bluuebunny/crossref_metadata_2025_split huggingface dataset:
The contribution of voltage‐gated Ca2+ currents to K+ channel activation during ovine adrenal chromaffin cell development
Authors: Keating Damien J. , Rychkov Grigori Y. , Roberts Michael L. 
Published: March 2009

AbstractPrior to the development of adrenal innervation, the adrenal medulla is capable of responding to low blood oxygen directly. However, this response is lost once adrenal innervation is established. Previous work by our group has outlined mechanisms involved in this direct hypoxic response and the means by which innervation causes the loss of the direct hypoxic response in the ovine adrenal. The current study further investigates mechanisms which may underlie the developmental loss of the direct hypoxic response by concentrating on two aspects of cell function which regulate catecholamine secretion: the contribution of different types of Ca2+ channels to the total Ca2+ current and the contribution of each Ca2+ channel type to K+ channel activation. We identified that Ca2+ current size at −40 to −10 mV is increased in amplitude in fetal chromaffin cells. This is not due to the increased prevalence or size of T‐type Ca2+ currents present at these voltages. The relative contribution of L‐, N‐ or P/Q‐type Ca2+ channels to total Ca2+ current and to activation of the K+ current is unchanged during chromaffin cell development, however K+ current density increases with age. Our results indicate that there is a developmental shift in relative expression of T‐type, but not L‐, N‐ or P/Q‐type, Ca2+ channels in ovine chromaffin cells. The increased K+ current density in adult cells may result in an altered response to an equal stimulus, while larger Ca2+ current at negative voltages in fetal cells may facilitate Ca2+ entry and catecholamine secretion in response to small depolarisations such as those induced by hypoxia.
Automation and Expert Systems in a Core Clinical Chemistry Laboratory
Authors: Streitberg George S. , Bwititi Phillip T. , Angel Lyndall , Sikaris Kenneth A. 
Published: March 2009

Clinical pathology has a major influence on clinical decisions and the past 60 years have seen an evolution brought about by advances in information technology and automation. The impact of the ever-changing technology in regard to responsibilities and training therefore needs continual appraisal. In this article, the authors have drawn on their experience on automation in clinical chemistry and the experience at Monash Medical Centre in Melbourne, Australia where one of the authors is based. Automation in other industries has also been reviewed, since the reasons to automate and the impact of automation have similarities and these include reduction in errors, increase in productivity, and improvement in safety. Advances in technology in clinical chemistry that have included total laboratory automation call for changes in job responsibilities to include skills in information technology, data management, instrumentation, patient preparation for diagnostic analysis, interpretation of pathology results, dissemination of knowledge and information to patients and other health staff, as well as skills in research. Research in clinical chemistry should not only emphasize evaluation of performance of automation but also should include pre- and postanalytical phases and training also needs to reflect this.
Involuntary Treatment of Adolescents in Psychiatric and Social Care
Authors: Kaltiala-Heino R. 
Published: March 2009

Background:Little is known about use of coercion on minors in psychiatric care. Questions of coercion, self-determination and competence are more complicated in minors than in adults. Choice between psychiatric and child welfare care is not always clear.Objective:To present findings in Finnish studies on involuntary treatment of adolescents.Methods:Register data, medical file data and interviews with the young people, their parents, and professionals participating in decision-making are used in an ongoing series of studies.Results:Involuntary psychiatric treatment and taking into care of adolescents has vastly increased since mid 1990's. Their use varies greattly within the same legislation. Involuntary care is more common in socially deprived ares. Involuntary treatment takes place justified by paternalistic motivations. Girls are more easily committed due to disruptive behaviours than boys.Conclusion:Involuntary care of minors is a sizeable and ignored ethical problem.
Subjectivity and Intersubjectivity in Psychiatric Diagnosis
Authors: Fuchs T. 
Published: March 2009

The establishment of criteriological and manualized systems of diagnosis since the 1980ies has lead to a valuable increase in the precision and reliability of psychiatric diagnosis. On the other hand, the limits of this approach for clinicians and researchers are increasingly becoming apparent. In particular, the assessment of subjective experience is nearly excluded on the theoretical level and downplayed on the pragmatic level, with serious consequences for the validity of psychiatric diagnosis, for empirical research and, above all, for therapeutic purposes.In my paper, I will argue that a thorough assessment and inclusion of subjective experience in our diagnostic systems will be indispensable for clinical, therapeutic as well as research purposes. To this purpose, I will distinguish three major approaches to the assessment of mental illness: 1.The positivistic, objectifying or 3rd person approach as endorsed by DSM IV and ICD 10, focusing mainly on observable behavioural symptoms.2.The phenomenological, subject-oriented or 1st person approach, focusing on the patient's self-experience and exploring its basic, often implicit structures.3.The hermeneutic, intersubjective or 2nd person approach, mainly aiming at the co-construction of shared narratives or interpretations regarding the patient's self-concept, conflicts and relationships, as e.g. in psychodynamic approaches.These three approaches will be compared regarding their respective values for psychopathological description, diagnosis, research and therapeutic purposes.
Efficacy and Safety of N-3 Phosphatidylserine in Children with Attention Deficit and Hyperactivity Disorder (ADHD)
Authors: Manor I. , Rozen S. , Manor Y. , Pelled D. , Weizman A. 
Published: March 2009

Attention-deficit/hyperactivity disorder (ADHD) encompasses a broad constellation of behavioral and learning problems. These patients are also characterized by low blood long-chain polyunsaturated fatty acid concentrations; however their supplementation effect on ADHD symptoms is not clear. It was recently (1) shown in children with inattention that consumption of n-3 phosphatidylserine (PS) for 3-mo favorably affected their visual sustained attention performance. We aimed to evaluate in children with ADHD the effect of n-3 PS on ADHD symptoms and wellbeing.Methods:In this 15-week, randomized, double-blind, placebo-controlled, parallel study the impact and tolerability of 150 mg b.i.d. n-3 PS were investigated in 200 children (6-13-y) with ADHD. Efficacy was assessed by teachers’ Conners Rating Scale (CRS) and strength and difficulties questionnaires (SDQ) - school version and clinicians who filled Clinical Global Impression of Improvement. Additional measures included parental rating of behavior (CRS and SDQ - home version) and wellbeing (Child Health questionnaire - Parental Form 50), and continuous performance test (Test of Variables of Attention). Safety evaluation included adverse event reports, vital signs, and parents’ Barkley’ side effects rating scale.Results:The interim results of the first group of children that were randomly assigned in a 2:1 ratio to n-3 PS or placebo will be presented.Conclusions:n-3 PS impact on ADHD symptoms at school and home as evaluated by teachers, clinicians, and parents will be discussed.Acknowledgement:This work was sponsored by Enzymotec LTD.
Adult ADHD: An Under-Diagnosed Condition
Authors: Filipe C.N. 
Published: March 2009

ADHD is a neurodevelopmental disorder that impairs executive functions, leads to maladaptive behavior and, in about 50%, has a livelong persistence. Nevertheless, adult ADHD is a very much under-diagnosed condition.We conducted a study aimed to identify ADHD in a special population of adults. Questionnaires were applied to the parents of children attending CADIn, a Clinical Centre for Developmental Disorders for evaluation or intervention (48% of their children were diagnosed as having ADHD and 22% were diagnosed as having Pervasive Developmental Disorder). We expected a higher incidence of ADHD in this population as well as a better awareness for the condition.We used the Adult ADHD Self-report Scale (ASRS-v1.1) and the questionnaires contained questions concerning degree of impairment, persistence of symptoms and comorbid psychiatric conditions. 114 parents were inquired, 29% fathers, 68% mothers 3% missed gender. 17% of the parents quoted above the cut-off-point for the ASRS-v1.1 screener and amongst those, 45% referred the ADHD symptoms as causing them severe impairment. Only 3 subjects had been previously diagnosed as ADHD. The prevalence of ADHD symptoms was similar for males and females. 56% of the ADHD population was diagnosed formerly as suffering from psychiatric disorder, compared to 35% of the total population. The more common diagnoses were depression (45%) and anxiety (30%).We conclude that ADHD is much under-diagnosed in the adult population. Considering its high heritability, a closer evaluation of the parents of children diagnosed with ADHD is suggested.
Treatment of Cocaine Dependence: No Standard, but Promising Innovations
Authors: Haasen C. , Reimer J. , Schäfer I. 
Published: March 2009

Treatment of cocaine dependence focuses on achieving abstinence and reducing problems associated to cocaine use. Despite extensive research and clinical experience, no “gold standard” has emerged from the different treatment options that have been researched. In general, research has shown that the evidence level for the efficacy of psychosocial interventions is higher than for pharmacologic interventions. With respect to psychosocial interventions, the evidence shows that all those interventions studied show efficacy to some extent, without greater differences in efficacy.With respect to the pharmacologic options, none of the tested drugs have shown sufficient evidence to clearly be indicated in the treatment of cocaine dependence. Several substances have so far only been tested in smaller descriptive studies or pilot trials and will have to be studied in larger controlled trials. The substance presently with the highest level of evidence is disulfiram, and its effect has been shown to be independent of concomitant alcohol use. Of the substances that find themselves in the pilot stage and need to be confirmed by larger trials, the antidepressant reboxetine and the antiepileptic topiramate can be considered as two very promising ones. Of great interest has been the development of a cocaine vaccine. This vaccine leads to the production of cocaine antibodies, which in turn make cocaine metabolites inactive. A randomised controlled study showed the vaccine to produce cocaine antibodies in humans. A recent open-label study resulted in a significantly higher likelihood for cocaine free urines among vaccinated subjects, so that results are encouraging.
Functional Sspects of the Endocannabinoid System in Schizophrenia
Authors: Leweke F.M. , Giuffrida A. , Pahlisch F. , Kranaster L. , Hoyer C. , Jöpen C. , Hellmich M. , Klosterkötter J. , Piomelli D. , Koethe D. 
Published: March 2009

Introduction:The endocannabinoid system represents the target for the hallucinogenic Δ9-Tetrahydrocannabinol. It consists of naturally occurring endocannabinoid lipids (eCBs) - of which anandamide is the first characterized example - and their attending CB1 cannabinoid receptors. Activation of CB1 receptors produces intense emotional and cognitive responses, suggesting that dysfunction in the eCB system may contribute to the pathogenesis of mental disorders.Methods:We examined levels of anandamide in cerebrospinal fluid (CSF) and serum of healthy volunteers (n=84) and various groups of patients suffering from acute psychiatric disorders (n=180).Results:Compared to controls, the levels of anandamide in CSF were significantly elevated in acute, antipsychotic-naïve, first-episode schizophrenic patients (n=47) and negatively correlated with psychotic symptoms. This was reversed by the administration of antipsychotics, which antagonize dopamine D2-like receptors (n=37), but not by those, which preferentially antagonize 5HT2A receptors (n=34). In addition, a significant elevation of anandamide was already apparent in a sample of persons clinically at high risk for developing psychosis (prodromal states, n=27). Furthermore, the levels of anandamide in CSF were found significantly lower in antipsychotic-naïve schizophrenic patients reporting more than 20 times of cannabis use in life when compared to those with no more than 5 times.Conclusion:Our results suggest that anandamide release in the central nervous system (CNS) may serve as an adaptive mechanism countering neurotransmitter abnormalities in acute schizophrenia. They indicate that frequent cannabis exposure may down-regulate CNS anandamide signaling in schizophrenia and thereby further impact the course of the disease.
Endophenotypical and Genetic Differentiation of Eating Disorder not Otherwise Specified
Authors: Schmidt U. 
Published: March 2009

Aims:The concept of endophenotypes has attracted considerable interest in psychiatry. It is thought that endophenotypes might be more closely related to the underlying biological processes and the genetic basis that give rise to a particular disorder than the relatively crude diagnostic categories defined in our conventional classificatory systems. In order to qualify as an endophenotype a characteristic has to be measurable and heritable, cosegregates with the illness, is state independent, is observed in unaffected family members and is a biologically plausible causal mechanism. In the field of eating disorders the study of endophenotypes is still in its infancy. The aims of this paper are to:a.give an introduction to the concept of endophenotypes and its criticism,b.review what is known about endophenotypes in eating disorders, andc.present recent data from our own recent work on putative social cognitive endophenotypes.Methods and results:Based on a review of the literature and our own research findings a handful of different temperamental and personality traits, neurocognitive and social characteristics can be identified that fulfill all the criteria to qualify as an endophenotypes. Other candidate endophenotypes need further study to ascertain whether they qualify.Conclusions:The implications of this research for the classification of eating disorders are potentially far reaching.
Current Therapeutic Approach in EDNOS
Authors: Fernandez-Aranda F. , Krug I. , Riesco N. , Sanchez-Diaz I.M. 
Published: March 2009

Background and aims:Despite the high prevalence of EDNOS only a small proportion of individuals with this disorder seek treatment, which may be due in part to difficulties in finding specialized treatment settings for EDNOS and the high costs and logistics associated with face-to-face individual psychotherapy. This omission is critical since there is evidence that the severity of psychopathology and degree of secondary psychosocial impairment in those with EDNOS are comparable to those seen in patients with anorexia nervosa (AN) or bulimia nervosa (BN). There has been hardly any research on the treatment of atypical EDs other than the promising effort on BED, for which Cognitive Behavior Therapy (CBT) is proposed to be the most effective treatment. The aim of this presentation is to show several pilot studies and our experience of treating EDNOS cases, but also to analyze variables associated to good-outcome.Method:We performed several clinical studies with EDNOS patients at the University Hospital of Bellvitge to assess the effectiveness and efficiency of specific outpatient CBT programs of short and long term duration.Results and conlusions:The few case-control studies where the effect of diagnosis on the prognosis has been analyzed have shown differential course and outcome in EDs. EDNOS (with exception of BED) showed the poorest long-term prognosis, due to their heterogeneity and, in many cases, to their lower motivation to change. Specific therapy programs, based on our experience, will be discussed.
Defining Replication in Gene × Environnment Interaction Research: The Risk of Spurious Associations
Authors: Munafo M. 
Published: March 2009

There has been considerable interest in recent years in the investigation of the role of gene x environment (G x E) interactions in aetiology of psychiatric disorders. While the fact that genetic effects may moderate the effects of environmental exposure is widely accepted, and supported by family and twin studies, there is controversy regarding the degree of evidence for specific G x E interactions reported in the literature. Here it is argued that examples of environmental interactions with genes identified at the molecular level are not as well established as widely believed.A number of relevant factors influencing the weight of evidence for specific G x E interactions will be discussed, including the degree of stringency employed in the definition of “replication”, the impact of different statistical models used to test for interactions, and the statistical power of individual studies. It is concluded that in only a minority of studies is a replication reported that is qualitatively comparable to that in the original report. Given reasonable assumptions regarding likely genetic and environmental effects, simulations indicate that published studies are most likely underpowered, suggesting that positive results for widely reported G x E interactions may be compatible with chance findings.
Schizophrenia and Motherhood
Authors: Riecher-Rössler A. 
Published: March 2009

Increasingly women with schizophrenia are becoming mothers. This can cause different problems for them, their partners, their relatives and other caregivers.Traditionally women with schizophrenia suffered from infertility - partly due to the illness itself and its psychosocial impacts such as social isolation and lack of partnership, partly due to treatment with hyperprolactinaemia-/infertility-inducing neuroleptics. Recently this has changed dramatically, due to better community-based psychosocial treatments and also due to prolactin-sparing neuroleptics. Many women with schizophrenia now become pregnant - planned or unplanned. This, as well as motherhood, can be a considerable strain to the women concerned and her caregivers.Counselling a women with schizophrenia therefore always has to include her fertility situation, her desire to become a mother or not, contraception or planning pregnancy and motherhood (considering the course of her illness, her medication, her psychosocial situation, partnership, social support etc.). Counselling in case of unwanted pregnancy is of utmost importance as well as addressing issues such as medication, prenatal care, etc. during pregnancy. Cooperation with the obstetrician, midwife, paediatrician and childcare agencies is necessary. After delivery, parenting assessment in mother-baby-units can be very helpful to evaluate the need for additional care. Long-time programmes for training parenting skills and “parenting rehabilitation” are urgently needed and should also support the relatives and others who care for the woman and her child.
Fathers and Mothers of Patients with Schizophrenia
Authors: Wancata J. , Freidl M. , Krautgartner M. , Friedrich F. , Matschnig T. , Unger A. , Strobl R. , Cerny G. 
Published: March 2009

Aims:To investigate caregiving and its consequences among fathers and mothers of the same patients suffering from schizophrenia.Methods:101 patients as well as both parents were investigated using the “Carers' Needs Assessment for Schizophrenia”, the “Beck Depression Inventory”, the “Involvement Evaluation Questionnaire” and the “Family Problem Questionnaire”.Results:The mean number of days fathers lived together with the patients was not significant from that of the mothers, but the average duration (hours per week) of contact with the patient was significantly higher for mothers than for fathers. Among 40% of the sample, fathers and mothers spend an equal amount of time caring for the patient. Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed some interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Mothers reported overall higher numbers of problems and needs for intervention than fathers. The overall score of caregivers' involvement did not differ significantly between fathers and mothers. The mothers' objective burden was significantly higher than the fathers' objective burden, but parents did not show differences concerning subjective burden. Using the “Beck Depression Inventory”, mothers were more often depressed than fathers.Conclusions:This study shows that often fathers and mothers spend an equal amount of time caring for the patient. The differences found between mothers and fathers should be considered when planning services for family caregivers.
Beyond Family Burden - the Complexities of Carer Roles
Authors: Steffen S. 
Published: March 2009

In her talk, Sigrid Steffen will speak about the core aims of EUFAMI in respect to family members and carers. Sigrid will base a lot of her talk around her own personal experience as a carer of a son who was diagnosed with schizophrenia, and she will augment this with experiences of other members of EUFAMI from across Europe. She will elaborate on the stresses and strains under which family members (the carers) come under and will discuss the challenges which carers face on a daily basis.Her talk will also include a description of a typical ‘journey’ which carers and families travel in the execution of their caring role in an attempt to describe the various feelings and pressures they experience. Sigrid will also discuss what she understands to be the critical needs of carers and the level of support required. In particular Sigrid will concentrate on the stigma which families feel and experience during their lifetime, a aspect which is little understood and appreciated by the wider public. In conclusion, Sigrid will detail some of the work which EUFAMI has been and is involved with and which is related to the subject of her talk.