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21.
Tyrer P Thompson S Schmidt U Jones V Knapp M Davidson K Catalan J Airlie J Baxter S Byford S Byrne G Cameron S Caplan R Cooper S Ferguson B Freeman C Frost S Godley J Greenshields J Henderson J Holden N Keech P Kim L Logan K Manley C MacLeod A Murphy R Patience L Ramsay L De Munroz S Scott J Seivewright H Sivakumar K Tata P Thornton S Ukoumunne OC Wessely S 《Psychological medicine》2003,33(6):969-976
BACKGROUND: We carried out a large randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behaviour therapy (MACT) versus treatment as usual (TAU) for deliberate self-harm. METHOD: Patients presenting with recurrent deliberate self-harm in five centres were randomized to either MACT or (TAU) and followed up over 1 year. MACT patients received a booklet based on cognitive behaviour therapy (CBT) principles and were offered up to five plus two booster sessions of CBT from a therapist in the first 3 months of the study. Ratings of parasuicide risk, anxiety, depression, social functioning and global function, positive and negative thinking, and quality of life were measured at baseline and after 6 and 12 months. RESULTS: Four hundred and eighty patients were randomized. Sixty per cent of the MACT group had both the booklet and CBT sessions. There were seven suicides, five in the TAU group. The main outcome measure, the proportion of those repeating deliberate self-harm in the 12 months of the study, showed no significant difference between those treated with MACT (39%) and treatment as usual (46%) (OR 0.78, 95% CI 0.53 to 1.14, P=0.20). CONCLUSION: Brief cognitive behaviour therapy is of limited efficacy in reducing self-harm repetition, but the findings taken in conjunctin with the economic evaluation (Byford et al. 2003) indicate superiority of MACT over TAU in terms of cost and effectiveness combined. 相似文献
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23.
N. K. MacLeod 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1976,25(3):267-278
Summary Spontaneous action potentials recorded from 126 neurons in the olfactory bulb of Salmo gairdneri show a higher tendency towards bursting patterns of activity than those shown in previous reports about other fish. Granule cells and periglomerular cells are more likely to fire in bursts than mitral cells. Natural chemical stimulation of the olfactory mucosa with amino acid solutions produced a unique pattern of excitatory and inhibitory responses across all units. Chi-square values were calculated for stimulatory effectiveness between forty-five pairs of odours. L-serine and L-alanine consistently showed a high degree of similarity with several other odours. The converse was true for GABA and L-histidine, although this pair had a high chi-square value when mutually compared. Enantiomeric pairs of amino acids were often found to have opposite stimulatory effects on bulbar units. These results are discussed in relation to the possible properties and configurations of odorant receptor sites for amino acids in the fish olfactory mucosa. 相似文献
24.
Dou Q; Tarnuzzer RW; Williams RS; Schultz GS; Chegini N 《Molecular human reproduction》1997,3(11):1005-1014
25.
Bruce Guthrie Tom Love Rebecca Kaye Margaret MacLeod Jim Chalmers 《The British journal of general practice》2008,58(550):311-317
BACKGROUND: The Shipman Inquiry recommended mortality rate monitoring if it could be 'shown to be workable' in detecting a future mass murderer in general practice. AIM: To examine the effectiveness of cumulative sum (CUSUM) charts, cross-sectional Shewhart charts, and exponentially-weighted, moving-average control charts in mortality monitoring at practice level. DESIGN OF STUDY: Analysis of Scottish routine general practice data combined with estimation of control chart effectiveness in detecting a 'murderer' in a simulated dataset. METHOD: Practice stability was calculated from routine data to determine feasible lengths of monitoring. A simulated dataset of 405,000 'patients' was created, registered with 75 'practices' whose underlying mortality rates varied with the same distribution as case-mix-adjusted mortality in all Scottish practices. The sensitivity of each chart to detect five and 10 excess deaths was examined in repeated simulations. The sensitivity of control charts to excess deaths in simulated data, and the number of alarm signals when control charts were applied to routine data were estimated. RESULTS: Practice instability limited the length of monitoring and modelling was consequently restricted to a 3-year period. Monitoring mortality over 3 years, CUSUM charts were most sensitive but only reliably achieved >50% successful detection for 10 excess deaths per year and generated multiple false alarms (>15%). CONCLUSION: At best, mortality monitoring can act as a backstop to detect a particularly prolific serial killer when other means of detection have failed. Policy should focus on changes likely to improve detection of individual murders, such as reform of death certification and the coroner system. 相似文献
26.
Growth and development in thanatophoric dysplasia 总被引:2,自引:0,他引:2
I M MacDonald A G Hunter P M MacLeod S B MacMurray 《American journal of medical genetics》1989,33(4):508-512
Two cases of prolonged survival of thanatophoric dysplasia are presented, in which ventilatory support was initiated in the neonatal period because of respiratory distress. Both patients required a ventriculoperitoneal shunt for hydrocephalus and had decompression of the posterior fossa. The history of each patient has been characterized by profound developmental delay and dramatic growth failure. 相似文献
27.
Needle biopsy of renal allografts: comparison of two techniques 总被引:2,自引:0,他引:2
Bogan ML; Kopecky KK; Kraft JL; Holladay AO; Filo RS; Leapman SB; Thomalla JV 《Radiology》1990,174(1):273-275
Two techniques for renal allograft biopsy were retrospectively evaluated to compare relative safety and efficacy. After ultrasound (US) localization of the kidney and biopsy with a hand-held 14-gauge cutting needle, an adequate specimen was obtained in 74 of 77 cases (96%). Major complications occurred in six of these 77 cases (8%). One hundred four biopsies were performed by using a smaller 18-gauge cutting needle with a spring-loaded biopsy "gun" and real-time US guidance. With this newer technique, specimens adequate for diagnosis were obtained in 99 biopsies (95%). There was a single major complication with this technique (1%). The 18-gauge needle with real-time US guidance yields comparably adequate specimens with a lower frequency of complications. 相似文献
28.
Chen Junxin; MacLeod Michael C.; Zhao Rushen; E.Geacintov Nicholas 《Carcinogenesis》1993,14(5):1049-1051
The fluorescence of mononucleoside adducts derived from thebinding of anti-7ß,8-dihydroxy-9,10-epoxy-7,8,9,10-tetra-hydrobenzo[a]pyrene(BPDE I) to N6-deoxyadenosine (BPDE-dA adducts) is 10100times stronger (depending on the methanol/water solvent composition)than the fluorescence of adducts derived from the binding ofthis diol epoxide derivative to N2-deoxyguanosine. It is shownhere that these fluorescence characteristics can be used toquantitate the relatively low yields of BPDE-dA adducts by fluorescencedetection when BPDEmodified DNA is subjected to enzymaticdegradation to the mononucleoside levels, followed by HPLC analysisof the digests. 相似文献
29.
Cost comparison of sevoflurane with isoflurane anesthesia in arthroscopic menisectomy surgery 总被引:1,自引:0,他引:1
Craig R. Ries Aliréza Azmudéh Luigi G. Franciosi Stephan K. W. Schwarz Bernard A. MacLeod 《Journal canadien d'anesthésie》1999,46(11):1008-1013
PURPOSE: To determine the "real world" cost of sevoflurane compared with isoflurane in balanced general anesthesia for daycare arthroscopic menisectomy, we prospectively investigated perioperative drug requirement and expense as well as recovery time. METHODS: Following intravenous induction, 40 consenting adult patients randomly received either sevoflurane- or isoflurane-based anesthesia with a standardized gas inflow rate of 3 l x min. Recovery was assessed in the postanesthetic recovery room (PARR) in a double-blind manner at 15 min intervals using the Aldrete scoring system until patients met discharge criteria. RESULTS: Patient demographics, anesthetic duration, volatile potency and adjunct drug requirements were similar in the two groups. Total perioperative drug cost per patient was CAN$38.10+/-10.13 (mean +/- SD) for the sevoflurane group and $23.87+/-6.59 for the isoflurane group (P<0.01). Although the nonvolatile drug cost was comparable between the two groups, the volatile drug cost per patient was $19.40+/-8.80 for sevoflurane and $4.50+/-1.90 for isoflurane (P<0.01). This four-fold sevoflurane-to-isoflurane cost difference was the product of two ratios, both based on the volume of liquid anesthetic: the ratio of consumption, 2.1; and the ratio of institutional price, 2.1. Intraoperative hemodynamic response, time until discharge from the PARR and incidences of postoperative nausea and vomiting did not significantly differ between the two groups. CONCLUSIONS: When used to maintain equipotent balanced general anesthesia for daycare arthroscopic menisectomy, volatile consumption and cost were greater for sevoflurane compared with isoflurane. Nonvolatile perioperative drug cost and recovery times were similar, however, in the two groups. 相似文献
30.