Pediatric End-of-Life Simulation Workshop to Clinical Care: Lasting Implications on Clinical Practice.

Background: Simulations are an important modality for practicing high-acuity, low-frequency events. We implemented a deliberate practice simulation-based workshop to improve pediatric end-of-life care skills (PECS) competence.

Purpose: To understand pediatric subspecialty fellows' perceptions about influences of a simulation-based workshop on PECS provided at the bedside several months following participation.

Relationship between mood and TSH response to TRH stimulation in bipolar affective disorder.

Moderate to severe depression and mania are associated with a reduced thyroid stimulating hormone (TSH) response to TSH releasing hormone (TRH). Continued reduction of this response after clinical recovery seems indicative of early relapse. The aim of the present study was to test the relationship between mild changes in mood and the TSH response to TRH stimulation in patients with bipolar affective disorder.

Relapse prevention by citalopram in SAD patients responding to 1 week of light therapy. A placebo-controlled study.

Objective: We have tested the relapse-preventive effect of citalopram when compared with placebo in 282 patients with Seasonal Affective Disorder (SAD) responding to 1 week of light therapy.

Method: The response rate to 1-week light therapy and relapse during the continuation phase of 15 weeks were assessed by use of the Hamilton Depression Rating Scale (HAM-D17), the six-item subscale (HAM-D6), the Melancholia Scale (MES), and the combined HAM-D/SIGH-SAD.

Results: The response rate to light therapy was 62.

The validity of the depression rating scales in discriminating between citalopram and placebo in depression recurrence in the maintenance therapy of elderly unipolar patients with major depression.

The World Federation of Societies of Biological Psychiatry guidelines for treatment of unipolar major depression has recommended three depression rating scales for evaluating outcome: The Hamilton Depression Rating Scale (HAM-D), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Bech-Rafaelsen Melancholia Scale (MES). In this study we evaluated the ability of these scales to differentiate between citalopram and placebo in the recurrence prevention of unipolar depression. The study is a psychometric reexamination of a trial on the efficacy of citalopram versus placebo in the maintenance therapy of elderly patients with unipolar depression.

The threat of predictable and unpredictable pain: differential effects on central nervous system processing?

Central nervous system performance is disrupted by pain and by the threat of pain. It is not known whether disruption caused by the threat of pain is dependent on the likelihood of pain occurring. We hypothesised that when a painful stimulus is possible but unpredictable central nervous system performance is reduced, but when the pain is predictable and unavoidable it is not.

[The sexual life of 60-year-old Danish men].

Introduction: The sexuality of men is influenced by many factors, and there are changes throughout life. In a literature search only 35 fairly representative cross-sectional studies of elderly men were found. There is no population study of elderly Danish men's sexuality.

Extramarital sexual relationships of middle-aged Danish men: attitudes and behavior.

This study explored Danish men's attitudes and behavior towards extramarital sexual relations (ESR), seen from two sides: men who had engaged in such relations (involved) and men who had not (non-involved). The participants, 439 men aged 51, completed a questionnaire concerning sexuality (behavior, attitudes and experience) as a part of a Danish cohort-investigation of health risk-factors. Thereafter 100 of the 439 men were interviewed.

Adverse effects of psychosocial stress on gonadal function and insulin levels in middle-aged males.

Objectives: To investigate the relationship between gonadal function, insulin and psychosocial stress in middle-aged men.

Design: A population-based, cross-sectional, observational study.

Setting: Glostrup Hospital, Copenhagen, Denmark.

Case-based hospital financing: the case of Norway.

Several European countries are experimenting with new ways of organising and financing the hospital sector. This paper discusses the present Norwegian reform, where a system of fixed grants is replaced by a combination of payment per case and fixed grants. Initially implemented in four hospitals only, the decision to move to a full-scale reform will be based on the evaluation of this pilot project.

Incapacity for work in elective orthopaedic surgery: a study of occurrence and the probability of returning to work after treatment.

Study Objective: The extent to which patients undergoing elective surgery for orthopaedic disorders were incapacitated for work while they were on the waiting list and whether they were able to return to work after surgery were studied.

Design: This was a prospective cohort study of patients admitted to hospital for elective orthopaedic surgery. Main outcome measures were occurrence of sickness certification during the waiting time, and whether those incapacitated for work at the time of surgery returned to work during the first year after treatment.

Sexual behaviour and attitudes of Danish middle-aged men-methodological considerations.

A Danish cohort-investigation of health risk-factors (started in 1976) included descriptions of the sexuality of the participants. This paper examines the validity/representativity of the results of the sexological investigation of the male participants, when in 1987 they were 51 years old. Remaining results will be published in separate articles about each main theme.

Frequency of sexual problems and sexual dysfunction in middle-aged Danish men.

The frequency of sexual dysfunction of a representative group of Danish middle-aged men was recorded, using a questionnaire and an interview that contained, respectively, 12 and 23 questions about sexual problems. The study sample consisted of 439 51-year-old men, all of whom received the questionnaire. Of these men, 100 were also interviewed.

Middle-aged Danish men's ideas of a male climacteric--and of the female climacteric.

The concept of a male climacteric as a parallel to the female climacteric appeared in both popular and scientific literature before 1940. The present population study describes the ideas regarding a male climacteric reported by a sample of men at the ages of 40, 45 and 51. The proportion who believed in the occurrence of a male climacteric decreased as the men became older, although 30% still believed in the phenomenon at the age of 51.

[The significance of unemployment for admissions to a psychiatric department].

A total of 295 patients, 152 women and 143 men, aged 18-70 years, were admitted to a psychiatric department during a period of three months. They were interviewed about their occupational conditions, the background for admission and help desired. Thirty-three women and 66 men were unemployed and half of these had been unemployed for over one year.

[Somatic disease at a department for acute psychiatric disease].

All of the patients admitted to the psychiatric inpatient department of the Municipal Hospital in Copenhagen during a period of three months were, on discharge, registered as regards somatic disease. 70% (95% confidence limits 66-75%) had somatic disease (38% of these were newly diagnosed). Treatment of these was carried out by the medical staff of the department and in 46% of the cases this was carried out in cooperation with the medical staffs of somatic departments.

[Organic disease among patients at an open psychiatric outpatient clinic].

All of the new consultations in the Copenhagen Municipal psychiatric outpatient department during a period of three month were registered. Out of these, 1,149 did not lead to admission of the patient. In 47% of these information about somatic condition was available and in 31% information about somatic disease was present.