bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of light therapy on depressed elders
Authors: Tsai Yun‐Fang , Wong Thomas K. S. , Juang Yeong‐Yuh , Tsai Hsiu‐Hsin 
Published: May 2004

AbstractBackgroundElderly depression has gradually become a severe issue in the health care system. No studies have focused on evaluating the effects of light therapy on the elderly with depression in a subtropical climate area.ObjectivesTo evaluate the effects of light therapy on hospitalized, depressed elders living in a subtropical climate area.MethodsExperimental design was used. For the experimental group, patients sat in front of a light box, receiving 5000 lux in the morning. The light therapy course was administered for 50 minutes per day and lasted for 5 days. The control group did not receive any treatment.ResultsDepressive symptoms were significantly reduced in the experimental group at post‐test but no significant decline was found in the control group.ConclusionsBased upon the results of this study, light therapy could be used to decrease depressive symptoms in the elderly. Copyright © 2004 John Wiley & Sons, Ltd.
Perceived mental health needs and adequacy of service provision to older people in care homes in the UK: a national survey
Authors: Purandare Nitin , Burns Alistair , Challis David , Morris Julie 
Published: May 2004

AbstractObjectiveTo assess perceived need and adequacy of service provision by old age psychiatrists (OAPs) to older people living in care homes in the UK.MethodsA postal survey of managers of a stratified random sample of 2638 (14% of 18,698) care homes in the UK caring for older residents. Reminders were sent to those not returning the questionnaires.ResultsThe response rate was 64% (n = 1689). Forty‐one percent of care home managers felt that at least 50% of their residents needed psychiatric evaluation. Cognitive impairment, depressive symptoms and challenging behaviour was thought to be present in at least a quarter of residents by 78%, 29% and 17% respectively. Thirty‐eight percent of managers reported that their homes ‘never’ received any visits from OAPs and only a half described the current frequency of visits as adequate. Pharmacological advice was perceived to be adequate by about three‐quarters but less than a half perceived non‐pharmacological advice as adequate. Eighty percent wanted more input for staff education and training. Perceived need ( p < 0.001), frequency of visits by OAPs ( p = 0.001), availability of geriatrician ( p = 0.001), amount of non‐pharmacological advice ( p = 0.014) and direct referral access to OAPs for known patients ( p = 0.036) were found to be independent predictors of perceived inadequacy of service provision by OAPs.ConclusionThe survey highlights the perception of unmet need and inadequacy of service provision by OAPs amongst managers of care homes in the UK. The study findings, if confirmed by direct observational studies, may have a considerable impact on already sparse resources with a need to explore efficacy of different models of care in meeting this need. Copyright © 2004 John Wiley & Sons, Ltd.
Neurosis and mortality in persons aged 65 and over living in the community: a systematic review of the literature
Authors: Dewey Michael E. , Chen Chih‐Mei 
Published: May 2004

AbstractBackgroundNo previous attempt has been made to synthesise information on mortality and neurosis in older people. Our objective was to estimate the influence on mortality of various types of neurosis in the older population.MethodsData sources were: Medline; Embase; and personal files. Studies were considered if they included a majority of persons aged 65 and over at baseline either drawn from a total community sample or drawn from a random sample from the community. Studies which sampled from a larger age range were also included if it was possible to retrieve results about those aged 65 and over. Samples from health care facilities were excluded. Effect sizes were extracted from the papers and if they were not included in the published papers effect sizes were calculated if possible. No attempt was made to contact authors for missing data.ResultsWe found seven reports (six of which used a neurosis diagnosis and one which used a symptom scale). Using Fisher's method we found an increase in mortality which was not significant (p = 0.08).ConclusionThere have been few studies, and the evidence is weakly in favour of an increased mortality risk. Copyright © 2004 John Wiley & Sons, Ltd.
The criterion validity of the Center for Epidemiological Studies Depression Scale (CES‐D) in a sample of self‐referred elders with depressive symptomatology
Authors: Haringsma R. , Engels G. I. , Beekman A. T. F. , Spinhoven Ph. 
Published: May 2004

AbstractBackgroundThe criterion validity of the Center for Epidemiological Studies Depression scale (CES‐D) was assessed in a group of elderly Dutch community‐residents who were self‐referred to a prevention program for depression.MethodsPaper‐and‐pencil administration of the CES‐D to 318 elders (55–85 years). Criterion validity was evaluated with the Mini International Neuropsychiatric Interview (MINI), a clinical diagnostic interview based on DSM‐IV. Sensitivity and specificity for various cut‐off scores of CES‐D were compared with the DSM‐IV major depressive disorder (MDD) and with clinically relevant depression (CRD), a composite diagnosis of MDD, subthreshold depression or dysthymia. Furthermore the characteristics of true versus false positives were analyzed.ResultsFor MDD, the optimal cut‐off score was 25, (sensitivity 85%, specificity 64%, and positive predicted value of 63%). For CRD, the optimal cut‐off was 22 (sensitivity 84%, specificity 60%, and positive predicted value 77%). True positives, MDD and CRD, reported significantly more anxiety symptomatology and more co‐morbid anxiety disorders, false positives reported more previous depressive episodes.ConclusionsThe criterion validity of the CES‐D for MDD and CRD was satisfactory in this semi‐clinical sample of elders. Subjects scoring ≥25 constitute a target group for further diagnostic assessment in order to determine appropriate treatment. Copyright © 2004 John Wiley & Sons, Ltd.
The CT‐based radial width of the temporal horn: pathological validation in AD without cerebrovascular disease
Authors: Rossi R. , Joachim C. , Smith A. D. , Frisoni G. B. 
Published: May 2004

AbstractBackgroundMedial temporal lobe atrophy is one of the most accurate markers of Alzheimer's disease (AD). Given the wide availability of the CT in the routine diagnostic assessment of patients with cognitive disturbances, a CT‐based marker of AD might be clinically useful.ObjectiveTo test the accuracy of a simple CT‐based measure, the radial width of the temporal horn (rWTH).MethodThe rWTH was taken in a group of 20 pathologically confirmed AD patients and 23 non demented persons enrolled in the Oxford Project to Investigate Memory and Aging (OPTIMA project).ResultsThe rWTH was significantly larger in AD patients than controls. Using a cutoff value between 3.9 at 50 and 8.1 at 90 years, the rWTH was able to correctly classify 16/20 and 19/23 subjects with a sensitivity and a specificity of 80% and 83%. The overall accuracy was 81%.ConclusionThe CT measurement of the rWTH is a simple and reasonably sensitive marker of regional brain atrophy in AD. Copyright © 2004 John Wiley & Sons, Ltd.
Critical Flicker Fusion Threshold in patients with Alzheimer's disease and vascular dementia
Authors: Curran Stephen , Wilson Simon , Musa Shabir , Wattis John 
Published: May 2004

AbstractBackgroundCritical Flicker Fusion Threshold (CFFT) is a psychophysical threshold and in psychological terms is regarded as a measure of information processing capacity. The test has previously been shown to be a valid and reliable measure of CNS functioning in patients with Alzheimer's disease and may be a useful as a screening measure for the early detection of Alzheimer's disease (AD).MethodsConsecutive referrals to the Wakefield Memory Clinic who met DSM‐IV criteria for AD or vascular dementia (VaD) were invited to take part in the study. A range of neuropsychological tests and CFFT were administered to the two groups using standardised protocols and the ability of these various tests to distinguish between the two conditions was investigated.ResultsForty‐six patients were included in the study. Of the various tests, only the descending component of CFFT and word fluency were significantly different in the two groups. In addition, the descending threshold had a sensitivity of 83% and a specificity of 69%.ConclusionCFFT could be useful as a screening instrument for early AD when combined with other measures and could facilitate the decision to commence antidementia treatment at an early stage. Further longitudinal work is needed to establish this. Copyright © 2004 John Wiley & Sons, Ltd.
Social factors and depression in carers of people with dementia
Authors: Waite Allyson , Bebbington Paul , Skelton‐Robinson Martin , Orrell Martin 
Published: May 2004

AbstractBackgroundResearch has highlighted the influence of psychosocial factors on the wellbeing of carers of people with dementia. This study aimed to investigate the interrelationships between life events, depression and social support in carers of people with dementia.MethodParticipants were 72 carers of people with dementia. They were interviewed using the Bedford College Life Events and Difficulties Schedule and the Geriatric Depression Scale.ResultsThe results showed that 31 (43%) of carers were depressed. Factors associated with depression in carers were a lack of confiding relationship, depression in the person with dementia, and living with the person with dementia.ConclusionsCarers of people with dementia appear more vulnerable to depression in the context of the caring experience rather than threatening life events. Copyright © 2004 John Wiley & Sons, Ltd.
Reliability of brain volumes from multicenter MRI acquisition: A calibration study
Authors: Schnack Hugo G. , van Haren Neeltje E.M. , Hulshoff Pol Hilleke E. , Picchioni Marco , Weisbrod Matthias , Sauer Heinrich , Cannon Tyrone , Huttunen Matti , Murray Robin , Kahn René S. 
Published: May 2004

AbstractMulticenter studies can provide additional information over single center studies because of their increased statistical power. Because similar acquisition protocols are being used internationally for structural magnetic resonance imaging (MRI) studies of the human brain, volumetric MRI data studies seem suitable for this purpose. Possible systematic differences between sites should be avoided, however, particularly when subtle differences in tissue volume are being searched for, such as in neuropsychiatric diseases. In this calibration study, the brains of six healthy volunteers were (re)scanned with MR scanners from four different manufacturers at five different sites, using the local acquisition protocols. The images were segmented at a central reference site. The intraclass correlation coefficient (ICC) was determined for the whole brain, gray and white matter, cerebellum, and lateral and third ventricle volumes. When required, the processing algorithms were calibrated for each site. Calibration of the histogram analysis was needed for segmentation of total brain volume at one site and for gray and white matter volume at all sites. No (additional) calibration was needed for cerebellum and ventricle volumes. The ICCs were ≥0.96 for total brain, ≥0.92 for cerebellum, ≥0.96 for lateral ventricle, ≥0.21 for third ventricle, ≥0.84 for gray matter, and ≥0.78 for white matter volume. Calibration of segmentation procedures allows morphologic MRI data acquired at different research sites to be combined reliably in multicenter studies. Hum. Brain Mapping 22:312–320, 2004. © 2004 Wiley‐Liss, Inc.
Aging and aggregate costs of medical care: conceptual and policy issues
Authors: Chernichovsky Dov , Markowitz Sara 
Published: May 2004

AbstractThe conventional wisdom says that because the cost of health care for the aged is more than that of the young at any time, there is a positive relationship between the aging or higher life expectancy of the population and aggregate health care spending. It is difficult, however, to find evidence to support this argument. We present a simple framework that shows how aging of the population may not necessarily increase the total cost of medical care over time or be observed across nations. This follows because numerous other factors that change with aging affect cost of care in ways that are not age‐neutral. Such factors include age‐specific shifts in morbidity and mortality, growth in income and insurance coverage, rising levels of education and changing technology. Consequently, the relative medical costs of the aged may indeed increase, at least for demographic reasons. Simultaneously, however, the costs of the young may decrease for the same reasons. The Israeli experience, used as a basis for a cursory empirical discussion of the issues, supports the line of reasoning presented in the paper. Copyright © 2003 John Wiley & Sons, Ltd.
Using stated preference and revealed preference modeling to evaluate prescribing decisions
Authors: Mark Tami L. , Swait Joffre 
Published: May 2004

AbstractThe use of stated preference analyses to evaluate choice of health care products has been growing in recent years. This paper shows how revealed preference data can be enriched with stated preference data and highlights the relative advantages of revealed and stated preference data. The techniques were applied to a study of determinants of physicians' prescriptions of alcoholism medications. Analyses were conducted on the relationship between physicians' perceptions of existing alcoholism medication attributes and their prescribing rates of those medications. Analyses were also conducted on physicians' decisions to prescribe hypothetical alcoholism medications with varying attributes such as efficacy, side effects, compliance, mode of action, and price. Finally, analyses were conducted on the combined stated and revealed preference data. Joint estimation suggests that parameters from the revealed and stated preference data are equal, up to scale. Joint analyses highlight how stated preference data can be used to estimate parameters for attributes that are not observed in the marketplace, that do not vary in the marketplace, or that are highly collinear with other attributes in actual markets. Copyright © 2003 John Wiley & Sons, Ltd.
Price discrimination in obstetric services – a case study in Bangladesh
Authors: Amin Mohammad , Hanson Kara , Mills Anne 
Published: May 2004

AbstractThis article examines the existence of price discrimination for obstetric services in two private hospitals in Bangladesh, and considers the welfare consequences of such discrimination, i.e. whether or not price discrimination benefited the poorer users. Data on 1212 normal and caesarean section patients discharged from the two hospitals were obtained. Obstetric services were chosen because they are relatively standardised and the patient population is relatively homogeneous, so minimising the scope and scale of product differentiation due to procedure and case‐mix differences. The differences between the hospital list price for delivery and actual prices paid by patients were calculated to determine the average rate of discount. The welfare consequences of price discrimination were assessed by testing the differences in mean prices paid by patients from three income groups: low, middle and high. The results suggest that two different forms of price discrimination for obstetric services occurred in both these hospitals. First, there was price discrimination according to income, with the poorer users benefiting from a higher discount rate than richer ones; and second, there was price discrimination according to social status, with three high status occupational groups (doctors, senior government officials, and large businessmen) having the highest probability of receiving some level of discount. Copyright © 2003 John Wiley & Sons, Ltd.
How property rights and patents affect antibiotic resistance
Authors: Horowitz John B. , Moehring H. Brian 
Published: May 2004

AbstractAntibiotic resistance tends to increase when a patent on an antibiotic expires. Since other companies can now sell the antibiotic, more of the antibiotic is produced and prices fall. Because the benefits of reducing current production go to other firms, pharmaceutical companies will have little concern about future resistance. This ‘open‐access’ problem causes excessive antibiotic use and resistance problems in the future. Extending patents is one solution. However, a pharmaceutical company that has patent protection on a drug that is cross‐resistant may have little concern about future resistance. This is because when people use completely different antibiotics which cause bacteria to become resistant to the original antibiotic, then the benefits of reducing current production go to other companies. A single buyer such as national health insurance or private health insurance may also have an incentive to reduce antibiotic resistance since they bear the future cost of future resistance. However, insurance coverage reduces the price that patients pay at the margin and thus the patients are likely to use more antibiotics. National health insurance policies may even set the price of antibiotics so low that resistance problems are created even when the patent is in effect. Copyright © 2004 John Wiley & Sons, Ltd.
Resistance‐induced antibiotic substitution
Authors: Howard David H. 
Published: May 2004

AbstractIn many cases, physicians prescribe antibiotics without knowing whether an individual patient is infected with a susceptible or resistant pathogen. As the proportion of resistant organisms in a community increases, physicians substitute away from older‐inexpensive drugs to newer, more expensive agents as first line therapy. This paper explores the implications of resistance‐induced antibiotic substitution for epidemiological models to predict future resistance levels, efforts to measure the health care costs associated with resistance, and policies to improve physicians' antibiotic prescribing decisions. The extent of resistance‐induced substitution in outpatient settings is documented using a data set consisting of observations on initial physician office visits for otitis media in the US controlling for new product introductions and price increases, per prescription antibiotic spending increased by 22% between 1980 and 1996, corresponding to a steep increase in resistance levels over the same period. Copyright © 2004 John Wiley & Sons, Ltd.
Evaporation performance of a new plate‐type heat exchanger with winding tubes on plate surfaces (estimation of performance of the heat exchanger)
Authors: Matsushima Hitoshi , Uchida Mari 
Published: May 2004

AbstractA method for evaluating and predicting the performance of a newly developed plate‐type heat exchanger as an evaporator for water‐refrigerant systems such as chillers has been developed. The main component of the developed heat exchanger consists of plates packed together in a casing with winding tubes connected to both sides of the plates. Refrigerant flows inside the tubes, and water flows in the space between the plates. A herringbone‐like pattern is formed in this space by the cross sections of the winding tubes. The newly developed method estimates evaporation performance of the developed heat exchanger using new empirical correlations. There are correlations for heat transfer and pressure drop in winding‐tube banks on the water side, and correlation for the pressure drop on the refrigerant side. © 2004 Wiley Periodicals, Inc. Heat Trans Asian Res, 33(4): 245–257, 2004; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/htj.20009
Statistical downscaling of daily precipitation from observed and modelled atmospheric fields
Authors: Charles Stephen P. , Bates Bryson C. , Smith Ian N. , Hughes James P. 
Published: May 2004

AbstractStatistical downscaling techniques have been developed to address the spatial scale disparity between the horizontal computational grids of general circulation models (GCMs), typically 300–500 km, and point‐scale meteorological observations. This has been driven, predominantly, by the need to determine how enhanced greenhouse projections of future climate may impact at regional and local scales. As point‐scale precipitation is a common input to hydrological models, there is a need for techniques that reproduce the characteristics of multi‐site, daily gauge precipitation. This paper investigates the ability of the extended nonhomogeneous hidden Markov model (extended‐NHMM) to reproduce observed interannual and interdecadal precipitation variability when driven by observed and modelled atmospheric fields. Previous studies have shown that the extended‐NHMM can successfully reproduce the at‐site and intersite statistics of daily gauge precipitation, such as the frequency characteristics of wet days, dry‐ and wet‐spell length distributions, amount distributions, and intersite correlations in occurrence and amounts. Here, the extended‐NHMM, as fitted to 1978–92 observed ‘winter’ (May–October) daily precipitation and atmospheric data for 30 rain gauge sites in southwest Western Australia, is driven by atmospheric predictor sets extracted from National Centers for Environmental Prediction–National Center for Atmospheric Research reanalysis data for 1958–98 and an atmospheric GCM hindcast run forced by observed 1955–91 sea‐surface temperatures (SSTs). Downscaling from the reanalysis‐derived predictors reproduces the 1958–98 interannual and interdecadal variability of winter precipitation. Downscaling from the SST‐forced GCM hindcast only reproduces the precipitation probabilities of the recent 1978–91 period, with poor performance for earlier periods attributed to inadequacies in the forcing SST data. Copyright © 2004 John Wiley & Sons, Ltd.
A framework for scaling of hydrologic conceptualizations based on a disaggregation–aggregation approach
Authors: Viney Neil R. , Sivapalan Murugesu 
Published: May 2004

AbstractA fundamental question in scale research is how to scale up descriptions of hydrological responses from the small scales at which they are developed to the larger scales at which predictions are required or can be validated, in the presence of spatial heterogeneity of soils, vegetation and topography, and of space–time variability of climatic inputs. One scaling approach is the disaggregation–aggregation approach, which involves disaggregating catchment‐scale state variables to point‐scale distributions, applying a suitable point‐scale physical model using these state variables, and aggregating the resulting point‐scale responses to yield a catchment‐scale response. Thus, the approach provides a way of linking the catchment‐scale state variables with the catchment‐scale responses and thereby permits the development of empirical large‐scale models that still retain some essence of the small‐scale physics. In this paper we illustrate the disaggregation–aggregation approach with two examples that deal with developing catchment‐scale conceptualizations of (a) infiltration excess runoff and (b) evapotranspiration, using detailed process‐based models available at the small scale. These conceptualizations became the building blocks of the large‐scale catchment model, LASCAM. Copyright © 2004 John Wiley & Sons, Ltd.