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Information about the location and magnitudes of natural gas (NG) leaks from urban distribution pipelines is important for minimizing greenhouse gas emissions and optimizing investment in pipeline management. To enable rapid collection of such data, we developed a relatively simple method using high-precision methane analyzers in Google Street View cars. Our data indicate that this automated leak survey system can document patterns in leak location and magnitude within and among cities, even without wind data. We found that urban areas with prevalent corrosion-prone distribution lines (Boston, MA, Staten Island, NY, and Syracuse, NY), leaked approximately 25-fold more methane than cities with more modern pipeline materials (Burlington, VT, and Indianapolis, IN). Although this mobile monitoring method produces conservative estimates of leak rates and leak counts, it can still help prioritize both leak repairs and replacement of leak-prone sections of distribution lines, thus minimizing methane emissions over short and long terms.

Using data from the Cambridge Study in Delinquent Development, a prospective longitudinal survey of more than 400 males in the United Kingdom followed from age 8 years to age 48 years, we investigated the role of Cluster B personality traits and the association with violent offending groups based on a typology theory of male intimate partner violence (IPV) perpetrators: those who committed family-only violence and the generally violent offender. We also considered whether offending/violent groups could be predicted using risk factors measured in childhood, adolescence, and adulthood. Our findings suggest that those men who are violent both within and outside the home (the generally violent men) are distinguished from those who are involved in IPV within the home only. The differences appear to be more in degree than in kind. We discuss these findings in relation to the idea of specific interventions and policy.

We investigate the T-matrix approach for the simulation of light scattering by an oblate particle near a planar interface. Its validity has been in question if the interface intersects the particle's circumscribing sphere, where the spherical wave expansion of the scattered field can diverge. However, the plane wave expansion of the scattered field converges everywhere below the particle, and in particular at the planar interface. We demonstrate that the particle-interface scattering interaction is correctly accounted for through a plane wave expansion in combination with Fresnel reflection at the planar interface. We present an in-depth analysis of the involved convergence mechanisms, which are governed by the transformation properties between spherical and plane waves. The method is illustrated with the cases of spherical and oblate spheroidal nanoparticles near a perfectly conducting interface, and its accuracy is demonstrated for different scatterer arrangements and materials.

Background: Dating violence is an important problem. Evidence suggests that women are more likely to perpetrate dating violence., Aims: The present study investigates the prevalence of dating violence compared with cohabiting violence in a community sample of men and women and assesses to what extent child and adolescent explanatory factors predict this behaviour. A secondary aim is to construct a risk score for dating violence based on the strongest risk factors., Methods: The Cambridge Study in Delinquent Development is a prospective longitudinal survey of 411 men (generation 2) born in the 1950s in an inner London area. Most recently, their sons and daughters [generation 3 (G3)] have been interviewed regarding their perpetration of dating and cohabiting violence, utilising the Conflict Tactics Scale. Risk factors were measured in four domains (family, parental, socio-economic and individual)., Results: A larger proportion of women than men perpetrated at least one act of violence towards their dating partner (36.4 vs 21.7%). There was a similar pattern for cohabiting violence (39.6 vs 21.4%). A number of risk factors were significantly associated with the perpetration of dating violence. For G3 women, these included a convicted father, parental conflict, large family size and poor housing. For G3 men, these included having a young father or mother, separation from the father before age 16, early school leaving, frequent truancy and having a criminal conviction. A risk score for both men and women, based on 10 risk factors, significantly predicted dating violence., Conclusion: Risk factors from four domains were important in predicting dating violence, but they were different for G3 men and women. It may be important to consider different risk factors and different risk assessments for male compared with female perpetration of dating violence. Early identification and interventions are recommended. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

We used data from the Cambridge Study in Delinquent Development, a prospective longitudinal survey of more than 400 males in the United Kingdom followed from age 8 to age 48 to investigate intimate partner violence (IPV) and its association with psychopathy. We investigated the differences in psychopathy scores between those men who were convicted of violence, those who were involved in both extra- and intra-familial violence, and those who committed IPV only. We also considered whether these generally violent men had poorer life success overall with regard to their drinking and drug taking, depression, and other mental disorders. Our findings suggest that those men who are violent both within and outside the home (the generally violent men) are distinguished from those who commit violent crimes outside the home and those who are involved in IPV within the home only. The differences appear to be more in degree than in kind. These findings are discussed with a focus on whether specific interventions are required for those who commit IPV or whether early intervention should be focused on violent behavior in general., (© The Author(s) 2015.)

Acute normovolemic hemodilution (ANH) is a blood conservation procedure that can be used in cases of refusal of blood transfusion for religious reasons. Herein, we describe a case of recurarization after reinfusion of collected blood. A combination of rocuronium/sugammadex has the potential to increase the safety of patients if ANH is done after induction. Prospective controlled studies evaluating this unique indication for sugammadex use are thus warranted.

Aim: The main aims of this article are to estimate the number of offences that are committed for every one that leads to conviction, and to estimate the probability of an offender being convicted., Method: In the Pittsburgh Youth Study, 506 boys were followed up from age 13 to age 24 years, in interviews and criminal records. Self-reports and convictions for serious theft, moderate theft, serious violence and moderate violence were compared., Results: On average, 22 offences were self-reported for every conviction. This scaling-up factor increased with age and was the highest for moderate theft and the lowest for serious theft. The probability of a self-reported offender being convicted was 54%. This percentage increased with the frequency and seriousness of offending and was always higher for African American boys than for Caucasian boys. These race differences probably reflected differences in exposure to risk factors., Conclusions: More research is needed on scaling-up factors, on frequent and serious offenders who are not convicted, on self-reported non-offenders who are convicted and on why African American boys are more likely than Caucasian boys to be convicted., (Copyright © 2014 John Wiley & Sons, Ltd.)

This article investigates the overlap between offending trajectories, criminal violence, and intimate partner violence (IPV) and the factors associated with these behaviors. Knowledge on these questions is relevant to theory and policy. For the former, this article considers the extent to which specific theories are needed for understanding crime, criminal violence, and/or IPV, whereas for the latter, it may suggest specific offense- and offender-based policies. We use data from the Cambridge Study in Delinquent Development that traces the offending, criminal violence, and IPV of males to age 50. Findings show that there is significant overlap between criminal violence and IPV, high-rate offending trajectories have increased odds of criminal violence and IPV, and early childhood risk factors have no additional effect on criminal violence and IPV in adulthood over and above the offending trajectories.

Purpose: Cross-sectional studies have established the prevalence and functional impairment of somatic symptoms in cancer patients. The purpose of this study was to determine the trajectory and adverse consequences of such symptoms over time., Methods: Secondary analysis of longitudinal data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale at baseline, 1, 3, 6, and 12 months. Outcomes included the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, the Sheehan Disability Scale (SDS) score, and self-reported total disability days. Mixed methods repeated measures analyses were conducted to determine whether antecedent change in somatic symptom burden predicted functional status and disability., Results: Symptoms were highly prevalent at baseline, with 15 of the 22 symptoms endorsed by more than half of the patients. A rather constant cross-sectional prevalence over 12 months at the group level belied a quite different trajectory at the patient level where the median persistence, resolution, and incidence rates for 14 of the most common symptoms were 39%, 37%, and 24%, respectively. A clinically significant (i.e., five points) reduction in somatic symptom burden predicted improvement in PCS, MCS, and SDS (all P < 0.001), as well as a lower likelihood of ≥14 disability days in the past 4 weeks (odds ratio, 0.84; 95% CI, 0.74 to 0.95)., Conclusions: Somatic symptoms remain burdensome in cancer patients over 12 months and symptom improvement predicts significantly better functional status and less disability.

Background: This study addresses to what extent child and adolescent explanatory factors predict male perpetrated intimate partner violence (IPV) in adulthood., Methods: We use prospective longitudinal data from the Cambridge Study in Delinquent Development (CSDD). The CSDD is a survey of 411 male born in the 1950s in an inner London area. The men were interviewed over a period of 40 years with information also gathered from their parents, peers and teachers and later from their female partners., Results: Family factors such as having a criminal father, a disrupted family, poor supervision and relationship problems with parents predicted later IPV. Individual predictors included unpopularity, daring, impulsivity, aggressiveness and low verbal IQ. There was evidence of cumulative risk for later violence in intimate partnerships., Conclusions: Early childhood factors predict adult male IPV. No other study has showed the predictability of IPV over a 40-year time interval in a prospective survey. The IPV men tended to have convictions for violence and tended to be unsuccessful in areas such as employment, drinking and drug use., (© 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.)

Whereas the majority of cocaine users quit as they experience the negative consequences of drug use, some lose control over their drug taking and compulsively seek drugs. We report that 20% of rats compulsively seek cocaine despite intermittent negative outcomes after escalating their cocaine self-administration. This compulsive subgroup showed marked reductions in forebrain serotonin utilization; increasing serotonin transmission reduced their compulsive cocaine seeking. Depleting forebrain serotonin induced compulsive cocaine seeking in rats with a limited cocaine taking history; this was reversed by systemic treatment with a 5-hydroxytryptamine (5-HT2C) receptor agonist and mimicked by systemic treatment with a 5-HT2C receptor antagonist in intact animals. These results indicate the causal involvement of reduced serotoninergic transmission in the emergence of compulsive drug seeking after a long cocaine-taking history.

Unlabelled: Brief measures to assess and monitor pain in cancer patients are available, but few head-to-head psychometric comparisons of different measures have been reported. Baseline and 3-month data were analyzed from 274 patients enrolled in the Indiana Cancer Pain and Depression (INCPAD) trial. Participants completed the Brief Pain Inventory (BPI), the PEG (a 3-item abbreviated version of the BPI), the short form (SF)-36 pain scale, and a pain global rating of change measure. The global rating was used as the criterion for standardized response mean and receiver operating characteristic curve analyses. To assess responsiveness to the trial intervention, we evaluated standardized effect size statistics stratified by trial arm. All measures were responsive to global improvement, discriminated between participants with and without improvement, and detected a significant intervention treatment effect. Short and longer measures were similarly responsive. Also, composite measures that combined pain severity and interference into a single score (BPI total, PEG, SF-36 pain) performed comparably to separate measures of each domain (BPI severity and BPI interference)., Perspective: Pain measures as brief as 2 or 3 items that provide a single score are responsive in patients with cancer-related pain. Ultra-brief measures offer a valid and efficient means of assessing and monitoring pain for the clinical management as well as research of cancer-related pain., (Published by Elsevier Inc.)

Context: Although the cross-sectional association between cancer-related pain and disability is well established, their longitudinal relationship has been less studied., Objectives: Data from the Indiana Cancer Pain and Depression (INCPAD) trial were analyzed to determine whether baseline cancer-related pain and changes in pain over time predict disability over 12 months., Methods: A total of 274 cancer survivors with cancer-related pain were accrued in the INCPAD trial. Data were collected at baseline, one, three, six, and 12 months by interviewers blinded to treatment arm. Disability outcomes included a continuous measure (Sheehan Disability Scale [SDS] score) and a categorical measure (≥14 days in the past four weeks with a ≥50% reduction in usual activities). Predictor variables, operationalized by the Brief Pain Inventory, included baseline pain severity and changes in pain severity scores between each time point. Multivariable analyses were conducted adjusting for treatment group, baseline disability, and selected covariates including depression., Results: Baseline pain severity did not predict disability outcomes at 12 months. However, improvement in pain severity predicted less disability over 12 months both in terms of SDS scores (b=-0.17, t=-5.33, P<0.001) and ≥14 disability days in the past month (odds ratio=0.85; 95% confidence interval, 0.79-0.93; P<0.001)., Conclusion: Disability over 12 months in patients with cancer-related pain is predicted by changes in pain severity over time. Results suggest that effective pain management may reduce subsequent disability among cancer survivors., (Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.)

Brain-implantable microprobe arrays, 6.5 mm shaft-length, incorporating several recessed Pt microelectrodes (50 μm×150 μm) and an integrated Ag/AgCl reference electrode fabricated by silicon micromachining dry etching techniques (DRIE) are described. The microelectrodes are coated by an enzyme membrane and a semi-permeable m-phenylenediamine layer for the selective detection of the neurotransmitters choline and L-glutamate at physiologically relevant concentrations. The functionalisation is based on electrochemically aided adsorption (EAA) combined with chemical co-cross-linking using glutaraldehyde and electrochemical polymerisation, respectively. These deposition methods are fully compatible with the fabricated microprobe arrays for the simultaneous detection of several analytes in different brain target areas. They are spatially controlled and allow fabricating biosensors on several microelectrodes in parallel or providing a cross-talk-free coating of closely spaced microelectrodes with different enzyme membranes. A sensitivity of 132±20 μA mM(-1) cm(-2) for choline and 95±20 μA mM(-1) cm(-2) for L-glutamate with limits of detections below 0.5 μM was obtained. The results of in vitro and in vivo experiments confirm the functional viability of the choline and l-glutamate biosensors., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Context: Pain and depression are two of the most prevalent and treatable cancer-related symptoms, each present in at least 20%-30% of oncology patients., Objective: To determine the associations of pain and depression with health-related quality of life (HRQL), disability, and health care use in cancer patients., Methods: The Indiana Cancer Pain and Depression study is a randomized clinical trial comparing telecare management vs. usual care for patients with cancer-related pain and/or clinically significant depression. In this article, baseline data on patients enrolled from 16 urban or rural community-based oncology practices are analyzed to test the associations of pain and depression with HRQL, disability, and health care use., Results: Of the 405 participants, 32% had depression only, 24% pain only, and 44% both depression and pain. The average Hopkins Symptom Checklist 20-item depression score in the 309 depressed participants was 1.64 (on 0-4 scale), and the average Brief Pain Inventory (BPI) severity score in the 274 participants with pain was 5.2 (on 0-10 scale), representing at least moderate levels of symptom severity. Symptom-specific disability was high, with participants reporting an average of 16.8 of the past 28 days (i.e., 60% of their days in the past four weeks) in which they were either confined to bed (5.6 days) or had to reduce their usual activities by 50% (11.2 days) because of pain or depression. Moreover, 176 (43%) participants reported being unable to work because of health-related reasons. Depression and pain had both individual and additive adverse associations with quality of life. Most patients were currently not receiving care from a mental health or pain specialist., Conclusion: Depression and pain are prevalent and disabling across a wide range of types and phases of cancer, commonly co-occur, and have additive adverse effects. Enhanced detection and management of this disabling symptom dyad is warranted., (Published by Elsevier Inc.)

Background: Depression is the most common mental disorder, and suicide is its most serious consequence. The primary objective of this study was to evaluate preliminary evidence for the P4 screener as a brief measure to assess potential suicide risk., Method: The P4 screener was prospectively evaluated in 2 randomized effectiveness trials of primary care (January 2005-June 2008; N = 250) and oncology patients (March 2006-August 2009; N = 309). Potential suicide ideation was assessed at 5 time points in both trials: baseline and 1, 3, 6, and 12 months. The P4 screener asks about the "4 P's": past suicide attempts, suicide plan, probability of completing suicide, and preventive factors. Patients were classified as minimal, lower, and higher risk based upon responses to these 4 items., Results: A suicide assessment was triggered 1 or more times by 17.6% (44 of 250) of Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) participants and 16.5% (51 of 309) of Indiana Cancer Pain and Depression (INCPAD) participants at some point in the trial. Of the patients who triggered a suicide assessment, the majority (29 of 44 in SCAMP and 27 of 51 in INCPAD) were classified as minimal risk by the algorithm. Only 1 (0.4%) of the SCAMP participants and 5 (1.6%) of the INCPAD participants were classified as higher risk. Among the latter, the most common factors preventing patients from attempting suicide were the "4 F's": faith, family, future hope, and fear of failing in their attempt., Conclusions: Preliminary findings suggest that the P4 screener may be useful in assessing potential suicide risk in the clinical care of depressed patients as well as in clinical research., Trial Registration: clinicaltrials.gov Identifier: NCT00118430 (SCAMP) and NCT00313573 (INCPAD).

The dual goals of the Organic Act of 1916 and Wilderness Act of 1964 are to protect natural resources and provide quality visitor experiences. Park managers need metrics of trail conditions to protect park resources and quality of visitor experiences. A few methods of sampling design for trails have been developed. Here, we describe a relatively new method, spatially balanced sampling, and compare it to systematic sampling. We evaluated the efficiency of sampling designs to measure recreation-related impacts in Rocky Mountain National Park. This study addressed two objectives: first, it compared estimates of trail conditions from data collected from systematic versus spatially balanced sampling data; second, it examined the relationship between sampling precision and sampling efficiency. No statistically significant differences in trail condition were found between the 100-m interval and the spatially balanced datasets. The spatially balanced probability-based dataset was found to be a good estimate of trail conditions when analyses were conducted with fewer sample points. Moreover, spatially balanced probability-based sampling is flexible and allows additional sample points to be added to a sample.

Background: Brain-derived neurotrophic factor (BDNF) plays an important role in neural plasticity in the adult nervous system and has been suggested as a target gene for antidepressant treatment. The neurotrophic hypothesis of depression suggests that loss of BDNF from the hippocampus contributes to an increased vulnerability for depression, whereas upregulation of BDNF in the hippocampus is suggested to mediate antidepressant efficacy., Methods: We have used a viral-mediated gene transfer approach to assess the role of BDNF in subregions of the hippocampus in a broad array of behavioral paradigms, including depression-like behavior and antidepressant responses. We have combined the adeno-associated virus (AAV) with the Cre/loxP site-specific recombination system to induce the knockout of BDNF selectively in either the CA1 or dentate gyrus (DG) subregions of the hippocampus., Results: We show that the loss of BDNF in either the CA1 or the DG of the hippocampus does not alter locomotor activity, anxiety-like behavior, fear conditioning, or depression-related behaviors. However, the selective loss of BDNF in the DG but not the CA1 region attenuates the actions of desipramine and citalopram in the forced swim test., Conclusions: These data suggest that the loss of hippocampal BDNF per se is not sufficient to mediate depression-like behavior. However, these results support the view that BDNF in the DG might be essential in mediating the therapeutic effect of antidepressants.

The transcription factor DeltaFosB is induced in the nucleus accumbens (NAc) and dorsal striatum by the repeated administration of drugs of abuse. Here, we investigated the role of DeltaFosB in the NAc in behavioral responses to opiates. We achieved overexpression of DeltaFosB by using a bitransgenic mouse line that inducibly expresses the protein in the NAc and dorsal striatum and by using viral-mediated gene transfer to specifically express the protein in the NAc. DeltaFosB overexpression in the NAc increased the sensitivity of the mice to the rewarding effects of morphine and led to exacerbated physical dependence, but also reduced their sensitivity to the analgesic effects of morphine and led to faster development of analgesic tolerance. The opioid peptide dynorphin seemed to be one target through which DeltaFosB produced this behavioral phenotype. Together, these experiments demonstrated that DeltaFosB in the NAc, partly through the repression of dynorphin expression, mediates several major features of opiate addiction.

The neurochemical correlates of the behavioural consequences of isolation rearing of rats are complex and involve many neurotransmitters, including the serotonergic system. Impaired functioning of the ascending serotonergic system has been implicated in many neuropsychiatric syndromes, including attention deficit hyperactivity disorder and schizophrenia. In the present investigation serotonergic function was assessed using in vitro receptor autoradiography. The 5-hydroxytryptamine(2A) (5-HT(2A)) receptor antagonist [(3)H]ketanserin and the 5-HT(1A) receptor antagonist, [(3)H]WAY100, 635 were used to compare 5-HT receptor subtype densities in the forebrains of socially and isolation-reared rats. Regions of highest receptor density were observed in the frontal cortex for 5-HT(2A) receptors and in the frontal cortex, dorsal hippocampus and lateral septum for 5-HT(1A) receptors. In isolation-reared rats, 5-HT(2A) receptor binding site densities were significantly increased by between 36 and 67% in the prelimbic, motor and cingulate cortices compared with socially reared controls. By contrast, 5-HT(1A) receptor binding site densities were significantly reduced by 22% in the prelimbic cortex, and significantly increased by between 10 and 50% in the motor cortex, somatosensory cortex, dentate gyrus and CA fields of the hippocampus. These data demonstrate that isolation-rearing produces significant effects on forebrain 5-HT(1A) and 5-HT(2A) receptor densities in the adult rat. It is hypothesised that altered serotonergic function, particularly in the hippocampus and prefrontal cortex, may underlie some of the behavioural abnormalities associated with isolation-rearing.

Objective: The problem of boredom in people with cancer has received little research attention, and yet clinical experience suggests that it has the potential to profoundly affect quality of life in those patients. We were interested in developing a Purposelessness, Understimulation, and Boredom (PUB) Scale to identify this problem and to begin to differentiate it from depression., Methods: Cancer patients and professionals were interviewed using a semi-structured format to elicit their perceptions of the incidence, causes, scope, and consequences of boredom. From their responses, 45 questions were developed, edited for clarity, and piloted. A total of 100 cancer patients were recruited to participate in the study. Preliminary validation of the PUB using a cross-sectional survey of the measure was conducted. Other instruments used for purposes of convergent and divergent validity included the Functional Assessment of Cancer Therapy Scale-Anemia, Zung Self-Rating Depression Scale, Boredom Proneness Scale, Leisure Boredom Scale, Cancer Behavior Inventory, Systems of Belief Inventory, and the Eastern Cooperative Oncology Group Performance Status Scale., Results: The average age of the sample was 62.37 years (SD = 13.43) and was comprised of 60 women (60.00%) and 40 men (40.00%). The results of a factor analysis on the 45 initial items (selected on the basis of professional and patient interviews) created a two-factor scale. The eight items from the strongest factor (items 1, 2, 3, 4, 5, 6, 9, 10) seemed to best tap the construct that could be deemed as overt boredom whereas the six items of the second factor (items 36, 38, 39, 42, 44, 45) seemed to tap the construct of boredom related to meaning and spirituality. Total scale internal consistency, when all 14 items were included in the analysis, yielded a coefficient alpha of 0.84 and good test-retest reliability at 2 weeks (r = .80, p < .001). The novel 14-item PUB Scale was significantly correlated to other measures of boredom; the Boredom Proneness Scale (r = -.588, p < .001) and the Leisure Boredom Scale (r = .576, p < .001)., Significance of Results: The PUB Scale was found to be a statistically viable tool with the ability to detect boredom and differentiate it from depression. In many respects this work is in concert with much of the current research and clinical effort going on in psycho-oncology that defines components of distress that in sum, redefines depression in advanced cancer.

Screening cancer patients for depression with self-report inventories presents clinical and methodological challenges. Many investigators separate "somatic" from "cognitive" symptoms when adapting such measures to oncology settings. However, this practice has rarely been empirically validated through factor-analytic studies. The following study describes a factor analysis of the Zung Self-Rating Depression Scale (ZSDS) from a large ambulatory sample of cancer patients (N = 1,109). A four-factor solution emerged, consisting of a cognitive symptom factor, a manifest depressed mood factor, and two somatic factors (eating and non-eating related). These factors accounted for 20% (cognitive), 13% (mood), 8% (non-eating), and 7% (eating) of the variance on the Zung, respectively. The authors discuss the implications of these results as they pertain to screening cancer patients for depression.

Purpose/objectives: To determine the degree to which nurses recognize levels of depressive symptoms in their patients with cancer and to describe patient characteristics that influence the accuracy of nurses' perceptions of depressive symptoms., Design: Descriptive, prospective correlational design., Setting: 25 community-based ambulatory oncology clinics affiliated with Community Cancer Care of Indiana., Sample: 40 clinic nurses rated the depression levels of 1,109 patients., Methods: Patients completed the Zung Self-Rating Depression Scale (ZSDS) prior to their medical oncology clinic appointment. Nurses rated their patients' level of depressive symptoms, anxiety, and pain on a 0-10 numerical scale along with determining a performance status score., Main Research Variables: Patient-rated depression and the nurse depression rating., Findings: The most frequent agreement between nurses and patients was observed when patients reported little or no depressive symptoms. They were only concordant 29% and 14% of the time in the mild and moderate/severe ranges, respectively. Nurses' ratings were influenced most by patients' endorsement of frequent and obvious mood symptoms and nurse ratings of patients' anxiety and pain., Conclusions: A marked tendency existed to underestimate the level of depressive symptoms in patients who were more severely depressed. Nurses' ratings were most influenced by symptoms such as crying, depressed mood, and medical factors that are useful but perhaps not the most reliable indicators of depression in this population., Implications for Nursing Practice: Nurse assessment of depression might be improved if greater emphasis were placed on the more diagnostically reliable symptoms of depression and if screening tools for depression were incorporated into nursing practice.

Blom-Singer valve prosthesis is an increasingly popular technique for voice rehabilitation in alaryngeal patients. Although primary voice puncture is being practised, the creation of the tracheo-oesophageal fistula is performed in the majority of patients as a secondary procedure. We describe a technique of secondary tracheo-oesophageal puncture using the flexible endoscope which can be performed under local anaesthetic and sedation. The technique overcomes the difficulty of passing a rigid oesophagoscope or forceps to the level of the tracheostome in a scarred and irradiated neck. The new technique also obviates the need for general anaesthesia. We have successfully used the technique in three patients.

Cancer of the oesophagus is the sixth commonest cancer in males in Singapore. The majority occur in the elderly and patients are often debilitated at presentation. Treatment is often aimed at palliation only. In this article, the preliminary results of 15 patients treated solely on a high dose rate remote afterloading Gammamed brachytherapy machine with an Iridium 192 (Ir192) source are reported. The patients were given 15 Gray (Gy) in a single or two 7.5 Gray fractions. All the patients treated had some improvement of their dysphagia, and seven out of 11 (63%) evaluable patients had symptom improvement lasting at least 11 weeks.

Acute intestinal pseudo-obstruction has been associated with various diverse aetiologies, including several types of malignancies. Malignant thymoma has never been reported before as a cause of acute intestinal pseudo-obstruction. We report here a case of malignant thymoma presenting as acute intestinal pseudo-obstruction. Existing literature on malignant causes of intestinal pseudo-obstruction is also reviewed and discussed.

Elicitation of pattern reversal evoked potentials (PREPs) was added to routine clinical EEG examinations in 100 consecutive adult psychiatric admissions. Latencies and correlations between the peaks and troughs of the triphasic complex were examined with particular reference to current hypotheses about neurophysiologic dysfunctions in schizophrenia and other psychiatric illnesses. PREP data also were examined in relation to age, sex, handedness, concurrent medications, and the clinical EEG findings. The results obtained indicated that age, sex, handedness, neuroleptic and anticholinergic medications and underlying EEG characteristics exert minimal influences upon the PREP. Schizophrenics showed lower hemispheric correlations and greater response stability than did patients with other diagnoses. No lateralized differences in relation to diagnosis were identified.

In a previous controlled group outcome study, a comparison of temperature biofeedback with progressive relaxation indicated that relaxation training was more effective in reducing migraine headache activity at the end of treatment. However, follow-up data obtained at 1, 2, and 3 months after the completion of treatment showed no difference between the two groups on any dependent measure. In the current study, 18 of 26 subjects who completed treatment in the original investigation collected headache data and completed a headache questionnaire 1 year subsequent to the conclusion of treatment in order to evaluate the long-term effectiveness of the two treatments. The results indicated that gains achieved in the reduction of headaches during both treatments were maintained at a 1-year follow-up. With the exception of medication consumption (for which relaxation training led to better long-term results) the 1-year follow-up data reveal no differential efficacy for temperature biofeedback or progressive relaxation in treating migraine headaches.

After an initial four-week baseline phase, during which daily records of headache frequency and intensity and daily medication records were kept, 30 patients with frequent (at least one per month) migraine headaches were randomly assigned to three conditions: (1) temperature biofeedback, autogenic training, and regular home practice; (2) progressive relaxation with regular home practice; and (3) a waiting-list control condition. Comparisons of headache data from the four weeks of baseline and last two weeks of treatment showed that both the relaxation and biofeedback groups improved significantly on total headache activity, duration of headaches, and peak headache intensity and reduced consumption of analgesic medication, while the waiting list control group did not. All three groups showed significant decreases in headache frequency. Although the relaxation training was more effective than biofeedback training at the last week of treatment, follow-up data at one, two, and three months showed no differences between the two treated groups on any dependent measure.