Vietnamese and Arabic women's responses to the Diagnostic Interview Schedule (depression) and self-report questionnaires: cause for concern

OBJECTIVE

The original study aimed to determine the best cut-off scores to screen for postnatal depression on translated versions of the Edinburgh Postnatal Depression Scale (EPDS) for Vietnamese and Arabic women. This research was conducted using the depression module of the Diagnostic interview Schedule (DIS) to determine caseness. This paper reports on the suitability of this diagnostic interview as a criterion measure of depression in these women with a non-English speaking background.

METHOD

Vietnamese and Arabic women in south-west Sydney completed the EPDS and a General Health Questionnaire (GHQ-30) antenatally. At 6-8 weeks postpartum they completed an EPDS, the GHQ-30 and a Faces Scale, and were interviewed using the depression module of the DIS. Members of a small convenience sample of women were asked about the cultural appropriateness of each of the instruments.

RESULTS

Vietnamese women admitted to few depressive symptoms on the DIS, whereas they appeared more open to reporting these on the EPDS and the GHQ-30. Arabic women responded more openly to the questionnaires and the interview, although they too were reluctant to report specific symptoms on the DIS.

CONCLUSION

The usefulness of the DIS in determining rates of major depression in the Vietnamese and Arabic community in Australia is questionable. Further studies designed specifically to investigate this are needed.

Intracellular alkalinization mobilizes calcium from agonist-sensitive pools in rat lacrimal acinar cells

1. We have investigated interactions between intracellular pH (pHi) and the intracellular free calcium concentration ([Ca2+]i) in collagenase-isolated rat lacrimal acinar cells. The fluorescent dyes fura-2 and 2',7'-bis(carboxyethyl)-5-carboxyfluorescein (BCECF) were used to measure [Ca2+]i and pHi, respectively. 2. Application of the weak base NH4Cl alkalinized the cytosol and caused a dose-dependent increase in [Ca2+]i. Trimethylamine (TMA) also alkalinized the cytosol and increased [Ca2+]i. The increase in [Ca2+]i evoked by NH4Cl or TMA was much smaller than that evoked by the secretory agonist acetylcholine (ACh). 3. Application of NH4Cl also increased [Ca2+]i in cells bathed in Ca(2+)-free medium, indicating that NH4Cl released Ca2+ from an intracellular pool. 4. Ammonium chloride had no effect on [Ca2+]i in cells bathed in Ca(2+)-free medium if agonist-sensitive intracellular Ca2+ pools had been depleted with either ACh or the microsomal Ca(2+)-ATPase inhibitor 2,5-di(tert-butyl)hydroquinone. Treatment of cells with NH4Cl in Ca(2+)-free medium reduced the amount of Ca2+ released by ACh. These results suggest that NH4Cl released Ca2+ from the same intracellular pool released by ACh. 5. Calcium release from the agonist-sensitive pool was also triggered when the cytosol was alkalinized by removing the weak acid acetate. 6. Ammonium chloride caused a modest increase in inositol phosphate production, suggesting that NH4Cl may have released stored Ca2+ via an increase in the intracellular inositol 1,4,5-trisphosphate concentration. 7. The increase in [Ca2+]i evoked by NH4Cl was not sustained even in the presence of extracellular Ca2+. In contrast, when a low dose of ACh was used to evoke intracellular Ca2+ release of similar magnitude, sustained Ca2+ entry was observed. 8. Alkalinizing the cytosol appeared to partially inhibit Ca2+ entry triggered by thapsigargin or by ACh. 9. We suggest that alkalinizing the cytoplasm in unstimulated lacrimal acinar cells can release Ca2+ from the intracellular agonist-sensitive Ca2+ pool. However, releasing stored Ca2+ via alkalinization does not appear to trigger significant Ca2+ entry, perhaps because intracellular alkalinization inhibits either the Ca2+ entry pathway or the mechanism which couples the entry pathway to store depletion.

The emission band spectrum of chlorine (Cl + 2 ). II

In continuation of our work (Elliott and Cameron 1937 a ) on the spectrum of chlorine excited by a high-frequency electrical discharge, we have established the fact that the discrete bands which appear are due (at least in part) to the ionized molecule Cl + 2 . In the publication referred to, we have described measurements of the wave numbers of the band heads in the region 3864-5435 A, as well as of the maxima of some continua in the ultra-violet. An extensive vibrational isotope effect was identified in the discrete bands, and on the basis of this a suggestion was made that two systems were present, with origins situated at 21000 and 21340 cm. -1 respectively. The vibrational analysis of Ota and Uchida (1928) was shown to be untenable, but no alternative analysis was put forward. It was suggested that the intervals of 627 and 632 cm. -1 , which occurred frequently, might be the vibrational frequency of the chlorine molecule in either the upper or the lower state involved. The bands considered in the present paper, with the exception of that at 26166∙5 cm. -1 , were all included in the first paper, but in some cases the wave numbers of the heads have been slightly amended. About one-half of the ninety-four bands previously tabulated (excluding isotopes) have now been classified and assigned to Cl + 2 . The two systems previously mentioned are now identified as the subsystems of a doublet system; the system origins are much more accurately determined and are found to be situated at 20596∙9 and 20797∙3 cm. -1 respectively. It is found that the intervals 627 and 632 (more accurately 627∙9 and 633∙7 cm. -1 ) are the vibrational frequencies of Cl + 2 for the hypothetical levels with vibrational quantum numbers 2½ and 1½.

Personal and family distress in homeless adolescents

Previous research has indicated that homeless children exhibit high rates of behavioral and emotional problems and come from families characterised by conflict and rejection. Further, some evidence exists to show that family variables may relate to adolescent distress differently for homeless males and females. In this study, 117 homeless adolescents were compared to a sample of non-homeless youths on the self reported incidence of personal and family problems. The homeless children reported the highest incidence of all behavioral and emotional problems, parental marital discord, overprotection, and the lowest levels of parental care and acceptance. Sex effects were not evident in reported levels of personal or family problems. However, substantially more variance in the adolescents level of behavioral and emotional disturbance was predictable from family measures for females than males. Overall, the results point to the importance of incorporating family distress models in the understanding and remediation of adolescent homelessness.

Dosimetry of 6-MV x-ray beam penumbra

The measurement of x-ray beam dose profiles in the penumbral region, using silicon diode, ionization chamber, TLD, and film dosimetry, has been investigated for a 6-MV beam defined by independent collimators. Penumbral width (80%-20%) at dmax, as measured by diode, film, and TLD was found to be 3.6, 3.6, and 3.4 mm, respectively. These results reflect the relative sensitive widths of each of the measurement systems (2.5, 2.0, and 1.0 mm, respectively). An empirical forming function was used to relate the penumbral shape measured with a finite-sized detector to that which would be measured with a point detector, the width of the point detector penumbra calculated from the diode penumbra is 3.4 mm, indicating that the TLD rods are a good approximation to a point detector. An alternative method of determining the width of a point detector penumbra is to extrapolate the penumbral widths obtained using two or more detectors of sensitive width. With this method, using Farmer and RK ionization chambers, a point detector penumbra width of 3.1 mm is obtained. An EGS4 Monte Carlo simulation, where a point source was assumed, gave a penumbral width of 2.8 mm. Negligible differences between the penumbra of beams defined by symmetric and asymmetric collimators was observed.

The penumbra of a 6-MV x-ray beam as measured by thermoluminescent dosimetry and evaluated using an inverse square root function

Data on the dose distribution in the penumbral region of megavoltage x rays are of importance for most radiotherapy planning systems. For medical linear accelerators the distance between the points representing 20% and 80% of the central axis dose (20/80) is typically only a few millimeters. To achieve good spatial resolution a radiation detector with small physical size has to be used for penumbra measurements. The penumbra in a 6-MV therapeutic x-ray beam was investigated for field sizes of 10 x 10 cm2 and 20 x 20 cm2 at depth of maximum dose (dmax = 1.5 cm) and at 10-cm depth in a solid water phantom. In addition, the field edge of an independent jaw driven to the center of the axis of the primary collimator was investigated. LiF thermoluminescent (TL) ribbons and rods were used embedded in solid water in different geometries resulting in relative detector sizes of 1, 3.1, and 6 mm. A forming function based on an inverse square root function was used to fit the experimental penumbra measurements. For the asymmetric field an amendment to the function is proposed to give a better fit for the experimental data. From the penumbra measured with the three different detector sizes, a penumbra can be extrapolated for an infinitesimal small detector. The extrapolated penumbral width (20/80) was found to be 2.3, 3.2, and 2.7 mm at dmax for the 10 x 10-cm2 symmetric, 10 x 10-cm2 asymmetric, and 20 x 20-cm2 field sizes, respectively. The 20/80 values at 10-cm depth in the solid water phantom for the same radiation fields were 4.2, 4.3, and 4.1 mm, respectively.

Impact of human immunodeficiency virus on transmission and severity of tuberculosis

It is now clear that tuberculosis is one of the major diseases associated with human immunodeficiency virus (HIV) infection and the acquired immune deficiency syndrome both in developing countries and in disadvantaged groups in the northern hemisphere. In the USA, and probably several other countries, the annual incidence of tuberculosis is rising as a result of the HIV epidemic. This is probably a result of an increase in both pulmonary and, especially, extrapulmonary tuberculosis, due to reactivation of latent infections, but a secondary increase in the infection rate is also possible. The hard-won gains in tuberculosis control of the last 30 years are thus in jeopardy. This article focuses on the effect HIV is likely to have on the known risk factors for infection with Mycobacterium tuberculosis and for reactivation. Whilst HIV-associated tuberculosis may be indistinguishable from HIV-negative disease, it is likely in other cases to present diagnostic difficulties, to respond poorly to treatment with more adverse effects, and to result in high early mortality, although this may not be due directly to tuberculosis. HIV-associated tuberculosis thus represents a major challenge to physicians, especially in developing countries, but like other forms of tuberculosis it is (i) treatable and (ii) preventable.

Macular detachment following laser treatment for proliferative diabetic retinopathy

Case records of patients who had macular detachment following argon laser photocoagulation for proliferative diabetic retinopathy were reviewed. Thirteen eyes of 11 patients out of a total of 480 patients treated had this complication, and in 12 eyes of 10 patients the short latency suggested a true precipitating effect. This represents 2.1% of patients receiving panretinal photocoagulation. Patients with detachment were younger and developed diabetes earlier than the controls (P less than 0.025), and the detached eyes had received more numerous laser burns on average per session than the controls (P less than 0.001). In 5 eyes the last photocoagulation dose exceeded 1000 burns delivered in the presence of traction membranes in an attempt to arrest continuing neovascular proliferation not responding to earlier more moderate treatment. Only 1 eye had received early, extensive and repeated photocoagulation. Vigorous treatment at an early stage of the proliferation may prevent this complication, although the advantages or disadvantages of fractionation of photocoagulation will only be shown by a prospective trial.

Pupil size after extracapsular cataract extraction and posterior chamber lens implantation: a prospective randomized trial of epinephrine and acetylcholine

The effects of using epinephrine in the irrigating fluid and intracameral acetylcholine were studied by measuring changes in pupil size in the 48 hours following extracapsular cataract extraction and intraocular lens implantation in 39 eyes. Epinephrine reduced peroperative pupil constriction, but its effect was insignificant thereafter. The pupil constriction following acetylcholine was maximal at 2 hours and was still significant at 4 hours, but pupils redilated by 6 hours. Neither drug had any effect after this time. The edge of most lens implants was visible at 6 hours, after which pupils steadily constricted.

The 'catch' mechanism in molluscan muscle: an electron microscopy study of freeze-substituted anterior byssus retractor muscle of Mytilus edulis

A method for quick-freezing muscles while observing their mechanical properties until the moment of freezing is described. This method was used to freeze the anterior byssus retractor muscle (ABRM) of Mytilus edulis. Intact muscle in the presence of sucrose as a cryoprotectant was freeze-substituted in acetone, fixed and embedded for electron microscopy. ABRM was frozen in a number of mechanical states including 'catch', the state of high passive tension particularly associated with some molluscan muscles. Transverse sections were examined to determine the distribution of filaments in the muscle cells. In the relaxed muscle thick and thin filaments are fairly randomly distributed. Groups of thin filaments and of thick filaments are often seen, and there is no obvious association between the two types of filaments. In contrast, in rigor muscles, both glycerol-extracted and intact, most of the thin filaments were found to lie in rings or rosettes around the thick filaments. In some places bridges between thick and thin filaments could be distinguished. In actively contracting muscle (phasic contraction) the appearance is intermediate between that of the relaxed and rigor muscles. Many thick filaments are surrounded by rosettes of thin filaments but many of the thin filaments are grouped and have no connections with thick filaments. The 'catch' state, left after a period of tonic contraction, is similar in its distribution of thick and thin filaments to the active state, many of the thin filaments lying between the thick. Frequently thick and thin filaments seem to be closer together than in other states of the muscle where a pronounced exclusion zone is present around the thick filaments. There is no evidence for association between the thick filaments. The different distribution of thin filaments in the different states is consistent with the previously described X-ray diffraction data if it is assumed that most of the contribution to the equatorial reflection at 12 nm comes from the groups of thin filaments. Our data support a model for catch in which there is a change in the association between thick and thin filaments, rather than one in which thick filaments are clumped.