bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability, Validity, and Clinical Use of the Dominic Interactive: A DSM-Based, Self-Report Screen for School-Aged Children
Authors: Bergeron Lise , Berthiaume Claude , St-Georges Marie , Piché Geneviève , Smolla Nicole 
Published: January 2017

Objectives: As no single informant can be considered the gold standard of child psychopathology, interviewing of children regarding their own symptoms is necessary. Our study focused on the reliability, validity, and clinical use of the Dominic Interactive (DI), a multimedia self-report screen to assess symptoms for the most frequent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, mental disorders in school-aged children. Methods: A sample of 585 children aged 6 to 11 years from the community and psychiatric clinics was used to analyze the internal consistency, the test-retest estimate of reliability, and the criterion-related validity of the DI against the referral status. In addition, cross-informant correlation coefficients between this instrument (child report) and the Child Symptom Inventory (parent report) were explored in a subsample of 292 participants. Results: For the total sample, Cronbach alpha coefficients ranged from 0.63 to 0.91. Test–retest kappas varied from 0.42 to 0.62 for categories based on cut-off points, except for specific phobias. Intraclass correlation coefficients ranged from 0.70 to 0.81 for symptom scales. The DI discriminated between referred and nonreferred children in psychiatric clinics for all symptom scales. Significant cross-informant correlation coefficients were higher for the externalizing symptoms (0.35 to 0.48) than the internalizing symptoms (0.14 to 0.27). Conclusions: Findings of our study reasonably support adequate psychometric properties of the DI. This instrument offers a developmentally sensitive screening method to obtain unique information from young children about their mental health problems in front-line services, psychiatric clinics, and research settings.
Attention Deficits and Divorce
Authors: Bouchard Geneviève , Saint-Aubin Jean 
Published: January 2017

Objective: Building on previous work on the role of attention deficits associated with the regulation of executive control in psychiatric disorders, we examine whether these attention deficits are related to an interpersonal disturbance, the experience of divorce. Method: Attentional capacities of 95 randomly selected couples from the general population were measured with a well-established task, the Attentional Network Task, which assesses the efficiency of 3 attention networks (that is, alerting, orienting, and executive control). Among the 190 participants, 32 had experienced a divorce in the past. ANCOVAs were used to compare divorced people in marital or cohabiting unions with people in first unions in their performance on this purely cognitive task. Results: Our findings indicate that divorced people who are currently living in a cohabiting relationship show significantly lower executive control than other adults living as couples, after controlling for sex, age, income, and education. This subgroup of divorced people not only exhibit greater difficulty in responding to some stimuli while ignoring irrelevant ones but also manifest cognitive deficits in conflict resolution. Conclusions: This study highlights the links between attention and the long-term maintenance of intimate relationships. Our results may have important implications for the identification of people at risk for divorce.
Depression and Employment Status in Primary and Tertiary Care Settings
Authors: Rizvi Sakina J , Cyriac Anna , Grima Etienne , Tan Mary , Lin Peter , Gallaugher Laura Ashley , McIntyre Roger S , Kennedy Sidney H 
Published: January 2017

Objective: Major depressive disorder (MDD) is a leading cause of disability. Impairment in work function considerably adds to symptom burden and increases the economic impact of this disorder. Our study aimed to investigate the factors associated with work status in MDD within primary and tertiary care. Method: We used data from 2 large databases for our analysis—Study 1: the InSight database, a chart review of MDD patients treated by primary care physicians across Canada ( n = 986); and Study 2: the International Mood Disorders Collaborative Project, a cross-sectional study of mood disorder patients (Canadian data only: n = 274). Results: Both studies demonstrated high rates of unemployment and disability (30.3% to 42.1%). Quebec showed the highest rate of unemployment (21%) and British Columbia had the greatest percentage of patients on disability (15%). Employed and unemployed groups were similar based on clinical characteristics; however, unemployed people may have higher age, prevalence of medical comorbidity, and greater likelihood of receiving a benzodiazepine. Increased disability rates were associated with history of childhood abuse, duration of current major depressive episode, comorbidity, benzodiazepine use, as well as greater depression and anxiety severity. The unemployed–disability groups had greater somatic symptoms and anhedonia. In keeping with this, anhedonia was the strongest predictor of disability. Absenteeism was also high across both studies. Conclusions: Unemployment and disability rates in MDD are high. The presence of anhedonia and medical comorbidity significantly influenced work status, emphasizing the need for treatment strategies to alleviate the additional symptom burden in this subpopulation.
Is Cognitive Psychopathology Plausible? Illustrations from Memory Research
Authors: Danion Jean-Marie , Weingartner Herbert , Singer Leonard 
Published: January 2017

Objective: To examine the strengths and weaknesses of cognitive psychopathology through the specific examples of the memory impairments associated with the administration of benzodiazepines, with schizophrenia, and with depression. Method: These examples are analyzed with reference to a model of memory based on the principle of division between specialized and central processing structures. A basic contention is that it is useful to consider 2 broad classes of processes—automatic, associative, or sensory/perceptual processes on the one hand and intentional, strategic, or reflective processes on the other hand—as being separate. Results: The functional mechanisms of the memory impairments associated with these conditions are beginning to be identified, and there is preliminary evidence that a deficit in an elementary computation may have dramatic consequences on highest cognitive functions. There is also evidence that certain memory impairments are linked to specific dysfunctional outcomes in everyday life. By showing that specific rate-limiting factors of cognitive performance can be identified and are amenable to cognitive interventions, existing data open the door for theoretically and empirically based cognitive remediation of mental disorders. Conclusion: The bulk of available evidence (albeit limited) makes the enterprise of cognitive psychopathology quite plausible and convincing.
Case—Control Studies of Cardiovascular Medications as Risk Factors for Clinically Diagnosed Depressive Disorders in a Hospitalized Population
Authors: Patten Scott B , Williams Jeanne VA , Love Edgar J 
Published: January 2017

Objective: Certain medications used in cardiovascular therapeutics may contribute to the etiology of substance-induced mood disorders. These medications include digoxin, angiotensin converting enzyme (ACE) inhibitors, β- blockers, and calcium channel blockers. The objective of this study was to evaluate associations between these drugs and clinical diagnoses of depressive disorders in a population of hospitalized patients. Method: Two case–control studies were conducted. For each study, subjects were selected from a health records data base maintained at the Calgary General Hospital. Selection of subjects in the first study was restricted to those receiving a discharge diagnosis of congestive heart failure and in the second study to subjects receiving a discharge diagnosis of hypertension. In each of these 2 studies, a single case group was selected along with 2 control groups: a psychiatric control group consisting of subjects receiving a psychiatric diagnosis other than a depressive disorder and a nonpsychiatric control group receiving no psychiatric diagnoses. Drug exposures and other variables were recorded from a chart review. Results: Exposures to digoxin, β- blockers, and calcium channel blockers were not associated with depressive diagnoses. An association was observed, however, for ACE inhibitors. An elevated odds ratio (OR) was observed in each case-control study and was stronger infernale subjects and subjects over the age of 65. Conclusions: This is the first reported epidemiological evidence of an association between ACE inhibitors and depressive disorders. The design of this study does not permit a determination of whether the observed association was causal. Additional studies are needed.
Tailored Educational Approaches for Consumer Health: A Model to Address Health Promotion in an Era of Personalized Medicine
Authors: Cohn Wendy F. , Lyman Jason , Broshek Donna K. , Guterbock Thomas M. , Hartman David , Kinzie Mable , Mick David , Pannone Aaron , Sturz Vanessa , Schubart Jane , Garson Arthur T. 
Published: January 2017

Purpose: To develop a model, based on market segmentation, to improve the quality and efficiency of health promotion materials and programs. Design: Market segmentation to create segments (groups) based on a cross-sectional questionnaire measuring individual characteristics and preferences for health information. Educational and delivery recommendations developed for each group. Setting: General population of adults in Virginia. Participants: Random sample of 1201 Virginia residents. Respondents are representative of the general population with the exception of older age. Measures: Multiple factors known to impact health promotion including health status, health system utilization, health literacy, Internet use, learning styles, and preferences. Analysis: Cluster analysis and discriminate analysis to create and validate segments. Common sized means to compare factors across segments. Results: Developed educational and delivery recommendations matched to the 8 distinct segments. For example, the “health challenged and hard to reach” are older, lower literacy, and not likely to seek out health information. Their educational and delivery recommendations include a sixth-grade reading level, delivery through a provider, and using a “push” strategy. Conclusion: This model addresses a need to improve the efficiency and quality of health promotion efforts in an era of personalized medicine. It demonstrates that there are distinct groups with clearly defined educational and delivery recommendations. Health promotion professionals can consider Tailored Educational Approaches for Consumer Health to develop and deliver tailored materials to encourage behavior change.
Physical Activity Interventions in Faith-Based Organizations: A Systematic Review
Authors: Tristão Parra Maíra , Porfírio Gustavo J. M. , Arredondo Elva M. , Atallah Álvaro N. 
Published: January 2017

Objective: To review and assess the effectiveness of physical activity interventions delivered in faith-based organizations. Data Source: We searched the Cochrane Library, DoPHER, EMBASE, LILACS, MEDLINE, PsycINFO, WHO ICTRP, and Clinicaltrials.gov databases until January 2016, without restriction of language or publication date. Study Inclusion and Exclusion Criteria: Randomized and nonrandomized controlled trials investigating physical activity interventions for adults delivered in faith-based organizations. Data Extraction: Two independent reviewers extracted data and assessed study methodological quality. Data Synthesis: We used relative risk and mean difference with 95% confidence interval to estimate the effect of the interventions on measures of physical activity, physical fitness, and health. Results: The review included 18 studies. Study participants were predominantly female, and the majority of trials were conducted in the United States. Study heterogeneity did not allow us to conduct meta-analyses. Although interventions delivered in faith-based organizations increased physical activity and positively influenced measures of health and fitness in participants, the quality of the evidence was very low. Conclusion: Faith-based organizations are promising settings to promote physical activity, consequently addressing health disparities. However, high-quality randomized clinical trials are needed to adequately assess the effectiveness of interventions delivered in faith-based organizations.
Breastfeeding in Women Having Experienced Childhood Sexual Abuse
Authors: Elfgen Constanze , Hagenbuch Niels , Görres Gisela , Block Emina , Leeners Brigitte 
Published: January 2017

Background: Childhood sexual abuse (CSA) can have a serious effect on general and obstetric health. Breastfeeding includes several triggers for memories of abuse experiences, which will likely influence decisions about breastfeeding and its implementation in daily life. This is important since breastfeeding improves maternal well-being and bonding with the child. Research aim: As breastfeeding strongly influences the long-term health of children, we investigated experiences with breastfeeding in women with a history of CSA. Methods: Data on breastfeeding were collected within a research project designed to compare labor and delivery experiences in women with a history of CSA to women without such antecedents. Data from 85 women having experienced CSA and 170 controls pair-matched for maternal age, children’s age, and nationality were evaluated. The clinical record of pregnancy and a self-administered questionnaire were used to collect data. Results: Although the prevalence of breastfeeding was similar in women with and without CSA experiences (96.5% vs. 90.6%), women exposed to CSA more often described complications associated with breastfeeding (77.7% vs. 67.1%, p = .08). Mastitis (49.4% vs. 27.6%, p < .01) and pain (29.4% vs. 18.8%, p = .15) were reported significantly more often by women after CSA. For 20% of women after CSA, breastfeeding was a trigger for memories of CSA. Furthermore, 58% of women with CSA reported dissociation when breastfeeding. Conclusion: In addition to the growing list of potential health consequences of CSA experience, this experience seems to be associated with an increased number of problems when breastfeeding. However, most women with a history of CSA intend to breastfeed despite particular challenges related to CSA. A support protocol tailored to the specific needs of these women during pregnancy and the lactation period may help to improve breastfeeding and the early mother–child relationship.
Editorial
Authors: Peck Edward 
Published: January 2017

By April 1994 only 4% of NHS units remained under the direct management of district health authorities. All the remaining 419 are NHS trusts. It is therefore timely to reflect on the experience of NHS trusts and the papers in this collection are intended to stimulate that reflection. This short introduction to those papers will serve two purposes: Firstly to refresh memories about the government aspirations for NHS trusts at the outset; and secondly to provide a guide to the content of the seven papers. In January 1989 the government issued the White Paper Working for Patients (DoH, 1989a) which stated its intention to create self-governing hospitals within the NHS. A subsequent working paper gave further details on this proposal which the Department of Health presented as the ‘next logical step in the process of extending local responsibility’ (DoH, 1989b). ‘The working paper indicated that self-governing hospitals would be established under statute as ‘separate legal entities’ with specified ‘extensive powers and freedoms’. The initiation of a trust application was ‘open to a variety of interest – including the health authority, the hospital management team, a group of staff or people from the local community’.
A Provider Perspective
Authors: Fry Mike 
Published: January 2017

In my two-year experience as a chief executive I have found a widespread tendency to greatly over-simplify trust status. This has led to casual observers adopting a stance regarding NHS trust, often based on the most flimsy acquaintance with any facts concerning them. For me, the reality of ‘self-government’ has been a complex blend of liberation, frustration, enervation and a heightened sense of both organisational potential and personal achievement. I have no doubts that trust status has very positively aided the development of Christie Hospital; however I can be equally confident that few first wave chief executives could be as unequivocally positive as myself. Much of this relates to our former position as one of four units within a very large, financially challenged teaching authority. The Christie is a specialist cancer centre with substantial research and specialist facilities which are almost entirely non-exchequer funded. As such it was always a cuckoo in the health authority nest. Attempts at becoming the first non-London special health authority had failed and consequently the prospect of self-governing status was immediately attractive to a number of key opinion formers on the site. This is not to down play both the internal and external opposition to the Christie Trust Application, but rather to indicate at the outset that the organisation had an instinctively more positive reaction to the allure of trust status than was the case in many other places.
GPs, STDs and Life Insurance
Authors: Keane F E A , Young S M 
Published: January 2017

We sought to ascertain general practitioners' (GPs) views on their patients' attendances at genitourinary medicine (GUM) departments regarding methods of referral, record keeping and supplying of information to insurance companies. A questionnaire was sent to 429 local GPs of whom 294 (68%) responded. A written means of referral was less likely for HIV than for sexually transmitted disease (STD) ( P<0.001), and in turn less likely for STD than for other genital problems ( P<0.02). The percentage of GPs who did not keep a record of referrals were: For HIV testing—29%; STDs—13%; and for other genital problems—8%. Whilst 48% of GPs did not feel obliged to divulge lifestyle information on a patient, 21% would feel it necessary to confirm that a patient had suffered from an STD if the ‘source’ on a cytology smear was shown to be that of a GUM department. Only 23 GPs (8%) felt they had sufficient knowledge as to the use to which the information they supplied to insurance companies was put. Many GPs acknowledged that their practice, with reference to patient attendance at a GUM department, was influenced by life insurance considerations. Bearing in mind the current policy of The Association of British Insurers which recommends that all applicants for life insurance be asked to declare any previous STD and counselling/testing for HIV, we make several suggestions which may aid GPs in this difficult area.
Seroprevalence and Incidence of Sexually Transmitted Diseases in a Rural Ugandan Population
Authors: Wagner H U , Van Dyck E , Roggen E , Nunn A J , Kamali A , Schmid D Scott , Dobbins J G , Mulder D W 
Published: January 2017

The aim of the study was to determine in a rural population the age-and sex-specific prevalence and incidence rates of serological reactivity of 5 common sexually transmitted diseases (STDs) and their association with HIV-1 antibody status. Of the adult population of two villages (529 adults aged 15 years or more) 294 provided an adequate blood specimen both on enrolment and at 12 months. The sera were tested at 3 collaborating laboratories for antibodies against HIV-1, Treponema pallidum, Haemophilus ducreyi, Chlamydia trachomatis and herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). A sample of 45 children were tested for HSV-1 and HSV-2. Seroprevalence rates in adults on enrolment were 7.8% for HIV-1, 10.8% for active syphilis, 10.4% for H. ducreyi, 66.0% for C. trachomatis, 91.2% for HSV-1 and 67.9% for HSV-2. Males were significantly more likely than females to be seropositive for H. ducreyi (15.6% versus 6.6%), but less likely to be HSV-2 antibody positive (57.0% versus 74.4%). Reactivity to H. ducreyi, C. trachomatis and HSV-2 rose with increasing age. In contrast, active syphilis showed no age trend. All STDs tended to be more common in those HIV-1 seropositive. Incidence rates over the 12 months were nil for HIV-1, 0.5% for syphilis, 1.2% for H. ducreyi, 11.3% for C. trachomatis, and 16.7% for HSV-2. The results of this exploratory study indicate that all STDs included are common in this rural population. The high HSV-2 prevalence rate among adolescents suggests that HSV-2 may be an important risk factor for HIV-1 infection. HSV-2 serology may be a useful tool to monitor sexual behaviour interventions in young people.
Comparative Methylprednisolone Pharmacokinetics in Renal Transplant Patients Receiving Double- or Triple-Drug Immunosuppression
Authors: Tornatore Kathleen M. , Walshe J. Joseph , Reed Kris A. , Holdsworth Mark T. , Venuto Rocco C. 
Published: January 2017

OBJECTIVE: To assess the pharmacokinetics of chronic methylprednisolone therapy in renal transplant patients receiving double-drug (methylprednisolone and azathioprine) and triple-drug (methylprednisolone, azathioprine, and cyclosporine) immunosuppression. DESIGN: Parallel, randomized trial. PATIENTS: Fourteen renal transplant recipients (aged 29–65 y) evaluated in a public, university-affiliated hospital clinic. INTERVENTIONS: All patients received their chronic oral dose of methylprednisolone via a 10–20-minute intravenous infusion. MAIN OUTCOME MEASURES: Serum methylprednisolone concentrations were determined by HPLC and were used to generate pharmacokinetic parameters for this drug. RESULTS: The mean daily methylprednisolone dosage was 19 ± 19 mg in the double-drug group and 9 ± 2 mg in the triple-drug group. Mean serum creatinine concentrations were 124 ± 44 and 124 ± 27 μmol/L, respectively. Mean methylprednisolone clearances were similar in both groups: 405 ± 205 (double-drug) and 373 ± 365 mL/h/kg (triple-drug) (p>0.05). Mean steady-state volume of distribution was 1.5 ± 0.8 L/kg in the double-drug group and 1.3 ± 0.8 L/kg in the triple-drug group (p>0.05). Plasma half-life ranged from 1.7 to 4.3 h (mean 2.7) in the double-drug group versus 1.4 to 3.4 h (mean 2.6) in the triple-drug group (p>0.05). CONCLUSIONS: These data indicate that cyclosporine had no definitive influence on methylprednisolone disposition. The results reveal a wide variation in methylprednisolone metabolism in renal transplant recipients receiving either a double- or triple-drug immunosuppressive regimen. Typically, methylprednisolone is prescribed according to a standardized dosing protocol that assumes minimal interpatient variation. Therefore, the pharmacokinetic variability noted in this study may have important clinical implications regarding the development of chronic toxicity (e.g., osteoporosis, hypothalamic-pituitary-adrenal suppression) and the attainment of successful immunosuppression.