bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consultation-Liaison Psychiatry: A Psychosomatic Service in the General Hospital
Authors: Krakowski Adam J. 
Published: May 2005

Consultation psychiatry, an outgrowth of the tenets of psychosomatic medicine that followed the departure from mental-hospital psychiatry to the general-hospital-based psychiatric units, is similar to those consultation services in other specialties available on medical-surgical wards. Its primary aim is to interpret the psychosocial phenomena of health and illness and to redirect the physician from disease- to patient-orientation and to a comprehensive approach. Its functions are diagnostic-therapeutic, instructional and research directed. The psychosomatic orientation is a sine qua non in the understanding of the psychosocial meaning of physical illness, its effect on psychic disability, the psychosocial adjustment of the patient and his family and his ability to adapt to illness and the hospital. An essential feature is the evaluation of the doctor-patient relationship, especially when severe illness requires serious interventions, including the consultation and its reciprocal effect upon the doctor-patient relationship. Liaison activity consists of interpretive-therapeutic mediation between the patient and the therapeutic team when strain endangers their satisfactory cooperation. The therapeutic activity must be short-term and so construed as not to interfere with the primary treatment. The instructional aspect is for the sake of the usual recipients of the service, as well as residents and students. Teaching the interview techniques, especially to students, should demonstrate the holistic approach, comprehensive diagnosis and the need of avoiding orthodox one-sidedness. This paper reviews briefly the scope and role of consultation psychiatry, compares its North American model with its status elsewhere and explores the resistances to it.
Psychopharmacologic Management of Anxiety in the Cardiac Patient
Authors: Greenblatt David J. , Shader Richard I. 
Published: May 2005

Of 253 patients who had suffered acute myocardial infarction ( MI), 88 percent received daytime sedation while hospitalized. Sixty percent of all prescriptions were for phenobarbital, 30 percent for chlordiazepoxide, and 6 percent for meprobamate. In addition, 79 percent of patients received night time hypnotic medication. Sixty-six percent of such prescriptions were for short-acting barbiturates, 21 percent for chloral hydrate, and 7 percent for diphenhydramine. Multiple drug use was common. The barbiturates, while inexpensive sedative agents, are of questionable efficacy in reducing anxiety and probably produce only general CNS depression. A narrow margin of safety, liability to produce habituation, and antagonism of warfarin-type anticoagulants are other disadvantages. The benzodiazepine tranquilizers, whose antianxiety efficacy is more clearly established, do not produce general CNS depression, have a wide margin of safety, and do not interact with oral anticoagulants. Antidepressant agents, phenothiazine tranquilizers, and propranolol were used infrequently or not at all. The risks associated with the use of these agents in patients with acute myocardial infarction are considerable and should be weighed carefully before they are administered.
Learning Processes in Physician Education: Integrating Psyche and Soma
Authors: Webster Thomas G. 
Published: May 2005

There was a wide range of difference in the way fifty-five third-year medical students wrote about a hypothetical medical patient with abdominal complaints and mild schizophrenic traits. The written exercise served as a projective test. Twenty-five wrote from a singularly psychological orientation; eighteen mentioned possible somatic disease in terms of dichotomy, psychic vs. somatic; twelve wrote in terms that allowed for the possible coexistence of psychic and somatic diseases. In each of these groups there were a few who demonstrated a relatively extreme attitude. The latter tend to represent a type of learning problem involving compartmentalized thinking. The three such students who dichotomized also demonstrated a tendency for strong ambivalence, vigorous likes and dislikes. One of the students who made a strong dichotomy between psyche and soma is the subject of a more intensive study of his learning processes. Hypotheses are suggested to explain how the physician learns to regard the “whole man” in his practice of medicine. An integration of psyche and soma must pervade the medical curriculum to enhance professional development. The development of a well-integrated image of the whole man is an emotional as well as an intellectual learning task, especially if “the whole man” orientation is to take deep root in the physician and in his everyday practice of medicine.
Somatic Treatment of Catatonia
Authors: Hawkins John M. , Archer Katharine J. , Strakowski Stephen M. , Keck Paul E. 
Published: May 2005

Objective: The authors reviewed the recent literature regarding the treatment of catatonia as a syndrome of multiple etiologies. Given the historical and clinical association of catatonia with schizophrenia, the authors' examined the assumption that the first-line treatment of catatonia is antipsychotic medication. Methods: Articles published between January 1, 1985 and December 31, 1994 were located using the Paperchase® medical literature search system. Additionally, references from those identified articles were examined for possible inclusion in this review. To be included in this review, articles had to be written in English and report specific symptoms of catatonia to determine, retrospectively, if DSM-IV criteria for catatonia were met. Results: Seventy publications met inclusion criteria and reported on a total of 178 patients and included 270 separate treatment episodes. Most of the articles were case-reports, although a few case-series were identified. Multiple causes of catatonia were identified in these reports. The most commonly reported treatment for catatonia was with benzodiazepines which were effective in 70 percent of the cases, with lorazepam demonstrating the highest frequency of use and a 79 percent complete response rate. Electroconvulsive therapy (ECT) was also efficacious (85%) and was more likely to provide a positive outcome in cases of malignant catatonia. Antipsychotics demonstrated poor efficacy. Conclusions: Catatonia is a nonspecific syndrome with multiple etiologies. Treatment of catatonia should be based on the underlying cause when it is identifiable. Lorazepam appears to offer a safe, effective first-line treatment of catatonia. ECT should be considered when rapid resolution is necessary (e.g., malignant catatonia) or when an initial lorazepam trial fails.
The Diffusion of New Hospital Technologies in the United States
Authors: Russell Louise B. 
Published: May 2005

Increases in the real resources used in hospital care have been an important cause behind rising hospital costs in the United States. Many of these resources have taken the form of new hospital technologies, and this paper begins by reviewing the trends in adoption of new hospital technologies over the years 1950–1974. The resource requirements, costs, and to the extent possible the patient benefits, of two of these technologies are then discussed in more detail: intensive care, a widespread facility with many variations, has been a major contributor to hospital costs; radiotherapy has been characterized by a succession of competing technologies. Regulatory efforts such as certificate-of-need reviews would be more effective if they viewed hospitals as flexible collections of such technologies—with the costs and patient benefits of each to be weighed separately—rather than primarily in terms of numbers of beds. A national center to collect information on the separate technological functions of hospitals and make it available to interested groups would make a useful contribution to hospital regulation.
What School can Teach about Health Services Planning
Authors: Klarman H. E. 
Published: May 2005

This paper advances two propositions. The first is: It is important to know why one wishes to plan in a particular instance. Sometimes it is better not to intervene; and at other times it may be preferable to resort to other mechanisms of public intervention than planning, such as licensure, public utility status, and pricing schemes. The second proposition is advanced more tentatively at this time: Schools should concentrate on teaching the techniques of planning. True, techniques are not all-important in planning. However, one can learn the limitations of techniques and the relative worth of value judgments from a critique of past planning efforts. This is the second part of a course in the Foundations of Health Planning, or the third if the bases for planning are taken as the first. This paper is based on a presentation given to the Seminar on Planning at The Johns Hopkins University School of Hygiene and Public Health in Baltimore on October 15, 1970. Much of the author's inquiry into health planning was supported by U.S. Public Health Service Grant Number HS00363, Research Program in the Economics of Health, from the National Center for Health Services Research and Development, which terminated on September 30, 1970.
A Review of the Postconcussion Syndrome
Authors: Szymanski Herman V. , Linn Richard 
Published: May 2005

Objective: This review will focus on aspects of the postconcussion syndrome (PCS), including accompanying symptomatology, neuropsychological changes, brain imaging studies and treatment. Method: In each topic area, those research studies resulting in the most interpretable data are reported. Since there is little research in some aspects of the PCS, some studies of limited merit are described, with their limitations outlined, in lieu of not reporting any study. The section on psychopharmacology largely consists of opinions of recognized clinicians, since there is almost no research on the psychopharmacology of PCS. Results: Mild traumatic brain injury is a relatively frequent occurrence which often results in the postconcussion syndrome (PCS), consisting of complaints of irritability, fatigue, headache, difficulty concentrating, dizziness, and memory problems. Anxiety and depression are also frequently present, especially later in its course. Although the PCS has often been thought to reflect a psychological response to injury, there is considerable recent evidence to suggest that it is primarily a physiologic disturbance. For most individuals, treatment consists primarily of education of the patient and his/her family, along with supportive counseling regarding emerging problems at work or at home. A subgroup of patients, however, may require psychopharmacologic intervention. Conclusion: More research is needed in all aspects of PCS, especially its neurophysiology and pharmacologic treatment. Relationships between neurophysiological changes and behavioral and neuropsychological changes are unknown. New imaging techniques, such as single-photon emission tomography, and positron emission tomography will likely play an important role in understanding the physiology of this disorder.
Obsessive-Compulsive Disorder following Brain Injury: A Review
Authors: Coetzer Bernardus R. 
Published: May 2005

Objective: This article reviews obsessive-compulsive disorder (OCD) following acquired brain injury. OCD type symptomatology without any other cognitive, behavioral, or emotional problems following a brain injury appears to be rare. However, the first onset of obsessions and compulsions following a brain injury has been described, but cognitive impairments can potentially color the presentation. Method: This article reviews obsessive-compulsive disorder (OCD) after brain injury, including traumatic brain injury, cerebrovascular accidents, brain tumors and brain infections. Overlapping symtomatology between OCD and brain injury is discussed. Results: Findings regarding the neuro-imaging of OCD after brain injury are reviewed and integrated with neuropsychological data from studies with idiopathic OCD. Conclusion: There appears to be some convergance between findings from studies of the neuropsychology of idiopathic OCD and neuro-imaging of OCD following brain injury.
Screening for Somatization and Depression in Saudi Arabia: A Validation Study of the Phq in Primary Care
Authors: Becker Susan , Al Zaid Khalid , Al Faris Eiad 
Published: May 2005

Objectives: Somatization, the tendency to seek treatment for medically unexplained physical symptoms, is an important issue in primary care practice. This study examines the somatoform, depression, and anxiety modules of the Patient Health Questionnaire (PHQ), a screening instrument for the identification of somatoform and other mental disorders. We also utilized the PHQ to measure the prevalence of somatization and co-morbid depression in Saudi Arabian primary care patients. Methods: This is a cross sectional study of 431 male and female Saudi Arabian primary care patients with a two stage design for purposes of validation of the somatoform, depression and anxiety modules of the PHQ. The self administered Patient Health Questionnaire was given to 431 primary care patients and, of this group, the first, consecutive 173 patients (40 percent) were interviewed by mental health professionals using the Structured Clinical Interview (SCID-R) as the criterion standard for validation of the PHQ in the Saudi population. The PHQ was then used to measure the prevalence of somatization and depression in the remaining 258 patients. Results: The somatoform and depression modules of the PHQ were found to be valid in a Saudi population using the criterion standard of SCID based psychiatric interviews. Agreement between the PHQ and psychiatric interviews was (κ = .65) for both somatoform disorders and depression but the anxiety module was weak in terms of sensitivity (.37) and agreement with the criterion standard (k = .37). Clinically significant rates of somatization (19.3 percent) and depression (20 percent) were identified in this population. Conclusions: The prevalence of somatization and co-morbid depression in a primary care population in Saudi Arabia is similar to published rates in the U.S. and worldwide. It is possible to screen primary care patients for mental disorders in international settings and the PHQ is a valid instrument for that purpose.
Mortality in Geriatric Psychiatric Inpatients
Authors: Hwang Jen-Ping , Tsai Shih-Jen , Yang Cheng-Hung 
Published: May 2005

Objective: This study investigated the deaths of patients sixty-five and older on a psychiatric ward to determine the mortality rate, the characteristics of illness, and the cause of death. Methods: We analyzed the case record of patients sixty-five and older who had died during hospitalization on a psychiatric ward during a seventeen-year period. Case data was collected by review of chart records. Results: The mortality rate in the patients sixty-five and older was 18/1208 (1.5%). Eight of these eighteen patients died of pneumonia. Mortality in the acutely ill geropsychiatric inpatients was difficult to predict. Age, sex, and diagnosis did not predict mortality. Conclusions: To reduce mortality, especially in male veterans, management of geropsychiatric patients should include early recognition of pneumonia symptoms, especially for patients with history of pulmonary disease.
Overcoming Barriers to Teaching Medical Housestaff about Psychiatric Aspects of Medical Practice
Authors: Luber M. Philip 
Published: May 2005

Objective: This article describes a training program in psychiatric aspects of medical practice. It is aimed at medical residents. Methods: Six fundamental elements have been identified that contribute to the effectiveness of this program. 1) It directly confronts resistance to such training. 2) Practical skills are emphasized. 3) Learning is active. 4) Attention to group process during training is used. 5) Integration by on-site location of the psychiatrist and co-teaching with medical faculty is essential. 6) Teaching efforts are integrated with clinical service. Results: All 112 medical housestaff participate in the program with a generally enthusiastic response. Conclusions: Successful educational programs for primary care residents require teaching collaboration between psychiatric and medical faculty and impart specific clinical skills while addressing perceived burdens of time and emotional reactions.
Health Planning in the United States: Some Categorical and General Approaches
Authors: Hilleboe H. E. , Barkhuus A. 
Published: May 2005

It is rather amazing that in 1971, the United States does not have a comprehensive health policy or national health plan. Our advanced science and technology have not taken root on a broad basis in the health field. Yet categorical planning has been done in several fields of health ever since the enactment of the Social Security Act in 1935. Planning was initiated in the fields of maternal and child health and crippled children by the federal Children's Bureau. This article gives some examples of both categorical and general approaches to health planning, how they came into being, and what planning concepts and processes were developed and used. These examples may be of some value to planners who have to employ categorical approaches—largely pragmatic—pending the time that comprehensive national health planning becomes feasible. The categorical areas chosen for discussion are: (a) health facilities, (b) heart, cancer, stroke, and kidney disease (Regional Medical Programs), (c) mental health, and (d) American Indian health. The general area includes comprehensive health planning. Following the passage of the Social Security Act of 1935, personal and environmental health services have been fragmented into a number of pieces. In 1971, utter confusion reigns in the federal and state structure and functions of health. Hopefully, the Congress may soon realize that a national system of health services is essential to provide 205 million people with the quality and distribution of services—without financial barriers—that $70 billion dollars a year should buy. Certainly the experiences gained with the categorical approaches to health planning can be of value to governmental leaders and their advisers as they prepare comprehensive health policies and national health plans for the 1970s.
The Prevalence of Psychiatric Disorders and Subsyndromal Mental Illness in Low-Income, Medically Ill Elderly
Authors: Areán Patricia A. , Alvidrez Jennifer 
Published: May 2005

Objective: This study estimated the past and current prevalence of psychiatric illness and subsyndromal mental illness (both pre-relapse and new onset) in a sample of low-income, medically ill older adults. Method: A convenience sample of 95 public sector medical patients aged 55 and older were assessed for the presence of psychiatric diagnosis and symptoms using the Geriatric Depression Scale, Beck Anxiety Inventory, the Short Michigan Alcohol Screening Test, and the Computerized Diagnostic Interview Schedule (DIS-C). Results: Dysthymia and Major Depression were the most prevalent current disorders and Alcohol Dependence the most prevalent past disorder. Overall, 25 percent met criteria for at least one Axis I disorder. An additional 44 percent of patients had subsyndromal mental illness: 14 percent had subsyndromal depression, 17 percent were significantly anxious, and 30 percent were problem drinkers. A prior model predicting current Axis I disorder in younger people was found to be predictive of current Axis I but did not predict to subsyndromal disorder. Conclusions: The rates of psychiatric disorders and symptoms in this older, low-income population were similar to those in other samples of older medical patients. The findings from this research suggest the need for larger epidemiological studies of the prevalence of psychiatric disorders in this disadvantaged aging population. The complexities of this type of research are also discussed.
Women's Technologies, Women's Literacies: Sewing and Computing across the Years
Authors: Rohan Liz 
Published: May 2005

This article compares the historical and contemporary clothing industry with the current microelectronics industry. It argues that the development of paper patterns, along with the perfection of the sewing machine as a technology in the 1870s, “democratized fashion” for lower and middle class women just as the development of the World Wide Web and Web-making software has democratized publishing for authors before unable to gain access to an audience for their writing. Comparing the businesses of three groups of women using the World Wide Web, this article finally problematizes these historical and contemporary democratizing technologies—the sewing machine and the computer—by pointing out both obvious and more subtle socioeconomic realities which undercut some utopian promises of publishing in Cyberspace. Women are … without class because the cut and fall of the skirt and good leather shoes can take you across the river and to the other side: the fairytales tell you that goose-girls may marry kings [1, pp. 15–16].
Motivating Engineering Students to Publish
Authors: Estrin Herman A. 
Published: May 2005

In a technical writing course, students analyze the classics of engineering literature, prepare annotated bibliographies of articles concerning engineering writing, write an in-depth technical report on a civil engineering topic, and analyze the various articles in science and engineering magazines. To acquaint the students with the different magazines to which they may submit manuscripts, they also analyze a professional magazine. In this way, they are prepared for publication. After having reviewed science books for children, the students prepare their own manuscripts of science literature and submit them to consultants at the Writers' Conference held annually at Newark College of Engineering during April.
Recognition of Proline‐Rich Motifs by Protein–Protein‐Interaction Domains
Authors: Ball Linda J. , Kühne Ronald , Schneider‐Mergener Jens , Oschkinat Hartmut 
Published: May 2005

AbstractProtein–protein interactions are essential in every aspect of cellular activity. Multiprotein complexes form and dissociate constantly in a specifically tuned manner, often by conserved mechanisms. Protein domains that bind proline‐rich motifs (PRMs) are frequently involved in signaling events. The unique properties of proline provide a mechanism for highly discriminatory recognition without requiring high affinities. We present herein a detailed, quantitative assessment of the structural features that define the interfaces between PRM‐binding domains and their target PRMs, and investigate the specificity of PRM recognition. Together with the analysis of peptide‐library screens, this approach has allowed the identification of several highly conserved key interactions found in all complexes of PRM‐binding domains. The inhibition of protein–protein interactions by using small‐molecule agents is very challenging. Therefore, it is important to first pinpoint the critical interactions that must be considered in the design of inhibitors of PRM‐binding domains.
On the Remarkable Antitumor Properties of Fludelone: How We Got There
Authors: Rivkin Alexey , Chou Ting‐Chao , Danishefsky Samuel J. 
Published: May 2005

AbstractSmall‐molecule natural products are presumably often biosynthesized with a view to optimizing their ability to bind to strategic proteins or other biomolecular targets. Although the ultimate setting in which a drug must function may be very different, the use of such natural products as lead compounds can serve as a significant head start in the hunt for new agents of clinical value. Herein we reveal the synergistic relationship between chemical synthesis and drug optimization in the context of our research program around the epothilones: how synthesis led to the discovery of more‐potent epothilone derivatives, and discovery inspired the development of new synthetic routes, thus demonstrating the value of target‐directed total synthesis in the quest for new substances of material clinical benefit.