Research without external funding in North American psychiatry

OBJECTIVE

The authors investigated the extent and characteristics of published psychiatric research from U.S. and Canadian medical schools that was carried out without external funding.

METHOD

They reviewed reports of unfunded research in 14 psychiatric journals, tabulating methodological factors and topics of study. They surveyed first authors about their academic duties and resources used in the studies.

RESULTS

Unfunded studies represented 26% of research reports, were usually prospective, most commonly dealt with phenomenology/epidemiology or psychopharmacology, used low levels of technology, and were accomplished on a modest budget of time and money.

CONCLUSIONS

Unfunded studies make a substantial and economically efficient contribution to psychiatric research. Future investigations should detail the institutional conditions necessary to sustain this type of research productivity.

The telephone in primary care

The telephone, a ubiquitous instrument in the practice of medicine, continues to have new applications for clinical practice. The goals of the ever-increasing managed care environment appear to fit nicely with these applications. Heightened attention toward telephone education, protocol development, and documentation are needed. This article reviews characteristics of telephone encounters, the telephone in managed care, trends in "telemedicine," telephone education, and medicolegal aspects of telephone care.

Treating the patient who is disfigured by head and neck cancer

A 46-year-old man with laryngeal carcinoma was admitted to the medical service for lethargy. The medical team requested a psychiatric consultation to assist with the patient's depression, substance abuse, and noncompliance. The case is presented and discussed with reference to the issues of depression, disfigurement, dysfunction, and substance abuse in the patient with head and neck cancer.

Dietary vitamin B12 deficiency in a patient with multiple sclerosis

The authors present a case of dietary vitamin B12 deficiency in a patient with multiple sclerosis. A simple schemata for evaluating patients for vitamin B12 deficiency is included as a clinical aid for physicians.

Water Relations and Hydraulic Architecture of a Tropical Tree (Schefflera morototoni) : Data, Models, and a Comparison with Two Temperate Species (Acer saccharum and Thuja occidentalis)

The water relations and hydraulic architecture of a tropical tree (Schefflera morototoni) and of two temperate species (Acer saccharum and Thuja occidentalis) are reported. Among the water relations parameters measured were leaf and stem water storage capacity, leaf water potential, transpiration, and vulnerability of stems to cavitation and loss of hydraulic conductivity by embolisms. Among the hydraulic architecture parameters measured were hydraulic conductivity per unit pressure gradient, specific conductivity, leaf-specific conductivity, and Huber value. In terms of vulnerability of stems to cavitation, stem and leaf capacitances, and leaf-specific conductivity, all three species followed the same sequence: Schefflera > Acer > Thuja. It is argued here that the high stem capacitance and high leaf-specific conductivity of Schefflera are necessary to compensate for its high vulnerability to cavitation. Extractable water storage per unit leaf area in Schefflera stems is >100 times that of Acer and may permit the species to survive unusually long, dry seasons in Panama. Although Schefflera frequently grows >20 meters, the biggest resistance to water flow in the shoots resides in the leaves.