Proxy reporting of quality of life using the EQ-5D.

Background: The economic evaluation of health interventions for older people is complicated by the difficulty in obtaining self-reports of quality of life from persons with cognitive impairments, physical impairments, or both.

Objectives: Using the EQ-5D (EuroQoL) measures, to assess: (1) agreement between subjects and proxies on subject's quality of life ratings at different points in time; (2) agreement between subjects and proxies on change of subject's quality of life ratings over time; and (3) subject and proxy characteristics related to agreement.

Research Design: Prospective study of subjects visiting hospital emergency departments (ED).

Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomized trial.

Background: Delirium is common and often goes undetected in older patients admitted to medical services. It is associated with poor outcomes. We conducted a randomized clinical trial to determine whether systematic detection and multidisciplinary care of delirium in older patients admitted to a general medical service could reduce time to improvement in cognitive status.

Predictors of functional decline in hospitalized elderly patients: a systematic review.

Background: This article will systematically review the methodological characteristics and results of studies of variables and indices that predict functional decline in older hospitalized patients.

Methods: We restricted this review to original longitudinal studies of predictors of either physical functional decline or nursing home admission among patients aged 60 and older. Two reviewers independently abstracted information on methodological characteristics and substantive results.

The tRNA-Tyr gene family of Saccharomyces cerevisiae: agents of phenotypic variation and position effects on mutation frequency.

Extensive phenotypic diversity or variation exists in clonal populations of microorganisms and is thought to play a role in adaptation to novel environments. This phenotypic variation or instability, which occurs by multiple mechanisms, may be a form of cellular differentiation and a stochastic means for modulating gene expression. This work dissects a case of phenotypic variation in a clinically derived Saccharomyces cerevisiae strain involving a cox15 ochre mutation, which acts as a reporter.

Synthesis of mono-substituted 2,2'-bipyridines.

The rapid synthesis of 4-aryl-2,2'-bipyridines is described leading to some previously reported compounds in good yields in addition to some new functionalized bipyridines.

Molecular and genetic analysis of the Cryptococcus neoformans MET3 gene and a met3 mutant.

The Cryptococcus neoformans MET3 cDNA (encoding ATP sulfurylase) was cloned by complementation of the corresponding met3 mutation in Saccharomyces cerevisiae. Sequence analysis showed high similarity between the deduced amino acid sequence of the C. neoformans Met3p and other fungal ATP sulfurylases.

Infant sucking ability, non-organic failure to thrive, maternal characteristics, and feeding practices: a prospective cohort study.

This prospective study examined the relation of neonatal sucking to later feeding, postnatal growth, maternal postpartum depression, and feeding practices. Healthy infants of at least 37 weeks gestational age were recruited. At 1 week of age, a strain-gage device was attached to the infant's cheeks during sucking to identify sucking efficiency.

Catalytic oxidative carbonylation of primary and secondary diamines to cyclic ureas. Optimization and substituent studies.

W(CO)(6)-catalyzed oxidative carbonylation of 1,3-propanediamine to the corresponding urea has been examined under a variety of conditions. Following optimization, the Thorpe-Ingold effect on ring closure was studied using 2,2-dialkyl-1,3-propanediamines. For the 2,2-dimethyl- and 2,2-dibutyl-1,3-propanediamines, the yields were increased significantly as compared to that of the unsubstituted case.

St John's wort or sertraline? Randomized controlled trial in primary care.

Objective: To compare the change in severity of depressive symptoms and occurrence of side effects in primary care patients treated with St John's wort (SJW) and sertraline.

Design: Double-blind, randomized 12-week trial.

Setting: Community-based offices of 12 family physicians practising in greater Montreal, Que.

Symptoms of delirium among elderly medical inpatients with or without dementia.

This study examined the frequencies of the 10 symptoms of delirium identified in DSM-III-R among patients with delirium (DSM-III-R criteria) who did or did not have dementia. The prevalence of each symptom, the numbers of symptoms, and the combinations of symptoms were determined among 322 elderly medical inpatients classified into one of four groups: delirium and dementia (n=128), delirium only (n=40), dementia only (n=94), or neither (n=60). Symptoms were assessed at the time of diagnosis and independently (by use of a different scale) within 24 hours of diagnosis.

Dissecting the architecture of a quantitative trait locus in yeast.

Most phenotypic diversity in natural populations is characterized by differences in degree rather than in kind. Identification of the actual genes underlying these quantitative traits has proved difficult. As a result, little is known about their genetic architecture.

Environmental risk factors for delirium in hospitalized older people.

Objectives: To evaluate the relationship of environmental risk factors in hospitals to changes over time in delirium symptom severity scores.

Design: Observational prospective clinical study with repeated measurements, several times during the first week of hospitalization and then weekly during hospitalization.

Setting: University-affiliated general community hospital.

Rapid emergency department intervention for older people reduces risk of functional decline: results of a multicenter randomized trial.

Objectives: To determine the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes.

Design: Controlled trial, randomized by day of ED visit, with follow-up at 1 and 4 months.

Setting: Four university-affiliated hospitals in Montreal.

Delirium predicts 12-month mortality.

Background: Delirium has not been found to be a significant predictor of postdischarge mortality, but previous research has methodologic limitations including small sample sizes and inadequate control of confounding. This study aimed to determine the independent effects of presence of delirium, type of delirium (incident vs prevalent), and severity of delirium symptoms on 12-month mortality among older medical inpatients.

Methods: A prospective, observational study of 2 cohorts of medical inpatients was conducted with patients 65 years or older: 243 patients had prevalent or incident delirium, and 118 controls had no delirium.

Calcineurin is essential for survival during membrane stress in Candida albicans.

The immunosuppressants cyclosporin A (CsA) and FK506 inhibit the protein phosphatase calcineurin and block T-cell activation and transplant rejection. Calcineurin is conserved in microorganisms and plays a general role in stress survival. CsA and FK506 are toxic to several fungi, but the common human fungal pathogen Candida albicans is resistant.

Bimolecular electron and energy transfer reactivity of exchange-coupled dinuclear iron(III) complexes.

Bimolecular quenching between photosensitizers and exchange-coupled transition metal complexes has been studied in an effort to experimentally establish a link between Heisenberg spin exchange and chemical reactivity. The acceptors are members of the oxo/hydroxo-biscarboxylato class of dinuclear Fe(III) compounds, where protonation of the oxo bridge provides a means for modulating the magnitude of spin exchange within the cluster. Photoexcitation of solutions containing Ru(II) polypyridyl sensitizers and the Fe(III) complexes results in quenching of emission from the (3)MLCT excited state of the Ru(II) chromophores; nanosecond time-resolved absorption measurements demonstrate that quenching occurs, in part, by electron transfer.

Electron Exchange and the Photophysics of Metal-Quinone Complexes. 1. Synthesis and Spectroscopy of Chromium-Quinone Dyads.

The synthesis, structural and spectroscopic characterization of monosemiquinone and monocatechol complexes of chromium(III) are described. Compounds of the general form [Cr(N(4))Q](n+), where N(4) represents a tetradentate or bis-bidentate nitrogenous ligand or ligands and Q represents a reduced form of an orthoquinone, have been prepared by two different routes from Cr(III) and Cr(II) starting materials. The complex [Cr(tren)(3,6-DTBSQ)](PF(6))(2), where tren is tris(2-aminoethyl)amine and 3,6-DTBSQ is 3,6-di-tert-butylorthosemiquinone, crystallizes in the monoclinic space group P2(1)/c with a = 11.

Development of Saccharomyces cerevisiae as a model pathogen. A system for the genetic identification of gene products required for survival in the mammalian host environment.

Saccharomyces cerevisiae, a close relative of the pathogenic Candida species, is an emerging opportunistic pathogen. An isogenic series of S. cerevisiae strains, derived from a human clinical isolate, were used to examine the role of evolutionarily conserved pathways in fungal survival in a mouse host.

Rapamycin and less immunosuppressive analogs are toxic to Candida albicans and Cryptococcus neoformans via FKBP12-dependent inhibition of TOR.

Candida albicans and Cryptococcus neoformans cause both superficial and disseminated infections in humans. Current antifungal therapies for deep-seated infections are limited to amphotericin B, flucytosine, and azoles. A limitation is that commonly used azoles are fungistatic in vitro and in vivo.

Attenuated total reflection design for in situ FT-IR spectroelectrochemical studies.

A versatile spectroelectrochemical apparatus is introduced to study the changes in IR spectra of organic and inorganic compounds upon oxidation or reduction. The design is based on an attenuated total reflection device, which permits the study of a wide spectral range of 16,700 (600 nm)-250 cm(-1), with a small opaque region of 2250-1900 cm(-1). In addition, an IR data collection protocol is introduced to deal with electrochemically nonreversible background signals.

Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study.

Background: Delirium in older hospital inpatients appears to be associated with various adverse outcomes. The limitations of previous research on this association have included small sample sizes, short follow-up periods and lack of consideration of important confounders or modifiers, such as severity of illness, comorbidity and dementia. The objective of this study was to determine the prognostic significance of delirium, with or without dementia, for cognitive and functional status during the 12 months after hospital admission, independent of premorbid function, comorbidity, severity of illness and other potentially confounding variables.

Antisocial behavioral syndromes and return to drug use following residential relapse prevention/health education treatment.

This study compared residential addiction treatment clients meeting full DSM-III-R criteria for antisocial personality disorder (ASPD) with those reporting syndromal levels of antisocial behavior only in adulthood (AABS) on time to and severity of first posttreatment drug use. Antisocial syndrome and selected other mental disorders were assessed using the Diagnostic Interview Schedule, Revised for DSM-III-R, and validity of self-reported posttreatment drug behavior was measured against results of hair analysis. Among subjects followed within 180 days after treatment exit, individuals with ASPD were at modestly increased risk of a first lapse episode compared to those with AABS.

Agitation in demented patients in an acute care hospital: prevalence, disruptiveness, and staff burden.

Unlabelled: BACKGROUND/LITERATURE REVIEW: The prevalence of agitated behaviors in different populations with dementia is between 24% and 98%. Although agitated behaviors are potentially disruptive, little research attention has been focused on the effects of these behaviors upon nursing staff. The objectives of this study of demented patients in long-term-care beds at an acute care community hospital were to determine the frequency and disruptiveness of agitated behaviors; to investigate the associations of patient characteristics and interventions with the level of agitation; and to explore the burden of these agitated behaviors on nursing staff.