The relationship between dietary fat intake and risk of colorectal cancer: evidence from the combined analysis of 13 case-control studies

The objective of this study was to examine the effects of the intakeof dietary fat upon colorectal cancer risk in a combined analysis of datafrom 13 case-control studies previously conducted in populations withdiffering colorectal cancer rates and dietary practices. Original datarecords for 5,287 cases of colorectal cancer and 10,470 controls werecombined. Logistic regression analysis was used to estimate odds ratios (OR)for intakes of total energy, total fat and its components, and cholesterol.Positive associations with energy intake were observed for 11 of the 13studies. However, there was little, if any, evidence of anyenergy-independent effect of either total fat with ORs of 1.00, 0.95, 1.01,1.02, and 0.92 for quintiles of residuals of total fat intake (P trend =0.67) or for saturated fat with ORs of 1.00, 1.08, 1.06, 1.21, and 1.06 (Ptrend = 0.39). The analysis suggests that, among these case-control studies,there is no energy-independent association between dietary fat intake andrisk of colorectal cancer. It also suggests that simple substitution of fatby other sources of calories is unlikely to reduce meaningfully the risk ofcolorectal cancer.     

Illness management and recovery: a review of the research

Illness management is a broad set of strategies designed to help individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, and cope effectively with their symptoms. Recovery occurs when people with mental illness discover, or rediscover, their strengths and abilities for pursuing personal goals and develop a sense of identity that allows them to grow beyond their mental illness. The authors discuss the concept of recovery from psychiatric disorders and then review research on professional-based programs for helping people manage their mental illness. Research on illness management for persons with severe mental illness, including 40 randomized controlled studies, indicates that psychoeducation improves people's knowledge of mental illness; that behavioral tailoring helps people take medication as prescribed; that relapse prevention programs reduce symptom relapses and rehospitalizations; and that coping skills training using cognitive-behavioral techniques reduces the severity and distress of persistent symptoms. The authors discuss the implementation and dissemination of illness management programs from the perspectives of mental health administrators, program directors, people with a psychiatric illness, and family members.     

United Kingdom national survey of the views of geriatric psychiatrists on the administration of electroconvulsive therapy to patients with fractures

Traditionally, psychiatrists have been cautious in administering electroconvulsive therapy (ECT) to patients with recent fractures. Drawing on the collective experience of geriatric psychiatrists in the United Kingdom may allow a better understanding of the use of ECT in fractures. The opinions of UK consultant geriatric psychiatrists on the use of ECT in the presence of recent fracture were acquired by a detailed questionnaire survey. Questionnaires were sent to 551 geriatric psychiatrists, and 306 (56%) usable responses were received. Twelve percent of geriatric psychiatrists had used ECT in fractures, and 55% would be prepared to administer ECT in the presence of fractures. They would seek specialist advice from anesthetists and orthopedic surgeons before, during, and after the administration of ECT. Geriatric psychiatrists generally did not seek advice from specialist ECT consultants. The researchers concluded that geriatric psychiatrists are prepared to administer ECT in the presence of fractures after seeking specialist advice from anesthetists and orthopedic surgeons.     

Landlords as partners for promoting success in supported housing: "it takes more than a lease and a key"

This paper examines the potential value of working with landlords and property managers to promote success in supported housing for people with psychiatric and addictive disabilities. The authors argue that relationships with landlords can promote tenants' housing stability, rehabilitation, social integration, and success in community living. A case history of the program is used to describe efforts to develop working relationships with landlords. It concludes presenting a model for how tenants, housing programs, and service providers can collaborate with landlords.     

CROHN'S DISEASE OF THE PREPUCE IN A 12-YEAR-OLD BOY: A Case Report and Review of the Literature

We report a case of Crohn's disease with involvement of the foreskin in a 12-year-old boy. One year previously, on the basis of clinical features (diarrhea with blood, perianal fissures) and histologic examination, a diagnosis of Crohn's disease was made. Subsequently, he developed phimosis and balanitis and underwent circumcision. Sections submitted from the foreskin revealed noncaseating granulomatous inflammation consistent with Crohn's disease. Crohn's disease with involvement of the genitalia is unusual. Only 26 cases including our case have been reported in the scientific literature. We have analyzed these cases with emphasis on gender, age, clinical features, duration of Crohn's disease, and probable mode of spread to the genitalia. Careful examination of sections from genital lesions, including those submitted from the foreskin, is essential to detect small isolated granulomas that may then lead to the diagnosis of inflammatory bowel disease.