A long-term follow-up study of patients with ischaemic heart disease versus patients with nonspecific chest pain

Ninety consecutive patients who were admitted to hospital with acute chest pain were followed-up five years later. At the time of the original admission, all of the patients received a detailed physical and psychiatric evaluation. Seventy-one patients were diagnosed as having ischaemic heart disease, and 19 were diagnosed as having nonspecific chest pain. Patients with nonspecific pain were younger, consumed greater amounts of alcohol, smoked more than their organic counterparts, and were more likely to suffer from psychiatric disorder. The five-year assessment was carried out using a self-report questionnaire. Of the original 71 patients with ischaemic heart disease, 14 had died; 43 questionnaires were returned, 80.2% of the original sample. Sixteen (84.9%) of the patients with nonspecific pain were followed up; none had died. Both groups were predominantly male. The patients with nonspecific pain still smoked more than the patients with ischaemic heart disease, and they had significantly more symptoms of anxiety. The overall prevalence of psychiatric morbidity remained high, however, in both groups. Patients who had psychiatric illness at the time of the original assessment were more anxious at follow-up and more likely to complain of chest pain than those who had been well. Patients with nonspecific chest pain continued to seek treatment on a regular basis from their general practitioners either for chest pain or for other symptoms, but few were in frequent contact with hospital services. The possible preventive effects of psychiatric intervention at an earlier stage in both groups of patients needs to be investigated.     

The relative effects of deprivation of the latent and manifest benefits of employment on the well-being of unemployed people.

This study investigated the relative contributions of the individual latent and manifest benefits of employment to well-being in a sample of 248 unemployed people. Participants completed measures of well-being and the latent (time structure, activity, status, collective purpose, and social contact) and manifest (financial strain) benefits of employment. Significant associations were found between the latent benefits and well-being and between the manifest benefits and well-being. Both latent and manifest benefits contributed significantly to the prediction of well-being, with the manifest benefit accounting for the largest proportion. Although all latent benefits contributed significantly, status emerged as the most important contributor, followed by time structure and collective purpose. Results are discussed in the context of M. Jahoda's (1982) latent deprivation model and D. Fryer's (1986) agency restriction model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health in the north west region of England: associations with deprivation

OBJECTIVES: To evaluate the prevalence, clinical and radiological characteristics, association with HLA B27 in a subgroup of patients with inflammatory bowel disease (IBD) and subclinical sacroileitis. The sensitivity of the diagnostic criteria for spondyloarthropathy in this group of patients is evaluated. MATERIALS AND METHODS: All patients with inflammatory bowel disease attending an outpatient gastroenterology unit from January 1994 to June 1994 were recruited. A total of 62 patients with IBD and without clinical evidence of axial involvement were included in the study. The demographic, clinical, and radiological characteristics were collected. The radiological examination included PA and lateral views for the dorso-lumbar, and three views (Ferguson, right and left oblique views) for the sacroiliac joints. Films were interpreted by three independent readers. The HLA B27 allele distribution was analyzed in the 62 patients and in 80 healthy controls. The modified New York criteria, Amor criteria, and European Spondyloarthropathy Study Group criteria were evaluated. Patients were prospectively followed for two years with the same initial protocol. The statistical management of data was performed with the information program SPSS/PC. RESULTS: Fifteen cases of silent sacroileitis were detected, and most of them were grade 2 unilateral sacroileitis. There was no correlation between sacroileitis and IBP type, extradigestive symptoms, disease duration, sex, or peripheral arthritis. The frequency of HLA B27 in the sacroileitis group was 20% (p < 0.05). During the two-year follow-up period none of these cases has changed from diagnostic category. The sensitivity of diagnostic the criteria for spondyloarthropathy was low in these patients (40%-53%). CONCLUSIONS: A high frequency of asymptomatic sacroileitis in patients with IBD was detected. We propose the term Silent Axial Arthropathy to define this category of patients and, as with other authors, we consider this is a third form of rheumatic syndrome in IBD, different from the classical forms of peripheral arthritis and ankylosing spondylitis.     

The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease

Although prior theories about psychiatric disorders causing inflammatory bowel disease (IBD) have largely been discredited, these same disorders have at times been associated with functional gastrointestinal symptoms such as those found in irritable bowel syndrome. Since functional gastrointestinal symptoms can also occur in patients with organic pathology, we hypothesized that a current psychiatric disorder might amplify or produce additional gastrointestinal symptoms in patients with organic gastrointestinal diseases such as IBD, leading to additive functional disability and decreased quality of life. This pilot study evaluated a sequential sample of 40 IBD patients using the NIMH Diagnostic Interview Schedule, structured interviews for functional gastrointestinal symptoms, and prior episodes of emotional, physical, and sexual abuse as well as self-report measures of personality and disability. We compared IBD patients with and without a current psychiatric disorder while controlling for disease severity. Eight patients with major depression were treated with antidepressants. Patients with a current psychiatric disorder had significantly higher 1) mean number of lifetime psychiatric diagnoses, 2) prevalence rates of prior sexual and physical victimization, and, 3) mean numbers of both gastrointestinal and other medically unexplained symptoms despite no differences in severity of IBD. Significant and trend level differences were apparent on several measures of functional disability. A regression analysis showed that number of psychiatric diagnoses, number of functional gastrointestinal symptoms, and dissociation scale scores significantly discriminated the groups. Treatment of current major depression decreased functional disability despite no objective changes in gastrointestinal disease severity. It was concluded that the presence of a current psychiatric disorder appears to alter the perception of disease severity in patients with IBD. Nonrecognition of the psychiatric disorder may lead to unnecessary and aggressive interventions for IBD patients such as medication changes, invasive testing, or surgery. The presence of a current psychiatric illness also appears to be associated with increased functional disability. Psychiatric evaluation and treatment, therefore, have an important role in the ongoing management of IBD patients with distressing gastrointestinal symptoms not directly attributable to their IBD.     

Effects of display format on proof-reading with VDUs

Two experiments are reported which compared proof-reading performance in various VDU display formats. Experiment 1 found that displaying text one paragraph at a time improved the accuracy of performance, relative to a full screen condition, but at the expense of speed. Subjects also preferred using the paragraph format. Display contrast (positive vs negative) had no effect on performance. Experiment 2 supported the findings of Experiment 1, and found increased accuracy when text was further subdivided into sentences, but speed was again reduced. Possible explanations for the format effect are presented, and its practical implications are considered.     

Seasonal fluctuations in plasma concentrations of luteinizing hormone and progesterone in Brahman (Bos indicus) and Hereford-Shorthorn (Bos taurus) cows grazing pastures at two stocking rates in a subtropical environment

The effects of day length and grazing intensity on seasonal fluctuations in plasma concentrations of luteinizing hormone (LH) and cyclic ovarian activity were determined in Brahman (Bos indicus) and Hereford-Shorthorn (Bos taurus) cows maintained at two stocking rates in a subtropical environment. Contemporary groups of ovariectomised cows were monitored for fluctuations in plasma concentrations of LH. Equal numbers (n = 5) of entire and ovariectomised Brahman and Hereford-Shorthorn cows were assigned to a pasture with a greater or lesser stocking rate. Over a 15-month period, live weight was recorded weekly, and a blood sample was taken at the same time for measurement of plasma LH in entire and ovariectomised cows, and plasma progesterone in entire cows. Plasma concentrations of progesterone were used as an index of cyclic luteal function (time of cessation or onset of oestrous cycles). Regression coefficients were calculated to determine the least-order regression coefficient (LORC; range 1st to 10 order) for which time of year explained at least 50% (r2 > 0.05) of changes in live weight, plasma LH, or plasma progesterone; regression coefficients of 4th and 5th order indicated seasonally-related changes in these variables. For all cows, live weight was greatest in late summer to early autumn and lowest in winter. Changes in live weight were more closely related to seasonal changes in pasture availability for cows on pastures at a greater stocking rate (LORC 4th-5th) than for cows on pastures at a lesser stocking rate (LORC 1st-3rd). Cyclic ovarian activity ceased in four Hereford-Shorthorn cows on pastures at a greater stocking rate in late autumn to early winter, and onset of oestrous cycles did not occur in all of these cows until late spring. Oestrous cycles were not detected in one of five cows in the other groups during different periods of the study; however, there were no apparent patterns to cessation of oestrous cycles in these groups. There were no seasonally-related changes in plasma LH in entire cows, at either stocking rate (LORC 10th; r2 = 0.16 to 0.41). In contrast, distinct seasonal fluctuations in plasma LH occurred in ovariectomised cows, with increases in spring and winter. Environmental cues induced greater fluctuations in plasma LH in ovariectomised cows at a greater stocking rate (LORC 3rd-5th; r2 = 0.71 to 0.72) compared with ovariectomised cows at a lesser stocking rate (LORC 3rd-5th; r2 = 0.53 to 0.58). The findings demonstrated that marked seasonal changes in reproductive activity of the hypothalamic pituitary axis can occur in cows with B. indicus and B. taurus genotypes in a subtropical environment; however, changes in plasma concentrations of LH are only apparent in ovariectomised cows. Concentrations of plasma LH in ovariectomised Brahman and Hereford-Shorthorn cows increased during winter, when pasture availability was limiting and cyclic luteal function ceased in four of five Hereford-Shorthorn cows.     

A survey of commercial meat block freezing in the United Kingdom and Fire

The results of a survey of meat block freezing in the UK and Eire have been compared with experimental and calculated data. This comparison showed that only 58% of the throughput is being frozen within ±20% of the actual time required. There was little standardization of block size, type of wrapping and carton, freezing and storage conditions. The weight of the majority of blocks was between 25 and 30 kg and 80% of the meat was frozen in cartons between 14.6 and 15.9 cm thick. The survey concludes that refrigeration and meat companies must aim for more realistic freezing times and conditions in order to avoid either incomplete freezing or wasting energy by freezing for longer than necessary.     

Fire performance of exterior wall insulation and finish systems

It is quite possible that variations of the systems currently available on the market may require additional or different fire testing. Successfully tested and approved systems do not present a fire hazard and should be permitted on all types of construction. Note: This paper has been unanimously adopted by EIMA as an industry position concerning fire hazard.