text: Medicine & Medical Science Research Collection http://hdl.handle.net/10197/2640 2015-04-02T00:16:51Z Enamel thickness in Asian human canines and premolars http://hdl.handle.net/10197/6455 Enamel thickness in Asian human canines and premolars Feeney, Robin N. M.; Zermeno, John P.; Reid, Donald J.; et al. Dental enamel thickness continues to feature prominently in anthropological studies of ape and human evolution, as well as studies of preventative oral care and treatment. Traditional studies of enamel thickness require physical sectioning of teeth for linear and scaled measurements. Recent applications of microtomographic imaging allow scientists to employ larger and more diverse samples, including global samples of recent humans as well as fossil hominin teeth. Unfortunately, little is known about the degree of enamel thickness variation among human populations, particularly across the dentition. This study employed microtomography to virtually image, section, and quantify the average enamel thickness of a sample of clinically extracted Indonesian canine and premolar teeth. This virtual sample was compared to physically sectioned African and European teeth. The results demonstrate that average enamel thickness is similar among human dentitions; no significant differences were detected within tooth positions, which is surprising given developmental differences between European and African canines and premolars. When populations were combined, differences were found in average enamel thickness between maxillary and mandibular premolars, and between canines and premolars within both dental arcades. This finding is potentially due to differences in premolar morphology and a trend of increasing enamel thickness distally throughout the dentition. The finding of limited population variation within tooth positions and significant variation between tooth positions is consistent with previous two-dimensional and three-dimensional studies of human molar enamel thickness. Average enamel thickness in canines and premolars does not differ between the sexes in our sample, although male teeth tend to have larger enamel and dentine cross-sectional areas, enamel–dentine junction lengths, and bi-cervical diameters. Males have significantly greater dentine area and enamel–dentine junction length than females for maxillary canines and premolars. The results of this study suggest that enamel thickness values in mixed-populations of humans are appropriate for comparisons with fossil hominins. 2010-05-01T00:00:00Z Alcohol Screening Among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program http://hdl.handle.net/10197/6440 Alcohol Screening Among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program Klimas, Jan; Muench, John; Wiest, Katharina; et al. Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n =208) and in an opioid treatment program (n = 204) over a two year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. Among the patients treated in the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counsellors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested organizational, structural, provider, patient and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow. 2015-02-25T00:00:00Z Investigation of ultrasound methods for the assessment of sex and age from human intact teeth http://hdl.handle.net/10197/6429 Investigation of ultrasound methods for the assessment of sex and age from human intact teeth Feeney, Robin N. M. Determining sex and age in human remains is necessary to achieve positive identification of individuals in forensic settings, and to provide data required for demographic analyses in archaeological samples. Due to their denser mineralization, teeth may be better preserved than other skeletal elements, which are often fragmentary and poorly preserved. This work is the first to investigate the use of ultrasound methods to accurately, objectively, and non-destructively assess sex and estimate age of human skeletal remains from intact teeth. An ultrasound imaging system using pulse-echo technique and nominal frequency (3.5 MHz) longitudinal waves was developed for application on teeth. Mechanical and acoustic properties of teeth were examined to explore their relationship with the interaction of ultrasound wave propagation. 2005-01-01T00:00:00Z Cervical dystonia: A disorder of the midbrain network for covert attentional orienting http://hdl.handle.net/10197/6288 Cervical dystonia: A disorder of the midbrain network for covert attentional orienting Hutchinson, Michael; Isa, Tadashi; Molloy, Anna; Kimmich, Okka; Williams, Laura; O'Riordan, Sean; et al. While the pathogenesis of cervical dystonia remains unknown, recent animal and clinical experimental studies have indicated its probable mechanisms. Abnormal temporal discrimination is a mediational endophenotype of cervical dystonia and informs new concepts of disease pathogenesis. Our hypothesis is that both abnormal temporal discrimination and cervical dystonia are due to a disorder of the midbrain network for covert attentional orienting caused by reduced gamma-aminobutyric acid (GABA) inhibition, resulting, in turn, from as yet undetermined, genetic mutations. Such disinhibition is (a) subclinically manifested by abnormal temporal discrimination due to prolonged duration firing of the visual sensory neurons in the superficial laminae of the superior colliculus and (b) clinically manifested by cervical dystonia due to disinhibited burst activity of the cephalomotor neurons of the intermediate and deep laminae of the superior colliculus. Abnormal temporal discrimination in unaffected first-degree relatives of patients with cervical dystonia represents a subclinical manifestation of defective GABA activity both within the superior colliculus and from the substantia nigra pars reticulata. A number of experiments are required to prove or disprove this hypothesis. 2014-04-28T00:00:00Z Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users http://hdl.handle.net/10197/6274 Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users Klimas, Jan; Tobin, Helen; Field, Catherine Anne; Bury, Gerard; Cullen, Walter; et al. Background: Problem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor contributing to a poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opiate overdose in opioid users. Objectives: To assess the effects of psychosocial interventions for problem alcohol use in illicit drug users (principally problem drug users of opiates and stimulants). Search methods: We searched the Cochrane Drugs and Alcohol Group trials register (June 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 11, June 2014), MEDLINE (1966 to June 2014); EMBASE (1974 to June 2014); CINAHL (1982 to June 2014); PsycINFO (1872 to June 2014) and the reference lists of eligible articles. We also searched: 1) conference proceedings (online archives only) of the Society for the Study of Addiction, International Harm Reduction Association, International Conference on Alcohol Harm Reduction and American Association for the Treatment of Opioid Dependence; 2) online registers of clinical trials: Current Controlled Trials, Clinical Trials.org, Center Watch and the World Health Organization International Clinical Trials Registry Platform. Selection criteria: Randomised controlled trials comparing psychosocial interventions with another therapy (other psychosocial treatment, including non-pharmacological therapies, or placebo) in adult (over the age of 18 years) illicit drug users with concurrent problem alcohol use. Data collection and analysis: We used the standard methodological procedures expected by The Cochrane Collaboration 2014-12-03T00:00:00Z Undergraduate psychiatry students' attitudes towards teaching methods at an Irish university http://hdl.handle.net/10197/6263 Undergraduate psychiatry students' attitudes towards teaching methods at an Irish university Jabbar, Faraz; Casey, Patricia R.; Kelly, Brendan D. Background: At University College Dublin, teaching in psychiatry includes clinical electives, lectures, small-group and problem-based teaching, consistent with international trends. Aims: To determine final-year psychiatry students' attitudes towards teaching methods. Methods: We distributed questionnaires to all final-year medical students in two classes (2008 and 2009), after final psychiatry examination (before results) and all of them participated (n = 111). Results: Students' interest in psychiatry as a career increased during psychiatry teaching. Students rated objective structured clinical examination (OSCE) as the most useful element of teaching and examination. The most common learning style was 'reflector'; the least common was 'pragmatist'. Two thirds believed teaching could be improved (increased patient contact) and 89 % reported that experience of psychiatry changed attitudes towards mental illness (increased understanding). Conclusions: Students' preference for OSCEs may reflect the closeness of OSCE as a form of learning to OSCE as a form of assessment: OSCEs both focus on specific clinical skills and help prepare for examinations. Future research could usefully examine the extent to which these findings are university-specific or instructor-dependent. Information on the consistency of various teaching, examination and modularisation methods would also be useful. 2014-10-18T00:00:00Z Finding the evidence for talking therapies http://hdl.handle.net/10197/6226 Finding the evidence for talking therapies Klimas, Jan In an attempt to prove that counselling works for reducing drinking in concurrent problem alcohol and illicit drug users, Jan Klimas ended up on a journey through research and review. 2014-11-01T00:00:00Z Epigenetic processes in the male germline http://hdl.handle.net/10197/6187 Epigenetic processes in the male germline O'Doherty, Alan; McGettigan, Paul A. Sperm undergo some of the most extensive chromatin modifications seen in mammalian biology. During male germline development, paternal DNA methylation marks are erased and established on a global scale through waves of demethylation and de novo methylation. As spermatogenesis progresses, the majority of the histones are removed and replaced by protamines, enabling a tighter packaging of the DNA and transcriptional shutdown. Following fertilisation, the paternal genome is rapidly reactivated, actively demethylated, the protamines are replaced with histones and the embryonic genome is activated. The development of new assays, made possible by high-throughput sequencing technology, has resulted in the revisiting of what was considered settled science regarding the state of DNA packaging in mammalian spermatozoa. Researchers have discovered that not all histones are replaced by protamines and, in certain experiments, various species of RNA have been detected in what was previously considered transcriptionally quiescent spermatozoa. Most controversially, several groups have suggested that environmental modifications of the epigenetic state of spermatozoa may operate as a non-DNA-based form of inheritance, a process known as 'transgenerational epigenetic inheritance'. Other developments in the field include the increased focus on the involvement of short RNAs, such as microRNAs, long non-coding RNAs and piwi-interacting RNAs. There has also been an accumulation of evidence illustrating associations between defects in sperm DNA packaging and disease and fertility. In this paper we review the literature, recent findings and areas of controversy associated with epigenetic processes in the male germline, focusing on DNA methylation dynamics, non-coding RNAs, the biology of sperm chromatin packaging and transgenerational inheritance. 2014-09-01T00:00:00Z What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service http://hdl.handle.net/10197/6013 What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service Jabbar, Faraz; Casey, Patricia R.; Schelten, Sofia Laureano; Kelly, Brendan D. Aim: This study aimed to measure patient satisfaction with the care they were receiving; examine patients' knowledge of the psychiatric services in general; and identify variables associated with satisfaction. Methods: Patients attending the Mater Misericordiae University Hospital psychiatric outpatient clinics over a 13-week period, and the Mater Misericordiae University Hospital clozapine clinic over a 4-week period and were invited to complete the Barker Scale of Patients' Views Towards Care Received From Psychiatrists. Results: One-hundred and ninety-two patients were invited to participate and there was a response rate of 94%. Eighty-six percent of respondents were satisfied with their care; 92% stated psychiatrists were caring towards them; 85% that psychiatrists know what they are doing; 84% that their illness was explained by their psychiatrist; and 65% that psychiatric care is improving; but 65% stated that psychiatric services are still not good enough. Eighty-six percent were, or had been, in receipt of a psychological treatment. On multi-variable analysis, satisfaction was associated with the view that doctors explained treatment clearly, the view that doctors do not rely excessively on medication, and having been visited by a community mental health nurse. Conclusion: Patients attending psychiatry outpatient services reported a high degree of satisfaction with the treatment they were receiving, although there were discrepancies between satisfaction with their own specific service and with psychiatric services in general. 2011-03-01T00:00:00Z National survey of psychiatrists' responses to implementation of the Mental Health Act 2001 in Ireland http://hdl.handle.net/10197/6012 National survey of psychiatrists' responses to implementation of the Mental Health Act 2001 in Ireland Jabbar, Faraz; Kelly, Brendan D.; Casey, Patricia R. Background: Ireland's Mental Health Act 2001 resulted in substantial changes to mental health services and the process of involuntary admission. Aims: To determine the views of Irish psychiatrists regarding the new legislation, 1 year after full implementation. Methods: We sent questionnaires to all 735 members of the Royal College of Psychiatrists in Ireland. Results: The response rate was 43.7%. As much as 84% of respondents reported satisfaction with training; 69.1% reported increased workloads; 26.8% reported decreased time with service-users; 40.7% reported changes in relationships with service-users (e.g. increased empathy, but more legalistic, conflicted relationships). Almost one in three (27.4%) stated that it was not feasible to implement the Mental Health Act. Negative comments highlighted the adversarial nature of mental health tribunals, effects on therapeutic relationships and issues related to children. Conclusions: The implementation of the Mental Health Act 2001 has resulted in increased workloads, more conflicted relationships with service-users and adversarial mental health tribunals. 2010-06-01T00:00:00Z Applications for fees waivers on medical and psychiatric grounds at an Irish third-level college http://hdl.handle.net/10197/6011 Applications for fees waivers on medical and psychiatric grounds at an Irish third-level college White, Daniel C.; Kelly, Brendan D.; Casey, Patricia R. Background: Physical and mental illness present substantial challenges to college students and authorities. Aims: (1) To characterize medical and psychiatric reasons underlying requests for fees waivers at an Irish third-level college; (2) to identify information included in applications; and (3) to develop proposals for standardizing applications. Methods: We examined all applications for exemption from fees for medical or psychiatric reasons over two academic years at an Irish third-level college. Results: Two hundred and twenty-two students applied for exemptions; 91% were successful. Psychiatric problems were more common than physical illness (64.1 vs. 27.9%). There was wide variation in details provided in applications with few providing details on likely ongoing duration of illness (5.0%). Conclusions: We recommend that (a) a structured medical application form be completed by medical practitioners supporting applications; (b) a medical practitioner review applications; and (c) there should be annual re-audit of this process. 2009-12-01T00:00:00Z The NO/cGMP pathway inhibits Rap 1 activation in human platelets via cGMP-dependent protein kinase I http://hdl.handle.net/10197/6008 The NO/cGMP pathway inhibits Rap 1 activation in human platelets via cGMP-dependent protein kinase I Danielewski, Oliver; Schultess, Jan; Smolenski, Albert P. The NO/cGMP signalling pathway strongly inhibits agonist-induced platelet aggregation. However, the molecular mechanisms involved are not completely defined. We have studied NO/cGMP effects on the activity of Rap 1, an abundant guanine-nucleotidebinding protein in platelets. Rap 1-GTP levels were reduced by NO-donors and activators of NO-sensitive soluble guanylyl cyclase. Four lines of evidence suggest that NO/cGMP effects are mediated by cGMP-dependent protein kinase (cGKI): (i) Rap 1 inhibition correlated with cGKI activity as measured by the phosphorylation state of VASP, an established substrate of cGKI, (ii) 8-pCPT-cGMP, a membrane permeable cGMP-analog and activator of cGKI, completely blocked Rap1 activation, (iii) Rp-8pCPT-cGMPS, a cGKI inhibitor, reversed NO effects and (iv) expression of cGKI in cGKI-deficient megakaryocytes inhibited Rap1 activation. NO/cGMP/cGKI effects were independent of the type of stimulus used for Rap1 activation. Thrombin-,ADP- and collagen-induced formation of Rap 1-GTP in platelets as well as turbulence-induced Rap 1 activation in megakaryocytes were inhibited. Furthermore, cGKI inhibited ADP-induced Rap 1 activation induced by the Galpha(i)-coupled P2Y12 receptor alone, i.e. independently of effects on Ca2+-signalling. From these studies we conclude that NO/cGMP inhibit Rap 1 activation in human platelets and that this effect is mediated by cGKI. Since Rap1 controls the function of integrin alpha(IIb)beta3, we propose that Rap 1 inhibition might play a central role in the anti-aggregatory actions of NO/cGMP. 2005-02-01T00:00:00Z Phosphodiesterases link the aryl hydrocarbon receptor complex to cyclic nucleotide signaling http://hdl.handle.net/10197/6007 Phosphodiesterases link the aryl hydrocarbon receptor complex to cyclic nucleotide signaling Oliveira, Simone Kobe de; Smolenski, Albert P. The aryl hydrocarbon receptor (AHR) is a major transcription factor regulated by different mechanisms. The classical view of AHR activation by xenobiotics needs to be amended by recent findings on the regulation of AHR by endogenous ligands and by crosstalk with other signaling pathways. In the cytosol the AHR recruits a large number of binding partners, including HSP90, p23, XAP2 and the ubiquitin ligases cullin 4B and CHIP. Furthermore, XAP2 binds the cyclic nucleotide phosphodiesterases PDE2A and PDE4A5. PDE2A inhibits nuclear translocation of AHR suggesting an important regulatory role of cyclic nucleotides in AHR trafficking. Signaling involving cAMP is organized in subcellular compartments and a distinct cAMP compartment might be required for proper AHR mobility and function. We conclude that the AHR complex integrates ligand binding and cyclic nucleotide signaling to generate an adequate transcriptional response. 2009-02-15T00:00:00Z Quantitative analysis of the cardiac fibroblast transcriptome-implications for NO/cGMP signaling http://hdl.handle.net/10197/6006 Quantitative analysis of the cardiac fibroblast transcriptome-implications for NO/cGMP signaling Smolenski, Albert P.; Schultess, Jan; Danielewski, Oliver; et al. Cardiac fibroblasts regulate tissue repair and remodeling in the heart. To quantify transcript levels in these cells we performed a comprehensive gene expression study using serial analysis of gene expression (SAGE). Among 110,169 sequenced tags we could identify 30,507 unique transcripts. A comparison of SAGE data from cardiac fibroblasts with data derived from total mouse heart revealed a number of fibroblast-specific genes. Cardiac fibroblasts expressed a specific collection of collagens, matrix proteins and metalloproteinases, growth factors, and components of signaling pathways. The NO/cGMP signaling pathway was represented by the mRNAs for α1 and β1 subunits of guanylyl cyclase, cGMP-dependent protein kinase type I (cGK I), and, interestingly, the G-kinase-anchoring protein GKAP42. The expression of cGK I was verified by RT-PCR and Western blot. To establish a functional role for cGK I in cardiac fibroblasts we studied its effect on cell proliferation. Selective activation of cGK I with a cGMP analog inhibited the proliferation of serum-stimulated cardiac fibroblasts, which express cGK I, but not higher passage fibroblasts, which contain no detectable cGK I. Currently, our data suggest that cGK I mediates the inhibitory effects of the NO/cGMP pathway on cardiac fibroblast growth. Furthermore the SAGE library of transcripts expressed in cardiac fibroblasts provides a basis for future investigations into the pathological regulatory mechanisms underlying cardiac fibrosis. 2004-04-01T00:00:00Z Can adjustment disorders and depressive episodes be distinguished? Results from ODIN http://hdl.handle.net/10197/6005 Can adjustment disorders and depressive episodes be distinguished? Results from ODIN Casey, Patricia R.; Maracy, Mohammad; Kelly, Brendan D.; et al. Background: No large-scale epidemiological study has included adjustment disorders (AD) for consideration yet it is considered to be a common psychiatric diagnosis. Methods:Using a two stage screening method, those above a threshold score for possible caseness on the Beck Depression Inventory (BDI), were interviewed using SCAN to identify those with depressive episode and AD. Variables that might distinguish AD from depressive episode were examined. Results:The prevalence of AD was extremely low with one centre having no cases. Finland, the country with the highest prevalence, only achieved a frequency of 0.8% and 1%, respectively, for urban and rural sites. Logistic regression failed to identify any variables that independently differentiated AD from depressive episode. Findings relating to severity of symptoms using BDI were robust. Limitations: The small sample size might have contributed to a failure to identify distinguishing features between AD and other disorders. Conclusions:Reasons for the failure of even robust results, such as BDI severity, to distinguish AD from depressive episode are considered of which problems in conceptualising AD are the most likely. Further studies are required. 2006-06-01T00:00:00Z Novel roles of cAMP/cGMP dependent signaling in platelets http://hdl.handle.net/10197/5887 Novel roles of cAMP/cGMP dependent signaling in platelets Smolenski, Albert P. Endothelial prostacyclin and nitric oxide potently inhibit platelet functions. Prostacyclin and nitric oxide actions are mediated by platelet adenylyl and guanylyl cyclases, which synthesize cyclic AMP (cAMP) and cyclic GMP (cGMP), respectively. Cyclic nucleotides stimulate cAMP-dependent protein kinase (protein kinase A [PKA]I and PKAII) and cGMP-dependent protein kinase (protein kinase G [PKG]I) to phosphorylate a broad panel of substrate proteins. Substrate phosphorylation results in the inactivation of small G-proteins of the Ras and Rho families, inhibition of the release of Ca2+ from intracellular stores, and modulation of actin cytoskeleton dynamics. Thus, PKA/PKG substrates translate prostacyclin and nitric oxide signals into a block of platelet adhesion, granule release, and aggregation. cAMP and cGMP are degraded by phosphodiesterases, which might restrict signaling to specific subcellular compartments. An emerging principle of cyclic nucleotide signaling in platelets is the high degree of interconnection between activating and cAMP/cGMP-dependent inhibitory signaling pathways at all levels, including cAMP/cGMP synthesis and breakdown, and PKA/PKG-mediated substrate phosphorylation. Furthermore, defects in cAMP/cGMP pathways might contribute to platelet hyperreactivity in cardiovascular disease. This article focuses on recent insights into the regulation of the cAMP/cGMP signaling network and on new targets of PKA and PKG in platelets. 2012-02-02T00:00:00Z Synaptotagmin-like protein 4 and Rab8 interact and increase dense granule release in platelets http://hdl.handle.net/10197/5881 Synaptotagmin-like protein 4 and Rab8 interact and increase dense granule release in platelets Hampson, A.; O'Connor, A.; Smolenski, Albert P. Background: Platelets are highly specialized cells that regulate hemostasis and thrombosis in the vasculature. Upon activation, platelets release various granules that impact on platelets, the coagulation system, other blood cells and the vessel wall; however, the mechanisms controlling granule release are only partially known. We have shown previously that synaptotagmin-like protein (Slp)1 decreases dense granule release in platelets. Objectives: To determine the role of other Slps and their binding partners on platelet dense granule release. Methods: RT-PCR and immunoblotting were used to identify Slps in human platelets. Interaction between Slp4 and Rab8 was investigated with pull-down assays, coimmunoprecipitation, and confocal microscopy. Secretion assays on permeabilized platelets were performed to investigate the effects of Slp4 and Rab8 on dense granule release. Results: Slp4 mRNA and protein are expressed in human platelets. Slp4 interacts with Rab8 in transfected cells and at endogenous protein levels in platelets. We mapped the Rab interaction site to the Slp-homology domain of Slp4, and showed preferential binding of Slp4 to the GTP-bound form of Rab8. Live microscopy showed colocalization of green fluorescent protein-Slp4 and mCherry-Rab8 at the plasma membrane of transfected cells. Endogenous platelet Slp4 and Rab8 colocalized in the center of activated platelets, where granule secretion takes place. Secretion assays revealed that Slp4 and Rab8 enhance dense granule release and that the Slp4 effect is dependent on Rab8 binding. Conclusions: Slp4 and Rab8 are expressed and interact in human platelets, and might be involved in dense granule release. 2013-01-27T00:00:00Z Cyclic Nucleotide Dependent Dephosphorylation of Regulator of G-protein Signaling 18 in Human Platelets http://hdl.handle.net/10197/5879 Cyclic Nucleotide Dependent Dephosphorylation of Regulator of G-protein Signaling 18 in Human Platelets Gegenbauer, Kristina; Nagy, Zoltan; Smolenski, Albert P. Regulator of G-protein signaling 18 (RGS18) is a GTPase-activating protein that turns off Gq signaling in platelets. RGS18 is regulated by binding to the adaptor protein 14-3-3 via phosphorylated serine residues S49 and S218 on RGS18. In this study we confirm that thrombin, thromboxane A2, or ADP stimulate the interaction of RGS18 and 14-3-3 by increasing the phosphorylation of S49. Cyclic AMP- and cyclic GMP-dependent kinases (PKA, PKG) inhibit the interaction of RGS18 and 14-3-3 by phosphorylating S216. To understand the effect of S216 phosphorylation we studied the phosphorylation kinetics of S49, S216, and S218 using Phos-tag gels and phosphorylation site-specific antibodies in transfected cells and in platelets. Cyclic nucleotide-induced detachment of 14-3-3 from RGS18 coincides initially with double phosphorylation of S216 and S218. This is followed by dephosphorylation of S49 and S218. Dephosphorylation of S49 and S218 might be mediated by protein phosphatase 1 (PP1) which is linked to RGS18 by the regulatory subunit PPP1R9B (spinophilin). We conclude that PKA and PKG induced S216 phosphorylation triggers the dephosphorylation of the 14-3-3 binding sites of RGS18 in platelets. 2013-11-01T00:00:00Z Addressing a Training Gap through Addiction Research Education for Medical Students: Letter to the Editor http://hdl.handle.net/10197/5878 Addressing a Training Gap through Addiction Research Education for Medical Students: Letter to the Editor Klimas, Jan; Cullen, Walter 2014-08-01T00:00:00Z Phosphodiesterase 2A forms a complex with the co-chaperone XAP2 and regulates nuclear translocation of the aryl hydrocarbon receptor http://hdl.handle.net/10197/5868 Phosphodiesterase 2A forms a complex with the co-chaperone XAP2 and regulates nuclear translocation of the aryl hydrocarbon receptor Oliveira, Simone Kobe de; Hoffmeister, Meike; Gambaryan, Stepan; Smolenski, Albert P.; et al. Phosphodiesterase type 2A (PDE2A) hydrolyzes cyclic nucleotides cAMP and cGMP, thus efficiently controlling cNMP-dependent signaling pathways. PDE2A is composed of an amino-terminal region, two regulatory GAF domains, and a catalytic domain. Cyclic nucleotide hydrolysis is known to be activated by cGMP binding to GAF-B; however, other mechanisms may operate to fine-tune local cyclic nucleotide levels. In a yeast two-hybrid screening we identified XAP2, a crucial component of the aryl hydrocarbon receptor (AhR) complex, as a major PDE2A-interacting protein. We mapped the XAP2 binding site to the GAF-B domain of PDE2A. PDE assays with purified proteins showed that XAP2 binding does not change the enzymatic activity of PDE2A. To analyze whether PDE2A could affect the function of XAP2, we studied nuclear translocation of AhR, i.e. the master transcription factor controlling the expression of multiple detoxification genes. Notably, regulation of AhR target gene expression is initiated by tetrachlorodibenzodioxin (TCDD) binding to AhR and by a poorly understood cAMP-dependent pathway followed by the translocation of AhR from the cytosol into the nucleus. Binding of PDE2A to XAP2 inhibited TCDD- and cAMP-induced nuclear translocation of AhR in Hepa1c1c7 hepatocytes. Furthermore, PDE2A attenuated TCDD-induced transcription in reporter gene assays. We conclude that XAP2 targets PDE2A to the AhR complex, thereby restricting AhR mobility, possibly by a local reduction of cAMP levels. Our results provide first insights into the elusive cAMP-dependent regulation of AhR. 2007-05-04T00:00:00Z Rap1GAP2 is a new GTPase-activating protein of Rap1 expressed in human platelets http://hdl.handle.net/10197/5867 Rap1GAP2 is a new GTPase-activating protein of Rap1 expressed in human platelets Schultess, Jan; Danielewski, Oliver; Smolenski, Albert P. The Ras-like guanine-nucleotide-binding protein Rap1 controls integrin alpha(IIb)beta3 activity and platelet aggregation. Recently, we have found that Rap1 activation can be blocked by the nitric oxide/cyclic guanosine monophosphate (NO/cGMP) signaling pathway by type 1 cGMP-dependent protein kinase (cGKI). In search of possible targets of NO/cGMP/cGKI, we studied the expression of Rap1-specific GTPase-activating proteins (GAPs) and guanine nucleotide exchange factors (GEFs) in platelets. We could detect mRNAs for a new protein most closely related to Rap1GAP and for postsynaptic density-95 discs-large and zona occludens protein 1 (PDZ)-GEF1 and CalDAG-GEFs I and III. Using 5'-rapid amplification of cDNA ends (RACE), we isolated the complete cDNA of the new GAP encoding a 715-amino acid protein, which we have termed Rap1GAP2. Rap1GAP2 is expressed in at least 3 splice variants, 2 of which are detectable in platelets. Endogenous Rap1GAP2 protein partially colocalizes with Rap1 in human platelets. In transfected cells, we show that Rap1GAP2 exhibits strong GTPase-stimulating activity toward Rap1. Rap1GAP2 is highly phosphorylated, and we have identified cGKI as a Rap1GAP2 kinase. cGKI phosphorylates Rap1GAP2 exclusively on serine 7, a residue present only in the platelet splice variants of Rap1GAP2. Phosphorylation of Rap1GAP2 by cGKI might mediate inhibitory effects of NO/cGMP on Rap1. Rap1GAP2 is the first GTPase-activating protein of Rap1 found in platelets and is likely to have an important regulatory role in platelet aggregation. 2005-04-15T00:00:00Z Regulator of G-protein signaling protein 18 integrates activating and inhibitory signaling in platelets http://hdl.handle.net/10197/5866 Regulator of G-protein signaling protein 18 integrates activating and inhibitory signaling in platelets Gegenbauer, Kristina; Elia, Giuliano; Blanco-Fernandez, Alfonso; Smolenski, Albert P. Regulator of G-protein signaling 18 (RGS18) is a GTPase-activating protein for the G-α-q and G-α-i subunits of heterotrimeric G-proteins that turns off signaling by G-protein coupled receptors. RGS18 is highly expressed in platelets. In the present study, we show that the 14-3-3γ protein binds to phosphorylated serines 49 and 218 of RGS18. Platelet activation by thrombin, thromboxane A2, or ADP stimulates the association of 14-3-3 and RGS18, probably by increasing the phosphorylation of serine 49. In contrast, treatment of platelets with prostacyclin and nitric oxide, which trigger inhibitory cyclic nucleotide signaling involving cyclic AMP-dependent protein kinase A (PKA) and cyclic GMP-dependent protein kinase I (PKGI), induces the phosphorylation of serine 216 of RGS18 and the detachment of 14-3-3. Serine 216 phosphorylation is able to block 14-3-3 binding to RGS18 even in the presence of thrombin, thromboxane A2, or ADP. 14-3-3-deficient RGS18 is more active compared with 14-3-3-bound RGS18, leading to a more pronounced inhibition of thrombin-induced release of calcium ions from intracellular stores. Therefore, PKA- and PKGI-mediated detachment of 14-3-3 activates RGS18 to block Gq-dependent calcium signaling. These findings indicate cross-talk between platelet activation and inhibition pathways at the level of RGS18 and Gq. 2012-04-19T00:00:00Z Cyclic nucleotide-dependent Protein Kinases Inhibit Binding of 14-3-3 to the GTPase-activating Protein Rap1GAP2 in Platelets http://hdl.handle.net/10197/5865 Cyclic nucleotide-dependent Protein Kinases Inhibit Binding of 14-3-3 to the GTPase-activating Protein Rap1GAP2 in Platelets Hoffmeister, Meike; Riha, Pavel; Neumüller, Olga; Smolenski, Albert P.; et al. GTPase-activating proteins are required to terminate signaling by Rap1, a small guanine nucleotide-binding protein that controls integrin activity and cell adhesion. Recently, we identified Rap1GAP2, a GTPase-activating protein of Rap1 in platelets. Here we show that 14-3-3 proteins interact with phosphorylated serine 9 at the N terminus of Rap1GAP2. Platelet activation by ADP and thrombin enhances serine 9 phosphorylation and increases 14-3-3 binding to endogenous Rap1GAP2. Conversely, inhibition of platelets by endothelium-derived factors nitric oxide and prostacyclin disrupts 14-3-3 binding. These effects are mediated by cGMP- and cAMP-dependent protein kinases that phosphorylate Rap1GAP2 at serine 7, adjacent to the 14-3-3 binding site. 14-3-3 binding does not change the GTPase-activating function of Rap1GAP2 in vitro. However, 14-3-3 binding attenuates Rap1GAP2 mediated inhibition of cell adhesion. Our findings define a novel crossover point of activatory and inhibitory signaling pathways in platelets. 2008-01-25T00:00:00Z Impact of severity of personality disorder on the outcome of depression http://hdl.handle.net/10197/5864 Impact of severity of personality disorder on the outcome of depression Kelly, Brendan D.; Nur, Nula A.; Tyrer, Peter; Casey, Patricia R. The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment (n = 121), group sessions on depression prevention (n = 106) or treatment as usual (n = 183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r = 0.21; p < 0.001), 6 months (r = 0.14; p = 0.02) and 12 months (r = 0.21; p = 0.001). On multi-variable analysis, BDI at baseline (p < 0.001) and type of treatment offered (individual therapy, group therapy, treatment as usual) (p = 0.01) were significant independent predictors of BDI at 6 months. BDI at baseline was the sole significant independent predictor of BDI at 12 months (p < 0.001). There was no interaction between personality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression. 2009-06-01T00:00:00Z The role of personality disorder in 'difficult to reach' patients with depression: Findings from the ODIN study http://hdl.handle.net/10197/5863 The role of personality disorder in 'difficult to reach' patients with depression: Findings from the ODIN study Kelly, Brendan D.; Casey, Patricia R.; Dunn, Graham; et al. Individuals with personality disorders (especially paranoid personality disorder) tend to be reluctant to engage in treatment. This paper aimed to elucidate the role of personality disorder in predicting engagement with psychological treatment for depression. The Outcomes of Depression International Network (ODIN) involves six urban and three rural study sites throughout Europe at which cases of depression were identified through a two-stage community survey. One patient in seven who was offered psychological treatment for depression had a comorbid diagnosis of personality disorder (most commonly paranoid personality disorder). Forty-five percent of patients who were offered psychological treatment for depression did not complete treatment. The odds of completion were higher for patients with a comorbid diagnosis of personality disorder, especially paranoid, anxious or dependent personality disorder. The relatively low number of cases with some specific personality disorders (e.g. schizoid personality disorder) limited the study's power to reach conclusions about these specific disorders. This study focused on a community-based sample which may lead to apparently lower rates of engagement when compared to studies based on treatment-seeking populations. Episodes of depression in the context of personality disorder may represent a valuable opportunity to engage with patients who might otherwise resist engagement. 2007-04-01T00:00:00Z Endothelium-dependent and -independent relaxation and VASP serines 157/239 phosphorylation by cyclic nucleotide-elevating vasodilators in rat aorta http://hdl.handle.net/10197/5862 Endothelium-dependent and -independent relaxation and VASP serines 157/239 phosphorylation by cyclic nucleotide-elevating vasodilators in rat aorta Schäfer, Andreas; Burkhardt, Mick; Vollkommer, Tobias; Smolenski, Albert P.; et al. Endothelium-dependent vasodilation is thought to be mediated primarily by the NO/cGMP signaling pathway whereas cAMP-elevating vasodilators are considered to act independent of the endothelial cell layer. However, recent functional data suggest that cAMP-elevating vasodilators such as β-receptor agonists, adenosine or forskolin may also be endothelium-dependent. Here we used functional and biochemical assays to analyze endothelium-dependent, cGMP- and cAMP-mediated signaling in rat aorta. Acetylcholine and sodium nitroprusside (SNP) induced a concentration-dependent relaxation of phenylephrine-precontracted aorta. This response was reflected by the phosphorylation of the vasodilator-stimulated phosphoprotein (VASP), a validated substrate of cGMP- and cAMP-dependent protein kinases (cGK, cAK), on Ser157 and Ser239. As expected, the effects of acetylcholine were endothelium-dependent. However, relaxation induced by the β-receptor agonist isoproterenol was also almost completely impaired after endothelial denudation. At the biochemical level, acetylcholine- and isoproterenol-evoked cGK and cAK activation, respectively, as measured by VASP Ser239 and Ser157 phosphorylation, was strongly diminished. Furthermore, the effects of isoproterenol were repressed by eNOS inhibition when endothelium was present. We also observed that the relaxing and biochemical effects of forskolin were at least partially endothelium-dependent. We conclude that cAMP-elevating vasodilators, i.e. isoproterenol and to a lesser extent also forskolin, induce vasodilation and concomitant cyclic nucleotide protein kinase activation in the vessel wall in an endothelium-dependent way. 2003-02-01T00:00:00Z Synaptotagmin-like protein 1 interacts with the GTPase-activating protein Rap1GAP2 and regulates dense granule secretion in platelets http://hdl.handle.net/10197/5848 Synaptotagmin-like protein 1 interacts with the GTPase-activating protein Rap1GAP2 and regulates dense granule secretion in platelets Neumüller, Olga; Hoffmeister, Meike; Babica, Jan; Gegenbauer, Kristina; Smolenski, Albert P.; et al. The small guanine-nucleotide–binding protein Rap1 plays a key role in platelet aggregation and hemostasis, and we recently identified Rap1GAP2 as the only GTPase-activating protein of Rap1 in platelets. In search of Rap1GAP2-associated proteins, we performed yeast-2-hybrid screening and found synaptotagmin-like protein 1 (Slp1) as a new binding partner. We confirmed the interaction of Rap1GAP2 and Slp1 in transfected COS-1 and HeLa cells and at endogenous level in human platelets. Mapping studies showed that Rap1GAP2 binds through amino acids T524-K525-X-T527 within its C-terminus to the C2A domain of Slp1. Slp1 contains a Rab27-binding domain, and we demonstrate that Rap1GAP2, Slp1, and Rab27 form a trimeric complex in transfected cells and in platelets. Purified Slp1 dose-dependently decreased dense granule secretion in streptolysin-O–permeabilized platelets stimulated with calcium or guanosine 5′-O-[gamma-thio] triphosphate. The isolated C2A domain of Slp1 had a stimulatory effect on granule secretion and reversed the inhibitory effect of full-length Slp1. Purified Rap1GAP2 augmented dense granule secretion of permeabilized platelets, whereas deletion of the Slp1-binding TKXT motif abolished the effect of Rap1GAP2. We conclude that Slp1 inhibits dense granule secretion in platelets and that Rap1GAP2 modulates secretion by binding to Slp1. 2009-08-13T00:00:00Z The prevalence of common mental and substance use disorders in general practice: a literature review and discussion paper http://hdl.handle.net/10197/5846 The prevalence of common mental and substance use disorders in general practice: a literature review and discussion paper Klimas, Jan; Neary, Anna; McNicholas, Claire; et al. Enhanced primary care management of common mental and substance use disorders is a key healthcare target. Though primary care may be well placed to achieve this target, a greater understanding of the prevalence and profile of common mental and substance use disorders in primary care settings is needed. We searched the MEDLINE database (2002–2012) to provide an update on biomedical literature describing the prevalence of common mental and substance use disorders in European general practice. Following 'PRISMA' guidelines, 17 studies were kept for qualitative synthesis. Prevalence, profile, screening instruments, associated co-morbidities, and gender distribution were tabulated. Depending on the screening method, the prevalence of common mental and substance use disorders ranged from 10.4% (Luxemburg) to 53.6% (Spain). Mood disorders were the most common. High co-morbidity with anxiety and somatisation hindered early identification and management. The continuing burden of common mental and substance use disorders, coupled with poor identification described in the updated EU biomedical literature, suggests that the unmet need for health care – identified by the World Health Organization a decade ago – remains unmet. Understanding the prevalence of common mental and substance use disorders, associated morbidity, and the extent to which general practice represents an important catchment mechanism can enhance their management at this level. General practitioners should be trained in accurate screening. Short screening instruments for general practitioners should be unified and promoted. 2014-07-16T00:00:00Z Experiences of using Prezi in psychiatry teaching http://hdl.handle.net/10197/5843 Experiences of using Prezi in psychiatry teaching Duffy, Richard M.; Guerandel, Allys; Casey, Patricia R.; Malone, Kevin; Kelly, Brendan D. Objective: Prezi is a presentation software allowing lecturers to develop ideas and produce mind maps as they might do on an old-style blackboard. This study examines students' experience of lectures presented using Prezi to identify the strengths and weaknesses of this new teaching medium. Methods: Prezi was used to present mental health lectures to final-year medical and physiotherapy students. These lectures were also available online. This cross-sectional study used a questionnaire to assess students' experience of the software. Results: Of students approached, 75.5 % (74/98) took part in the study. A majority, 98.6 % (73/74), found Prezi to be a more engaging experience than other styles of lecture delivery. The overview or 'mind map' provided by Prezi was found to be helpful by 89.2 % (66/74). Problems arose when students used Prezi in their personal study, with 31.1 % (23/74) reporting some difficulties, mostly of a technical nature. Conclusion: This study highlights the potential of Prezi for providing students with an engaging and stimulating educational experience. For Prezi to be effective, however, the lecturer has to understand and be familiar with the software and its appropriate use. 2014-08-01T00:00:00Z Urban Overdose Hotspots: A 12-Month Prospective Study in Dublin Ambulance Services http://hdl.handle.net/10197/5835 Urban Overdose Hotspots: A 12-Month Prospective Study in Dublin Ambulance Services Klimas, Jan; O'Reilly, Martin; Egan, Mairead; Tobin, Helen; Bury, Gerard Background: Opioid overdose is the primary cause of death among drug users globally. Personal and social determinants of overdose have been studied before, but the environmental factors lacked research attention. Area deprivation or presence of addiction clinics may contribute to overdose. Objectives: To examine the baseline incidence of all new opioid overdoses in an ambulance service, and their relationship with urban deprivation and presence of addiction services. Methods: A prospective chart review of pre-hospital advanced life support patients was performed on confirmed opioid overdose calls. Demographic, geographic, and clinical information, i.e. presentation, treatment, outcomes, was collected for each call. The Census data were used to calculate deprivation. Geographical information software mapped the urban deprivation and addiction services against the overdose locations. Results: There were 469 overdoses, 13 of which were fatal; most were male (80%), of a young age (32 years), with a high rate of repeated overdoses (26%), and common poly-drug use (9.6%). Majority occurred in daytime (275), on the streets (212). Overdoses were more likely in more affluent areas (r = .15, P < .05), and in a 1000 m radius of addiction services. Residential overdoses were in more deprived areas than street overdoses (mean difference 7.8, t(170) = 3.99, P < .001). Street overdoses were more common in the city centre than suburbs (χ2(1) = 33.04, P < 0.001). Conclusions: the identified clusters of increased incidence – urban overdose hotspots - suggest a link between environment characteristics and overdoses. This highlights a need to establish overdose education and naloxone distribution in the overdose hotspots. 2014-07-01T00:00:00Z Social capital and suicide in 11 European countries: an ecological analysis http://hdl.handle.net/10197/5834 Social capital and suicide in 11 European countries: an ecological analysis Kelly, Brendan D.; Davoren, Mary; Ní Mhaoláin, Áine; Breen, Eugene G.; Casey, Patricia R. Background: 'Social capital' refers to the existence of voluntary community networks and relationships based on trust, and the use of these networks and relationships to enable positive social action. Social capital is positively associated with selected indices of mental health. Methods: We performed an ecological investigation of the relationship between social trust (as one component of social capital) and national suicide rates in 11 European countries (n=22,227). Results: There was an inverse relationship between social trust and national suicide rates (i.e. the higher the social trust, the lower was the suicide rate), after controlling for gender, age, marriage rates, standardised income and reported sadness. Conclusions: Social capital may have a protective effect against suicide at the national level. Multi-level analysis, taking into account both group-level and individual-level variables, would help clarify this relationship further and guide appropriate interventions at both the group and individual levels. 2009-11-01T00:00:00Z Distinguishing between adjustment disorder and depressive episode in clinical practice: The role of personality disorder http://hdl.handle.net/10197/5833 Distinguishing between adjustment disorder and depressive episode in clinical practice: The role of personality disorder Doherty, Anne; Jabbar, Faraz; Kelly, Brendan D.; Casey, Patricia R. Background: There is significant symptomatic overlap between diagnostic criteria for adjustment disorder and depressive episode, commonly leading to diagnostic difficulty. Our aim was to clarify the role of personality in making this distinction. Methods: We performed detailed assessments of features of personality disorder, depressive symptoms, social function, social support, life-threatening experiences and diagnosis in individuals with clinical diagnoses of adjustment disorder (n=173) or depressive episode (n=175) presenting at consultation-liaison psychiatry services across 3 sites in Dublin, Ireland. Results: Fifty six per cent of participants with adjustment disorder had likely personality disorder compared with 65% of participants with depressive episode. Compared to participants with depressive episode, those with adjustment disorder had fewer depressive symptoms; fewer problems with social contacts or stress with spare time; and more life events. On multi-variable testing, a clinical diagnosis of adjustment disorder (as opposed to depressive episode) was associated with lower scores for personality disorder and depressive symptoms, and higher scores for life-threatening experiences. Limitations: We used clinical diagnosis as the main diagnostic classification and generalisability may be limited to consultation-liaison psychiatry settings. Conclusions: Despite a substantial rate of likely personality disorder in adjustment disorder, the rate was even higher in depressive episode. Moreover, features of likely personality disorder are more strongly associated with depressive episode than adjustment disorder, even when other distinguishing features (severity of depressive symptoms, life-threatening experiences) are taken into account. 2014-10-01T00:00:00Z I'm spiritual but not religious : Implications for research and practice http://hdl.handle.net/10197/5832 I'm spiritual but not religious : Implications for research and practice Casey, Patricia R. There is an assumption, amongst some mental health service users, clinicians, researchers and others, that religiousness and spirituality are the same construct. A consideration of the history of these concepts shows that, over time, each has become separated from the other. Both require careful definition. The definitions of spirituality are heterogeneous and, with important implications for research and practice, some encompass mood states. The failure to separate spirituality and religiousness, and the confounding of spirituality with mood states in some research in psychiatry, makes interpretation of the findings difficult. Greater clarity and precision will be required in future research including, if possible, attempts to provide distinctive operational definitions of spirituality and religiousness. 2013-05-01T00:00:00Z Mental health professionals and information sharing: carer perspectives http://hdl.handle.net/10197/5831 Mental health professionals and information sharing: carer perspectives Wilson, Lorna; Pillay, Divina; Kelly, Brendan D.; Casey, Patricia R. Background: The important role played by carers of those with mental health problems is frequently undervalued among healthcare professionals. Aims: To identify the difficulties encountered by carers in relation to obtaining information from mental health teams. Methods: Participants in the study included carers or family members of persons with mental illness who were affiliated with a support group in Ireland. Information was gathered using an 18-item self-report questionnaire. This is an amended version of the Carer Well-Being and Support Questionnaire for carers of people with a mental health problem or dementia. Results: One-hundred and fifty-nine carers complete the questionnaire. On average respondents stated that they have been in the role of a carer for someone with a mental health problem for 14.4 years, spending a median of 20-h caring each week. Despite most carers maintaining that they are generally satisfied with the support offered to them from medical and/or care staff, the majority (56.3 %) of respondents stated that they have specifically encountered difficulties accessing information from the treating mental health team. The main reasons given to them by the mental health team for withholding information include: lack of patient consent (46.2 %) and unavailability of a team member (46.2 %). From a carer perspective, respondents stated that the main reason they feel there is difficulty in accessing information is a lack of concern for their role as a carer in the patient's management (60.5 %). More than 75 % of all respondents are afraid of negative consequences for them or for the person in their care as a result of information being withheld by the treating team. Conclusions: Carer involvement is essential for the complete and effective management of individuals with mental illness. Confidentiality should not be used as a reason for completely excluding carers. 2014-07-15T00:00:00Z Adjustment disorder: epidemiology, diagnosis and treatment http://hdl.handle.net/10197/5830 Adjustment disorder: epidemiology, diagnosis and treatment Casey, Patricia R. Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, although the concept was recognized for many years before that. In DSM-IV, six subtypes are described based on the predominant symptoms, but no further diagnostic criteria are offered to assist the clinician. These are common conditions, especially in primary care and in consultation liaison psychiatry, where the prevalence ranges from 11% to 18% and from 10% to 35%, respectively. Yet they are under-researched, possibly due to the failure of some of the common diagnostic tools to allow for the diagnosis of adjustment disorder. Among the tools that incorporate adjustment disorder, the concordance between the clinical and interview diagnosis is very poor, with the diagnosis being made more commonly in clinical practice than the diagnostic tools allow for. Adjustment disorder is found in all cultures and in all age groups. The presence of a causal stressor is essential before a diagnosis of adjustment disorder can be made, while the symptoms vary and include those that are found in other common psychiatric disorders. It is also important to distinguish adjustment disorder from normal reactions to stressful events. Adjustment disorders are difficult to distinguish from normal responses to life's stressors, while the distinction from major depression also poses a classificatory conundrum since both are conceptually different. Adjustment disorder is a diagnosis based on the longitudinal course of symptoms in the context of a stressor, while a diagnosis of major depression is a cross-sectional one based on symptom numbers. Treatments consist mainly of brief interventions, while pharmacotherapy is limited to the symptomatic management of anxiety or insomnia. There are no robust studies demonstrating benefits from antidepressants. However, the number of studies of either type of intervention is very limited. 2009-11-01T00:00:00Z The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study http://hdl.handle.net/10197/5829 The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study Casey, Patricia R.; Dunn, Graham; Kelly, Brendan D.; et al. Background: Suicidal ideation is believed to be part of a constellation of suicidal behaviours that culminates in suicide. There is little information on the cross-national prevalence of all suicidal ideation or of serious suicidal ideation in spite of its likely public health importance. Methods: A two-stage screening approach of over 12,000 adults from the general population were evaluated by face to face interview to identify those meeting ICD-10 criteria for depressive disorders at eight sites in five European countries. This study is a cross-sectional analysis of item 9 (suicidal ideation) of the Beck depression inventory from the total screened sample. Results: The standardised period prevalence for all suicidal ideation varied from 1.1 to 19.8% while for serious suicidal ideation there was much less variation. Examining the inter-relationships between all suicide ideation, serious suicide ideation, depressive disorders and suicide failed to support a seamless transition from suicide ideation through depression and serious ideation to suicide. Conclusions: Strategies to prevent suicide should be tailored to take account of site specific differences in its aetiology and understanding the path from suicidal ideation through depression to suicide is crucial to this. 2008-04-01T00:00:00Z The Role of a Neuropsychiatry Clinic in a Tertiary Referral Teaching Hospital: A Two-Year Study http://hdl.handle.net/10197/5828 The Role of a Neuropsychiatry Clinic in a Tertiary Referral Teaching Hospital: A Two-Year Study Jabbar, Faraz; Doherty, Anne; Duffy, R.; Aziz, M.; Casey, Patricia R.; Sheehan, John D.; Lynch, T.; Kelly, Brendan D. Objectives: Mental disorder is common among individuals with neurological illness. We aimed to characterise the patient population referred for psychiatry assessment at a tertiary neurology service in terms of neurological and psychiatric diagnoses and interventions provided. Methods: We studied all individuals referred for psychiatry assessment at a tertiary neurology service over a 2-year period (n= 82). Results: The most common neurological diagnoses among those referred were epilepsy (16%), Parkinson's disease (15%) and multiple sclerosis (8%). The most common reasons for psychiatric assessment were low mood or anxiety (48%) and medically unexplained symptoms or apparent functional or psychogenic disease (21%). The most common diagnoses among those with mental disorder were mood disorders (62%), and neurotic, stress-related and somatoform disorders, including dissociative (conversion) disorders (28%). Psychiatric diagnosis was not related to gender, neurological diagnosis or psychiatric history. Conclusion: Individuals with neurological illness demonstrate significant symptoms of a range of mental disorders. There is a need for further research into the characteristics and distribution of mental disorder in individuals with neurological illness, and for the enhancement of integrated psychiatric and neurological services to address the comorbidities demonstrated in this population. 2014-01-01T00:00:00Z What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service. http://hdl.handle.net/10197/5826 What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service. Jabbar, Faraz; Casey, Patricia R.; Schelten, Sofia Laureano; Kelly, Brendan D. Aim: This study aimed to measure patient satisfaction with the care they were receiving; examine patients' knowledge of the psychiatric services in general; and identify variables associated with satisfaction. Methods: Patients attending the Mater Misericordiae University Hospital psychiatric outpatient clinics over a 13-week period, and the Mater Misericordiae University Hospital clozapine clinic over a 4-week period and were invited to complete the Barker Scale of Patients' Views Towards Care Received From Psychiatrists. Results: One-hundred and ninety-two patients were invited to participate and there was a response rate of 94%. Eighty-six percent of respondents were satisfied with their care; 92% stated psychiatrists were caring towards them; 85% that psychiatrists know what they are doing; 84% that their illness was explained by their psychiatrist; and 65% that psychiatric care is improving; but 65% stated that psychiatric services are still not good enough. Eighty-six percent were, or had been, in receipt of a psychological treatment. On multi-variable analysis, satisfaction was associated with the view that doctors explained treatment clearly, the view that doctors do not rely excessively on medication, and having been visited by a community mental health nurse. Conclusion: Patients attending psychiatry outpatient services reported a high degree of satisfaction with the treatment they were receiving, although there were discrepancies between satisfaction with their own specific service and with psychiatric services in general. 2011-03-01T00:00:00Z Adjustment disorder: implications for ICD-11 and DSM-5 http://hdl.handle.net/10197/5823 Adjustment disorder: implications for ICD-11 and DSM-5 Casey, Patricia R.; Doherty, Anne Adjustment disorder has been a recognised disorder for decades but has been the subject of little epidemiological research. Now researchers have identified the prevalence of adjustment disorder in primary care, and found general practitioner recognition very low but with high rates of antidepressant prescribing. Possible reasons for the seemingly low prevalence, recognition rate and inappropriate management include its recognition as a residual category in diagnostic instruments and poor delineation from other disorders or from normal stress responses. These problems could be rectified in ICD-11 and DSM-5 if changes according it full syndromal status, among others, were made. This would have an impact on future research. 2012-01-01T00:00:00Z Risk Factors of Postpartum Depression in Rural Areas of Isfahan Province, Iran http://hdl.handle.net/10197/5809 Risk Factors of Postpartum Depression in Rural Areas of Isfahan Province, Iran G.R. Kheirabadi, M.R. Maracy, M. Barekatain, M. Salehi, G.H. Sadri, M. Kelishadi, P. Casey. Background: Postpartum depression is defined as a major depressive episode that occurs within four weeks after delivery. However, investigators describe a dramatic increase in the incidence of mood disorders after childbirth with the largest risk during 90 days after delivery. We aimed to study the risk factors of postpartum depression in women living in rural areas of Isfahan Province in Iran. Methods: We assessed 6627 women, two to 12 months after delivery, for depression and putative risk factors. Results: Unemployment, low education, mothers' young age, undesired gender of the child, unplanned pregnancy, and history of depression were the main risk factors of postpartum depression. History of depression, low education, primiparity, unplanned pregnancy, and undesired gender of the child had the highest risk score for postpartum depression in this group of Iranian women. Conclusion: Risk factors of postpartum depression in Isfahan Province were very similar to other studies, but the negative impact of low level of education, unplanned pregnancy, and undesired gender of the child on postnatal depression seems to be characteristic of this population. 2009-09-01T00:00:00Z Impact of severity and type of depression on quality of life in cases identified in the community http://hdl.handle.net/10197/5803 Impact of severity and type of depression on quality of life in cases identified in the community Nuevo, R.; Leighton, C.; Dunn, G.; Casey, Patricia R.; et al. Background: The impact of different levels of depression severity on quality of life (QoL) is not well studied, particularly regarding ICD-10 criteria. The ICD classification of depressive episodes in three levels of severity is also controversial and the less severe category, mild, has been considered as unnecessary and not clearly distinguishable from non-clinical states. The present work aimed to test the relationship between depression severity according to ICD-10 criteria and several dimensions of functioning as assessed by Medical Outcome Study (MOS) 36-item Short Form general health survey (SF-36) at the population level. Method: A sample of 551 participants from the second phase of the Outcome of Depression International Network (ODIN) study (228 controls without depression and 313 persons fulfilling ICD criteria for depressive episode) was selected for a further assessment of several variables, including QoL related to physical and mental health as measured with the SF-36. Results: Statistically significant differences between controls and the depression group were found in both physical and mental markers of health, regardless of the level of depression severity; however, there were very few differences in QoL between levels of depression as defined by ICD-10. Regardless of the presence of depression, disability, widowed status, being a woman and older age were associated with worse QoL in a structural equation analysis with covariates. Likewise, there were no differences according to the type of depression (single-episode versus recurrent). Conclusions: These results cast doubt on the adequacy of the current ICD classification of depression in three levels of severity. 2010-01-01T00:00:00Z Abortion among young women and subsequent life outcomes http://hdl.handle.net/10197/5799 Abortion among young women and subsequent life outcomes Casey, Patricia R. This article will discuss the nature of the association between abortion and mental health problems. Studies arguing about both sides of the debate as to whether abortion per se is responsible will be presented. The prevalence of various psychiatric disorders will be outlined and where there is dispute between studies, these will be highlighted. The impact of abortion on other areas such as education, partner relationships and sexual function will also be considered. The absence of specific interventions will be highlighted. Suggestions for early identification of illness will be made. 2010-08-01T00:00:00Z Written information on bipolar affective disorder: the patients' perspective http://hdl.handle.net/10197/5780 Written information on bipolar affective disorder: the patients' perspective White, Daniel C.; Schelten, Sofia Laureano; Kelly, Brendan D.; Casey, Patricia R. Aims and method: The mental health information available to people with bipolar affective disorder is variable in quality. We conducted a qualitative survey in an urban out-patient department to elicit the opinions of people with bipolar affective disorder on the written information provided by three health information providers.Results: Participants' responses were generally positive for each leaflet. The two leaflets rated highest by participants used quality assurance tools. However, 20-30% had difficulty understanding the leaflets. Medical jargon and verbosity were common criticisms. Clinical implications: Professional bodies such as the Royal College of Psychiatrists play an important role in providing patients with written information. Quality assurance standards should be used in the production of patient information. A tool measuring individuals' appraisal of information may ensure information is appropriate to their requirements. 2010-01-01T00:00:00Z Adjustment disorder considered http://hdl.handle.net/10197/5736 Adjustment disorder considered Casey, Patricia R.; Jabbar, Faraz Adjustment disorder has been included in psychiatric classifications for over 40 years but has received little attention from the research community. It is particularly common in consultation liaison psychiatry. Evaluation is problematic since it may be mistaken for major depression, generalised anxiety or non-pathological reactions to stress. Its measurement by structured interview is difficult since it is not included in many instruments and, in others, cannot be diagnosed once the threshold for another disorder is reached. There are few evidence-based treatments and it is possible that these transient reactions may not require any formal intervention. Adjustment disorder generally carries an excellent prognosis but in some individuals is associated with self-harm and suicide. 2013-01-01T00:00:00Z Adjustment disorders: the state of the art http://hdl.handle.net/10197/5730 Adjustment disorders: the state of the art Casey, Patricia R.; Bailey, Susan Adjustment disorders are common, yet under-researched mental disorders. The present classifications fail to provide specific diagnostic criteria and relegate them to sub-syndromal status. They also fail to provide guidance on distinguishing them from normal adaptive reactions to stress or from recognized mental disorders such as depressive episode or post-traumatic stress disorder. These gaps run the risk of pathologizing normal emotional reactions to stressful events on the one hand and on the other of overdiagnosing depressive disorder with the consequent unnecessary prescription of antidepressant treatments. Few of the structured interview schedules used in epidemiological studies incorporate adjustment disorders. They are generally regarded as mild, notwithstanding their prominence as a diagnosis in those dying by suicide and their poor prognosis when diagnosed in adolescents. There are very few intervention studies. 2011-02-01T00:00:00Z Factors associated with suicidal ideation in the general population : Five-centre analysis from the ODIN study http://hdl.handle.net/10197/5727 Factors associated with suicidal ideation in the general population : Five-centre analysis from the ODIN study Casey, Patricia R.; Dunn, Graham; Kelly, Brendan D.; et al. Background: Very few studies have examined the cross-national prevalence of suicidal ideation in the general population or variables associated with it. Aims: To examine the risk factors for suicidal ideas in the general population. Method: As part of a five-country two stage epidemiological study of depressive disorder (the ODIN study) a random sample of over 12 000 people were screened using the Beck Depression Inventory (BDI). There followed detailed analysis of item 9 of the BDI, which measured the severity of suicidal ideation. Results: Age, marriage, concern by others and severity of depressed mood independently increased or decreased the odds of suicidal ideation overall. An interaction between life events and social supports was identified, although this differed between men and women. Only concern by others and severity of depression were independently associated with serious suicidal ideation. The study does not allow for interpretation of the direction of the association. Conclusions: A number of social, clinical and demographic variables were independently associated with all suicidal ideation and with serious suicidal ideation. Longitudinal studies are required to confirm whether these are risk factors for or the result of suicidal ideation or have some other relationship. 2006-01-01T00:00:00Z Adjustment disorders with depressed mood: A critique of its DSM-IV and ICD-10 conceptualization and recommendations for the future http://hdl.handle.net/10197/5726 Adjustment disorders with depressed mood: A critique of its DSM-IV and ICD-10 conceptualization and recommendations for the future Baumeister, H.; Maercker, A.; Casey, Patricia R. Background: The volume of research involving adjustment disorder (AD) is limited. The scientific neglect of AD seems to result from the inadequate operationalisation of AD in DSM-IV and ICD-10. The aims of the present proposal are to discuss the shortcomings of AD conceptualisations and to present recommendations for the future. Sampling and methods: This conceptual paper is based on an iterative process of debate between the authors. Results: The current operational definition of AD is characterised by 3 main limitations: (1) the inadequately defined clinical significance criterion, (2) the relegation of AD behind other diagnoses and (3) the missed recognition of the importance of contextual factors, such that normal human adaptive processes might be pathologised. Furthermore, subtypes of AD lack operational clarity. Based on a discussion of the limitations, recommendations for DSM-V are presented, including the addition of new subtypes. Conclusions: The revision of AD criteria will reduce the likelihood of false-positive and false-negative diagnoses. These changes will enable the scientific exploration of this common and relevant disorder, and will make epidemiological studies, and ultimately service planning based on these, more reliable than at present. 2009-01-01T00:00:00Z Personality disorder, depression and functioning: results from the ODIN study http://hdl.handle.net/10197/5725 Personality disorder, depression and functioning: results from the ODIN study Casey, Patricia R.; Birbeck, Gail; McDonagh, Catherine; et al. Background: There is little information of the prevalence of personality disorder (PD) in those with depressive disorder in community samples; neither is there any data on the impact of PD on service utilisation or outcome in this setting. Methods: A two stage screening study to identify cases of depressive disorder using SCAN in five European countries. Personality assessed 6 months after the diagnostic interview. Follow-up for 1 year using symptom and social function measures. Results: Personality disorder is present in 22% of a community sample with depressive disorders but the range varied from 13.7% to 33.3% across countries. Cluster C formed 43% of the total. Long-term psychotropic drug use was more common in the PD group even after depression was controlled. Those with PD had higher symptom scores at the outset and, although the PD group was more likely to be cases at follow-up, this disappeared when the depression score was co-varied. Only initial social function predicted outcome at 6 and 12 months. Limitations: The use of a non-treatment seeking population may limit the application of the findings to clinical populations. Conclusions: PD is common even in a non-treatment seeking population with depressive disorder. It impacts upon outcome at 6 and 12 months but this is related to the initial severity of depressed mood. Social function is the only independent predictor of outcome and should be assessed separately. 2004-10-15T00:00:00Z Health service use by adults with depression: community survey in five European countries - Evidence from the ODIN study http://hdl.handle.net/10197/5724 Health service use by adults with depression: community survey in five European countries - Evidence from the ODIN study McCracken, Cherie; Dalgard, Odd Steffen; Ayuso-Mateos, Jose Luis; Casey, Patricia R.; Wilkinson, Greg; Lehtinen, Ville; Dowrick, Christopher Background: Little is known about patterns of healthcare use by people with depression in Europe. Aims: To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors. Method: People aged 18-65 years with depressive or adjustment disorders (n=427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services. Outcome measures were self-reported use Client Services Receipt Interview and costs of general practice, generic, psychiatric or social services in the past 6 months. Results: Less frequent use was made of generic services in Norway and psychiatric services in the UK. Severity of depression, perceived health status, social functioning and level of social support were significant predictors of use; the number of people able to provide support was positively associated with greater health service use. Conclusions: Individual participant factors provided greater explanatory power than national differences in healthcare delivery. The association between social support and service use suggests that interventions may be needed for those who lack social support. 2006-01-01T00:00:00Z Peer reviewing made easy http://hdl.handle.net/10197/5723 Peer reviewing made easy Halder, Neel; Ramsay, Rosalind; Tyrer, Peter; Casey, Patricia R. Peer review in scientific journals has existed for over 200 years. This process is currently the accepted way of assessing scientific manuscripts prior to publication for most journals. Despite this, little has been written about the process of peer reviewing, with hardly anything specific to psychiatric journals. This article answers fundamental questions related to peer reviewing and includes practical tips to writing reviews. It will be helpful for those keen on improving their knowledge about the peer-review process. It will not only benefit those who are reviewers or thinking about becoming reviewers, but also authors, who can use the information to improve their chances of publication. 2011-01-01T00:00:00Z


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GE Profile versus Bosch
We are remodling our kitchen. I currently own Frigidare Professional appliances. I am trying to decide between series 800 bosch double oven or ge profile. double ovens. Are Bosh appliances on the overall better. We are going to replace all of the appliances.
I know others will also say this but I'll be first. Please consider putting two single ovens one over the other in your remodel. If you can do this you will save the great expense of repairing/replacing an expensive double oven. Doing so with the same brand will make it matching. In some cases this will allow you to choose features on two different models from the same line/manufacturer. We have a GE profile microwave/oven combo. and when we had a problem with the microwave, were faced with a large expense to replace it if we hadn't found a repair shop that could fix the microwave for us.

subset: commoncrawl


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I can't understand how to let Intellisense work in
ICSharpCode.TextEditor. As of today, replies are incomplete. On the web, there are no samples...
I need to display a completion box with my custom keywords.
Any help?
I can't understand how to let Intellisense work in
I need to display a completion box with my custom keywords.
Any help?
I had the same problem a couple weeks ago and grabbed the sample app for ICSharpCode texteditor CodeComplete and was able to consolidated it all into one file
See here for my first pass at it: http://o2platform.googlecode.com/svn/trunk/O2%20-%20All%20Active%20Projects/O2%20Modules%20Using%203rd%20Party%20Dlls/O2_External_SharpDevelop/Ascx/O2CodeCompletion.cs
My objective at that stage was to create one file will all dependencies so that I could (for example) add code complete to any TextEditorControl control (I also had to make a couple changes to allow dynamic code complete updates from multiple source code files)
To use the O2ComdeCompletion.cs object just call:
o2CodeCompletion = new O2CodeCompletion( {your instance of TextEditorControl} );


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Laguna Pressure Flo UVC Pond Filters by Rolf C. Hagen Inc.
Designed to provide enhanced filtration for clean, pristine ponds up to 4000 gallons. Improvements to the pressurized filters include increased UV wattage, durable foam filters pads and upgraded biological media (BioLava) for beautiful water and healthier fish. Click-Fit fast connectors make setup and backwashing maintenance quick, simple and clean. www.hagen.com
TH-C Series Titanium Heater by Aquatop
Fully submersible heaters with digital controls that offer a compact design for versatile placement and extreme durability due to the tough titanium construction. Holds temperatures from 68 to 92 degrees Fahrenheit and each unit has a separate temperature probe. Available in two sizes for aquariums up to 150 gallons. www.aquatop.com
Zooplankton Harvest Sieve by Reed Maricultuer
This 40-micron zooplankton harvest sieve is constructed from durable schedule 80 PVC. The screen is polyester, providing greater chemical resistance and it's recessed for protection. Holds almost a liter. Ideal for harvesting rotifers produced in the APBreed Compact Culture System and copepods. www.reedmariculture.com
Bio-Calcium Original Balling Salts by Tropic Marin
These reef salts are packaged in the three individual components of the Balling Method for a complete ionically-balanced independent dosage of calcium and carbonates in the reef aquarium while also maintaining a stable pH. The three separate packets of salt are easily dissolved in RO/DI water. www.tropicmarin-usa.com
Fish Food Line by API
API Fish Food diets contain a unique, nutritionally enhanced protein to ensure easy uptake of nutrients for maximum absorption. Fish more readily use the nutrients and release 30 percent less ammonia for cleaner, clear water. www.apifishcare.com
LED Track Lights Display Rack by Elive
Here is a new merchandising display for Elive LED Track Lights, LED Track Light Advanced and accessories. These sturdy steel racks are free standing and can be displayed in-line or by themselves. The displays come complete with a complement of product that will enhance your aquatic lighting section. www.elivepet.com
Clear Magic New Packaging by Aquatop
Aquatop has launched new modern blue and black packaging for their Clear Magic water clarification additive. Clear Magic water additive improves filter performance and results in crystal clear water. Clear Magic is completely safe with freshwater, marine and reef aquariums. One package treats 30 gallons. www.aquatop.com
Desktop Aquarium Kits by API and KollerCraft
Here's a new line of desktop aquariums that are easy to setup and care for. Each kit includes optimum filtration, LED lighting and API's Perfect Start water treatment plan. A wide assortment of designs available to appeal to any customer. www.apifishcare.com
Aquavitro Salinity Salt in New Size by Seachem
Blend of salts specifically for reef aquariums now available in 20-gallon size. Contains all major, minor and trace components found in natural seawater and delivers appropriate pH of 8.4 to 8.6. Highly concentrated so it yields more salt water per bucket. www.seachem.com
Hot Salt by Acrylic Tank Manufacturing
Hot Salt is a high quality aquarium salt composed of anhydrous materials that have no water embedded within the chemical structure. It absorbs water so rapidly it develops an exothermic reaction that heats up the salt until fully hydrated. Hot Salt is ready to use in only one hour. www.acrylictankmanufacturing.com
Reef Glue by Seachem
Cyanocrylate adhesive for mounting frags and coral colonies on reef rocks. It bonds within seconds and has excellent hold, durability and control. Usable underwater and for aquascaping in fresh, salt and reef aquariums. The aluminum tube protects the glue from drying out between uses. www.seachem.com
Coral Food by Cobalt Aquatics
A fine powder and fully nutritious food for all corals and other filter-feeding invertebrates. This broad-spectrum, highly attractive formula will get a coral's attention and create a vigorous feeding response. It stimulates growth and color in invertebrates. www.cobaltaquatics.com
Aquavitro Coral Cutter by Seachem
Surgical quality stainless steel blades make the Coral Cutter an ideal tool for fragging or trimming corals to maintain space or shape a reef. Can cut through thick corals with ease. www.seachem.com
Coralific Delite by Hikari
This unique miniature pellet allows using it as a broadcast food or as a target food by soaking it in aquarium water. Soaking time impacts the thickness and stickiness so the food goes where the hobbyist puts it. Promotes excellent feeding response and polyp extension. www.hikariusa.com
Egg-Rocker by Cobalt Aquatics
This innovative design is easy to use, having self-standing legs to stay upright while harvesting eggs. Easy airflow adjustment dials allow perfect water flow to gently rock eggs. Consistent flow will yield high hatch rates. Comes in two sizes. www.cobaltaquatics.com


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The Ritz-Carlton, Charlotte, Charlotte
Location. Located in the heart of Uptown Charlotte, the Ritz-Carlton overlooks the city skyline and is close to the business and historic districts. The hotel is adjacent to the EpiCentre entertainment complex and less than a mile from the Charlotte Convention Center.
Hotel features. The hotel features the two-story penthouse Spa & Wellness Center with four rooms for spa treatments, a sauna, fitness center, indoor swimming pool, and spa tub. The hotel's restaurant, BLT Steak, is a French bistro with modern decor. Breakfast is available. The Lobby Lounge serves a regional, organic menu along with specialty cocktails and martinis, and has complimentary wireless Internet access.
Complimentary transportation is available on weekday mornings within the I-277 loop. Meeting space of over 12,000 square feet includes a large ballroom and 9 function rooms. The hotel also has a full-service business center with wired and wireless Internet access and mail services.
Guestrooms. Guestrooms and suites at the Ritz-Carlton, Charlotte feature views of the skyline and Uptown Charlotte from floor-to-ceiling windows. Beds come with 400-thread-count Frette Italian linens. Bathrooms include separate bathtubs and showers, dual vanities, and flat-panel televisions. Rooms also include 42-inch LCD televisions, DVD players, iPod docking stations, multi-line phones, and wireless Internet access (surcharge) . Housekeeping is provided twice each day and complimentary newspapers are delivered daily. Extra beds and baby cots are available on request, and connecting/adjoining rooms can be provided.
Came into town for the NCAA basketball tournament Friday and a show at Belk Theater on…
We went down for the Hornets game and a relaxing evening.
Enter dates to check prices
Hotel Info: 866-539-8117from $459
- Deluxe Room
- Executive Suite
- Suite, 1 King Bed with Sofabed
Recommended hotels
At a glance
Key facts
Hotel size
- This hotel has 146 rooms
- This hotel is arranged over 18 floors
- Check-in time starts at 4 PM
- Check-out time is noon
- Express check-out
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Pets not allowed
Extra people
- Roll-away beds available, charges may apply*
- Free WiFi and wired Internet access in public areas
- WiFi and wired Internet access in rooms *
- Valet parking *
- Free area shuttle within 2 mi
Nearby Five Star Charlotte hotels
In the hotel
- Buffet breakfast daily (surcharge)
- Restaurant
- Bar/lounge
- Coffee shop/café
- 24-hour room service
- Indoor pool
- Health club
- Full-service spa
- Spa treatment room(s)
- Bicycle rentals on site
- Pilates classes on site
- Yoga classes/instruction on site
- Golfing nearby
- Rafting nearby
- Spa tub
- Steam room
- Sauna
- 24-hour business center
- Number of meeting rooms - 9
- Conference space
- Meeting rooms
- Conference space size (feet) - 12,000
- Conference space size (meters) - 1115
- 24-hour front desk
- Concierge services
- Limo or Town Car service available
- Dry cleaning/laundry service
- Laundry facilities
- Wedding services
- Number of buildings/towers - 1
- Year Built 2009
- Elevator/lift
- Fireplace in lobby
- Television in lobby
- Accessible path of travel
- Braille or raised signage
- Accessibility equipment for the deaf
- Accessible bathroom
- In-room accessibility
- Roll-in shower
In the room
- Climate control
- Air conditioning
- Espresso maker
- Coffee/tea maker
- Bathrobes
- Slippers
- Iron/ironing board
- Down comforter
- Blackout drapes/curtains
- Turndown service
- Premium bedding
- Pillowtop mattress
- Private bathroom
- Separate bathtub and shower
- Free toiletries
- Hair dryer
- 42-inch flat-screen TV
- Pay movies
- Premium TV channels
- IPod docking station
- DVD player
- Video-game console
- Desk
- Free newspaper
- WiFi (surcharge)
- Free bottled water
- Daily housekeeping
- In-room safe (laptop compatible)
- Connecting/adjoining rooms available
Top Charlotte hotels
Recently reviewed hotels in Charlotte
- Red Roof Inn Charlotte UNCCFrom
- Hilton Garden Inn Charlotte AirportFrom
"Perfect place to stay before flying out of Charlotte since you can leave your car there and take the shuttle to the airport. The staff was super nice."Mar 8, 2015
- Hampton Inn & Suites Charlotte - PinevilleFrom
- Greenleafe InnFrom
"my stay was very comfortable and enjoyed it"Mar 8, 2015
Nearby hotels
Special features
The Spa & Wellness Center is 13,000 square feet and includes four treatment rooms, a couples room, and separate ladies and gentlemen's relaxation lounges. Spa services include rejuvenating treatments, and guests can take advantage of movement and kinesis and cycle studios.
DiningBLT Steak - This steakhouse serves lunch and dinner. Guests can enjoy drinks at the bar.
Lobby Lounge - This lobby lounge specializes in international cuisine and serves lunch, dinner, and light fare.
Urban Sip - This bar specializes in international cuisine and serves light fare only. Open select days.
Bar Cocoa - This café serves breakfast, brunch, lunch, and light fare.
Peets Coffee and Tea - This coffee shop serves breakfast, lunch, and light fare. Open select days.
On Site
- Health club
- Sauna
- Spa tub
- Steam room
- Bicycle rentals on site
- Pilates classes on site
- Yoga classes/instruction on site
- Golfing nearby
- Rafting nearby
The Ritz-Carlton, Charlotte, Charlotte's small print
Also known as
- Ritz Carlton Charlotte
- The Ritz-Carlton, Charlotte Charlotte
- The Ritz-Carlton, Charlotte
The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
Optional extras
Valet parking costs USD 30 per day
Buffet breakfast is offered for an extra charge of USD 29 per person (approximately)
WiFi is available in guestrooms for USD 9.95 per day (rates may vary)
High-speed Internet access (wired) is available in guestrooms for USD 9.95 per day (rates may vary)
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.


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Evy Nicole Bailey
Jarrod Heath Bailey and Megan Nicole Bailey of Paragould, Ark. announce the birth of their daughter, Evy Nicole Bailey, on May 17, 2012 at St. Bernard's Hospital in Jonesboro.
Latest News
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text: [ http://issues.datanucleus.org/browse/NUCRDBMS-610?page=com.atlassian.jira.plugin.system.issuetabpanels:comment-tabpanel&focusedCommentId=20293#action_20293 ] Andy Jefferson commented on NUCRDBMS-610: ----------------------------------------- 1). I would prefer *no* other deps, presence of deps implies the chance of something else causing the problem. So just some entity, the JPA main and DataNucleus, so omit Spring (particularly as your DasJpa doesn't use it!). You have "datanucleus-api-jdo" yet are using JPA, so remove it. You have mongodb, why since using RDBMS? remove it. What is "datanucleus.option.mapping"? Doesn't exist. 2). Post the exception you say you get with current codebase; it certainly is not what you post in the issue (since 3.1 is different code). All method instances are generated by OSGi's class loader, so since it works for everyone else who use OSGi then you must be doing "something different". 3). Please provide some step-by-step guide of what (command) you run "in Karaf", since I am not familiar with it. I would expect some sort of load bundle(s), in some order, followed by some invocation ... so what is the karaf-specific commands (or if done via a Maven plugin, what is the "mvn" plugin and method?) > Not able to access JPQL methods like Max in karaf 2.2.6 OSGI environment > ------------------------------------------------------------------------ > > Key: NUCRDBMS-610 > URL: http://issues.datanucleus.org/browse/NUCRDBMS-610 > Project: DataNucleus Store RDBMS > Issue Type: Bug > Environment: Windows xp, Java 1.6, Apache Karaf 2.2.6, OSGI > Reporter: Sunil > Priority: Incomplete > Attachments: das-consumer-basic - dn.zip > > > I am getting error during runtime when i try to use the Max function in a query given below (EVERY THING IS WORKING AS EXPECTED IF I AM NOT USING ANY METHOD). > Query q = em.createQuery("SELECT max(s.studentID) FROM StudentJpa s"); > Long value = (Long)q.getSingleResult(); > System.out.println("MAX VALUE IS ***************** " + value); > The error is given below. > ========================= > Caused by: org.datanucleus.exceptions.NucleusUserException: Expected SQLMethod class "org.datanucleus.store.rdbms.sql.method.MaxFunction" was not found! > at org.datanucleus.store.rdbms.sql.expression.SQLExpressionFactory.invokeMethod(SQLExpressionFactory.java:341) > at org.datanucleus.store.rdbms.query.QueryToSQLMapper.processInvokeExpression(QueryToSQLMapper.java:2835) > at org.datanucleus.store.rdbms.query.QueryToSQLMapper.compileResult(QueryToSQLMapper.java:593) > at org.datanucleus.store.rdbms.query.QueryToSQLMapper.compile(QueryToSQLMapper.java:400) > at org.datanucleus.store.rdbms.query.JPQLQuery.compileQueryFull(JPQLQuery.java:800) > at org.datanucleus.store.rdbms.query.JPQLQuery.compileInternal(JPQLQuery.java:279) > at org.datanucleus.store.query.Query.executeQuery(Query.java:1748) > at org.datanucleus.store.query.Query.executeWithMap(Query.java:1694) > at org.datanucleus.api.jpa.JPAQuery.getSingleResult(JPAQuery.java:232) > MY FINDINGS: > ============= > JDOClassLoaderResolver is not able to load this class using any class loader. > org.datanucleus.store.rdbms is exporting all the methods in that particular package but no bundle is importing it. > I believe datanucleus is missing something here. -- This message is automatically generated by JIRA. - If you think it was sent incorrectly contact one of the administrators: http://issues.datanucleus.org/secure/Administrators.jspa - For more information on JIRA, see: http://www.atlassian.com/software/jira


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The Originators of Quick & Easy Cooking!
"Easy as Pie" Recipes: 40 Chocolate Pie Recipes, Fruit Pie Recipes
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Impossible Pumpkin Pie
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Talk about having a secret helper in the kitchen! Impossible pies make their own crust, so we don't have to do a thing but mix 'em together and bake! Why wait for Thanksgiving when we can enjoy this lighter pumpkin pie anytime?!
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If you want to fancy up this pie a bit, top with dollops of light whipped cream and a cinnamon stick.
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Submitted by Jon Fitz (not verified) on Fri, 05/23/2014 - 12:03pm.
Production companies usually owe very little in taxes to the state. You can actually owe literally nothing in taxes, and still receive the credit. Thus "Refundable Tax Credit" is a pretty misleading name. It's more of a cash grant or subsidy. The industry will probably leave, but your state has been losing money trying to keep it there. Every $1 dollar spent, you make .60¢ back, so that math doesn't quite add up to a good deal.


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Watercolour on Paper, 21cm X 15cm. Better photo now….other one was pretty grim. I need to start waiting till I have a good shot BEFORE I upload stuff.
Portrait of Jenelle.
Little wiki quote about the title
. Introspection is the self-observation and reporting of conscious inner thoughts, desires and sensations.
Stilll experimenting and honing my watercolour skillzzzz…getting there.
You are so talented ! Love your work very much . The expression is pretty well rendered here
thanks :) uploaded a decent photo at last…..more different;better if you ask me :)
– modernlifeform
Beautiful…..keep honing those skillzzzzzzz. (love it)
:) thanks.updated photo now
– modernlifeform
Quite nice on all spheres