Self-esteem: A Clinical Field Study
Authors: Nisbet Wallis Denise A.
Published: July 2008

The Cognitive Behavioural Therapy Group Program at Central Coast Mental Health Specialty Clinics includes treatments for generalised anxiety disorder, panic disorder and depression. This study provides empirical validation for hypotheses developed in clinical controlled studies; that is, that cognitive-behaviour therapy provided benefits in the treatment of anxiety and depression in a service setting. This would be reflected in decreases in the symptoms of anxiety and depression and increased self-esteem. Participants (N = 139) were referred to Specialty Clinics, Central Coast Mental Health Services for treatment for depression and/or anxiety in CBT groups. They were tested on the BDI, STAI and the SERS at three time points, prior to entering the group, at termination of the group and at 3-month follow-up. Depression and anxiety symptoms decreased and self-esteem increased between pre- and post-group and the trends continued to 3-month follow-up.
Reliability and Factor Structure of the NEO-Five-Factor Inventory for Australian Adolescents
Authors: Sneed Carl D. , Gullone Eleonora , Moore Susan
Published: July 2008

This study evaluated the reliability and factor structure of the NEO Five-factor Inventory (NEO-FFI) among a sample of Australian adolescents (N = 459). With the exception of openness, the factors had good internal consistency. Item-level factor analyses using varimax and oblique rotation were used to examine the factor structure of the NEO-FFI. Visual inspection of the factor structures revealed a pattern that gave preliminary support for the five-factor model. However, statistical indices for factor structure did not support a five-factor model. Items for Conscientiousness and Neuroticism had the highest factor loadings and the fewest conflicting cross-loadings on the other factors. The discussion focuses on the importance of external validation of the traits from the five-factor model with other behavioural indicators.
A Comparison of Checking-related Beliefs in Individuals with Obsessive Compulsive Disorder and Normal Controls
Authors: Overton Sarah M. , Menzies Ross G.
Published: July 2008

The potential roles of perceived danger, responsibility, thought-action fusion, confidence in memory, intolerance of uncertainty and need to control one's thoughts in mediating compulsive checking were examined. Belief ratings were obtained from 21 individuals with compulsive checking concerns and 21 nonclinical controls about the most prominent checking concern of each individual with obsessive compulsive disorder (OCD), with controls being yoked to individuals with OCD on the basis of gender and age. If control participants and individuals with OCD have some similar beliefs regarding, for example, locking their front door, then it follows that those beliefs are unlikely to be mediating or driving the disorder. Large and significant differences were found between sufferers of OCD and nonclinical controls on ratings of beliefs concerning the probability and severity of harm, intolerance of uncertainty and the need to control thoughts. However, no differences were found between individuals with OCD checking concerns and nonclinical controls in ratings of beliefs concerning perceived personal responsibility, thought-action fusion (TAF) and confidence in memory. The findings concerning personal responsibility are of particular interest and suggest that perceptions of harm or a negative outcome may be a necessary precursor to perceptions of responsibility and the decision to act.
Using Self-generated Feedback for Generalising and Maintaining Staff Performance in a Rehabilitation Program
Authors: Arco Lucius
Published: July 2008

The aim of this study was to examine whether a low cost self-generated feedback procedure was sufficient for generalising and maintaining staff performance. Two staff members were trained to implement a communication skills program with a client with severe closed head injuries. Staff were first trained to perform competently via written instructions, videotaped models, discussion, and on-the-job supervisory feedback. Posttraining conditions consisted of staff continuing with recording and graphing gains in client skills, or rating their own performance (i.e., they continued with self-generated feedback). A multiple baseline design across client skills and staff was used to observe generalised effects on staff performance (prompts and positive consequences) and client skills. Results show that after staff attained competency, and without further supervisory feedback, their performance generalised to topographically similar performance, and the staff member who consistently participated in the study maintained her performance for 16 weeks.
The Revised Child Anxiety and Depression Scale: A Psychometric Investigation with Australian Youth
Authors: de Ross Raelene L. , Gullone Eleonora , Chorpita Bruce F.
Published: July 2008

The Revised Child Anxiety and Depression Scale (RCADS) is a 47-item self-report measure intended to assess children's symptoms corresponding to selected DSM-IV anxiety and major depressive disorders. The scale comprises six subscales (e.g., Separation Anxiety Disorder; Social Phobia; Obsessive Compulsive Disorder; Panic Disorder; Generalised Anxiety Disorder; and Major Depressive Disorder). To date, only one normative study of youth has been published with results providing strong initial support for the reliability and validity of this new measure (Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000). The present investigation provides additional psychometric data derived from an Australian sample comprising 405 youth aged 8 to 18 years. In general, the data were found to be consistent with those reported in the initial normative study. Internal consistency for the overall scale and its subscales was found to be adequate. Good convergent validity was demonstrated through moderate to strong correlations between the subscales of the RCADS with scores on the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). Confirmatory factor analysis suggested reasonable fit for the six-factor model by Chorpita et al. (2000). Notwithstanding the need for additional validation, it is concluded that the RCADS is a promising instrument for use in both clinical and research settings.
Danger Expectancies, Self-efficacy and Subjective Anxiety as Mediators of Avoidance Behaviour in Spider Phobia
Authors: Gilroy Lisa J. , Kirkby Kenneth C. , Daniels Brett A. , Menzies Ross G. , Montgomery Iain M.
Published: July 2008

Forty-five participants diagnosed with specific phobia (spiders) gave ratings of subjective anxiety, self-efficacy and the probability of being bitten or injured by a spider while completing a behavioural avoidance test involving exposure to a live spider. Testing was performed before and after treatment and at a 3-month follow-up. Results indicated that subjective anxiety was a more useful predictor of avoidance behaviour than self-efficacy. Danger expectancies in relation to being bitten and/or injured by a spider were not found to be a significant cognitive symptom in the majority of spider phobia sufferers during the behavioural avoidance test with a live spider. Methodological factors that may account for the low reporting of danger-related cognitions in the present study are discussed.
Motivational Interviewing: Enhancing Engagement in Treatment for Mental Health Problems
Authors: Baker Amanda , Hambridge John
Published: July 2008

Motivational interviewing has been employed extensively and successfully among people with alcohol and other drug problems in order to enhance involvement in treatment and to reduce substance use. Despite clear commonalities in motivating people with mental health problems to recognise their problem and adhere to treatment, motivational interviewing has not been widely adopted by mental health professionals, largely due to the separation of mental health versus substance use services. The existing evidence for the effectiveness of motivational interviewing in improving engagement in treatment for mental health problems is reviewed. It is recommended that, based on the evidence available, motivational interviewing should be applied to people with mental health problems as well as those with substance-related problems to enhance treatment engagement, retention and response. Guidelines for its application are suggested.