bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abuse of Carers by Relatives with Severe Mental Illness
Authors: Vaddadi Krishna S. , Gilleard Chris , Fryer Helen 
Published: April 2004

Background: Relatives often experience considerable problems looking after a family member with severe mental illness. The problems arising from verbal and physical abuse are not well researched or acknowledged. Aims: To examine the frequency with which family carers experienced verbal and physical abuse from relatives who were being looked after by a community mental health service and to identify the correlates and consequences of that abuse. Method: Interviews with all the clients of a community mental health service in suburban Melbourne who had regular contact with a family carer together with interviews with the carers. Results: One hundred and one clients and their family carers were interviewed. Supporting a previous study of patients on an acute admission ward, the experiences of verbal and physical abuse were positively correlated. Higher rates of abuse were associated with poor relationships between patients and their families and a history of poly-drug misuse and previous criminal offences on the part of the patient. Relatives experiencing higher levels of abuse were more likely to have symptoms of emotional distress and were rated as experiencing more burden. Conclusions: Verbal and physical abuse are not infrequent problems facing family members caring for a relative with severe mental illness. Some of the risk factors for such abuse can be identified. Care plans for family carers could usefully target risk reduction strategies to minimise the occurrence of abuse.
Mental Health Services in Slovenia
Authors: Švab Vesna , Tomori Martina 
Published: April 2004

Background: Development of mental health services in Slovenia has some originalities described in the present article. Slovenia is a small Central European country with a population of 2 million. Its mental health system has been influenced by the western de-institutionalization movement and eastern models of care which are predominately institutional. Aims: Mental health reform in the 1970s was a silent one with displacement of long-term psychiatric patients to old-people's homes, asylums and to their families. During the last decade community mental health services have been established in the non-government sector, primarily as social institutions providing support to patients with severe mental illness. Psychosocial rehabilitation movement changed some therapeutic approaches in hospitals and has been gaining more and more influence in the NGO services. Results: The article describes Slovene psychiatric hospitals and community rehabilitation services. Mental health services in Slovenia are compared to services in Slovakia, the United Kingdom and the Netherlands. Conclusions: The authors are proposing guidelines for future development of mental health services for the severely mentally ill in our country in order to improve the present deficient state of care.
An Evaluation of Two Screening Methods to Identify Cases with Schizophrenia and Affective Disorders in a Community Survey in Rural Ethiopia
Authors: Shibre T. , Kebede D. , Alem A. , Negash A. , Kibreab S. , Fekadu A. , Fekadu D. , Jacobsson L. , Kullgren G. 
Published: April 2004

Background: Detecting cases with psychiatric disorders in the general population is costly and it is not clear which is the method of choice for community surveys in low-income countries. Aim: To compare the performance of a standardized diagnostic layman interview instrument-the Composite International Diagnostic Interview (CIDI 2.1) versus the Key Informant method in identifying cases with schizophrenia and major affective disorders in a community survey. Method: Both screening methods were tested against an expert interview the Schedule for Clinical Assessment in Neuropsychiatry (SCAN 2.1) in a rural district in Ethiopia with 25,632 inhabitants. Result: CIDI identified 524 and key informants 192 individuals as probable cases who were invited for a further SCAN interview. Seventy-two individuals were identified by both methods. Of those identified as probable cases by either method, a total of 481 volunteered the SCAN interviews. The Key Informant method alone detected more cases of schizophrenia, 59 vs. 29 for CIDI, whereas CIDI alone detected more cases of affective disorders, 45 vs. 30. Key informants performed better in detecting chronic cases. Conclusion: For community surveys, which aim at identifying cases with major mental disorders in low-income countries like Ethiopia, the combined use of both CIDI and the Key Informant method is recommended.
Mode-II Fracture at the Interface between a Base and a Repair Graphite/Epoxy Laminates
Authors: Jarrah M. A. , Tahat M. S. M. , Hoa S. V. 
Published: April 2004

Experimental investigation of the characteristics of the interface between a base laminate [08] T and a repair laminate [08] T was carried out through Mode II fracture tests, compliance calibration tests, and microscopic observations. The material used for manufacturing the test samples is unidirectional carbon fiber prepreg (Newport Composites NCT-301 graphite/epoxy). The laminate lay-up used in all experiments was [016] T.The specimens were subjected to variations in the autoclave pressure in the repair curing cycle. A standard sample (reference) was subjected to the manufacture recommended cure cycle. The repair samples were subjected to the manufacturer recommended curing cycle (for temperature) with different values for pressure. Results show a significant effect of pressure. However, the effect of the magnitude of the pressure is not significant after some threshold values. More than 28% drop in the fracture toughness is experienced by the lack of bonding between the older previously cured matrix and the newly added composite laminate. There is some difference between the Mode-II test and compliance calibration test, but no preference, in terms of accuracy, can be given to what method to be used to obtain Mode II fracture toughness.
Cancer Patient Preferences for Communication of Prognosis in the Metastatic Setting
Authors: Hagerty Rebecca G. , Butow Phyllis N. , Ellis Peter A. , Lobb Elizabeth A. , Pendlebury Susan , Leighl Natasha , Goldstein David , Lo Sing Kai , Tattersall Martin H.N. 
Published: April 2004

Purpose To identify preferences for and predictors of prognostic information among patients with incurable metastatic cancer. Patients and Methods One hundred twenty-six metastatic cancer patients seeing 30 oncologists at 12 outpatient clinics in New South Wales, Australia, participated in the study. Patients were diagnosed with incurable metastatic disease within 6 weeks to 6 months of recruitment. Patients completed a survey eliciting their preferences for prognostic information, including type, quantity, mode, and timing of presentation; anxiety and depression levels; and information and involvement preferences. Results More than 95% of patients wanted information about side effects, symptoms, and treatment options. The majority wanted to know longest survival time with treatment (85%), 5-year survival rates (80%), and average survival (81%). Words and numbers were preferred over pie charts or graphs. Fifty-nine percent (59%) wanted to discuss expected survival when first diagnosed with metastatic disease. Thirty-eight percent and 44% wanted to negotiate when expected survival and dying, respectively, were discussed. Patients with higher depression scores were more likely to want to know shortest time to live without treatment (P = .047) and average survival (P = .049). Lower depression levels were significantly associated with never wanting to discuss expected survival (P = .03). Patients with an expected survival of years were more likely to want to discuss life expectancy when first diagnosed with metastases (P = .02). Conclusion Most metastatic cancer patients want detailed prognostic information but prefer to negotiate the extent, format, and timing of the information they receive from their oncologists.
Influence of Biologic Markers on the Outcome of Hodgkin's Lymphoma: A Study by the Spanish Hodgkin’s Lymphoma Study Group
Authors: Montalbán Carlos , García Juan F. , Abraira Víctor , González-Camacho Leocricia , Morente Manuel M. , Bello Jose L. , Conde Eulogio , Cruz Miguel A. , García-Sanz Ramón , García-Laraña José , Grande Carlos , Llanos Marta , Martínez Rafael , Flores Eduardo , Méndez Miguel , Ponderós Concepción , Rayón Concepción , Sánchez-Godoy Pedro , Zamora Javier , Piris Miguel A. 
Published: April 2004

Purpose Current therapies fail to cure a significant proportion of patients with Hodgkin's lymphoma (HL). Predictive systems for stratification of the disease and selection of treatment based on sets of clinical variables, such as the international prognostic score (IPS), are of relatively small practical value. The predictive use of biologic parameters has so far provided limited and inconsistent results. Here we explore the influence of a set of molecular markers on the outcome of HL. Patients and Methods Forty molecular markers involved in B-cell differentiation and activation, signal transduction, cell cycle, and apoptosis control were analyzed in 259 classic HL patient cases by using tissue microarrays. Univariate analysis was performed to evaluate the influence of markers on favorable outcome (complete remission of > 12 months). Significant variables were included in a multivariate logistic regression analysis, and the probability of favorable outcome was estimated. Results Univariate analysis revealed four molecular markers that predicted outcome, and the multivariate analysis showed p53, Bcl-XL, and terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate-biotin nick-end labeling (TUNEL) to have independent significance. The combination of these factors determined two groups of patients (group I, zero to one factor; group II, two to three factors) with a probability of a favorable outcome of .948 and .687, respectively. A multivariate Cox's model shows that these biologic risk groups have special predictive power in low-IPS patients. Conclusion The data from this exploratory study suggest that the accumulation of molecular events seems to influence the outcome of HL, particularly in the low-IPS group.
Clinical Relevance of Different Sequencing of Doxorubicin and Cyclophosphamide, Methotrexate, and Fluorouracil in Operable Breast Cancer
Authors: Bonadonna Gianni , Zambetti Milvia , Moliterni Angela , Gianni Luca , Valagussa Pinuccia 
Published: April 2004

Purpose To assess the clinical relevance of different sequences of doxorubicin (DOX) and cyclophosphamide, methotrexate, and fluorouracil (CMF) in patients with operable breast cancer at risk of disease relapse. Patients and Methods Two randomized trials were activated in the early 1980s. The first study, in patients with one to three involved nodes, was intended to assess the effectiveness of intravenous (IV) CMF given every 3 weeks for 12 courses versus eight courses of the same CMF regimen followed by four courses of full-dose DOX (CMF→DOX). The second study, in patients with more than three involved nodes, compared four courses of full-dose DOX sequentially followed by eight courses of IV CMF (DOX→CMF) versus alternating two courses of the same CMF regimen with one course of DOX (CMF/DOX) for a total of 12 courses. Results After a median observation of 210 months, no statistically significant difference was documented in the first study (relapse-free survival hazard rate [HR], 1.06; total survival HR, 1.03). In contrast, the delivery of DOX first, followed by CMF significantly reduced the risk of disease relapse (HR, 0.68; 95% CI, 0.54 to 0.87; P = .0017) and death (HR, 0.74; 95% CI, 0.57 to 0.95; P = .018) compared with the alternating regimen. Conclusion Anthracycline-containing regimens can further reduce the odds of relapse and death compared with CMF. However, the findings observed in our trials emphasize that the relative merits of anthracycline adjuvant programs also can depend on the modality of administration and must be assessed in properly designed trials in which the magnitude of the benefits can be weighed against potential risks.
A comparison of pseudo-ternary diagrams of aqueous mixtures of Quil A, cholesterol and phospholipid prepared by lipid-film hydration and dialysis
Authors: Demana P. H. , Berger B. , Vosgerau U. , Rades T. , Davies N. M. 
Published: April 2004

Abstract
Pseudo-ternary diagrams for Quil A, phospholipid (phosphatidylcholine (PC) or phosphatidylethanolamine (PE)) and cholesterol were established in order to identify combinations that result in the formation of immune-stimulating complex (ISCOM) matrices and other colloidal structures produced by these three components in aqueous systems following lipid-film hydration or dialysis (methods that can be used to produce ISCOMs). In addition, the effect of equilibration time (1 month at 4°C) on the structures formed by the various combinations of the three components was investigated. Depending on the ratio of Quil A, cholesterol and phospholipid, different colloidal particles, including ISCOM matrices, liposomes and ring-like micelles, were found irrespective of the preparation method used. In contrast, worm-like micelles were only observed in systems prepared by lipid-film hydration. For samples prepared by dialysis, ISCOM matrices were predominantly found near the Quil A apex of the pseudo-ternary diagram (&gt; 50% Quil A). On the other hand, for samples prepared by lipid-film hydration, ISCOM matrices were predominantly found near the phospholipid apex of the pseudo-ternary diagram (&gt; 50% phospholipid). The regions in the pseudo-ternary diagrams in which ISCOM matrices were observed increased following an extended equilibration time, particularly for samples prepared by lipid-film hydration. Differences were also observed between pseudoternary diagrams prepared using either PE or PC as phospholipids.
Pharmaceutical evaluation of liquorice before and after roasting in mice
Authors: Majima Takami , Yamada Tomohiro , Tega Eiji , Sakurai Hiroaki , Saiki Ikuo , Tani Tadato 
Published: April 2004

Abstract
Liquorice has been used for allergic-inflammatory and liver disorders in both traditional Chinese and modern medicine. In traditional Chinese formulations, it is mainly roasted liquorice that has been used rather than un-roasted liquorice. We have compared the pharmaceutical characteristics of liquorice before and after roasting to clarify the pharmaceutical significance of the roasting. Although roasted liquorice contained less glycyrrhizin (an anti-allergic component) than un-roasted liquorice, the inhibitory potency of roasted liquorice extract (200 mg kg−1) on immunoglobulin E (IgE)-mediated triphasic ear swelling in mice was much greater compared with un-roasted liquorice. To search for additional active ingredients, roasted liquorice extract was subjected to gel-chromatography to give an anti-allergic fraction (Fa) of molecular weight ranging from 15000 to 200000 or more, in which glycyrrhizin was not detected. By testing the activity of the various fractions, it was proved that the anti-allergic effect of roasted liquorice was due to glycyrrhizin, its metabolite glycyrrhetic acid, and the Fa fraction. The inhibitory potency of the Fa fraction (15 and 75 mg kg−1) prepared from roasted liquorice was stronger than that prepared from un-roasted liquorice. Therefore, a pharmaceutical implication of roasting the liquorice seems to be associated with an increase in the anti-allergic property of the Fa fraction. It is notable that oral administration of the high molecular mass fraction (Fa) significantly inhibited IgE-mediated ear swelling six days after challenge at doses as low as 3, 15 or 75 mg kg−1.
Media to simulate the postprandial stomach I. Matching the physicochemical characteristics of standard breakfasts
Authors: Klein Sandra , Butler James , Hempenstall John M. , Reppas Christos , Dressman Jennifer B. 
Published: April 2004

Abstract
To better predict food effects on the bioavailability/bioequivalence of drugs and drug products from in-vitro data, a dissolution medium that simulates the initial composition of the postprandial stomach was developed. First, the physical parameters of two homogenized standard breakfasts often administered to assess food effects in pharmacokinetic studies were measured. These included pH, buffer capacity, osmolality, surface tension and viscosity. Subsequently, the match of the physical parameters of several commercially available liquid meals, including long-life milk, Ensure and Ensure Plus to those of the breakfasts was evaluated. Of the three liquid meals studied, Ensure Plus had the closest physicochemical behaviour to that of homogenized standard breakfasts. By increasing the viscosity of Ensure Plus with 0.45% pectin, it was possible to obtain a medium that closely resembles the FDA standard breakfast.
Composition of LDL particle discriminates between hypercholesterolaemic persons with and without symptoms of coronary heart disease
Authors: Van Jaarsveld Henretha , Pool Gertruida F , Bester Catharina J 
Published: April 2004

Background: It is well known that high total and LDL cholesterol concentrations are not prerequisites for ischemic heart disease. This study aimed to differentiate between patients with coronary heart symptoms and healthy subjects with high cholesterol concentrations, using other potential risk factors such as oxidation state, body iron status and the oxidative state of the LDL particle. Methods: Healthy persons were divided in low cholesterol (<6 mmol/L) (LC) and high cholesterol (≥6 mmol/L) (HC) groups. An additional group consisted of patients with symptoms of coronary heart disease (P). The lipid profile, body iron status, plasma antioxidants and LDL oxidation status were measured. Results: No significant differences could be observed between the LC and HC groups or between the lipid profiles, plasma antioxidants and parameters of body iron status of the HC and patient groups. Some parameters measured on isolated LDL differed between the HC and patient groups, such as LDL oxidative potential (134.47 vs 93.70 min) and LDL μ-tocopherol (21.83 vs 11.73 μmol/mmol cholesterol). Conclusion: The oxidative state of the LDL particle discriminated between patients with symptoms of coronary heart disease and hypercholesterolaemic persons without symptoms of coronary heart disease.
Longitudinal changes of insulin-like growth factors and their binding proteins throughout normal pregnancy
Authors: Monaghan John M , Godber Ian M , Lawson Nigel , Kaur Malveen , Wark Gwen , Teale Derrick , Hosking David J 
Published: April 2004

Background: Insulin-like growth factors (IGFs) are anabolic proteins that are essential regulators of cell division, differentiation and growth. We describe the longitudinal changes in IGF-I, IGF-II and the binding proteins IGFBP-1, -2 and -3 before and during normal pregnancy. Method: Serum samples were taken before conception and then at 12, 24 and 36 weeks of gestation in 41 healthy women with uncomplicated pregnancies. We measured IGF-I using an automated chemiluminescent method, IGF-II and IGFBP-2 using in-house radioimmunoassays (RIAs), and IGFBP-1 and IGFBP-3 using commercial enzyme-linked immunosorbent assay (ELISA) and RIA kits, respectively. Because of the potential haemodilution effects during pregnancy, albumin was also measured in all samples. Results: There was a significant fall in IGF-I during the first (36%) and second trimesters (21%) followed by an increase of 25% at 36 weeks. During pregnancy, the mean IGF-II concentrations fell by 12% at 12 weeks, 8% at 24 and 8% at 36 weeks compared with pre-conception values. When IGF-II results were adjusted for the haemodilution of pregnancy, its concentrations increased. During pregnancy, there was a rapid increase in mean IGFBP-1 levels by 17-fold (12 weeks), 24-fold (24 weeks) and 25-fold (36 weeks). IGFBP-2 concentrations fell after conception but started to increase towards term. This increase was more significant when adjusted for haemodilution. In contrast, IGFBP-3 concentrations increased significantly throughout pregnancy. Conclusion: Our data on the physiological changes of IGFs and their binding proteins add further evidence of the vital roles of these hormones throughout normal pregnancy.
Can the addition of interpretative comments to laboratory reports influence outcome? An example involving patients taking thyroxine
Authors: Kilpatrick ES 
Published: April 2004

Introduction: There is little evidence that the addition of interpretative comments to biochemistry reports can influence outcome for patients. Interpretative comments on thyroid function test (TFT) requests were introduced in Hull in August 1999, providing the opportunity to determine whether feedback on hypothyroid patients taking thyroxine could lead to a reduction in the proportion whose thyroxine was inadequately replaced. Patients and methods: The study comprised 15 584 TFT requests, made from 1 August 1999 to 30 August 2002 by general practitioners (GPs), for 8281 patients taking thyroxine. Under-replacement of thyroxine, defined as a TSH concentration above the upper reference limit (i.e. 4.7 mU/L), was usually commented on in the biochemical report. Results: In the first, second and third years following introduction of interpretative comments, the proportions of samples with a TSH concentration of >4.7 mU/L were 21.3%, 17.6% and 16.6%, respectively (x2trend = 43.1, P <0.0001). The proportion with a TSH concentration of <0.1 mU/L showed a more modest change, from 12.5% in year 1 to 14.0% and 14.8% in years 2 and 3, respectively (x2trend = 22.3, P <0.0001). Conclusion: This study shows that in the three years following the introduction of interpretative comments there was a 22% reduction in the number of GPs' samples indicating thyroxine under-replacement. It seems likely that these data provide evidence that comments can indeed influence the biochemical outcome of patients.
Dimercaptosuccinic acid loading test for assessing mercury burden in healthy individuals
Authors: Archbold GP , McGuckin Roisin M , Campbell NA 
Published: April 2004

Background: Oral chelation tests have been used to try to define mercury toxicity in individuals with dental amalgams, who are suffering from a variety of non-specific symptoms. Methods: Self-reported healthy individuals volunteered to undergo an oral chelation test using dimercaptosuccinic acid (DMSA) at a dose of 30 mg/kg body weight. Urinary mercury : creatinine ratios were measured pre-dose and 3 h post-dose. Results: Urinary mercury : creatinine ratios were similar to levels previously reported in individuals with symptoms that could have been attributed to mercury toxicity. One volunteer suffered a serious reaction to DMSA. Conclusion: The oral chelation test using DMSA may lead to misleading diagnostic advice regarding potential mercury toxicity and can be associated with serious side effects.