bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of ethanol on the hardness and relaxation modulus of experimental photo‐activated soft lining materials stored in aqueous solutions
Authors: Fujii K. , Arikawa H. , Kanie T. , Kamiunten O. , Miura K.
Published: March 2003

Summary We studied changes in the hardness, relaxation modulus {Er(t)}, and weight change ratio (Wc) of experimental photo‐activated acrylic soft lining materials (EPLs) stored in three aqueous solutions [distilled water (DW), physiological saline solution (PS), and artificial saliva (AS)] at 37 °C for 8 weeks. The hardness of the EPLs increased markedly during the first 4 days of storage, and subsequently changed little. The greatest hardness occurred in the EPL specimen containing the largest amount of ethanol (Et). The relaxation modulus {Er(8)} of the EPLs ranged from 1·35 to 1·66 MPa immediately before storage, and from 1·43 to 2·21 MPa after an 8‐week immersion. Like hardness, the increase in {Er(t)} was greatest when the EPL contained large amounts of Et. The Wc ranged from 0·118 to 0·661% after storage for 8 weeks, and increased most for the EPL specimen containing the smallest amount of Et. Furthermore, 3–7 days after the start of immersion many hollows were observed in the surface of specimens with a high Et content. The results indicate that Wc and hollow formation are sensitive to the Et content of the EPL, and that Et content is closely tied to the change in hardness and relaxation modulus with time.
Effect of occlusal splint and transcutaneous electric nerve stimulation on the signs and symptoms of temporomandibular disorders in patients with bruxism
Authors: ALVAREZ‐ARENAL A. , JUNQUERA L. M. , FERNÁNDEZ J. P. , GONZÁLEZ I. , OLAY S.
Published: March 2003

Summary A crossed‐design experimental study has been made involving simple blind paired data and random assignment to treatment, with the aim of evaluating the action of an occlusal splint with transcutaneous electric nerve stimulation (TENS) upon the manifestations of temporomandibular disorders (TMD) in patients with bruxism. The prevalence of TMD in the 24 patients with bruxism was 62·5%%; the corresponding severity, as determined by the pantographic reproducibility index (PRI), was mild (mean value: 20·71). Clicking and pain in the lateral pterygoid muscle were the most frequent clinical manifestations. The occlusal splint and TENS did not significantly improve the signs and symptoms of TMD in these patients with bruxism.
Stress distribution associated with loaded acrylic–metal–cement crowns by using finite element method
Authors: Toparli M. , Aykul H. , Aksoy T.
Published: March 2003

SUMMARY  The axisymmetrical finite element method (FEM) was used to compare stress distribution in a maxillary second premolar restored tooth. The three models were evaluated by crowning the tooth with Au–Pd alloy, Ni–Cr alloy and Ti alloy with acrylic. A longitudinal static force, 200 N in magnitude at an angle of 45° was applied on the occlusal margin of each model. The tooth was assumed isotropic, homogenous and elastic. This numerical study was carried out using axisymmetric finite element models and calculation programmes were prepared by the authors using FORTRAN 77. Comparison of stress distributions was made in four regions of apex, cole, dentin–metal interface and metal–acrylic interface. The highest stress values were obtained when NiCr alloy with acrylic was used.
Shear bond strengths of tooth fragments reattached or restored
Authors: Sengun A. , Ozer F. , Unlu N. , Ozturk B.
Published: March 2003

summary  This study investigated the shear bond strengths of sectioned human mandibular incisor edge fragments reattached using luting cements, bonding agents or restored with composite resins. Seventy teeth were randomly distributed among six experimental groups and a control group. Leaving half of the anatomic crowns exposed, the teeth were embedded in self‐cure acrylic resins with the exposed part then sectioned. The fragments in groups 1–4 were bonded to their respective teeth using Clearfil Liner Bond 2V, Scotch Bond Multi Purpose Plus, Panavia‐F and 3M Opal Luting cement. The 5th and 6th groups were restored with composite resins (Silux 3M and Clearfil AP‐X) using their bonding agents (Single Bond and Clearfil SE Bond). The results indicated that reattachment of fractured incisal fragments by using new generation bonding agents was effective against shear stresses, comparable with the intact teeth. Instead of restoration with composite resins therefore reattachment of a fractured fragment might be more preferable in cases of dental trauma.
A clinical and radiographic evaluation of fixed partial dentures (FPDs) prepared by dental school students: a retrospective study
Authors: Hochman N. , Mitelman L. , Hadani P. E. , Zalkind M.
Published: March 2003

summary  In recent years, there has been an increasing interest in fixed partial dentures (FPD) quality, expected lifetime and possible reasons for failure. This study probed the FPD success rate and the relationship among various factors and their effect on FPD failure. Patients treated by dental students under supervision and installed FPDs were examined clinically and radiographically. A total of 247 FPDs were evaluated after a mean service period of 6·3 years (ranging from 1 to 25 years) after cementation. Caries was found to be the most frequent cause of failure and non‐vital abutments decreased survival rates.
The effect of the addition of poly(methyl methacrylate) fibres on some properties of high strength heat‐cured acrylic resin denture base material
Authors: Jagger D. , Harrison A. , Jagger R. , Milward P.
Published: March 2003

summary  The self‐reinforcement of acrylic resin with butadiene styrene surface treated poly(methyl methacrylate) fibres has been reported to have the potential to substantially improve the transverse bend strength of conventional heat‐cured acrylic resin. The aim of this study was to investigate the effect of the addition of butadiene styrene surface treated poly(methyl methacrylate) fibres in cross‐ply arrangement to high impact acrylic resin on the transverse and impact strength. Specimens were prepared as specified in the International Standard Organization and British Standards for the Testing of Denture Base Resins (ISO 1567, 1988; BS 2487, 1989) and the British Standard Specification for Orthodontic resins (BS 6747, 1987) for transverse bend and impact testing. The impact strength was measured using a Zwick pendulum impact tester and the transverse bend strength measured using a Lloyds Instruments testing machine. The results showed that the impact strength was not improved with the addition of fibres, high impact acrylic resin with fibres (LF) 11·1 kJ m−2 and high impact acrylic resin (L) (12·5 kJ m−2). The modulus of rupture was decreased with the addition of fibres (57·8 MPa) for (LF) compared with (60·4 MPa) for (L). The modulus of elasticity was also reduced with the addition of fibres (1834·9 MPa) (LF) and 2086·2 MPa (L) as was the peak load (LF) (50·8 N) and (L) (55·8 N). It was concluded that the addition of surface treated poly(methyl methacrylate) fibres in cross‐ply arrangement to high strength acrylic resin did not produce an improvement in the impact or transverse strength and cannot be recommended as a method of reinforcement.
The impact of oral disease among the institutionalized and non‐institutionalized elderly in Hong Kong
Authors: Mcmillan A. S. , Wong M. C. M. , Lo E. C. M. , Allen P. F.
Published: March 2003

summary  The study aimed to describe and compare the psychosocial and functional impact of oral disease on the quality of life of the institutionalized and non‐institutionalized elderly in Hong Kong. A total of 268 institutionalized and 318 non‐institutionalized elderly aged 60–80 years took part. The 49‐statement Oral Health Impact Profile (OHIP) was administered in a structured interview format and sociodemographic information collected prior to a clinical, oral examination. A greater number of the institutionalized were edentulous (19%); they also had more untreated dental disease. The number of elderly reporting negative impacts was generally low. The percentage of institutionalized elderly reporting a negative impact was significantly lower in one of the OHIP subscales (handicap, P < 0·001) and similar in the other six. The main factors affecting the OHIP score were living location, socio‐economic status, dental disease and treatment seeking behaviour. In conclusion, the psychosocial and functional impact of oral conditions was low and similar in the institutionalized and non‐institutionalized elderly although the pattern of oral disease was different. Life events and socially and culturally derived values appeared to affect the elderly perception of the impact of oral disease.
The mental health experiences of gay men: a research study exploring gay men's health needs
Authors: Robertson
Published: March 2003

As part of a qualitative study exploring the health needs of gay men, undertaken in the Lothian area of Scotland (Robertson & Hutcheson 1995), the mental health needs of gay men were elicited through focus groups and individual interviews. A grounded theory approach (Glaser & Strauss 1967) was used to analyse the responses from a sample of 37 gay men. This research followed a social interactionist approach and examined from the respondents' stance the effects of being perceived as deviant and the subsequent impact on self‐identity and self‐esteem. The findings were that there is a reluctance amongst gay men to disclose their sexuality in health care settings which results in mental health needs remaining unrecognized by health professionals. The research also showed that the respondents faced profound social difficulties when coming to terms with their sexuality, a process that can occur throughout their life time. Those who were married faced the strain of living two lives and cited alcohol misuse and depression amongst the effects of this stressful lifestyle.
Mental health: what do we know, how did we find it out and what does it mean for nurses?
Authors: Robertson
Published: March 2003

As part of a qualitative study exploring the health needs of gay men, undertaken in the Lothian area of Scotland (Robertson & Hutcheson 1995), the mental health needs of gay men were elicited through focus groups and individual interviews. A grounded theory approach (Glaser & Strauss 1967) was used to analyse the responses from a sample of 37 gay men. This research followed a social interactionist approach and examined from the respondents' stance the effects of being perceived as deviant and the subsequent impact on self‐identity and self‐esteem. The findings were that there is a reluctance amongst gay men to disclose their sexuality in health care settings which results in mental health needs remaining unrecognized by health professionals. The research also showed that the respondents faced profound social difficulties when coming to terms with their sexuality, a process that can occur throughout their life time. Those who were married faced the strain of living two lives and cited alcohol misuse and depression amongst the effects of this stressful lifestyle.
Creativity and psychic distress in artists, writers and scientists: implications for emergent models of psychiatric nursing practice
Authors: Barker
Published: March 2003

Many of the great discoveries and developments in the sciences and the arts were made by people who were ‘mentally different’. Some such pioneers or innovators had experiences that were indistinguishable from the phenomena defined as mental illness (or madness). It has been argued that such experiences are a necessary constituent of the creative process, and that this may apply to the sciences as much as to the arts. Increasingly, scientists propose a means by which it may be possible to identify (and eliminate) the factors that influence the altered states associated with mental illness. This may be an appropriate time to review the cultural and social significance of all forms of ‘madness’, especially in the light of emerging models of psychiatric nursing practice.
Absconding: a literature review
Authors: Bowers  , Jarrett  , Clark
Published: March 2003

Incidents of absconding from inpatient care are high‐risk events which have been linked to serious harm to self and others. This paper brings together for the first time findings from a disparate body of research literature spanning many years. Varied definitions of absconding and methods of calculating the rates of absconding make comparisons between studies difficult. Nevertheless, it is clear that absconders are more often young, male, from disadvantaged groups, and suffering from schizophrenia, compared to admissions generally. Roughly half of the abscondings take place while the patient is temporarily off the ward with permission, the remainder of absconding patients use an assortment of means to make their escape. A large variety of reasons for absconding have been elicited from patients or advanced as possibilities by researchers. Only six evaluative studies of interventions impacting upon absconding have been reported in the literature, but no firm conclusions can be drawn from them.
Intensive care psychiatric nursing – psychoanalytic perspectives1
Authors: WINSHIP
Published: March 2003

Based on unobtrusive observations, a parallel is drawn between general and psychiatric intensive care nursing. The correlation between bedside skills and the incidence of physical contact between nurse and patient in each setting is considered. The phenomenon of physical attacks by patients on carers and the process of restraint in the psychiatric intensive care unit (ICU) is then examined. It is suggested that attack by and subsequent restraint of a disturbed patient may be considered in terms of an unconscious re‐enactment of an early skin‐on‐skin object relation. It is argued that the physical holding of a psychotic patient is functional in re‐establishing their bodily ego. Some thoughts are offered on how the intensive care of psychotic patients might be carried forward in the future.
Provision of out‐of‐hours support to a forensic population: strategies and research potential
Authors: COFFEY
Published: March 2003

Community Mental Health Nurses (CMHNs) working within regional forensic services are increasingly expected to provide out‐of‐hours cover for community forensic patients. This is often in the absence of appropriate resources or indeed informed knowledge as to what are appropriate resources. In areas such as forensic services it would be assumed that out‐of‐hours cover is essential. Yet most forensic services find it difficult to provide this cover, because of the low number of CMHNs and the regional nature of the service. One option which has not been explored is the use of telephone support in conjunction with individual contingency plans for each patient. This paper explores this area and makes suggestions for researching outcomes for this service change.
The life of a New Long Stay Patient: a reflexive experience
Authors: Maccallum E. J. , Robertson A. E.
Published: March 2003

The care received by one patient in an acute psychiatric ward setting is described and analyzed by examining the relevant literature and the patient’s perspective through a therapeutic relationship with a psychiatric nursing student. The patient is described as the new long stay patient and the reasons for the existence of this group are discussed. The paper concludes by stating the need to provide for those patients who are inappropriately occupying acute beds because there is no available alternative. This is found to cause problems for the individual, for psychiatric services and for nursing care.
Who wants to be a psychiatric nurse? Novice student nurses’ interest in psychiatric nursing
Authors: Happell B.
Published: March 2003

Available research findings suggest that nursing students do not regard psychiatric nursing as a desirable future career option. This paper addresses the results of a research project conducted by the author. This research addresses the relative popularity of psychiatric nursing in comparison to other nursing specialties, within Victoria, Australia. The research was conducted by use of a questionnaire in which commencing undergraduate nursing students were asked to rank nine areas of nursing specialty in order of preference and provide some explanation for their choices. The results indicate that psychiatric nursing emerges as the second least popular career choice for student nurses at this stage of their education.
Research utilization and attitudes towards research among psychiatric nurses in Northern Ireland
Authors: PARAHOO K.
Published: March 2003

Evidence‐based practice depends on a number of factors including practitioners' attitudes towards, and knowledge of, research, the availability and access to relevant research, adequate resources and managers' support. Yet little is known about these issues with regard to psychiatric nurses. The aim of this study was to survey psychiatric nurses on their attitudes to research, their perceptions of their use of research and other research‐related activities. This paper reports data collected from a convenience sample of 236 nurses from the six main psychiatric hospitals and from the psychiatric wards of six general hospitals. The results show that, while they report positive attitudes towards research, their perception of their use of research in practice indicates that evidence‐based practice is far from being realized. There is also some evidence to suggest that psychiatric nurses' reported extent of research utilization and frequency of reading research literature in this study are lower than those of general nurses. The implications of these and other findings are discussed.
4. Absconding: nurses views and reactions
Authors: Davis Bryn , CLARK N. , KIYIMBA F. , BOWERS L. , JARRETT M. , Mcfarlane L.
Published: March 2003

Absconding from acute psychiatric wards is common. This paper reports the views of 25 staff nurses working on acute mental health wards in East London about absconding. Interviews explored how staff feel when a patient absconds, the complexities of risk assessment and observation policies, who is blamed when patients abscond and what might reduce absconding.

The assessment of the level of risk which a patient posed varied considerably, with some wards using standard risk assessment tools and others talking about their own methods. There was some evidence of conflict with medical staff about what measures should be put in place to manage the risk (observation level, leave). The interviewees were aware of serious consequences of absconding, and this made them worry when patients absconded. Following an abscond most nurses look for an explanation, and this can lead to blame of other members of the team. A sizeable minority spoke of feeling unsupported by their managers, and that their jobs could be at risk following an abscond.

The nurses felt that absconding could be reduced through a number of measures, principally raising staffing levels and reducing the reliance on agency nurses.
Subjective lack of social support and presence of dependent stressful life events characterize patients suffering from major depression compared with healthy volunteers
Authors: Skärsäter I. , Ågren H. , Dencker K.
Published: March 2003

The aim of this study was to characterize and compare patients with major depression and healthy volunteers concerning stressful negative life events, social support and social network occurring during a 12‐month period. Forty outpatients who fulfilled DSM‐IV criteria for major depression and 19 healthy volunteers were included in the study. The results showed no significant differences between the patients and the volunteers concerning the number of independent life events, perceived sufficient persons in the network, the number of family members, having a partner, and perceiving family members as offering the best support. Thus, there were differences in the number of both dependent stressful life events, especially increased arguments with partner and family members, and life events including personal illness. The patient group had experienced a greater number of these events compared with the volunteer group. Comparisons between the two groups revealed differences concerning social support and social network. Fewer patients, especially women, felt they had sufficient social support, had fewer persons in the network, less contact with persons in the network, and fewer confidants compared with the volunteers.
From medicalization to hybridization: a postcolonial discourse for psychiatric nurses
Authors: Wilkin P. E.
Published: March 2003

I begin with an Orwellian dilemma [Orwell G. (1968)The Collected Essays, Journalism and Letters of George Orwell, Vol. 1, p. 239. Harcourt Brace Jovanovich, New York]: do I ‘shoot the elephant’ (by writing the abstract) to impress the editor? Or, with the courage of my postmodern convictions, do I lay down my rifle and disregard such suppressive editorial instructions? Bang! My words strafe the paper and the elephant is dead. How difficult it is to stay standing against the powerful currents of the dominant tradition. How easy it is to disavow the inequalities and injustices of that tradition when your livelihood (and your ego) depends upon it. So goes the theme of my paper, that, despite the clarion calls of the illustrious minority to reject the patriarchal model of medical psychiatry, psychiatric nurses continue to be propelled by the twin engines of illness and diagnosis. Yet as soon as psychiatry encounters the ‘other’ it becomes, in Homi K. Bhabha’s words, ‘hybridized’: a pregnant pause created from the seeds of two different cultures. In this sense, every psychiatric moment becomes a golden opportunity for the psychiatric nurse to abdicate her role as medical factotum. Freed from these contractual obligations, she can join the ‘other’ and share in his experiences, sustaining rather than negating him within a truly therapeutic alliance. In similar fashion, this article has become a mixture of rhetorical fluidity and structured reality: a hybridized compromise which acknowledges the journal’s publication boundaries yet still revels, at times, in the freedom of an open and lyrical text.
Multiprofessional clinical supervision: challenges for mental health nurses
Authors: Mullarkey K. , Keeley P. , Playle J. F.
Published: March 2003

Recent reform and developments in mental health care provision have increasingly espoused the value of multiprofessional teamwork in order to ensure that clients are offered co‐ordinated packages of care that draw on the full range of appropriate services available (DoH 1999a; DoH 2000). Supervision in some form is seen as a key part of all professional practice to provide support to practitioners, enhance ongoing learning, and, to a greater or lesser degree, offer some protection to the public (Brown & Bourne 1996, UKCC 1996). Clinical supervision has gained increasing momentum within the nursing profession, but to a large extent this has been within a uni‐professional framework – nurses supervising other nurses. This paper seeks to explore the ways in which multiprofessional working and clinical supervision interlink, and whether supervision across professional boundaries might be desirable, possible, and/or justifiable. Whilst our own view is that multiprofessional supervision is both possible and desirable, we seek to open up a debate, from our perspective as mental health nurses, about some of the issues related to the concept. Our motivation to explore this topic area emanates from our experiences as supervisors to colleagues within multiprofessional teams, as well as the experiences of those attending supervisor training courses. Following a brief overview of the development of clinical supervision in mental health care and recent policy guidelines, some models of clinical supervision are reviewed in terms of their suitability and applicability for multiprofessional working.
Improving serious mental illness through interprofessional education
Authors: Rolls L. , Davis E. , Coupland K.
Published: March 2003

Current health policies emphasize partnership between professional groups, between agencies and with users, to ensure more integrated health and social care services. However, a number of reasons have been consistently identified as inhibiting interprofessional working. Among the many factors identified are poor communication, conflicting power relations and role confusion, and these present immense challenges to those who wish to offer interprofessional education and training opportunities. East Gloucestershire NHS Trust worked in partnership with the University of Gloucestershire (formerly the Cheltenham and Gloucester College of Higher Education) to overcome these problems and deliver an important postqualifying interprofessional training for those working with people with serious mental illness – the Thorn‐based ‘Diploma in Integrated Approaches to Serious Mental Illness’. This collaborative initiative represents a good model by which practitioners of all disciplines can be trained to a high standard and meet the requirements of the National Service Framework for Mental Health. This paper describes the initiative and identifies the extent to which the course has, by mirroring the practice it is seeking to generate, ‘pulled together’ to ensure interprofessional, intersectoral and professional/user collaboration. The key challenges associated with interprofessional working (with people with serious mental illness and with others) and with course implementation and how these were met are discussed and further opportunities are identified.
Forensic psychiatric nursing: a literature review and thematic analysis of role tensions
Authors: Mason T.
Published: March 2003

This literature review was undertaken to explore the emergent issues relating to the difficulties encountered in forensic psychiatric nursing. The rationale for the study revolved around the paucity of research undertaken to identify the constituent parts of this professional practice. The aims included both a thematic analysis of the literature and the construction of a theoretical framework to guide further research. The method was a snowballing collection of literature and a computerized database search. The results were the identification of a series of major issues, which were broadly categorized as negative and positive views, security vs. therapy, management of violence, therapeutic efficacy, training and cultural formation. From this the six binary oppositions, or domains of practice, emerged as a theoretical framework to develop further research. These were medical vs. lay knowledge, transference vs. counter‐transference, win vs. lose, success vs. failure, use vs. abuse, and confidence vs. fear. Further research is currently underway.
Genetic factors in human sleep disorders with special reference to Norrie disease, Prader–Willi syndrome and Moebius syndrome
Authors: Parkes
Published: March 2003

Sleep–wake problems are common in specific inborn errors of metabolism and structure of the central nervous system. Psychological factors, behavioural difficulties, metabolic disturbances, and widespread rather than focal damage to the nervous system are present in many of these diseases and all influence the sleep–wake cycle. However, a number of conditions cause relatively focal damage to the neuroanatomical substrate of sleeping and waking. These include fatal familial insomnia, with involvement of the prion protein gene on chromosome 20, Norrie disease, the Prader–Willi syndrome and the Moebius syndrome. The last three important conditions, although rare, are considered in detail in this review. They result in sensory deprivation, hypothalamic and mid‐brain damage, and involve the X‐chromosome, chromosome 15, and chromosome 13, respectively. These conditions cause a wide variety of sleep disturbance, including parasomnias, daytime sleepiness, and a condition like cataplexy. The place of the relevant gene products in normal sleep regulation needs further exploration.
Familial incidence of insomnia
Authors: Bastien Célyne H. , Morin Charles M.
Published: March 2003

This study evaluated the familial incidence of sleep disturbances among individuals with insomnia complaints. The sample consisted of 285 patients evaluated for insomnia at a sleep disorders clinic. All patients completed a sleep survey and underwent a semistructured clinical interview as part of their initial evaluation of insomnia. Information on the presence and nature of sleep disturbances among their family members (first‐ and second‐degree relatives) was obtained from a sleep survey. The findings indicate that 35% of patients consulting for insomnia had a positive family history of sleep disturbances. Insomnia was the most common type of sleep disturbance identified (76%) and the mother was the most frequently afflicted family member. Reports of sleep disturbances among a family member were more prevalent when the onset of insomnia was before 40‐years‐old than when it was later in life. A positive family history was slightly higher when the insomnia complaint involved sleep‐onset difficulties relative to sleep‐maintenance or mixed insomnias. Although the present findings suggest that a positive family history of insomnia may be a potential risk factor for insomnia, it is unclear whether this reflects a genetic predisposition or a social learning phenomenon.
Quality of life assessment of treatment with dental appliance or UPPP in patients with mild to moderate obstructive sleep apnoea. A prospective randomized 1‐year follow‐up study
Authors: Walker‐Engström  , Wilhelmsson  , Tegelberg  , Dimenäs  , Ringqvist
Published: March 2003

The objectives of this study were: to evaluate the change in the three quality of life (QOL) dimensions of vitality, contentment and sleep before intervention and 1 year after treatment with a dental appliance or uvulopalatopharyngoplasty (UPPP); to compare the effect of treatment between these two treatment groups on these three dimensions; and to determine the relation between the QOL scores and somnographic values. Ninety‐five patients with mild to moderate obstructive sleep apnoea (OSA) (AI > 5) were randomly allocated to either a dental appliance or UPPP treatment group. Seven patients withdrew after randomization but before treatment, leaving 88 patients eligible for treatment. The patients were examined using somnography and administered the Minor Symptoms Evaluation‐Profile (MSE‐P), a QOL questionnaire, before and 1 year after intervention. Thirty‐seven patients in the dental appliance group and 43 in the UPPP group completed the 1‐year follow‐up. The mean values for the three dimensions vitality, contentment and sleep improved significantly 1 year after intervention in the dental appliance and UPPP groups. No difference in the QOL scores at baseline was noted between the groups. One year after intervention the UPPP group showed significantly more contentment than the dental appliance group. In contrast, vitality and sleep dimensions did not differ between the two treatment groups. No significant correlations were observed between the QOL scores and somnographic values. In conclusion, quality of life improved significantly in the dental appliance and UPPP groups 1 year after intervention. However, the dental appliance group showed a lower level of contentment than the UPPP group, even though the somnographic values were superior in the former group.
Effects of melatonin administration on daytime sleep after simulated night shift work
Authors: Sharkey Katherine M. , Fogg Louis F. , Eastman Charmane I.
Published: March 2003

Disturbed sleep and on‐the‐job sleepiness are widespread problems among night shift workers. The pineal hormone melatonin may prove to be a useful treatment because it has both sleep‐promoting and circadian phase‐shifting effects. This study was designed to isolate melatonin’s sleep‐promoting effects, and to determine whether melatonin could improve daytime sleep and thus improve night time alertness and performance during the night shift. The study utilized a placebo‐controlled, double‐blind, cross‐over design. Subjects (n=21, mean age=27.0 ± 5.0 years) participated in two 6‐day laboratory sessions. Each session included one adaptation night, two baseline nights, two consecutive 8‐h night shifts followed by 8‐h daytime sleep episodes and one recovery night. Subjects took 1.8 mg sustained‐release melatonin 0.5 h before the two daytime sleep episodes during one session, and placebo before the daytime sleep episodes during the other session. Sleep was recorded using polysomnography. Sleepiness, performance, and mood during the night shifts were evaluated using the multiple sleep latency test (MSLT) and a computerized neurobehavioral testing battery. Melatonin prevented the decrease in sleep time during daytime sleep relative to baseline, but only on the first day of melatonin administration. Melatonin increased sleep time more in subjects who demonstrated difficulty in sleeping during the day. Melatonin had no effect on alertness on the MSLT, or performance and mood during the night shift. There were no hangover effects from melatonin administration. These findings suggest that although melatonin can help night workers obtain more sleep during the day, they are still likely to face difficulties working at night because of circadian rhythm misalignment. The possibility of tolerance to the sleep‐promoting effects of melatonin across more than 1 day needs further investigation.
Mental health, parental rules and sleep in pre‐adolescents
Authors: Meijer Anne Marie , Habekothé Rita T. , Van Den Wittenboer Godfried L.H.
Published: March 2003

A health‐sleep model concerning the relationship of mental health and parental rules with time in bed and sleep quality has been developed on the basis of survey data collected from 448 children in the first trimester of the regular school year. The children had a mean age of about 11 years and were attending last two grades of primary school. The relations between mental health characteristics, parental rules concerning sleep, sleep environment, sleep quality and time in bed are analysed using a structural equation model. In addition to a latent variable for ‘mental health’, two uncorrelated latent variables had to be introduced for sleep to achieve a satisfactory fit. One latent variable is related to sleep quality (restorative sleep), and the other relates to lying awake in bed prior to sleep (awake in bed). Restorative sleep shows a strong relationship with mental health, and awake in bed is related to having an own bedroom.
Active processing of declarative knowledge during REM‐sleep dreaming
Authors: Cipolli C. , Bolzani R. , Tuozzi G. , Fagioli I.
Published: March 2003

The ability to process recently acquired knowledge is clearly maintained during sleep. Here we assess whether and how far the sleeper controls this processing (in a non‐volitional and non‐conscious manner). We posit that during sleep, the cognitive concerns of previous waking may guide access to, and processing of, items of declarative knowledge with which those concerns are associated. In a delayed recall task, before each of three sleep onsets in the same night, 12 subjects heard a different nonsense sentence. When awakened in rapid eye movement (REM) sleep, they were asked to report their dream experience and to recall the last sentence heard. Occurrences of incorporation into dream content were more frequent for this sentence than for the sentences heard before previous sleep onsets, and also more frequent than occurrences of similar contents in reports from a control night. However, the modalities of elaboration of dream contents did not vary. These findings indicate that cognitive concern can affect the accessing of recently acquired declarative knowledge during sleep, but not the modalities by which this is inserted into dream content. They also suggest that cognitive concern may help consolidate knowledge by increasing the likelihood of it being processed during sleep.
Sleep complaints are not corroborated by objective sleep measures in post‐traumatic stress disorder: a 1‐year prospective study in survivors of motor vehicle crashes
Authors: Klein Ehud , Koren Danny , Arnon Isaac , Lavie Peretz
Published: March 2003

Disturbed sleep is a common complaint among patients with post‐traumatic stress disorder (PTSD). However, laboratory studies of sleep in PTSD have provided inconsistent evidence of objective sleep disturbances. A major shortcoming of most previous studies is the fact that they were performed retrospectively in patients with chronic PTSD, often complicated by comorbid psychiatric disorders and drug abuse. Thus, little is known about the development of sleep disturbances in recently traumatized subjects. In this study, 102 motor vehicle collision (MVC) survivors were followed from the time of collision throughout 1 year. Nineteen subjects hospitalized for elective surgery served as a comparison group. Subjective quality of sleep was assessed using the mini‐Sleep Questionnaire and the Sleep Habit Questionnaire. In addition, a 48‐h actigraphic recording was obtained 1 week, 3 and 12 months after the collision. At 12 months, a structured clinical interview (SCID) was administered to reach a formal diagnosis of PTSD. Twenty‐six of the MVC survivors, but none of the comparison subjects, met the diagnostic criteria for PTSD. While MVC survivors with PTSD reported markedly poorer sleep as reflected by significantly higher scores on the mini‐Sleep Questionnaire, there were no significant differences between the three groups on the actigraphic measures that were largely normal. These results, which were obtained in subjects with no evidence of active psychiatric symptoms at the time of trauma and free of psychotropic or hypnotic medications, further support previous polysomnographic (PSG) studies suggesting that altered sleep perception, rather than sleep disturbance per se, may be the key problem in PTSD.
Pharmacokinetics of oxytetracycline in the red pacu (Colossoma brachypomum) following different routes of administration
Authors: DOI  , STOSKOPF  , Lewbart
Published: March 2003

Oxytetracycline (OTC) pharmacokinetics were studied in the red pacu (Colossoma brachypomum) following intravenous (i.v.) and intramuscular (i.m.) administration at a dose of 5 mg/kg body weight. OTC plasma concentrations were determined by high‐performance‐liquid‐chromatography (HPLC). A non‐compartmental model was used to describe plasma drug disposition after OTC administration. Following i.m. administration, the elimination half‐life (t½) was 62.65 ± 1.25 h and the bioavailability was 49.80 ± 0.01%. After i.v. administration the t½ was 50.97 ± 2.99 h, the Vd was 534.11 ± 38.58 mL/kg, and CIb was 0.121 ± 0.003 mL/min.kg. The 5 mg/kg i.v. dose used in this experiment resulted in up to 48 h plasma concentrations of OTC above the reported MIC values for some strains of fish pathogens such as Aeromonas hydrophila, A. liquefaciens, A. salmonicida, Cytophaga columnaris, Edwardsiella ictaluri, Vibrio anguillarium, V. ordalii, V. salmonicida and Yeersinia ruckeri. These MIC values are below the susceptible range (4 μg/mL) listed by the National Committee for Clinical Laboratory Standards (NCCLS) as determined by the NCCLS susceptibility interpretive criteria.
Effect of experimental renal impairment on disposition of marbofloxacin and its metabolites in the dog
Authors: Lefebvre  , Schneider  , Dupouy  , Laroute  , Costes  , Delesalle  , Toutain
Published: March 2003

The pharmacokinetics of marbofloxacin was studied in eight healthy female Beagle dogs before and after moderate renal impairment was induced experimentally. A single intravenous (i.v.) administration and repeated administration for 8 days (2 mg/kg, once‐a‐day) of marbofloxacin were studied. Renal impairment was induced by a right kidney nephrectomy and electrocoagulation of the left kidney. An increase (P < 0.001) in the plasma concentrations of urea (from 3.8 ± 0.7 to 9.8 ± 2.1 mmol/L) and creatinine (from 78.8 ± 3.4 to 145.8 ± 22.3 μmol/L), and a significant decrease (2.9 ± 0.3 vs 1.5 ± 0.2 mL/kg/min) (P < 0.001) in glomerular filtration rate were observed in the renal‐impaired dogs. The clearance of marbofloxacin was slightly decreased after the induction of renal failure (1.6 ± 0.2 to 1.4 ± 0.1 mL/kg/min) (P < 0.05), but no significant variation of volume of distribution at steady state (Vss) and mean residence time (MRT) was observed after intravenous administration of marbofloxacin (P > 0.05). Following oral administration of marbofloxacin, an increase in total area under the concentration time curve (AUC) was observed after renal failure (from 10372 ± 1710 to 11459 ± 1119 mg.min/L) (P < 0.05), but indices of accumulation were not modified. An increase (P < 0.01) in the AUC of N‐oxide‐marbofloxacin was observed after surgery. In conclusion, renal impairment has no biologically relevant influence on marbofloxacin disposition and there is no need for dosage adjustment of marbofloxacin in dogs with mild renal impairment.
Influence of experimentally induced theileriosis (Theileria annulata) on the pharmacokinetics of a long‐acting formulation of oxytetracycline (OTC‐LA) in calves
Authors: Kumar  , Malik
Published: March 2003

The effects of experimental Theileria annulata infection on the i.m. (20 mg/kg) pharmacokinetics of oxytetracycline were investigated in crossbred calves. The serum concentration–time curves of oxytetracycline (OTC‐LA), before and after experimental infection, were best described by a one‐compartment open model. The experimental infection by subcutaneous administration of ground‐up tick supernate (GUTS), equivalent to 30 Hyalomma anatolicum anatolicum ticks infected with Theileria annulata, produced a clear temperature rise and signs of clinical disease in calves. Subsequently, haemoglobin, packed cell volume, total leucocyte count and serum Cu, Fe and Zn concentrations decreased after infection. The absorption and elimination half‐lives (t½Ka and t½Ke), mean absorbance time (MAT), time to peak concentration (Tmax), mean residence time (MRT), area under the serum concentration time curve (AUC∞) and the bioavailability (F) were significantly (P < 0.05) decreased. The peak serum concentration (Cmax), however, remained unchanged after infection. These changes may necessitate alterations in the dosage regimen of oxytetracycline used to treat Theileria annulata infections in cattle under field conditions.
Chronic hepatitis C: the virus, its discovery and the natural history of the disease
Authors: Booth J. C. L.
Published: March 2003

The identification of hepatitis A and hepatitis B led to the recognition that a third virus was capable of causing blood‐borne hepatitis. The pathogen responsible for this nonA, nonB hepatitis was identified in the late 1980s and subsequently named hepatitis C. Since the discovery of hepatitis C there has been a pandemic of research publications describing the natural history of the infection and it is now known that this virus can cause serious liver damage in a proportion of infected patients. It is now clear that the effects of infection with hepatitis C and alcohol misuse are additive and that there is an increased risk of hepatic complications in infected patients who abuse alcohol.
Pathogenesis of hepatitis B and C‐induced hepatocellular carcinoma
Authors: Idilman R. , De Maria N. , Colantoni A. , Van Thiel D. H.
Published: March 2003

Hepatocellular carcinoma (HCC) is estimated to have an annual worldwide incidence of 0.25 to 1.2 million new cases per year. Both the prevalence and incidence of HCC vary markedly as a function of geography and the local prevalence of chronic viral hepatitis. Both chronic hepatitis B and chronic hepatitis C are recognized as risk factors for HCC. The prevalence of cirrhosis in individuals with HCC and chronic hepatitis B or C is reported to be 80.9% and 75.8%, respectively. HCC occurs at a lower rate in chronic viral hepatitis in the absence of cirrhosis. Moreover, hepatitis C virus (HCV) rather than hepatitis B virus (HBV) is associated with the majority of non‐cirrhotic cases of HCC. It is probable that the ongoing process of hepatocyte necrosis and liver cell renewal coupled with inflammation, which is characteristic of chronic viral hepatitis, causes not only nodular regeneration and cirrhosis but also progressive genomic errors in hepatocytes as well as unregulated growth and repair mechanisms leading to hepatocyte dysplasia and, in some cases, hepatic carcinoma. Current concepts concerning virus‐induced HCC are reported and discussed in the following review.
Liver‐directed gene transfer: a linear polyethylenimine derivative mediates highly efficient DNA delivery to primary hepatocytes in vitro and in vivo
Authors: Chemin I. , Moradpour D. , Wieland S. , Offensperger W. ‐B. , Walter E. , Behr J. ‐ P. , Blum H. E.
Published: March 2003

Efficient DNA delivery is a prerequisite for the successful implementation of molecular antiviral strategies against chronic viral hepatitis and gene therapy in general. The cationic polymer polyethylenimine (PEI) has recently been explored as a gene transfer vector in various cell types in vitro and in vivo. In this study, we evaluated a linear PEI derivative (lPEI) as a vector for gene and oligodeoxynucleotide transfer into hepatocytes in vitro and in vivo. A simple protocol was developed that allowed transfection of up to 50% of primary hepatocytes in vitro. In addition, fluorescent oligodeoxynucleotides were efficiently delivered to the liver in vivo after intravenous injection into Pekin ducks. Thus, lPEI mediates highly efficient gene and oligodeoxynucleotide transfer into primary hepatocytes and is potentially useful for DNA delivery in vivo.
A survey on hepatitis A in Portuguese children and adolescents
Authors: Barros H. , Oliveira F. , Miranda H.
Published: March 2003

In the early 1980s, Portugal could be classified as a highly endemic area for hepatitisA. However, marked economic and sanitary improvements took place during the following years. In this study we evaluated the temporal trends in the prevalence of hepatitisA in children and adolescents, to identify risk factors for the infection. The study sample included students aged 6 to 19years (n=999), attending public and private schools. All randomly selected participants gave information on social, demographic, clinical and behavioural variables, but only 667 (67.4%) agreed to provide a blood sample for the determination of total and immunoglobulin M (IgM) anti‐hepatitisA virus (HAV) antibodies. The prevalence of anti‐HAV‐positive subjects was 27.9%, with a linear age‐related increase (r=0.87, P=0.011) from 20.9% at 6–7years to 37.8% at 18–19years. The crowding index and the level of maternal education were the only independent predictors of hepatitisA infection. This study showed a clear decrease in hepatitisA prevalence in our population. However, it remains a common infection in Portugal, easily acquired early in life and associated with indicators of poverty.