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Two-thirds
Kinds of Two-thirds Terms modified by Two-thirds Selected AbstractsNa+/H+ exchangers and the regulation of volumeACTA PHYSIOLOGICA, Issue 1-2 2006R. T. Alexander Abstract The regulation of volume is fundamental to life. There exist numerous conditions that can produce perturbations of cell volume. The cell has developed mechanisms to directly counteract these perturbations so as to maintain its physiological volume. Directed influx of the major extracellular cation, sodium, serves to counteract a decreased cell volume through the subsequent osmotically coupled movement of water to the intracellular space. This process, termed regulatory volume increase is often mediated by the ubiquitous sodium/hydrogen ion exchanger, NHE1. Similarly, the maintenance of intravascular volume is essential for the maintenance of blood pressure and consequently the proper perfusion of vital organs. Numerous mechanisms exist to counterbalance alterations in intravascular volume, not the least of which is the renal absorption of sodium filtered at the glomerulus. Two-thirds of filtered sodium and water are absorbed in the renal proximal tubule, a mechanism that intimately involves the apical sodium/hydrogen ion exchanger, NHE3. This isoform is fundamental to the maintenance and regulation of intravascular volume and blood pressure. In this article, the effects of cell volume on the activity of these different isoforms, NHE1 and NHE3, will be described and the consequences of their activity on intracellular and intravascular volume will be explored. [source] Mechanisms of intercellular hypertonicity and isotonic fluid absorption in proximal tubules of mammalian kidneysACTA PHYSIOLOGICA, Issue 1 2002F. KIILArticle first published online: 30 APR 200 ABSTRACT The main purpose of this theoretical analysis (second of two articles) is to examine whether transjunctional diffusion of NaCl causes intercellular hypertonicity, which permits transcellular water transport across solute-impermeable lateral cell membranes until osmotic equilibration. In the S2 segment with tubular NaCl concentration 140 mM, the calculated apical intercellular NaCl concentration is c0 , 132 mM, which exceeds peritubular NaCl concentration by 12 mM or 22 mOsm kg,1. Variations in volume flow, junctional reflection coefficient (,NaCl=0.25,0.50), gap distance (g=6,8 Å), junctional depth (d=18,100 Å), intercellular diffusion coefficient (DLIS=500,1500 ,m2 s,1) and hypothetical active NaCl transport alter c0 only by a fraction of 1 mM. However, dilution and back-leakage of NaHCO3 lower apical intercellular hyperosmolality to ,18 mOsm kg,1. Water transport through solute-impermeable lateral cell membranes continues until intercellular and cellular osmolalities are equal. Transcellular and transjunctional volume flow are of similar magnitude (2 nL min,1 mm,1 tubule length) in the S2 segment. Thus, diffusion ensures isotonic absorption of NaCl. Two-thirds of NaHCO3 and other actively transported sodium salts are extruded into the last third of the exponentially widening intercellular space where the exposure time is only 0.9 s. Osmotic equilibration is dependent on aquaporins in the cell membranes. If permeability to water is low, transcellular water transport stops; tubular fluid becomes hypotonic; NaCl diffusion diminishes, but transjunctional water transport remains unaltered as long as transcellular transport of NaHCO3 and other solutes provides the osmotic force. [source] A study of endodontic treatment carried out in dental practice within the UKINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2001S. M. Jenkins Abstract Aim The purpose of this study was to gather both qualitative and quantitative information on the nature of root canal treatment carried out by a group of dentists working within the United Kingdom. Methodology A two-part questionnaire was posted to 720 dentists who graduated from the Dental School, Cardiff, Wales, UK. The first part requested basic information regarding age, year of qualification, field of practice, etc. The second part consisted of 15 questions on endodontic practice and root canal treatment. Results The response rate was 41.5%. Two hundred and ninety-nine questionnaires contained useful information. The majority of practitioners did not use rubber dam during root canal treatment. The vast majority (89%) exposed a radiograph with an instrument of known length in situ to gauge the ,working length', a small number relied upon tactile sensation. Most practitioners used local anaesthetic solution as an irrigant during instrumentation of the root canal. A wide variety of instruments were used for root canal treatment; a stepback technique was preferred by almost half the practitioners. Antiseptic solution was preferred as an interappointment dressing. More than half of the respondents used laterally condensed gutta-percha to obturate root canals in anterior teeth but only one-third used the same technique in posterior teeth. Less than half the respondents exposed a radiograph to check the fit of the master point prior to obturation. Two-thirds of practitioners used a zinc oxide based material as their root canal sealer. Three-quarters of the practitioners exposed a post obturation radiograph. Conclusions The results of this study suggest that although some dentists are using the techniques taught during their undergraduate careers, a large percentage now use techniques with no evidence of clinical effectiveness. [source] Oral squamous cell carcinoma and cultural oral risk habits in VietnamINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2010SL Priebe To cite this article: Int J Dent Hygiene,8, 2010; 159,168 DOI: 10.1111/j.1601-5037.2010.00461.x Priebe SL, Aleksej,nien, J, Zed C, Dharamsi S, Thinh DHQ, Hong NT, Cuc TTK, Thao NTP. Oral squamous cell carcinoma and cultural oral risk habits in Vietnam. Abstract: Objectives:, In South-Central Asia, 80% of head and neck cancers are found in the oral cavity and oropharynx. In Vietnam, oral cancer is often not being detected until people experience debilitating circumstances to normal oral function. The aims of the study were to explore the patterns of oral squamous cell carcinoma (OSCC) and its risk indicators, the structure of oral health care in Vietnam and trends in prevalence of cultural risk habits in southern Vietnamese patients. Materials and Methods:, A retrospective clinical study was performed from 1 July 2005 to 1 April 2006 at Ho Chi Minh City Oncology hospital in Vietnam. Of the 161 cases, 147 subjects were diagnosed with OSCC, including 100 male and 47 female adults aged 24,85 years. Data were collected by a structured interview and clinical examination. Results:, Over 40% of the women with OSCC reported chewing betel quid and the most prevalent risk habit in males was smoking (91.0%). Daily alcohol use was reported by 79.0% of males and 2.1% of females. Two-thirds of the cases of OSCC were diagnosed at the 2nd and 3rd stage of cancer. The more advanced stages of cancer were observed in males than in females. The prevalence of tobacco and alcohol use in males with OSCC was higher in this study than in the previous Vietnamese studies. Conclusion:, High frequency of risk habits in both genders was reported in OSCC Vietnamese patients. A trend of increased tobacco and alcohol use was observed in male OSCC patients. A lower prevalence of later staging in Vietnam was observed in this study than in earlier studies. [source] Do older adults presenting with memory complaints wish to be told if later diagnosed with Alzheimer's disease?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2006Paul Elson Abstract Background Many patients with Alzheimer's disease are not told their diagnosis. Studies have shown that relatives possess mixed views regarding whether or not patients should be told while elderly peers favour disclosure. Recent studies have shown that patients with diagnosed dementia also favour being told. The present study sought the views of patients prior to diagnosis. Method Participants were a consecutive sample of patients aged 65 and over suffering from memory complaints. They were asked what they considered to be causing their memory problems and whether or not they would want to know the cause. They were then specifically asked if they would want to know if diagnosed with Alzheimer's disease and what were their reasons for this. Results Two-thirds of patients were uncertain regarding the cause of their memory difficulties although the remainder did offer some valid explanations. Eighty-six per cent wanted to know the cause while 69% wanted to know if diagnosed with Alzheimer's disease and a variety of reasons were offered to support their preference. Conclusion The majority of older adults presenting to services with memory complaints had little understanding of the potential cause of their problems. Most were nevertheless keen to know the cause, even if this transpired to be Alzheimer's disease. The clinical implications of the findings are discussed and suggestions made for future research. Copyright © 2006 John Wiley & Sons, Ltd. [source] A sociodental approach to assessing dental needs of children: concept and modelsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2006S. GHERUNPONG Summary. Objectives., Traditional normative methods of assessing dental needs do not correspond to current concepts of ,health' and ,need'. Although there is dental research on quality of life, evidence-based practice, and oral behaviours, those concepts are rarely applied to dental needs estimation. Dental needs are usually calculated mainly from clinical data and are likely to be inaccurate. A structured comprehensive method for assessing dental needs is required. The objectives of this study are to develop and test a new sociodental system of needs assessment for overall dental needs of primary schoolchildren. Furthermore, normative and sociodental estimates of need are compared. Design., The study developed a theoretical framework and pathway algorithms of sociodental needs assessment and applied them to assessing overall dental needs. Normative dental needs were assessed using standard normative criteria. The child oral impacts on daily performances (Child-OIDP) was used to assess oral impacts, and a self-administered questionnaire was used to obtain information on demographic variables and oral behaviours. Data were analysed according to the developed algorithms. Setting., A cross-sectional survey in Suphanburi Province, Thailand. Participants., All 1126 children aged 11,12 years in a town. Main results., The sociodental approach was acceptable and not costly. In all, 54·4% had normative need under the dental needs model for life-threatening and progressive conditions, but only 16·6% had high propensity-related need; the remaining 37·8% would require dental health education or oral health promotion (DHE/OHP) or both and appropriately adjusted clinical interventions. Under the basic model of dental needs, 45·1% had normative need. Two-thirds of them (30·9%) had impact-related need and the remaining 14·2% did not have oral impacts and therefore should only receive dental health education. Only one-third of those with impact-related need had high propensity and were suitable for evidence-based conventional treatments; the remaining two-thirds should receive DHE/OHP and alternative clinical interventions. Conclusions., A sociodental system of dental needs assessment was developed and tested on school children. It decreased the estimates of conventionally assessed dental treatment needs and introduced a broader approach to care. [source] Elderly Patients' Preferences and Experiences with Providers in Managing Their Drug CostsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2007Chien-Wen Tseng MD OBJECTIVES: To determine whether elderly patients with high drug expenditures want and receive providers' help in managing drug costs. DESIGN: Cross-sectional survey. SETTING: A Medicare managed care plan (>400,000 members) in one state in 2002. PARTICIPANTS: One thousand one hundred six seniors (62% response rate) sampled so that half exceeded caps on their drug benefits the previous year, and all had total drug expenditures in the top quartile of members in their cap level. MEASUREMENTS: Participants' preferences and experiences with providers discussing costs and participation in choosing medications. RESULTS: Two-thirds reported difficulty paying for medications, and one-fourth decreased medication use because of cost. Most wanted providers to ask about medication affordability (81%), consider cost (86%), offer choices (70%), and to persuade them or decide for them which medication to use (88%), but few said providers asked about affordability (17%), usually or always discussed prices (19%), or offered choices (45%), although nearly all said providers chose their medications (93%). Sixty-two percent had asked providers for help with drug costs, although 34% who used less medication because of cost or had difficulty paying for medications had not asked for help. CONCLUSION: Providers should be aware that elderly patients want their help in managing drug costs but do not always receive it or ask for help when they need it. Providers could improve communication by initiating conversations about cost and by asking patients about preferences when prescribing. [source] Early Markers of Prolonged Hospital Stays in Older People: A Prospective, Multicenter Study of 908 Inpatients in French Acute HospitalsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2006Pierre-Olivier Lang MD OBJECTIVES: To identify early markers of prolonged hospital stays in older people in acute hospitals. DESIGN: A prospective, multicenter study. SETTING: Nine hospitals in France. PARTICIPANTS: One thousand three hundred six patients aged 75 and older were hospitalized through an emergency department (Sujet Âgé Fragile: Évaluation et suivi (SAFEs) ,Frail Elderly Subjects: Evaluation and follow-up). MEASUREMENTS: Data used in a logistic regression were obtained through a gerontological evaluation of inpatients, conducted in the first week of hospitalization. The center effect was considered in two models as a random and fixed effect. Two limits were used to define a prolonged hospital stay. The first was fixed at 30 days. The second was adjusted for Diagnosis Related Groups according to the French classification (f-DRG). RESULTS: Nine hundred eight of the 1,306 hospital stays that made up the cohort were analyzed. Two centers (n=298) were excluded because of a large volume of missing f-DRGs. Two-thirds of subjects in the cohort analyzed were women (64%), with a mean age of 84. One hundred thirty-eight stays (15%) lasted more than 30 days; 46 (5%) were prolonged beyond the f-DRG-adjusted limit. No sociodemographic variables seemed to influence the length of stay, regardless of the limit used. For the 30-day limit, only cognitive impairment (odds ratio (OR)=2.2, 95% confidence interval (CI)=1.2,4.0) was identified as a marker for prolongation. f-DRG adjustment revealed other clinical markers. Walking difficulties (OR=2.6, 95% CI=1.2,16.7), fall risk (OR=2.5, 95% CI=1.7,5.3), cognitive impairment (OR=7.1, 95% CI=2.3,49.9), and malnutrition risk (OR=2.5, 95% CI=1.7,19.6) were found to be early markers for prolonged stays, although dependence level and its evolution, estimated using the Katz activity of daily living (ADL) index, were not identified as risk factors. CONCLUSION: When the generally recognized parameters of frailty are taken into account, a set of simple items (walking difficulties, risk of fall, risk of malnutrition, and cognitive impairment) enables a predictive approach to the length of stay of elderly patients hospitalized under emergency circumstances. Katz ADLs were not among the early markers identified. [source] Protein profiling of organic stone matrix and urine from dogs with urolithiasisJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 5-6 2006S. Forterre Summary Two-thirds of the organic matrix in urinary stones consists of proteins. Their relationship to calculogenesis remains controversial with regard to their effect as inhibitors or promoters during stone formation. The purpose of the present study was to determine the differences in peptide and protein pattern between the urine of stone formers (n = 23) and control dogs (n = 12), as well as between organic matrix of different urinary stones (struvite n = 11, calcium oxalate n = 8, uric acid n = 4) using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. Specific differences in protein and peptide profiles were found in the organic matrix of different mineral compositions. Characteristic differences were also found in urinary peptide and protein pattern especially in molecular masses below 20 kDa between affected and healthy dogs. Based on the obtained molecular masses they were in some cases tentatively identified as proteins that are known to be involved in stone formation in humans. The study shows that in dogs, specific-urinary peptides and proteins might be associated with urolithiasis. It indicates the importance to further characterize those proteins for possible diagnostic purposes in prognosis and therapy. [source] Cigarette smoking and periodontal disease among 32-year-olds: a prospective study of a representative birth cohortJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007W. Murray Thomson Abstract Background: Smoking is recognized as the primary behavioural risk factor for periodontal attachment loss (AL), but confirmatory data from prospective cohort studies are scarce. Aim: To quantify the association between cigarette smoking patterns and AL by age 32. Methods: Periodontal examinations were conducted at ages 26 and 32 in a longstanding prospective study of a birth cohort born in Dunedin (New Zealand) in 1972/1973. Longitudinal categorization of smoking exposure was undertaken using data collected at ages 15, 18, 21, 26 and 32. Results: Complete data were available for 810 individuals of whom 48.9% had ever smoked (31.5% were current smokers). Compared with never-smokers, long-term smokers (and other age-32 smokers) had very high odds ratios (ORs of 7.1 and 5.7, respectively) for having 1 +sites with 5 +mm AL, and were more likely to be incident cases after age 26 (ORs of 5.2 and 3.2, respectively). Two-thirds of new cases after age 26 were attributable to smoking. There were no significant differences in periodontal health between never-smokers and those who had quit smoking after age 26. Conclusions: Current and long-term smoking in young adults is detrimental to periodontal health, but smoking cessation may be associated with a relatively rapid improvement in the periodontium. [source] Prevalence and risk factors of hepatic steatosis and its impact on liver injury in Chinese patients with chronic hepatitis B infectionJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2008Jun-ping Shi Abstract Background and Aims:, The clinical significance of hepatic steatosis in chronic hepatitis B infection (CHB) is unclear. The aims of this study were thus to investigate the prevalence and risk factors for hepatic steatosis in patients with CHB and its relationship with liver injury. Methods:, Consecutive patients with biopsy-proven CHB at Hangzhou Sixth People's Hospital between January 2005 and June 2007 were included. Patients co-infected with other viruses or suffering from liver disease of any other cause were excluded. Liver steatosis, necroinflammation and fibrosis were assessed by both Brunt and Scheuer classifications. Results:, A total of 1915 patients (1497 men) with a mean age of 31 ± 9.5 years were analyzed. Hepatic steatosis was present in 260 (14%) patients. The steatosis involved < 33% of hepatocytes in 90% of cases, and was more frequent among men than women (15% vs 8%, P < 0.001). Two-thirds (178 of 260) of patients with steatosis were hepatitis B e antigen (HBeAg)-positive, but there was no correlation with either serum HBeAg status or hepatitis B virus DNA titer. Degree of inflammation and fibrosis were more mild among those with steatosis than those without. Multivariate analysis showed that steatosis was independently associated with body mass index, serum triglyceride, apolipoprotein B, uric acid, and fasting blood glucose. However, fibrosis was only independently associated with age and inflammatory grade, and the latter associated with viral load and fibrosis stage. Conclusions:, Hepatic steatosis is common in CHB, it is associated with metabolic factors not viral ones, and does not appear to affect the severity of liver disease. [source] Nurses' Tobacco-Related Knowledge, Attitudes, and Practice in Four Major Cities in ChinaJOURNAL OF NURSING SCHOLARSHIP, Issue 1 2007Sophia S.C. Chan Purpose: To (a) identify Chinese nurses' tobacco-related knowledge, attitude, and practice (KAP), including perception of competency in smoking-cessation interventions; (b) identify barriers and facilitators to smoking cessation interventions to patients; and (c) assess the learning needs and smoking status of nurses. Design: A cross-sectional survey was conducted in four major cities (Beijing, Shanghai, Guangzhou, and Chongqing) in China from November to December 2003. Methods: 2,888 registered nurses working in hospitals affiliated with five university schools of nursing in these cities were invited to complete a questionnaire. An instrument used to assess tobacco-related KAP in Hong Kong was translated into Chinese and pilot tested to ensure reliability and validity. Findings: 2,179 questionnaires were returned and after exclusion of the grossly incomplete questionnaires, 1,690 were included in the present analysis. Only 2% of participants were current and 1% were former smokers; most had not received training for smoking-cessation interventions as part of their nursing education program. Two-thirds recognized smoking as a leading cause of preventable death and that smoking cessation was the most cost effective intervention, but only a third routinely assisted patients' quit attempts. Nurses who received training reported greater competence in providing smoking-cessation intervention, and more frequent practice of cessation interventions. Conclusions: Chinese nurses had some knowledge about the health effects of tobacco use, but seldom practiced smoking-cessation interventions. Those who had prior training had greater competence and more practice. Including tobacco control, especially smoking cessation, in nursing curricula in China has the potential to save millions of lives. [source] Youth Risk Behavior Surveillance , United States, 2001JOURNAL OF SCHOOL HEALTH, Issue 8 2002Jo Anne Grunbaum ABSTRACT: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. This report covers data during February-December 2001. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority healthrisk behaviors among youth and young adults; these behaviors contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 34 state surveys, and 18 local surveys conducted among students in grades 9,12 during February-December 2001. In the United States, approximately three-fourths of all deaths among persons aged 10,24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2001 national Youth Risk Behavior Survey demonstrated that numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 14.1% had rarely or never worn a seat belt during the 30 days preceding the survey; 30.7% had ridden with a driver who had been drinking alcohol; 17.4% had carried a weapon during the 30 days preceding the survey; 47.1% had drunk alcohol during the 30 days preceding the survey; 23.9% had used marijuana during the 30 days preceding the survey; and 8.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2001, 45.6% of high school students had ever had sexual intercourse; 42.1% of sexually active students had not used a condom at last sexual intercourse; and 23% had ever injected an illegal drug. Two-thirds of all deaths among persons aged ,25 years result from only two causes: cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2001, 28.5% of high school students had smoked cigarettes during the 30 days preceding the survey; 78.6% had not eaten ,5 servings per day of fruits and vegetables during the 7 days preceding the survey; 105% were overweight; and 67.8% did not attend physical education class daily. Health and education officials at national, state, and local levels are using these YRBSS data to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators. [source] Review article: the optimal medical management of acute severe ulcerative colitisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2010A. L. Hart Aliment Pharmacol Ther 2010; 32: 615,627 Summary Background, Management of acute severe ulcerative colitis (UC) is a clinical challenge, with a mortality rate of approximately 1,2%. The traditional management with intravenous corticosteroids has been modified by introduction of ciclosporin and more recently, infliximab. Aim, To provide a detailed and comprehensive review of the medical management of acute severe UC. Methods, PubMed and recent conference abstracts were searched for articles relating to treatment of acute severe UC. Results, Two-thirds of patients respond to intravenous steroids in the short term. In those who fail steroids, low-dose intravenous ciclosporin at 2 mg/kg/day is effective. Approximately 75% and 50% of patients treated with ciclosporin avoid colectomy in the short and long-terms, respectively. Long-term outcome of ciclosporin therapy is improved by introduction of azathioprine on discharge from hospital, together with oral ciclosporin as a bridging therapy. Controlled data show that infliximab is effective as rescue therapy for acute severe UC and the effect appears to be durable, although longer-term follow-up data are needed. Conclusions, Both ciclosporin and infliximab have demonstrated efficacy as rescue medical therapies in patients with acute severe UC, but surgery needs to be considered if there is failure to improve or clinical deterioration. [source] Patient perceptions of the burden of coeliac disease and its treatment in the UKALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2009J. K. H. WHITAKER Summary Background, Coeliac disease affects about 1% of the population, with the majority being undetected. As a consequence, there have been calls for the introduction of screening. Before screening is given serious consideration, it is important to assess how acceptable early diagnoses and treatment would be. Aim To assess patients' views as to the diagnosis and treatment of disease. Methods, Coeliac disease patients who had taken a gluten-free diet for at least 12 months (mean 60 months) were mailed a questionnaire. Coeliac patients presenting with typical classical symptoms were compared with those diagnosed without such symptoms. Results, Overall, 83% (147/177) of coeliac patients returned the questionnaires. Two-thirds (68%, 101/147) reported that their dietary restrictions reduced their enjoyment of food; 46% (68/147) believed their food cost them more and estimated this to be an extra £10 (,16) per week. Of those reporting greater cost, 31 (21%) said this was a problem for them. Half (54%, 80/147) reported doing things they enjoyed less often because of their diet, with the most common activity sacrificed being dining out (n = 65). In spite of these findings, 81% (119/147) reported being pleased that they were diagnosed, with 66% (59/89) of cases with classical symptoms wishing they had been diagnosed earlier compared with 45% (23/51) of those without such symptoms (,2 = 6.0, P < .05). In contrast, 27% (14/51) of coeliacs diagnosed without classical symptoms regretted being diagnosed with their condition compared with 10% (9/89) of those with classical symptoms (,2 = 7.1, P < .01). Conclusions, Even after several years of a gluten-free diet, many patients with coeliac disease regard it as a substantial burden, with a quarter of screen detected patients reporting regret at being diagnosed. Our findings question how acceptable screening for coeliac disease would be in people with minimal or no symptoms. [source] Antimitochondrial antibodies in patients with chronic hepatitis C virus infection: description of 18 cases and review of the literatureJOURNAL OF VIRAL HEPATITIS, Issue 6 2005M. Ramos-Casals Summary., To describe the clinical and immunologic patterns of disease expression of patients with chronic hepatitis C virus (HCV) infection and positive antimitochondrial antibodies (AMA). We investigated the presence of AMA in 237 consecutive HCV patients with extrahepatic manifestations from an International Registry. AMA were detected by indirect immunofluorescence in triple rat tissue (liver, stomach and kidney), aceton-fixed criosections and FITC-conjugated rabbit anti-human immunoglobulins. We found positive AMA in 18 (8%) out of 237 HCV patients. All patients were female with a mean age at protocol inclusion of 65.8 years (ranging from 37 to 87 years). Twelve (67%) patients fulfilled classification criteria for systemic autoimmune diseases (SAD), including Sjögren's syndrome (n = 7), systemic sclerosis (n = 3) and systemic lupus erythematosus (n = 2). Fourteen (78%) of the HCV-AMA patients presented at least one of the highly suggestive characteristics of primary biliary cirrhosis (PBC): 9 (50%) had a specific M2 pattern, 6 (33%) had more than twice normal levels of alkaline phosphatase, 5 (28%) had raised IgM levels and 4 (22%) a histological pattern compatible with PBC. Five (28%) patients developed neoplasia after detection of AMA. Seven (39%) patients died, due to neoplasia (n = 4), cirrhotic complications (n = 2) and hepatopulmonary syndrome (n = 1). We describe a subset of HCV patients with positive AMA who presented a broad spectrum of clinical features, including liver, autoimmune and neoplasic manifestations. Two-thirds of these patients presented an associated SAD, mainly Sjögren's syndrome or systemic sclerosis, together with a high frequency of multiple autoantibodies and an increased prevalence of cirrhosis and neoplasia. [source] Research on Direct versus Translated Writing: Students' Strategies and Their ResultsMODERN LANGUAGE JOURNAL, Issue 2 2001Andrew D. Cohen This study explored an alternative approach to short essay writing on language assessment tasks. Thirty-nine intermediate learners of French performed 2 essay writing tasks: writing directly in French as well as writing in the first language and then translating into French. Two-thirds of the students did better on the direct writing task across all rating scales; one-third, better on the translated task. While raters found no significant differences in the grammatical scales across the 2 types of writing, differences did emerge in the scales for expression, transitions, and clauses. Retrospective verbal report data from the students indicated that they were often thinking through English when writing in French, suggesting that the writing tasks were not necessarily distinct in nature. Since the study was intended to simulate writing situations that students encounter in typical classroom assessments, the findings suggest that direct writing in French as a target language may be the most effective choice for some learners when under time pressure. [source] Biology, clinical characteristics, and management of adrenocortical tumors in childrenPEDIATRIC BLOOD & CANCER, Issue 3 2005Carlos Rodriguez-Galindo MD Abstract Childhood adrenocortical tumors (ACT) are very aggressive endocrine neoplasms whose incidence is quite low. Little is known about their pathogenesis, clinical presentation, and optimal treatment. In recent years, however, new information has been derived from the International Pediatric Adrenocortical Tumor Registry (IPACTR), and new clues to its pathogenesis have emerged. To provide an overview of the available data that may apply to pediatric ACT, we reviewed the epidemiology, pathogenesis, and treatment of ACT in adults and in children. Germline TP53 mutation is almost always the predisposing factor in childhood ACT. A unique germline mutation (TP53,R337H) has been described in Southern Brazil, where the incidence of ACT is 10,15 times the general incidence. Childhood ACT typically present during the first 5 years of life and has female predominance. Hormone hyperproduction is almost universal, and most patients present with virilization. Two-thirds of patients have resectable tumors. Surgery is the definitive treatment for ACT, and a curative complete resection should always be attempted. Cisplatin-based chemotherapy with mitotane is indicated for unresectable or metastatic disease, although its impact on overall outcome is slight. In childhood ACT, age, tumor size, and tumor resectability are the most important prognostic indicators. Outcome is stage-dependent; patients with small, resectable tumors have survival rates in excess of 80%, whereas the outcome for patients with unresectable disease is dismal. Patients with large, resectable tumors have an intermediate outcome. Childhood ACT are rare, but their unique epidemiology appear to implicate novel oncogenic pathways that are unique to the pediatric population. Multi-institutional and prospective studies are necessary to further our understanding of the pathogenesis and to improve outcomes. © 2005 Wiley-Liss, Inc. [source] Contribution of non-agricultural pesticides to pesticide load in surface water,PEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 6 2004Christian Skark Abstract Two small creeks, tributaries of the River Ruhr near Schwerte, Federal Republic of Germany, were investigated to reveal the regional agricultural and non-agricultural sources of pesticide inputs and the main pathways to surface water. In addition, the receiving water was monitored for pesticides. The watersheds are situated at the northern margin of the Rhenian Schiefergebirge, a highland landscape in North-Rhine,Westphalia. Solid carboniferous shale is covered by a shallow layer of quaternary unconsolidated rock (porous aquifer thickness <5 m). Occurrence of herbicides such as chlortoluron, isoproturon and terbuthylazine in surface water could be due to their broad agricultural application in regional dominant crops, such as barley, wheat and maize. Occurrence of diuron and glyphosate results from their use in residential settlements and industrial areas as well as from weed control on railway tracks. Atrazine concentrations up to 0.8 µg litre,1 indicated recent use of this herbicide, which has been banned since 1991, and was also the result of non-agricultural applications. Pathways for pesticide input to the receiving waters were related to both surface run-off and underground passage. Two-thirds of the observed diuron load in the surface water resulted from an input by run-off. This was expected as a result of total herbicide application targets to sealed surfaces infringing current regulations and recommendations. Diuron load varied between 0.6 and 1.2% of the estimated amount applied annually in the investigated catchments. Non-agricultural pesticide use contributed more than two-thirds of the whole observed pesticide load in the tributaries and at least one-third in the River Ruhr. Copyright © 2004 Society of Chemical Industry [source] Teen workers' exposures to occupational hazards and use of personal protective equipmentAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2008Carol W. Runyan MPH Abstract Background Prior research indicates that working adolescents seek care for the toxic effects of on-the-job chemical and environmental hazard exposures. Methods This cross-sectional survey of a nationally representative sample of 866 adolescent workers in the retail and service sector examines their exposures, personal protective equipment (PPE) use, and training. Results Two-thirds of respondents were exposed to continuous, very loud noise, 55% to thermal hazards and 54% to chemical hazards. Few teens reported using any PPE, though those who had been trained reported somewhat higher usage. Conclusions Teens working in the retail and service sectors experience a variety of chemical, thermal, biologic and noise exposures. Efforts to eradicate such exposures need to be complemented by increased provision of PPE and appropriate training in their use by employers. Am. J. Ind. Med. 51:735,740, 2008. Published 2008 Wiley-Liss, Inc. [source] Latest news and product developmentsPRESCRIBER, Issue 7 2007Article first published online: 11 JUL 200 Poor asthma control with off-licence prescribing Children who are prescribed off-licence medications are more likely to have poor asthma control, according to an analysis from Dundee (Br J Gen Practice 2007;57:220-2). The review of 17 163 consultations identified 1050 (6.1 per cent) who received a prescription for an unlicensed use (defined as not licensed for children or the particular age group, or dose not licensed). High doses (4.5 per cent) were more frequent than unlicensed indications (1.9 per cent). Children who received off-label prescriptions reported statistically significantly more symptoms in the day or night, symptoms during activity, and increased use of daily short-acting beta2-agonists. The authors note that off-label prescribing appears to be increasing. Atkins diet most effective over one year? The ultra low-carbohydrate, high-protein Atkins diet achieved greater weight loss than other popular diets in overweight women over one year, say US investigators (J Am Med Assoc 2007;297:969-77). The study compared the Atkins diet with three diets designed as low- or very high-carbohydrate, or based on USA nutritional guidance, in 311 women with body mass index 27-40. After one year, mean weight loss was 4.7kg with the Atkins diet , significantly greater than with the low- carbohydrate diet (1.6kg) but not compared with very high-carbohydrate (2.2kg) or the nutrition-based diet (2.6kg). Metabolic endpoints were comparable or more favourable in women using the Atkins diet. Androgen therapy linked to gum disease The majority of men treated with androgen deprivation therapy for prostate cancer are more likely to have periodontal disease (J Urol 2007;177:921-4). After controlling for risk factors, the prevalence of periodontal disease was 80.5 per cent among treated men compared with 3.7 per cent in matched controls not receiving treatment. There was no difference in bone mineral density between the groups but plaque scores were significantly higher among treated men. Food Commission rebuts MHRA on additives An independent watchdog has not accepted the MHRA's justification for including certain additives in medicines for children. The Food Commission (www.foodcomm.org.uk) found that most medicines for children contained additives, some of which , including azo dyes and benzoates , are not permitted in food. The Commission called on the pharmaceutical industry to stop using ,questionable additives'. The MHRA stated that the licensing process takes into account the likely exposure to excipients that are considered essential to make medicines palatable to children. Colouring helps children to identify the correct medicine, and preservatives ensure a reasonable shelf-life. A list of additives is included in the product's summary of product characteristics and patient information leaflet. In response, the Commission states: , , it is quite possible to flavour medicines with natural oils or extracts, and natural colourings such as beetroot and beta-carotene can be used instead of azo dyes. If parents were advised to give these medicinal products at mealtimes the manufacturers could also add a little sugar to sweeten their products, rather than relying on artificial sweeteners.' All triptans the same? There is no economic case for choosing one triptan over another and no evidence for preferring a particular triptan for adults, a systematic review has concluded. The Canadian Agency for Drugs and Technologies in Health (www.cadth.ca) found that published trials had compared most triptans with sumatriptan but not with one another, and most economic evaluations were flawed. New drug for HIV Janssen-Cilag has introduced darunavir (Prezista), a new protease inhibitor for the treatment of HIV infection. Licensed for highly pre- treated patients in whom more than one other pro- tease inhibitor regimen has failed, darunavir must be co-administered with ritonavir (Norvir). A month's treatment at the recommended dose of 600mg twice daily costs £446.70. Variation in liquid captopril for children The NHS uses a wide range of liquid formulations of captopril to treat children with heart failure , with no assurance of their bioequivalence (Arch Dis Child 2007; published online 15 March. doi: 10.1136/adc.2006.109389). Specialists in Leicester surveyed 13 tertiary paediatric cardiac centres and 13 hospitals that referred patients to them. Only three tertiary centres supplied the same liquid for-mulation of captopril as their referring hospitals. Four hospitals supplied tablets for crushing and dissolving in water; the other hospitals and centres used a total of nine different formulations. The authors say the formulations had widely varying shelf-lives, determined empirically in all but one case, and were used interchangeably despite a lack of quality control data to establish their bioequivalence. QOF CVD targets not good enough for GPs Two-thirds of GPs want Quality Outcome Framework (QOF) targets for cardiovascular disease brought into line with those of the Joint British Societies latest guidance (JBS2), according to a survey by doctor.net.uk. The survey of 1000 GPs showed that 88 per cent were aware of the JBS2 guidelines and most were already implementing the targets for lipids, blood pressure and blood glucose in some form; however, only 55 per cent were implementing the JBS2 obesity target and 14 per cent were implementing screening for the over-40s. The JBS2 target for lipids in at-risk patients is <4mmol per litre total cholesterol and <2 mmol per litre LDL-cholesterol, compared with <5 and <3mmol per litre respectively in QOF and the NSF. The survey was commissioned by Merck Sharp & Dohme and Schering- Plough. Fracture warning Following warnings in the US that rosiglitazone (Avandia) is associated with an increased risk of fractures in women, Takeda has advised prescribers that pioglitazone (Actos) carries a similar risk. An analysis of the company's clinical trials database has revealed an excess risk of fractures of bones below the elbow and knee. The incidence was similar to the excess risk associated with rosiglitazone and also confined to women. Scottish approvals The Scottish Medicines Consortium (www.scottish medicines.org.uk) has approved for use within NHS Scotland the sublingual tablet formulation buprenorphine/naloxone (Suboxone) for the treatment of opioid dependence. It has also approved the combined formulation of valsartan and amlodipine (Exforge) and the restricted use of the If inhibitor ivabradine (Procoralan). [source] Opioid Deaths in Rural Virginia: A Description of the High Prevalence of Accidental Fatalities Involving Prescribed MedicationsTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2009Martha J. Wunsch MD In rural Virginia, drug overdose deaths increased 300% from 1997 to 2003. Polydrug deaths predominate (57.9%) in this review of 893 medical examiner cases. Prescription opioids (74.0%), antidepressants (49.0%), and benzodiazepines (39.3%) were more prevalent than illicit drugs. Two-thirds of decedents were 35,54 years old; 37% were female. When compared to western Virginia metropolitan cases, polydrug abuse was more common, specific medication combinations were found, the death rate per population was higher, and fewer illicit drugs were detected. These rural prescription overdose deaths differ from urban illicit drug deaths, suggesting the need for different strategies in prevention, treatment, and intervention by clinicians and policymakers. [source] Macaque,human interactions and the societal perceptions of macaques in SingaporeAMERICAN JOURNAL OF PRIMATOLOGY, Issue 10 2009John Chih Mun Sha Abstract Humans and long-tailed macaques (Macaca fascicularis) interface in several locations in Singapore. We investigated six of these interface zones to assess the level of conflict between the two species. We observed macaque-to-human interactions and distributed questionnaires to residents and visitors of nature reserves. We observed an average of two macaque-to-human interactions per hour at the sites, which included affiliative or submissive behaviors (46.9%), aggression (19.1%), taking food and other items (18.5%) searching bins, cars, and houses (13.4%), and nonaggressive contact (2.1%). Two-thirds of interactions occurred when a human was carrying food or food cues, and one-quarter occurred when a human provoked macaques. Only 8% of interactions occurred without a clear human-triggered context. Our interview showed one-third of respondents experienced nuisance problems from macaques. They had items taken from them (50.5%) and received threats (31.9%). Residents reported more nuisance problems than visitors, and their perceptions toward macaques differed. Residents were more aware of the consequences of food provisioning and that there were regulations against feeding. Residents fed macaques less and held more negative sentiments toward macaques. Nearly half of the interviewed people held neutral attitudes toward macaques and only 26.2% of respondents thought conflict with macaques warranted urgent action. Nearly two-thirds of the respondents supported education programs to ameliorate human,macaque conflict, and less than 15% supported removing or eradicating macaques. 87.6% felt that it is importance to conserve and protect macaques. Our results show that human,macaque conflict exists in Singapore, but that it may not be severe. Human behavior is largely responsible for macaque-to-human interactions, and thus could be lessened with management of human behavior in interface zones (i.e. restrict food carrying and provocation). Moreover, our interviews shows people living in Singapore value macaques, do not wish them entirely removed, prefer education-based solutions, and consider conservation and protection of them important. Am. J. Primatol. 71:825,839, 2009. © 2009 Wiley-Liss, Inc. [source] Sustained granule cell activity disinhibits juvenile mouse cerebellar stellate cells through presynaptic mechanismsTHE JOURNAL OF PHYSIOLOGY, Issue 2 2008Simone Astori GABA release from cerebellar molecular layer interneurons can be modulated by presynaptic glutamate and/or GABAB receptors upon perfusing the respective agonists. However, it is unclear how release and potential spillover of endogenous transmitter lead to activation of presynaptic receptors. High frequency firing of granule cells, as observed in vivo upon sensory stimulation, could lead to glutamate and/or GABA spillover. Here, we established sustained glutamatergic activity in the granule cell layer of acute mouse cerebellar slices and performed 190 paired recordings from connected stellate cells. Train stimulation at 50 Hz reduced by about 30% the peak amplitude of IPSCs evoked by brief depolarization of the presynaptic cell in 2-week-old mice. A presynaptic mechanism was indicated by changes in failure rate, paired-pulse ratio and coefficient of variation of evoked IPSCs. Furthermore, two-photon Ca2+ imaging in identified Ca2+ hot spots of stellate cell axons confirmed reduced presynaptic Ca2+ influx after train stimulation within the granular layer. Pharmacological experiments indicated that glutamate released from parallel fibres activated AMPARs in stellate cells, evoking GABA release from surrounding cells. Consequential GABA spillover activated presynaptic GABABRs, which reduced the amplitude of eIPSCs. Two-thirds of the total disinhibitory effect were mediated by GABABRs, one-third being attributable to presynaptic AMPARs. This estimation was confirmed by the observation that bath applied baclofen induced a more pronounced reduction of evoked IPSCs than kainate. Granule cell-mediated disinhibition persisted at near-physiological temperature but was strongly diminished in 3-week-old mice. At this age, GABA release probability was not reduced and presynaptic GABABRs were still detectable, but GABA uptake appeared to be advanced, attenuating GABA spillover. Thus, sustained granule cell activity modulates stellate cell-to-stellate cell synapses, involving transmitter spillover during a developmentally restricted period. [source] Glutamate receptor-mediated ischemic injury of premyelinated central axons,ANNALS OF NEUROLOGY, Issue 5 2009James J.P. Alix Objective Ischemic injury of axons is a feature of periventricular leukomalacia, a pathological correlate of cerebral palsy. Recent evidence suggests that axons are damaged before they receive the first layer of compact myelin. Here we examine the cellular mechanisms underlying ischemic-type injury of premyelinated central axons. Methods Two-thirds of axons in the postnatal day 10 (P10) rat optic nerve are small premyelinated axons (<0.4,m in diameter), and one-third have undergone radial expansion in preparation for glial contact and the onset of myelination. Compound action potential recording and quantitative electron microscopy were used to examine the effect of modeled ischemia (oxygen-glucose deprivation) upon these two axon populations. Glutamate receptor (GluR) expression was investigated using polymerase chain reaction (PCR) and immunostaining approaches at the confocal light and ultrastructural levels. Results Oxygen-glucose deprivation produced action potential failure and focal breakdown of the axolemma of small premyelinated axons at sites of contact with oligodendrocyte processes, which were also disrupted. The resulting axon loss was Ca2+ -dependent, Na+ - and Cl, -independent, and required activation of N -methyl-D-aspartic acid (NMDA) and non-NMDA GluRs. NMDA receptor expression was localized to oligodendrocyte processes at sites of contact with premyelinated axons, in addition to expression within compact myelin. No periaxonal NMDA receptor expression was observed on oligodendrocyte processes ensheathing large premyelinated axons and no protective effect of GluR block was observed in these axons. Interpretation NMDA receptor-mediated injury to oligodendrocyte processes navigating along small premyelinated axons precedes damage to the underlying axon, a phenomena that is lost following radial expansion and subsequent oligodendrocyte ensheathment. Ann Neurol 2009;66:682,693 [source] What's behind crashing memories?APPLIED COGNITIVE PSYCHOLOGY, Issue 9 2009Plausibility, belief, memory in reports of having seen non-existent images The present study investigated the precise nature of crashing memory reports: Are they truly memories or are they based on beliefs? We asked 88 individuals whether they had seen non-existent footage of the Pim Fortuyn assassination and conducted thorough post-experimental interviews. Two-thirds of our participants falsely reported having seen the footage, while less than 10% also reported details that they could not have seen. Moreover, plausibility ratings of having seen the images were higher than false belief ratings, which in turn were higher than false memory ratings. After having been fully debriefed, 81% of the participants who reported crashing memories attributed their false report to their lack of a full understanding of the critical question. Another 10% of this subsample stated that they truly remembered the images (i.e. false memories). Thus, only a small subset of crashing memory reports seems to be induced by false beliefs and/or false memories. Copyright © 2009 John Wiley & Sons, Ltd. [source] Use of ,dual protection' and other combinations of contraceptive methods in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2007Nick Parr Abstract Objective: To examine the demographic profiles of contraceptive users in Australia, paying particular attention to the use of condoms with other methods. Method: Data from a specific section on contraceptive use in the 2005 Wave 5 of the nationwide, longitudinal Household Income and Labour Dynamics in Australia (HILDA) were analysed. The section was restricted to 2,221 women aged 18-44; women were excluded if they were pregnant or subfecund, or if they or their partner had been sterilised. Results: Two-thirds of respondents were using contraception, including more than 15% who indicated use of more than one method. The contraceptive pill (39%) was the most widely used method, followed by the condom (28%). Women using sex-related methods were more likely to be using more than one method. More than one-quarter of pill users (28%) were using condoms as well. The combination of pill and condom was significantly associated with age, being a student, and country of birth. Less than 3% of women reported using rhythm methods and of these two-thirds were using another method. Conclusions: Dual protection provided by the combination of the condom with the pill or other methods has become an important factor in the prevention of sexually transmitted infections and unwanted pregnancies, but continuing education on dual protection and better access to treatment is still necessary for both men and women, particularly among at-risk groups. [source] Glove perforations during open surgery for gynaecological malignanciesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2008AP Manjunath Objective, To audit glove perforations at laparotomies for gynaecological cancers. Setting, Gynaecological oncology unit, cancer centre, London. Design, Prospective audit. Sample, Twenty-nine laparotomies for gynaecological cancers over 3 months. Methods, Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations. Main outcome measure, Glove perforation rate. Results, Perforations were found in gloves from 27/29 (93%) laparotomies. The perforation rate was 61/462 (13%) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63% for primary surgeons, 54.5% for first assistant, 4.7% for second assistant and 40.5% for scrub nurses. Clinical fellows were at highest risk of injury (94%). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54% of cases. In 50% of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95% CI 1.9,16.7). The indicator glove system failed to identify holes in 44% of cases. Conclusions, Glove perforations were found in most (93%) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system. [source] Violence against pregnant women: prevalence and characteristics.BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2005A population-based study in Nicaragua Objective This study aims to estimate the prevalence and characteristics of partner abuse during pregnancy as well as to investigate associated social factors in León, Nicaragua. Design Cross-sectional community-based study. Setting All pregnant women from 50 randomly selected geographical clusters out of 208 in the municipality of León, Nicaragua. Sample A total of 478 pregnant women were included; only one woman refused to participate. Method The domestic violence questionnaire from the WHO-co-ordinated Multi-Country Study on Women's Health and Life Events was used with each participant being interviewed twice during pregnancy. Main outcome measures Prevalence and characteristics of partner violence during pregnancy. Results The prevalence of emotional, physical and sexual abuse during pregnancy was 32.4%, 13.4% and 6.7%, respectively. Seventeen percent reported experience of all three forms of violence. Two-thirds of the victims reported repeated abuse. Half of the abused women had experienced punches and kicks directed towards the abdomen and 93% had been injured. Most women had not sought health care in relation to the abuse, but those who did were usually hospitalised. Factors such as women's age below 20 years, poor access to social resources and high levels of emotional distress were independently associated with violence during pregnancy. Conclusion Violence against pregnant women in Nicaragua is common and often repeated. Although these women have poor access to social resources and high levels of emotional distress, they are rarely assisted by the health services. Innovative strategies are needed to provide support and counselling. [source] Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health StudyCHILD & FAMILY SOCIAL WORK, Issue 1 2010Lovie J. Jackson ABSTRACT This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14,17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is ,creator' and God is ,love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to ,bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care. [source] | ||||||||||||||||||||||||||||||||||||||||||||||