Substitutional carbon doping of free-standing and Ru-supported BN sheets: a first-principles study.

The development of spatially homogeneous mixed structures with boron (B), nitrogen (N) and carbon (C) atoms arranged in a honeycomb lattice is highly desirable, as they open the possibility of creating stable two-dimensional materials with tunable band gaps. However, at least in the free-standing form, the mixed BCN system is energetically driven towards phase segregation to graphene and hexagonal BN. It is possible to overcome the segregation when BCN material is grown on a particular metal substrate, for example Ru(0 0 0 1), but the stabilization mechanism is still unknown. With the use of density-functional theory we study the energetics of BN/Ru slabs, with different types of configurations of C substitutional defects introduced to the h-BN overlayer. The results are compared to the energetics of free-standing BCN materials. We found that the substrate facilitates the C substitution process in the h-BN overlayer. Thus, more homogeneous BCN material can be grown, overcoming the segregation into graphene and h-BN. In addition, we investigate the electronic and transport gaps in free-standing BCN structures, and assess their mechanical properties and stability. The band gap in mixed BCN free-standing material depends on the concentration of the constituent elements and ranges from zero in pristine graphene to nearly 5 eV in free-standing h-BN. This makes BCN attractive for application in modern electronics.

Are we van der Waals ready?

We apply a range of density-functional-theory-based methods capable of describing van der Waals interactions with weakly bonded layered solids in order to investigate their accuracy for extended systems. The methods under investigation are the local-density approximation, semi-empirical force fields, non-local van der Waals density functionals and the random-phase approximation. We investigate the equilibrium geometries, elastic constants and binding energies of a large and diverse set of compounds and arrive at conclusions about the reliability of the different methods. The study also points to some directions of further development for the non-local van der Waals density functionals.

van der Waals bonding in layered compounds from advanced density-functional first-principles calculations.

Although the precise microscopic knowledge of van der Waals interactions is crucial for understanding bonding in weakly bonded layered compounds, very little quantitative information on the strength of interlayer interaction in these materials is available, either from experiments or simulations. Here, using many-body perturbation and advanced density-functional theory techniques, we calculate the interlayer binding and exfoliation energies for a large number of layered compounds and show that, independent of the electronic structure of the material, the energies for most systems are around 20 meV/Å2. This universality explains the successful exfoliation of a wide class of layered materials to produce two-dimensional systems, and furthers our understanding the properties of layered compounds in general.

The life circumstances of persons with a psychiatric disability: a survey in a region in southern Sweden.

This article describes the life circumstances of persons with a psychiatric disability living in one urban and six rural areas in a single region in Sweden. Furthermore, the life circumstances of persons with a psychiatric disability are discussed in relation to the aims of social policies in Sweden. Data were collected by means of a survey study exploring the formal support provided by local authorities to its citizens and the informal support given by family members and volunteers. The results reveal how the respondents themselves describe their life circumstances in terms of their living conditions, occupation and activities, health, and formal and informal support. The results indicate that persons with a psychiatric disability, regardless of where they live, need both formal and informal support in order to cope with their everyday lives. The family plays an important role in this, and it is essential for the formal and informal support systems to cooperate with each other. The lack of activities and opportunities for work experienced by persons with a psychiatric disability indicates that the sociopolitical goal of fostering access to employment and work and to earning a living for this group is far from having been attained.

Are stigma experiences among persons with mental illness, related to perceptions of self-esteem, empowerment and sense of coherence?

The aim of the study was to explore the relationship between stigmatizing rejection experiences and self-related variables. Our hypothesis was that rejection experiences would be negatively associated with perceptions of self-esteem, empowerment and sense of coherence. A cross-sectional study assessing rejection experiences, empowerment, sense of coherence and self-esteem was performed, including 200 persons in current or earlier contact with mental health services. The results showed that experiences of rejection were negatively associated with sense of coherence, empowerment and self-esteem. This exploratory investigation suggests that experiences of rejection might be a target for coping interventions. Mental health nurses are in a key position to identify patients' experiences of stigma and by that to understand what consequences of devaluation/discrimination can have for the afflicted.

Dynamical stabilization of the body centered cubic phase in lanthanum and thorium by phonon-phonon interaction.

A recently developed self-consistent ab initio lattice dynamical method has been applied to the high temperature body centered cubic (bcc) phase of La and Th, which are dynamically unstable at low temperatures. The bcc phase of these metals is found to be stabilized by phonon-phonon interactions. The calculated high temperature phonon frequencies for La are found to be in good agreement with the corresponding experimental data.

What works for whom in a computer-mediated communication intervention in community psychiatry? Moderators of outcome in a cluster randomized trial.

OBJECTIVE: An intervention to structure patient-key worker communication has been tested in a randomized controlled trial. The aim of this paper was to investigate effectiveness of the intervention in terms of moderators of effectiveness. METHOD: A total of 507 patients with schizophrenia were included. Moderators of effectiveness were investigated using two-way anovas. RESULTS: Patients with a better relationship with their key worker and a shorter duration of illness at baseline benefited more from the intervention in terms of quality of life. Patients who received the intervention who were in competitive employment or had a shorter duration of illness showed greater reduction of unmet needs. Older patients receiving the intervention had better treatment satisfaction. CONCLUSION: Outcome of the intervention was moderated by patient characteristics. Moreover, the moderating characteristics varied depending on the specific outcome. Evidence on moderators is very limited, even though, they are significant for understanding, targeting and implementing complex interventions.

Are important patient-rated outcomes in community mental health care explained by only one factor?

INTRODUCTION: The study tested whether four commonly used patient-rated outcomes are explained by only one factor, reflecting a general appraisal tendency of patients. METHOD: Quality of life, needs and symptoms were rated by 92 patients in community mental health care at baseline and after 18 months and 6 years follow-up periods. At follow ups treatment satisfaction was also assessed. Scores and change scores were subjected to factor analyses. We then tested which individual items predicted factor scores. RESULTS: One factor explained between 55% and 66% of the variance of the tested patient-rated outcomes cross-sectionally and longitudinally. Only change scores of treatment satisfaction loaded on a separate factor. Seven items consistently explained more than 80% of the variance of the general factor. CONCLUSION: Four important patient-rated outcomes are uniformly and substantially influenced by a general tendency for positive or negative appraisals. This tendency can be assessed more simply than using currently established methods.

Predictors of improvement in quality of life of long-term mentally ill individuals receiving case management.

One hundred and thirteen long-term mentally ill clients receiving case management were investigated with regard to psychosocial and clinical predictors of changes in subjective quality of life during an 18-month follow-up. Better psychosocial functioning and fewer psychiatric symptoms at baseline predicted a greater improvement in quality of life. A larger decrease in symptom severity and a greater improvement in the social network during the follow-up were identified as the most important predictors of a greater improvement in subjective quality of life. The results of the study suggest that an emphasis should be put on effective symptom management, a reduction of needs for care and social support in order to fulfill the aims of improving subjective quality of life in patients receiving case management.

Regulation of osteoprotegerin secretion from primary cultures of human bone marrow stromal cells.

Osteoprotegerin (OPG) is a soluble receptor for receptor activator of NF kappa B-ligand, a factor required for osteoclastogenesis. OPG secreted from bone marrow stromal cells is believed to inhibit osteoclast differentiation and several agents known to influence bone resorption have been demonstrated to regulate mRNA levels of OPG. In this report we have investigated the secretion of OPG protein from primary cultures of human bone marrow stromal cells. An ELISA was developed for measuring the concentration of OPG in culture medium. OPG secretion was decreased by 50% when the human bone marrow stromal cells were treated with 1 microM of prostaglandin E(2), possibly through activation of the protein kinase A-pathway since stimulation of protein kinase A by forskolin also inhibited OPG secretion. Treatment with phorbol 12,13 di butyrate, an activator of the protein kinase C-pathway, potently stimulated the secretion of OPG from human bone marrow stromal cells. The cells were also stimulated with inflammatory mediators and glucocorticoids. Treatment with interleukin-1 alpha (IL-1 alpha) and tumor necrosis factor-alpha (TNF-alpha) stimulated OPG secretion to 500% and 400% of control whereas dexamethasone decreased OPG production by 40%. In conclusion, an ELISA measuring OPG in cell culture media was developed. Using this ELISA, the amount of OPG secreted from human bone marrow stromal cells was clearly detectable, and the secretion of OPG-protein was potently regulated by prostaglandin E(2), forskolin, phorbol 12,13 di butyrate, IL-1 alpha, TNF-alpha, and dexamethasone.

What do case managers do? An investigation of case manager interventions and their relationship to client outcome.

BACKGROUND: The aim of the present study, which forms part of a wider case management multicenter study, was to explore the content of case managers' work, service patterns, and their relationship to client outcome. METHODS: Client background characteristics were registered at admission, and needs of care and psychosocial functioning were assessed at admission to the service and after 18 months. In seven of the services an extended follow-up was performed, which included assessments regarding quality of life, level of symptoms and social network. The study comprised 176 severely mentally ill clients, of whom 153 participated in a general 18-month follow-up (87%), with 113 clients out of 134 participating in an extended follow-up sample (84%). RESULTS: The investigation of service patterns showed that clients received services in a great variety of life areas using a number of different types of interventions. The results support the assumption that severely mentally ill clients are in need of case management services that offer more than brokerage services and coordination. A more active rehabilitation-oriented approach was found towards younger clients and clients who had a job, which may reflect a higher level of ambition in assisting younger clients to gain access to and stay in education and the labor market. Several types of intervention were related to client outcome. Brokerage, intervention planning and more interventions in the area of skills relating to activities of daily living were related to a more pronounced decrease in needs of care. More time spent on indirect work on behalf of the clients was related to a better outcome with regard to psychiatric symptoms and social network. CONCLUSIONS: The results indicate that specific service components have a more obvious distinct impact than others on outcome, and that this increase in effectiveness varies with the outcome targeted.

The role of the nurse in community psychiatry.

The transformation of psychiatry during the last decades has also resulted in changed and more independent roles for mental health workers of all categories. The nurse has traditionally had a central role in psychiatric care. In the community oriented care the nurse still plays an important role which can be summarised in four points: 1. focus on the rehabilitation of long term mentally ill patients, 2. the case manager function, 3. to provide individual support in the daily living and 4. to provide support to the relatives of the patients. Those different roles are described. The research being done on these different approaches is presented and it is concluded that case management, social skills training and family intervention programmes have all proved to be effective. In these programmes nurses often play a central role.

Solubilization of phosphates and micronutrients by the plant-growth-promoting and biocontrol fungus trichoderma harzianum rifai 1295-22

We investigated the capability of the plant-growth-promoting and biocontrol fungus Trichoderma harzianum Rifai 1295-22 (T-22) to solubilize in vitro some insoluble or sparingly soluble minerals via three possible mechanisms: acidification of the medium, production of chelating metabolites, and redox activity. T-22 was able to solubilize MnO2, metallic zinc, and rock phosphate (mostly calcium phosphate) in a liquid sucrose-yeast extract medium, as determined by inductively coupled plasma emission spectroscopy. Acidification was not the major mechanism of solubilization since the pH of cultures never fell below 5.0 and in cultures containing MnO2 the pH rose from 6.8 to 7.4. Organic acids were not detected by high-performance thin-layer chromatography in the culture filtrates. Fe2O3, MnO2, Zn, and rock phosphate were also solubilized by cell-free culture filtrates. The chelating activity of T-22 culture filtrates was determined by a method based on measurement of the equilibrium concentration of the chrome azurol S complex in the presence of other chelating substances. A size exclusion chromatographic separation of the components of the culture filtrates indicated the presence of a complexed form of Fe but no chelation of Mn. In liquid culture, T. harzianum T-22 also produced diffusible metabolites capable of reducing Fe(III) and Cu(II), as determined by the formation of Fe(II)-Na2-bathophenanthrolinedisulfonic acid and Cu(I)-Na2-2, 9-dimethyl-4,7-diphenyl-1,10-phenanthrolinedisulfonic acid complexes. This is the first report of the ability of a Trichoderma strain to solubilize insoluble or sparingly soluble minerals. This activity may explain, at least partially, the ability of T-22 to increase plant growth. Solubilization of metal oxides by Trichoderma involves both chelation and reduction. Both of these mechanisms also play a role in biocontrol of plant pathogens, and they may be part of a multiple-component action exerted by T-22 to achieve effective biocontrol under a variety of environmental conditions.

Quality of life of the mentally ill. Reliability of the Swedish version of the Lancashire Quality of life profile.

There has been a growing interest in the quality of life (QoL) of the mentally ill, subsequently a number of instruments to measure QoL have been developed. One of the measures of QoL which has received considerable attention is the Lancashire QoL Profile (LQOLP). The present study investigated test-retest reliability and internal consistency in the Swedish translation of the LQOLP using a cross-sectional sample of 29 inpatients. The results showed that test-retest reliability of subjective life satisfaction in the nine life domains covered by the LQOLP was satisfactory in seven of the domains, and acceptable in two (social relations and religion). Test-retest reliability for total subjective satisfaction score, global well-being, and an interviewer rated QoL were all on a satisfactory level (r > 0.80). The internal consistency and homogeneity of the total subjective QoL scale and the nine life domain subscales was satisfactory except for the social relations scale, where it was somewhat low.

Circulating hyaluronan, chondroitin sulphate and dextran sulphate bind to a liver receptor that does not recognize heparin.

Chondroitin sulphate, injected intravenously into rats and given prior to intravenous 125I-labelled hyaluronan with a mean Mw of about 400 kDa, was shown to inhibit the rapid receptor-mediated uptake of hyaluronan by the liver. The labelled hyaluronan that remained in the circulation was shown, by size exclusion chromatography of serum and urine, to be rapidly degraded down to fragments of lower Mw and filtered out into the urine and tissues. When the uptake of 125I-hyaluronan was inhibited by unlabelled hyaluronan, only very low degradation and urinary excretion were found. Liver uptake could also be inhibited by dextran sulphate but not by heparin. Unlabelled hyaluronan could inhibit the liver uptake of labelled chondroitin sulphate but not labelled heparin. Unlabelled chondroitin sulphate and dextran sulphate inhibited cell association of labelled hyaluronan to liver endothelial cells in culture more effectively than unlabelled hyaluronan. Our data show that the liver hyaluronan receptors also recognize and effectively bind chondroitin sulphate and dextran sulphate but not heparin and that a hyaluronan-specific saturable degradative mechanism exists in the circulation. Such a mechanism could explain why hyaluronan in the general circulation has a much lower Mw than the hyaluronan in lymph. The results also indicate that increased hyaluronan levels in serum, and increased urinary excretion of hyaluronan, may be secondary to increased outflow of chondroitin sulphate from the tissues during some pathological conditions.

The rationalisation movement in perspective and some ergonomic implications.

The paper gives an overview of the Rationalisation Movement from Taylor to the most recent organisation models such as 'Business Process Reengineering'. Special emphasis is put on the estimated implications of the different rationalisation strategies in terms of ergonomics/work physiology. In addition, basic terms and concepts are defined. According to the author, Taylorism, Fordism and Lean Production seem to offer an insufficient potential for good ergonomics. However, more recent organisational models such as 'Time Based Management' and 'Business Process Reengineering', may appear more promising but unfortunately almost no research has been conducted to describe the ergonomics implications of these models.

The assessment of needs in psychiatric patients. Interrater reliability of the Swedish version of the Camberwell Assessment of Needs instrument and results from a cross-sectional study.

The assessment of needs has been put forth as an important dimension in both the planning, development and evaluation of psychiatric services. A needs assessment tool for routine use should ideally be brief, not require additional staff, be valid and reliable with respect to setting, gender and culture, and also be sensitive to changes in needs and differences in needs between subgroups of patients. In this study, the interrater reliability of the Swedish version of the Camberwell Assessment of Needs instruments (CAN), measuring needs in 22 areas, was investigated in a cross-sectional sample consisting of 119 psychiatric inpatients and outpatients. The prevalence and severity of needs, prevalence of unmet needs, as well as current help received was also investigated. The interrater reliability of the instrument was found to be good both measured as total percentages of agreement in ratings, where an agreement of 80% or above was found in 90% of the comparisons, and as measured by Cohen's kappa. Predominant needs in the sample were in addition to clinical needs concerning psychological distress and psychotic symptoms, social needs such as the need for company, daytime activities and information concerning condition and treatment. The CAN seems to be a instrument with a high interrater reliability also when used under routine conditions as in this study. It also seems to have a high degree of feasibility with regard to different types of patients and settings and a sensitivity concerning differences in needs in subgroups of patients.

Accessible hyaluronan receptors identical to ICAM-1 in mouse mast-cell tumours.

Immunohistochemical studies of the hyaluronan (HA)-receptor (R), originally found on liver endothelial cells (LEC) and related to the intercellular adhesion molecule 1 (ICAM-1), showed that polyclonal antibodies against HARLEC (HA receptor on LEC) also stain structures in mouse mastocytomas, mainly vessels. To test if intravenously administered HA might target the tumour receptors in vivo, mice carrying an inoculated mastocytoma in one hind leg muscle were injected in the tail vein with 125I-tyrosine (T)-labelled HA and killed 75 min after injection when organs and tissues were checked for radioactivity. When doses exceeding the binding capacity of the liver were injected, a significant increase in radioactivity (up to five-fold) within the tumour tissue was found. The weight adjusted difference between control and tumour tissue was greater for smaller tumours, probably due to necrosis in the larger. HA-staining of tumours from animals receiving 125I-T-HA, showed HA in areas that also stained weakly for ICAM-1 using monoclonal antibodies. ICAM-1 staining was dramatically increased after hyaluronidase treatment of the sections, indicating that the HA is bound to these receptors and thereby blocks antibody recognition.

Labelling of high molecular weight hyaluronan with 125I-tyrosine: studies in vitro and in vivo in the rat.

Studies on the metabolism of the polysaccharide hyaluronan has previously been hampered by the lack of radioactive hyaluronan of high molecular weight (MW) and high specific activity. In the present study 125I-tyrosine (T)-labelled hyaluronan was produced after CNBr-activation of the polysaccharide. A specific activity of approximately 0.1 MBq microgram-1 was achieved using 100 micrograms of 0.5 x 10(6) Da hyaluronan labelled for 2 h with 18 MBq 125I. The 125I-T-hyaluronan kept a high MW-profile upon gel filtration chromatography and was found to be cleared from the circulation with the kinetics and organ distribution reported for biosynthetically labelled hyaluronan of high MW. The 125I-labelled polysaccharide is also taken up by liver endothelial cells both in vivo and in vitro, indicating that the labelling does not interfere with the binding to specific cell-surface receptors found on these cells. The intracellular degradation is slower than that earlier reported for biosynthetically labelled hyaluronan and seems to be halted at the level of low MW oligo- or mono-saccharides that eventually leave the organism via the urine. Scintigraphic images of rats after intravenous injection of 125I-T-hyaluronan showed rapid uptake in the liver and a redistribution of radioactivity from liver to urine with time. Our results indicate that the 125I-T-hyaluronan is suitable for studies of hyaluronan-metabolism in a number of ways. The gamma emitters 125I and 131I are easy to monitor and can be used also for in vivo 3D-imaging using single photon emission computer tomography.

What is important in psychiatric inpatient care? Quality of care from the patient's perspective.

The development of quality assurance programs for psychiatric care has increased the interest in quality of care and accountability from the patient's perspective. However, most investigations of patient satisfaction use instruments which rate aspects of care defined and held to be important by professionals and care givers. The aims of this study were 2-fold. To map descriptive characteristics of ideal inpatient psychiatric care through open patient interviews, using a sample of 78 hospitalized patients and, secondly, based on a content analysis of these interviews, to have another sample of 77 hospitalized patients rank the importance of 48 treatment characteristics extracted from the qualitative analysis. Results of the content analysis showed that characteristics of ideal inpatient treatment could be classified in six categories: staff-patient relationship, patient co-influence, treatment content, activities, ward atmosphere and staff competence. Results from the patients' rating of the importance of treatment characteristics showed that patients put the highest emphasis on staff empathic qualities: being caring, interested and understanding, respecting patients, devoting time to patients, and creating a safe treatment environment. The least importance was ascribed to characteristics of the physical environment and daily routines on the ward. It is concluded that in order to secure content validity of investigations of the quality of psychiatric inpatient care from the patient's perspective, effort should be put into including the areas of staff-patient relationships and patient information and co-influence.