Medicalizing meaning: demoralization syndrome and the desire to die

Objective: To critically analyse the proposed new psychiatric condition, demoralization syndrome, and the implications drawn by its proponents for the clinical-ethical status of requests by terminally ill patients for assistance to die. Method: The diagnostic features of demoralization syndrome, a proposed new psychiatric disorder, recognizable particularly in palliative care settings, are summarized. The consequences of proposed therapeutic interventions are described, one of which is relief of the desperation which motivates some demoralized patients to consider ending their lives and to seek assistance in dying. The connections between the proposed condition and the desire to die are analysed in the context of the continuing tensions surrounding the ontological status and sociopolitical implications of psychiatric categories and the pervasive medicalization of modern life. Results: The analysis suggests that by medicalizing existential cognitions at the end of life, the proposed diagnostic category also normalizes a particular moral view concerning assistance in dying. Conclusions: While further research into the issues described in this provisional syndrome may benefit some patients, the categorization of demoralization as a medical diagnosis is a questionable extension of psychiatry's influence, which could serve particular social, political and cultural views concerning the end of life.

An evolutionary radiation of beeflies in semi-arid Australia: systematics of the Exoprosopini (Diptera : Bombyliidae)

Almost half of the 4822 described beeflies in the world belong to the subfamily Anthracinae, with most of the diversity found in three cosmopolitan tribes: Villini, Anthracini, and Exoprosopini. The Australian Exoprosopini previously contained three genera, Ligyra Newman, Pseudopenthes Roberts and Exoprosopa Macquart. Pseudopenthes is an Australian endemic, with two species including Ps. hesperis, sp. nov. from Western Australia. Two new species of the exoprosopine Atrichochira Hesse, Atr. commoni, sp. nov. and Atr. paramonovi, sp. nov., are also described from Australia, extending the generic distribution from Africa. Cladistic analysis clarified the phylogenetic relationships between the recognised groups of the Exoprosopini and determined generic limits on a world scale. Inclusion of 18 Australian exoprosopines placed the Australian species in the context of the world fauna. The Exoprosopini contains six large groups. The basal group I contains species previously included in Exoprosopa to which the name Defilippia Lioy is applied. Group II contains Heteralonia Rondani, Atrichochira, Micomitra Bowden, Pseudopenthes, and Diatropomma Bowden. Colossoptera Hull is newly synonymised with Heteralonia. Group III is a paraphyletic assemblage of Pterobates Bezzi and Exoprosopa including the Australian Ex. sylvana ( Fabricius). Ligyra is paraphyletic, forming two well-separated clades. The African clade is described as Euligyra Lambkin, gen. nov., which, together with Litorhina Bezzi and Hyperalonia Rondani, form group IV. The Australian group V is true Ligyra. The remaining monophyletic lineage of exoprosopines, group VI, the Balaana-group of genera, shows evidence of an evolutionary radiation of beeflies in semi-arid Australia. Phylogenetic analysis of all 42 species of the Balaana-group of genera formed a basis for delimiting genera. Seven new genera are described by Lambkin & Yeates: Balaana, Kapua, Larrpana, Munjua, Muwarna, Palirika and Wurda. Four non-Australian species belong to Balaana. Thirty two new Australian species are described: Bal. abscondita, Bal. bicuspis, Bal. centrosa, Bal. gigantea, Bal. kingcascadensis, K. corusca, K. irwini, K. westralica, Lar. collessi, Lar. zwicki, Mun. erugata, Mun. lepidokingi, Mun. paralutea, Mun. trigona, Muw. vitreilinearis, Pa. anaxios, Pa. basilikos, Pa. blackdownensis, Pa. bouchardi, Pa. cyanea, Pa. danielsi, Pa. decora, Pa. viridula, Pa. whyalla, W. emu, W. impatientis, W. montebelloensis, W. norrisi, W. patrellia, W. skevingtoni, W. windorah, and W. wyperfeldensis. The following new combinations are proposed: from Colossoptera: Heteralonia latipennis (Brunetti); from Exoprosopa: Bal. grandis (Pallas), Bal. efflatounbeyi (Paramonov), Bal. latelimbata ( Bigot), Bal. obliquebifasciata ( Macquart), Bal. tamerlan (Portschinsky), Bal. onusta ( Walker), Def. busiris (Jaennicke), Def. efflatouni ( Bezzi), Def. eritreae (Greathead), Def. gentilis ( Bezzi), Def. luteicosta ( Bezzi), Def. minos (Meigen), Def. nigrifimbriata ( Hesse), Def. rubescens ( Bezzi), K. adelaidica ( Macquart), Lar. dimidiatipennis ( Bowden), Muw. stellifera ( Walker), and Pa. marginicollis ( Gray); from Ligyra: Eu. enderleini ( Paramonov), Eu. mars ( Bezzi), Eu. monacha (Klug), Eu. paris ( Bezzi), Eu. sisyphus ( Fabricius), and Eu. venus (Karsch).

Probing the S100 protein family through genomic and functional analysis

The EF-hand superfamily of calcium binding proteins includes the S100, calcium binding protein, and troponin subfamilies. This study represents a genome, structure, and expression analysis of the S100 protein family, in mouse, human, and rat. We confirm the high level of conservation between mammalian sequences but show that four members, including S100A12, are present only in the human genome. We describe three new members of the S100 family in the three species and their locations within the S100 genomic clusters and propose a revised nomenclature and phylogenetic relationship between members of the EF-hand superfamily. Two of the three new genes were induced in bone-marrow-derived macrophages activated with bacterial lipopolysaccharide, suggesting a role in inflammation. Normal human and murine tissue distribution profiles indicate that some members of the family are expressed in a specific manner, whereas others are more ubiquitous. Structure-function analysis of the chemotactic properties of murine S100A8 and human S100A12, particularly within the active hinge domain, suggests that the human protein is the functional homolog of the murine protein. Strong similarities between the promoter regions of human S100A12 and murine S100A8 support this possibility. This study provides insights into the possible processes of evolution of the EF-hand protein superfamily. Evolution of the S100 proteins appears to have occurred in a modular fashion, also seen in other protein families such as the C2H2-type zinc-finger family. (C) 2004 Elsevier Inc. All rights reserved.

The 1000 brightest HIPASS galaxies H I properties

We present the HIPASS Bright Galaxy Catalog (BGC), which contains the 1000 H I brightest galaxies in the southern sky as obtained from the H i Parkes All-Sky Survey ( HIPASS). The selection of the brightest sources is based on their H I peak flux density (S-peak greater than or similar to116 mJy) as measured from the spatially integrated HIPASS spectrum. The derived H I masses range from similar to10(7) to 4 x 10(10) M-.. While the BGC ( z< 0.03) is complete in S-peak, only a subset of &SIM;500 sources can be considered complete in integrated H I flux density (F-H I &GSIM;25 Jy km s(-1)). The HIPASS BGC contains a total of 158 new redshifts. These belong to 91 new sources for which no optical or infrared counterparts have previously been cataloged, an additional 51 galaxies for which no redshifts were previously known, and 16 galaxies for which the cataloged optical velocities disagree. Of the 91 newly cataloged BGC sources, only four are definite H I clouds: while three are likely Magellanic debris with velocities around 400 km s(-1), one is a tidal cloud associated with the NGC 2442 galaxy group. The remaining 87 new BGC sources, the majority of which lie in the zone of avoidance, appear to be galaxies. We identified optical counterparts to all but one of the 30 new galaxies at Galactic latitudes > 10degrees. Therefore, the BGC yields no evidence for a population of free-floating'' intergalactic H I clouds without associated optical counterparts. HIPASS provides a clear view of the local large-scale structure. The dominant features in the sky distribution of the BGC are the Supergalactic Plane and the Local Void. In addition, one can clearly see the Centaurus Wall, which connects via the Hydra and Antlia Clusters to the Puppis Filament. Some previously hardly noticable galaxy groups stand out quite distinctly in the H I sky distribution. Several new structures, including some not behind the Milky Way, are seen for the first time.

The comprehensive osteoarthritis test: a simple index for measurement of treatment effects in clinical trials

Objective. To assess the measurement properties of a simple index of symptom severity in osteoarthritis (OA) of the hips and knees. Methods. Both the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the proposed new Comprehensive Osteoarthritis Test (COAT) instrument were completed weekly by 125 subjects in the context of a randomized, 12-week, 3 parallel-arm clinical trial. The reliabilities of the various scales were assessed on a weekly basis by use of Cronbach's alpha coefficients. The validity of the COAT total scale was assessed by correlation with the WOMAC total scale on a weekly basis with correlation coefficients, and in terms of the correlations between subject-level intercepts and slopes over time. The relative responsiveness of the WOMAC and COAT total scales was assessed using a multilevel (longitudinal) multivariate (WOMAC, COAT) linear model. Results. The WOMAC and COAT total scales were highly reliable (mean over weeks: WOMAC alpha = 0.98; COAT alpha = 0.97). The correlations between the WOMAC and COAT scales were very high (mean over weeks = 0.92; subject-level intercepts = 0.91, slopes = 0.88). The COAT total scale was significantly more responsive than the WOMAC total scale in the active treatment (34.8% improvement vs 26.8%; p = 0.002). Conclusion. The COAT total scale is simple to administer, reliable, valid, and responsive to treatment effects.

Upper Devonian biostratigraphy of the Iberian Pyrite Belt, southwest Spain Part Two: Organic-walled microphytoplankton

Upper Devonian rocks of the Iberian Pyrite Belt (IPB) in southwest Spain, comprising the Phyllite-Quartzite Group (PQ) and the lower part of the overlying Volcano-Sedimentary Complex (VSC), contain a diversity of terrestrial and marine palynomorphs (miospores and organic-walled microphytoplankton, respectively), which constitute the basis of this biostratigraphically oriented research project. Part One of the report has previously detailed the miospore content of the constituent 117 palyniferous samples. In the present paper (i.e., the concluding Part Two), the organic-walled microphytoplankton (acritarchs and prasinophyte phycomata) are systematically described and illustrated, and their occurrence in the study material is fully documented. The acritarchs are represented by 23 species (including one species complex) allocated among 14 genera (one of which, Dupliciradiatum, is newly established), together with a very rare and novel category (informally termed Gen. nov. A). The following new acritarch species are formally instituted: Dupliciradiatum crassum (type species), D. tenue, Histopalla languida, and Winwaloeusia repagulata. Five genera allied with the prasinophycean algae are identified; these accommodate a total of 15 species of which two - Cymatiosphaera tenuimembrana and Maranhites multioculus - are formally proposed as new. In addition, representatives of the prasinophyte genera Leiosphaeridia and Tasmanites are recorded but are not discriminated at species level. The microphytoplankton suite is clearly consonant, from previously published occurrences in other regions, with a Late Devonian dating. However, most of the species are known to be relatively long ranging through (and in some cases beyond) that epoch and hence are not amenable to detailed biozonal subdivision of the IPB succession. Moreover, the distribution of the species therein tends to be erratic in comparison with the more consistently occurring miospores, possibly due to stress factors induced by fluctuating conditions in the IPBs Upper Devonian marine environment. By contrast, the land-derived (miospore) assemblages are readily applicable in a blostratigraphic context: they can be correlated precisely with the Devonian miospore biozonation scheme for Western Europe. In those terms, the sampled PQ strata are assignable to the Diducites versabilis-Grandispora cornuta (VCo) Biozone of late Famennian age; while the samples from the anoxic sequence at the base of the VSC belong to the Retispora lepidophyta-Verrucosisporites nitidus (LN) Biozone (latest Famennian = latest Devonian). The biochronostratigraphic data, in conjunction with the findings from earlier IPB studies, imply two appreciable palynostratigraphic breaks within the PQ. These are representative, respectively, of the lower Frasnian-middle Famennian interval and of part of the Strunian/upper Famennian. Speculation currently remains as to whether the inferred gaps are more apparent than real; i.e., whether one or both represent actual hiatuses in IPB sedimentation or are simply a manifestation of hitherto unsampled and/or non-palyniferous PQ strata.

RNA interference for the treatment of cancer

RNA interference (RNAi) is the latest new technology in the field of genetic medicine in which specific genes can be turned off, or silenced, so as to affect a therapeutic outcome. It can be highly specific, works in the nanomolar range and is far more effective than the antisense approaches popular 10-15 years ago. Here we review the field and explore the potential role of RNAi in cancer therapy, highlighting recent progress and examining the hurdles that must be overcome before this promising technology is ready for clinical use. (C) 2006 Prous Science. All rights reserved.

Validation and reliability of the Modified Elderly Mobility Scale

Objective: To establish concurrent validity, interrater and test-retest reliability of the Modified Elderly Mobility Scale (MEMS). Methods: Ninety elderly patients were scored on the MEMS. To establish concurrent validity, 75 patients MEMS scores were compared to Functional Independence Measure (FIM) scores using Spearman's correlation. Videotaped patient performances were used to establish interrater and test-retest reliability using percentage absolute agreement and intraclass correlation coefficients (ICCs). Results: The total MEMS score demonstrated a significant association with the motor (r = 0.725) and total FIM scores (r = 0.718). Absolute agreement for interrater reliability was greater than 93% for all test items, with 97 and 98% for the two new measures, respectively. Test-retest reliability demonstrated similar high levels of absolute agreement and had ICCs ranging from 0.870 to 1.0. Conclusions: The MEMS is a quick, valid and reliable test of motor function of elderly patients with a spread of functional levels.

Genetic analysis of West Nile New York 1999 encephalitis virus

Analysis of the genome of the flavivirus responsible for the 1999 New York City encephalitis epidemic cloned from human brain by reverse-transcription polymerase chain reaction indicates its identity as a lineage I West Nile virus (WNV; WNV-NY1999) closely related to WNVs previously isolated in the Middle East.