A double blind comparative study of amitriptyline and a new reversible MAO A inhibitor R011-1163 was conducted in 25 depressed inpatients over 4 weeks. Response to treatment was assessed with the Hamilton depression rating scale, the Carroll depression self rating scale and the Visual analogue scale. Both drugs produced significant changes in depressive symptomatology (P less than 0.01, MANOVA) and there were no statistically significant differences between drugs (P greater than 0.05 MANOVA). Side effects were of mild to moderate severity with dry mouth the most commonly reported side effect of amitriptyline and vague, generalised headache in patients, treated with R011-1163.

Adjustment Disorders↗

PubMedDate not supplied

A sequential double-blind controlled study of moclobemide and diazepam in patients with atypical depression.

A double-blind controlled study comparing moclobemide and diazepam in patients with atypical depression was carried out. Statistical comparison of the 14 pairs completing 4 weeks showed that significant reductions in depressive symptomatology as measured by the Hamilton and Carroll depression rating scales occurred in both drug groups, and that diazepam was significantly better than moclobemide. A separate analysis of the 10 pairs completing 8 weeks treatment showed that significant decreases in depression ratings occurred in both drug groups but that by week 8 there was no significant difference between the two drugs for depression scores. Side-effects were minimal, and the most common side-effects emerging for both drugs were sleep disturbance and physical tiredness.

Adult↗

PubMedDate not supplied

Assessment of need for a children's hospice program.

Canuck Place, North America's first free-standing pediatric hospice of its kind, opened in 1995 in British Columbia, Canada. The province-wide program encompasses a broad spectrum of services intended to support community-based care and provide periodic, facility-based respite and palliative care to children with life-threatening, progressive illness and to their families. Loss and grief support is another integral component of the program. The concept of pediatric hospice care is founded on the premise that dying children and their families can benefit from care designed to maximize present quality of life; yet, the creation of such programs must be based on demonstrated need. One vital step in the development of the Canuck Place program was assessing the need for such a program within the province. Data from both traditional quantitative and less traditional qualitative sources were used to document and put forth an argument in support of developing a children's hospice program. The final report addressed several components that are summarized in this article for the purposes of assisting others who may wish to undertake similar projects in their own communities.

Adolescent↗

PubMedDate not supplied

Comparing parent loss with sibling loss.

The death of a loved one is a traumatic loss for children, but little attention has been paid to how children's responses vary according to who died--a parent or a sibling. This article reports the findings of a comparison between children's responses to parent and sibling loss. Two samples of bereaved children were combined for the project, which compared children's scores on the Achenbach Child Behavior Checklist. Findings indicated that there were no significant differences between the two loss groups in the total number of problems, in any of the syndrome scales, or in the percentage of children at risk. However, when the two loss groups were considered by gender, differences appeared--boys were more impacted by the loss of a parent than by the loss of a sibling and girls were most affected by the loss of a sibling, particularly a sister. Possible explanations for these differences are discussed.

Adolescent↗

PubMedDate not supplied

Changes in blood markers of serotoninergic activity following high intensity cycle ergometer exercise.

The purpose of this study was to measure concentrations of adrenaline (A), noradrenaline (NE), free tryptophan (f-Trp), prolactin (PRL), nonesterified fatty acids (NEFA), and blood lactate following 30 s of high-intensity cycle ergometer exercise. Adrenaline (A) and NE concentrations increased immediately postexercise (P < 0.05) and returned to levels observed at baseline 24 h later. Plasma f-Trp concentration decreased by 23.5% immediately following exercise (P < 0.05). There were no changes observed in serum concentrations of PRL. Plasma NEFA concentrations decreased immediately following exercise by 46% (P < 0.05) and returned to baseline values 24 h later. Whole blood lactate concentrations increased immediately post exercise (P < 0.05), and were higher than those measured 24 h later (P < 0.05). These findings indicate that blood markers of serotoninergic activity were unaltered by a single 30 s bout of maximal cycling.

Adult↗

PubMedDate not supplied

International collaborative workshops. A 6-year partnership between Canada and China.

Interprofessional exchanges such as workshops are common activities in international development programs. The authors describe processes used to select, implement, and evaluate six collaborative workshops held in Tianjin, China, between 1990 and 1995. These workshops targeted curricular change for a baccalaureate nursing program in Tianjin Medical University. Our experience highlights the importance of understanding the assumptive base for change, developing an institutional memory in both partner universities, introducing interactive teaching methods congruent with Chinese value systems, and using a formative evaluation strategy to foster cross-cultural dialogue and mutual understanding among project partners.

Canada↗

PubMedDate not supplied

Identifying speech acts from contextual and linguistic information.

We conducted an experiment to examine the comprehension of interrogatives such as Could you make the pencil roll?, which can be intended as yes-no questions, as directives to perform an action, or as both. Clark (1979) has claimed that the comprehension of such sentences is governed by, among other things, the answer obviousness rule; that is, listeners are more likely to interpret such a sentence as a question if the question posed is nonobvious to the speaker. One purpose of the present experiment was to test Clark's claim. A second purpose was to begin identifying the types of contextual information listeners use in comprehending speech acts. The final purpose was to provide data relevant to the controversy about whether listeners evaluate the syntactically direct, literal meaning of a sentence in the course of arriving at a syntactically indirect interpretation. We found that listeners follow an answer obviousness rule, utilize their knowledge of objects and the actions they allow as context for sentence interpretation, and do sometimes evaluate the syntactically direct reading of a sentence before arriving at an indirect speech act.

Adult↗

PubMedDate not supplied

Home care of the frail elderly in the United Kingdom: matching resources to needs.

The paper reports the essential features and evaluation of a scheme to improve the effectiveness of home care for the frail elderly. Decisions about resource allocation were devolved to front line social work staff giving them greater autonomy within clear expenditure parameters. More imaginative responses were noted in the management of a number of difficult problems and the results of the evaluation were generally positive. It appeared that the scheme was most cost-effective for the extremely mentally and physically frail living with others and also for the less frail, socially isolated, depressed elderly person.

Aged↗

PubMedDate not supplied

Physiotherapy in the care of the dying.

This paper examines the role of the physiotherapist in the care of patients whose conditions have reached the point at which intensive active treatment is no longer appropriate and is, therefore, replaced by palliative care directed toward the comfort and support of the patients and their families. The principles of physiotherapy in the delivery of palliative care (modified treatment aims, team approach, and acceptance of death), the possible contexts--both physical and psychological--of effective palliative care, and the attitudinal characteristics of physiotherapists best suited to the implementation of effective palliative care are discussed. The results of a survey of Canadian undergraduate training in physiotherapeutic palliative care, and the present level and method of instruction in this area, are included. The article demonstrates how the physiotherapist can play a central role in the multidisciplinary approach to terminal patient care by assisting patients to make the most of their decreasing potentials, by encouraging them to set short-term goals, and by relieving them of their discomfort.

Humans↗

PubMedDate not supplied

Robots in medicine and surgery.

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Humans↗

PubMedDate not supplied

Dimensions of the supportive role of the nurse in palliative care.

The purpose of this study was to describe the clinical component of the nurse's role in supportive or palliative care. Data were derived from in-depth retrospective descriptions of the care given by a supportive care nurse to 10 patients and their families. Constant comparative analysis revealed that the nurse's role was a supportive one with multiple dimensions. A model of the supportive role in palliative care was developed, comprised of six interwoven but discrete dimensions: Valuing, Connecting, Empowering, Doing For, Finding Meaning, and Preserving Own Integrity. Valuing and Preserving Own Integrity were key concepts related to the nurse as person and were central to the other dimensions. The findings imply that the nurse as a professional cannot be separated from the nurse as a person.

Attitude to Death↗

PubMedDate not supplied

Speaking out in defense of illness care.

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Disease↗

PubMedDate not supplied

Effect of sesamoid position on long-term results of hallux abducto valgus surgery.

Radiographic parameters for 70 patients that underwent hallux abducto valgus (HAV) surgery were evaluated with emphasis on the tibial sesamoid position. The preoperative and postoperative sesamoid positions were analyzed. Soft tissue bunionectomies, metatarsal head and base osteotomies, and first metatarsocuneiform arthrodesis are procedures that were included in this evaluation. The inadequate relocation of the sesamoids, along with other standard parameters, were then correlated with recurrence of hallux abducto valgus and metatarsus primus adductus. The surgical relocation of the sesamoid apparatus is discussed, including both an intracapsular and extracapsular release. Possible indications for fibular sesamoidectomy are suggested. Effects of sesamoid position on the long-term results of HAV surgery are presented.

Hallux Valgus↗