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OBJECTIVES: To estimate the proportion of community-dwelling older adults with dementia being prescribed a psychotropic and to identify patient and caregiver factors associated with antipsychotic use. METHODS: Retrospective cohort study of the Aging, Demographics, and Memory Study (ADAMS) from 2002 to 2004 designed to assess dementia severity and service use of community-dwelling older adults. The frequency of psychotropic medication (antipsychotics, antidepressants, anticonvulsants, and benzodiazepines) use was tabulated and weighted to the U.S. population according to dementia diagnosis. Logistic regression analysis identified factors associated with antipsychotic use. RESULTS: The 307 ADAMS participants had the following dementia diagnoses: Alzheimer's disease (69.3%), vascular dementia (17.7%), and other dementia (12.4%). The proportion of participants prescribed a psychotropic medication broken down according to therapeutic class was 19.1% antipsychotics, 29.1% antidepressants, 9.8% benzodiazepines, and 8.8% anticonvulsants. Older adults with dementia were significantly more likely to receive an antipsychotic if they had moderate (odds ratio (OR) = 7.4, P = .002) or severe (OR = 5.80, P = .002) dementia than if they had mild dementia or were diagnosed with Alzheimer's disease (OR = 6.7, P = .04) compared to vascular dementia. Older adults with dementia who lived with a caregiver were significantly less likely to taking an antipsychotic (OR = 0.19, P = .001) than those who lived alone. Also, persons with dementia were significantly less likely to be prescribed an antipsychotic if their caregiver was clinically depressed (OR = 0.03, P = .005) than if their caregiver was not depressed. CONCLUSION: Psychotropic medication use is common in community-dwelling older adults with dementia. Caregivers appear to have a substantial effect on whether an antipsychotic is prescribed, which adds additional complexity to conversations discussing the risk:benefit ratio of this medication class.

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This study evaluated the hypothesis that if hydrophilic nanofillers were dispersed evenly within the adhesive layer under moist conditions, adding them to a one-bottle dentin adhesive might improve the mechanical properties of the adhesive layer, and accordingly increase the bond strength. The flexural strength (FS), the degree of conversion (DC), and the microtensile bond strength (MTBS) to the dentin of four experimental ethanol-based one-bottle dentin adhesives containing 0, 0.5, 1.0, and 3.0 wt % of 12-nm hydrophilic fumed silica were evaluated, and the distribution of the nanofillers were compared using transmission electron microscopy (TEM). Although the nanofiller content did not affect the DC, the FS tended to increase with increasing nanofiller content. The MTBS appeared to increase when up to 1.0 wt % of the nanofillers were added, but they were statistically not significant. However, when 3.0 wt % of the nanofillers were added, the MTBS decreased significantly comparing to the adhesive containing 0.5 wt % nanofillers (p < 0.05). The TEM image suggested that if the nanofillers within the adhesive were 3.0 wt % and applied to a wet dentin surface, they aggregated easily into large clusters and would decrease the MTBS.

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OBJECTIVES: To investigate the sexual behavioral characteristics and HIV/AIDS knowledge among men who have sex with men (MSM), one of the HIV high risk groups. METHODS: A three month survey among individuals who were able to be contacted was carried out over the entire Republic of Korea, between May and August, 2001. 348 individuals completed a self-administered questionnaire. The data collected included demographic information, sexual behavior and AIDS knowledge. RESULTS: Eighty-seven and ninety-two per cent of the 348 MSM were aged 20-39 years and had never been married, respectively. Fifty-five per cent of participants reported at least one sexual contact with women, and a quarter of the MSM surveyed had engaged in high-risk sexual behavior (more than 6 partners) during the previous year. About twenty per cent of the MSM had anal sex as their favorite way of having sex, and seventy-four per cent did not use condoms regularly due to loss of enjoyment, and were more likely to be engaged in risky behaviors. Only ten per cent had a regular HIV test history, and most had obtained knowledge or information on HIV/AIDS through the mass media. CONCLUSIONS: A large proportion of the MSM in Korea still remain at an elevated risk for contracting HIV infection. Change in high-risk sexual behaviors will prevent the spread of HIV infection among the MSM population, which requires public health education for preventive interventions, and should be culturally and socially specific in order to be effective.

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BACKGROUND: The purpose of this study was to detect differences in regional areas of the corpus callosum (CC) in subjects with early-onset minor depression (dysthymia or depressive personality disorder) and healthy comparison subjects. Based on previous reports that have suggested reduced frontal lobe volume and reduced hemispheric lateralization in the frontal regions of the brain in depression, we hypothesized that the area of the CC that interconnects the frontal regions of the brain, i.e., the genu, will be smaller compared to that of healthy comparison subjects. METHODS: Forty female subjects with early-onset dysthymia or depressive personality disorder, as defined by the Structured Clinical Interview for DSM-III-R and the Diagnostic Interview for Depressive Personality, respectively, and age- and gender-matched healthy comparison subjects (n = 42) were recruited (age: 21.4 +/- 2.1 and 20.9 +/- 2.8 years, respectively). All subjects were psychotropic medications-naïve and right-handed. A 1.5T GE Sigma scanner was used to acquire 124 1.5-mm-thick contiguous coronal images. Midsagittal slice images were carefully selected from reconstructed magnetic resonance images both from native and stereotaxic space to measure seven regional areas of the CC. RESULTS: There were significant diagnosis by CC region interactions [F(6,480) = 4.06, p <.001; F(6,480) = 3.30, p =.003, native and stereotaxic space, respectively]. Early-onset minor depression subjects had a 9.9% (native space) and 6.9% (stereotaxic space) smaller genu of the CC compared to the healthy comparison subjects (the Newman-Keuls post hoc test, p =.005 and.019, native and stereotaxic space, respectively). Early-onset minor depression subjects also had a 7.8% smaller posterior midbody relative to the comparison subjects (the Newman-Keuls post hoc test, p =.033) only in the native space. Severity of current depressive symptoms or duration of illness did not correlate with the size of the genu or the posterior midbody parts of the CC. CONCLUSIONS: These results suggest frontal lobe structural, and possibly functional, abnormalities in the brain in young female adults with a milder spectrum of depression, i.e., DSM-IV early-onset dysthymia or depressive personality disorder. The present findings point out the possible role of frontal lobe abnormality in pathophysiology of early-onset minor depression.

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Shrinkage in light curing resin composites is assumed to be directed toward the light source. However, the strong bond at the dentin-resin interface achieved by newer generation dentin bonding systems may affect the direction of polymerization shrinkage. In this study, various curing modes of adhesive resin simulating different bond qualities were applied to determine the extent of interfacial gap formation with a scanning electron microscope. We also measured the free surface depression with a profilometer. The direction of polymerization shrinkage was inferred from the ratio of the interfacial gap measurement at the floor to the free surface depression. Various curing modes used in this study include Group 1: light curing of resin composite without the bonding agent as the negative control; Group 2: simultaneous light curing of the bonding agent and resin composite; Group 3: start of the chemical cure of the dual-cured bonding agent before light curing the resin composite; Group 4: curing the light-initiated bonding agent before insertion and light curing of the resin composite. When the bonding agent was light cured prior to inserting the resin composite (Group 4), the free surface depression was the greatest and the interfacial gap smallest among those in all groups. Therefore, if a good bond between dentin and resin composite can be established, the shrinkage flow will be directed toward a center located near the bonded interface rather than toward the incident light, thus reducing detrimental shrinkage stress.

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