Validity and reliability of the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER).

This study evaluates the validity and reliability of a new instrument developed to assess symptoms of depresonalization: the Structured Clinical Interview for the Depersonalization-Derealization Spectrum (SCI-DER). The instrument is based on a spectrum model that emphasizes soft-signs, sub-threshold syndromes as well as clinical and subsyndromal manifestations. Items of the interview include, in addition to DSM-IV criteria for depersonalization, a number of features derived from clinical experience and from a review of phenomenological descriptions. Study participants included 258 consecutive patients with mood and anxiety disorders, 16.7% bipolar I disorder, 18.6% bipolar II disorder, 32.9% major depression, 22.1% panic disorder, 4.7% obsessive compulsive disorder, and 1.5% generalized anxiety disorder; 2.7% patients were also diagnosed with depersonalization disorder. A comparison group of 42 unselected controls was enrolled at the same site. The SCI-DER showed excellent reliability and good concurrent validity with the Dissociative Experiences Scale. It significantly discriminated subjects with any diagnosis of mood and anxiety disorders from controls and subjects with depersonalization disorder from controls. The hypothesized structure of the instrument was confirmed empirically

Duloxetine in panic disorder with somatic gastric pain

Panic disorder is the most common type of anxiety disorder, and its most common expression is panic attacks characterized with sudden attacks of anxiety with numerous symptoms, including palpitations, tachycardia, tachypnea, nausea, and vertigo: ie, cardiovascular, gastroenterologic, respiratory, and neuro-otologic symptoms. In clinical practice, panic disorder manifests with isolated gastroenteric or cardiovascular symptoms, requiring additional clinical visits after psychiatric intervention. The first-line treatment for anxiety disorders, and in particular for panic disorder, is the selective serotonin reuptake inhibitors. However, these drugs can have adverse effects, including sexual dysfunction, increased bodyweight, and abnormal bleeding, that may be problematic for some patients. Here we report the case of a 29-year-old Caucasian woman affected by panic disorder with agoraphobia who was referred to our clinic for recurrent gastroenteric panic symptoms. The patient reported improvement in her anxiety symptoms and panic attacks while on a selective serotonin reuptake inhibitor, but not in her gastric somatic problems, so the decision was taken to start her on duloxetine, a serotonin-norepinephrine reuptake inhibitor. After 6 months of treatment, the patient achieved complete remission of her gastric and panic-related symptoms, and was able to stop triple gastric therapy. Other authors have hypothesized and confirmed that duloxetine has greater initial noradrenergic effects than venlafaxine and is effective in patients with panic disorder. This case report underscores the possibility of tailoring therapeutic strategies for the gastroenteric expression of panic disorder

The Effect of Stocking Rate and Lamb Grazing System on Sward Performance of \u3cem\u3eTrifolium Repens\u3c/em\u3e and \u3cem\u3eLotus Corniculatus\u3c/em\u3e in Uruguay

Lambs have a great potential to diversify and stimulate meat and wool production and economical returns within the industry. The main objective of this study was to evaluate different feeding and management alternatives for the production of high quality wool and meat as well as their effects on sward characteristics in the Basaltic region of Uruguay

Lebensform und familiale Einstellung: ein empirischer Beitrag zur Pluralisierungsdiskussion

'Seit den 60er-Jahren wird in der demographischen Forschung die so genannte 'Pluralisierungsthese' diskutiert. BefürworterInnen der Pluralisierungsthese argumentieren, dass neben der Ehe und der traditionellen Familie immer mehr andere Formen von Partnerschaft und Familie gewählt werden. GegnerInnen der Pluralisierungsthese vertreten die Auffassung, dass diese Entwicklung keine wirkliche Alternative zur Ehe und zur traditionellen Familie darstellt. Bei diesen Formen handle es sich vielmehr um relativ kurzfristige Übergangsphasen oder um unfreiwillige Notlagen. Die Pluralisierungsthese wird daher als realitätsfernes wissenschaftliches Konstrukt abgelehnt. Anhand der Daten des 'Population Policy Acceptance Survey 2' (PPA 2) wird die Gültigkeit folgender Thesen überprüft: Personen, die in einer außerehelichen Lebensform leben, müssten sich mit dieser identifizieren oder zumindest keine an die Ehe gebundene Lebensform anstreben. Weiters müssten diese Personen stärker nicht-traditionale Lebensformen und deren Konsequenzen wie mehr uneheliche Kinder und mehr kinderlose Paare akzeptieren. Die Ergebnisse zeigen, dass - auch gegen das familienpolitische Festhalten am Modell Kleinfamilie - zunehmend neue Lebensformen bewusst gewählt und gesellschaftlich akzeptiert werden.' (Autorenreferat

Schwangerschaftsabbruch - gesellschaftspolitische Aspekte und empirische Befunde

'Der vorliegende Beitrag ist der Thematik Schwangerschaftsabbruch in Österreich gewidmet und behandelt mehrere Aspekte. Zuerst erfolgt eine Darstellung der gesetzlichen Lage, der Praxis sowie der politischen Diskussion seit den 70er-Jahren. Vor dem Hintergrund fehlender Statistiken gilt ein weiterer Abschnitt der Problematik der Schätzungen über die jährliche Zahl der Abbrüche. Empirische Befunde zur Einstellung der Bevölkerung zur Fristenlösung sowie zu sozialen und biographischen Risikofaktoren konnten aus Daten des 'Family and Fertility Survey' (FFS 1996) gewonnen werden. Aus früheren Studien zur Frage der Fristenlösung ist der bedeutsame Einfluss der religiösen Einstellung und der regionalen Herkunft auf die Meinung der Bevölkerung bekannt. Dies konnte auch für unsere Studie bestätigt werden. Darüber hinaus wurde das Augenmerk auf das soziale und familiäre Netz der befragten Frauen gerichtet, um zu überprüfen, inwieweit dieses den Prozess der Entscheidungsfindung für oder gegen eine ungeplante Schwangerschaft beeinflusst. In Anbetracht der jüngsten politischen Diskussion um eine Fristverlängerung für Abtreibung bei eugenischer Indikation ist auch ein Kapitel zu Fragen der Eugenik sowie zu ethischen Problemen angefügt, die aus den aktuellen Entwicklungen in der Reproduktionstechnologie resultieren.' (Autorenreferat

Specificity of Four Laboratory Approaches for Cross-Sectional HIV Incidence Determination: Analysis of Samples from Adults with Known Nonrecent HIV Infection from Five African Countries

Assays to determine cross-sectional HIV incidence misclassify some individuals with nonrecent HIV infection as recently infected, overestimating HIV incidence. We analyzed factors associated with false-recent misclassification in five African countries. Samples from 2197 adults from Botswana, Kenya, South Africa, Tanzania, and Uganda who were HIV infected > 12 months were tested using the (1) BED capture enzyme immunoassay (BED), (2) avidity assay, (3) BED and avidity assays with higher assay cutoffs (BED+ avidity screen), and (4) multiassay algorithm (MAA) that includes the BED+ avidity screen, CD4 cell count, and HIV viral load. Logistic regression identified factors associated with misclassification. False-recent misclassification rates and 95% confidence intervals were BED alone: 7.6% (6.6, 8.8); avidity assay alone: 3.5% (2.7, 4.3); BED+ avidity screen: 2.2% (1.7, 2.9); and MAA: 1.2% (0.8, 1.8). The misclassification rate for the MAA was significantly lower than the rates for the other three methods (each p < 0.05). Misclassification rates were lower when the analysis was limited to subtype C-endemic countries, with the lowest rate obtained for the MAA [0.8% (0.2, 1.9)]. Factors associated with misclassification were for BED alone: country of origin, antiretroviral treatment (ART), viral load, and CD4 cell count; for avidity assay alone: country of origin; for BED+ avidity screen: country of origin and ART. No factors were associated with misclassification using the MAA. In a multivariate model, these associations remained significant with one exception: the association of ART with misclassification was completely attenuated. A MAA that included CD4 cell count and viral load had lower false-recent misclassification than the BED or avidity assays (alone or in combination). Studies are underway to compare the sensitivity of these methods for detection of recent HIV infection

Intra-fraction setup variability: IR optical localization vs. X-ray imaging in a hypofractionated patient population

<p>Abstract</p> <p>Background</p> <p>The purpose of this study is to investigate intra-fraction setup variability in hypo-fractionated cranial and body radiotherapy; this is achieved by means of integrated infrared optical localization and stereoscopic kV X-ray imaging.</p> <p>Method and Materials</p> <p>We analyzed data coming from 87 patients treated with hypo-fractionated radiotherapy at cranial and extra-cranial sites. Patient setup was realized through the ExacTrac X-ray 6D system (BrainLAB, Germany), consisting of 2 infrared TV cameras for external fiducial localization and X-ray imaging in double projection for image registration. Before irradiation, patients were pre-aligned relying on optical marker localization. Patient position was refined through the automatic matching of X-ray images to digitally reconstructed radiographs, providing 6 corrective parameters that were automatically applied using a robotic couch. Infrared patient localization and X-ray imaging were performed at the end of treatment, thus providing independent measures of intra-fraction motion.</p> <p>Results</p> <p>According to optical measurements, the size of intra-fraction motion was (<it>median ± quartile</it>) 0.3 ± 0.3 mm, 0.6 ± 0.6 mm, 0.7 ± 0.6 mm for cranial, abdominal and lung patients, respectively. X-ray image registration estimated larger intra-fraction motion, equal to 0.9 ± 0.8 mm, 1.3 ± 1.2 mm, 1.8 ± 2.2 mm, correspondingly.</p> <p>Conclusion</p> <p>Optical tracking highlighted negligible intra-fraction motion at both cranial and extra-cranial sites. The larger motion detected by X-ray image registration showed significant inter-patient variability, in contrast to infrared optical tracking measurement. Infrared localization is put forward as the optimal strategy to monitor intra-fraction motion, featuring robustness, flexibility and less invasivity with respect to X-ray based techniques.</p

Ancient DNA reveals admixture history and endogamy in the prehistoric Aegean (advance online)

The Neolithic and Bronze Ages were highly transformative periods forthe genetic history of Europe but for the Aegean—a region fundamentalto Europe’s prehistory—the biological dimensions of cultural transitionshave been elucidated only to a limited extent so far. We have analysed newlygenerated genome-wide data from 102 ancient individuals from Crete, theGreek mainland and the Aegean Islands, spanning from the Neolithic tothe Iron Age. We found that the early farmers from Crete shared the sameancestry as other contemporaneous Neolithic Aegeans. In contrast, the endof the Neolithic period and the following Early Bronze Age were marked by‘eastern’ gene flow, which was predominantly of Anatolian origin in Crete.Confirming previous findings for additional Central/Eastern Europeanancestry in the Greek mainland by the Middle Bronze Age, we additionallyshow that such genetic signatures appeared in Crete gradually from theseventeenth to twelfth centuries bc, a period when the influence of themainland over the island intensified. Biological and cultural connectednesswithin the Aegean is also supported by the finding of consanguineousendogamy practiced at high frequencies, unprecedented in the globalancient DNA record. Our results highlight the potential of archaeogenomicapproaches in the Aegean for unravelling the interplay of genetic admixture,marital and other cultural practice