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Kinds of From Terms modified by From Selected AbstractsFROM THE EDITOR: How to Get an Article Accepted at American Anthropologist (or Anywhere), Part 2AMERICAN ANTHROPOLOGIST, Issue 3 2010Tom Boellstorff Editor-in-Chief First page of article [source] 8th Asian Pacific Society of Respirology Congress MESSAGE FROM THE ORGANIZING CHAIRMANRESPIROLOGY, Issue 1 2003Professor Chong-Kin Liam No abstract is available for this article. [source] COOKING WARES IN ANCIENT SYRIA (FIRST TO 10TH CENTURIES ad): RECONSTRUCTING THE PRODUCTION CONTEXTS FROM THE CONSUMPTION SITESARCHAEOMETRY, Issue 4 2010A. VOKAER This paper deals with Brittle Ware, a cooking ware product that appears to have been highly standardized and widely distributed in Syria during the Roman and the Byzantine periods. The study intends to determine the distribution of Brittle Ware through time and space, by combining typology and a thorough examination of the fabrics in the field, using binocular microscopy (n = 2807 diagnostic fragments). Based on the fabric groupings, petrological and chemical analyses were then undertaken. Resting on an archaeological background and several analytical methods, this paper aims at going beyond a limited provenance study, by characterizing the Brittle Ware production system and thus providing some insights into the economy of ancient Syria. [source] EXCITATION,CONTRACTION COUPLING FROM THE 1950s INTO THE NEW MILLENNIUMCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2006AF Dulhunty SUMMARY 1Excitation,contraction coupling is broadly defined as the process linking the action potential to contraction in striated muscle or, more narrowly, as the process coupling surface membrane depolarization to Ca2+ release from the sarcoplasmic reticulum. 2We now know that excitation,contraction coupling depends on a macromolecular protein complex or ,calcium release unit'. The complex extends the extracellular space within the transverse tubule invaginations of the surface membrane, across the transverse tubule membrane into the cytoplasm and then across the sarcoplasmic reticulum membrane and into the lumen of the sarcoplasmic reticulum. 3The central element of the macromolecular complex is the ryanodine receptor calcium release channel in the sarcoplasmic reticulum membrane. The ryanodine receptor has recruited a surface membrane L-type calcium channel as a ,voltage sensor' to detect the action potential and the calcium-binding protein calsequestrin to detect in the environment within the sarcoplasmic reticulum. Consequently, the calcium release channel is able to respond to surface depolarization in a manner that depends on the Ca2+ load within the calcium store. 4The molecular components of the ,calcium release unit' are the same in skeletal and cardiac muscle. However, the mechanism of excitation,contraction coupling is different. The signal from the voltage sensor to ryanodine receptor is chemical in the heart, depending on an influx of external Ca2+ through the surface calcium channel. In contrast, conformational coupling links the voltage sensor and the ryanodine receptor in skeletal muscle. 5Our current understanding of this amazingly efficient molecular signal transduction machine has evolved over the past 50 years. None of the proteins had been identified in the 1950s; indeed, there was debate about whether the molecules involved were, in fact, protein. Nevertheless, a multitude of questions about the molecular interactions and structures of the proteins and their interaction sites remain to be answered and provide a challenge for the next 50 years. [source] 10-Year trends in the treatment and outcomes of patients with first-episode schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010J. Nielsen Nielsen J, le Quach P, Emborg C, Foldager L, Correll CU. 10-Year trends in the treatment and outcomes of patients with first-episode schizophrenia. Objective:, The first episode of schizophrenia is a critical period for illness course and outcomes. We aimed to investigate treatments and outcomes during the first year after the diagnosis of schizophrenia. Method:, Pharmacoepidemiologic inception cohort study of all newly diagnosed patients with schizophrenia in Denmark (n = 13 600) 1996,2005. Results:, From 1996 to 2005, the mean age at first diagnosis decreased significantly (29.2,26.1 years), more patients received antipsychotics (67.2,80.7%, annual OR = 1.07, CI: 1.06,1.09, P < 0.001) and antipsychotic polypharmacy for >4 months (16.7,37.1%, OR = 1.14, CI: 1.12,1.57, P < 0.001). The antipsychotic defined daily dosage (DDD) doubled (150,332 DDD, P < 0.001), use of antidepressants (24.3,40.6%, P < 0.001). Bed days [89.9 days (CI: 81.8,98.8) to 71.8 days, CI: 63.7,80.8, P < 0.0001] decreased, whereas outpatient contacts [10.2 (CI: 9.5,11.0) to 21.4 (CI: 19.9,21.0), P < 0.0001] doubled. Conclusion:, Between 1996 and 2005, there was an earlier recognition of schizophrenia, intensified outpatient treatment, increased use and dosing of antipsychotics and antidepressants, but also more antipsychotic polypharmacy. [source] National Study on Emergency Department Visits for Transient Ischemic Attack, 1992,2001ACADEMIC EMERGENCY MEDICINE, Issue 6 2006Jonathan A. Edlow MD Abstract Objectives: To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten-year time period. Methods: The authors obtained data from the 1992,2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD-9 code 435. Results: From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in < 5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten-year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%). Conclusions: Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation. [source] Effectiveness of Corticosteroid Treatment in Acute Pharyngitis: A Systematic Review of the LiteratureACADEMIC EMERGENCY MEDICINE, Issue 5 2010Andrew Wing Abstract Objectives:, The objective was to examine the effectiveness of corticosteroid treatment for the relief of pain associated with acute pharyngitis potentially caused by group A beta-hemolytic Streptococcus (GABHS). Methods:, This was a systematic review of the literature. Data sources used were electronic databases (Cochrane Library, MEDLINE, EMBASE, Biosis Previews, Scopus, and Web of Science), controlled trial registration websites, conference proceedings, study references, experts in the field, and correspondence with authors. Selection criteria consisted of randomized controlled trials (RCTs) in which corticosteroids, alone or in combination with antibiotics, were compared to placebo or any other standard therapy for treatment of acute pharyngitis in adult patients, pediatric patients, or both. Two reviewers independently assessed for relevance, inclusion, and study quality. Weighted mean differences (WMDs) were calculated and are reported with corresponding 95% confidence intervals (CIs). Results:, From 272 potentially relevant citations, 10 studies met the inclusion criteria. When compared to placebo, corticosteroids reduced the time to clinically meaningful pain relief (WMD = ,4.54 hours; 95% CI = ,7.19 to ,1.89); however, they provided only a small reduction in pain scores at 24 hours (WMD = ,0.90 on a 0,10 visual analog scale; 95% CI = ,1.5 to ,0.3). Heterogeneity among pooled studies was identified for both outcomes (I2 = 81 and 74%, respectively); however, the GABHS-positive subgroup receiving corticosteroid treatment did have a significant mean reduction in time to clinically meaningful pain relief of 5.22 hours (95% CI = ,7.02 to ,3.42; I2 = 0%). Short-term side effect profiles between corticosteroids and placebo groups were similar. Conclusions:, Corticosteroid administration for acute pharyngitis was associated with a relatively small effect in time to clinically meaningful pain relief (4.5-hour reduction) and in pain relief at 24 hours (0.9-point reduction), with significant heterogeneity in the pooled results. Decision-making should be individualized to determine the risks and benefits; however, corticosteroids should not be used as routine treatment for acute pharyngitis. ACADEMIC EMERGENCY MEDICINE 2010; 17:476,483 © 2010 by the Society for Academic Emergency Medicine [source] Randomized controlled multicentre trial of cognitive behaviour therapy in the early initial prodromal state: effects on social adjustment post treatmentEARLY INTERVENTION IN PSYCHIATRY, Issue 1 2007Andreas Bechdolf Abstract Aim:, Improvement of social adjustment is a major aim of indicated prevention in young people at risk of developing psychosis. The present study explores the effect of specific cognitive behaviour therapy (CBT) as compared with supportive counselling (SC) on social adjustment in people in a potential early initial prodromal state of psychosis (EIPS) primarily defined by self-experienced cognitive thought and perception deficits (basic symptoms). Methods:, A total of 128 help-seeking outpatients in the EIPS were randomized to receive either specific CBT or SC for 12 months. Social adjustment was assessed with the Social Adjustment Scale II (SAS II) at baseline, time of transition or post treatment Results:, From 113 patients, who completed the SAS II at intake, 67 (59.3%) completed the SAS assessments at time of transition or post treatment. Both specific CBT and SC resulted in improvements in scales of SAS II, with no significant between-group differences post treatment. Conclusions:, Although treatment in specially designed early detection and intervention centres improves functioning of people in the EIPS, specific CBT was not superior to SC. One could hypothesize that additional vocational rehabilitation, case management and involvement of multidisciplinary teams are needed to further improve short-term outcome of specific interventions on this dimension. [source] EEG Characteristics Related to Educational Impairments in Children with Benign Childhood Epilepsy with Centrotemporal SpikesEPILEPSIA, Issue 11 2007Joost Nicolai Summary Purpose: Learning and behavioral difficulties often occur in benign childhood epilepsy with centrotemporal spikes (BCECTS). In recent years, several electroencephalogram (EEG) characteristics have been related to the occurrence of learning and behavioral problems. Methods: From 28 children medical, school and psychological reports were present and children were rated according to a 4-point scale for educational and behavioral impairment (Part 1). Thirty 24-h EEG recordings were reanalyzed for spike frequency, the presence of atypical EEG criteria, and the presence of a nondipole spike. EEGs were scored during wakefulness, first hour of sleep and whole night sleep (minus the first hour of sleep) separately (Part 2). Results: The presence of I: an intermittent slow-wave focus during wakefulness, II: a high number of spikes in the first hour of sleep (and during whole night sleep), and III: multiple asynchronous bilateral spike-wave foci in the first hour of sleep correlates significantly with a sum score , 3 which indicates a complicated course with educational or behavioral impairment. It is sufficient to analyze an EEG during wakefulness and a sleep EEG for only the first hour of sleep instead of a whole night recording to demonstrate those EEG criteria. Conclusions: On basis of our reanalysis we can possibly conclude that the aforementioned EEG characteristics correlate with educational impairments, and that analysing an EEG recording during wake and the first hour of sleep is sufficient to look adequately for those EEG criteria in children with BCECTS. [source] Results of the PETHEMA ALL-96 trial in elderly patients with Philadelphia chromosome-negative acute lymphoblastic leukemiaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2007Juan-Manuel Sancho Abstract Background and aim:,Only 20,30% of elderly patients with acute lymphoblastic leukemia (ALL) are enrolled in clinical trials because of co-morbid disorders or poor performance status. We present the results of treatment of Philadelphia chromosome-negative (Ph,) ALL patients over 55 yr treated in the PETHEMA ALL-96 trial. Patients and methods:,From 1996 to 2006, 33 patients 55 yr with Ph, ALL were included. Induction therapy was vincristine, daunorubicin, prednisone, asparaginase, and cyclophosphamide over 5 weeks. Central nervous system (CNS) prophylaxis involved triple intrathecal (IT) therapy, 14 doses over the first year. Consolidation-1 included mercaptopurine, methotrexate, teniposide and cytarabine, followed by one consolidation-2 cycle similar to the induction cycle. Maintenance consisted of mercaptopurine and methotrexate up to 2 yr in complete remission (CR) with monthly reinduction cycles (vincristine, prednisone and asparaginase) during the first year. Results:,Median (range) age was 65 yr (56,77). Phenotype (30 patients): early-pre-B 7, common/pre-B 18, T 5. Cytogenetics (28 patients): normal 12, complex 10, t(4;11) 2 and other 4. CR was achieved in 19/33 (57.6%) patients, early death occurred in 12 (36.4%) and 2 (6%) were resistant. Overall survival and disease-free survival probabilities (2 yr, 95% CI) were 39% (21%,57%) and 46% (22%,70%), respectively (median follow up of 24 months). Removal of asparaginase and cyclophosphamide from the induction decreased induction death (OR 0.119, CI 95% 0.022,0.637, P = 0.013) and increased survival (20% vs. 52%, P = 0.05). Conclusions:,The prognosis of elderly Ph, ALL patients is poor. In this study, less intensive induction decreased toxic death, allowing delivery of planned consolidation therapy and increased survival probability. [source] Iron status in Danish men 1984,94: a cohort comparison of changes in iron stores and the prevalence of iron deficiency and iron overloadEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2002Nils Milman Abstract:,Background and objectives : From 1954 to 1987, flour in Denmark was fortified with 30 mg carbonyl iron per kg. This mandatory fortification was abolished in 1987. The aim of this study was to compare iron status in Danish men before and after abolition of iron fortification. Methods : Iron status (serum ferritin, haemoglobin), was assessed in population surveys in Copenhagen County during 1983,84 comprising 1324 Caucasian men (1024 non-blood-donors, 300 blood donors) and in 1993,94 comprising 1288 Caucasian men (1103 non-blood-donors, 185 donors), equally distributed in age cohorts of 40, 50, 60 and 70 yr. Results : In the 1984 survey median serum ferritin values in the four age cohorts in non-blood-donors were 136, 141, 133 and 111 µg/L, and in the 1994 survey 177, 173, 186 and 148 µg L ,1 , respectively. The difference was significant in all age groups ( P <0.001). There was no significant difference between the two surveys concerning the prevalence of small iron stores (ferritin 16,32 µg L ,1 ), depleted iron stores (ferritin <16 µg L ,1 ) or iron-deficiency anaemia (ferritin <13 µg L ,1 and Hb <5th percentile for iron-replete men). However, from 1984 to 1994, the prevalence of iron overload (ferritin >300 µg L ,1 ) increased from 11.3% to 18.9% ( P <0.0001). During the study period there was an increase in body mass index ( P <0.0001), alcohol consumption ( P <0.03) and use of non-steroid anti-inflammatory drugs (NSAID) ( P <0.0001), and a decrease in the use of vitamin,mineral supplements ( P <0.04) and in the prevalence of tobacco smoking ( P <0.0001). In contrast, median ferritin in blood donors showed a significant fall from 1984 to 1994 (103 vs. 74 µg L ,1 , P <0.02). Conclusion : Abolition of iron fortification reduced the iron content of the Danish diet by an average of 0.24 mg MJ ,1 , and the median dietary iron intake in men from 17 to 12 mg d ,1 . From 1984 to 1994, body iron stores and the prevalence of iron overload in Danish men increased significantly, despite the abolition of food iron fortification. The reason appears to be changes in dietary habits, with a lower consumption of dairy products and eggs, which inhibit iron absorption, and a higher consumption of alcohol, meat, and poultry, containing haem iron and enhancing iron absorption. The high prevalence of iron overload in men may constitute a health risk. [source] Injuries Related to Snow Blowers in the United States: 2002 Through 2008ACADEMIC EMERGENCY MEDICINE, Issue 5 2010Bart Hammig PhD Abstract Objectives:, The objective was to examine injuries related to the use of a snow blower among patients treated in an emergency department (ED). Methods:, Data were obtained from the National Electronic Injury Surveillance System (NEISS) for the years 2002,2008. National estimates of ED visits for injuries associated with the use of a snow blower were obtained, and descriptive epidemiologic characteristics assessed. Results:, From 2002 through 2008, there were an estimated 32,307 ED visits for injuries related to the use of a snow blower in the United States. Older adults had a higher proportion of ED visits for such injuries than younger age groups. The majority of injuries involved injuries to the hand, with 42% of cases diagnosed with fractures and 20% resulting in amputations. Conclusions:, Findings indicate that injuries from snow blowers remain a public health problem. Efforts to reduce injury incidence are discussed in accordance with inherent challenges of prevention of injuries associated with these products. ACADEMIC EMERGENCY MEDICINE 2010; 17:566,569 © 2010 by the Society for Academic Emergency Medicine [source] EMU and the Shift in the European Labour Law Agenda: From ,Social Policy' to ,Employment Policy'EUROPEAN LAW JOURNAL, Issue 3 2001Diamond Ashiagbor This article examines the interaction between EMU and the European Union (EU) employment strategy and its implications for law. It focuses on the importance of EMU as a catalyst in the development of the EU's social and employment policy in the years following the Treaty on European Union in 1992, up to the inauguration of a new employment policy in the Treaty of Amsterdam. In analysing the EU's discourse on labour market regulation, it is arguable that a shift has occurred in the EU's position on the ,labour market flexibility' debate: that the EU institutions are more readily accepting of the orthodoxy that labour market regulation and labour market institutions are a major cause of unemployment within EU countries and that a deregulatory approach, which emphasises greater ,flexibility' in labour markets, is the key to solving Europe's unemployment ills, along with macroeconomic stability, restrictive fiscal policy and wage restraint. As the EU's employment strategy has matured, this increased emphasis on employment policy has come to displace discourses around social policy. This change in emphasis has important implications for EMU since it signals a re-orientation from an approach to labour market regulation which had as its core a strong concept of employment protection and high labour standards, to an approach which prioritises employment creation, and minimises the role of social policy, since social policy is seen as potentially increasing the regulatory burden. [source] Hypertonic Saline Treatment of Severe Hyperkalemia in Nonnephrectomized DogsACADEMIC EMERGENCY MEDICINE, Issue 9 2000Justin L. Kaplan MD Abstract. Objectives: To determine whether a hypertonic saline bolus improves cardiac conduction or plasma potassium levels more than normal saline infusion within 15 minutes of treatment for severe hyperkalemia. Previously with this model, 8.4% sodium chloride (NaCl) and 8.4% sodium bicarbonate (NaHCO3) lowered plasma potassium equally effectively. Methods: This was a crossover study using ten conditioned dogs (14-20 kg) that received, in random order, each of three intravenous (IV) treatments in separate experiments at least one week apart: 1) 2 mmol/kg of 8.4% NaCl over 5 minutes (bolus); 2) 2 mmol/kg of 0.9% NaCl over one hour (infusion); or 3) no treatment (control). Using isoflurane anesthesia and ventilation (pCO2= 35-40 torr), 2 mmol/kg/hr of IV potassium chloride (KCl) was infused until conduction delays (both absent p-waves and ,20% decrease in ventricular rate in ,5 minutes) were sustained for 15 minutes. The KCl was then decreased to 1 mmol/kg/hr (maintenance) for 2 hours and 45 minutes. Treatment (0 minutes) began after 45 minutes of maintenance KCl. Results: From 0 to 15 minutes, mean heart rate increased 29.6 (95% CI = 12.2 to 46; p < 0.005) beats/min more with bolus than infusion and 23.4 (95% CI = 2.6 to 43.5; p < 0.03) beats/min more with bolus than control. No clinically or statistically significant difference was seen in heart rate changes from 0 to 30 minutes. Decreases in potassium from 0 to 15 minutes were similar with bolus, infusion, and control. Conclusions: In this model, 8.4% NaCl bolus reversed cardiac conduction abnormalities within the first 15 minutes after treatment, more rapidly than did the 0.9% NaCl infusion or control. This reversal occurred despite similar reductions in potassium levels. [source] Oral hygiene and the need for treatment of the dependent institutionalised elderlyGERODONTOLOGY, Issue 2 2006Sylvie Montal Objective:, To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. Background:, For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. Materials and methods:, From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. Results:, The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. Conclusion:, The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly. [source] Migraine Prevention: What Patients Want From Medication and Their Physicians (A Headache Specialty Clinic Perspective)HEADACHE, Issue 5 2006Todd D. Rozen MD Objective.,To document the results of a migraine patients survey, from a headache specialty clinic, in which patients were asked to rank, in order of importance, certain characteristics of migraine preventive treatment. Methods.,A 10-question survey was completed by 150 patients (114 females and 36 males) with a history of migraine who presented to the Michigan Head Pain & Neurological Institute. The patients were asked to rank, in order of importance, characteristics of migraine preventive treatment. Each characteristic was rated individually on a 1 to 10 scale (1 being of little importance and 10 being extremely important). The mean rating of each characteristic was then calculated and the results analyzed. Results/Discussion.,From this migraine preventive treatment survey, the most important thing to migraineurs, from a headache specialty clinic population, is that the prescribing physician involves them in the decision making of choosing a preventive agent. The physician taking time to explain the possible medication side effects is the second most highly ranked characteristic. Migraine preventives with published efficacy in the medical literature are also deemed very important. Migraineurs do not mind using more than 1 preventive agent at one time if greater efficacy can be achieved. Agents that may affect weight and /or cause sedation may be important factors as to why patients (especially females) may not want to take a preventive medication. Natural therapies and once-daily dosing are ranked lower overall but still are important characteristics of preventive treatment. Some gender differences are noted in the ranking of migraine preventive characteristics. [source] Effect of Autogenic Training on Drug Consumption in Patients With Primary Headache: An 8-Month Follow-up StudyHEADACHE, Issue 3 2003Terezia Zsombok MD Objective.,To examine the effects of Schultz-type autogenic training on headache-related drug consumption and headache frequency in patients with migraine, tension-type, or mixed (migraine plus tension-type) headache over an 8-month period. Background.,Behavioral treatments often are used alone or adjunctively for different types of headache. There are, however, only a few studies that have compared the efficacy and durability of the same treatment in different types of primary headache, and the effects of treatment on headache-related drug consumption rarely have been assessed even in these studies. Methods.,Twenty-five women with primary headache (11 with mixed headache, 8 with migraine, and 6 with tension-type headache) were evaluated via an open-label, self-controlled, 8-month, follow-up study design. After an initial 4 months of observation, patients began learning Schultz-type autogenic training as modified for patients with headache. They practiced autogenic training on a regular basis for 4 months. Based on data from headache diaries and daily medication records, headache frequencies and the amounts of analgesics, "migraine-specific" drugs (ergots and triptans), and anxiolytics taken by the patients were compared in the three subgroups over the 8-month period. Results.,From the first month of implementation of autogenic training, headache frequencies were significantly reduced in patients with tension-type and mixed headache. Significant reduction in frequency was achieved in patients with migraine only from the third month of autogenic training. Decreases in headache frequencies were accompanied by decreases in consumption of migraine drugs and analgesics resulting in significant correlations among these parameters. Reduction in consumption of anxiolytic drugs was more rapid and robust in patients with tension-type headache compared to patients with migraine, and this outcome failed to show any correlation with change in headache frequency. Conclusion.,Schultz-type autogenic training is an effective therapeutic approach that may lead to a reduction in both headache frequency and the use of headache medication. [source] Electronic journal provision in a health-care library: insights from a consultation with NHS workersHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2006Sarah E. Crudge Objective:, This study determines the current awareness journal reading requirements of the users of Stockport National Health Service (NHS) Trust's library. The overlap between requirements and the provision of the NHS Core Content resources, four major electronic journal bundles, and the holdings of North West health libraries is also investigated. Methods:, A survey of both hospital and Primary Care Trust staff was conducted, and respondents were required to provide a list of their favourite journal titles. Each requested title was assigned a subject code, and the impact factor was noted. Results:, From 135 survey responses, 217 journal titles were identified and 33 category codes were utilized. There was little overlap between the request list and the NHS Core Content titles, but substantial correspondence existed between the request list and the print holdings of North West health libraries. Conclusions:, Current awareness journal reading requirements will not be met by the Core Content provision alone. Bundles of titles offer value-for-money solutions, but may be at the expense of popular titles. Furthermore, the success of regional document supply schemes may be compromised if large numbers of health-care libraries replace print holdings with similar electronic journal bundles. [source] Pharmacoeconomics of Gastrointestinal Drug Utilisation Prior and Post Helicobacter pylori EradicationHELICOBACTER, Issue 1 2004Rogier M. Klok ABSTRACT Background., Eradication of Helicobacter pylori prevents recurrence of peptic ulcer. In pharmacoeconomic analyses it is often presumed that after successful eradication no more gastrointestinal drugs are used. We investigated this presumed positive monetary effect using General Practitioners prescribing data, including information in diagnosis. Methods., From the RNG-database we identified patients with a H. pylori eradication in the years 1997,2000. H. pylori eradication was defined as a prescription of two antibiotics and one gastrointestinal drug on the same day. Patients were divided into a group with diagnosed ulcers and a group without diagnosed ulcers. Gastrointestinal drug costs were calculated for 4 months prior to eradication and 9,12 months post eradication. For comparison costs in all periods were expressed per patient per period. For statistical analysis the paired t -test was used. Results., One hundred and two patients were eligible for evaluation. Of these patients 35 had a diagnosed ulcer and 67 had not. Generally the number of patients on gastrointestinal drugs decreased (61% prior vs. 33% post), however, the drug costs did not change (,33 prior vs. ,34 post). Costs for proton pump inhibitors increased post eradication (,14 prior vs. ,28 post). The ulcer and nonulcer group showed similar results. Conclusion.,Helicobacter pylori eradication is thought to be cost effective, however, we did not find a decrease in costs for all gastrointestinal drugs. There may be a great pharmacoeconomical advantage when it is possible to predict which patients are more likely to ,fail' eradication therapy. [source] Helicobacter pylori -Associated Chronic Gastritis and Unexplained Iron Deficiency Anemia: a Reliable Association?HELICOBACTER, Issue 6 2003Stéphane Nahon Abstract Background and aim., About 35% of iron deficiency anemia cases remain unexplained after a gastrointestinal evaluation. An association between Helicobacter pylori and iron malabsorption has been suggested. The aim of this study was to determine whether H. pylori -associated chronic gastritis is linked to unexplained iron deficiency anemia in adults. Methods., From 1996 to 2001, we identified 105 patients with unexplained iron deficiency anemia after upper endoscopy, colonoscopy, small bowel radiographic examination and duodenal biopsies. Two biopsies were obtained from the gastric antrum and two from the corpus of each patient. Gastritis status was described according to the Sydney System and H. pylori infection was assessed by an immunohistochemical test on biopsy specimens. This group was compared to a control group matched for sex and age. Results., There were 76 women and 29 men (mean age 57.4 ± 21.4 years) examined in the study. A H. pylori -associated chronic gastritis was identified in 63 cases (60%) vs. 45 cases (43%) cases in the control group (p < .01). Atrophic gastritis was significantly associated with iron deficiency anemia compared with the control group [16 (15%) vs. 6 (6%); p < .03]. In the unexplained iron deficiency anemia group, (1) patients with chronic gastritis were significantly younger (52 ± 22 vs. 64 ± 20 years; p < .005), and (2) chronic gastritis was not linked to sex [sex ratio (male/female): 0.5 vs. 0.34, p = .34]. The prevalence of H. pylori infection was similar between premenopausal and postmenopausal women [28 (27%) vs. 26 (25%); p = .7] with iron deficiency anemia. Conclusion.,H. pylori infection and chronic gastritis, especially atrophic gastritis, are significantly associated with unexplained iron deficiency anemia. Relationships between H. pylori -associated chronic gastritis and unexplained iron deficiency anemia should be considered. [source] Long-term clinical outcome of living-donor liver transplantation for primary biliary cirrhosisHEPATOLOGY RESEARCH, Issue 2007Etsuko Hashimoto Aim:, We described the recurrence of primary biliary cirrhosis (PBC) after living donor liver transplantation (LDLT) (Liver Transplantation, 7, 2001: 588). However, since the follow-up period in that study was insufficiently long (median 35.5 months), we performed a long-term study to further characterize recurrence of PBC after LDLT. Patients:, From 1991 to 2006, 15 patients with end-stage PBC underwent LDLT at Tokyo Women's Medical University. Of these patients, we studied 8 PBC patients (age 29 to 51 years, all females) who survived LDLT for more than 5 years. The follow-up period for these patients ranged form 68 to 120 months. Immunosuppression was maintained with tacrolimus and prednisone. Laboratory examinations performed in every patient and donor before LDLT included routine biochemical studies, antimitochondrial antibody (AMA) by immunofluorescence (IF), anti-M2 by enzyme-linked immunosorbent assay as well as antinuclear antibody (ANA) by IF, and immunoglobulin. After LDLT, the same laboratory examinations were performed in patients every 6 months. Liver biopsy was performed when patients exhibited clinical or biochemical signs of graft dysfunction. In addition, protocol biopsy was performed every 1 to 2 years after LDLT. Results:, At the time of LDLT, all patients had end-stage cholestatic liver failure. Seven patients were positive for AMAand anti-M2 while 1 patient was negative for these markers but strongly positive for ANA. Donors were blood relatives in 6 cases, and 2 donors who were not blood relatives still exhibited multiple HLA matches with the recipients. At the end of the study in May 2006, all patients were doing well. On laboratory examination, mild abnormal liver function test results were found in 4 patients: 3 were probably due to recurrence of PBC, 1 resulted from nonalcoholic steatohepatitis. Comparison of the AMA titer between before LDLT and the most recent follow-up visit showed an increase in three patients, a decrease in two patients and no change in three patients. In contrast, the ANA titer increased in five patients. Histologically, strong evidence of recurrent PBC was found in 4 patients, and findings compatible with PBC were present in 2 additional patients. Conclusions:, Although the number of our patients is small, our findings confirm that PBC can recur at high frequency after LDLT. However, this complication has not developed to advanced stages and has not caused appreciable symptoms in our patients, all of whom have a good quality of life. [source] Oral health-related quality of life in children: Part I. How well do children know themselves?INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 2 2008A systematic review Abstract:, Objective:, Paediatric oral disorders are likely to have a negative effect on the quality of life. Until recently, children's oral health-related quality of life (OHRQoL) was measured using parents as informants. Instruments have now been developed, which have demonstrated that with appropriate questionnaire techniques, valid and reliable information can be obtained from children. The aim of this study was to make a systematic review of the existing literature about child perceptions of OHRQoL and their validation. Methods:, A computerized search was conducted using Medline, ISI, Lilacs and Scielo for children's perception of OHRQoL. The inclusion criteria were: the articles should contain well-validated instruments and provide child perceptions of OHRQoL. Results:, From 89 records found, 13 fulfilled the criteria. All studies included in the critical appraisal of the project suggested good construct validity of overall child perceptions of OHRQoL. However, children's understanding of oral health and well-being are also affected by variables (age, age-related experiences, gender, race, education, culture, experiences related to oral conditions, opportunities for treatment, childhood period of changes, back-translating questionnaire, children self-perceived treatment need). Conclusions:, The structure of children's self-concept and health cognition is age-dependent as a result of their continuous cognitive, emotional, social and language development. By using appropriate questionnaire techniques, valid and reliable information can be obtained from children concerning their OHRQoL. [source] A retrospective study of paediatric oral lesions from ThailandINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2007KITTIPONG DHANUTHAI Aim., To survey the paediatric oral lesions in Thailand. Design., Biopsy records over a 15-year period (1990,2004) were retrieved from the files of the Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University. Paediatric cases with an age of 16 years or younger were selected. The age of the patients was divided into three groups according to the dentition period. The lesions were classified into three categories: inflammatory/reactive lesions, cystic lesions, and tumour/tumour-like lesions. Results., From a total of 8314 oral biopsies, 1251 cases (15.05%) were in the paediatric population. The greatest number of lesions fell into the cystic category, followed closely by the inflammatory/reactive category and tumour/tumour-like category, respectively. The top ten most frequently encountered lesions in the present study were dentigerous cyst, mucocele, pyogenic granuloma, ameloblastoma, radicular cyst, odontoma, odontogenic keratocyst, irritation fibroma (focal fibrous hyperplasia), fibrous dysplasia, and osteomyelitis. The majority of lesions were found in the mixed dentition period (49.24%). There was no statistical difference in the occurrence between genders in this study. Conclusions., The present study shows an almost similar trend to previous studies except in the ranking among and within categories. These differences may be attributable to the nature of the population studied and because Chulalongkorn University is a major referral centre. [source] Use of over-the-counter medicines in childrenINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2003John McIntyre senior lecturer in child health ABSTRACT Objective To assess the reasons for over-the-counter (OTC) medicine use in children and the sociodemographic factors influencing this choice of self-care rather than GP consultation. Method Questionnaires were sent to the home address of a randomly generated list of children under 12 years of age from three GP practices in the East Midlands selected to represent bottom, middle and top tertiles of deprivation on the basis of the Jarman score. Analysis using chi-square and Mann-Whitney tests was used to identify associated factors (number of carers in the home, number of children, deprivation score, parent/carer's age, age and number of children in the house) of the responses. Setting Primary care setting in the East Midlands region of England. Key findings From 424 completed questionnaires returned (response rate 61%), 413 parents/carers had purchased OTC medicines. Fifty-one different products had been purchased, with analgesic/antipyretic and cough/cold remedies the most frequently bought. The most commonly reported reasons for parent/carer initiated medication were to avoid troubling the GP with minor childhood ailments (79% of respondents) and to have medicines available in case of future need (74%). Cost was a barrier to buying OTC medicines for the more deprived. Advice-seeking behaviour was associated with the symptom, the number of children, affluence and the age of the child. Conclusion Parent/carer initiated use of OTC medication is widespread, particularly for analgesic/antipyretic and cough/cold remedies. Differences in advice-seeking behaviour are associated with the presenting symptom and a variety of sociodemographic factors. [source] Family-Based Weight Management With Latino Mothers and ChildrenJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2008Kathy Shadle James PURPOSE.,This paper aims to design a culturally appropriate weight management intervention for high-risk Latino families and to examine the feasibility of recruiting program participants. DESIGN AND METHODS.,A descriptive design using qualitative and quantitative data collected during preliminary phases of an ongoing intervention study. RESULTS.,From the preliminary works, a curriculum was revised for Latino families who have overweight children. The curriculum was modified to include suggestions from the focus groups, including helping mothers set limits with their children and make the transition to lighter foods and a more active family life. PRACTICE IMPLICATIONS.,The information will aid professionals in the process of program design for Latino families who have weight concerns. [source] The Status of the "Material" in Theories of Culture: From "Social Structure" to "Artefacts"JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR, Issue 2 2002Andreas ReckwitzArticle first published online: 27 JUN 200 First page of article [source] Effectiveness of cutaneous warming systems on temperature control: meta-analysisJOURNAL OF ADVANCED NURSING, Issue 6 2010Cristina Maria Galvão galvão c.m., liang y. & clark a.m. (2010) Effectiveness of cutaneous warming systems on temperature control: meta-analysis. Journal of Advanced Nursing,66(6), 1196,1206. Abstract Title.,Effectiveness of cutaneous warming systems on temperature control: meta-analysis. Aim., This paper is a report of a meta-analysis to identify the effectiveness of different types of cutaneous warming systems in temperature control for patients undergoing elective surgery. Background., Hypothermia is a common and serious complication of surgery. Different cutaneous warming systems are used to prevent hypothermia during surgery but there have been no previous meta-analyses of the effectiveness of different warming systems in controlling temperature. Data sources., We conducted a search of the CINAHL (2000 to April 2009), Medline (2000 to April 2009), Embase (2000 to April 2009) and the Cochrane Register of Controlled Trials (2000 to April 2009) databases for randomized controlled trials published in English, Spanish and Portuguese. The primary outcome measure of interest was core body temperature. Methods., A systematic review incorporating meta-analysis was carried out. Results., From 329 papers, 23 trials compared warming systems. Forced-air warming systems had a strong tendency towards superior temperature control over passive insulation via cotton blankets (mean difference: 0·29°C; 95% confidence interval: ,0·02 to 0·59, three trials 292 patients) and radiant warming systems (mean difference: 0·16°C; 95% confidence interval: ,0·01 to 0·33, three trials, 161 patients). However, circulating water garments tended to be more effective than forced-air warming systems (mean difference: ,0·73°C; 95% confidence interval: ,1·51 to 0·05, I2 = 97%; four trials, 198 patients). Pooled results approached statistical significance and indicated clinically meaningful differences in temperature control. Conclusion., Current evidence suggests that circulating water garments offer better temperature control than forced-air warming systems, and both are more effective than passive warming devices. [source] Hospital Charges Attributable to a Primary Diagnosis of Infectious Diseases in Older Adults in the United States, 1998 to 2004JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2008Aaron T. Curns MPH OBJECTIVES: To describe total and average hospital charges associated with infectious disease (ID) hospitalizations and specific ID categories and to estimate ID hospitalization rates in adults aged 65 and older in the United States from 1998 through 2004. DESIGN: Retrospective analysis of hospital discharge data obtained from the Nationwide Inpatient Sample for 1998 through 2004. SETTING: United States. PATIENTS: Older adults hospitalized in the United States from 1998 through 2004. MEASUREMENTS: Hospital charges and hospitalization rates for IDs described according to year, age group, sex, U.S. Census region, and ID category. Charges for non-ID hospitalizations were also described. Hospital charges were adjusted for inflation. RESULTS: From 1998 through 2004, total charges for ID hospitalizations exceeded $261 billion and accounted for 13% of all hospital charges for older adults. Total charges for ID hospitalizations increased from $31.4 billion in 1998 to $45.7 billion in 2004. The average annual ID hospital charge was lower than the average annual non-ID hospital charge during the study period ($21,342 vs $22,787, P<.001). The average annual rate for ID hospitalizations was 503 per 10,000 older adults, which remained stable during the study period. CONCLUSION: The total charges for ID hospitalizations and for all hospitalizations in older adults in the United States increased 45% and nearly 40%, respectively, during the 7-year study period, whereas the population of older adults grew by only 5%. Sustained increases of such magnitude will have major implications for the U.S. healthcare system as it prepares for the more than doubling of the older U.S. adult population during the first 30 years of this century. [source] Diagnosing acute lung injury in the critically ill: a national survey among critical care physiciansACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2009A. P. J. VLAAR Background: Incidence reports on acute lung injury (ALI) vary widely. An insight into the diagnostic preferences of critical care physicians when diagnosing ALI may improve identification of the ALI patient population. Methods: Critical care physicians in the Netherlands were surveyed using vignettes involving hypothetical patients and a questionnaire. The vignettes varied in seven diagnostic determinants based on the North American European Consensus Conference and the lung injury score. Preferences were analyzed using a mixed-effects logistic regression model and presented as an odds ratio (OR) with a 95% confidence interval. Results: From 243 surveys sent to 30 hospitals, 101 were returned (42%). ORs were as follows: chest X-ray consistent with ALI: OR 1.7 (1.3,2.3), high positive end-expiratory pressure (PEEP) (15 cmH2O): OR 5.0 (3.9,6.6), low pulmonary artery occlusion pressures (PAOP) (<18 mmHg): OR 4.7 (3.6,6.1), low compliance (30 ml/cmH2O): OR 0.7 (0.5,0.9), low PaO2/FiO2 (<250 mmHg): OR 9.2 (6.9,12.3), absence of heart failure: OR 1.2 (0.9,1.5), presence of a risk factor for ALI (sepsis): OR 1.0 (0.8,1.3). The questionnaire revealed that critical care physicians with an anesthesiology background differed from physicians with an internal medicine background with regard to hemodynamic variables when considering an ALI diagnosis (P<0.05). Conclusions: Dutch critical care physicians consider the PEEP level, but not the presence of a risk factor for ALI, as an important factor to diagnose ALI. Background specialty of critical care physicians influences diagnostic preferences and may account for variance in the reported incidence of ALI. [source] Population Trends in BMD Testing, Treatment, and Hip and Wrist Fracture Rates: Are the Hip Fracture Projections Wrong?JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2005Susan B Jaglal PhD Abstract A worldwide epidemic of hip fractures has been predicted. Time trends in BMD testing, bone-sparing medications and hip and wrist fractures in the province of Ontario, Canada, were examined. From 1996 to 2001, BMD testing and use of bone-sparing medications increased each year, whereas despite the aging of the population, wrist and hip fracture rates decreased. Introduction: If patients with osteoporosis are being diagnosed and effective treatments used with increasing frequency in the population, rates of hip and wrist fractures will remain stable or possibly decrease. We report here time trends in BMD testing, prescriptions for bone-sparing medications, hip and wrist fracture rates, and population projections of fracture rates to 2005 in the province of Ontario, Canada. Materials and Methods: Ontario residents have universal access to Medicare. To examine time trends in BMD testing, all physician claims for DXA from 1992 to 2001 were selected from the Ontario Health Insurance Plan (OHIP) database. Trends in prescribing were examined from 1996 to 2003 using data from the Ontario Drug Benefit plan, which provides coverage to persons ,65 years of age. Actual numbers of hip and wrist fractures were determined for 1992-2000 and population projections for 2001-2005 using time-series analysis. Wrist fractures were identified in the OHIP database and hip fractures through hospital discharge abstracts. Results: From 1992 to 2001, the number of BMD tests increased 10-fold. There has been a steady increase in the number of persons filling prescriptions for antiresorptives (12,298 in 1996 to 225,580 in 2003) and the majority were for etidronate. For women, the rate of decline for wrist fractures is greater than that for hip fractures. The rate of hip fracture was fairly constant around 41 per 10,000 women ,50 years between 1992 and 1996. In 1997, the hip fracture rate began to decrease, and the population projections suggest that this downward trend will continue to a rate of 33.1 per 10,000 in 2005. Conclusions: Our findings suggest that fracture rates may be on the decline, despite the aging of the population, because of increased patterns of diagnosis and treatment for osteoporosis. [source] | |||||||||||||||||||||||||||||||||||||||||||