Living with under-fives: a programme for parents with a mental illness

Parenthood is considered a major life role. Yet for people with a major mental illness, it is one that is fraught with difficulties and for which they receive the least support. Research on parenting and parenting programmes for people with a major mental illness is sparse and most of the papers presented do not provide a working model that can be easily replicated. This lack of support for parents or knowledge of working parenting programmes has often resulted in children being placed in care. Occupational therapists working in an Australian mental health service developed a two-stream programme which aimed to consolidate the parent/child relationship and enable the parents to develop effective parenting skills. This programme has a parents' educational stream and a stream with developmentally appropriate activities for the children. Observed outcomes have included the parents becoming more responsive to their children, increased treatment compliance, improved community access, and a decrease in the number of children in temporary foster care.

Patient based method of assessing adverse events in clinical trials in rheumatology: the revised Stanford Toxicity Index

We describe the progress towards developing a patient rated toxicity index that meets all of the patient-important attributes defined by the OMERACT Drug Safety Working Party, These attributes are frequency, severity. importance to patient, importance to the clinician, impact on economics, impact on activities, and integration of adverse effects with benefits. The Stanford Toxicity Index (STI) has been revised to collect all attributes with the exception of impact on activities. However, since the STI is a part of the Health Assessment Questionnaire (HAQ). impact on activities is collected by the HAQ. In particular, a new question asks patients to rate overall satisfaction, taking into consideration both benefits and adverse effects. The nest step in the development of this tool is to ensure that the STI meets the OMERACT filter of truth, discrimination, and feasibility. Although truth and feasibility have been confirmed by comparisons within the ARAMIS database, discrimination needs to be assessed in clinical trials.

(Book review) Neuropsychotherapy and Community Integration: Brain Illness, Emotions, and Behavior. T. Judd. 1999. New York: Kluwer Academic/Plenum Publishers

As individuals gain expertise in a chosen field they can begin to conceptualize how what they know can be applied more broadly, to new populations and situations, or to increase desirable outcomes. Judd's book does just this. It takes our current understanding of the etiology, course, and sequelae of brain injuries, combines this with established psychotherapy and rehabilitation techniques, and expands these into a cogent model of what Judd calls “neuropsychotherapy.” Simply put, neuropsychotherapy attempts to address the cognitive, emotional and behavioral changes in brain-injured persons, changes that may go undiagnosed, misdiagnosed, or untreated.

Body mass index and the prediction of percentage body fat in Australian Chinese women

Background Body mass index (BMI) is frequently related to percentage body fat. Nevertheless, the relationship between BMI and fat mass/height(2) (FM/H-2), theoretically, should be more appropriate. Aim: This study seeks to evaluate the relationship between BMI and both percentage body fat and FM/H-2 in a group of Chinese Australian females. Subjects and methods: Forty subjects took part in the study and all were Chinese females resident in Brisbane, Australia. Body mass index was calculated from height and weight. Percentage body fat and fat mass were calculated from measurements of total body water. Results: The use of BMI to predict FM/H-2 accounted for double the variance of that found when BMI was used to predict percentage body fat. Conclusions: As a consequence, it is possible that the use of BMI to predict FM/H-2 and not percentage body fat in the first instance may prove to be more useful in a number of adult populations. Nevertheless, with a relatively small sample size it is difficult, if not impossible, to test the developed equations on a validation group and further investigation into the findings described in this paper needs to be undertaken.

A proposed maceral index to predict combustion behavior of coal

To predict the combustion performance in pulverized coal-fired boilers, this paper examines existing indices and develops a maceral index (MI). These indices were compared with the data of 68 coals and blends in a range of the mean vitrinite reflectance from 0.25 to 1.63. The results showed that the fuel ratio and the mean vitrinite reflectance could qualitatively indicate the burnout of the coals and blends. The new MI, MI = L + V/R-2/I-1.25(HV/30)(2.5), provides a useful correlation for the burnout of the coals and blends. The correlation coefficient (I-) is 0.982 for the EER data, and 0.808 for the ACIRL data. The MI also has potential to correlate ignition and flame stability of the coals and blends. The MI predicts the burnout better than the other indices. (C) 2001 Elsevier Science Ltd. All rights reserved.

The effect of heat treatment on the toughness, hardness and microstructure of low carbon white cast irons

The effect of destabilisation and subcritical heat treatment on the impact toughness, hardness, and the amount and mechanical stability of retained austenite in a low carbon white cast iron have been investigated. The experimental results show that the impact energy constantly increases when the destabilisation temperature is raised from 950 degreesC to 1200 degreesC. Although the hardness decreases, the heat-treated hardness is still greater than the as-cast state. After destabilisation treatment at 1130 degreesC, tempering at 200 to 250 degreesC for 3 hours leads to the highest impact toughness, and secondary hardening was observed when tempering over 400 degreesC. The amount of retained austenite increased with the increase in the destabilisation temperature, and the treatment significantly improves the mechanical stability of the retained austenite compared with the as-cast state. Tempering below 400 degreesC does not affect the amount of retained austenite and its mechanical stability. But the amount of retained austenite is dramatically reduced when tempered above 400 degreesC. The relationship between the mechanical properties and the microstructure changes was discussed. (C) 2001 Kluwer Academic Publishers.

Heat of desorption measured by means of electrical heat excitation

A new method of measuring heat of desorption is proposed in this Letter. The principle of the method is to measure the amount of mass released when a controlled amount of energy is supplied directly to a solid adsorbent. This is in contrast to conventional methods such as microcalorimetry, where heat released upon adsorption is measured. In this method, a quantified heat supply is generated by passing a de current through a carbon pellet, which is equilibrated with a gas phase confined in a closed vessel. As a consequence of the heating, the particle temperature is increased, resulting in partial desorption of adsorbed molecules. The variations of pellet temperature and the system pressure with respect to time are used to determine the heat of desorption as a function of loading.

Presentations of physical illness in people with developmental disability: the example of gastro-oesophageal reflux

People with developmental disabilities are becoming an important part of the general practice population. Although they have a similar range of medical conditions to the general population, there are some important differences in prevalence, risk factors, presentation and management of particular conditions. We use gastro-oesophageal reflux to illustrate how developmental disability may affect the presentation, assessment and management of a common condition.

Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners

Background: The Edinburgh Postnatal Depression Scale (EPDS) has been validated and used extensively in screening for depression in new mothers, both in English speaking and non-English speaking communities. While some studies have reported the use of the EPDS with Fathers, none have validated it for this group, and thus the appropriate cut-off score for screening for depression or anxiety caseness for this population is not known. Method: Couples were recruited antenatally and interviewed at six weeks postpartum. EPDS scores and distress caseness (depression or anxiety disorders) for 208 fathers and 230 mothers were determined using the Diagnostic Interview Schedule. Results: Analyses of the EPDS for fathers using distress caseness (depression or anxiety disorders) as the criterion shows that a cut-off of 5/6 has optimum receiver operating characteristics. Furthermore acceptable reliability (split-half and internal consistency) and validity (concurrent) coefficients were obtained. For mothers the optimum cut-off screening value to detect distress caseness was 7/8. Item analysis revealed that fathers endorsed seven of the ten items at lower rates to mothers, with the most significant being that referring to crying. Conclusions: The EPDS is a reliable and valid measure of mood in fathers. Screening for depression or anxiety disorders in fathers requires a two point lower cut-off than screening for depression or anxiety in mothers, and we recommend this cut-off to he 5/6. (C) 2001 Elsevier Science B.V. All rights reserved.

Immunoelectron microscopy provides evidence for the presence of mitochondrial heat shock 10-kDa protein (chaperonin 10) in red blood cells and a variety of secretory granules

Hsp10 (10-kDa heat shock protein, also known as chaperonin 10 or Cpn10) is a co-chaperone for Hsp60 in the protein folding process. This protein has also been shown to be identical to the early pregnancy factor, which is an immunosuppressive growth factor found in maternal serum. In this study we have used immunogold electron microscopy to study the subcellular localization of Hsp10 in rat tissues sections embedded in LR Gold resin employing polyclonal antibodies raised against different regions of human Hsp10. In all rat tissues examined including liver, heart, pancreas, kidney, anterior pituitary, salivary gland, thyroid, and adrenal gland, antibodies to Hsp10 showed strong labeling of mitochondria. However, in a number of tissues, in addition to the mitochondrial labeling, strong and highly specific labeling with the Hsp10 antibodies was also observed in several extramitochondrial compartments. These sites included zymogen granules in pancreatic acinar cells, growth hormone granules in anterior pituitary, and secretory granules in PP pancreatic islet cells. Additionally, the mature red blood cells which lack mitochondria, also showed strong reactivity with the Hsp10 antibodies. The observed labeling with the Hsp10 antibodies, both within mitochondria as well as in other compartments/cells, was abolished upon omission of the primary antibodies or upon preadsorption of the primary antibodies with the purified recombinant human Hsp10. These results provide evidence that similar to a number of other recently described mitochondrial proteins (viz., Hsp60, tumor necrosis factor receptor-associated protein- 1, P32 (gC1q-R) protein, and cytochrome c), Hsp10 is also found at a variety of specific extramitochondrial sites in normal rat tissue. These results raise important questions as to how these mitochondrial proteins are translocated to other compartments and their possible function(s) at these sites. The presence of these proteins at extramitochondrial sites in normal tissues has important implications concerning the role of mitochondria in apoptosis and genetic diseases.