bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytochrome P450 Monooxygenases and Interactions of Psychotropic Drugs: A Five-Year Update
Authors: Shen Winston W. 
Published: May 2005

Objective: This article is a five-year update on a previous review article ( International Journal of Psychiatry in Medicine, 21:47–56, 1991) on cytochrome P450 monooxygenases and interactions of psychotropic drugs. Method: In the literature review, the recent committee work on nomenclature of the P450 superfamily are highlighted. Then, the author reviewed gene clusters of three human cytochrome P450s— CYP1A2, CYP2D6, and CYP3A4 with the focus on the changes of serum levels of the coadministered psychotropic drugs in the context of enzymatic induction and inhibition of these three hepatic enzymes. Results: As indicated in one table, the author stratified probes, inducers, inhibitors, chemical reactions, and substrates under these three gene clusters. As shown in another simple table, the author compared the hepatic enzymatic inhibitions of four selective serotonin reuptake inhibitors and pointed out the inhibition potentials of fluvoxamine at CYP1A2, fluoxetine and paroxetine at CYP2D6, and fluoxetine and fluvoxamine at CYP3A4 if these two SSRIs have higher serum concentrations. Conclusion: The author suggests that with these systematic approaches, this rapidly adding knowledge can help psychiatrists better understand psychotropic drug interactions and maximize the benefits of patients' psychopharmacotherapy.
Hopelessness Ratings in Relapsing-Remitting and Secondary Progressive Multiple Sclerosis
Authors: Patten Scott B. , Metz Luanne M. 
Published: May 2005

Objective: Two recent randomized double-blind placebo controlled clinical trials of interferon beta-1a in multiple sclerosis have obtained hopelessness ratings using the Beck Hopelessness Scale (BHS). One of these studies, the PRISMS trial, evaluated interferon beta-1a in relapsing remitting multiple sclerosis (RRMS). Another, the SPECTRIMS trial, evaluated the same medication in secondary progressive (SP) MS. The objective of this analysis was to compare levels of hopelessness in persons with RRMS and SPMS, and to describe changes over time in the clinical trial participants. Method: Raw data from each clinical trial was obtained from the sponsor of the trials (Serono). Median BHS ratings, and the proportions at or above the BHS cut-point of 10 were calculated over a two (PRISMS) or three (SPECTRIMS) year period. Results: The analysis included n = 532 clinical trial participants. Ratings of hopelessness were higher in SPMS clinical trial participants (SPECTRIMS) than in the RRMS group (PRISMS) at baseline (Fisher's exact test, p = 0.0035). Furthermore, ratings of hopelessness were higher during follow-up than at baseline, in the SPMS group (McNemar's exact probability, p = 0.0015), but not in the RRMS group (McNemar's exact probability, p = 0.65). Depression was strongly associated with hopelessness in both RRMS ( z = 4.13, p < 0.001) and SPMS ( z = 5.24, p < 0.001). Conclusions: Hopelessness is associated with SPMS, and may increase over time in this group. Hopelessness may influence suicide risk in people with MS and may potentially have an impact on coping and quality of life. Additional research is necessary to define the clinical implications of hopelessness in persons with this condition.
Polio, Politics, Publicity, and Duplicity: Ethical Aspects in the Development of the Salk Vaccine
Authors: Brandt Allan M. 
Published: May 2005

This paper is an historical account of the discovery, testing, and early distribution of the Salk polio vaccine. The discovery posed fundamental dilemmas of medical research, pharmaceutical production, and public health. This paper assesses the ethical problems which arose, and examines critically their resolution. The National Foundation for Infantile Paralysis (March of Dimes) financed and directed the discovery of the vaccine, subsequent field trials, and early distribution. The Foundation's role is analyzed with special attention to the conflicts between its philanthropic and scientific functions. The great public demand which the discovery of the vaccine generated created a need for federal control which was only partly met. The federal government did not have sufficient institutional and legal mechanisms to assure the safety of the vaccine and protect the public. This discussion illustrates the failure of the government to keep pace with medical technology.
Rectal Prolapse: A Possibly Underrecognized Complication of Anorexia Nervosa Amenable to Surgical Correction
Authors: Dreznik Zeev , Vishne Tal H. , Kristt Don , Alper Dan , Ramadan Edward 
Published: May 2005

Objective: Rectal prolapse is a complication of AN that may be more common than previously recorded experience would suggest. Method: In this report we document, for the first time, the association of anoxia nervosa (AN) and rectal prolapse in a series of three patients seen in the past three years. An extensive review of the literature using Medline over the period from 1966 to Jan 2000 failed to reveal any previous example of this association. Results and Conclusion: The finding could have significant health care implications if confirmed. It would suggest that patients with either the psychiatric or surgical problem may not be receiving the appropriate complementary referrals: psychiatrist to surgeon and vice versa. The importance of recognition of this association in anorectic patients is the availability of effective surgical therapy.
The Attitudes of Medical Inpatients toward Psychiatric Consultation: A Re-Examination
Authors: Klein David A. , Saravay Stephen M. , Pollack Simcha 
Published: May 2005

Objective: Several surveys from twenty to thirty years ago demonstrated that approximately 80 percent of patients were readily accepting of psychiatric consultation. The aim of this study was to re-examine whether medical inpatient attitudes toward psychiatric consultation have changed in the past twenty-five years and whether the type of psychiatric disorder affects the attitude toward consultation. Method: Forty-eight medical inpatients seen in psychiatric consultation consented to answering a questionnaire pre- and post-consultation to assess their attitudes to this intervention. Chi-square and t-tests were used to determine statistically significant differences between the “before” and “after” consultation groups. Results: Eight-one percent stated they would be moderately, to very, agreeable to psychiatric consultation if their primary care doctor felt it was indicted. Sixty-seven percent claimed not to have been informed beforehand that a psychiatric consultation was requested. Only 8 percent of patients were disinterested in having the consultation. Psychiatric diagnosis (primary vs. organic) and the attitude toward psychiatric consultation were not significantly related. Conclusions: Our results show little change in attitude over the past twenty-five years and support earlier studies that show medical inpatients are generally accepting of psychiatric consultation, that consultation does not pose a threat to the doctor-patient relationship, and that careful preparation of the patient by the primary care provider can improve patients' attitudes toward the consultation.
Communication Complexity and Quality: A New Perspective
Authors: Steiner Richard 
Published: May 2005

Communication practitioners place much emphasis on the role and function of the message in the communication system. However, message effects do not occur in isolation. In order to comprehend how a message operates on the acceptance and source credibility process, one must consider the role of such message-based variables as communication complexity and quality. This study starts with the hypothesis that neither the level of message complexity nor quality used has a unique or inherent effect, singly or in combination, on either acceptance or source credibility. Analysis of variance provides firm data for accepting this hypothesis. This lack of relationship is attributed to the type of communication used, i.e. motivational type, to the experiential base of attitudes, and to the respondents high tolerance for complexity. The study also found subjects downgrading the message rather than its source. Writers are urged to communicate neither down to, nor up to, but at a target population. Each message should be created for a specific purpose, to be communicated to a unique audience, for a particular situation and for achieving a certain desired effect.
A Study of Some Results of an Educational Media Course within a Teacher Preparation Program
Authors: McCavitt William 
Published: May 2005

This study sought to examine one dimension of the on-the-job behavior of secondary public school teachers who have completed a teacher preparation program at Indiana University of Pennsylvania. More specifically, the study examined the on-the-job behaviors and attitudes of these teachers in the following terms: (1) use of instructional media in the classroom, (2) use of instructional media in making student assignments, (3) use of instructional media in conducting student evaluation, (4) years experience (first year or fifth year teacher), (5) teaching area (behavioral science or physical science). The data revealed that differences do exist between the secondary teachers in the behavioral sciences in their attitudes toward and use of instructional media in student assignments and evaluation with physical science teachers scoring higher. Study data also seem to indicate that, regardless of the number of years of teaching experience teachers have, attitudes and uses of instructional media differ very little. It should be pointed out, however, that the attitudes and behaviors toward the use of instructional media by first year teachers, as shown by their mean scores, were slightly higher than those with five years teaching experience.
Endocrine Disruption Comes into Regulatory Focus
Authors: Baltz Davis 
Published: May 2005

Endocrine disruption has come under regulatory scrutiny since the passage of 1996 federal laws. The U.S. Environmental Protection Agency (EPA) convened the Endocrine Disruptor Screening and Testing Advisory Committee (EDSTAC) to develop recommendations for a screening and testing program to assess chemicals' potential to disrupt hormone function. The committee's September 1998 consensus report is important because it signals that endocrine disruption is a threat which a responsible society has an obligation to address. Furthermore, the program will generate significant new toxicological data. However, shortcomings in the EPA program will include: inadequate low dose testing; lack of a screening assay that examines early developmental exposure; and mechanisms that substitute “functionally equivalent” information. Implementation will face serious hurdles: insufficient funding; realistic validation yardsticks; resolution of crucial scientific questions, and political will. A wide diversity of constituencies appeared before the EDSTAC during public meetings, and the public will stay engaged by commenting on EPA's proposed program and by nominating chemicals for inclusion in the program. A meaningful response to endocrine disruption exposes a fundamental flaw in traditional risk assessment. If there is no “safe” exposure, there is also no regulatory threshold to identify.
The Somatizing Patient in General Practice
Authors: Verhaak P. F. M. , Tijhuis M. A. R. 
Published: May 2005

Objective: The exploratory study described in this article followed two groups of patients over a twelve-month period. Subjects were drawn from a pool of patients who had consulted their general practitioner during the three-month selection period. One group consisted of patients who had consulted their general practitioner at least once about a physical complaint that the GP regarded as predominantly psychosocial; these patients did not articulate complaints of an explicitly mental or social nature. The second group was characterized by the fact that its members voiced precisely such mental or social complaints. Method: The study investigated the extent to which the two groups (which were comparable in the severity of their complaints) differ with respect to patient characteristics such as the severity of their possible psychological problems, the frequency with which they visited their GPs, and the types of complaints—e.g. mental, psychosomatic and purely physical—they presented. Results: It was found that patients in the first group, whose somatic complaints were seen to have a psychosocial basis, are not the dependent types generally mentioned in theories about somatization. In fact, they adopt a more independent attitude to the GP than do patients voicing mental complaints. There are indications that for “somatizing” patients, underlying mental problems are less important than for “psychologizing” patients. Conclusions: Both the somatizing patients and the psychologizing patients continued very frequent visits to their GP during the 12-month research period, although chiefly to address physical complaints that the GP also assessed as such.
Dying in a Hospital Intensive Care Unit: The Social Significance for the Family of the Patient
Authors: Sherizen Sanford , Paul Lester 
Published: May 2005

A four month study of the relatives of patients who died in the Intensive Care Unit of a large Midwestern Hospital was prepared. Four factors related to the Intensive Care Unit (structure of the unit, staff feedback as modification, changes in the physical status of the patient, and role switching) were found to have important influences on the family-patient interaction. Interaction, in turn, had an effect on the family's grieving process. The dynamics of the family interaction-grieving process is illustrated in the following schema: It was found that, for the family, the critical aspect of the patient's situation was not the illness and death, per se, but rather the means by which the family was able to become involved with the patient. Structured as it was, the I.C.U. became a major constraint upon the family's ability to face the death of the patient.
Technical Communication in Britain
Authors: Bratchell D. F. 
Published: May 2005

Colleges of advanced technology in Great Britain became technological universities following the recommendation of the Robbins Report of the Committee on Higher Education in 1963. This paper discusses developments in communication studies in the context of general education for students entering commerce and industry. Central to the discussion is a description of the integration of courses in spoken and written communication at the University of Wales Institute of Science and Technology. Specialists in technical communication in industry were consulted with the result that an existing degree course was adapted to meet the industrial challenge.
User-Controlled Technology in the Humanities
Authors: Hansen Desna Wallin 
Published: May 2005

Humanists have resisted and sometimes actively opposed the use of instructional technology for a variety of reasons including, but not limited to, the following: 1) self-preservation, fear of being replaced by a “machine”; 2) myths associated with technology; and 3) lack of technical skills. Upon closely examining these frequently used reasons, it becomes apparent that the common link among them is the instructor's fear of somehow relinquishing control over the teaching/learning environment It would appear that, in order to be acceptable to most humanists, any new instructional technology must be user-controlled. Cases are presented in which user-controlled technology is being used successfully in literature, drama, art, music and languages.
Motivations and Deterrents to Educational Use of “Intelligent Videodisc” Systems
Authors: Eastwood Lester F. 
Published: May 2005

The “intelligent videodisc” — a combination of advanced microprocessor, display, and storage technology — holds the potential for developing into a powerful instructional delivery system. In an inexpensive package, it could combine advanced computer-aided instruction (CAI) software power and display capability for audio, video, and textual programming. Attractive technically though it is, this system's real contribution will be that CAI will fit the institutional structure of education for the first time. In contrast to existing, large-scale CAI systems, this small-scale device could be purchased locally, e.g., by one teacher or administrator. Another unique attribute of this technology is its potential attractiveness to consumers. Acceptance in the home may speed acceptance in schools. Despite these unique characteristics, this new technology will face some of the same traditional barriers to innovation in education that have doomed other systems. It is likely that many teachers will retain their unwillingness to innovate using technology. Tight budgets will remain because of shrinking student populations and voter apathy. High costs might restrict software availability. This paper investigates these and other driving forces and barriers to use of the “intelligent videodisc” as a personal instructional delivery system. The paper can serve as a platform for a discussion of needs and opportunities for a Federal role in promoting educational utilization of this system.
Effectiveness of Addiction Science Presentations to Treatment Professionals, Using a Modified Solomon Study Design
Authors: Erickson Carlton K. , Wilcox Richard E. , Miller Gary W. , Littlefield John H. , Lawson Kenneth A. 
Published: May 2005

Objectives: Knowledge of addiction research findings is critical for healthcare professionals who treat addicted patients. However, there is little information available about the instructional effectiveness of lecture-slide presentations in changing knowledge vs. beliefs of such professionals. Design: A modified Solomon four-group experimental design was used to assess the instructional effectiveness (knowledge gain vs. belief changes) of threehour addiction science workshops presented to health-care professionals by neurobiologically-trained academic researchers. Effectiveness of the workshops was assessed by a 28-item questionnaire on participant versus control group knowledge/beliefs on addiction. Six-month follow-up questionnaires measured “retention” of knowledge and belief changes. Results: The workshop participants showed significant knowledge gain and belief changes, whereas the two control groups showed no change in knowledge or beliefs. After six months, knowledge gains decreased, but were still higher than pre-test scores. In contrast, belief changes on three subscales persisted over six months in 40 to 52 percent of the subjects. Conclusions: These results illustrate a successful continuing education model by which academic researchers who are skilled teachers present a three-hour lecture-slide workshop with extensive question-and-answer sessions on addictions. We conclude that motivated health-care professionals can experience important knowledge gains and belief changes by participating in such workshops. In contrast to the transient retention of knowledge, belief changes persisted surprisingly well for at least six months in about half the subjects. These results suggest that long-term changes in the professional orientation of these health-care workers are possible.
Grief-Related Facsimile Illness
Authors: Zisook Sidney , De Vaul Richard A. 
Published: May 2005

One aspect of the grief process which is frequently mentioned in the literature on mourning but has not yet received adequate clinical attention is the tendency for the bereaved to assume symptoms and behavior of the deceased. This paper presents evidence that pathologic identification 1) is an important clinical syndrome that is frequently misdiagnosed and mistreated, 2) defines a population at high medical and surgical risk, 3) can be diagnosed by history alone, and 4) carries a good prognosis when identified and properly managed. Four of a series of ten clinical cases are presented and discussed. Analysis of the cases reveals a number of common features, including 1) an arrest of the normal grief process; 2) a presentation of symptoms identical or nearly identical to those experienced by the deceased; 3) previous ineffective and inappropriate treatment endeavors; 4) referral for reasons other than a recognition of an abnormal grief state; and 5) improvement or recovery during treatment aimed at facilitating the grief response. Based on a survey of the literature and the clinical material analyzed, the authors conclude that patients who present with psychologic identification with the deceased have a distinct clinical syndrome (grief-related facsimile illness) for which recognition is important to institute proper management. Contrary to the reports in the literature, it frequently presents as other than hypochondriasis. When identified, this syndrome carries a good prognosis.
The Consulting Psychiatrist and the Polydipsia-Hyponatremia Syndrome in Schizophrenia
Authors: Vieweg Victor , Pandurangi Anand , Levenson James , Silverman Joel 
Published: May 2005

Objective: The authors seek to extend understanding and treatment of hospitalized schizophrenics presenting with complications of polydipsia and dilutional hyponatremia. Attending physicians may ask the consultation/liaison psychiatrist to see schizophrenics with hyponatremically-induced delirium or other psychiatric syndromes. The referring physician may or may not have identified polydipsia and dilutional hyponatremia and their complications. This article will help the consultation/liaison psychiatrist recognize early evidence of water imbalance, describe evaluation, and provide somatic and behavioral treatment approaches to this life-threatening syndrome. Method: Over the past ten years, the authors have treated more than 100 patients with the polydipsia-hyponatremia syndrome. The authors discuss their and others' experience with drugs that help and hinder patients suffering from dilutional hyponatremia. They review current key articles from the polydipsia-hyponatremia syndrome literature including articles identified via Medline search 1985–94. Results: Schizophrenics with the polydipsia-hyponatremia syndrome most commonly present with polydipsia, polyuria, urinary incontinence, cognitive, affective, and behavioral changes, seizures, or coma. Quantitating polydipsia, hyponatremia, and diurnal changes in body weight facilitate therapeutic interventions. Treatment include patient and caregiver education, drug therapies to better treat psychosis and better treat osmotic dysregulation, behavioral interventions to interdict polydipsia, and diurnal weight monitoring. Conclusions: Once recognized, acute, subacute, and chronic complications of the polydipsia-hyponatremia syndrome are readily treatable. Besides treating the patient, consultation/liaison psychiatrists can teach their medical colleagues about this syndrome. In so doing, they will enhance the quality of their patients' lives and help the internist and surgeon feel more comfortable when working with schizophrenics.
Late Onset Anorexia Nervosa: Two Case Reports
Authors: Inagaki Takuji , Horiguchi Jun , Subouchi Kent , Miyaoka Tsuyoshi , Uegaki Jun , Seno Haruo 
Published: May 2005

Objective: Some patients develop an eating disorder at a late age. It is worth investigating why this syndrome develops at such widely different ages. Methods: Two Japanese cases of late onset anorexia nervosa are reported. Results: In these late onset cases, anorexia developed out of sadness over a loss such as bereavement, divorce, and fear or anxiety for the future. In addition, these two patients didn't demonstrate a fear of aging or of losing their attractiveness and sexuality, nor did they develop a dissociative disturbance based on an early traumatic history of sexual abuse in PTSD. Conclusion: Although the clinical features are similar, there appear to be differences between late onset and adolescent cases in psychological mechanisms.