Hitch up your humor suspenders, case managers.

Purpose/objectives: Although case managers must project professionalism, a dash of healing humor can accomplish a lot of trust in a little space of time. To show how case managers can incorporate humor into case management (CM), the article explores beneficial humor-based interventions and sources of unhealthy humor. Suspending the garment of good humor are 2 main straps: (1) increasing the theoretical knowledge base about healthcare humor for case managers and (2) encouraging knowledge transfer through appropriate humorous exchanges up and down the care continuum bucket brigade.

Atomoxetine modulates right inferior frontal activation during inhibitory control: a pharmacological functional magnetic resonance imaging study.

Background: Atomoxetine, a selective noradrenaline reuptake inhibitor (SNRI) licensed for the treatment of attention-deficit/hyperactivity disorder (ADHD), has been shown to improve response inhibition in animals, healthy volunteers, and adult patients. However, the mechanisms by which atomoxetine improves inhibitory control have yet to be determined.

Methods: The effects of atomoxetine (40 mg) were measured with a stop-signal functional magnetic resonance imaging (fMRI) paradigm in 19 healthy volunteers, in a within-subject, double-blind, placebo-controlled design.

Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study.

Background: Trichotillomania (repetitive hair-pulling) is an Axis I psychiatric disorder whose neurobiological basis is incompletely understood. Whole-brain trichotillomania neuroimaging studies are lacking.

Aims: To investigate grey and white matter abnormalities over the whole brain in patients with trichotillomania.

Orbitofrontal dysfunction in patients with obsessive-compulsive disorder and their unaffected relatives.

Obsessive-compulsive disorder (OCD) is characterized by repetitive thoughts and behaviors associated with underlying dysregulation of frontostriatal circuitry. Central to neurobiological models of OCD is the orbitofrontal cortex, a neural region that facilitates behavioral flexibility after negative feedback (reversal learning). We identified abnormally reduced activation of several cortical regions, including the lateral orbitofrontal cortex, during reversal learning in OCD patients and their clinically unaffected close relatives, supporting the existence of an underlying previously undiscovered endophenotype for this disorder.

Sex differences in parent and child pain ratings during an experimental child pain task.

Research in the field of pediatric pain has largely ignored the role of fathers in their children's pain experiences. The first objective of the present study was to examine the effect of the presence of mothers versus fathers on children's subjective ratings, facial expressions and physiological responses to acute pain. The second objective was to examine whether child and parent sex influence parents' proxy ratings of their children's pain.

Further evidence for the association of MMP9 with nephropathy in type 2 diabetes and application of DNA pooling technology to candidate gene screening.

Background: Diabetic nephropathy is characterised by extracellular matrix (ECM) expansion, a key modulator of which is TGF-b1. Glucose-stimulated transcriptional activation of the TGF-b1 gene is an important component of the pathogenesis of nephropathy, following which latent TGF-b1 protein is synthesised. Matrix metalloproteinase 9 (MMP9) remodels the ECM and has been implicated in TGF-b1 activation.

The Irritability Questionnaire: a new scale for the measurement of irritability.

Irritability is an important symptom in patients with neuropsychiatric disorders. It is a major source of distress to patients and their carers and can lead to social and family dysfunction. Despite this, there has been little systematic research on irritability in psychiatry.

Diabetic nephropathy, inflammation, hyaluronan and interstitial fibrosis.

Hyaluronan (HA) is a ubiquitous connective tissue glycosaminoglycan component of most extracellular matrices and alterations in its synthesis have been suggested to be involved in the glomerular changes of diabetic nephropathy. Similarly it has been suggested that macrophages are involved in the initiation of diabetic glomerular injury. Much less is known regarding the role of the prognostic value of changes in interstitial HA and interstitial inflammatory infiltrate.

Pathogenic expansions of the SCA6 locus are associated with a common CACNA1A haplotype across the globe: founder effect or predisposing chromosome?

Spinocerebellar ataxia type 6 (SCA6) is a common cause of dominantly inherited ataxia due to an expansion of the CAG repeat in the CACNA1A gene. Affected individuals from the same population share a common haplotype, raising the possibility that most SCA6 cases have descended from a small number of common founders across the globe. To test this hypothesis, we carried out haplotype analysis on SCA6 families from Europe, South America and the Far East, including an established de novo SCA6 expansion.

Brief report: judging pain intensity in children with autism undergoing venepuncture: the influence of facial activity.

The biasing effect of pain sensitivity information and the impact of facial activity on observers' judgements of pain intensity of children with autism were examined. Observers received information that pain experience in children with autism is either the same as, more intense than, or less intense than children without autism. After viewing six video clips of children with autism undergoing venepuncture, observers estimated pain intensity using a visual analogue scale.

Episodic ataxia and hemiplegia caused by the 8993T->C mitochondrial DNA mutation.

The m.8993T-->C MTATP6 mutation of mitochondrial DNA (mtDNA) usually causes mitochondrial disease in childhood, but was recently described in a family with adult onset ataxia and polyneuropathy. Cytochrome c oxidase muscle histochemistry, which is the standard clinical investigation for mitochondrial disease in adults, is usually normal in patients with MTATP6 mutations.

Acuity and case management: a healthy dose of outcomes, part III.

Purpose Of Study: This is the third of a 3-part series presenting 2 effective applications--acuity and dosage--that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Concepts were presented that related the practice of CM to the use of evidence-based practice (EBP), knowledge, and methods and the development of instruments that measure and score pivotal CM actions.

Acuity and case management: a healthy dose of outcomes, part II.

Purpose: This is the second of a 3-part series presenting 2 effective applications-acuity and dosage-that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Part I also featured a specific exemplar, the CM Acuity Tool, and described how to use acuity to identify and score the complexity of a CM case.

Recognition and discrimination of prototypical dynamic expressions of pain and emotions.

Facial expressions of pain and emotions provide powerful social signals, which impart information about a person's state. Unfortunately, research on pain and emotion expression has been conducted largely in parallel with few bridges allowing for direct comparison of the expressive displays and their impact on observers. Moreover, although facial expressions are highly dynamic, previous research has relied mainly on static photographs.

Obsessive-compulsive disorder: boundary issues.

The boundaries between obsessive-compulsive disorder (OCD) and other neuropsychiatric disorders remain unresolved and may well differ from one disorder to another. Endophenotypes are heritable, quantitative traits hypothesized to more closely represent genetic risk for complex polygenic mental disorders than overt symptoms and behaviors. They may have a role in identifying how closely these disorders are associated with another and with other mental disorders with which they share major comorbidity.

Acuity and case management: a healthy dose of outcomes, part I.

Purpose Of Study: This article presents acuity and dosage as two concepts that describe how the business case for case management (CM) can be made. Dosage and acuity concepts are explained as client need-severity, CM intervention-intensity, and CM activity-dose by amount, duration, extent, and timing. Concepts are related to the practice of CM using evidence-based knowledge and methods to develop instruments that measure and score pivotal CM actions.

Expressive dimensions of pain catastrophizing: a comparative analysis of school children and children with clinical pain.

We investigated the role of the child's pain catastrophizing in explaining (1) children's self-reported tendency to verbally share their pain experience with others and (2) different dimensions of pain expression, as described by the mother and the father, including non-verbal and verbal communicative pain behaviour and protective pain behaviour. Participants were school children, children with chronic or recurrent pain, and their parents. The results showed that: (1) Pain catastrophizing was associated with children's greater self-acknowledged tendency to verbally share their pain experience with others.

Evaluation of the elderly driver.

Driving is a daily activity for people across the country. Most Americans, including the elderly, consider it a right. Driving, however, is dangerous and can become more challenging as people age.

Differential selection of acridine resistance mutations in human DNA topoisomerase IIbeta is dependent on the acridine structure.

Type II DNA topoisomerases are targets of acridine drugs. Nine mutations conferring resistance to acridines were obtained by forced molecular evolution, using methyl N-(4'-(9-acridinylamino)-3-methoxy-phenyl) methane sulfonamide (mAMSA), methyl N-(4'-(9-acridinylamino)-2-methoxy-phenyl) carbamate hydrochloride (mAMCA), methyl N-(4'-(9-acridinylamino)-phenyl) carbamate hydrochloride (AMCA), and N-[2-(dimethylamino)ethyl]acridines-4-carboxamide (DACA) as selection agents. Mutations betaH514Y, betaE522K, betaG550R, betaA596T, betaY606C, betaR651C, and betaD661N were in the B' domain, and betaG465D and betaP732L were not.

Judgments of infant pain: the impact of caregiver identity and infant age.

Objective: To examine whether caregiver judgments of infant pain would vary systematically with different infant caregiver groups and infant age.

Methods: A total of 123 caregivers (41 parents, 41 in patient nurses, 41 pediatricians) viewed videotapes of the vigorous behavioral responses of healthy infants (aged 2, 4, 6, 12, and 18 months) to a routine immunization injection and provided ratings of both the affective distress and pain intensity observed.

Results: A principal components analysis of affective and intensity ratings yielded a weighted pain summary score for each injection event.