bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing clock tests for dementia screening: naïve judgments vs formal systems—what is optimal?
Authors: Scanlan James M. , Brush Michael , Quijano Christina , Borson Soo 
Published: October 2002

AbstractBackgroundClock drawing tests (CDTs) vary in format, scoring, and complexity. Herein, we compared the dementia screening performance of seven CDT scoring systems and the judgements of untrained raters.Methods80 clock drawings by subjects of known dementia status were selected, 20 from each of four categories (Consortium to Establish a Registry for Alzheimer's disease [CERAD] defined normal, mild, moderate, and severe abnormality). An expert rater scored all clocks using published criteria for seven systems. Additionally, 20 naïve raters judged clocks as either normal or abnormal, without formal instructions. Clocks were then classified by drawers' dementia status for comparison of dementia detection across systems.ResultsNaïve and formal CDT systems showed 90–100% agreement in CERAD normal, moderate and severe categories, but poor agreement (mean = 39%) for mildly impaired clocks. When CDT systems were compared for accurate dementia classification, the Mendez and CERAD systems correctly identified the greatest proportion of subjects (84–85%), and Wolf‐Klein the smallest (58%). The better systems correctly identified> 70% of mildly demented individuals (CDR = 1). In contrast, medical records from patients' personal physicians correctly identified only 24% of the mildly demented. Strikingly, naïve raters' CDT judgements were as effective as five of the seven CDT systems in dementia identification.ConclusionsWhile the Mendez system was the most accurate overall, it was not significantly better than CERAD, which had simpler scoring rules. Untrained raters discriminated normal from abnormal clocks with acceptable accuracy for community screening purposes. Results suggest that, if used, most CDT systems would improve personal physicians' dementia recognition in difficult to detect mildly demented subjects. Copyright © 2002 John Wiley & Sons, Ltd.
Mini Mental State Examination in Sinhalese: a sensitive test to screen for dementia in Sri Lanka
Authors: de Silva H. A. , Gunatilake S.B. 
Published: October 2002

AbstractBackgroundAlthough the Sri Lankan population is ageing rapidly, dementia has not been systematically investigated here. The Mini Mental State Examination (MMSE) is a brief global instrument used to assess cognitive abilities in the elderly.ObjectiveThis study aimed to develop and validate a Sinhalese translation of the MMSE, which could be used as a screening instrument to detect impaired cognition in an epidemiological investigation of dementia in Sri Lanka.MethodsDue to the high literacy rate in the country, the MMSE was translated and modified slightly without having to make major changes to the original version. 380 randomly selected subjects over 65 years in a semi‐urban area were screened with the translated version of the MMSE. The cut‐off score for cognitive impairment was taken as 17. Of the 380 subjects screened, 33 scored ≤ 17, and were thus considered cases of suspected dementia. All 33 who scored ≤ 17 and 24 randomly selected subjects who scored > 17 on the MMSE, thus considered cognitively normal, underwent a brief clinical examination and neuropsychological assessment with the more comprehensive neuropsychiatric test battery, Cambridge Cognitive Score (CAMCOG), to determine the presence of dementia.ResultsEvaluated against the performance at the CAMCOG, the sensitivity and specificity of the translated MMSE were 93.5% and 84.6% respectively.ConclusionTherefore, the Sinhalese translation of the MMSE described here is a sensitive instrument to screen for dementia in Sri Lanka. Copyright © 2002 John Wiley & Sons, Ltd.
The effect of selegiline in the treatment of people with Alzheimer's disease: a meta‐analysis of published trials
Authors: Wilcock G. K. , Birks J. , Whitehead A. , Evans Sir John Grimley 
Published: October 2002

AbstractObjectiveTo evaluate the effect of selegiline in the treatment of patients with Alzheimer's disease, in terms of cognitive performance, functional ability, emotional state (including behaviour and mood) and global response.Data SourcesThe Cochrane database of trials, Embase, Medline and Psychlit.Study SelectionUnconfounded, double‐blind, randomised trials of selegiline compared with placebo reported before 31 December 1998.Data ExtractionThe reviewers selected trials for inclusion. Individual patient data were sought, but when these could not be retrieved summary data were extracted from published papers.ResultsOf 27 identified trials, 14 met the inclusion criteria. Individual patient data were retrieved from eight trials on 821 patients. Summary data were extracted from five trials on 240 patients. No data were available from one trial on 12 patients, which was therefore excluded from the meta‐analysis. Fixed and random effects meta‐analyses were performed on standardised mean differences. For cognition there was a statistically significant difference between selegiline and placebo at 4–6 weeks and 8–17 weeks after randomisation (at 8–17 weeks: smd=0.45 [95% confidence interval 0.03 to 0.88]), but this disappeared at later assessments. The size of the treatment difference was considered unlikely to be of clinical importance. Although there was a statistically significant difference at 4–6 weeks for activities of daily living, this disappeared at later assessments (at 8–17 weeks: smd=0.33 [−0.33, 0.69]). There were no statistically significant differences or clinically relevant differences between selegiline and placebo in terms of emotional state or global response.ConclusionAlthough there was some evidence of improvement with selegiline in the short term in cognition and activities of daily living, the magnitude of the effect did not reach clinical importance. There was no evidence of long term effects. Copyright © 2002 John Wiley & Sons, Ltd.
Positive aspects of caregiving: rounding out the caregiver experience
Authors: Cohen Carole A. , Colantonio Angela , Vernich Lee 
Published: October 2002

AbstractObjectivesTo identify positive aspects of caregiving and examine how they are associated with caregiver outcomes.MethodThis study used a national sample of caregivers derived from the Canadian Study of Health and Aging (part 2). Two hundred and eighty‐nine caregivers caring for seniors living in the community were questioned about their experience of caregiving. Caregivers were asked whether they could identify any positive aspects related to their role, the type of positive aspects and to rate their feelings about caring. Using a conceptual model developed by Noonan and Tennstedt (1997), a staged stepwise multiple regression approach was used factoring the background/contextual variables, stressor variables (3 MS score, ADL limitations), mediator variables (positive aspects of caregiving, number of services used) and outcome variables (depression, burden and self‐assessed health measures) into the model.ResultsTwo hundred and eleven caregivers (73%) could identify at least one specific positive aspect of caregiving. An additional 20 (6.9%) could identify more than one positive aspect. Positive feelings about caring were associated with lower CES‐D scores ( p < 0.001), lower burden scores ( p < 0.001) and better self assessed health ( p < 0.001).ConclusionClinicians should inquire about the positive aspects of caregiving if they are to fully comprehend the caregiver experience and identify risk factors for negative caregiver outcomes. Copyright © 2002 John Wiley & Sons, Ltd.
Incidence, prevalence, and outcomes of depression in residents of a long‐term care facility with dementia
Authors: Payne Jennifer L. , Sheppard Jeannie‐Marie E. , Steinberg Martin , Warren Andrew , Baker Alva , Steele Cynthia , Brandt Jason , Lyketsos Constantine G. 
Published: October 2002

AbstractBackgroundThe course of depression in residents of long‐term care with dementia is not well studied.ObjectivesTo estimate the incidence, prevalence, and outcomes of depression in long‐term care residents with dementia.Method201 residents of Copper Ridge, a long‐term care facility for the memory impaired, were followed every six months during the first year after their admission.ResultsOn admission 19.9% of the residents had depression, the majority (75%) occurring in persons with a prior history of depression. At six months, only 15% of the original 40 depressed patients were still depressed, while at twelve months only 7.5% were depressed. The incidence of depression at six and twelve months was 1.8% and 6.4% respectively. Most persons with new depression at six months were no longer depressed at one year. The annual attack rate (cumulative likelihood of depression over one year) for the total population was 26.4%. The rates for the subgroup of Alzheimer's were similar to the rates of the total population, except for an annual attack rate of 17.5%, reflecting a lower rate of depression on admission. The decline in depression over the year after admission is noteworthy and likely reflects appropriate diagnosis and treatment of depression.ConclusionsThese results indicate that, over the course of one year, depression afflicts a considerable proportion of long‐term care residents with dementia. Admission to a long‐term care facility may actually result in a reduction of depression within the year after admission in part due to rapid recognition, appropriate diagnosis and treatment. Copyright © 2002 John Wiley & Sons, Ltd.
Olanzapine associated weight gain, Hyperglycemia and Neuroleptic Malignant Syndrome: case report
Authors: Malyuk Rhonda , Gibson Bruce , Procyshyn Ric M. , Kang Nirmal 
Published: October 2002

AbstractWe describe here a case of olanzapine associated weight gain, hyperglycemia and neuroleptic malignant syndrome in a 64 year‐old woman with a significant medical history. Eighteen weeks after initiating olanzapine, Mrs X lost glycemic control, exhibited signs and symptoms consistent with neuroleptic malignant syndrome and gained 8.9 kg. We suggest that utilization of olanzapine in the less medically stable geriatric patient be implemented with vigilant monitoring for such complications mentioned above. Copyright © 2002 John Wiley & Sons, Ltd.
The prevalence and phenomenology of auditory hallucinations among elderly subjects attending an audiology clinic
Authors: Cole Martin G. , Dowson Lorna , Dendukuri Nandini , Belzile Eric 
Published: October 2002

AbstractBackgroundStudies of auditory hallucinations are scant.MethodTo determine the prevalence and phenomenology of auditory hallucinations among elderly subjects with hearing impairment.ObjectiveWe surveyed 125 men and women aged 65 years and over referred to the Audiology department of a university‐affiliated primary acute‐care hospital.ResultsThe prevalence of auditory hallucinations was 32.8% (95% confidence interval (CI) 24.7–41.8). These hallucinations represented a spectrum of phenomenology from elementary personal impressions to complex percepts. The types of auditory hallucinations included humming or buzzing (35.9%), shushing (12.8%), beating or tapping (10.6%), ringing (7.7%), other individual sounds (15.4%), multiple sounds (12.6%), voices (2.5%) or music (2.5%). Subjects with any type of hallucination were younger and had poorer discrimination scores in the left ear and impaired binaural discrimination with lip‐reading. Subjects with hallucinations that had more qualities of a true percept heard different types of sounds and had lower reflex thresholds and better air conduction in the right ear.ConclusionAuditory hallucinations are frequent in elderly subjects with hearing impairment and seem to be associated with younger age and asymmetrical hearing impairment. Copyright © 2002 John Wiley & Sons, Ltd.
Mental health in older adult recipients of primary care services: is depression the key issue? Identification, treatment and the general practitioner
Authors: Watts S. C. , Bhutani G. E. , Stout I. H. , Ducker G. M. , Cleator P. J. , McGarry J. , Day M. 
Published: October 2002

AbstractObjectivesMental health services for older people in primary care are relatively underdeveloped. This study has sought to determine the nature and extent of mental health problems in older people presenting to primary care and to compare this with the detection and management of mental health problems by the primary health care team (PHCT).MethodParticipants were patients aged 65 years and above attending a representative inner city general practice. Screening tools included the General Health Questionnaire (GHQ‐28), Hospital Anxiety and Depression Scale (HADS), Mini Mental State Examination (MMSE). The PHCT used a brief checklist to rate participants for the presence of mental health problems. Follow‐up interviews using the Geriatric Mental State (GMSA), Cambridge Examination for Mental Disorders in the Elderly (CAMDEX)—cognitive subscale (CAMCOG), National Adult Reading Test (NART), were carried out.ResultsA high level of psychological morbidity was identified at screening (48.1%). There was a considerable degree of agreement between the HADS and GMSA, and the MMSE and GMSA at follow‐up. Agreement rates between the PHCT and initial screening tools were low suggesting under‐recognition of mental health problems at primary care level by the PHCT. Contributory factors included: short consultation times with a concentration on physical symptoms; few patients presenting explicitly with mental health problems; few decisions to treat or refer patients; and the general practitioners tended to monitor, or defer decisions.ConclusionsThis study found lower levels of severe mental health problems, especially depression, than reported elsewhere, but higher prevalence of psychological distress. High levels of physical and mental health co‐morbidity were found. These findings suggest that planning for primary care services needs to adopt a flexible assessment model. The development of effective, time‐limited protocols and screening tools to assist the PHCT in improving their identification rates is recommended. This needs to be supported by the availability of appropriate treatments for the psychological distress. Copyright © 2002 John Wiley & Sons, Ltd.
A confirmatory factor analysis of the 12‐item General Health Questionnaire among older people
Authors: Bun Cheung Yin 
Published: October 2002

AbstractBackgroundThe 12‐item General Health Questionnaire (GHQ) is useful in measuring psychiatric morbidity in older people. Previous studies of its factor structure were often based on samples of young persons and on exploratory factor analysis techniques. The results varied from suggesting one to three factors.MethodsThis study involved 2123 participants aged over 60 and 7490 younger adults in a population‐based survey in Britain. It compared the relative plausibility of several factor structures proposed by previous researchers, as indicated by the Akaike's Information Criterion and the Non‐Normed Fit Index. Correlation between factors and internal consistency were examined. Mean subscale scores by demographic characteristics were analysed by ANOVA for the best‐fit model.ResultsThe 3‐factor structure proposed by Graetz gave the best fit in both older and younger people. The properties of this model in older people were examined in details. The patterns of internal consistency and between‐factor correlation were found satisfactory. Differences and similarities in subscale scores between demographic groups e.g. marital status, were presented.ConclusionThe 12‐item General Health Questionnaire may measure three aspects of mental health, namely Anxiety and Depression, Social Dysfunction, and Loss of Confidence. Copyright © 2002 John Wiley & Sons, Ltd.
Carpal tunnel syndrome modifies sensory hand cortical somatotopy: A MEG study
Authors: Tecchio Franca , Padua Luca , Aprile Irene , Rossini Paolo Maria 
Published: October 2002

AbstractThe adult somatosensory system has shown reorganizational abilities at cortical and subcortical levels after peripheral nerve lesions. In the present study the effects of carpal tunnel syndrome (CTS) are investigated as reflected on the somatotopy of the primary cortical hand representation. Position and intensity of cortical sources activated by the separate electrical stimulation of median nerve and Digits 1, 3, and 5 of both affected and non‐affected hands are evaluated by magnetoencephalographic (MEG) technique. Correlation of MEG results with patient‐, physician‐ and neurophysiological‐oriented evaluations of CTS was carried out. Patients showed changes in cortical hand somatotopy in strict relationship to self‐referred assessment of symptoms and hand disability in daily activities, including: 1) a more extended representation of the affected hand when paresthesias prevailed; and 2) a more restricted representation due to lateral shift of the little finger was observed when pain symptoms dominated the clinical picture. Contralateral to the side of CTS, the cortical sources activated by Digit 5‐stimulation appeared significantly enhanced with respect to contralateral ones from non‐affected hand. When comparing the amplitude of peripheral sensory nerve action potentials of median and ulnar nerves to that of cortical responses (i.e., ECD strengths of M20 and M30 components after stimulation of Digits 3 and 5), a significant selective amplification of M30 with respect to M20 and sensory nerve action potential (SNAP) appeared during Digit 3 stimulation compared to that observed for Digit 5. This has been interpreted as a central magnification mechanism in brain responsiveness, possibly revealing a safety factor enabling sensory perception despite the small peripheral signal due to nerve trunk dysfunction. Hum. Brain Mapping 17:28–36, 2002. © 2002 Wiley‐Liss, Inc.
A scanning electron microscopic study on thrombogenicity of intraarterial catheters for chemotherapeutic treatment in head and neck cancer
Authors: Moser Doris , Rasse Michael , Schopper Christian , Lagogiannis Georgios , Frass Michael , Ewers Rolf , Kaye Alan D. , Hofbauer Roland 
Published: October 2002

AbstractBackgroundThe purpose of this study was to assess the impact of standard anticoagulation and intermittent catheter irrigation on clot formation on intraarterial chemotherapeutical catheters.MethodsSixteen nonheparinized catheters were placed in the carotid vessels of 10 patients. Ten catheters were perfused with chemotherapeutic drugs; six catheters were not perfused. Patients received LMWH anticoagulation; catheters were irrigated with boluses of heparinized saline daily. Catheters were retrieved for SEM evaluation after a mean intravessel placement interval of 21 days.ResultsAll samples demonstrated accumulation of thrombotic debris on luminal sides and outsides of catheters. Obliteration was seen in three samples. Detachment of thrombus fragments was present in several specimens. No significant dependence of clot formation on placement interval and chemotherapeutic perfusion was calculated.ConclusionsStandard anticoagulation was ineffective in clot prevention. Heparinized catheters might potentially reduce the risk of clot formation. A delivery system should be engaged for continuous irrigation of catheters with heparinized saline. © 2002 Wiley Periodicals, Inc. Head Neck 24: 566–574, 2002
Study of performance characteristics of a small Stirling refrigerator
Authors: Otaka Toshio , Ota Masahiro , Murakami Kazuhiko , Sakamoto Moriyoshi 
Published: October 2002

AbstractA prototype Stirling cycle refrigerator employing helium as a working fluid was investigated to determine whether a freon‐free machine was a viable alternative for the current household refrigerator. A displacer‐type or β‐type Stirling cycle machine of 100‐W capacity was designed and tested using varying design parameters such as dead volume ratio, working fluids, the ratio of the compression volume to the expansion volume, and the phase difference between a power piston and displacer. The detrimental effect of the dead space on the refrigeration capacity was confirmed. The refrigeration produced by nitrogen in an expansion space was 28% less than that produced by helium. The optimum volume ratio and the phase difference for maximum refrigeration was determined under the design operation conditions. Moreover, the refrigeration correlation formula as a function of these parameters was obtained. © 2002 Wiley Periodicals, Inc. Heat Trans Asian Res, 31(5): 344–361, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/htj.10033
Effects of alcohol on risk‐taking during simulated driving
Authors: Burian Scott E. , Liguori Anthony , Robinson John H. 
Published: October 2002

AbstractThe effect of alcohol on judgement or conscious risk‐taking may increase the likelihood of an automobile accident. This study examined the direct effects of penalty severity and alcohol on risk‐taking in a novel simulated‐driving lane‐choice task. Thirteen male social drinkers received alcohol (0.3 g/kg, 0.5 g/kg, 0.8 g/kg) or placebo during each of four test sessions in a randomized, within subject design. In repeated trials, subjects selected, then drove through a cone‐defined lane. Contingent upon performance, points were added (+ 5 for the narrower lane, + 3 for the wider lane) and taken away (− 1, − 3, or − 5 points per hit cone) after each trial. Risk‐taking was defined as a selection of the narrower‐width lane. The frequency of risk‐taking decreased as the penalty increased. The 0.5 g/kg dose, compared to other alcohol doses or placebo, significantly increased risk‐taking in the high‐risk (5‐point penalty) condition. This finding suggests that breath alcohol concentrations within current legal standards can alter a driver's decision‐making such that the willingness to enter a high‐risk situation is increased. Copyright © 2002 John Wiley & Sons, Ltd.
Short‐term treatment of post‐traumatic stress disorder with naltrexone: an open‐label preliminary study
Authors: Lubin Gad , Weizman Abraham , Shmushkevitz Mordechai , Valevski Avi 
Published: October 2002

AbstractEight patients (6 men and 2 women) with chronic post‐traumatic stress disorder (PTSD) were treated with naltrexone 100–200 mg/day. Seven patients completed 2 weeks of treatment. A subtle and clinically insignificant improvement was noted in intrusive and hyperarousal symptoms (p < 0.05 for both), but not in avoidance symptoms. All patients demonstrated side effects which limited the targeted dose. It is suggested that the subtle positive effect of naltrexone and the hypersensitivity of these patients to its side effects do not encourage the use of naltrexone in the treatment of PTSD patients. Copyright © 2002 John Wiley & Sons, Ltd.