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PubMed2006

Psychometric properties of the French and English versions of the Vancouver Obsessional-Compulsive Inventory and the Symmetry Ordering and Arranging Questionnaire.

The Vancouver Obsessional-Compulsive Inventory (VOCI) and the Symmetry Ordering and Arranging Questionnaire (SOAQ) are self-report measures that assess a wide variety of symptoms and features of obsessive-compulsive disorder (OCD) including checking, contamination, obsessions, hoarding, "just right", indecisiveness, and symmetry, ordering and arranging obsessions and compulsions. The original English versions of the VOCI and SOAQ have been shown to demonstrate excellent psychometric properties. The present study examined the reliability and validity of French translations of these measures in a non-clinical sample, and also involved the collection of supplementary psychometric information about the English versions of the scales from a new sample. Volunteer undergraduate students completed questionnaire packages including the VOCI and SOAQ, as well as measures of obsessive-compulsive, phobic and depressive symptomatology in their native language of either French or English. Results indicate that the French versions of the VOCI and SOAQ demonstrate similar and excellent psychometric properties to the English versions and that these measures are highly valid and reliable assessment tools for use in clinical and research applications in both languages.

Adolescent↗
PubMedDate not supplied

Torpor and digestion in food-storing hibernators.

Many species of hibernating mammals rely on hoarded food rather than body fat to support winter energy requirements. Here, we evaluate whether the associated ingestive and digestive requirements reduce the benefits that food-storing hibernators can accrue from torpor. Using a simple model, we predict (1) that digestive efficiency could either increase or decrease with increased use of torpor, depending on the Q(10) of digestion relative to the Q(10) of whole-animal metabolism and (2) that increased torpor will result in a linear decrease in energy consumption but an exponential increase in euthermic intake requirements. In 16 captive eastern chipmunks (Tamias striatus), the proportion of time that different individuals spent in torpor was highly variable (29.8%+/-5.9%; 0.0%-86.3%), positively correlated with dry matter digestibility (r2=0.53, P=0.02) and negatively correlated with energy consumption (r2=0.72, P=0.002). Thus, by both increasing conversion efficiency and reducing energy requirements, torpor appears to provide a double benefit for energy conservation by food-storing hibernators. Despite this, a comparative analysis shows that the euthermic intervals of food-storing rodents are four times as long and torpor intervals are half as long as that of fat-storing rodents. Given that required euthermic intake rates are expected to increase exponentially at high levels of torpor, the reduced torpor expression of food-storing species may result from constraints on their ability to load enough food into the gut when euthermic to cover the energy requirements of the subsequent torpor cycle.

Animals↗
PubMedDate not supplied

The role of energy availability in Mammalian hibernation: an experimental test in free-ranging eastern chipmunks.

Reduced torpor expression by hibernating mammals is often attributed to physiological constraints that limit their hibernation ability but may instead reflect adaptive, plastic responses to surplus energy availability. We evaluated this hypothesis by supplementing the food hoards of free-ranging eastern chipmunks (Tamias striatus) before hibernation and then documenting their use of torpor during the subsequent winter. In both years of study, chipmunks that received additional food were euthermic more than twice as frequently as nonsupplemented individuals. Furthermore, when food-supplemented individuals did express torpor, their minimum collar temperature was 5 degrees -10 degrees C warmer than nonsupplemented animals. These results indicate that reduced torpor expression by hibernators can result from an absence of energetic necessity rather than a lack of physiological capability and suggest that even endotherms sequestered in a hibernaculum may benefit from maintaining an elevated body temperature whenever possible.

Animals↗
PubMed2005

Medication management at home: medication-related risk factors associated with poor health outcomes.

BACKGROUND: Some patients may have medication-related risk factors only identified by home visits, but the extent to which those risk factors are associated with poor health outcomes remains unclear. OBJECTIVE: To determine the association between medication-related risk factors and poor patient health outcomes from observations in the patients' homes. DESIGN: Cross-sectional study. SETTING: Patients' homes. SUBJECTS: 204 general practice patients living in their own homes and at risk of medication-related poor health outcomes. METHODS: Medications and medication-related risk factors were identified in the patients' homes by community pharmacists and general practitioners (GPs). The medication-related risk factors were examined as determinants of patients' self-reported health related quality of life (SF-36) and their medication use, as well as physicians' impression of patient adverse drug events and health status. RESULTS: Key medication-related risk factors associated with poor health outcomes included: Lack of any medication administration routine, therapeutic duplication, hoarding, confusion between generic and trade names, multiple prescribers, discontinued medication repeats retained and multiple storage locations. Older age and female gender were associated with some poorer health outcomes. In addition, expired medication and poor adherence were also associated with poor health outcomes, however, not independently. CONCLUSION: The findings support the theory that polypharmacy and medication-related risk factors as a result of polypharmacy are correlated to poor health outcomes.

Adult↗
PubMedDate not supplied

Environmental enrichment and cortical injury: behavioral and anatomical consequences of frontal cortex lesions.

Rats with large unilateral or bilateral frontal cortical lesions were placed in either isolated or enriched housing conditions for 90 d and then were compared behaviorally and neuroanatomically to control rats. The frontal lesions reduced chronic body weight, produced impairments in claw cutting, food hoarding, tongue extension, and spatial navigation in the Morris water task, and increased running wheel activity. Enriched rearing attenuated many of the behavioral changes, but with the exception of tongue extension and spatial navigation, it had similar effects in both normal and brain-injured animals. Analysis of the brains showed that enrichment increased brain weight and dendritic branching in visual cortex similarly in normal and brain-injured rats. In contrast, however, enrichment affected parietal neurons in normal but not in brain-damaged animals. Instead, the frontal operates showed an increase in parietal branching irrespective of the rearing condition, which implies that the lesion itself may have led to some form of reactive synaptogenesis that subsequently precluded environmental effects.

Animals↗
PubMed1991

Dopamine increase in the nucleus accumbens of rats exposed to high pressure.

When human divers and experimental animals are exposed to high pressure, they develop the high pressure neurological syndrome (HPNS) characterized by electroencephalographic changes, sleep and behavioral disturbances. Free-moving rats chronically implanted in the nucleus accumbens with carbon electrodes essentially selective to dopamine (DA) were compressed to 80 bar. Compression was found to lead to a sustained increase in extracellular DA level (+88%), then during the stay and decompression phases, values progressively decreased. These results are discussed in the field of the involvement of the DA meso-limbic pathways in the occurrence of some of the behavioral disturbances of HPNS in rats including hyperlocomotor activity and hoarding behavior.

Animals↗
PubMed1995

The CNS and staff empowerment: a case of shifting paradigms.

The essence of nursing practice occurs at the bedside. In the midst of shifting health care dynamics, the need for excellence and stability at the bedside remains paramount. Past bureaucratic paradigms, focused on power hoarding and competitiveness, create dysfunctional work conditions in nursing units. Successful nursing administrations are turning to newer paradigms of staff empowerment where values focus on initiative, creativity and perpetual learning in the work place. The CNS has a unique opportunity to contribute to staff empowerment by enhancing staff impact in clinical practice, building staff competence in dynamic situations, revitalizing the meaningfulness of patient care and facilitating intelligent choice alternatives in complex situations.

Clinical Competence↗
PubMed1999

Management forecast: optimizing the use of organizational and individual knowledge.

Knowledge management provides a means for sharing data, lessons learned, and accumulated knowledge throughout an organization or within an entire industry. Gone are the days of hoarding knowledge to ensure job security; today's workers and managers must work together to find new and innovative ways to use what they know and optimize how that knowledge is accessed. Knowledge management's new approach to shared intellectual resources has implications for workers and managers in all fields and promises to redraw the management landscape. But are healthcare organizations setting the stage for reengineering themselves all over again?

Administrative Personnel↗
PubMed2005

McLeod syndrome: life-long neuropsychiatric disorder due to a novel mutation of the XK gene.

A 50-year-old man presented with worsening, virtually lifelong, chorea and progressive behavioural disturbance, involving disinhibition and hoarding, over 10 years. Clinical assessment revealed chorea, dysarthria, areflexia, an inappropriately jovial, impulsive manner and neuropsychological evidence of frontosubcortical dysfunction. Investigation results included an elevated creatine kinase, caudate atrophy and hypoperfusion, acanthocytes in the peripheral blood and the McLeod phenotype. DNA studies demonstrated a single-base deletion at position 172 in exon 1 of the XK gene, giving rise to a premature stop codon at position 129 in exon 2.

Acanthocytes↗
PubMed2002

Biofeedback therapy expedites the resolution of reflux in older children.

PURPOSE: In older children the spontaneous resolution rate of low grade vesicoureteral reflux is low and currently its management is controversial in regard to surgery versus prophylaxis versus observation alone. Bladder dysfunction in children with neurogenic bladders and to a less declarative degree in neurologically intact children has a role in the etiology or persistence of reflux. We determine the impact of biofeedback therapy on neurologically intact children with vesicoureteral reflux and detrusor-sphincter dyssynergia. MATERIALS AND METHODS: Vesicoureteral reflux was detected by voiding cystourethrography in children evaluated for urinary tract infections. Children with breakthrough infections or dysfunctional voiding based on history underwent uroflowmetry with concomitant patch electromyography of the external sphincter. Dyssynergia was defined as increased or steady electromyography activity during micturition. Biofeedback was initially performed weekly and the interval increased as indicated. The goals were to eliminate dyssynergia and reduce or eliminate post-void residual urine. Voiding cystourethrography was performed 1 year later to determine the status of the reflux. Ureteral reimplantation was performed during the period of biofeedback when indicated. RESULTS: From February 1997 to March 2001, 25 children 6 to 10 years old (mean age 9) with vesicoureteral reflux and detrusor-sphincter dyssynergia were treated with biofeedback therapy. There were 31 units (5 bilateral) with reflux, which was grade I in 10, II in 15, III in 5 and IV in 1. Children underwent an average of 7 sessions of biofeedback (range 2 to 20). On followup voiding cystourethrography, vesicoureteral reflux resolved in 17 units (55%), grade improved in 5 (16%) and reflux remained unchanged in 9 (29%). All cured vesicoureteral reflux was grade I (8 cases) or II (9). Four children (5 renal units) underwent reimplantation. In cured children there were no breakthrough infections during or since therapy and post-void residual urine decreased from an average of 40% before to 10% after therapy. Symptoms of urgency, daytime wetting and hoarding of urine improved or were eliminated in all children with resolved vesicoureteral reflux. CONCLUSIONS: Treating external detrusor-sphincter dyssynergia in older children with low grade vesicoureteral reflux, with biofeedback results in 1-year resolution rates that are considerably greater than historical resolution rates. External detrusor-sphincter dyssynergia should be screened for in children when surgery or discontinuation of chemoprophylaxis is considered so that biofeedback can be started.

Biofeedback, Psychology↗
PubMed2006

An evolutionary perspective on caching by corvids.

A principal finding in the food-caching literature is that species differences in hoarding propensity are positively correlated with species differences in degree of adaptations to caching behaviour, such as performance on spatial memory tasks and hippocampal volume. However, there are examples that do not fit this pattern. We argue that these examples can be better understood by considering the phylogenetic relatedness between species. We reconstruct the ancestral state for caching behaviour in corvids and assess when transitions in caching behaviour occurred within the corvid phylogeny. Our analysis shows that the common ancestor of all corvids was a moderate cacher. This result suggests that corvids followed a bi-directional evolutionary trajectory in which caching was secondarily lost twice and there were at least two independent transitions from moderate to specialized caching. The independent evolution of specialized cachers in the two groups must, therefore, be a case of convergent evolution. This is exemplified by the fact that specialized cachers show structurally different adaptations serving the same function to intense caching, such as different pouches to transport food. Finally, we argue that convergent evolution may have led to adaptations in memory and hippocampus that serve the same function but differ in design, and that these different adaptations may explain the examples that do not fit the pattern predicted by the adaptive specialization hypothesis.

Animals↗
PubMed1976

Food caching by red foxes and some other carnivores.

Food caching by the red fox, Vulpes vulpes, may safeguard surplus food for future consumption. Because of practical difficulties involved in observation the extent to which the fox making a cache, or any other fox, can utilise the hoard was not known. This problem is tackled through extended observation, using unfra-red binoculars, on wild foxes (some of which were radio-tagged), together with experiments involving hand-reared tame foxes, either walked on a long leash or free and radio-tagged. The results demonstrate the fox's ability to rediscover its caches and shed light on the adaptive significance of the behaviour, which is then dsicussed in the context of food safeguarding by other carnivores.

Animals↗
PubMed1999

Uncovering a multitude of sins: medication management in the home post acute hospitalisation among the chronically ill.

BACKGROUND: Sub-optimal use of prescribed medication is often associated with unplanned hospitalisation among the chronically ill. AIMS: To examine the extent of sub-optimal use of prescribed medication in a 'high risk' patient cohort recently discharged from acute hospital care. METHODS: Chronically ill patients discharged from acute hospital care (n = 342) were studied. At one week post discharge a home visit was performed by a nurse and a pharmacist during which medication management (including compliance and medication-related knowledge) was assessed. RESULTS: During the majority of home visits at least one medication-related problem was detected: approximately half of the cohort subject to a 'reliable' pill-count were found to be mal-compliant and almost all demonstrated inadequate medication-related knowledge. Mal-compliance was correlated with > or = five prescribed medications (Odds ratio [OR] 2.6: p < 0.002). Comparatively, lower medication-related knowledge was correlated with age > 75 years (OR 2.2: p < 0.001), exacerbation of a pre-existing chronic illness (OR 2.7: p = 0.044) and < or = six years formal education (OR 1.9: p = 0.004). Neither were modulated by extent of in-hospital counselling. Other previously unknown problems detected during the home visit included hoarding of previously prescribed medication (35%) and reducing medication intake to minimise costs (21%). CONCLUSIONS: Management of prescribed medications among chronically ill patients recently discharged from acute hospital care is often sub-optimal. Assessment of medication management in the home provides an invaluable opportunity to detect and address problems likely to result in poorer health outcomes.

Aged↗
PubMed1996

Obsessions and compulsions in Prader-Willi syndrome.

This study examines the nature, severity and correlates of non-food obsessions and compulsions in 91 people with Prader-Willi syndrome (PWS) aged 5-47 years (mean age = 19 years). Prominent symptoms, seen in 37-58% of the sample, included hoarding; ordering and arranging; concerns with symmetry and exactness; rewriting; and needs to tell, know or ask. A remarkably high proportion of participants had moderate to severe symptom severity ratings; 64% showed symptom-related distress, and 80% showed symptom-related adaptive impairment. The study also compared obsessive-compulsive symptoms in 43 adults with PWS to age- and sex-matched non-retarded adults with obsessive-compulsive disorder (OCD). The PWS and OCD groups showed similar levels of symptom severity and numbers of compulsions; they also showed more areas of symptom similarity than difference. Increased risks of OCD in persons with PWS are strongly indicated. Implications are discussed for pharmacotherapy, behavioral therapy and family support.

Adolescent↗
PubMed1998

An unusual mechanism for ligand antagonism.

The ratio of late to early events stimulated by the mast cell receptor for immunoglobulin E (IgE) correlated with the affinity of a ligand for the receptor-bound IgE. Because excess receptors clustered by a weakly binding ligand could hoard a critical initiating kinase, they prevented the outnumbered clusters engendered by the high-affinity ligands from launching the more complete cascade. A similar mechanism could explain the antagonistic action of some peptides on the activation of T cells.

2,4-Dinitrophenol↗
PubMed1997

Signal transduction and transcriptional and posttranscriptional control of iron-regulated genes in bacteria.

Iron is an essential element for nearly all living cells. Thus, the ability of bacteria to utilize iron is a crucial survival mechanism independent of the ecological niche in which the microorganism lives, because iron is scarce both in potential biological hosts, where it is bound by high-affinity iron-binding proteins, and in the environment, where it is present as part of insoluble complex hydroxides. Therefore, pathogens attempting to establish an infection and environmental microorganisms must all be able to utilize the otherwise unavailable iron. One of the strategies to perform this task is the possession of siderophore-mediated iron uptake systems that are capable of scavenging the hoarded iron. This metal is, however, a double-edged sword for the cell because it can catalyze the production of deadly free hydroxyl radicals, which are harmful to the cells. It is therefore imperative for the cell to control the concentration of iron at levels that permit key metabolic steps to occur without becoming a messenger of cell death. Early work identified a repressor, Fur, which as a complex with iron repressed the expression of most iron uptake systems as well as other iron-regulated genes when the iron concentration reached a certain level. However, later work demonstrated that this regulation by Fur was not the only answer under low-iron conditions, there was a need for activation of iron uptake genes as well as siderophore biosynthetic genes. Furthermore, it was also realized that in some instances the actual ferric iron-siderophore complex induced the transcription of the cognate receptor and transport genes. It became evident that control of the expression of iron-regulated genes was more complex than originally envisioned. In this review, I analyze the processes of signal transduction, transcriptional control, and posttranscriptional control of iron-regulated genes as reported for the ferric dicitrate system in Escherichia coli; the pyochelin, pyoverdin, and enterobactin systems in Pseudomonas species; the irgB system in Vibrio cholerae; and the plasmid-mediated anguibactin system in Vibrio anguillarum. I hope that by using these diverse paradigms, I will be able to convey a unifying picture of these mechanism and their importance in the maintenance and prosperity of bacteria within their ecological niches.

Bacteria↗
PubMed1976

Medicines and elderly people: a general practice survey.

All 151 patients of 75 years and over in one practice were visited at home to survey their health and how they managed their medicines. Altogehter 87% were on regular treatment, 34% taking three or four different drugs each day. Most were responsible for their own drugs and managed them well, but many left their drugs in exposed places and were uncertain about how to dispose of unwanted medicines. Overall they were prescribed about three times the number of drugs prescribed for the general population, and women took twice as many drugs regularly as men. Although many drugs were obtained directly from a pharmacist, his advice was rarely sought. Most were labelled, but more explicit instructions about indications for taking the drug would have been helpful, and information about hoarded drugs would have been enhanced by dispensing and expiry dates. Treatment was facilitated when patients brought their drugs to the consultation and careful records were made of repeat prescriptions. As so many patients take three or more different types of drugs each day a container in which a day's supply could be laid out would be useful.

Aged↗
PubMed2006

Enhanced activation of reward mediating prefrontal regions in response to food stimuli in Prader-Willi syndrome.

BACKGROUND: Individuals with Prader-Willi syndrome (PWS) exhibit severe disturbances in appetite regulation, including delayed meal termination, early return of hunger after a meal, seeking and hoarding food and eating of non-food substances. Brain pathways involved in the control of appetite in humans are thought to include the hypothalamus, frontal cortex (including the orbitofrontal, ventromedial prefrontal, dorsolateral prefrontal and anterior cingulate areas), insula, and limbic and paralimbic areas. We hypothesised that the abnormal appetite in PWS results from aberrant reward processing of food stimuli in these neural pathways. METHODS: We compared functional MRI blood oxygen level dependent (BOLD) responses while viewing pictures of food in eight adults with PWS and eight normal weight adults after ingestion of an oral glucose load. RESULTS: Subjects with PWS demonstrated significantly greater BOLD activation in the ventromedial prefrontal cortex than controls when viewing food pictures. No significant differences were found in serum insulin, glucose or triglyceride levels between the groups at the time of the scan. CONCLUSIONS: Individuals with PWS had an increased BOLD response in the ventromedial prefrontal cortex compared with normal weight controls when viewing pictures of food after an oral glucose load. These findings suggest that an increased reward value for food may underlie the excessive hunger in PWS, and support the significance of the frontal cortex in modulating the response to food in humans. Our findings in the extreme appetite phenotype of PWS support the importance of the neural pathways that guide reward related behaviour in modulating the response to food in humans.

Adult↗