Macronutrient intake in anorexia nervosa: The National Heart, Lung, and Blood Institute Growth and Health Study.

Objective: To compare the macronutrient intake of females with or without a history of anorexia nervosa (AN) at three times: two years and one year before the onset of AN, and during the first year of the illness.

Study Design: Prospective cohort study with 3-day food intake records collected over 10 years. Subjects were 154 white females (aged 9 or 10 years at study entry), of whom 14 had AN and 140 were healthy females matched for age at study entry and parental education.

Chronic pain in a biracial population of young women.

This study investigated dimensions of chronic pain and temporomandibular disorders (TMDs) in a census tract sampling of African-American and Caucasian young women enrolled (from racially congruent households) at ages 9-10 in the longitudinal multicenter National Heart Lung and Blood Institute's Growth and Health Study (NGHS). The present study, which examined participants at the California clinical NGHS center when they were 19-23 years old, investigates five commonly reported chronic pains: back, head, face/jaw, abdomen, and chest. Chronic pain grade (CPG) status based on pain self-reports (frequency, duration, severity, and interference with usual activities) is reported for each of the five pain sites.

Characteristics of free-roaming cats evaluated in a trap-neuter-return program.

Objective: To determine characteristics of free-roaming cats evaluated in a trap-neuter-return program.

Design: Cross-sectional study.

Animals: 5,323 free-roaming cats.

A case study of hemispatial neglect using finite element analysis and positron emission tomography.

Background: The authors present a patient who developed transient hemispatial neglect following surgical drainage of a large right frontotemporal arachnoid cyst. As symptoms evolved in parallel with brain shift over the subsequent months, the authors hypothesized that the disorder was associated with the appearance of mechanical stresses in the cerebral mantle.

Methods: To map tissue stress at the various stages of deformation, a finite element computer simulation was conducted on the basis of computed tomography scans of the patient.

Molecular analysis for genetic counselling in amelogenesis imperfecta.

Objective: To use molecular genetics to establish the mode of inheritance in a family with amelogenesis imperfecta.

Materials And Methods: The polymerase chain reaction was used to amplify exons of the amelogenin gene on the short arm of the X chromosome.

Results: A single base deletion mutation in exon 6 of the amelogenin gene was identified.

Ethnic differences in bone mass of young women vary with method of assessment.

To examine ethnic differences in bone mass measured by calcaneus ultrasound (CUS) and dual energy X-ray absorptiometry (DXA), and to compare the two methodologies, CUS was performed in 904 healthy Asian, African American, Latina, and Caucasian women 20-26 yr old using the Lunar Achilles Plus ultrasonometer. CUS measurements (broadband ultrasound attenuation [BUA] and speed of sound [SOS]) were made following standard methodology (standard CUS) and repeated adjusting for foot size using shims (with-shim CUS). Areal bone mineral density (BMD) and estimated volumetric bone density (BMAD) at the spine, femoral neck, and whole body were determined using the Lunar DPX-IQ.

Decline in physical activity in black girls and white girls during adolescence.

Background: Physical activity declines during adolescence, but the underlying reasons remain unknown.

Methods: We prospectively followed 1213 black girls and 1166 white girls enrolled in the National Heart, Lung, and Blood Institute Growth and Health Study from the ages of 9 or 10 to the ages of 18 or 19 years. We used a validated questionnaire to measure leisure-time physical activity on the basis of metabolic equivalents (MET) for reported activities and their frequency in MET-times per week; a higher score indicated greater activity.

Interdisciplinary work in community mental health.

The idea of mental health and social care staff working within clearly defined roles is often frowned upon as poor and retrogressive practice, out of step with the government's modernisation agenda. But as this article points out, increasingly blurred roles in already stressful and demanding clinical teams can be counterproductive, with practitioners becoming entrenched in their own perception of their particular roles and less flexible in their work. Conversely, well-defined boundaries and clearly defined roles can be supportive and enabling, providing a containing structure for teams to work within.

Reluctant empiricists: community mental health nurses and the art of evidence-based praxis.

The National Service Framework for Mental Health (1999) emphasizes the need for a culture of evidence-based practice (EBP) in mental health care. However, there is relatively little research addressing EBP from the perspective of community mental health nurses and we are still unsure of why the uptake of this style of working has been slow. This paper suggests that rather than thinking in terms of 'barriers' to the uptake of EBP, the issue may best be conceptualized as a form of praxis on the part of nurses, as they seek to manage the diversity of ideologies and practices in their working lives.

'Like a friend going round': reducing the stigma attached to mental healthcare in rural communities.

Traditionally, stigma is seen as something that is the fault of the mental health system, and that involves an individual suffering social disapprobation and reduced life chances as a result of having been given a diagnostic label and an identity as a patient as a result of their contact with psychiatric institutions. The present study, based on focus group discussions conducted with users and mental healthcare workers in a rural setting, suggests that this classic conception of stigma does not readily apply to care in the community. First, workers described themselves as actively trying to challenge stigma at an institutional level, as well as being apt to change their own practice to reduce the stigmatizing effect of mental healthcare on their clients and make their presence less conspicuous.

Epilepsy and pregnancy.

Pregnancies in women with epilepsy are high risk and need careful management by both the medical and obstetric teams due to the increased incidence of complications and adverse outcomes of pregnancy. By the time a pregnant woman with epilepsy presents, the foetus is virtually fully formed and the opportunity for altering drug treatment has passed. Women need to be counselled and told to seek advice about their anticonvulsant therapy should they wish to become pregnant.

The associations between epilepsy and depressive illness in secondary care.

Background: The association between epilepsy and depressive illness has long been established. However, though various explanations-psychosocial and anatomical-have been proposed findings from studies are inconsistent and often contradictory.

Aims: This study aimed to compare the features of those people with epilepsy seen in a secondary care setting who developed a depressive illness with those that did not.

Community outreach: a call for community action.

For a variety of reasons, end-stage renal disease disproportionately affects minority populations. Factors such as socioeconomic status, cultural differences, and genetic variations, are all involved. In addition, there are often real and perceived barriers for these patient groups in fully accessing the healthcare system.

Early predictors of daily smoking in young women: the national heart, lung, and blood institute growth and health study.

Background: Smoking is highly prevalent in young women and little is known about early multilevel independent risk or protective factors that are predictive of daily smoking in young women.

Methods: Multiple logistic regression was conducted on data from NGHS, a 10-year cohort study of Black (1,213) and White (1,166) girls recruited from three clinical centers in the United States, ages 9-10 years on entry to ages 18-19.

Results: Compared with never smokers, White girls were at higher risk than Black girls of being daily smokers at ages 18-19.

Epidemiology of adult brain tumours in Great Britain and Ireland.

The objective of this study was to review published reports on the epidemiology of primary brain tumours in adults and present the body of knowledge related to these tumours in Great Britain and Ireland. A literature search of all published epidemiological data on brain tumours was conducted in Pre-Medline, Medline, Embase and the Cochrane databases from 1966 to the present. A hand search of all the references alluded to was conducted and older studies identified.

A language for nursing: furthering the debate.

Continuing the debate on language for nursing, Paul Crawford and Brian Brown argue that merely having a common sense understanding of language is inadequate.

Interactions between antiepileptic drugs and hormonal contraception.

An interaction between antiepileptic drugs (AEDs) and the combined oral contraceptive pill was first proposed when the dose of estradiol in the oral contraceptive pill was reduced from 100 to 50 microg. There was a higher incidence of breakthrough bleeding and contraceptive failure among women with epilepsy compared with women in general. Since then, interaction studies have been undertaken to look for possible interactions between AEDs and the combined oral contraceptive pill.

Remacemide hydrochloride as an add-on therapy in epilepsy: a randomized, placebo-controlled trial of three dose levels (300, 600 and 1200 mg/day) in a Q.I.D. regimen.

Remacemide hydrochloride is a low-affinity, non-competitive N-methyl-D-aspartic acid (NMDA) receptor channel blocker, under investigation in epilepsy. This double-blind, placebo-controlled, multicentre study assessed the safety and efficacy of remacemide hydrochloride or placebo, as adjunctive therapy, in 252 adult patients with refractory epilepsy who were already taking up to three antiepileptic drugs (including an enzyme-inducer). Patients were randomized to one of three doses of remacemide hydrochloride (300, 600 or 1200 mg /day) or placebo Q.

Clinical and radiographic features of a family with autosomal dominant amelogenesis imperfecta with taurodontism.

This paper describes the clinical features of a family of four generations with autosomal dominant amelogenesis imperfecta with taurodontism (ADAIT). Considerable variation in phenotype was seen, both between individuals and within the dentition of some individuals. Many of the adults had received extensive dental restorative work.

Service user involvement in care planning: the mental health nurse's perspective.

A dissonance between espoused values of consumerism within mental health care and the 'reality' of clinical practice has been firmly established in the literature, not least in terms of service user involvement in care planning. In order to begin to minimize such dissonance, it is vital that mental health nurse perceptions of service user involvement in the core activity of care planning are better understood. The main findings of this qualitative study, which uses semistructured interviews, suggest that mental health nurses value the concept of user involvement but consider it to be problematic in certain circumstances.

Amelogenesis imperfecta phenotype-genotype correlations with two amelogenin gene mutations.

Amelogenin, the predominant matrix protein in developing dental enamel, is considered essential for normal enamel formation, but its exact functions are undefined. Mutations in the AMELX gene that encodes for amelogenin protein cause X-linked amelogenesis imperfecta (AI), with phenotypes characterized by hypoplastic and/or poorly mineralized enamel. Eight different AMELX deletion and substitution mutations have been reported to date.

The value of community mental health nurses based in primary care teams: 'switching the light on in a cellar'.

This paper explores the impact of placing Community Mental Health Nurses (CMHNs) at two primary care practices in South Staffordshire. Data were collected by means of a questionnaire which was sent to primary care personnel at these practices, to ascertain their opinions with respect to the contribution of practice-based CMHNs. Overall, primary care personnel were satisfied with the quality of the service received from the CMHNs, especially in terms of improved communication.

Persistent leg ulcers in an obese patient with venous insufficiency and elephantiasis.

Options in Practice presents different management approaches to the same clinical situation. You are invited to submit a brief case description, including the specialty nursing care provided, and several glossy color photographs of the clinical situation. The case material will then be sent to another wound, ostomy, or continence care nurse, who will also address management concerns.

Exploring the relationship between timing of menarche and eating disorder symptoms in Black and White adolescent girls.

Objective: This study examined the relationship between timing of sexual maturation and eating disorders symptoms in adolescent girls.

Method: Data were collected over 10 years for a cohort of 1,213 Black girls and 1,166 White girls who were either 9 or 10 years old at study entry. Annually, girls' height and weight were measured and, biannually, girls completed self-report measures of eating disorders symptoms.

Use of adult cat serum to correct failure of passive transfer in kittens.

Objective: To evaluate the use of adult cat serum as an immunoglobulin supplement in kittens with failure of passive transfer.

Design: Randomized controlled study.

Animals: 11 specific pathogen-free queens and their 43 kittens.