bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between salivary flow rates and masticatory performance
Authors: NIEDERMEIER W. , MAYER B.
Published: March 2003

The aim of the present investigation was to study the effect of saliva flow on chewing efficiency by means of measurements of salivary flow rates as well as of parameters of masticatory performance. For this reason, 26 patients (13 xerostomic and 13 controls) with similar individual characteristics (14 females aged 41·3 ± 12·2 years; 12 males aged 38·0 ± 10·9 years) without CMD were encouraged to chew different foods (jelly bears, peanuts and rusk). Resting and stimulated flow rates of whole saliva (WHL) were ascertained after the method of Dawes (1987); resting and stimulated flow rates of palatal saliva (PAL) were determined with the help of the method of Niedermeier and Huber (1989); time of mastication (TM) as well as the number (NC) and duration (DC) of chewing cycles and time for swallowing (TS) were assessed using video recording. The mean resting WHL was 0·12 ± 0·05 mL min−1; the mean stimulated WHL was 0·24 ± 0·09 mL min−1; the mean resting PAL was 8·29 ± 7·88 µL cm−2 min−1 and the mean stimulated PAL was 8·96 ± 8·34 μL cm−2 min−1. Statistical analysis (Pearson method) revealed a strong correlation between resting or stimulated PAL and TM (R=0·808 or 0·834 for rubber bears; R=0·877 or 0·900 for peanuts; R=0·840 or 0·882 for rusk), DC (R=0·763 or 0·785 for rubber bears; R=0·836 or 0·867 for peanuts; R=0·749 or 0·779 for rusk) and TS (R=0·877 or 0·902 for rubber bears; R=0·860 or 0·918 for peanuts; R=0·822 or 0·864 for rusk). Only for rusk, resting and stimulated PAL correlated fairly with NC (R=0·697 and 0·736). No sufficient correlation was found between resting or stimulated WHL and parameters of mastication. The results clearly demonstrate that mucous saliva flow rates significantly bias measurements of masticatory performance.
A reliability study of clinical occlusal tooth wear measurements
Authors: LOBBEZOO F. , GROENINK W. J. , KRANENDONK A. A. , AARTMAN I. H. , NAEIJE M.
Published: March 2003

Tooth wear represents a clinical problem that is becoming increasingly important in ageing populations. Attrition caused by bruxism is its most visible sign. To determine the optimal moment to start the restoration of the worn dentition, one should first be able to measure the amount of tooth wear reliably in the clinical setting. So far, most studies of tooth wear severity have been performed on dental study casts. However, such an indirect approach is less applicable to the everyday dental practice, the more so because by grading of casts, the identification of dentine exposure is hard or even impossible to achieve. In this study, occlusal tooth wear was assessed clinically in 45 volunteers (17 men; 28 women; mean age 33·7 ± 10·7 years), TMD patients and symptom‐free persons alike, on four occasions: two calibrated examiners graded the occlusal wear at two different points in time, using a 5‐point scale (0=no wear; 1=visible wear within the enamel; 2=visible wear with dentine exposure and loss of clinical crown height <1/3; 3=loss of crown height between 1/3 and 2/3; 4=loss of crown height >2/3). The overall values of the intra‐rater and interrater reliability, expressed as Cohen's κ, were substantial (κ=0·632–0·678) and did not differ significantly from one another (repeated measures anova: F3,19=1·428, P=0·266). The clinical variable ‘quadrant’ (e.g. right maxillary dental arch) did not influence the values of κ whereas the interrater reliability during the first session was better for the element types ‘incisors’ and ‘cuspids’ than for the element type ‘premolars’ (one‐way anova: F3,23=4·577, P=0·012; post hoc Bonferroni tests: P=0·030 and 0·036). Qualitative assessment of the clinical variable ‘severity of wear’ indicated that the more advanced the tooth wear is, the more reliably it can be graded. The presence of restorations did not influence the reliability. It was concluded that occlusal tooth wear can be assessed reliably in the clinical setting, especially in the anterior parts of a dentition that demonstrates considerable wear. (Supported by the lOT)
A mimic osseointegrated implant model for three‐dimensional finite element analysis
Authors: Akagawa Y. , Sato Y. , Teixeira E. R. , Shindoi N. , Wadamoto M.
Published: March 2003

summary  The purpose of this study was to develop a new three‐dimensional (3D) mimic model of an osseointegrated implant for finite element analysis (FEA) and to evaluate stress distributions in comparison with a model commonly used in most studies as a control. Based on the 3D computer graphic data obtained by serial in vivo bucco‐lingual peri‐implant bone structure at 75 μm interval in monkey, a mimic FEA model with trabecular structure and a control model with uniform cancellous bone were constructed. A vertical load of 143 N was applied at the top of the implant and induced stress was evaluated at the peri‐implant bone. In the mimic model, stress was distributed at both cortical and cancellous bones (1–5 MPa) in bucco‐lingual central planes, but concentrated at the cortical crest (3–7 MPa) in the mesio‐distal central plane. In contrast, the control model presented stress concentration at the cortical crest around the implant (5–14 MPa), with less stress (0–1 MPa) at the peri‐implant cancellous bone in both planes. The findings, that stress distribution at the peri‐implant bone were quite different between the mimic and control models, suggest the need to carefully interpret stress distribution in previous studies with models of uniform cancellous peri‐implant bone.
Longitudinal study of the influence of removable partial denture and chemical control on the levels of Streptococcus mutans in saliva
Authors: Rocha E. P. , Francisco S. B. , Del Bel Cury A. A. , Cury J. A.
Published: March 2003

summary  Some studies have evaluated the salivary levels of mutans streptococci (MS) in removable partial denture (RPD) users. Saliva samples (2·0 mL) were obtained from 31 patients in six periods: (T0): immediately before installation of RPD; (T8): 8 days after T0; (T48): 48 days after T0; (T92): 92 days after T0; (T140): 140 days after T0 and (T189): 189 days after T0. The samples were vortexed and serially diluted from 10−1 to 10−6 in 0·05 m phosphate buffer (pH 7·4). From each dilution, 0·025 mL was plated on Mitis Salivarius Bacitracin (MSB). The plates were incubated in 5% CO2 at 37 °C for 72 h. There was an increase (t‐test, P < 0·05) in the number of MS between periods T0 and T48 (mean/s.d., CFU mL−1 of saliva): T0: 2·26/4·43 × 106 and T48: 0·47/1·48 × 108. After this, intensive treatment with CHX was accomplished in 29 patients. Saliva samples were obtained after treatment in four periods: (T24 h): 24 h after T0; (T14): 14 days after T24 h; (T28): 28 days after T24 h, and (T63): 63 days after T24 h. The number of MS in saliva did not decrease (t‐test, P > 0·05). A new CHX formulation was applied in 15 patients. Saliva samples were obtained in periods: (T0): before new CHX application; (T24 h): 24 h after T0 and (T82): 82 days after T0. The new CHX reduced MS levels in saliva: (mean/s.d., CFU mL−1 of saliva): T0: 6·64/8·47 × 106 and T24 h: 3·2/4·27 × 105 (sign rank, P < 0·05). In conclusion, there was a significant increase in the number of MS in saliva after the installation of RPD. The intensive treatment with a properly formulated CHX was effective in the reduction of MS, between 24 h and 82 days after its application.
The role of mental health nursing in the prevention of child sexual abuse and the therapeutic care of survivors
Authors: Long  , Smyth
Published: March 2003

This paper is primarily designed to stimulate discussion and debate on the role of the mental health nurse dealing with survivors of sexual abuse. The authors contend that, in reality, all nurses should be prepared through education and training to treat the sufferers of emotional and spiritual pain, regardless of from where the hurting stems. The need for nurses to open their eyes and acknowledge the agony and distress caused to children as a result of abuse by adults is highlighted. So too is the necessity for nurses to enhance their own unique and specific practice. Nurses (and particularly mental health nurses) have a role in promoting a healthy generation of children — children who are looked after and protected by caregivers and not by caretakers. As the result of nurses advocating healthy caregiving and healthy relationships children may never need to suffer from inhumane and denigrating acts against their very beings. Nurses have no excuse for being unable to imagine child sexual abuse. Therefore they have no excuse for not being prepared to deal with the resulting, excruciating pain. It is both uncaring and inhumane for nurses not to be prepared to accept the sharing of such emotionally painful and disturbing experiences. Mental health nurses have a genuine role in offering therapeutic care to victims and survivors. This paper concludes by exploring and examining the nurse's role in counselling survivors of child sexual abuse.
Schizophrenia and genetics: a review and critique for the psychiatric nurse
Authors: Dawson
Published: March 2003

Nursing authors such as McCrone and Gournay persist in the orthodox view that the genetic heritability of schizophrenia is an established scientific fact. In this article I take issue with the view they propound by way of an examination of the literature pertaining to schizophrenia and genetics. My reading of the literature suggests that the certainty they seek is not to be found in any of the scientific evidence so far put forward in support of the genetic hypothesis. Much of the early work in this field is fatally flawed and can no longer be used to support the genetic argument. More recent work tends to give increasing support to a greater role for environmental factors than is compatible with a hereditarian argument. Fifty years of research in this field has consistently failed to provide reliable scientific evidence in support of any of the genetic hypotheses relating to schizophrenia. Nurses, it is argued, should not be dispensing advice to patients on the basis of a genetic model that is at best mere hypothesis.
Mental illness and irish people: stereotypes, determinants and changing perspectives
Authors: Clarke
Published: March 2003

The causes of psychological illness in Irish people have been identified with colonial rule and the catastrophic conditions deriving from famine in the nineteenth century. In particular, the scourge of unremitting emigration, resulting from famine, has formed a background against which speculative theories of inferiority, alienation and mental illness have been constructed. In particular, the long standing idea that Irish people exhibit higher rates of schizophrenia, both in Ireland and abroad, is discussed. Contemporary studies which suggest that these elevated rates do not correspond to international diagnostic criteria for schizophrenia are introduced. Rather, these enhanced rates may reflect a malaise which resembles schizophrenia but which is really a product of historical dispossession. The importance of these factors is underscored by the previous neglect of Irish people, considered as an ethnic minority, as well as the particular distaste which many Irish people display towards such a notion.
Suicidal patients and special observation
Authors: Cleary M. , Jordan R. , Horsfall J. , Mazoudier P. , Delaney J.
Published: March 2003

Special observation is a nursing practice utilized in in‐patient psychiatric facilities for patients who are suicidal. Special observation is carried out by an allocated registered nurse remaining continuously at arms length from, or within sight of (as specified), the patient; or a registered nurse observing the patient within a 30 min interval. In this exploratory study, we investigated the role of the registered nurse when caring for patients on special observation. Semistructured interviews were conducted with 10 randomly selected registered nurses from 4 acute psychiatric wards. The 9 themes that emerged were: 1) Safety; 2) Therapeutic relationships; 3) Supporting patients and carers; 4) Consequences of special observation for nurses; 5) Continuity of care concerns; 6) Peer support; 7) Suicide indicators; 8) Responsibilities and rights: nurses and patients; and 9) Nurses, doctors and the hospital hierarchy. Recommendations for alleviation of the concerns about the practice of special observation are outlined and discussed.
Qualitative and quantitative approaches in mental health nursing: moving the debate forward
Authors: Burnard P. , Hannigan B.
Published: March 2003

In recent years, two distinct, and apparently opposing, positions have arisen in debates concerned with mental health nursing research, education and practice. Each of the two has its champions and ‘gurus’, and its detractors. Writers associated with the quantitative camp have argued in favour of: experimental research where the aims are the investigation of the outcomes of nursing care; multidisciplinary rather than unidisciplinary research; a physiological explanation for mental illness; clinical practice which is evidence based, and skills based education. Qualitative camp writers, on the other hand, have argued for: qualitative research to explore the experiences of illness, and of nursing; the preservation of nursing‐only research; the relative irrelevance of physical explanations of mental illness, and holistic nursing practice in which clinical techniques are less important than interpersonal relationships. In this paper, we first review and criticise some key ideas associated with these two positions. In our subsequent analysis, we argue that, rather than differing at some fundamental level, the differences found between the two camps may be more a matter of emphasis. The possibilities of reconciliation and synthesis are, finally, presented and discussed.
Psychiatry and citizenship: the Liverpool black mental health service users’ perspective
Authors: Pierre S. A.
Published: March 2003

This study investigates the appropriateness of statutory psychiatric services for the Black community in Liverpool by appraising the services through the views of Black British, Black African, and Black Caribbean service users residing in Liverpool. Semi‐structured and un‐structured interviews, which characterize methodological approaches used to harness and deploy service users’ views to generate involvement in service decisions at local level, are utilized and analyzed by thematic content analytical procedures described in Burnard (1991), and demonstrated by
Evans (1995). Interview transcripts are individually studied, manipulated, and aggregated to generate the main themes discussed during this process. The findings are discussed in the presentation of the data as supporting or disconfirming evidence of the researcher’s understanding of the anomalies in the characteristics of psychiatric services in cross‐cultural settings. The study shows that structures already exist in the Black Community for mental health service providers to action user involvement, a contemporary policy initiative in the British National Health Service (
DoH 1997). This study demonstrates the process.
Self‐esteem in community mental health nurses: findings from the all‐Wales stress study
Authors: Fothergill A. , Edwards D. , Hannigan B. , Burnard P. , Coyle D.
Published: March 2003

The authors conducted an all‐Wales survey of community mental health nurses (CMHNs) to determine their levels of stress, coping and burnout. A total of 301 CMHNs were surveyed in 10 NHS Trusts in Wales. A range of measures were used. These included the General Health Questionnaire (GHQ‐12), Maslach Burnout Inventory (MBI), Rosenberg Self‐Esteem Scale (SES), Community Psychiatric Nursing (CPN) Stress Questionnaire, and PsychNurse Methods of Coping Questionnaire. The findings from the Rosenberg SES are reported here. Community mental health nurses in Wales scored as having average self‐esteem. When the data were divided into high and low self‐esteem, a large group of CMHNs (40%) were found to have low self‐esteem. Factors that are associated with low and high self‐esteem were identified. Alcohol consumption and being on lower nursing grades (D, E, F) were associated with low self‐esteem, whilst amount of experience working as a CMHN was associated with high self‐esteem.
A survey of community mental health nurses' perceptions of clinical supervision in Northern Ireland
Authors: Kelly B. , Long A. , Mckenna H.
Published: March 2003

Since the early 1990s, clinical supervision has been the subject of debate by nurse academics and practitioners. This debate has encouraged the adoption of clinical supervision by the profession throughout the United Kingdom. Search of the literature demonstrates that there has been little published research regarding clinical supervision in Northern Ireland. This study is designed to redress this information deficit. The current position of clinical supervision in relation to community psychiatric nursing in Northern Ireland is explored and evaluated. A survey approach was adopted, collecting data from community psychiatric nurses (CPNs) in Health and Social Services Trusts in Northern Ireland. Data was obtained relating to the practice of clinical supervision and to attitudes of CPNs, their managers and supervisors. Results indicate that there is support for clinical supervision and that it is being implemented within community psychiatric nursing in Northern Ireland, although not in all cases. However, the findings indicate that serious education and training deficits exist, and the importance of the interface between managerial and clinical supervision is emphasized. The issues of providing effective education and training in supervision skills, and the uncertainty that was highlighted regarding fundamental concepts underpinning clinical supervision, have implications for nursing practice, education and management. In addition, based on findings of this study, the difference between management‐led supervision and clinical supervision as envisaged by the UKCC, which promotes the personal and professional development of nurses, requires further exploration.
The aphasic person’s views of the encounter with other people: a grounded theory analysis
Authors: Andersson S. , Fridlund B.
Published: March 2003

Being affected by aphasia influences the total life experience. The aim of this study was to generate a theoretical model, from a nursing perspective, of what aphasic persons (n = 12) experience in encounters with other people. Data were collected through interviews which adopted a biophysical, socio‐cultural and psychological approach and then analysed using grounded theory method. Two main categories emerged, namely: ‘interaction’ and ‘support’. Encountered experiences led to: ‘a feeling of having ability’; ‘a feeling of being an outsider’; and ‘a feeling of dejection or uncertainty’. The feeling state was dependent on whether the interaction was ‘obstructed’ or ‘secure’ and on whether the support resulted in ‘strengthened’ or ‘impaired’ self‐esteem. Therefore nurses need to give support that enhances patients’ self‐esteem and which results in them gaining a positive and realistic view of their aphasia, as well as involving those around them in this perspective. This then will give the possibility for the patient to turn the interaction process from an obstructed into a secure one.
Involving mental health service users and carers in curriculum development: moving beyond ‘classroom’ involvement
Authors: Masters H. , Forrest S. , Harley A. , Hunter M. , Brown N. , Risk I.
Published: March 2003

Recent policy statements that address the future priorities for nurse education have emphasized that service users and carers should be actively engaged in partnerships with education professionals in all aspects of the curriculum. The development of this agenda is well advanced; however, examples of ‘how to do it’ are sparse. The development of a strategy to involve users and carers in the design and delivery of the Diploma of Higher Education in Nursing at Napier University provided an opportunity to evaluate the process of developing partnerships in this area of nurse education. This paper presents the findings from a process evaluation from the various standpoints of the key interest groups. The overall project and evaluation is outlined, along with methodological and practical issues surrounding this type of ‘collaborative’ evaluation. The importance and satisfaction of practical aspects of the project are examined. The issues of representativeness, expertise in ‘involvement’ and the importance of the ‘process’ of involvement are explored. Finally, the challenges to developing ‘meaningful involvement’ that goes beyond ‘classroom involvement’ in nurse education are identified and discussed.
Women's experiences of hospital admission
Authors: CUTTING P. , HENDERSON C.
Published: March 2003

The primary aim of this study was to examine women's experiences of inpatient psychiatric services. A secondary aim was to use the emerging themes in service planning and to develop an evaluation tool. Focus groups and individual interviews with women in receipt of psychiatric services in Croydon were used. The findings suggest continuity with both negative and positive aspects of institutional care described before the policy of community care was introduced. The attempts to ‘normalize’ institutional care by desegregating wards appear rather to have compounded problems faced by women. Women were clear about what they felt they wanted and needed. Women are dissatisfied about many aspects of care aside from the problems associated specifically with mixed sex wards. This suggests that sexual segregation of wards alone is a necessary but an insufficient measure to improve inpatient care. The findings can inform development of a women‐only service in Croydon and of a tool to evaluate it.
6‐Sulfatoxymelatonin excretion and self‐reported sleep in good sleeping controls and 55–80‐year‐old insomniacs
Authors: LUSHINGTON KURT , LACK LEON , KENNAWAY DAVID J , ROGERS NAOMI , VAN DEN HEUVEL CAMERON , DAWSON DREW
Published: March 2003

The pineal hormone melatonin is thought to play a role in sleep initiation and maintenance. This was examined in a large sample of good sleeping controls ( n=52) and sleep maintenance insomniacs (n=56), aged 55–80 y. Subjects collected 5 d of self‐reported sleep diary measures, and 12‐h urine samples (08.00–20.00 and 20.00–08.00 h) for analysis of the urinary melatonin metabolite, 6‐sulphatoxymelatonin (aMT.6S). Insomniacs reported a significantly greater amount of wake after sleep onset, less sleep in total, less efficient sleep and poorer quality sleep compared to controls. However, no significant differences in melatonin excretion were observed between controls and insomniacs, with both groups showing similar mean (SEM) 12‐h night‐time [30.9 (2.9) vs. 30.6 (3.3) nmoles, respectively] as well as 24‐h total [38.7 (3.4) vs. 36.7 (3.8)] aMT.6S excretion levels. No significant correlations were observed with any sleep parameters nor any effects of medication (anti‐inflammatory agents, hormone replacement therapy, and an undifferentiated group of medications). The present results do not support a simple relationship between total melatonin production and self‐reported sleep quality and duration in the aged.
Dreaming and insomnia: Dream recall and dream content of patients with insomnia
Authors: SCHREDL MICHAEL , SCHÄFER GERARD , WEBER BETTINA , HEUSER ISABELLA
Published: March 2003

The present study investigated dream recall frequency and dream content of patients with insomnia in comparison to healthy controls. Patients’ dream recall frequency was elevated, due mainly to their heightened frequency of nocturnal awakenings. Dream content seems to reflect waking life stressors found in these patients, i.e. dream emotions were more negative and dreams were characterized by themes of depression, ‘negatives’ in self‐description and health themes. Patients taking antidepressants showed lower dream recall frequency than patients without any medication; benzodiazepine intake, however, did not affect dream recall frequency. Both drug groups reported more positively toned dreams than drug‐free patients. It is suggested that future studies should use more dreams per subject in order to reduce error variance of the dream content measures and more detailed measures of waking life stress.
Quantitative trait loci approach to the genetics of sleep in recombinant inbred mice
Authors: Tafti  , Chollet  , Valatx  , Franken
Published: March 2003

Sleep is a complex trait controlled by many genes, the environment, and probably by gene–environment interactions. Among different approaches to the genetics of sleep, analysis of quantitative traits (QTL) has the advantage of being able to detect, along with major genes, minor and/or modifier genes influencing different quantitative aspects of sleep. We have used QTL analysis in two different sets of recombinant inbred (RI) strains and sought for confirmation of several localizations in eight histocompatibility congenic strains. Several QTLs were identified which influenced the amount of vigilance states. In a first RI series (seven strains) the only QTLs identified were those affecting paradoxical sleep (PS), whereas analysis in a second RI series (25 strains) revealed QTLs influencing PS, slow‐wave sleep, and total sleep. Among these, a single QTL on chromosome 5 was associated with all vigilance states, suggesting the presence of a major gene influencing a basic aspect of sleep amount. Search for candidate genes around the identified QTLs indicated several immune related genes that have been implicated in sleep regulation. Transgenic animals carrying loss‐of‐function and/or gain‐of‐function mutations affecting these candidate genes should confirm these findings.
Sleep, age, and shiftwork experience
Authors: Marquié J. C. , Foret J.
Published: March 2003

The effects of age and shiftwork experience (never, past, present) on sleep were studied in a sample of 3236 wage earners and retired workers by means of a questionnaire. The sample was composed of 32‐, 42‐, 52‐, and 62‐year‐old subjects, and included both sexes and various occupational statuses. Age resulted in a continuously increasing frequency of sleep disturbances and hypnotic use, except for difficulty getting back to sleep and early awakening, which peaked at 52 years and then decreased at 62 years, thus suggesting a ‘retirement effect’. Current and past shiftworkers reported more problems with falling asleep and early awakening than subjects who had never worked on shifts. This is a likely explanation of why the effect of age was massive in the latter group and much less pronounced in the former groups. There were no clear effects of the length or recency of shiftwork experience. This finding does not support the hypothesized permanent effect of shiftwork experience on subsequent sleep. Females had higher complaint rates at every age. There was little interaction between age and sex, but women were affected more by shiftwork as they got older, particularly as to hypnotic consumption. Some of the results support the hypothesis that a selection process excludes workers who are no longer able to cope with the demands of shiftwork.
Functional neuroanatomy of human sleep states after zolpidem and placebo: A H215O‐PET study
Authors: Finelli Luca A. , Landolt Hans‐Peter , Buck Alfred , Roth Corinne , Berthold Thomas , Borbély Alexander A. , Achermann Peter
Published: March 2003

Changes in the functional organization of the brain during the course of sleep and waking are reflected by different patterns of regional cerebral blood flow (rCBF). To investigate the effect of the hypnotic zolpidem, a benzodiazepine receptor agonist, drug or placebo were administered to eight young, healthy men prior to bedtime. The subjects were sleep‐deprived to promote sleep during the 4‐h recording period in the positron emission tomography scanner. Intravenous injections of labelled water were administered during pre‐drug wakefulness, and during Stage 2, Stage 4 and rapid eye movement (REM) sleep, each injection being followed by an emission scan. Statistical parametric mapping was used to investigate the effects of treatment and sleep states. During sleep (combined Stages 2 and 4, and REM sleep) relative rCBF was lower after zolpidem than after placebo in the basal ganglia and insula, and higher in the parietal cortex. A ‘multiple study’ analysis of REM sleep revealed that rCBF in the anterior cingulum was lower after zolpidem than after placebo, whereas rCBF in the occipital and parietal cortex, parahippocampal gyrus and cerebellum was higher. When the pooled data (drug and placebo) of Stages 2 and 4 were compared with wakefulness, rCBF was lower in prefrontal cortex and insula, and higher in the occipital and parietal cortex. The results indicate that some differences in rCBF from wakefulness to non‐REM sleep are further augmented by zolpidem.
Tactile arousal threshold of sleeping king penguins in a breeding colony
Authors: Dewasmes  , Telliez
Published: March 2003

The tactile arousal threshold of sleeping birds has not been investigated to date. In this study, the characteristics of this threshold were assessed by stimulating either the upper back or a foot of two groups (one cutaneous site per group) of 60 sleeping king penguins (Aptenodytes patagonica) in the breeding colony of Baie du Marin (Crozet Archipelago). Increasing weights were put onto one of the feet or the upper back of individuals that had been sleeping for more than 5 min until they showed behavioural signs of arousal (head raising). The weight applied to the upper back that was needed to awaken a sleeper (837 ± 73 g) was 20 times greater than that applied to a foot (38 ± 6 g). In terms of pressure, the difference remained five times higher for the back (209 ± 18 g/cm2) than the foot (40 g ± 7 g/cm2). Because the king penguin incubates its single egg and rears its young chick on its feet, the low threshold measured at this level could be viewed as an adaptation against progeny predation. Sleepers are frequently bumped by conspecifics walking through the colony. The increased arousal threshold associated with tactile stimulation of the back may help to preserve sleep continuity under these conditions.
The variability of the apnoea–hypopnoea index
Authors: Bittencourt Lia Rita Azeredo , Suchecki Deborah , Tufik Sergio , Peres Clóvis , Togeiro Sônia Maria , Bagnato Maurício Da Cunha , Nery Luiz Eduardo
Published: March 2003

This study was designed to evaluate the variability of the apnoea–hypopnoea index (AHI) in 20 patients with obstructive sleep apnoea–hypopnoea syndrome (OSAHS) and to determine possible relationships of this variability with other polysomnographic parameters. The subjects were recorded on four consecutive nights. The mean AHI values were not significantly altered throughout the four recording nights (P=0.67). The intraclass correlation coefficient of the AHI on the four nights was 0.92. However, the Bland and Altman plot showed that, individually, the AHI presented an important variability, which was not related to its initial value. In regard to the OSAHS severity, 50% of the patients changed the classification from the first to the subsequent nights. Thirteen of the 20 patients (65%) presented a variation in the AHI value equal or higher than 10 events h–1. When we evaluated the AHI mean values for a specific body position and sleep stage, no difference was observed among the nights. In both supine and lateral–ventral decubitus, higher AHI was observed during Stages 1 and 2 than the other stages. Additionally, the AHI during Stages 1 and 2 and REM sleep was higher on the supine than on the lateral–ventral decubitus. The AHI in OSAHS patients presented a good correlation among the four recording nights; however, a significant individual variability should be considered, especially when AHI is applied in OSAHS classification or as a criterion of therapeutic success.
Sleep and daytime sleepiness in retinitis pigmentosa patients
Authors: Ionescu Doina , Driver Helen S. , Heon Elise , Flanagan John , Shapiro Colin M.
Published: March 2003

Objective We examined sleep, daytime sleepiness and the ability to stay awake during the day in patients affected with retinitis pigmentosa (RP), to further delineate the role of photoreceptors in the circadian cycle.

Methods Twelve individuals diagnosed with RP (40 ± 8 years) And 12 normally sighted healthy individuals (39 ± 7 years) matched for age, body mass index (BMI) and sex were selected for the study. Participants had their sleep recorded on two consecutive nights and were monitored on the two following days. On the first day, their ability to stay awake and on the second, their sleep propensity were assessed using the Maintenance of Wakefulness Test (MWT) and the Multiple Sleep Latency Test (MSLT), respectively. Self‐report measures were obtained using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Toronto Hospital Alertness Test (THAT).

Results Subjective daytime sleepiness (ESS: 9 ± 5 vs. 6 ± 4, P=0.053) and objectively measured sleep propensity (MSLT: 10 ± 5 vs. 17 ± 3 min, P < 0.000) were significantly higher in RP patients than controls, whilst their alertness (THAT: 29 ± 9 vs. 38 ± 7, P=0.016) and ability to stay awake (MWT: 21 ± 9 vs. 29 ± 2 min, P=0.006) were significantly reduced. Retinitis pigmentosa participants had more disturbed nighttime sleep, with significantly more awakenings (arousal index: 14 ± 8 vs. 8 ± 6 h, P=0.039), and tended to have less rapid eye movement (REM) sleep (19 ± 5 vs. 22 ± 3%, P=0.094).

Conclusion Patients with RP have increased daytime sleepiness, reduced alertness and more disturbed nighttime sleep of poorer quality than their normally sighted counterparts, suggesting an influence of photoreceptor degeneration on the circadian cycle.
Sleep‐ and circadian‐dependent modulation of REM density
Authors: KHALSA SAT BIR S. , CONROY DEIRDRE A. , DUFFY JEANNE F. , CZEISLER CHARLES A. , DIJK DERK‐JAN
Published: March 2003

Rapid eye movement (REM) density, a measure of the frequency of rapid eye movements during REM sleep, is known to increase over the course of the sleep episode. However, the circadian modulation of REM density has not been thoroughly evaluated. Data from a forced desynchrony protocol, in which 20 consecutive sleep opportunities were systematically scheduled over the entire circadian cycle, were analysed. The REM density was evaluated from polysomnographically recorded REM sleep episodes, and analyzed as a function of time in the sleep opportunity and as a function of phase in the circadian cycle. The REM density showed a robust increase over the course of the sleep episode. This sleep‐dependent increase was observed regardless of circadian phase, because data analyzed from different thirds of the circadian cycle exhibited a similar pattern. The REM density did not show a significant circadian‐dependent modulation for data from the entire sleep opportunity. However, analysis of circadian modulation from separate thirds of the sleep opportunity revealed a significant circadian modulation in the last third of the sleep episode. Maximum REM densities were observed when the last third of the sleep episode coincided with the wake‐maintenance zone, i.e. ˜8–10 h before the crest of the circadian rhythm of REM sleep propensity. These results confirm the dominant sleep‐dependent modulation of REM density, and indicate that the density of REMs is greatest when sleep pressure is low, such as in the latter part of the sleep episode, at which time the circadian modulation of REM density is also appreciable.
A simple way to measure daily lifestyle regularity
Authors: Monk Timothy H. , Frank Ellen , Potts Jaime M. , Kupfer David J.
Published: March 2003

A brief diary instrument to quantify daily lifestyle regularity (SRM‐5) is developed and compared with a much longer version of the instrument (SRM‐17) described and used previously. Three studies are described. In Study 1, SRM‐17 scores (2 weeks) were collected from a total of 293 healthy control subjects (both genders) aged between 19 and 92 years. Five items (1) Get out of bed, (2) First contact with another person, (3) Start work, housework or volunteer activities, (4) Have dinner, and (5) Go to bed were then selected from the 17 items and SRM‐5 scores calculated as if these five items were the only ones collected. Comparisons were made with SRM‐17 scores from the same subject‐weeks, looking at correlations between the two SRM measures, and the effects of age and gender on lifestyle regularity as measured by the two instruments. In Study 2 this process was repeated in a group of 27 subjects who were in remission from unipolar depression after treatment with psychotherapy and who completed SRM‐17 for at least 20 successive weeks. SRM‐5 and SRM‐17 scores were then correlated within an individual using time as the random variable, allowing an indication of how successful SRM‐5 was in tracking changes in lifestyle regularity (within an individual) over time. In Study 3 an SRM‐5 diary instrument was administered to 101 healthy control subjects (both genders, aged 20–59 years) for two successive weeks to obtain normative measures and to test for correlations with age and morningness. Measures of lifestyle regularity from SRM‐5 correlated quite well (about 0.8) with those from SRM‐17 both between subjects, and within‐subjects over time. As a detector of irregularity as defined by SRM‐17, the SRM‐5 instrument showed acceptable values of kappa (0.69), sensitivity (74%) and specificity (95%). There were, however, differences in mean level, with SRM‐5 scores being about 0.9 units [about one standard deviation (SD)] above SRM‐17 scores from the same subject‐weeks. SRM‐5 scores also deviated more from a Gaussian distribution than did SRM‐17 ones. In a study with a sample size of 101, the new SRM‐5 instrument yielded scores with a mean of 4.11 and an SD of 1.13. Correlations between lifestyle regularity and age, and between lifestyle regularity and morningness appeared similar whether 5‐item or 17‐item SRM measures were used. When a gender difference in lifestyle regularity appeared, it was detected by both SRM‐5 and SRM‐17 measures.
Daytime testing after laboratory or home‐based polysomnography: comparisons of middle‐aged insomnia sufferers and normal sleepers
Authors: Edinger Jack D. , Glenn D. Michael , Bastian Lori A. , Marsh Gail R. , Dailey Dorothy , Hope T. Victor , Young Margaret , Shaw Edmund , Meeks George
Published: March 2003

Many studies have shown only modest differences between insomnia sufferers and matched, non‐complaining normal controls in regard to their levels of daytime sleepiness and diurnal performances. The current study was conducted to determine whether such daytime comparisons might be affected by the setting (home vs. sleep lab) in which study participants sleep on the nights before such testing. The study used a counter‐balanced, matched‐group design in which participants underwent three consecutive nocturnal polysomnographs (PSG) conducted either in the sleep lab or in their homes prior to undergoing daytime multiple sleep latency test (MSLT) and computer‐administered performance testing. The study participants were 35 (18 women and 17 men) middle‐aged (40–59 years) non‐complaining normal sleepers and 33 middle‐aged insomnia sufferers (17 women and 16 men) who met structured interview criteria for persistent primary insomnia. Use of a hierarchical linear statistical model showed only insomnia sufferers who underwent nocturnal home PSG were more alert on the MSLT than were normal sleepers who underwent lab PSG. However, these insomnia sufferers showed a greater propensity toward attention lapses on selected reaction time tests than did either of the two normal control groups (i.e. either those who slept in the lab or those who slept at home). The results suggest the nocturnal sleep setting (home vs. lab) may affect subsequent MSLT and performance test comparisons of insomnia sufferers and normal sleepers.
Pharmacokinetics of exogenous corticotropin in normal dogs, hospitalized dogs with non adrenal illness and adrenopathic dogs
Authors: Greco  , Behrend  , Brown  , Rosychuk  , Groman
Published: March 2003

Corticotropin (ACTH) pharmacokinetics was assessed in 10 normal dogs receiving exogenous ACTH (0.5 U/kg, i. v.). A two‐compartment open model was most appropriate for description of exogenous ACTH pharmacokinetics. The apparent distribution and elimination rate constants (α and β) were 7.4 ± 2.7 ×10−2min−1and 5.5 ± 3.8 ×10−3min−1, respectively. Area under the concentration‐time curve (AUC) was 2.91 ± 0.78 ×104pg.min/mL, mean residence time (MRT) was 45.0 ± 12.2 min, the distribution half‐life (t½α) was 9.4 min (harmonic mean), and the elimination half‐life (t½β) was 128 min (harmonic mean). The total body clearance of ACTH (ClB) was 1.83 ± 0.46 × 104mL. min/kg and volume of distribution (Vdarea) was 30 ± 15 L/kg.

 Corticotropin pharmacokinetics was also assessed in 12 client owned dogs, six dogs with non adrenal illness (NAI) and six dogs with hyperadrenocorticism (HAC), receiving exogenous ACTH (0.5 U/kg, i. v.). For these patients, data was best fitted to a one‐compartment open model. In dogs with NAI, theAUCwas 6.23 ± 0.62 × 105pg·min/mL,MRTwas 38.7 ± 12 min, the apparent elimination rate constant (kel) was 0.26 ± 0.0017 min−1, elimination half‐life was 26.7 min,ClBwas 0.84 ± 0.1 × 104mL/min/kg, andVdareawas 31.9 ± 5.7 L/kg. In dogs with HAC,AUCwas 4.74 ± 0.23 × 105pg·min/mL,MRTwas 20.4 min, kelwas 0.034 ± 0.009 min−1, half‐life was 20.4 min,ClBwas 1.06 ± 6.0 × 104mL /min/kg andVdareawas 29.7 ± 6.7 L/kg. Dogs with pituitary‐dependent hyperadrenocorticism showed more rapid elimination and clearance of exogenous corticotropin than dogs with NAI.
Some pharmacokinetic parameters of the trypanocidal drug homidium bromide in Friesian and Boran steers using an enzyme‐linked immunosorbent assay (ELISA)
Authors: Murilla  , Holmes  , Peregrine  , Eisler  , Ndung’U
Published: March 2003

Pharmacokinetic studies on the trypanocidal drug homidium bromide using a competitive enzyme immunoassay (detection limit 0.1 ng/mL) are reported for non‐infected Friesian and Boran steers following treatment with homidium bromide at a dose of 1.0 mg/kg b.w. Following intravenous (i.v.) treatment of Friesian steers (n=5), the mean serum drug concentrations were 31.9±2.1 and 3.9±0.4 ng/mL at 1 and 24 h, respectively. The decline in serum drug concentration was tri‐exponential with half‐lives of 0.064±0.037 h fort½α, 7.17±1.87 h fort½βand 106.3±6.6 h fort½γfor distribution and elimination phases 1 and 2, respectively. Drug was detectable in serum for 17 days following treatment. The mean residence time (MRT) was 63.4±7.5 h. Following intramuscular (i.m.) treatment of Friesian steers (n=5), the drug concentration at 1 h after treatment was 72.5±2.2 ng/mL. This declined to 9.8±1.8 ng/mL at 24 h. Low concentrations of between 0.1 and 0.3 ng/mL remained in circulation for up to 90 days post‐treatment. Following intramuscular treatment of Boran steers (n=5), the mean serum drug concentration at 1 h after treatment was 112.1±40.3 ng/mL. By 24 h after treatment, the concentration had fallen to 13.0±3.3 ng/mL. Thereafter, the serum drug concentration‐versus‐time profile and the pharmacokinetic parameters obtained following non‐compartmental analysis were similar to those obtained following intramuscular treatment of Friesian steers.
Single‐dose pharmacokinetics of flumequine in the eel (Anguilla anguilla) after intravascular, oral and bath administration
Authors: Hansen M. K. , Horsberg T. E.
Published: March 2003

Knowledge of the pharmacokinetic properties of drugs to combat bacterial infections in the European eel (Anguilla anguilla) is limited. One antimicrobial agent likely to be effective is flumequine. The aim of this study was to investigate the pharmacokinetic properties of flumequine in European eels in fresh water. Flumequine was administered to eels (Anguilla anguilla) intravenously (i.v.) and orally (p.o.) at a dose of 10 mg/kg body weight, and as a bath treatment at a dose of 10 mg/L water for 2 h. The study was performed in fresh water with a temperature of 23±0.3 °C, pH 7.15. Identical experimental designs were used. Two additional bath treatments were also performed, one in which the pH in the water was lowered by approximately 1 unit to 6.07 (dose: 10 mg/L) and one at a dose of 40 mg/L for 2 h in a full‐scale treatment. Following i.v. administration, the volume of distribution at steady state was 3.4 L/kg. Total body clearance was 0.012 L/h per kg and the elimination half‐life (t1/2λz) was calculated to be 314 h. Mean residence time was 283 h. Following oral administration, the t1/2λz was 208 h. Maximal plasma concentration (Cmax) was 9.3 mg/L, at 7 h after administration (Cmax). The oral bioavailability (F) was calculated to be 85%. Following bath administration in 10 mg/L for 2 h, maximal plasma concentration was 2.1 mg/L, observed immediately after the end of the bath. The ‘bioavailability’ in eel following a 2‐h bath treatment was 19.8%. Reducing the pH in the bath to 6.07 produced a maximal plasma concentration of 5.5 mg/L, observed immediately after the end of the bath. The ‘bioavailability’ was increased to 41% by the lowering of the pH. A similar effect was observed in a full‐scale treatment (1 kg eels/L water). The CO2 produced by the eel lowered the pH and increased ‘bioavailability’ to 35%.
Effects of altered plasma α‐1‐acid glycoprotein levels on pharmacokinetics of some basic antibiotics in pigs: simulation analysis
Authors: Kuroha M. , Son D.‐S. , Shimoda M.
Published: March 2003

Effects of altered plasma α‐1‐acid glycoprotein (AGP) levels on pharmacokinetic parameters of basic antimicrobials, erythromycin (EM), lincomycin (LM) and clindamycin (CM) were evaluated in pigs by simulation analysis. Intravenous (i.v.) injections of EM, LM and CM were performed to obtain pharmacokinetic parameters in healthy conditions. Binding parameters were obtained from an in vitro study using ultrafiltration. Simulation studies indicated that an increase of plasma AGP levels resulted in a decrease of both volume of distribution at steady state (Vdss) and total body clearance (Cltot) for all the drugs. Elimination rate constant for LM was almost unchanged by an increase of plasma AGP levels, whereas those for EM and CM were increased. Plasma concentration–time profiles at a high AGP level (often observed in pathophysiological conditions) were also simulated. All of the total plasma concentration–time profiles were different from those at normal AGP level. The differences were characterized by a higher initial concentration with faster or similar elimination. Unbound plasma concentration–time profile of LM was unaffected by AGP levels, whereas EM and CM were eliminated from plasma more rapidly at high AGP level. These results suggested that adjustment of dosage regimen of EM and CM is required in pathophysiological conditions, but that of LM is not required.