Effect of age and gender on citalopram and desmethylcitalopram steady-state plasma concentrations in adults and elderly depressed patients.

The effect of aging on steady-state plasma concentrations of citalopram (CIT) and desmethylcitalopram (DCIT) was investigated in 128 depressive patients treated with 10-80 mg/day CIT. They were separated into three groups, with age up to 64 years (mean age+/-S.D.: 47+/-12 years; n=48), between 65 and 79 years (72+/-1 years; n=57), and from 80 years or older (84+/-1 years; n=23). Body mass index (BMI), renal and hepatic functions were similar in the three groups. A large interindividual variability of plasma levels of CIT (16-fold) and DCIT (12-fold) was measured for a given dose. The mean plasma levels of CIT corrected for a 20 mg daily dose were 55% higher in the very elderly (>=80 years) patients (65+/-30 ng/ml; p<0.001) and 38% higher in the elderly (65-79 years) patients (58+/-24 ng/ml; p<0.001) when compared to the adult patients (42+/-17 ng/ml). DCIT mean plasma level was 38% higher (p<0.05) in the group of very elderly patients (22+/-10 ng/ml) when compared to the adult patients (16+/-9 ng/ml). As a consequence, the mean plasma concentration of CIT+DCIT was 48% higher in the very elderly patients (86+/-36 ng/ml; p<0.001) and 33% higher in the elderly patients (77+/-28 ng/ml; p<0.001) when compared to the adult patients (58+/-21 ng/ml). Age correlated significantly with CIT (r=0.43, p<0.001), DCIT (r=0.28, p<0.01), and CIT+DCIT plasma levels (r=0.44, p<0.001), and thus accounts for 18% of the variability of CIT plasma levels, with no influence of gender. The recommended dose reduction of CIT in elderly patients seems therefore justified.

Integrating sexuality into gynaecological consultations: gynaecologists' perspectives

There are currently few studies exploring doctors' personal perspectives on integrating sexuality into medical consultations. This study focuses on the views of gynaecologists on introducing, or not introducing, sexuality into their work. A total of 30 semistructured interviews were conducted with gynaecologists in the French-speaking part of Switzerland. The thematic content analysis and computer-assisted lexical analysis (Alceste) on the interview transcripts highlighted four categories: perceptions and description of sexuality, patient's sexological history, training in sexology and perceived difficulties. It is observed that, above all, the 'medical dimension' characterises gynaecologists' perceptions. Of greater interest is our observation of disparities in gynaecologists' discussion of their practice, which is often the product of lay knowledge based on common sense and/or personal experience. Finally, the decision to integrate questions relating to sexuality seems to depend on non-medical factors such as the personal experience, interest or gender of the doctor.

A productivity map of cognitive pretest methos for improving survey questions

Interest in cognitive pretest methods for evaluating survey questionnaires has been increasing for the last three decades. However, analysing the features of the scientific output in the field can be difficult due to its prevalence in public and private institutes whose main mission is not scientific research. The aim of this research is to characterize the current state of scientific output in the field by means of two bibliometric studies for the period from 1980 to 2007. Study 1 analysed documents obtained from the more commonly used bibliographic databases. Study 2 supplemented the body of documents from Study 1 with documents from non-indexed journals, conference papers, etc. Results show a constant growth in the number of publications. The wide dispersion of publication sources, together with the highlighted role of the public and private institutions as centres of production, can also be identified as relevant characteristics of the scientific output in this field.

Unnatural Mothers, Mothering Unnaturally: Technologies of Reproduction and the Politics of Maternity in Hiromi Goto's "Hopeful Monsters"

Through scientific discourse and reproductive technologies, the reproductive body and the maternal body continue to be constructed as ‘natural’. At the same time,these technologies have begun to blur the boundaries between what is consideredan acceptable reproductive body, and consequently an acceptable maternal body,and an unnatural or a socially undesireable one. As science purports to offerwomen greater control over how and when they choose to procreate, through methods which range between delaying or eliminating the possibility of contraception to those which extend the possibility of conception to postmenopausal or infertile women, these same procedures raise questions about thenature and ‘naturalness’ of reproduction. Added to these concerns are thesuitablility of the reproductive body as a maternal body. Consequently, and moreand more frequently, bodies which defy ideals about maternity and motherhoodemerge, and questions about what it means to mother are raised. Bodies whichcontest the construction of motherhood as natural are frequently represented asmonstrous or freakish, and the debate between science and nature is heightened.Hiromi Goto’s short story ‘Hopeful Monsters’ resists the construction of the‘natural’ maternal body by highlighting the way in which women’s bodies areshaped by scientific discourse. In turn, images of ‘monstrous’ mothers emerge andare challenged, suggesting the need to reimagine what it means to mother and whatit means to be a mother. Through reading a selection of the stories this paper willinterrogate possible alternatives to constructions of the ‘natural’ maternal body and motherhood, suggesting that the Goto’s ‘monsters’ are perhaps only monstrous as a result of scientific discourse which constructs them as such.