bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resistance to Beta-Lactams in Enterobacteriaceae: Distribution of Phenotypes Related to Beta-Lactamase Production
Authors: Sirot D , Sirot J , Saulnier P , Joly B , Chanal M , Cluzel M , Cluzel R 
Published: January 2017

Phenotypes of susceptibility to amoxycillin (Amo), ticarcillin (Tic), cephalothin (Ctn) were determined in 1366 isolates of Enterobacteriaceae by disk method and beta-lactamases were identified in 243 strains belonging to different phenotypes of amoxycillin-resistant strains. AmoR TicR Ctns strains (25%) were penicillinase producers and all of them were susceptible to the combination amoxicillin/clavulanic acid (Amo/CA) and ticarcillin/clavulanic acid (Tic/CA). AmoI/R Tics CtnR strains (12%) were cephalosporinase producers and resistance to Amo/CA was observed, except for Proteus vulgaris. AmoR TicR CtnR strains (18%) often produced two beta-lactamases (penicillinase and cephalosporinase) and they were resistant to Amo/CA; in this group, susceptibility to Tic/CA depends on the nature and the amount of the beta-lactamase produced, except for Serratia marcescens for which antibiotic resistance is probably due to other mechanisms. Tic/CA resistance was mainly found in Serratia marcescens (41%) and Enterobacter cloacae (36%).
Multicentre Double-Blind Clinical Trials of Ciclopirox Olamine Cream 1% in the Treatment of Tinea Corporis and Tinea Cruris
Authors: Bogaert Huberto , Cordero Carlos , Ollague Wenceslao , Savin Ronald C , Shalita Alan R , Zaias Nardo 
Published: January 2017

In separate multicentre, randomized, double-blind clinical trials, 1% ciclopirox olamine cream was compared with its cream vehicle and with 1% clotrimazole cream as treatment for tinea corporis and tinea cruris. Patients who demonstrated clinical and mycological findings consistent with the diagnoses of tinea corporis or tinea cruris were included in the study. Clinical and mycological evaluations were made pretreatment, at the end of each of the four, weeks of treatment, and weekly for the two weeks immediately following cessation of treatment. In both studies, use of ciclopirox olamine cream resulted in demonstrable improvements after the first week of therapy and in complete clinical and mycological clearing in two thirds of the patients at the end of the treatment period. These results were maintained through the two-week drug-free observation period that followed the end of treatment. Statistically, the results with ciclopirox olamine cream were significantly better than those with the vehicle and were equivalent to those with clotrimazole cream. All treatments were well tolerated.
Economic Impacts of Supported Employment for Persons with Severe Mental Illness
Authors: Latimer Eric A 
Published: January 2017

Background: Most persons with severe mental illness prefer competitive to sheltered vocational settings. Supported employment (SE) has become a clearly defined model for helping people with severe mental illness to find and maintain competitive jobs. It involves individualized and rapid placement, ongoing support and assessment, and integration of vocational and mental health staff within a single clinical team. Previous studies show that SE secures competitive employment much more effectively than do other approaches. This review focuses on its economic impacts. Methods: Studies reporting some service use or monetary outcomes of adding SE programs were identified. These outcomes were tabulated and are discussed in narrative form. Results: Five nonrandomized and 3 randomized studies compare SE programs with day treatment or transitional employment programs. The introduction of SE services can result in anything from an increase to a decrease in vocational service costs, depending on the extent to which they substitute for previous vocational or day treatment services. Overall service costs tend to be lower, but differences are not significant. Earnings increase only slightly on average. Conclusions: Converting day treatment or other less effective vocational programs into SE programs can be cost-saving or cost-neutral from the hospital, community centre, and government points of view. Investments of new money into SE programs are unlikely to be materially offset by reductions in other health care costs, by reductions in government benefit payments, or by increased tax revenues. Such investments must be motivated by the value of increasing the community integration of persons with severe mental illness.
Schizophrénie et psychothérapies cognitivo-comportementales
Authors: Abdel-Baki Amal , Nicole Luc 
Published: January 2017

Objectif: Différencier les approches de psychothérapie cognitivo-comportementale pour la schizophrénie selon leurs buts, objectifs et techniques, puis exposer les études d'efficacité. Méthode: Synthèse de l'information recueillie au moyen de recherches électroniques (MEDLINE, PSYchlit) et bibliographiques. Résultats: Les thérapies cognitivo-comportementales ont pour objectif global une meilleure adaptation à l'expérience psychotique au point de vue cognitif, comportemental et affectif, en proposant au patient un nouveau modèle explicatif de la psychose, soit le modèle vulnérabilité-stress. Ces approches comportent différents niveaux et visent différents buts. Certaines sont axées sur la correction des déficits cognitifs de base ou sur la modification des symptômes psychotiques ou de la détresse associée. À l'autre extrémité, les approches métacognitives visent la modification et la restructuration des schèmes du soi et de l'environnement dysfonctionnels pour faciliter l'acquisition de stratégies cognitives plus adaptées et généralisables. L'efficacité de ces thérapies a été démontrée par quelques études dont la puissance et la méthodologie sont limitées. Conclusion: Les thérapies cognitivo-comportementales se révèlent un traitement adjuvant prometteur dont l'efficacité a été démontrée en ce qui concerne l'amélioration de l'ajustement social, la qualité de vie ainsi que la diminution des symptômes psychotiques et de la détresse entraînée par l'expérience de la psychose. Elles visent à la fois les symptômes positifs, négatifs, cognitifs, comportementaux, et affectifs en tenant compte de la phase de la maladie et des besoins particuliers du patient. Des recherches futures devront permettre de préciser la durée, la fréquence idéale d'administration et la spécificité de ces approches.
Risperidone Treatment of Outpatients with Schizophrenia: No Evidence of Sex Differences in Treatment Response
Authors: Labelle Alain , Light Margaret , Dunbar Fiona 
Published: January 2017

Objective: Given the renewed interest in the role of sex differences in schizophrenia, we undertook a post hoc analysis to determine whether sex differences in treatment response were present among outpatients with schizophrenia who received risperidone in an 8-week, open-label, Phase IV clinical study. Method: We evaluated 330 adult patients (232 men, 98 women) with a DSM-III-R diagnosis of schizophrenia for safety and 292 (206 men, 86 women) for efficacy. Antipsychotic and antiparkinsonian medications were discontinued at study entry. Treatment with risperidone was initiated at a dosage of 2 mg daily, increased to the target dosage of 6 mg daily by day 3, and maintained at 6 mg daily until day 14. The dosage was then maintained at 6 mg daily, increased or decreased by 2 mg daily each week, based on the patient's response. Risperidone treatment was given for 8 weeks; the permitted dosage range was 4 mg to 10 mg daily. Results: Both male and female participants responded well to risperidone treatment; by the final assessment day, they had experienced decreases from baseline in their total Positive and Negative Syndrome Scale (PANSS) scores of 41.0% and 36.5%, respectively. Most male (77%) and female (78%) participants were considered to be PANSS responders: risperidone was effective against both the positive and negative symptoms of schizophrenia. Both sexes showed improvements over baseline in the incidence and severity of parkinsonism, dystonia, and dyskinesia. No significant (P > 0.05) sex differences in treatment response were observed for any of the efficacy outcomes or in the incidence and severity of extrapyramidal symptoms (EPS). Conclusions: In this population of outpatients with chronic schizophrenia, both men and women responded well to flexible doses of risperidone. No significant sex differences were evident either in treatment response or in neurological side effects. The absence of sex differences in response to risperidone treatment may obviate the need for a sex-based differential dosing in schizophrenia management.
Pre-, Peri-, and Postnatal Trauma in Subjects with Attention-Deficit Hyperactivity Disorder
Authors: Zappitelli Michael , Pinto Teresa , Grizenko Natalie 
Published: January 2017

Objective: To review research on pre-, peri-, and postnatal stress and their potential relation to attention-deficit hyperactivity disorder (ADHD). Method: We selected and critically reviewed 51 research reports from the medical and psychology literature, between January 1, 1976 and May 1, 2001, based on the subjects of pre-, peri-, or postnatal stress and ADHD. Results: Children with ADHD show higher percentages of pre-, peri-, or postnatal insult, compared with unaffected children; however, the relative influence of various factors is still controversial. Conclusions: The etiology of ADHD encompasses genetic and environmental factors. Pre-, peri-, and postnatal stressors are environmental factors that may play a role in its etiology. Future research should carefully examine interactions between genetic predisposition and environmental factors as etiologies of ADHD.
Preventing Postpartum Depression Part II: A Critical Review of Nonbiological Interventions
Authors: Dennis Cindy-Lee E 
Published: January 2017

Objective: To critically review the literature to determine the current state of scientific knowledge concerning the prevention of postpartum depression (PPD) from a nonbiological perspective. Methods: Databases searched for this review include Medline, PubMed, Cinahl, PsycINFO, Embase, ProQuest, the Cochrane Library, and the World Health Organization Reproductive Health Library. Studies selected were peer-reviewed English-language articles published between January 1, 1966, and December 31, 2003. Criteria used to evaluate the interventions were derived from the standardized methodology developed by the Canadian Task Force on Preventive Health Care. Results: Twenty-nine studies that met criteria were examined. These included studies evaluating interpersonal psychotherapy, cognitive-behavioural therapy, psychological debriefing, antenatal classes, intrapartum support, supportive interactions, continuity of care, antenatal identification and notification, early postpartum follow-up, flexible postpartum care, educational strategies, and relaxation with guided imagery. Conclusions: While this review demonstrates that no specific approach can be strongly recommended for clinical practice, many explicit research implications have been highlighted. To further address PPD as a public health problem, it is critical to include ethnically and socioeconomically diverse women in research efforts examining the differences among depression symptoms, intervention response rates, and health service use.
Elements of Affective Instability Associated with Suicidal Behaviour in Patients with Borderline Personality Disorder
Authors: Links Paul S , Eynan Rahel , Heisel Marnin J , Nisenbaum Rosane 
Published: January 2017

Objective: To identify elements of affective instability associated with an increased likelihood of impulsivity and then to determine whether these elements characterize patients with borderline personality disorder (BPD) and suicidal behaviour. Method: We prospectively followed 82 individuals with BPD and a history of recurrent suicidal behaviour who recorded their current mood states, impulsivity, suicide ideation, and environmental stressors (triggers) 6 times daily over 3 weeks. Results: Our results suggested that mood amplitude was correlated with impulsivity and that 4 subgroups defined by mean scores on mood amplitude and negative mood intensity significantly differed in the number of suicidal behaviours reported in the last year. Conclusions: A subgroup of BPD patients appears to be at elevated risk for suicidal behaviour based on high mood amplitude and mean negative mood intensity. Clinicians might target this group for monitoring and interventions to reduce the likelihood of suicidal behaviour.
Postpartum Depression Symptoms in Newcomers
Authors: Stewart Donna E , Gagnon Anita , Saucier Jean-Francois , Wahoush Olive , Dougherty Geoffrey 
Published: January 2017

Objectives: To determine if postpartum depression (PPD) symptoms are more common in newcomer women than in Canadian-born women. Methods: Refugee, nonrefugee immigrant, asylum-seeking, and Canadian-born new mothers were administered questionnaires for depression, social support, interpersonal violence, and demographic information. We created a PPD variable based on a score of ⩾10 on the Edinburgh Postnatal Depression Scale (EPDS) and performed a logistic regression analysis for PPD. Results: Immigrants (35.1%), asylum seekers (31.1%), and refugees (25.7%) were significantly more likely than Canadian-born (8.1%) women to score ⩾10 ( P = 0.008) on the EPDS, with the regression model showing an increased risk (odds ratio) for refugee (4.80), immigrant (4.58), and asylum-seeking (3.06) women. Women with less prenatal care were also more likely to have an EPDS of ⩾10 ( P = 0.03). Newcomer women with EPDS scores of ⩾10 had lower social support scores than Canadian-born women ( P < 0.0001). Conclusions: Newcomer mothers have an increased risk for PPD symptoms. Social support interventions should be tested for their ability to prevent or alleviate this risk.
A Measure of Daily Distress in Practising Medicine
Authors: Lepnurm Rein , Lockhart Wallace S , Keegan David 
Published: January 2017

Objective: Existing measures of stress either focus on burnout or frustration and fatigue factors, often referred to as job strain. The objectives of this study were to: establish a reliable measure of distress that is sensitive enough to identify job strain at lower levels of distress and risk of burnout at higher levels of distress; and document levels of distress among the major medical specialties and across varying patterns of clinical practice. Methods: A stratified cross-sectional survey of physicians in Canada was conducted in 2004. Among the eligible population, 2810 physicians (56.7%) responded. Response bias was negligible. Responding physicians completed a 13-item measure of distress. Confirmatory factor analysis was used to establish the measure. Scheffe tests were used to document differences in the levels of distress among specializations and by clinical practice profile. Results: Factor analysis revealed reliable dimensions of: fatigue (α = 0.75) and reaction (α = 0.73). The distress measure was reliable (α = 0.82). Emergency physicians ( n = 4.51), surgeons ( n = 4.35), and general practitioners ( n = 4.33) reported the highest levels of distress, while administrative physicians ( n = 3.30), community health ( n = 3.35), and clinical specialists ( n = 3.46) reported the lowest levels of distress. Physicians with clinical and administrative responsibilities reported the highest levels of distress ( n = 4.40), compared with purely clinical physicians ( n = 3.94) and clinician-academics ( n = 3.98). Conclusions: Some specializations are associated with more distress than others. Administrative duties appear to add to distress for all physicians. Counterintuitively, adding academic as well as administrative responsibilities appears to add less distress than adding administrative duties alone. Academic duties are viewed as advancing medicine.
Initiation de la consommation d'ecstasy chez les adolescents québécois à la fin du secondaire: Prédicteurs distaux et proximaux
Authors: Gagnon Valérie , Fallu Jean-Sébastien , Brière Frédéric N , Janosz Michel 
Published: January 2017

Objectif: Identifier des prédicteurs distaux et proximaux de l'initiation de la consommation d'ecstasy à l'adolescence. Méthode: L'échantillon comprenait 2162 adolescents issus d'écoles secondaires de milieux défavorisés du Québec, suivis annuellement pendant 5 ans. L'analyse causale a été utilisée pour prédire l'initiation de la consommation d'ecstasy en secondaire 5 (16–17 ans) à partir de prédicteurs en secondaire 1 et 2 (12–14 ans) et en secondaire 4 (15–16 ans). Résultats: Les adolescents qui initiaient la consommation d'ecstasy en secondaire 5 présentaient un risque accru sur de multiples facteurs, comparativement aux non-consommateurs. L'initiation était principalement prédite par des facteurs de risque proximaux liés à la consommation individuelle ainsi qu'à la consommation et à la déviance des pairs. Néanmoins, plusieurs facteurs proximaux se développaient en continuité avec leur facteur distal correspondant (lien indirect). La consommation de marijuana était le prédicteur le plus puissant de l'initiation de la consommation d'ecstasy, le risque relatif étant, toutes choses égales par ailleurs, 2,04 fois plus élevé chez les adolescents ayant consommé de la marijuana l'année précédente (secondaire 4). Conclusions: L'initiation de la consommation d'ecstasy en secondaire 5 semble globalement liée à un profl extériorisé plutôt qu'intériorisé. Cette consommation était fortement associée à la consommation d'autres substances et partage probablement plusieurs facteurs de risque avec la consommation de ces autres substances, en particulier la consommation de marijuana.
Schizophrenia, An Illness with Bad Outcome: Myth or Reality?
Authors: Abdel-Baki Amal , Lesage Alain , Nicole Luc , Cossette Mariève , Salvat Emilie , Lalonde Pierre 
Published: January 2017

Objective: Different myths about schizophrenia endorsed by clinicians maintain the pessimism about outcome thus reducing chances of improvement. There are no recent North American studies on the long-term outcome of first-episode schizophrenia to clarify if these beliefs are myths or reality. Our study describes the long-term outcome (10 to 16 years) of a first-episode schizophrenia incidence cohort ( n = 142) in a Canadian urban centre between 1983 and 1999. Method: Clinical and social functioning at different time points were assessed retrospectively from medical files of a catchment area hospital in Montreal. Service use and deaths were noted from provincial databases of physician billings, hospitalization, and vital statistics. Results: Hospitalization days decreased considerably after the first year, with a small minority still needing it episodically after 4 years. Marital and occupational status were generally stable over time, but autonomy in living arrangements worsened. Thirty-three percent of subjects quit the Catchment Area Specialized Psychiatric Services. This group showed better social functioning while they were followed, were hospitalized less afterwards, and had fewer suicides, therefore indicating a better outcome for them. At the end of our study, 15% of the patients still alive were well enough to function without seeking medical help and 25% were not taking antipsychotic medication. Better outcome was predicted by older age at admission, being married, higher premorbid autonomy in living arrangements, and female sex. Conclusion: A significant proportion of first-episode schizophrenia patients achieve moderate long-term outcome, and the stability of global functioning is more frequent than deterioration, as shown in most industrialized countries.
Psychiatric Conditions and Behavioural Problems in Adolescents with Intellectual Disabilities: Correlates with Autism
Authors: Bradley Elspeth A , Ames Catherine S , Bolton Patrick F 
Published: January 2017

Objective: To determine whether psychiatric and behavioural disorders occur more frequently in adolescents with autism and intellectual disabilities, compared with those without autism. Method: A population-based case–control study was undertaken and 36 adolescents with autism were pairwise matched for age and IQ to 36 adolescents without autism. Caregivers were interviewed with structured psychiatric interview and questionnaire measures of psychiatric and behavioural problems. Results: Compulsive behaviours and stereotypies were significantly more common in adolescents with autism. Conclusions: Adolescents with autism are prone to compulsive behaviours and stereotypies as well as specific manifestations of anxiety, fears, and phobias.
Depression in Primary Care: Current and Future Challenges
Authors: Craven Marilyn A , Bland Roger 
Published: January 2017

Objectives: To describe the current state of knowledge about detection and treatment of major depressive disorder (MDD) by family physicians (FPs), and to identify gaps in practice and current and future challenges. Methods: We reviewed the recent literature on MDD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, or International Classification of Diseases, Revision 10) in primary care, with an emphasis on systematic reviews and meta-analyses addressing prevalence, the impact of an aging population and of chronic disease on MDD rates in primary care, detection and treatment rates by FPs, adequacy of treatment, and interventions that could improve recognition and treatment. Results: About 10% of primary care patients are likely to meet criteria for MDD. The number of cases will increase as the baby boomer cohort ages and as the prevalence of chronic disease increases. The bidirectional relation between MDD and chronic disease is now firmly established. Detection and treatment rates in primary care remain low. Treatment quality is frequently inadequate in terms of follow-up and monitoring. Formal case management and collaborative care interventions are likely to provide some benefits. Conclusions: Low detection rates and low treatment rates need to be addressed. Planned reassessment may improve detection rates when the FP is uncertain whether MDD is present, but further research is needed to determine why FPs frequently do not initiate treatment, even when MDD is detected. A caring, attentive FP who monitors depressed patients is likely to have considerable placebo effect. Greater focus on integrated, concurrent treatment for MDD and chronic physical diseases in the middle-aged and elderly is also required.