Biomedical subjects

H Christensen

Publications and source records attributed to H Christensen.

At least 145 records · Page 8Linked to original sources

PubMed1997

"Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment.

OBJECTIVES: To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy"). DESIGN: A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia. PARTICIPANTS: A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette. RESULTS: Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics. CONCLUSION: If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.

Adolescent↗

PubMed1997

GP attendance by elderly Australians: evidence for unmet need in elderly men.

OBJECTIVES: To examine GP service use by elderly people and, in particular, to compare those who had not consulted a GP in one year with those who were low attenders and those who were high attenders. DESIGN: Medicare data on GP service use were matched to data collected by interview in 1990-1991 and reinterview in 1994 as part of a community study on health and well-being. SETTING: Canberra and Queanbeyan in the Australian Capital Territory. PARTICIPANTS: People aged 70 years and over, living in the community. MAIN OUTCOME MEASURES: The number of visits made to a GP in 12 months. RESULTS: Medicare data were available for 624 of the 897 participants interviewed (70%). While the women non-attenders reported similar levels of physical illness and symptoms to the low attenders, men non-attenders reported significantly higher levels of illness (P < 0.01) than the low-attender group. The health of men who were non-attenders was very similar to men who were high attenders of GP services. Men who had not seen a GP in one year reported significantly more pain (P = 0.002) and less social support than both low attenders and high attenders (P = 0.012 and P = 0.049, respectively). CONCLUSION: We identified a group of men who had not attended a GP in one year, despite significant levels of morbidity. Such a group may benefit from consultation with a GP and could be targeted in any attempt to improve elderly men's health.

Aged↗

PubMed1997

The psychogeriatric assessment scales (PAS): further data on psychometric properties and validity from a longitudinal study of the elderly.

The PAS is a standardized interview which assesses the changes seen in dementia and depression using a set of scales. There are three scales derived from an interview with the subject (cognitive impairment, depression, stroke) and three from an interview with an informant (cognitive decline, behaviour change, stroke). The aim was to provide data on the psychometric properties and validity of the PAS. The scales were originally developed using data from the first wave of a longitudinal study of the elderly. Reported here are further data on the PAS from the second wave of the same study, carried out 3 1/2 years later. The setting was a community survey carried out in the Australian city of Canberra. Seven hundred and nine elderly persons, with a mean age of 80 years, and 641 informants participated. Besides the PAS, participants were administered several other scales: the Mini-Mental State Examination, the Informant Questionnaire on Cognitive Decline in the Elderly, the National Adult Reading Test and the Goldberg anxiety and depression scales. Diagnoses of dementia and depression were made with the Canberra Interview for the Elderly, from which the PAS is derived. Confirmatory factor analysis replicated the five-factor model which underpins the PAS. The PAS was found to correlate with the other scales having similar content and showed correspondence with diagnoses of dementia and depression derived from the Canberra Interview for the Elderly. Longitudinal data supported the validity of the cognitive decline scale as a measure of change. Overall, the results support the original psychometric and validity research on the PAS.

Aged↗

PubMed1997

Education and decline in cognitive performance: compensatory but not protective.

The association between education and cognitive change was investigated in a large community sample of elderly people followed up after 3.6 years. Lower education was predictive of decline on the Mini-Mental State Examination (MMSE) and on tests of language and knowledge, but not on tests of cognitive speed, memory or reaction time. The effects of education were not attenuated when adjusted for health, disability or activity level. The findings suggest that education slows the rate of decline on crystallized intelligence, but not other cognitive abilities. Education may compensate for neurodegenerative changes rather than protect against them.

Activities of Daily Living↗

PubMed1997

ICD-10 mild cognitive disorder: its outcome three years later.

OBJECTIVE: The aims were to (i) report the outcome of mild cognitive disorder (MCD) 3.6 years after initial interview and diagnosis; (ii) identify predictors of new cases of MCD. The hypotheses were that (i) persons with MCD are more likely to develop dementia than those without MCD; (ii) symptoms of anxiety or depression predict MCD caseness at follow-up. DESIGN: Longitudinal cohort study. SETTING: Community of elderly people (age 70-97 years). PARTICIPANTS: 612 of 897 elderly subjects (mean 76 years) were reinterviewed. Of the 36 MCD cases originally identified, 25 were available at follow-up. 24 incident cases of MCD were identified. MAIN OUTCOME MEASURES: ICD-10 dementia, DSM-III-R dementia, ICD-10 mild cognitive disorder diagnoses made by the Canberra Interview for the Elderly, tests of anxiety, depression, neuroticism and cognitive performance. MAIN RESULTS: Of the original 25 MCD cases available at follow-up, two had a diagnosis of MCD, and three had a diagnosis of both ICD-10 and DSM-III-R dementia. The prevalence of MCD and DSM-III-R dementia at follow-up was no greater for MCD cases diagnosed at initial interview than in normal subjects at initial interview. There was, however, an increased prevalence of ICD-10 dementia among original MCD cases. At initial interview and at follow-up MCD cases were more anxious and depressed but had similar cognitive performance to normals. For incident cases of MCD the only significant predictor was age. CONCLUSIONS: MCD cannot be seen to be a specific forerunner of dementia. Those with a diagnosis of MCD are distinguished more by their anxiety, depression and neuroticism than by their cognitive deficits.

Aged↗

PubMed1997

Belief systems of the general public concerning the appropriate treatments for mental disorders.

A study was conducted to assess the belief systems of the general public concerning the appropriate treatments for mental disorders and correlates of these belief systems. The study was based on the results of a household survey of the general public in Australia, using a national random sample of 2,031 adults aged 18-74 years. Respondents were given a vignette describing either a person with depression or one with schizophrenia, and were asked for their opinions about the helpfulness of various professional and non-professional treatments for the person described. A principal components analysis of the helpfulness ratings gave three factors: a Medical factor with high loadings on all drug treatments (except Vitamins) and on Psychiatric ward and ECT; a Psychological factor with high loadings on Counsellor, Social Worker, Phone counselling, Psychiatrist, Psychologist, Psychotherapy and Hypnosis; and a Lifestyle factor with high loadings on Close family, Close friends, Naturopath, Vitamins, Physical activity and Get out more. The same factors emerged from ratings of the two vignettes. Mean scores on scales constructed from the items with high loadings showed that the public tend to have a negative view of medical treatments and a positive view of psychological and lifestyle ones. However, medical treatments were rated more negatively for depression than for schizophrenia, psychological treatments were rated more positively for schizophrenia, and lifestyle treatments more positively for depression. Age, sex and education of respondents showed few associations with scores on the scales, although the better educated were more in favour of psychological treatments for both depression and schizophrenia and were less opposed to medical treatments for schizophrenia. Respondents who had suffered from the symptoms described in the schizophrenia vignette were more negative towards medical treatments. These findings about public belief systems could have implications for the provision of treatment: where there is a discrepancy in belief system between the patient and the clinician there may be poor adherence to treatment.

Adolescent↗

PubMed1997

Public beliefs about causes and risk factors for depression and schizophrenia.

The objective of this study was to carry out a national survey to assess the Australian public's beliefs about causes and risk factors for mental disorders. A national household survey of 2,031 Australian adults was carried out. Half the respondents were presented with a vignette describing a person with major depression and the other half with a vignette describing schizophrenia. Respondents were asked to rate whether various factors are likely causes of problems such as that described in the vignette and to rate whether various groups are at higher or lower risk. For depression, social environmental factors were often seen as likely causes, which is consistent with the epidemiological evidence. However, genetic factors were considered as a likely cause by only half the population. For schizophrenia, social environmental factors were also often seen as causes, which is in contrast to the weak epidemiological evidence for such a role. Genetic factors attracted more support as a cause of schizophrenia than of depression. These findings point to areas where the mental health literacy of the population could be improved, particularly the over-emphasis on social environmental factors in schizophrenia. Of some concern was the belief of half the population that weakness of character is a likely cause of both depression and schizophrenia. This belief implies a negative evaluation of the sufferer as a person.

Adult↗

PubMed1997

Leukemia and/or myeloproliferative syndrome in neonates with Down syndrome.

Approximately 10% of newborn infants with Down Syndrome develop a form of megakaryoblastic leukemia which usually disappears spontaneously during the first months of life. The evidence that this "Transient Leukemia" is truly leukemia includes the following: it is clonal proliferation, it can be fatal and tissue infiltration of leukemic cells occurs. Also in approximately 25% of cases that recover, Acute Megakaryoblastic Leukemia will develop in the first four years of life, which, if not treated, is fatal. Evidence regarding the megakaryoblastic nature of the leukemic cells is presented as well as a description of the lethal forms of the disease. The study of Transient Leukemia is of considerable importance because it can provide insight into both the nature of leukemia and its relation to trisomy 21.

Biopsy↗

PubMed1997

Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample.

Data from a two-wave longitudinal study of an elderly community sample were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.

Aged↗

PubMed1997

The course of depression in the elderly: a longitudinal community-based study in Australia.

BACKGROUND: We report the outcome of depressive states after 3-4 years in a community sample of the elderly. METHODS: A sample of 1045 persons aged 70+ years in 1990-1 was re-interviewed after 3.6 years. RESULTS: Mortality (21.7%) and refusal or non-availability (10.4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990-1, 13% retained that diagnosis. Of those who were not depressed initially only 2.5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia. CONCLUSIONS: Non-random sample attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.

Activities of Daily Living↗

PubMed1997

A prospective study of cognitive function in the elderly.

BACKGROUND: We report on the change in cognitive function in a population sample of elderly people who have been examined on two occasions more than 3 years apart. METHODS: A sample of 1135 persons aged 70-102 years was interviewed at base-line then re-interviewed 3.6 years later with the Canberra Interview for the Elderly, which included tests of episodic memory and cognitive speed as well as the Mini-Mental State Examination and the National Adult Reading Test (NART). RESULTS: Mortality and loss to follow-up reduced the sample to 736, of whom 614 completed at least one test of cognitive performance on both occasions. Cognitive performance decreased with age, except on the NART. Decline over the follow-up period increased as a function of age in all cognitive measures, except the NART. Change in cognitive scores was close to normal distribution. Incident dementia was associated strongly with age and current level of cognitive performance, but not with rate of decline. Cognitive decline and the risk of incident dementia did not differ by gender. CONCLUSIONS: A score indicating possible impairment in the very elderly carries a worse prognosis than for the younger elderly. Decline is almost universal in at least one cognitive area among those over the age of 85.

Aged↗

PubMed1997

Differentiation of Shewanella putrefaciens and Shewanella alga on the basis of whole-cell protein profiles, ribotyping, phenotypic characterization, and 16S rRNA gene sequence analysis.

Seventy-six presumed Shewanella putrefaciens isolates from fish, oil drillings, and clinical specimens, the type strain of Shewanella putrefaciens (ATCC 8071), the type strain of Shewanella alga (IAM 14159), and the type strain of Shewanella hanedai (ATCC 33224) were compared by several typing methods. Numerical analysis of sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell protein and ribotyping patterns showed that the strains were separated into two distinct clusters with 56% +/- 10% and 40% +/- 14% similarity for whole-cell protein profiling and ribotyping, respectively. One cluster consisted of 26 isolates with 52 to 55 mol% G + C and included 15 human isolates, mostly clinical specimens, 8 isolates from marine waters, and the type strain of S. alga. This homogeneous cluster of mesophilic, halotolerant strains was by all analyses identical to the recently defined species S. alga (U. Simidu et al., Int. J. Syst. Bacteriol, 40:331-336, 1990). Fifty-two typically psychrotolerant strains formed the other, more heterogeneous major cluster, with 43 to 47 mol% G + C. The type strain of S. putrefaciens was included in this group. The two groups were confirmed by 16S rRNA gene sequence analysis. It is concluded that the isolates must be considered two different species, S. alga and S. putrefaciens, and that most mesophilic isolates formerly identified as S. putrefaciens belong to S. alga. The ecological role and potential pathogenicity of S. alga can be evaluated only if the organism is correctly identified.

Animals↗

PubMed1997

Evaluation of a fluorescence-labelled oligonucleotide probe targeting 23S rRNA for in situ detection of Salmonella serovars in paraffin-embedded tissue sections and their rapid identification in bacterial smears.

A method for the detection of Salmonella based on fluorescence in situ hybridization (FISH) has been developed and applied for the direct detection of Salmonella in pure cultures and in formalin-fixed, paraffin-embedded tissue sections. On the basis of the 23S rRNA gene sequences representing all of the S. enterica subspecies and S. bongori, an 18-mer oligonucleotide probe was selected. The specificity of the probe was tested by in situ hybridization to bacterial cell smears of pure cultures. Forty-nine of 55 tested Salmonella serovars belonging to subspecies I, II, IIIb, IV, and VI hybridized with the probe. The probe did not hybridize to serovars from subspecies IIIa (S. arizonae) or to S. bongori. No cross-reaction to 64 other strains of the family Enterobacteriaceae or 18 other bacterial strains outside this family was observed. The probe was tested with sections of formalin-fixed, paraffin-embedded tissue from experimentally infected mice or from animals with a history of clinical salmonellosis. In these tissue sections the probe hybridized specifically to Salmonella serovars, allowing for the detection of single bacterial cells. The development of a fluorescence-labelled specific oligonucleotide probe makes the FISH technique a promising tool for the rapid identification of S. enterica in bacterial smears, as well as for the detection of S. enterica in histological tissue sections.

Animals↗

PubMed1997

Helpfulness of interventions for mental disorders: beliefs of health professionals compared with the general public.

BACKGROUND: The study aimed to compare the beliefs of health professionals about the potential helpfulness of various mental health interventions with those of the general public. METHOD: Surveys were carried out in Australia of 872 general practitioners, 1128 psychiatrists, 454 clinical psychologists and 2031 members of the public. Respondents were presented with a case vignette describing either a person with depression or one with schizophrenia. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. RESULTS: The professionals gave much high ratings than the public to the helpfulness of antidepressants for depression, and of antipsychotics and admission to a psychiatric ward for schizophrenia. Conversely, the public tended to give much more favourable ratings to vitamins and minerals and special diets for both depression and schizophrenia, and to reading self-help books for schizophrenia. CONCLUSION: The beliefs that health practitioners hold about mental disorders differ greatly from those of the general public. There is a need for mental health education campaigns to help close the gap between professional and public beliefs.

Adolescent↗

PubMed1997

Long-term results of the Stamey Bladder-neck suspension procedure and of the Burch colposuspension.

This retrospective study compares the long-term results of the Stamey bladder-neck suspension and the Burch colposuspension following operation for urinary incontinence in women. A total of 182 women underwent operation for urinary incontinence: 83 by Stamey bladder-neck suspension and 99 by Burch colposuspension. The case records were perused and questionnaires were sent to the 169 women who were still alive: 129 women had no previous operation for urinary incontinence. At follow-up in this group a median of 7 years after the operation, 32% were completely continent and 39% had improved after the Stamey method, as against 33% and 29%, respectively, after Burch (p > 0.05). The Stamey operation was associated with a lower complication rate (12%) and a lower rate of re-operation (16%) than the Burch operation (23% and 22%, respectively) (p > 0.05). Previous incontinence surgery and mixed type of incontinence was associated with poor outcome in the Stamey group.

Adult↗

PubMed1997

Aspirin, anti-inflammatory drugs and risk of dementia.

OBJECTIVE: To test the hypothesis that aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) may prevent dementia or cognitive impairment. DESIGN: A two-wave longitudinal study over 3.6 years. SETTING: A community survey of elderly persons living in Canberra, Australia. PARTICIPANTS: There were 1045 elderly persons aged 70 at the start of the study; cognitive assessment was obtained at both waves on 588. MAIN OUTCOME MEASURES: Cognitive functioning was measured using the Mini-Mental State Examination, an episodic memory test, a test of mental speed and the National Adult Reading Test. Dementia was assessed using the Canberra Interview for the Elderly. RESULTS: On cross-sectional data, those who had been taking NSAIDs or aspirin performed no better on the cognitive tests after account had been taken of other confounding variables. There was no interaction with apolipoprotein E genotype. On longitudinal data, no difference was found between NSAID or aspirin users and controls, either in cognitive decline or incidence of dementia. CONCLUSIONS: The results do not support the hypothesis that aspirin or NSAIDs have a protective effect, but it remains possible that various sources of measurement error may have attenuated an effect of clinical significance from either type of drug. Conclusive evidence can be obtained only by a prospective trial.

Aged↗

PubMed1997

A quantitative review of cognitive deficits in depression and Alzheimer-type dementia.

Meta-analysis was used to examine the performance of depressed and Alzheimer-type dementia (DAT) patients on standard and experimental clinical tests of cognitive function. Deficits were found for depression on almost every psychological test. Relative to nondepressed controls, the average deficit was 0.63 of a standard deviation, but the magnitude of the effect varied with the type of test. DAT patients performed worse than depressed patients, with an average effect size of 1.21 standard deviations, but the size of the effect depended on the clinical test. Effect sizes for the comparison between depressives and controls were significantly affected by age, treatment setting, ECT use, severity of depression, and the source of diagnostic criteria, but not by the type of depression. Effect sizes in the comparison of depressives to DAT patients were influenced by age, the severity of depression, and ECT. Depressives performed proportionately worse than controls on tasks with pleasant or neutral, compared with unpleasant content, on speeded compared with nonspeeded tasks, and on vigilance tasks. However, there were no differences in the magnitude of effect size for tests using recall compared with recognition, using categorical compared with noncategorical word lists, on story compared with word comprehension, and using verbal compared with visual material. Relative to DAT patients, depressives performed no better on recall compared to recognition tasks, or verbal compared to visual material. The findings of the review are not consistent with the hypothesis that depression is associated with deficits in effortful processing. A model of psychological deficit in depression as a deficit in speed or attention has more promise.

Aged↗

PubMed1996

Role of nucleotide exchange and hydrolysis in the function of profilin in action assembly.

Profilin, an essential G-actin-binding protein, has two opposite regulatory functions in actin filament assembly. It facilitates assembly at the barbed ends by lowering the critical concentration (Pantaloni, D., and Carlier, M.-F. (1993) Cell 75, 1007-1014); in contrast it contributes to the pool of unassembled actin when barbed ends are capped. We proposed that the first of these functions required an input of energy. How profilin uses the ATP hydrolysis that accompanies actin polymerization and whether the acceleration of nucleotide exchange on G-actin by profilin participates in its function in filament assembly are the issues addressed here. We show that 1) profilin increases the treadmilling rate of actin filaments in the presence of Mg2+ ions; 2) when filaments are assembled from CaATP-actin, which polymerizes in a quasireversible fashion, profilin does not promote assembly at the barbed ends and has only a G-actin-sequestering function; 3) plant profilins do not accelerate nucleotide exchange on G-actin, yet they promote assembly at the barbed end. The enhancement of nucleotide exchange by profilin is therefore not involved in its promotion of actin assembly, and the productive growth of filaments from profilin-actin complex requires the coupling of ATP hydrolysis to profilin-actin assembly, a condition fulfilled by Mg-actin, and not by Ca-actin.

Actins↗