bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomised-Control Trial of Family Intervention for 78 First-Episode Male Schizophrenic Patients
Authors: Zhang Minglian , Wang Mingtao , Li Jianjun , Phillips Michael R.
Published: August 2018

At the time of discharge from their first stay in psychiatric hospital, 78 male schizophrenic patients were randomly assigned to a family intervention (experimental) group or a ‘standard care’ control group and were followed for the next 18 months. The family intervention consisted of both group and individual counselling sessions every 1–3 months that focused on education about the illness and on methods of dealing with the patient. There was a significantly lower rate of hospital readmission in the family intervention group than in the control group (15.4% versus 53.8%, χ2= 12.75, P<0.01), and the mean hospital-free period for those who were readmitted was significantly longer in the experimental group than in the control group (245 days versus 130 days, t =2.91, P<0.01). Moreover, the clinical status and overall level of functioning in patients who were not readmitted were significantly better in experimental subjects than in control subjects. Stratified analysis showed that family intervention and regular use of medication had independent and additive effects on the outcome. During the 18 months after the index discharge patients who did not take medication regularly and who did not receive family intervention were 7.9 times as likely to be readmitted to hospital as patients who took medication regularly and received family intervention.
The Yantai Model of Community Care for Rural Psychiatric Patients
Authors: Wang Qingtong , Gong Yuzhu , Niu Kezhen
Published: August 2018

The main characteristics of the Yantai model are (a) a three-tier (county, township, village) management structure; (b) the vertical integration of community mental health workers, including a professional advisory group of psychiatrists from the central psychiatric hospital, groups of community psychiatrists at small county psychiatric hospitals, non-psychiatric physicians who run psychiatric out-patient clinics at township general hospitals, and village paramedics (‘village doctors’) who supervise patients in the community; (c) ongoing training of all community mental health workers; (d) registration and yearly follow-up of all patients with mental illnesses in the community; (e) provision of home-care services to a proportion of acutely ill patients; and (f) most of the cost of the service is borne by the state. The network of services provided by this model makes it convenient for patients to obtain treatment and, if necessary, go into hospital; it reduces the economic burden on the family and the community; it combines treatment, prevention, rehabilitation, and supervision under one administrative network; and it decreases the overall level of psychopathology and psychosocial dysfunction in the community.
A glutamatergic deficiency model of schizophrenia
Authors: Carlsson A. , Hansson L. O. , Waters N. , Carlsson M. L.
Published: August 2018

Although the presence of hyperdopaminergia has been demonstrated in the brains of people with schizophrenia, at least in some circumstances, other neurotransmitters are important in this disorder, and a glutamatergic deficiency model of schizophrenia is proposed. It is suggested that the amount of sensory input allowed to reach the cerebral cortex is restricted by an inhibitory effect of the striatal complexes on the thalamus, thereby protecting it from being overwhelmed. Several strands of evidence are presented to support the concept that a weakened glutamatergic tone increases the risk of sensory overload and of exaggerated responses in the monoaminergic systems that could result in psychosis.
An approach to treatment resistance in schizophrenia
Authors: Marder Stephen R.
Published: August 2018

Currently, patients with schizophrenia are usually considered refractory to treatment if they continue to be floridly symptomatic despite receiving treatment with conventional antipsychotic agents. Attempts to improve their response by increasing the dosage, adding supplementary drugs, or switching to agents of another class have not been very successful, and may increase side-effects. Clozapine can be effective, but it is a difficult drug to administer and has therefore been reserved for patients who are doing poorly. With the recent introduction of newer, safer antipsychotic agents, however, even patients who have milder refractory symptoms that persist after treatment with conventional antipsychotics can now be treated.
On Developing a Psychiatric Multiaxial Schema for ICD-10
Authors: Mezzich J. E.
Published: August 2018

As work proceeds on the development of the Tenth Revision of the International Classification of Diseases (ICD-10) widespread interest has been expressed in the preparation of a multiaxial diagnostic schema for psychiatric patients. In consideration of this task, the present paper briefly notes pertinent international experience on multiaxial diagnosis, the discernible purposes of this approach, design requirements, and a specific multiaxial proposal.
Psychiatric Aspects of Normal-Pressure Hydrocephalus
Authors: Pujol J. , Leal S. , Fluvia X. , Conde C.
Published: August 2018

Normal-pressure hydrocephalus (NPH) was described in 1964 (Adams, 1965; Hakim, 1965) and defined by the symptom triad: dementia, motor disturbance, and sphincter disturbance. The original publication by Adams already contained a reference to psychiatric symptoms: depression, slowness, hallucinations, and apathy. Rice & Gendelman (1973) reported five cases, and commented on the development of both early cognitive impairment and behavioural regression, suggesting that personality factors might play a role in the appearance of latter symptoms. Trevor et al (1977) described a case suffering from psychotic depression, paranoid symptoms, inadequate affect, and self-destructive behaviour.
The Diagnosis of Public Mental Health Care Bureaucracies*
Authors: Marcos Luis Rojas , Gil Rosa M.
Published: August 2018

The proliferation of large-scale organisations is a phenomenon of modern society. As Etzioni (1968) puts it, “We are born in organisations, educated by organisations and most of us spend much of our lives working for organisations”. Most public organisations in modern society are bureaucracies and the field of psychiatry is no exception: a trend toward growing bureaucratisation, of both public and private mental health services organisations, can be observed everywhere. To a large extent, this is because, as standards of care become regulated and quality controls increase, the tasks that mental health professionals and administrators perform become better understood, more predictable, and more programmed. There is still room for creativity and innovation, but only in incremental, well controlled steps.
Patient-Environment Relationships in Schizophrenia
Authors: Nuechterlein Keith H. , Goldstein Michael J. , Ventura Joseph , Dawson Michael E. , Doane Jeri A.
Published: August 2018

The general view that relationships between factors within the patient and those in the environment are important in understanding schizophrenia has been widely accepted and is the basis for vulnerability/stress models of this disorder. However, the specifics of the patient-environment relationships that may be critical for schizophrenia continue to be largely a mystery. At the UCLA Clinical Research Center for the Study of Schizophrenia, we have developed a tentative working model of schizophrenic episodes that emphasises the mediating role of information-processing and autonomic abnormalities in the patient in interaction with stressful circumstances and protective factors in the patient's environment (Nuechterlein & Dawson, 1984a; Liberman, 1986; Dawson & Nuechterlein, 1987; Nuechterlein, 1987). Here we examine two examples of patient-environment relationships that may increase our understanding of such processes in schizophrenia.
What Works in Work with Relatives? – A Hypothesis
Authors: Katschnig Heinz , Konieczna Teresa
Published: August 2018

In the past, psychiatry has paid little attention to the relatives of the mentally ill, but this attitude has changed gradually since the 1950s, when increasing numbers of patients began to be discharged from psychiatric hospitals through the introduction of neuroleptics and other changes. Especially for schizophrenic patients, with the low age of onset of the disorder, this development has meant that in many cases, the burden of care fell on their families, and as a consequence of this development, relatives have gradually become an important factor in care (Katschnig & Konieczna, 1987a). This field of involvement of relatives continues to expand, but is becoming increasingly confusing and complex. Our task here is an attempt to offer a structure within which to understand the manifold relative-centred activities that exist today.
Serotonin Receptor Subtypes: Implications for Psychopharmacology
Authors: Cowen P. J.
Published: August 2018

Serotonin (5-HT) interacts with multiple brain 5-HT receptor subtypes to influence a wide range of behaviours. Three main families of 5-HT receptors (5-HT1, 5-HT2 and 5-HT3) have been described which differ in their binding affinity for selective ligands, their receptor-effector coupling mechanisms, and the behavioural processes they regulate. Nevertheless, manipulation of several different 5-HT receptor subtypes (5-HT1A, 5-HT1c, 5-HT2 and 5-HT3) may produce anxiolytic effects; 5-HT1A and 5-HT2 receptors may be involved in the aetiology of major depression and the therapeutic effects of antidepressant treatment; and 5-HT3 receptors have been linked to reward mechanisms and cognitive processes. These advances offer therapeutic possibilities, the value of which can only be satisfactorily assessed by controlled clinical trials.
Anxiety and Alcoholism: A Serotonin Link
Authors: Tollefson Gary D.
Published: August 2018

The augmentation of serotonin (5-HT) neurotransmission attenuates alcohol consumption, whereas depletion enhances use. A number of serotonin-specific pharmacological probes appear to be effective in reducing the voluntary consumption of alcohol. The 5-HT1Areceptor agonist buspirone is an anxiolytic which has been shown to diminish the desire to consume alcohol in anxious alcoholic patients. Thus, serotonin may represent a common denominator for a spectrum of behavioural disorders including anxiety and alcoholism. Novel serotonin drugs, such as the azapirones, may usefully supplement conventional treatment strategies for substance abuse.
IV. Performance on Psychological Tests. Demographic and Clinical Correlates of the Results of these Tests
Authors: Frith C. D. , Leary J. , Cahill Concepta , Johnstone Eve C.
Published: August 2018

It has become increasingly apparent that schizophrenic patients can suffer from many cognitive deficits (Hemsley, 1982). These include a decline in IQ (Nelson et al, 1990), loss of concentration (Garmezy, 1978), and various ‘executive’ difficulties similar to those observed in patients with frontal lobe lesions (Morice, 1990). The availability of a large, population-based sample of schizophrenic patients in the Harrow study provided the opportunity to examine the prevalence of these impairments and to relate them to the signs and symptoms of the disorder.
Delusional Jealousy and Awareness of Reality
Authors: Enoch David
Published: August 2018

Who are mad, those in lunatic asylums or the rest of us, pruning our inane rituals outside? What is reality, what delusion? These are the basic questions of the human predicament posed by Pirandello's play Henry IV, now revived on the London stage with Richard Harris's mesmeric central performance as the alienated Everyman, who finds fulfilment in posing as the tormented medieval king.
The Delusional Misidentification Syndromes
Authors: Christodoulou G. N.
Published: August 2018

The basic concept characterising the delusional misidentification syndromes (DMS), particularly the Capgras variety, is the concept of double, or its equivalents. It seems that this concept is prominent in all cultures and this explains the amazing universality of these delusions. Cases of DMS have been reported in practically all parts of the world. In fact, most patients actually mention the word double (or σωσιας, sosie etc.) or refer to transformations (metamorphose, μεταμoρΦωσεις and the like). The preoccupation, and even enchantment, of man with the notion of doubles from time immemorial in all cultures, as reflected in the myths, traditions, literature, beliefs and metaphysical motions, has been dealt with extensively elsewhere (Christodoulou, 1986a).
Delusional Misidentification and the Role of the Right Hemisphere in the Appreciation of Identity
Authors: Cutting J.
Published: August 2018

For over 50 years, Capgras' syndrome (Capgras & Reboul-Lachaux, 1923) was considered a psychiatric curiosity, fit only for inclusion among other ‘rarities’ in psychiatric textbooks and explicable only in psychodynamic terms. In the last few years, however, the number of publications on the topic has increased enormously, and three solid facts have emerged which give a clue to its nature. In this article, I shall discuss these three facts and, in the light of them, propose a psychological and neuropsychological explanation for the syndrome.
Delusional Infestation
Authors: Morris Michael
Published: August 2018

The patient who develops the delusional conviction that he/she is infested with small organisms, such as mites or insects, has been recognised in the medical literature for over a century. A wide range of descriptive terms — ‘dermatophobia’ ‘acarophobia’, ‘parasitophobia’ and ‘entomophobia’ (Table 1) have been applied to this symptom. Such terminology is now inappropriate but it has continued to be used until relatively recently: Pope (1970), for example, defined parasitophobia as “a delusional state in which there are sensations of infestation of the skin by insects”.
Delusional Atmosphere
Authors: Berner Peter
Published: August 2018

The condition termed ‘delusional atmosphere‘ belongs to the ‘precursor phenomena‘ of delusion and has always attracted special attention because its peculiarities evoke the hope of obtaining better insight into the conditions governing the emergence and formation of delusion. The following considerations represent a review of the most important topical hypotheses about the nature of the delusional atmosphere and its progression into finalised delusional elaborations as seen in the perspective of the psychopathology of German-speaking countries.
Long-Term Administration of Tianeptine in Depressed Patients after Alcohol Withdrawal
Authors: Malka R. , Lôo H. , Ganry H. , Souche A. , Marey C. , Kamoun A.
Published: August 2018

Alcohol interferes with the central metabolism of the catecholamines and especially with indolamines (5-HT). Thus, the use of an antidepressant such as tianeptine, whose main neurochemical effect is to increase the reuptake of 5-HT, seems to be particularly indicated for the continued treatment of depressed patients after alcohol withdrawal. This study evaluated the therapeutic efficacy and acceptability during long-term administration of tianeptine in depressed patients (major depressive episode or dysthymic disorder) in a multicentre trial, after withdrawal from alcohol abuse or dependence. The results relate to 130 depressed patients, who abstained from alcohol and received treatment for a year. Only one patient dropped-out because of side-effects, and medication was interrupted in 5% of subjects because of alcoholic relapses. Prescribed in the long term, tianeptine did not produce orthostatic hypotension, changes in bodyweight, or alterations in the ECG. All changes found in haematological and biochemical investigations suggested an improvement in patients' physical state. This, and other studies, indicate that tianeptine appears to have the potential to be a safe antidepressant, which might be particularly useful in those patients who are susceptible to the side-effects of psychotropic drugs.
Do Central Antiadrenergic Actions Contribute to the Atypical Properties of Clozapine?
Authors: Baldessarini Ross J. , Huston-Lyons D. , Campbell A. , Marsh E. , Cohen B. M.
Published: August 2018

Full neuropharmacological understanding of the atypical antipsychotic agent clozapine remains elusive. Antidopaminergic actions of most neuroleptics probably contribute to their antipsychotic benefits, but also to neurological side-effects. Clinical evidence of abnormalities of dopamine (DA) and serotonin (5-HT) in psychotic disorders is inconsistent, but there is substantial metabolic and post-mortem evidence for hyperactivity of noradrenalin (NA). Clozapine is only weakly antidopaminergic but is a potent antagonist at brain α1-adrenergic, 5-HT2-serotonergic, and muscarinic receptors. Its apparent limbic-over-extrapyramidal neuro-physiological selectivity can be mimicked by combining a typical neuroleptic with a central α1 antagonist. Clozapine strongly upregulates α1, but not DA, receptor abundance, and may supersensitise α1 but not DA receptors in rat brain. Clozapine also selectively increases activity of NA neurons and metabolic turnover in NA more than DA areas of rat brain, and also increases NA, but not DA or 5-HT, metabolites in human CSF. Potential psychotropic effects of selective central antiadrenergic agents may deserve reconsideration.
Clinical Pharmacology and Pharmacokinetics of Fluoxetine: A Review
Authors: Bergstrom R. F. , Lemberger L. , Farid N. A. , Wolen R. L.
Published: August 2018

Drugs are discovered by a variety of approaches, which include a systematic evaluation of synthetic compounds, using extensive structure activity relationships. After a lead compound which possesses desirable pharmacological properties is found, through the exhaustive screening of a variety of compounds, a number of congeners are then synthesised and tested, using specific physiological or biochemical models of therapeutic agents. The discovery of fluoxetine involved this complex process, and led to the description in the literature of one of the first selective serotonin uptake inhibitors (Wonget al, 1974); it was subsequently tested clinically, and these studies demonstrated its effectiveness and safety as an antidepressant drug (Chouinard, 1985). This paper reviews the published information relevant to fluoxetine's pharmacology and pharmacokinetics in man.
Effect of a Reversible Monoamine Oxidase-A Inhibitor (Moclobemide) on Sleep of Depressed Patients
Authors: Monti J. M.
Published: August 2018

The effect of moclobemide, a short-acting, reversible, preferential monoamine oxidase-A inhibitor in a 4-week therapeutic trial, on the sleep of ten depressed patients, was assessed by polysomnographic recordings. Compared with their time on placebo, patients receiving moclobemide showed improved sleep continuity, particularly during the intermediate and late stages of drug administration. The total increase in sleep time was comprised of larger amounts of stage 2 non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. Withdrawal of moclobemide was followed by a further increase of REM sleep, although values did not surpass those sometimes observed in adults with normal sleep. In these patients, the symptoms of depression were rated as being significantly improved during the study period.
Early detection and intervention of schizophrenia: rationale and research
Authors: McGlashan Thomas H.
Published: August 2018

Background The primary rationale for early detection and intervention in schizophrenia is the disorder's severity, chronicity and treatment resistance. This suggests that researchers pay closer attention to schizophrenia's premorbid and onset phases, when the vulnerability to psychosis becomes expressed and the neurobiological deficit processes driving symptom formation appear to be the most active.

Method We review the evidence that brain plasticity may be retained or reversed despite deficit processes.

Results The data are preliminary but suggestive enough to warrant further research.

Conclusions Overall, we need to focus on the early course of schizophrenia, detecting cases early at onset or in the prodrome, testing whether this enhances treatment response and prognosis, and predicting at-risk cases early in the prodromal phase. Designs to address these questions are presented, and relevant issues are discussed.
Understanding the topography of the early psychosis pathways
Authors: Lincoln Clare , Harrigan Susy , McGorry Pat D.
Published: August 2018

Background This study aims to gain an understanding of treatment delays and their nature in initial psychotic episodes. We investigated to whom people turn for help, how long that approach takes and subsequent delays in commencing treatment.

Method Qualitative and quantitative methods were combined with interviews of 62 people suffering from first-episode psychoses, aged 16–30 years, who had recently accessed a specialist mental health service in Melbourne, Australia. A modified version of the World Health Organization Encounter Form was analysed in conjunction with other data.

ResultsPathways to care and the ways in which they were experienced were highly variable, with 50% of people experiencing psychotic symptoms before approaching any service. The general practitioner played a key role with 50% of people having had GP contact at some point prior to commencing effective treatment. Where an individual's own efforts to seek early help failed, the role of relatives and others was subsequently vital.

Conclusions Opportunities exist for shortening delays through targeted health promotion activities and professional training. The need is indicated for a multi-layered or topographical strategy to identify and minimise critical barriers on the route to early intervention. Refinement of interview techniques and instruments of measurement are needed to enhance the explanatory power of data collected.
Effect of substance misuse in early psychosis
Authors: Addington Jean , Addington Donald
Published: August 2018

BackgroundStudies examining the temporal relationship between substance use and the onset of psychotic symptoms in schizophrenia are inconclusive.

MethodThree groups of out-patients with schizophrenia were compared on onset of illness, symptoms and quality of life. Fifty-one subjects had no past or present history of substance misuse, 29 subjects had a history of past substance misuse occurring around the onset of their illness, and 33 subjects were currently misusing substances.

ResultsCurrent substance misusers had poorer quality of life scores and less negative symptoms than the non-users. Those who had a past history of substance misuse had a significantly earlier age of onset than those with no substance use.

ConclusionsAttention should be paid to substance misuse present at the first episode. Treatment for schizophrenia should begin even though a diagnosis of drug-induced psychosis cannot be ruled out.
New perspectives in research and treatment of obsessive–compulsive disorder
Authors: Hohagen F. , Berger M.
Published: August 2018

In recent years, there has been a renewed interest in obsessive-compulsive disorder (OCD) among psychiatrists due to several factors. OCD is not a rare disease as was believed in former times. New epidemiological studies demonstrate that 1–2% of the adult population suffer from OCD. This result was confirmed by several epidemiological studies among different cultural environments which are summarised by Dr Bebbington in this supplement. Thus, OCD figures among the most common of mental disorders. Lately a unique category of disorders has emerged that share some common key features with OCD. These ‘obsessive-compulsive spectrum disorders’ and their treatments are characterised in Dr Hollander's paper.
Genetics of novel therapeutic targets in schizophrenia
Authors: Kerwin R. , Owen M.
Published: August 2018

For many years, following the introduction of chlorpromazine in the 1950s, little progress was made in the discovery of new drugs for schizophrenia (Reynolds, 1992). Dopamine D2 receptor blockade was recognised as the only therapeutic target for antipsychotics (Creese et al, 1976) and the inevitable consequences of striatal blockade remained problematic. However, the strategies and stimuli for discovery of new drugs changed with the introduction of new, atypical antipsychotics in the 1990s. These include clozapine, remoxipride (now withdrawn), olanzapine, risperidone and sertindole (Kerwin & Taylor, 1996). The goal of antipsychotic drug development has always been to widen the therapeutic ratio between efficacy and adverse effects. These new drugs have in the main achieved this. However, which therapeutic targets these drugs employ remains a mystery, and this information is clearly important for future research into more selectively targeted agents.
Psychopharmacology of olanzapine
Authors: Stephenson C. M. E. , Pilowsky L. S.
Published: August 2018

The development of atypical antipsychotics has revolutionised the treatment of schizophrenia, as well as providing new insights into its cause. The archetypal atypical antipsychotic is clozapine, which has therapeutic advantages over traditional antipsychotics, as well as a low potential for producing extrapyramidal side-effects (EPS) (Kane et al, 1988). However, clozapine causes agranulocytosis in 1% of patients, and there has consequently been a search for novel atypical antipsychotics, as efficacious as clozapine, but without the need for intensive blood monitoring. There has been much discussion of the definition and characteristics of an atypical antipsychotic drug, and an operational understanding seems to have been agreed upon, that atypical drugs have therapeutic efficacy in treating schizophrenia, without producing EPS (Deutch et al, 1991; Kerwin, 1994).
A Dimensional Model for Common Mental Disorders
Authors: Goldberg David
Published: August 2018

Although categorical diagnoses are valued by clinicians and those wishing to collect homogeneous groups of patients for research projects, in the field of non-psychotic mental disorders they correspond poorly to actual clinical syndromes. Indeed, patients often satisfy several sets of categorical criteria simultaneously. A more parsimonious representation of symptomatology can be obtained by using a dimensional model for symptoms – with two correlated axes corresponding to anxiety and depression for ratings derived from the Present State Examination. The Composite International Diagnostic Interview is likely to produce a third dimension – somatic symptoms – because of a radically different symptom content. Preliminary data analysis indicates that the somatic symptoms dimension correlates with both anxiety and depression. Symptomatic individuals in particular areas of dimensional space will satisfy several criteria for categorical diagnoses, and thus display comorbidity. However, evidence that these disorders are distinct is far from persuasive, as they appear to share several common causes.
Cancer and Depression
Authors: Spiegel David
Published: August 2018

Half of all cancer patients have a psychiatric disorder, usually an adjustment disorder with depression. Anxiety about illness, such as cancer, often leads to delay in diagnosis, which has been estimated to reduce prospects of long-term cancer survival by 10% to 20%. Although earlier studies showed that depressed individuals were at higher risk for cancer incidence, later studies have not confirmed this predictive relationship. Nonetheless, effective psychotherapeutic treatment for depression has been found to affect the course of cancer. Psychotherapy for medically ill patients results in reduced anxiety and depression, and often pain reduction. In three randomised studies, psychotherapy resulted in longer survival time for patients with breast cancer (18 months), lymphoma, and malignant melanoma. The physiological mechanisms for these findings have not yet been determined, but four fundamental possibilities for psychotherapeutic effects on physiological change include health maintenance behaviour, health-care utilisation, endocrine environment, and immune function. Thus, effective treatment of depression in cancer patients results in better patient adjustment, reduced symptoms, reduced cost of care, and may influence disease course. The treatment of depression in these patients may be considered a part of medical as well as psychiatric treatment.
Depressive Syndromes and Symptoms in Subjects with Human Immunodeficiency Virus (HIV) Infection
Authors: Maj Mario
Published: August 2018

The association between the infection produced by the human immunodeficiency virus (HIV) and syndromal or subsyndromal depression has been the topic of several studies in recent years. The results of the WHO Neuropsychiatric AIDS Study, conducted in the five geographical areas predominantly affected by the HIV epidemic, suggest that the symptomatic stages of HIV infection are associated with an increased prevalence of depressive symptoms, and, at least in some contexts in which the spreading of the infection is more recent and the social rejection of HIV-seropositive subjects is harsher, may also be associated with an increased prevalence of a syndromal diagnosis of depression.
Management of Treatment Refractory Schizophrenia
Authors: Morrison D. P.
Published: August 2018

There is a general consensus that 5–25% of schizophrenic patients are partially or totally unresponsive to antipsychotic drug therapy (Brenner et al, 1990). Agreement is needed on how to define the varying degrees of response and resistance in individual patients on conventional antipsychotic medication. Apparent “treatment resistance” may be due to noncompliance; excessive protein binding with inadequate bio-availability of the neuroleptic; an inadequate or excessive dose resulting in poor efficacy or side-effects outweighing therapeutic effects (Osser, 1989); or incorrect diagnosis.
The Management of Difficult to Treat Patients with Schizophrenia, Using Non-drug Therapies
Authors: Kuipers Elizabeth
Published: August 2018

When we consider what defines a person with schizophrenia as ‘difficult to treat’, a number of questions are raised. These concern some fundamental assumptions about patients, therapy and the sick role in society (Parsons, 1951).
Pectointercostal Fascial Block Catheters for Thoracic Injuries: A Case Series
Authors: Burns Landon T. , Beasley Drew A. , Stevens Mark A. , Crabtree Donald E. , Mehaffey Gregory R.
Published: August 2018

Providing analgesia for patients with anterior rib and sternum fracture has been addressed from various types of modalities. Regional anesthesia via epidurals or peripheral nerve blocks, opiates, and other forms of multimodal pain regimens have been used. However, in the polytraumatic injury patient, positioning for an epidural may be problematic, and a predominantly opiate-based treatment plan may compromise respiratory status. In this case series, we describe the pectointercostal fascial block as another tool to treat patients with anterior rib and sternal fracture with polytraumatic injuries. All 3 of the block’s successes were evident by improvement in the respiratory status of each patient.
Dexmedetomidine-Induced Massive Diuresis in a Patient Undergoing Spinal Fusion Surgery: A Case Report and Synthesis of the Literature
Authors: Kirschen Gregory W. , Kim Ethan , Adsumelli Rishimani S. N.
Published: August 2018

Dexmedetomidine is an α2-adrenergic sedative–hypnotic medication used as an adjunct to general anesthesia. While experimental studies in animals have demonstrated a mild diuretic effect of dexmedetomidine, only recently have case reports described dexmedetomidine-induced diuresis in humans. Interestingly, the majority of such cases have involved patients undergoing spinal fusion surgery. Here, we report a case of a 30-year-old woman undergoing cervical spinal fusion surgery who experienced a massive diuresis starting 30 minutes after receiving dexmedetomidine intravenous infusion. We discuss the differential diagnosis and synthesize the current literature on this rare effect.
1H NMR Determination of Incorporated Porphyrin Location in Lipid Membranes of Liposomes
Authors: Nakaya Toshimi , Tsuchiya Yuki , Horiguchi Banri , Sugikawa Kouta , Komaguchi Kenji , Ikeda Atsushi
Published: August 2018

Lipid-membrane-incorporated symmetrical and unsymmetrical porphyrins were prepared with relatively high concentrations via exchange from cyclodextrins to liposomes. We determined the location of these porphyrins in the lipid membranes from chemical shift changes of the lipid signals in the 1H NMR spectra. Symmetrical tetraphenyl porphyrin accumulates in the hydrophobic core of the lipid membranes. In contrast, several unsymmetrical porphyrins with more polar group(s), such as pyridine and pyridinium moieties, are located close to the liposome surface.
The institutional work of creating and implementing Social Impact Bonds
Authors: Lowe Lowe , Kimmitt Jonathan , Wilson Rob , Martin Mike , Gibbon Jane
Published: August 2018

Social Impact Bonds (SIBs) are a new and increasingly popular public policy tool which link payments to outcomes thus, in theory, transferring risk from governments to private investors. This paper draws on the concepts of institutional work and discursive institutionalism to analyse how a SIB influenced the rules, norms and decisions of key actors. It identifies two dominant discourses. One focused on addressing the social determinants of health, the other on creating the financial structure needed to run a SIB. These discourses were congruent at a macro-policy level, but tensions emerged between them at the meso and micro levels. This exemplifies the interdependence of structure and agency in institutional work and the mediating role which discourse plays. It also suggests that the effectiveness of a SIB depends not just on whether it achieves its outcome targets but also on whether it can institute new sets of practices and thinking.
Use of the direct method for evaluation and valuation of the landscape visual quality
Authors: Costa Talía da , Lampert Aline Dal Conti
Published: August 2018

ABSTRACTThe concept of landscape is used by the most diverse areas such as geography, architecture, plastic arts, psychology and the environmental area where it receives an important role in the management of environmental resources. The direct method evaluates the visual quality of the landscape from the contemplation of its totality, through the visualization at the site or through the use of substitutes giving rise to different levels of subjectivity during the process. The scale used to evaluate the landscape visual quality comprised integer values equal to one, two, three, four and five, corresponding to very low, low, good, high and very high visual quality classes, respectively. Of the 21 photos evaluated, only two photographs received the extreme ratings.Keywords: landscape, direct method, valuation
Maçonaria e Educação - Poucos mas bons
Authors: Arriada Eduardo , Tambara Elomar
Published: August 2018

Esta investigação teve como escopo analisar a relação entre instituição maçônica brasileira e educação.  Caracterizou-se o processo de elitização que distingue aquela organização social. Tal processo significou a congregação de um grupo extremamente qualificado tanto em termos acadêmicos como financeiros. Quanto à educação verificou-se que esta foi uma preocupação sempre presente na pauta das diversas lojas maçônicas. Apesar desta priorização observou-se que, a despeito de algumas iniciativas pioneiras neste sentido, os resultados, como um todo, foram relativamente acanhados.Palavras chaves: Educação e Maçonaria; História da Educação; Instituições Educacionais.Abstract This investigation has the purpose of analyzing the relationship between the Brazilian freemasonry institution and education. The process of elitism which distinguishes this social organization is characterized. Such a process meant the association of an extremely qualified group, both in academic and financial terms. Regarding education it was verified that this has always been a present concern in the many freemasonry stores’ agendas. Despite this prioritization, it was observed that regardless of some pioneer initiatives in that sense the results as a whole were relatively timid.Key words: Education and Freemasonry; History of Education; Educational Institutions. ResumenEsta investigación tiene como objetivo analizar la relación entre la institución masónica de Brasil y la educación. En ella se presentan las características del proceso de elitización que distingue a esta institución social. Éste proceso significó la congregación de un grupo extremadamente calificado de personas tanto a nivel académico como financiero. En relación a la educación, se constató que esta fue una preocupación siempre presente en las prioridades de las diversas logias masónicas, pero pesar de este criterio y del desarrollo de algunas iniciativas pioneras, los resultados fueron relativamente bajos.Palabras clave: Educación y Masonería, Historia de la Educación, Instituciones Educativas.
On the maximum conjecture
Authors: Sabzevari Masoud
Published: August 2018

We verify the maximum conjecture on the rigidity of totally nondegenerate model CR manifolds in the following two cases: (i) for all models of CR dimension one, (ii) for the so-called full-models, namely those in which their associated symbol algebras are free CR. In particular, we discover that in each arbitrary CR dimension and length≥3{\geq 3}, there exists at least one totally nondegenerate model, enjoying this conjecture. Our proofs rely upon some recent results in the Tanaka theory of transitive prolongation of fundamental algebras.
Homogeneous Finsler spaces and the flag-wise positively curved condition
Authors: Xu Ming , Deng Shaoqiang
Published: August 2018

In this paper, we introduce the flag-wise positively curved condition for Finsler spaces (the (FP) condition), which means that in each tangent plane, there exists a flag pole in this plane such that the corresponding flag has positive flag curvature. Applying the Killing navigation technique, we find a list of compact coset
spaces admitting non-negatively curved homogeneous Finsler metrics
satisfying the (FP) condition. Using a crucial technique we developed previously, we prove that most of these coset spaces cannot be endowed with positively curved homogeneous Finsler metrics. We also prove that any
Lie group whose Lie algebra is a rank 2 non-Abelian compact Lie algebra
admits a left invariant Finsler metric satisfying the (FP) condition.
As by-products, we find
the first example of non-compact coset space

S
3

×
ℝ

{S^{3}\times\mathbb{R}}

which admits homogeneous flag-wise positively curved Finsler metrics.
Moreover, we find some non-negatively curved Finsler metrics
on

S
2

×

S
3

{S^{2}\times S^{3}}

and

S
6

×

S
7

{S^{6}\times S^{7}}

which satisfy the (FP) condition, as well as some flag-wise positively curved Finsler metrics on

S
3

×

S
3

{S^{3}\times S^{3}}

, shedding some light on the long standing general Hopf conjecture.
Relationship between various maternal conditions and lactic acid dehydrogenase activity in umbilical cord blood at birth
Authors: Patavoukas Evangelos , Åberg-Liesaho Josefina , Halvorsen Cecilia Pegelow , Winbladh Birger , Wiberg-Itzel Eva
Published: August 2018

Background:

Lactic acid dehydrogenase (LDH) is a valuable marker for some of the most important diseases in newborns and the plasma LDH activity in newborns correlates well with conditions such as asphyxia. If LDH should be considered as a useful tool also in obstetric care, key factors associated with maternal health before and during pregnancy which could affect umbilical cord LDH activity need to be known. The aims of this study were to explore relationships between selected maternal conditions and arterial lactic acid dehydrogenase activity (aLDH) in umbilical cord blood at delivery.

Methods:

A prospective observational study was conducted at Sodersjukhuset, Stockholm, Sweden. Included in the study were 1247 deliveries, and cord blood samples from each were analyzed for aLDH. Background, delivery and neonatal data were collected from the medical records.

Results:

Higher median values of aLDH were found (P=0.001) among women with chronic disorders not related to pregnancy but there was no increased frequency of high aLDH levels (>612 μ/L, P=0.30). No difference in aLDH was identified between infants born to women with pregnancy-related disorders compared with healthy women, neither in median values, nor in high values (>612 μ/L, P=0.95).

Conclusion:

Newborn infants born to women with non-pregnancy-related chronic disorders had a somewhat higher median value of aLDH in cord blood at delivery. The influence of common maternal conditions and diseases on umbilical cord arterial LDH levels is small compared to the increase reported in fetal distress and several other critical conditions in the newborn.
Domination in 4-regular Knödel graphs
Authors: Mojdeh Doost Ali , Musawi S.R. , Nazari E.
Published: August 2018

A subset D of vertices of a graph G is a dominating set if for each u ∈ V(G) ∖ D, u is adjacent to some vertex v ∈ D. The domination number, γ(G) of G, is the minimum cardinality of a dominating set of G. For an even integer n ≥ 2 and 1 ≤ Δ ≤ ⌊log2
n⌋, a Knödel graph W

Δ, n
is a Δ-regular bipartite graph of even order n, with vertices (i, j), for i = 1, 2 and 0 ≤ j ≤ n/2 − 1, where for every j, 0 ≤ j ≤ n/2 − 1, there is an edge between vertex (1, j) and every vertex (2, (j+2
k
− 1) mod (n/2)), for k = 0, 1, ⋯, Δ − 1. In this paper, we determine the domination number in 4-regular Knödel graphs W
4,n
.
Algebras of right ample semigroups
Authors: Guo Junying , Guo Xiaojiang
Published: August 2018

Strict RA semigroups are common generalizations of ample semigroups and inverse semigroups. The aim of this paper is to study algebras of strict RA semigroups. It is proved that any algebra of strict RA semigroups with finite idempotents has a generalized matrix representation whose degree is equal to the number of non-zero regular 𝓓-classes. In particular, it is proved that any algebra of finite right ample semigroups has a generalized upper triangular matrix representation whose degree is equal to the number of non-zero regular 𝓓-classes. As its application, we determine when an algebra of strict RA semigroups (right ample monoids) is semiprimitive. Moreover, we prove that an algebra of strict RA semigroups (right ample monoids) is left self-injective iff it is right self-injective, iff it is Frobenius, and iff the semigroup is a finite inverse semigroup.
The Riemann hypothesis and universality of the Riemann zeta-function
Authors: Garunkštis Ramūnas , Laurinčikas Antanas
Published: August 2018

We prove that, under the Riemann hypothesis, a wide class of analytic functions can be approximated by shifts ζ(s + iγk
), k ∈ ℕ, of the Riemann zeta-function, where γk
are imaginary parts of nontrivial zeros of ζ(s).
Backward doubly SDEs with continuous and stochastic linear growth coefficients
Authors: Owo Jean Marc
Published: August 2018

We study backward doubly stochastic differential equations when the coefficients are continuous with stochastic linear growth.
Via an approximation and comparison theorem, the existence of minimal and maximal solutions are obtained.
Structural, Optoelectronic and Thermoelectric Properties of Ternary CaBe2X2 (X = N, P, As, Sb, Bi) Compounds
Authors: Khan Abdul Ahad , Rehman Aziz Ur , Laref A. , Yousaf Masood , Murtaza G.
Published: August 2018

The structural, electronic, optical and thermoelectric properties of ternary CaBe2X2 (X = N, P, As, Sb and Bi) have been investigated comprehensively for the first time using density functional theory. All the compounds are optimized to obtain their ground states. Computed structural parameters agree to the available experimental results. Electronic band structure calculations reveal the semiconducting nature of the compounds, while bang gap decreases by changing the anion X from N to Bi the band gap decreases. In the valence band, major contribution is due to X-p state, while in conduction band (CB) the major contribution is mainly due to the Ca-d state. Furthermore, electron charge density plots reveal ionic bonding character with small covalent bonding. Optical properties are calculated in detail. Static value of refractive index shows inverse variation with band gap. The refractive indices of these compounds are high in the infrared region and gradually decreased in the visible and ultraviolet region. The thermoelectric properties are studied using Boltzmann statistics through BoltzTraP code. High optical conductivity peaks and figure of merits (ZT) for compounds reveal that they are good candidates for the optoelectronics and thermo-electric devices.
ISIL İŞLEM VE OLGUNLAŞTIRMA SÜRELERİNİN EZİNE PEYNİRİNDE BİYOJEN AMİN OLUŞUMUNA ETKİLERİ
Authors: DİLER Mehmet , AKBAĞ Erhan , IŞIK Volkan , AVŞAR GÜNAY Emine , ERKAYACAN Hakan , GÜNEŞER Onur , KARAGÜL YÜCEER Yonca
Published: August 2018

Bu çalışmanın amacı farklı ısıl işlem sürelerinin Ezine peynirinde biyojen amin oluşumu ve mikroorganizma profilindeki değişimlerin olgunlaştırma süresince araştırılmasıdır. Çiğ süte 65oC’de 10 ve 30 dakika ısıl işlem uygulanarak Ezine peyniri üretilmiştir. Histamin, putresin, kadaverin, tiramin, triptamin ve feniletilamin biyojen aminleri yüksek basınçlı sıvı kromatografisi kullanılarak saptanmıştır. Peynir örneklerinde toplam psikrofilik ve mezofilik aerobik bakteriler, laktik asit bakterileri, fekal koliform, toplam maya-küf, Enterobacteriaceae spp. Escherichia coli ve Clostridium perfiringens sayıları da tespit edilmiştir. Taze peynirlerde biyojen amin oluşmamış olup peynir örneklerinde olgunlaşma süresince biyojen amin miktarı artmıştır. Ezine peynirinde saptanan biyojenik amin miktarlarının sağlık riski oluşturacak düzeylerde olmadığı görülmüştür.  Ezine peynirinde farklı ısıl işlem sürelerinin toplam mezofilik aerobik bakteri ve laktik asit bakterisi üzerine etkisi depolama süresine bağlı olarak değişim göstermiştir.﻿
Disentangling Law and History
Authors: Geiger Andrea
Published: August 2018

This article juxtaposes the history of Japanese immigrants in Canada—which parallels that of Japanese immigrants to the United States in significant ways—with that of Canada’s Indigenous people, who were also marginalized, to explore larger issues related to the way in which history is deployed in court actions. Although it uses a Canadian case—the 2008 decision of Canada’s Supreme Court in R. v. Kapp (which upheld an exclusive 24-hour communal sales fishery established on behalf of three First Nations)—to frame this discussion, the questions raised are relevant on both sides of the U.S.-Canada border. The article speaks, for example, to ways in which efforts to meet the elements of a given legal test can lead to the distortion of historical evidence, also a danger for U.S. courts. In reviewing the historical arguments made by the Japanese Canadian Fishermen’s Association in R. v. Kapp, which invoked two earlier cases from the 1920s in which Japanese immigrants challenged their exclusion from Canadian fisheries on race-based grounds, the article also provides a summary of that history of exclusion. It highlights the importance of reading immigration and Indigenous histories together in order to develop a more comprehensive understanding of the complex ways in which racialized groups have negotiated racial divides. These negotiations produced a far more intricate set of alignments and divisions among and within various racialized groups than is often recognized.