Low serum osteocalcin levels in glucocorticoid-treated asthmatics.

Serum osteocalcin (OC) levels were measured in 19 asthmatic patients receiving long term glucocorticoid therapy and in age- and sex-matched asthmatic patients not receiving this treatment. In the glucocorticoid-treated patients, the mean OC level was approximately 50% less than that in the control group (P less than 0.001), and there was a direct correlation between serum OC and 1,25-dihydroxyvitamin D [1,25-(OH)2D; r = 0.71; P less than 0.001]. Multiple regression analysis in a total of 39 glucocorticoid-treated patients indicated that OC correlated directly to 1,25-(OH)2D and inversely to glucocorticoid dose. There was no correlation between OC and 1,25-(OH)2D in the control group and no significant difference in mean serum 1,25-(OH)2D between the steroid-treated asthmatic patients and the asthmatic control patients. The effect of a 4-day course of oral 1,25-(OH)2D on serum OC was studied in six patients with glucocorticoid excess and six normal subjects. There was a similar percent increase in OC levels in both groups, though the basal concentrations and absolute increases were substantially less in the steroid-treated group. It is likely that the depression of serum OC in glucocorticoid-treated patients results from the reduction in the rate of bone formation induced by these hormones.

Identification of a 27-kDa enkephalin-containing protein associated with bovine adrenal medullary chromaffin granule membranes by immunoblotting.

An antiserum which recognizes high molecular mass enkephalin-containing proteins was used to compare proenkephalin intermediates in both the soluble and membrane components of bovine adrenal chromaffin granules by immunoblotting. While a range of molecular mass forms were identified in the soluble lysate the major form in the membranes corresponded to a 27-kDa enkephalin-containing protein. Enzymic digestion of bands of 27-kDa material and quantitation of the enkephalin released showed that 22% of this material was membrane-associated. High concentrations of chaotropic agents were required to extract this material from the membranes. Association of hormone and neuropeptide precursors with membrane components may be important for targeting of precursors to secretory granules or correct processing.

Verbal fluency in Parkinson's disease.

This study compares the performance of Parkinson's disease patients with age-matched controls on semantic and letter-initial verbal fluency tests. An analysis of variance revealed that Parkinsonian patients showed impaired word production. However when the covariates of age, present verbal ability (Mill Hill Synonyms) and severity of depression (Geriatric Depression Screening Scale) were included in an analysis of covariance, the significant effect of Parkinson's disease on verbal fluency disappeared. Instead, age and present verbal ability were revealed to be the significant sources of between subject variation in total verbal fluency performance; results indicated that increased age and lower present verbal ability resulted in poorer performance on the verbal fluency tests. Depression score was not a significant source of between subject variation. The results are discussed in relation to those recently reported by Gurd and Ward (1989).

Perception and memory for faces in Parkinson's disease.

This study investigated face processing abilities in patients with late-onset Parkinson's disease. In the first experiment, the Parkinson's disease patients were impaired on a recognition memory test for unfamiliar faces but showed no deficit relative to controls in recognition memory for words. The Parkinson's disease patients were also impaired at matching different photographs of unfamiliar faces. Experiment 2 revealed that the memory deficit affected recognition of familiar as well as unfamiliar faces and extended the face perception impairment to sex decisions and to the analysis of facial speech. An additional verbal recognition memory test again revealed no significant differences between the performance of the Parkinson's disease and control groups. It is argued that the memory impairment is not accountable for simply in terms of the perceptual deficits, and the problems that the patients experience are discussed in terms of the functional model of face processing put forward by Bruce and Young (Brit. J. Psychol. 77, 305-327, 1986).

Understanding memory for faces in Parkinson's disease: the role of configural processing.

It has previously been reported that unfamiliar face recognition memory is impaired in Parkinson's disease (PD) [(Dewick, H. C., Hanley, J. R., Davies, A. D. M., Playfer, J. R. & Turnbull, C. J., Perception and memory for faces in Parkinson's disease. Neuropsychologia, 1991, 29, 785-802), (Haeske-Dewick, H. C., Are perception and memory for faces influenced by a specific age at onset factor in Parkinson's disease? Neuropsychologia, 1996, 34, 315-320), (Levin, B. E., Llabre, M. M. & Weiner, W. J., Cognitive impairments associated with early Parkinson's disease. Neurology, 1989, 39, 557-561)]. In the work reported here, we consider the possible mechanisms that might underlie this impairment. 28 PD patients and 28 controls were given a two-part test of recognition memory for words and faces, and two perceptual tests to measure their configural and componential processing ability. We found that PD patients were significantly worse than controls on the recognition memory test for faces, but not when the stimuli were words. In addition, PD patients were significantly impaired relative to controls on the closure test (FCT) used to measure configural processing, but there was no difference between the two groups on a test of componential processing ability. Multiple regression analyses revealed that even after accounting for the influence of age, intelligence and level of depression, configural processing ability was the important predictor of unfamiliar face recognition memory in Parkinson's disease. There was no effect of Parkinson's disease specific variables on either face recognition or FCT performance. In addition, some recently diagnosed patients were poor at face recognition. It is suggested that face configuration skills may be affected very early in the course of Parkinson's disease, and that this may be connected to the fact that considerable nigrostriatal degeneration and alteration in brain neurotransmitter levels occur before the clinical symptoms of PD appear.

Remembering and knowing in a patient with preserved recognition and impaired recall.

ROB is a patient who has a severe deficit in recalling recently presented verbal material following rupture and repair of an anterior communicating artery aneurysm [Hanley JR, Davies ADM, Downes J, Mayes A. Cognitive Neuropsychology 1994;11:543-78; Hanley JR, Davies ADM. In: Parkin A, editor. Case Studies in the Neuropsychology of Memory. Hillsdale, NJ: Lawrence Erlbaum, 1997. p. 111-26]. Despite this, her performance on tests of recognition memory is comfortably within the normal range. In the present series of experiments, we investigated whether or not ROB's performance on tests of recognition memory might be associated with a disproportionately large number of correct decisions made on the basis of familiarity rather than contextual retrieval [e.g. Mandler G. Psychological Review 1980;87:252-71]. Contrary to this hypothesis, the results showed that ROB made a high proportion of remember decisions relative to know decisions in recognition [cf. Gardiner JM. Memory & Cognition 1988;16:309-13] and produced a high recollection score when conscious recollection and familiarity were placed in opposition to one another [cf. Jacoby LL, Woloshyn V, Kelley C. Journal of Experimental Psychology: General 1989;118:115-25.]. ROB's recognition memory performance therefore appears to be qualitatively as well as quantitatively similar to that found in the normal population. As ROB has suffered damage to both the fornix and the anterior thalamus, the results of the present study are consistent with the claim that damage to the extended hippocampal system has a much more severe effect on recall than on recognition [Aggleton JP, Shaw C. Neuropsychologia 1996;34:51-62; Aggleton JP, Saunders RC. Memory 1997;5:49-71]. The present results provide no support, however, for the additional suggestion [Aggleton JP, Brown MW. Behavioral and Brain Sciences 1999;22:425-56.] that the extended hippocampal system is necessary for recognition memory decisions that are based on contextual retrieval.

Engagement and depressive symptoms in a community sample of elderly people.

Fifty-three elderly women attending a day centre were interviewed and observed to examine hypotheses about depressive symptoms and behaviour. Observers were blind to interview findings. The Geriatric Mental Status Schedule (GMS) and Multiple Affect Adjective Checklist (MAACL) provided information on current symptoms and mood. Time-sampling was used to assess clients' level and type of engagement. No significant relation was found between 'disengagement' (absence of engaged activity) and symptom level. Those clients reaching the Feighner criteria for depression did not differ from other clients either in level of 'disengagement' or in type of engaged activity. Within the whole sample 'disengagement' was related to age and to self-reports of good health. 'Onlooking' was correlated with 'recent loss of interest' and self-blame'. Results are discussed in relation to behavioural formulations of depression and studies of engagement.

Age differences in the rating of life-stress events: does contextual detail make a difference?

Twenty-four young (20 to 25 years) and 24 elderly (61 to 81 years) subjects rated the short-term (ST) and long-term (LT) threat of 36 life-events drawn from a community study of elderly people. Subjects were presented either with full contextual detail about the respondent and the event or with an edited version in which only a basic outline of the event was presented. Assignment of subjects to conditions was random. Agreement of subjects within and between groups as to what events were threatening was high and the untrained groups were also in close agreement with the consensus ratings of a trained panel. There were no significant main effects of age or contextual condition. It is concluded that the concept of the 'threat' of an event is generalizable over samples. Analysis of a significant age x context interaction showed that only young subjects rating LT threat were affected by contextual condition. Events supplied with context were rated by them as less threatening than those presented in outline. Some evidence was found to support the view that there may be age differences in the perceived impact of an event over time.

Global ratings of stress in the elderly.

The properties of four global ratings of life stress were investigated using data from 237 elderly subjects interviewed using the Brown & Harris life event and difficulties schedule. The global ratings had high one-year test-retest reliability and inter-rater reliability agreement. A summary measure of Adversity (based on contextual rating of all events and difficulties) may be reliably derived when a single index of life stress is desired. In the elderly sample Adversity was more closely related to chronic difficulties than to life-events.

Nuclear magnetic moment of the 57Cu ground state.

The nuclear magnetic moment of the ground state of (57)Cu(Iota(pi) = 3/2(-), T(1/2) = 196.3 ms) has been measured to be /mu((57)Cu)/ = (2.00 +/- 0.05)mu(N) using the beta-NMR technique. Together with the known magnetic moment of the mirror partner (57)Ni, the spin expectation value was extracted as = -0.078 +/- 0.13. This is the heaviest isospin mirror T = 1/2 pair above the (40)Ca region for which both ground state magnetic moments have been determined. The discrepancy between the present results and shell-model calculations in the full f p shell giving mu((57)Cu) approximately 2.4mu(N) and approximately 0.5 implies significant shell breaking at (56)Ni with the neutron number N = 28.

Probing shell structure and shape changes in neutron-rich sulfur isotopes through transient-field g-factor measurements on fast radioactive beams of 38S and 40S.

The shell structure underlying shape changes in neutron-rich nuclei near N = 28 has been investigated by a novel application of the transient-field technique to measure the first-excited-state g factors in 38S and 40S produced as fast radioactive beams. There is a fine balance between proton and neutron contributions to the magnetic moments in both nuclei. The g factor of deformed 40S does not resemble that of a conventional collective nucleus because spin contributions are more important than usual.

29Na: defining the edge of the island of inversion for Z=11.

The low-energy level structure of the exotic Na isotopes (28,29)Na has been investigated through beta-delayed gamma spectroscopy. The N=20 isotones for Z=10-12 are considered to belong to the "island of inversion" where intruder configurations dominate the ground state wave function. However, it is an open question as to where and how the transition from normal to intruder dominated configurations happens in an isotopic chain. The present work, which presents the first detailed spectroscopy of (28,29)Na, clearly demonstrates that such a transition in the Na isotopes occurs between 28Na (N=17) and 29Na (N=18), supporting the smaller N=20 shell gap in neutron-rich sd shell nuclei. The evidence for inverted shell structure is found in beta-decay branching ratios, intruder dominated spectroscopy of low-lying states, and shell model analysis.

The social behaviour of geriatric patients at mealtimes: an observational and an intervention study.

Two studies of the social behaviour of geriatric patients are reported. In the first, lunchtime observations were made of two comparable wards in a continuing-care hospital and all episodes of social interaction recorded. There were twice as many interactions on one ward as on the other and their type and variety differed. A second study concentrated on the ward with fewer interactions and attempted to increase the social behaviour of twelve patients by altering the seating arrangements and by providing simple prompts to encourage patients to exercise more control over the way the meal was served. A count was made of all social interactions during lunchtime both before and after change in serving arrangements. There was a significant increase in social behaviour for all patients, even those initially regarded as isolated. Staff-patient interaction also increased.

Setting performance goals in geriatric nursing.

Behavioural techniques are increasingly being applied in the geriatric field as part of a broader emphasis on psychological and social treatments in the care of the elderly. The nurse is in the best position to analyse a patient's performance and manage an intervention programme; however, some nurses have had little experience of autonomously diagnosing problems and setting performance goals. The authors argue that it is important to set such goals and give examples of how performance may be objectively specified, prerequisites made explicit, criteria for success defined and the consequences of goal attainment or non-attainment discussed with those most concerned. A complex situation drawn from the geriatric setting which was used as part of a teaching workshop to help nurses define suitable targets for intervention is described in the Appendix.

Stresses of hospitalization in the elderly: nurses' and patients' perceptions.

A study of stress in hospital is reported. Twenty-five patients (aged 70-93 years) and their nurses were interviewed about the patient's perceived stresses during the first and third weeks of hospitalization. The ward was modern in design and a 'patient allocation' system of nursing care was in operation in which one nurse had primary responsibility for each patient. Patients differed significantly from nurses in their use of a 16-item stress scale, using low scale values rather than high (stressful) values. Although as groups, patients and nurses showed significant correlations between stress ratings over the items, this was interpreted as their sharing common stereotypes about the hospital situation. There was no significant relation between nurses' and patients' ratings of the overall stress being experienced by the patients. An analysis of stress items showed there to be significant differences between type of stress. There was least discrepancy between nurses and patients concerning aspects of physical illness and most on the stressful impact of the hospital environment and routine. While patients rated items within this group (e.g. toiletting) to increase in stress during their stay in hospital, nurses rated the stress value as decreasing.

An investigation of the molecular properties and stability of intermediates of proenkephalin in isolated bovine adrenal medullary chromaffin granules.

An antiserum to a synthetic peptide corresponding to residues 95-117 of bovine proenkephalin recognizes all the major intermediates of this prohormone in bovine adrenal medulla (Birch, N. P. and Christie, D. L. (1986) J. Biol. Chem. 261, 12213-12221). This antiserum enabled an investigation of the stability and molecular properties of intermediates in the processing of proenkephalin in bovine adrenal medullary chromaffin granules. Intact and hypotonic lysates of chromaffin granules were incubated at 37 degrees C and the stability of intermediates assessed by gel filtration followed by radioimmunoassay and gel electrophoresis in combination with immunoblotting. Processing was slow in intact granules compared with incubations of hypotonic lysates which resulted in the selective cleavage of an Mr 27,000 intermediate and increases in the amounts of immunoreactivity of lower molecular weight. Protease inhibitors increased the stability of the 27-kilodalton intermediate, the most effective being p-chloromercuribenzoate. Preliminary evidence was obtained for the regulation of the processing of this intermediate by soluble factors present in chromaffin granules. It appears that membrane-associated intermediates of proenkephalin are relatively stable, although analysis of soluble immunoreactivity released during the incubation of chromaffin granule membranes showed a decrease in the 27-kilodalton intermediate and increased amounts of lower molecular weight intermediates. Analysis of hypotonic lysates by two-dimensional gel-electrophoresis showed that proenkephalin intermediates exhibit significant microheterogeneity. It will be important to compare the products of proenkephalin generated by purified proteases with a putative role in the processing of this prohormone with the properties of endogenous intermediates as revealed in this study.

Depression and anxiety in patients undergoing diagnostic investigations for head and neck cancers.

Patients attending a regional head and neck Oncology Unit were assessed for depression and anxiety (using the Leeds self-assessment scales) before diagnostic biopsy investigations. At the time of the assessments, neither patients nor investigators knew the biopsy results. Patients whose biopsies subsequently proved positive (showing the presence of a tumour) had significantly higher depression scores than those whose biopsies were negative. Differences in mean anxiety scores did not differ between groups. It is suggested that depression is part of the clinical picture of head and neck cancer.