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Medical Sciences53%
Life Sciences25%
Humanities and Social Sciences5%
Earth and Environmental Science3%
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Chemistry2%
7 Other Domains9%
Distribution within Medical Sciences
Anesthesia & Pain Management3%
65 Other Subdomains85%

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    • Selected Abstracts

    A survey of tobacco dependence treatment services in 36 countries

    ADDICTION, Issue 2 2009
    Martin Raw
    ABSTRACT Aims This paper reports the results of a survey of national tobacco dependence treatment services in 36 countries. The objective was to describe the services and discuss the results in the context of Article 14 of the Framework Convention on Tobacco Control, which asks countries to promote adequate treatment for tobacco dependence. Design, setting and participants A questionnaire on tobacco dependence treatment services was e-mailed to a convenience sample of contacts in 2007. Completed questionnaires were received from contacts in 36 countries. Measurements The survey instrument was a 10-item questionnaire asking about treatment policy and practice, including medications. Findings According to our informants, fewer than half the countries in our survey had an official written policy on (44%), or a government official responsible for (49%), treatment. Only 19% had a specialized national treatment system and only 24% said help was easily available in general practice. Most countries (94%) allowed the sale of nicotine replacement therapy (NRT), bupropion (75%) and varenicline (69%) but only 40% permitted NRT on ,general sale'. Very few countries responding to the question fully reimbursed any of the medications. Fewer than half (45%) fully reimbursed brief advice and only 29% fully reimbursed intensive specialist support. Only 31% of countries said that their official treatment policy included the mandatory recording of patients' smoking status in medical notes. Conclusion Taken together, our findings show that few countries have well-developed tobacco dependence treatment services and that, at a national level, treatment is not yet a priority in most countries. [source]

    Freshwater crayfish farming technology in the 1990s: a European and global perspective

    FISH AND FISHERIES, Issue 4 2000
    H.E.G. Ackefors
    This paper aims to describe the state of crayfish farming technology in the USA, Australia and Europe, and to discuss some of the prerequisites for this industry. Data from Europe are partly based on replies from a questionnaire sent out to scientists in all European countries. For other parts of the world, the crayfish literature has been reviewed and data from the August 2000 meeting of the International Association of Astacology are also included. Issues addressed in this review are cultivated species, production and productivity figures, production technique with regard to enclosures, reproduction and feed items, disease problems, predators, pond vegetation and water quality. Fewer than a dozen crayfish species are cultivated. The most attractive ones for culture and stocking in natural waters have been transferred to more than one continent. Pond rearing techniques predominate in all countries, and the technology required to achieve the spawning and rearing of juveniles is relatively simple. Pieces of fish, carrots and potatoes are frequent supplementary feed items; plants, cereals, pieces of meat, zooplankton and pellets are also common. Diseases are not usually a major concern, except in Europe where the American plague fungus, Aphanomyces astaci, has eradicated many European crayfish populations. Predators identified as common include insects and amphibians, as well as fishes, birds and mammals. Many water macrophytes are common in crayfish farms. These may either serve a useful function or cause problems for the crayfish farmer. Water temperature is the crucial factor for crayfish production. Water parameters such as pH and certain inorganic ion concentrations may also be of concern. Acidic waters that occur in some areas are generally detrimental to crayfish. The total yield from crayfish production from farming and fishery is in the order of 120 000,150 000 tonnes, more than four times the quantity given by FAO statistics. The largest crayfish producer is the Peoples' Republic of China, followed by the USA (70 000 and 50 000 tonnes in 1999, respectively). Of the quantity produced in the USA in 1999, about 35 000 tonnes was farmed. The yield in Europe was about 4500 tonnes in 1994, and of this quantity only 160 tonnes came from aquaculture. There are no official statistics for crayfish fishery production in Australia, but about 400 tonnes came from aquaculture in 1999. [source]

    Emergence of larval yellow perch, Perca flavescens, in South Dakota lakes: potential implications for recruitment

    FISHERIES MANAGEMENT & ECOLOGY, Issue 4 2008
    D. A. ISERMANN
    Abstract, Temporal patterns in length frequency distributions and hatch dates were described for larval yellow perch, Perca flavescens (Mitchill), captured in surface ichthyoplankton trawls from late April to mid-June 2000 to 2002 in six South Dakota, USA lakes. Fewer than 15 larval yellow perch were collected in four of six lakes during 2002, suggesting that in some cases factors prior to, during or immediately after hatching likely play a critical role in the perch recruitment process. When larval yellow perch were encountered in larger numbers, temporal trends in total length (TL) frequencies indicated that only a single cohort was produced annually in each lake. Most yellow perch in these lakes hatched between 29 April and 17 May, and most hatching occurred during 5,11 days each year. Larval TL was not related to hatch date. The apparent prevalence of relatively short hatch periods in these yellow perch populations probably increases the risk of catastrophic losses resulting from periods of poor environmental conditions. [source]

    Endemic species and ecosystem sensitivity to climate change in Namibia

    GLOBAL CHANGE BIOLOGY, Issue 5 2006
    WILFRIED THUILLER
    Abstract We present a first assessment of the potential impacts of anthropogenic climate change on the endemic flora of Namibia, and on its vegetation structure and function, for a projected climate in ,2050 and ,2080. We used both niche-based models (NBM) to evaluate the sensitivity of 159 endemic species to climate change (of an original 1020 plant species modeled) and a dynamic global vegetation model (DGVM) to assess the impacts of climate change on vegetation structure and ecosystem functioning. Endemic species modeled by NBM are moderately sensitive to projected climate change. Fewer than 5% are predicted to experience complete range loss by 2080, although more than 47% of the species are expected to be vulnerable (range reduction >30%) by 2080 if they are assumed unable to migrate. Disaggregation of results by life-form showed distinct patterns. Endemic species of perennial herb, geophyte and tree life-formsare predicted to be negatively impacted in Namibia, whereas annual herb and succulent endemic species remain relatively stable by 2050 and 2080. Endemic annual herb species are even predicted to extend their range north-eastward into the tree and shrub savanna with migration, and tolerance of novel substrates. The current protected area network is predicted to meet its mandate by protecting most of the current endemicity in Namibia into the future. Vegetation simulated by DGVM is projected to experience a reduction in cover, net primary productivity and leaf area index throughout much of the country by 2050, with important implications for the faunal component of Namibia's ecosystems, and the agricultural sector. The plant functional type (PFT) composition of the major biomes may be substantially affected by climate change and rising atmospheric CO2, currently widespread deciduous broad leaved trees and C4 PFTs decline, with the C4 PFT particularly negatively affected by rising atmospheric CO2 impacts by ,2080 and deciduous broad leaved trees more likely directly impacted by drying and warming. The C3 PFT may increase in prominence in the northwestern quadrant of the country by ,2080 as CO2 concentrations increase. These results suggest that substantial changes in species diversity, vegetation structure and ecosystem functioning can be expected in Namibia with anticipated climate change, although endemic plant richness may persist in the topographically diverse central escarpment region. [source]

    Long-term utility of measuring adherence by self-report compared with pharmacy record in a routine clinic setting

    HIV MEDICINE, Issue 5 2005
    CK Fairley
    Objectives To compare long-term adherence to antiretroviral therapy in an HIV service, as measured by self-report and by pharmacy records. To determine the level of adherence by each measure required to suppress viral load in a majority of patients. Methods The percentage of prescribed doses taken was calculated from (a) the number of missed doses in the previous 28 days reported by patients in a questionnaire at each clinic visit, and (b) pharmacy dispensing records. These were compared with each other and with HIV viral load data. Results Mean adherence was 96.2% by pharmacy record over 44 months and 98.6% by self-report over 25 months. The two methods correlated with each other (P<0.001) and the proportion of patients with viral load <400 HIV-1 RNA copies/mL increased with adherence as measured by self-report (P=0.001) and pharmacy record (P=0.004). Fewer than 60% of patients always had viral loads <400 copies/mL if adherence fell below 95% (pharmacy record) or 97% (self-report). Adherence was higher for once-daily than for twice-daily therapy (by pharmacy record: 97.2% vs. 96.0%; P<0.001). Adherence by both measures increased over time. Conclusions Self-reported antiretroviral adherence correlates with pharmacy dispensing records and predicts suppression of viral load at levels ,97%. It is practical to adopt this into routine HIV clinical care. [source]

    Invertebrate diet of the Houbara Bustard Chlamydotis [undulata] macqueenii in Abu Dhabi from calibrated faecal analysis

    IBIS, Issue 3 2000
    BARBARA J. TIGAR
    The ecology of the Houbara Bustard Chlamydotis [undulata] macqueenii is poorly known and populations are declining due to hunting and habitat loss. As wintering populations in Abu Dhabi may be limited by habitat and food, we studied the diet using calibrated faecal analysis. Prey were categorized into 16 groups and fed to captive birds under controlled conditions. We calculated the recovery rates of prey following digestion and identified consistent fragments for each group. Wild Houbara Bustard faeces were collected and examined for key fragments, and initial prey intake was calibrated. Plant remains were identified and their contribution was estimated. Fewer than 28% faeces contained >50% plant material by volume and only 12% contained 95% or more. Numerically, the most important prey were: ants (64%), large nocturnal tenebrionids (14.5%), small climbing tenebrionids (12%) and diurnal tenebrionids. However, the Tenebrionidae contributed 97% of the animal biomass. The relative proportions of prey in the diet were similar to relative abundance as assessed by pitfall trapping. Estimates of the energetic value of the prey suggested that on average Houbara Bustards must consume around 670 desert invertebrates/day to meet energy needs. The effort required to catch these prey may vary at least ten-fold seasonally. On average plants could provide a further 6.4,14% energy but more work is needed on this. Whether Houbara Bustards wintering in Abu Dhabi are prey-limited depends on prey densities and renewal rates which remain unknown. [source]

    Longitudinal study of periapical and endodontic status in a Danish population

    INTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2006
    L.-L. Kirkevang
    Abstract Aim, To describe and discuss changes in periapical and endodontic status in a general Danish population. Methodology, In 1997, 616 randomly selected individuals had a full-mouth radiographic survey taken. In 2003, 77% of the participants attended for a new full-mouth radiographic examination. Information on endodontic treatment and periapical status was obtained. The periapical index (PAI) was used to assess apical periodontitis (AP). Results, More participants had root filling(s) and AP in 2003 than in 1997. More teeth had AP and/or root fillings in 2003. Fewer of the root-filled teeth (RFT) had AP in 2003. Less than 3% of the teeth without root fillings (NRFT) that in 1997 had no AP, developed AP and/or received a root filling. Of the NRFT which in 1997 had AP, more than 35% still had AP and no root filling in 2003. Approximately, 30% of the NRFT with AP in 1997 received a root filling. Of the teeth that received a root filling, 40% had healed, whereas 60% had not. Approximately, 25% of the NRFT that in 1997 had AP had been extracted. In 1997 there were 618 RFT, 314 of the RFT had no AP in 1997. Almost 20% of the RFT that in 1997 were periapically sound, developed AP. Of the 304 RFT with AP in 1997, approximately 30% had healed, in 60% AP persisted, and 10% were extracted. Conclusions, The present study indicates that caution must be exercised when statements on the outcome of root canal treatment are made based on the cross-sectional studies. [source]

    The ABC of New Zealand's Ten Year Vision for Pharmacists: awareness, barriers and consultation

    INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2009
    Shane Scahill
    Abstract Objectives This study aimed to determine New Zealand pharmacists' awareness of, recall of consultation about, and potential barriers to the implementation of the Focus on the Future: Ten Year Vision for Pharmacists in New Zealand: 2004,2014 document. Method A national postal survey was carried out in New Zealand of practising pharmacists registered with the Pharmacy Council of New Zealand (n = 1892). The survey was conducted between September and December 2006. Key findings The response rate was 51.8% (n = 980 usable surveys). Approximately three-quarters (73.4%) reported being aware of the 10-year vision document and 40.9% recall being consulted. Fewer than one-third (29.8%) had read the document prior to completing the survey. Thirty-two variables describing potential barriers to implementing the 10-year vision were reduced, through factor analysis, to seven factors with significant eigenvalues (>1.0). The factors describe the underlying themes of barriers identified in the survey, including pharmacist humanistic, integrated systems of care and teamwork, funder stakeholder relationships and remuneration, lack of appreciation of knowledge and skills, lack of research support, current expertise and continuing professional development, and lack of voice. The majority of barrier variables within the seven factors were rated as extremely or quite important. Conclusions There was a high level of awareness and moderate level of recall of consultation on the document among respondents. Although 40% recall being consulted on the document, fewer than one-third reported having read the document prior to completing our survey. Pharmacists highlighted a significant number of potential barriers to the implementation of the 10-year vision. If the pharmacy profession in New Zealand is to move forward towards the state described in the 10-year vision document then these potential barriers need to be better understood and addressed. [source]

    Anticipatory grieving among parents living with a child with cancer

    JOURNAL OF ADVANCED NURSING, Issue 9 2010
    Ekhlas Al-Gamal
    al-gamal e. & long t. (2010) Anticipatory grieving among parents living with a child with cancer. Journal of Advanced Nursing,66(9), 1980,1990. Abstract Aim., This paper is a report of a comparative study of anticipatory grief of parents of children newly diagnosed with cancer and those whose children were diagnosed 6,12 months earlier. Background., Public perceptions of cancer as a fatal illness persist despite improved prognosis for children. Parents may experience feelings of despair, hopelessness, and worthlessness , the most common psychological expressions of anticipatory grief. With a focus on developing more effective therapeutic intervention, healthcare professionals have developed greater interest in the concept of anticipatory grief. Method., One hundred and forty parents, divided between ,newly diagnosed' and ,6,12 months after diagnosis' groups, were recruited in 2006 from two hospitals representative of the healthcare sector in Jordan. Structured interviews were conducted to assess anticipatory grief, using the Marwit and Meuser Caregiver Inventory: Childhood Cancer. Analysis was performed using t -tests. Results., Fewer than half of the parents in both groups reported being at peace with themselves and their situation in life. Parents of newly diagnosed children reported more severe anticipatory grief responses than those in the second group. No statistically significant differences were found in responses between mothers and fathers. Conclusion., Healthcare professionals should encourage parents to discuss negative feelings related to their child's illness and potential outcome. Hospital policies need to include the provision and promotion of support group services for parents, and nurses should encourage parents to exploit such services. [source]

    Impact of Collaborative Management and Early Admission in Labor on Method of Delivery

    JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 2 2003
    Debra J. Jackson senior researcher
    Objective: This study compared the effects of early admission in labor and perinatal care provider on delivery method. Higher spontaneous vaginal delivery rates for certified nurse midwives as compared with physicians have been reported in observational studies and randomized clinical trials. Certified nurse midwives, with their more expectant approach to labor management, would be expected to admit women later in labor than obstetricians. Methods: Prospective cohort study of 2,196 low-risk pregnancies, with singleton, vertex infants admitted in spontaneous labor. Independent and joint effects of perinatal care provider and cervical dilation at admission on delivery method were evaluated. Confounding was addressed using restriction and multiple regression. Results: Fewer (23.4%) women in collaborative care were admitted in early labor (< 4 cm cervical dilation) than women managed by obstetricians (95% CI =,27.6 to ,19.2). Obstetrician care had 9% to 30% fewer spontaneous vaginal deliveries. Women admitted early in labor also had 6% to 34% fewer spontaneous vaginal deliveries. Evaluation of joint effects suggested that interaction between obstetrician provider and earlier admission increased the risk of operative delivery. Conclusion: Later admission in labor (at 4 cm or greater cervical dilation) and management of perinatal care by certified nurse midwives in collaboration with obstetricians increased the rate of spontaneous vaginal delivery in low-risk women. [source]

    Physical Activity Pattern of Prepubescent Filipino School Children During School Days

    JOURNAL OF SCHOOL HEALTH, Issue 7 2009
    Consuelo B. Gonzalez-Suarez MD
    ABSTRACT Background:, Little is known about pre-pubescent Filipino children's involvement in moderate-to-vigorous physical activity (MVPA). There are international guidelines regarding required levels of MVPA for healthy children. Methods:, This study describes participation of 11- to 12-year-olds in randomly selected public and private schools in San Juan, Metromanila, in MVPA and sports during a school day. The Filipino-modified Physical Activity Questionnaire for Older Children (F_PAQ_C) was administered in English and Filipino. Additional data was collected on sex, age, type of school, and amount of time spent using television and computers. Children's self-assessment of physical activities (1 question in the F_PAQ_C) was correlated with their cumulative F_PAQ_C score. Results:, Three hundred eighty subjects (167 boys, 213 girls) participated. Participation in MVPA varied between sex and age groups, from 56.1% to 65.0%. Fewer than 10% of participants were very active. The children were more active during physical education classes than at recess or lunch, after class, or in the evening. Walking for exercise, jumping, jogging and running, free play, and dance were most common. Boys, younger children, and private school students most commonly engaged in MVPA. Self-assessed physical activity had modest correlation (r2= 0.21) with cumulative F_PAQ_C score, after adjusting for sex, age, and school type. Conclusion:, Most children were not physically active during the school day, except in physical education classes. To reduce the gap between recommended and current activity levels, more opportunities should be provided for preteen Filipino children to engage in MVPA during and after school. [source]

    Adherence rate to inhaled corticosteroids and their impact on asthma control

    ALLERGY, Issue 5 2009
    L. Lasmar
    Background:, Poor asthma control is associated to high morbidity. The objective of this study was to assess the association between adherence rates to beclomethasone dipropionate (BDP) and the degree of asthma control. Methods:, A cohort concurrent study was carried out for 12 months with 122 asthmatic patients, aged 3,12 years, randomly selected in a pediatric pulmonology outpatient clinic, who received BDP free of charge. Adherence rates were verified by pharmacy records. Clinical control was assessed through a scoring system comprised four variables (nocturnal and morning symptoms, limitation of physical activities and exacerbations). Total score was 16 points. Patients whose score was below or equal to two were considered controlled (group 1), and patients whose score was above or equal to three were considered uncontrolled (group 2). For patients able to perform spirometry, we considered as controlled the patients with forced expiratory volume in 1 s (FEV1) equal to or above 80% of the predicted value, and as uncontrolled the patients with FEV1 below 80%. Results:, Fewer than half (40.3% maximum) of the 122 patients maintained asthma control. Median adherence rate of groups 1 and 2 were 85.5% and 33.8%, (P < 0.001) in the 4th month, 90.0% and 48.0% (P < 0.001) in the 8th month and 84.4% and 47.0% in the 12th month (P < 0.001), respectively. Conclusion:, In all periods, there were statistically significant differences in adherence rates for maintaining or not maintaining the asthma control. Optimal asthma control entailed adherence rate higher than 80%. Strategies for reducing asthma morbidity should include a regular monitoring of adherence to inhaled steroids. [source]

    Attitudes and Factors Affecting Research Utilization

    NURSING FORUM, Issue 4 2003
    FWACN, Rosaline A. Olade RN
    PROBLEM The gap between nursing research findings and their application in practice, particularly in rural areas. METHODS A descriptive-correlational study design focused on the attitude of nurses (N= 106) in rural practice settings toward nursing research and the relationship between their attitudes and other factors. FINDINGS Fewer than a quarter of the nurses in this study had favorable attitudes toward research. Attitudes and interest varied with levels of education and position. Also, the isolation of rural nurses from nurse researchers creates a peculiar barrier to research utilization. CONCLUSIONS The influence of nurse educators/researchers and administrators cannot be overemphasized. Nurse leaders need to perceive nursing research as the base for evidence-based practice, and enhance the utilization of scientific evidence in practice settings. [source]

    Occupational colour vision requirements for police officers

    OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2008
    Jennifer Birch
    Abstract Inclusion of public service professions in the UK Disability Discrimination Act in 2004 prompted a review of occupational colour vision requirements for police officers. Changes in the regulations which existed prior to 2003 were proposed. The aim of this study was to obtain the views of serving police officers in Northern Ireland on the importance of good colour discrimination in everyday police work and on the recruitment regulations for patrol constables introduced in 2003 in mainland UK. These views were obtained by means of a questionnaire and informal discussions. More than 65% of police officers who responded to the questionnaire considered that good colour vision was very important for effective policing. Fewer than 2% considered that colour vision was unimportant. Experienced police officers agreed that the employment of colour-deficient patrol constables, as permitted in the new regulations, would lead to reduced efficiency and organisational difficulties at the local level. A number of everyday activities were described which showed the need for accurate colour discrimination. The change in recruitment policy and the lack of clarity in the new regulations show inadequate appreciation of the needs of the occupation, of different types of colour vision anomalies and of the diagnostic function of colour vision tests. Failure to provide guidance on appropriate colour vision tests, examination procedures and counselling services is likely to result in inconsistent employment policies in different police forces. It is recommended that the colour vision standard in place prior to 2003 is reinstated at the recruitment stage. The Ishihara test should be used for screening, and colour-deficient applicants further examined with the Farnsworth D15 test as a replacement for the City University Test 2nd edition. [source]

    Infant leukemia and congenital abnormalities: A Children's Oncology Group study,

    PEDIATRIC BLOOD & CANCER, Issue 1 2010
    Kimberly J. Johnson PhD
    Abstract Background Leukemia in infants is rare and has not been well studied apart from leukemia in older children. Differences in survival and the molecular characteristics of leukemia in infants versus older children suggest a distinct etiology, likely involving prenatal factors. Procedure We examined the association between eight categories of maternally reported congenital abnormalities (CAs) (cleft lip or palate, spina bifida or other spinal defect, large or multiple birthmarks, other chromosomal abnormalities, small head or microcephaly, rib abnormalities, urogenital abnormalities, and other) and infant leukemia in a case,control study. The study included 443 cases diagnosed at <1 year of age at a Children's Oncology Group Institution in the United States or Canada from 1996 to 2006 and 324 controls. Controls were recruited from the cases' geographic area either by random digit dialing (1999,2002) or through birth certificates (2003,2008) and were frequency-matched to cases on birth year. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for birth year and a measure of follow-up time to account for differences in the CA observation period. Results No statistically significant associations were observed between infant leukemia and any CA (OR,=,1.2; 95% CI: 0.8,1.9), birthmarks (OR,=,1.4; 95% CI: 0.7,2.5), urogenital abnormalities (OR,=,0.7; 95% CI: 0.2,2.0), or other CA (OR,=,1.4; 95% CI: 0.7,2.8). Results were similar for acute lymphoblastic and myeloid leukemia cases. Fewer than five subjects were in the remaining CA categories precluding analysis. Conclusions Overall, we did not find evidence to support an association between CAs and infant leukemia. Pediatr Blood Cancer 2010;55:95,99. © 2010 Wiley-Liss, Inc. [source]

    Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives

    PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 3 2005
    B. Lawrence
    CONTEXT: Understanding women's reasons for having abortions can inform public debate and policy regarding abortion and unwanted pregnancy. Demographic changes over the last two decades highlight the need for a reassessment of why women decide to have abortions. METHODS: In 2004, a structured survey was completed by 1,209 abortion patients at 11 large providers, and in-depth interviews were conducted with 38 women at four sites. Bivariate analyses examined differences in the reasons for abortion across subgroups, and multivariate logistic regression models assessed associations between respondent characteristics and reported reasons. RESULTS: The reasons most frequently cited were that having a child would interfere with a woman's education, work or ability to care for dependents (74%); that she could not afford a baby now (73%); and that she did not want to be a single mother or was having relationship problems (48%). Nearly four in 10 women said they had completed their childbearing, and almost one-third were not ready to have a child. Fewer than 1% said their parents' or partners' desire for them to have an abortion was the most important reason. Younger women often reported that they were unprepared for the transition to motherhood, while older women regularly cited their responsibility to dependents. CONCLUSIONS: The decision to have an abortion is typically motivated by multiple, diverse and interrelated reasons. The themes of responsibility to others and resource limitations, such as financial constraints and lack of partner support, recurred throughout the study. [source]

    Prevalence, prevention, and treatment of pressure ulcers: Descriptive study in 89 institutions in The Netherlands

    RESEARCH IN NURSING & HEALTH, Issue 2 2002
    Gerrie J.J.W. Bours
    Abstract The purpose of the present study was to assess the prevalence of pressure ulcers and the use of Dutch guidelines for the prevention and treatment of pressure ulcers. A survey of 16,344 patients in 89 health care institutions on 1 day showed a mean prevalence of pressure ulcers of 23.1%. It was found that Dutch guidelines on some aspects of prevention and treatment of pressure ulcers were not being followed. Only 53% of the patients who should have been positioned on a support surface were positioned on such a device. Fewer than one-third of the patients who should have been repositioned, should have received nutritional support, or should have been educated received these interventions, and only 33.6% of all pressure ulcers were dressed as recommended. More attention to the dissemination and implementation of the guidelines is needed to reduce this high prevalence of pressure ulcers. © 2002 Wiley Periodicals, Inc. Res Nurs Health 25:99,110, 2002 [source]

    Restoring Stream Ecosystems: Lessons from a Midwestern State

    RESTORATION ECOLOGY, Issue 3 2004
    Ashley H. Moerke
    Abstract Reach-scale stream restorations are becoming a common approach to repair degraded streams, but the effectiveness of these projects is rarely evaluated or reported. We surveyed governmental, private, and nonprofit organizations in the state of Indiana to determine the frequency and nature of reach-scale stream restorations in this midwestern U.S. state. For 10 attempted restorations in Indiana, questionnaires and on-site assessments were used to better evaluate current designs for restoring stream ecosystems. At each restoration site, habitat and water quality were evaluated in restored and unrestored reaches. Our surveys identified commonalities across all restorations, including the type of restoration, project goals, structures installed, and level of monitoring conducted. In general, most restorations were described as stream-relocation projects that combined riparian and in-stream enhancements. Fewer than half of the restorations conducted pre- or post-restoration monitoring, and most monitoring involved evaluations of riparian vegetation rather than aquatic variables. On-site assessments revealed that restored reaches had significantly lower stream widths and greater depths than did upstream unrestored reaches, but riparian canopy cover often was lower in restored than in unrestored reaches. This study provides basic information on midwestern restoration strategies, which is needed to identify strengths and weaknesses in current practices and to better inform future stream restorations. [source]

    Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders

    THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 3 2004
    M. Elena Garralda
    Background:, Functional impairment is a key feature of chronic fatigue syndrome (CFS) of childhood. Aim:, To compare impairment, illness attitudes and coping mechanisms in childhood CFS and in other paediatric disorders. Method:, Participants were 28 children and adolescents with CFS, 30 with juvenile idiopathic arthritis (JIA) and 27 with emotional disorders (ED). The measures used were interviews with children and parents, with detailed enquiry on impairment, including the Functional Disability Inventory (FDI), Illness Attitudes Scales (IAS), and Kidcope to measure coping styles in relation to common problems, illness and disability. Results:, Children with CFS reported significantly more illness impairment, especially in school attendance, than those with JIA and ED. They had higher ,worry about illness' scores on the IAS. On the Kidcope they named school issues (work, expectations, attendance) as illness- or disability-related problems more than the other two groups. Fewer CFS participants reported using problem solving as a strategy to cope with illness and disability than with other problems in their lives. More in the CFS than in the JIA group used emotional regulation to cope with illness and disability. Fewer in the CFS than in the ED groups used social withdrawal to cope with illness and self-criticism for disability, but more used resignation to cope with disability. Conclusion:, Severe illness-related impairment, particularly through school non-attendance, and high levels of illness-related school concerns appear specific to CFS. CFS may also have characteristically high levels of generalised illness worry and particular styles of coping with illness and disability. [source]

    Early-onset gastric carcinomas display molecular characteristics distinct from gastric carcinomas occurring at a later age

    THE JOURNAL OF PATHOLOGY, Issue 1 2004
    Ralph Carvalho
    Abstract Gastric cancer is thought to result from a combination of environmental factors and accumulation of specific genetic alterations, and consequently mainly affects older patients (>50 years of age). Fewer than 10% of patients present with the disease before 45 years of age and these young patients are thought to develop carcinomas with a different molecular genetic profile from that of sporadic carcinomas occurring at a later age. Forty early-onset gastric carcinoma resection specimens were characterized for microsatellite instability (MSI) and loss of heterozygosity status using 22 polymorphic microsatellite markers. Twenty-four biopsies were additionally evaluated for the presence of MSI. No MSI was observed in any of the cases analysed. Losses were infrequent, but were most common for the D1S234 (26.1%) and D1S1676 (17.4%) markers, flanking the RUNX3 gene; for the p53ALU (23.1%) and TP53 (15.4%) markers, near the TP53 gene; and for the D16S2624 (17.2%) marker, near the E-cadherin (CDH1) gene. All cases with loss of CDH1, as well as 6/7 cases with loss of TP53, displayed aberrant staining of the corresponding proteins, pointing to a functional role for these proteins in early-onset gastric carcinogenesis. No germline CDH1, TP53 or RUNX3 mutations were detected in any of the cases analysed. No correlation was observed between non-functional E-cadherin and the histological type of the tumours analysed. Finally, Epstein,Barr virus was not detected in any of the cases analysed. On the basis of these results, early-onset gastric carcinomas appear to have characteristics distinct from gastric carcinomas occurring at a later age. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source]

    Use of Cardioprotective Medications in Kidney Transplant Recipients

    AMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2009
    R. S. Gaston
    Death with function causes half of late kidney transplant failures, and cardiovascular disease (CVD) is the most common cause of death in these patients. We examined the use of potentially cardioprotective medications in a prospective observational study at seven transplant centers in the United States and Canada. Among 935 patients, 87% received antihypertensive medications at both 1 and 6 months after transplantation. Similar antihypertensive regimens were used for patients with and without diabetes and CVD, but with wide variability among centers. In contrast, while 44% of patients were on angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) at the time of transplantation, the proportion taking these agents dropped to 12% at month 1, then increased to 24% at 6 months. Fewer than 30% with CVD or diabetes received ACEI/ARB therapy 6 months posttransplant. Aspirin use was uncommon (<40% of patients). Even among those with diabetes and/or CVD, fewer than 60% received aspirin and only half received a statin at 1 and 6 months. This study demonstrates marked variability in the use of cardioprotective medications in kidney transplant recipients, a finding that may reflect, among several possible explanations, clinical uncertainty due the lack of randomized trials for these medications in this population. [source]

    Litigation related to drug errors in anaesthesia: an analysis of claims against the NHS in England 1995,2007

    ANAESTHESIA, Issue 12 2009
    J. Cranshaw
    Summary Ninety-three claims (total cost £4 915 450) filed under ,anaesthesia' in the NHS Litigation Authority database between 1995 and 2007, alleging patient harm directly by drug administration error or by an allergic reaction, were analysed. Alleged errors were categorised using systems employed by the National Coordinating Council for Medication Error Reporting and Prevention, the American Society of Anesthesiologists Closed Claims Project and the UK Health and Safety Executive. The severity of outcome in each claim was categorised using adapted National Patient Safety Agency definitions. Sixty-two claims involved alleged drug administration errors (total cost £4 283 677) and 15 resulted in severe harm or death. Half alleged the administration of the wrong drug, in most (16) a neuromuscular blocker. Of the claims alleging the wrong dose had been given (25), nine alleged opioid overdose including by neuraxial routes. The most frequently recorded adverse outcomes were awake paralysis (19 claims; total cost £182 347) and respiratory depression requiring intensive care treatment (13 claims; total cost £2 752 853). Thirty-one claims involved allergic reactions (total cost £631 773). In 20 claims, the patient allegedly received a drug to which they were known to be allergic (total cost £130 794). All claims in which it was possible to categorise the nature of the error involved human error. Fewer than half the claims appeared likely to have been preventable by an ,ideal double checking process'. [source]

    Ambulance Diversion as a Proxy for Emergency Department Crowding: The Effect on Pediatric Mortality in a Metropolitan Area

    ACADEMIC EMERGENCY MEDICINE, Issue 2 2009
    Rohit P. Shenoi MD
    Abstract Objectives:, The objective was to determine the prevalence of emergency department (ED) ambulance diversion among Houston pediatric hospitals and its association with mortality of pediatric patients. Methods:, Hospital diversion and patient data between August 2002 and December 2004 were used to examine the impact of diversion on mortality of children under age 18 years. Patients were assumed to be exposed to ED crowding if diversion and admission or ED arrival times overlapped. Univariate and logistic regression were performed to determine if diversion was associated with mortality while controlling for age, illness severity, injury, and transfer status. Results:, Mean hospital diversion hours as a percentage of operating hours were 10.58 (standard deviation [SD] ± 9). Overall, of 63,780 admissions, there were 4,095 (6.4%) children admitted during diversion. Fewer severely ill patients were admitted during diversion than nondiversion times (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.66 to 0.78). The presence of diversion was protective for mortality (OR = 0.51; 95% CI = 0.34 to 0.77) in bivariate analysis. Mortality was associated with presence of major or extreme illness (OR = 60.7; 95% CI = 45.2 to 81.5), injury (OR=1.7; 95% CI = 1.4 to 2.1), and transfer status (OR = 6.3; 95% CI = 5.4 to 7.3). Using conditional logistic regression, major or extreme illness (OR = 50.7; 95% CI = 37.7 to 68.3), injury (OR 3.7; 95% CI = 2.9 to 4.7), and transfer (OR = 2.7; 95% CI = 2.2, 3.2) were associated with mortality, but diversion did not show any association with mortality. After combining ED and inpatient deaths, no association between diversion and mortality was observed. Conclusions:, Hospital diversion due to ED crowding is common in pediatrics. The authors found no evidence of an association between diversion and ED and inpatient pediatric mortality. [source]

    Knowledge, use and attitudes towards emergency contraceptive pills among swedish women presenting for induced abortion

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2002
    Gunilla Aneblom
    Objective To investigate the knowledge, experiences and attitudes towards emergency contraceptive pills (ECP) among women presenting for induced abortion. Design Survey by self-administered waiting room questionnaires. Setting Three large hospitals in the cities of Uppsala, Västerås and Örebro in Sweden. Population 591 Swedish-speaking women consecutively attending the clinics for an induced abortion during a four-month period in 2000. Results The response rate was 88% (n= 518). As many as 43% had a history of one or more previous abortions and 43% were daily smokers. Four out of five women, 83%, were aware of ECP, but only 15 women used it to prevent this pregnancy. Fewer, 38%, knew the recommended timeframes for use and 54% had knowledge of the mode of action. The two most common sources of information about ECP were media and friends. One out of five, 22%, had previously used the method, and at the time of conception, 55% would have taken ECP if it had been available at home, and 52% were positive to having ECP available over the counter. Conclusions Emergency contraception is well known but is still underused. Lack of awareness of pregnancy risk may be one limiting factor for its use. Making ECP available over the counter may be an important measure towards better availability. Information strategies to the public are needed before ECP will be a widely used back-up method. [source]

    Dystrophic epidermolysis bullosa pruriginosa is not associated with frequent FLG gene mutations

    BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008
    H. Schumann
    Summary Background, Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr; OMIM 604129) is a rare manifestation of dystrophic epidermolysis bullosa (DEB), characterized by pruritus, nodular prurigo-like lesions and fragility of the skin mainly in the extremities. Fewer than 40 patients with autosomal dominant or recessive inheritance, or sporadic DEB-Pr, have been described in the literature. Objectives, To disclose mutations in DEB-Pr and to elucidate the role of other pathogenic factors which may influence the pruriginous phenotype. Methods, Seven patients with typical clinical features of DEB-Pr were studied. Results, In all patients, mutations in the gene encoding collagen VII (COL7A1) were disclosed, two of them novel (p.G2623V, p.E2736K). Three mutations were dominant, three recessive and one de novo. In the families with dominant DEB there were one or more members with DEB-Pr, but also at least one affected sibling who did not develop DEB-Pr. In six of seven patients, the clinical history revealed factors that initially induced pruritus, such as atopy, pregnancy, thyroid hormone imbalance, diabetes, infections and contact sensitization. Common filaggrin mutations were ruled out in all patients and normal filaggrin staining was found in the skin samples. Conclusions, DEB-Pr develops as a result of COL7A1 gene mutations and acquired phenotype-modifying factors. Filaggrin mutations did not contribute to the pruriginous phenotype in the present patient cohort. [source]

    Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2007
    H. A. Ashton
    Background: Long-term benefits of screening for abdominal aortic aneurysm (AAA) are uncertain. These are the final results of a randomized controlled screening trial for AAA in men, updating those reported previously. Benefit and compliance over a median 15-year interval were examined. Methods: One group of men were invited for ultrasonographic AAA screening, and another group, who received standard care, acted as controls. A total of 6040 men aged 65,80 years were randomized to one of the two groups. Outcome was monitored in terms of AAA-related events (surgery or death). Results: In the group invited for screening, AAA-related mortality was reduced by 11 per cent (from 1·8 to 1·6 per cent, hazard ratio 0·89) over the follow-up interval. Screening detected an AAA in 170 patients; 17 of these died from an AAA-related cause, seven of which might have been preventable. The incidence of AAA rupture after an initially normal scan increased after 10 years of follow-up, but was still low overall (0·56 per 1000 person-years). Conclusion: Screening with a single ultrasonography scan still conferred a benefit at 15 years, although the results were not significant for this population size. Fewer than half of the AAA-related deaths in those screened positive could be prevented. Registration number: ISRCTN 00079388 (http://www.controlled-trials.com). Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

    Season of birth and multiple sclerosis in Sweden

    ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010
    J. Salzer
    Objective,,, To estimate the risk of multiple sclerosis (MS) by month of birth in Sweden. Materials and Methods,,, Cases (n = 9361) were obtained from the Swedish MS Registry. All births in Sweden 1900,2007 served as controls (n = 12,116,853). The risk of MS was analyzed for each month of birth separately compared with birth during the other 11 months. Results,,, More (11%) cases with MS than expected were born in June. Fewer (8% and 10%) cases with MS than expected were born in December and January (non-significant after correction for multiple analyses). More (5%) cases with MS than expected were born in February,July as compared with August,January. Conclusions,,, This study supports previous results suggesting an association between the risk of MS and the season of birth. Decreased exposure to sun in the winter leading to low vitamin D levels during pregnancy is a possible explanation that needs further research. [source]

    Characteristics of environmental reporters on the OM Stockholm exchange

    BUSINESS STRATEGY AND THE ENVIRONMENT, Issue 5 2002
    Pontus Cerin
    External validation of company environmental performance is normally based on corporate environmental reports, due to the lack of other information. Critics of these reports, however, claim that these are no more than public relations exercises, consisting mainly of wordy descriptions and glossy pictures. It is therefore important to turn the spotlight on the real character of the companies behind the reports. Fewer than 10% of the companies listed on the OM Stockholm Exchange, however, provide documented environmental reports on the Internet (DERI) annually. The highest DERI percentages are found among those industry sectors that began reporting some ten years ago. Data from the Dow Jones Country Index Sweden shows that DERI producers have an average market capitalization some six times greater than non-producers. Moreover, the DERI producers emitted twice as much CO2 per turnover as the non-DERI producers. The fact that less than half of the companies on the OM Stockholm Exchange presented CO2 emission data somewhat weakens the conclusions on emissions. The fact that 60% of the DERI producers could not provide complete CO2 emission data for their companies does say something concrete about the usefulness of current DERIs as a tool for externally determining company environmental performance characteristics. Copyright © 2002 John Wiley & Sons, Ltd and ERP Environment. [source]

    Follow-up of adolescents born extremely preterm: cognitive function and health at 18 years of age

    ACTA PAEDIATRICA, Issue 9 2010
    Anne-Li Hallin
    Abstract Aim:, To compare cognitive ability, school achievement and self-perceived health aspects in adolescents born extremely preterm and term born controls. Method:, Fifty-two, out of 61, extremely preterm born adolescents (mean age 18.4 years) and 54 matched controls (mean age 18.3 years) born at full term were investigated; intelligence quotient was measured with the Wechsler Adult Intelligence Scale; cognitive flexibility, i.e. a measure of visuomotor speed and attention, with the Trail Making Test; school achievement and choice of upper secondary programmes were reported. Health aspects were investigated in a semi structured interview. Result:, The adolescents born prematurely had significantly lower IQ than the controls, mean 93 (SD 15.4) vs 106 (12.5), p < 0.001; showed slower visuomotor speed; had lower grades from compulsory school (192.7 vs 234.8, p < 0.001); and chose to a greater extent practical upper secondary school programmes. There were no differences between the groups in health care consumption, prevalence of chronic disease, allergy or infectious diseases. Conclusion:, Poorer cognitive performance, in extremely preterm born individuals, seems to persist into late adolescence. Fewer prematurely born than control chose theoretical upper secondary school programmes. However, no difference was noted regarding self-perceived health aspects. [source]

    The use and therapeutic drug monitoring of teicoplanin in the UK

    CLINICAL MICROBIOLOGY AND INFECTION, Issue 1 2004
    E. S. R. Darley
    Abstract Teicoplanin dosage recommendations for specific infections have been modified in recent years. However, there was no significant increase in the proportion of pre-dose concentrations >,20 mg/L between 1994 and 1998 in samples sent for teicoplanin assay at the Regional Antimicrobial Reference Laboratory, Bristol, UK. A questionnaire on the use of teicoplanin and therapeutic drug monitoring (TDM) was sent to all UK National External Quality Assurance Scheme antibiotic assay users. Teicoplanin was widely used in the UK, although vancomycin was more popular as a choice of glycopeptide. Fewer than 25% recommended teicoplanin TDM during routine use, the main reasons being perceived lack of toxicity and lack of evidence for the use of teicoplanin TDM. Pre-dose concentrations <,20 mg/L were considered appropriate for treatment of bacteraemia caused by methicillin-resistant Staphylococcus aureus by 53% of those responding. Data sheet advice was relied upon more than TDM as an indication of therapeutic dosing. Microbiologists who mainly used vancomycin tended to perform more TDM and seek higher serum concentrations when using teicoplanin than those who preferentially used teicoplanin. [source]