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Selected AbstractsAgricultural productivity and rural incomes in England and the Yangtze Delta, c.1620,c.18201ECONOMIC HISTORY REVIEW, Issue 3 2009ROBERT C. ALLEN The productivity of agriculture in England and the Yangtze Delta are compared c.1620 and c.1820 in order to gauge the performance of the most advanced part of China vis-à-vis its counterpart in Europe. The value of real output is compared using purchasing power parity exchange rates. Output per hectare was nine times greater in the Yangtze Delta than in England. More surprisingly, output per day worked was about 90 per cent of the English performance. This put Yangtze farmers slightly behind English and Dutch farmers c.1820, but ahead of most other farmers in Europe,an impressive achievement. There was little change in Yangtze agricultural productivity between 1620 and 1820. In 1820, the real income of a Yangtze peasant family was also about the same as that of an English agricultural labourer. All was not rosy in the Yangtze, however, for incomes there were on a downward trajectory. Agriculture income per family declined between 1620 and 1820, even though income per day worked changed little since population growth led to smaller farms and fewer days worked per year. The real earnings of women in textile production also declined, since the relative price of cotton cloth dropped,possibly also because a larger population led to greater production. The implication is that the Yangtze family, unlike the English family, had a considerably higher real income c.1620, and that period was the Delta's golden age. [source] Genetic and environmental interactions on oral cancer in Southern ThailandENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 2 2001Suparp Kietthubthew Abstract Many countries are interested in understanding the relationship between genetic susceptibility and their prevalent environmental cancers for disease prevention. In Thailand we conducted a population-based case-control study of 53 matched pairs to assess the risk of oral cancer in relation to genetic polymorphism of the glutathione-S-transferase genes (GSTM1 and GSTT1) in cigarette smokers, alcohol drinkers, and betel quid chewers. Interaction of the genes with other potential risk factors such as local bean consumption were also elucidated. Homozygous deletion of GSTM1 has a frequency of 56.6% (n = 30 over 53) among the patients and 30.2% (16/53) among the controls. This gene is associated with a 2.6-fold higher risk for development of oral cancer (95% CI 1.04,6.5). Among the null GSTM1 individuals, those who smoke, consume alcohol, and/or chew betel quid have a significantly increased risk for oral cancer with an odd ratio (OR) = 4.0 (95% CI = 1.2,13.7), OR = 7.2 (95% CI = 1.5,33.8), and OR = 4.4 (95% CI = 1.1,17.8), respectively. Interactions between any two of the lifestyle habits for oral cancer risk, however, are not found. The frequency of the GSTT1 null genotype is 34.0% (18/53) among the patients and 47.2% (25/53) among our controls. There is no association between the GSTT1 null allele and oral cancer risk. In conclusion, our study provides data to indicate that individuals who have homozygous deletion of the GSTM1 gene have increased risk for oral cancer. The risk increases further when these individuals are exposed to environmental toxicants such as chemicals in cigarette smoke, alcohol, and betel quid. These baseline data can be applied to a larger population-based study, both to verify the observation and to conduct mechanistic investigations. Environ. Mol. Mutagen. 37:111,116, 2001 © 2001 Wiley-Liss, Inc. [source] Mediastinal lymph node CD8,, DC initiate antigen presentation following intranasal coadministration of ,-GalCerEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 8 2007Sung-Youl Ko Abstract Our previous study revealed that ,-galactosylceramide (,-GalCer) is a potent nasal vaccine adjuvant inducing both potent humoral and cellular immune responses and affording complete protection against viral infections and tumors. However, the antigen-presenting cells (APC) that are activated by NKT cells and thereby initiate the immune responses following intranasal coadministration of protein antigen and ,-GalCer are poorly understood. We assessed here where antigen presentation occurs and which APC subset mediates the early stages of immune responses when protein antigen and ,-GalCer are intranasally administered. We show that dendritic cells (DC), but not B cells, initiated the mucosal immune responses at mediastinal lymph nodes. Of the DC subsets, the CD8,,B220,CD11c+ DC subset played the most prominent role in the direct and cross-presentation of protein antigen to naive T cells and in triggering the naive T cells to differentiate into effector T cells. This might be mainly caused by a relatively larger population of CD1dhigh cells of CD8,,B220,CD11c+ DC subset than those of other DC subsets. These results indicate that CD8,,B220,CD11c+ DC is the principal subset becoming immunogenic after interaction with NKT cells and abrogating tolerance to intranasally administered protein antigen when ,-GalCer is coadministered as a nasal vaccine adjuvant. [source] Evaluation of newly developed combination therapy of intra-arterial 5-fluorouracil and systemic pegylated interferon ,-2b for advanced hepatocellular carcinoma with portal venous invasion: preliminary resultsHEPATOLOGY RESEARCH, Issue 2 2009Kazuhiro Kasai Aim:, Prognosis is extremely poor for advanced hepatocellular carcinoma (HCC) in patients with portal invasion. The present study evaluated the efficacy of combined intra-arterial 5-fluorouracil (5-FU) and systemic pegylated interferon (PEG-IFN),-2b in patients with advanced HCC. Methods:, The subjects comprised nine HCC patients with portal vein thrombosis treated using subcutaneous administration of PEG-IFN,-2b (50,100 µg on day 1 of every week, for 4 weeks) and intra-arterial infusion of 5-FU (250 mg/day for 5 h on days 1,5 of every week, for 4 weeks). For four patients with hepatitis C virus (HCV) infection, oral administration of ribavirin (400,800 mg/day) was added. At the end of every cycle, response to therapy was assessed using Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. Results:, Partial response (PR) was observed in seven of nine patients, with stable or progressive disease in the remaining two patients. Tumors were resectable in three patients displaying PR after treatment. Tumor markers decreased significantly after therapy. Serum HCV-RNA titers were markedly decreased and became undetectable in all patients with HCV infection. National Cancer Institute,Common Toxicity Criteria: version 3.0 (NCI-CTC) grade 3 thrombocytopenia was seen in one case at the end of treatment, but was resolved with cessation of treatment. Other adverse effects were manageable. Conclusion:, Combination therapy with intra-arterial 5-FU and systemic PEG-IFN,-2b may be useful as a palliative treatment for patients with advanced HCC. A prospective controlled trial using a larger population of patients with advanced HCC is needed to evaluate this new combination therapy. [source] Lactate concentrations in the rectal lumen in patients in early septic shockACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010M. IBSEN Background: Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock. Methods: A prospective observational multicentre study of 130 patients with septic shock at six general ICU's of university hospitals. Six to 24 h after the onset of septic shock, the concentration of lactate in the rectal lumen was estimated by a 4-h equilibrium dialysis. Dialysate concentrations of lactate were determined using an auto-analyser. Results: The overall 30-day mortality was 32%, with age and Simplified acute physiology scores II and sequential organ failure assessment scores being significantly higher in non-survivors. In contrast, there were no differences in concentrations of lactate in the rectal lumen [2.2 (1.4,4.1) and 2.8 (1.6,5.1) mmol/l (P=0.34)] (medians and 25th,75th percentiles) or arterial blood [2.1 (1.4,4.2) and 2.0 (1.3,3.2) mmol/l (P=0.15)] between non-survivors and survivors. The rectal,arterial difference of the lactate concentration was higher in survivors. There were no differences in blood pressure, noradrenaline dose or central venous oxygen saturation between the groups. Conclusion: In this prospective, observational study of unselected patients with early septic shock, there was no difference in the concentration of lactate in the rectal lumen between non-survivors and survivors. Trial Registration: Clinicaltrials.gov (no: NCT00197938). [source] Prediction of organ-confined disease by prostate-specific antigen nadir after neoadjuvant therapyINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2000Takahiko Hachiya Abstract Background It is not clear whether or not serum prostate-specific antigen (PSA) levels after androgen deprivation prior to radical prostatectomy (neoadjuvant therapy) have any value in the prediction of the final pathologic stage. Methods We conducted a study on 49 patients who underwent retropubic radical prostatectomy following neoadjuvant therapy for clinical stage T1c, T2, and T3a prostate cancer. We evaluated progression-free survival based on the PSA failure rate and the predictive value of the PSA nadir after neoadjuvant therapy and other clinical factors to determine the most important predictor of organ confinement. Results Of the 49 patients, 30 had organ-confined disease. Of 31 patients without adjuvant therapy after surgery, the PSA failure-free rates at 2 years were 81.6 and 34.3% in the subset of organ-confined disease and non-organ-confined disease, respectively (P = 0.0031). Of the 18 patients with adjuvant androgen deprivation therapy after surgery, the PSA failure-free rate at 2 years was 100% and 59.7% in patients with organ-confined disease and non-organ-confined disease, respectively. Baseline PSA (P = 0.037), PSA nadir (P < 0.0001) and PSA density (P = 0.003) significantly correlated with organ confinement. Multivariate logistic regression analysis revealed that the PSA nadir was the only independent predictor of organ confinement (P = 0.044). Conclusions There was a trend that the patients with non organ-confined disease had a higher probability of PSA failure than did the patients with organ-confined disease. The PSA nadir after neoadjuvant therapy was the strongest predictor of organ confinement. The predictive value of the serum PSA nadir should be validated in well-designed larger population-based studies. [source] Prevalence of high antibody titers of pertussis in Turkey: reflection of circulating microorganism and a threat to infantsJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 3 2007Berrin Esen Abstract Acute pertussis infection among adults can cause its transmission to the larger population, especially to infants and young children, who can develop severe disease. In order to determine an age-dependent pertussis immune response, anti-pertussis toxin (PT) antibody was detected by the indirect enzyme-linked immunosorbent assay (ELISA) method in serum samples from 2,085 healthy subjects ranging in age from 6 months to ,60 years. Also included in the evaluation were responses to a questionnaire including sociodemographic characteristics, vaccination, and infection history. Titers of 50,99 ELISA units (EU)/mL and of ,100,EU/mL were accepted as indicative for recent exposure or infection. In addition, 30,EU/mL was estimated to be a sufficient titer in women of childbearing age to protect their newborns until administration of their first dose of pertussis vaccine. After the age of 4,5 years, presence of high-titered antibodies that increase with age might be a reflection of circulating infection and indicate the magnitude of the threat to infants. According to the questionnaires, in the groups younger than 15 years old, three to four doses of diphtheria toxoid-whole cell pertussis-tetanus toxoid (DwPT) were administered in 47.2 to 77.4%, 91.2 to 100.0%, and 83.5 to 100.0% of participants in Diyarbakir, Samsun, and Antalya, respectively. In addition, up to half of the expectant mothers we studied lacked a sufficient level of estimated antibody titers. To protect infants from life-threatening pertussis infection, improving vaccination coverage to ensure herd immunity and uniformly establishing coverage throughout the country are essential. Furthermore, revaccination with acellular vaccine for schoolchildren as well as for the households of pregnant women is recommended. J. Clin. Lab. Anal. 21:154,161, 2007. © 2007 Wiley-Liss, Inc. [source] Association of polymorphisms of glutamate-cystein ligase and microsomal triglyceride transfer protein genes in non-alcoholic fatty liver diseaseJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2010Claudia Pinto Marques Souza Oliveira Abstract Background and Aims:, Although the metabolic risk factors for non-alcoholic fatty liver disease (NAFLD) progression have been recognized, the role of genetic susceptibility remains a field to be explored. The aim of this study was to examine the frequency of two polymorphisms in Brazilian patients with biopsy-proven simple steatosis or non-alcoholic steatohepatitis (NASH): ,493 G/T in the MTP gene, which codes the protein responsible for transferring triglycerides to nascent apolipoprotein B, and ,129 C/T in the GCLC gene, which codes the catalytic subunit of glutamate-cystein ligase in the formation of glutathione. Methods:, One hundred and thirty-one biopsy-proven NAFLD patients (n = 45, simple steatosis; n = 86, NASH) and 141 unrelated healthy volunteers were evaluated. Genomic DNA was extracted from peripheral blood cells, and the ,129 C/T polymorphism of the GCLC gene was determined by restriction fragment length polymorphism (RFLP). The ,493 G/T polymorphism of the MTP gene was determined by direct sequencing of the polymerase chain reaction products. Results:, The presence of at least one T allele in the ,129 C/T polymorphism of the GCLC gene was independently associated with NASH (odds ratio 12.14, 95% confidence interval 2.01,73.35; P = 0.007), whereas, the presence of at least one G allele in the ,493 G/T polymorphism of the MTP gene differed slightly between biopsy-proven NASH and simple steatosis. Conclusion:, This difference clearly warrants further investigation in larger samples. These two polymorphisms could represent an additional factor for consideration in evaluating the risk of NAFLD progression. Further studies involving a larger population are necessary to confirm this notion. [source] Results of balloon valvuloplasty in 40 dogs with pulmonic stenosisJOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2004M. Stafford Johnson The records of 43 dogs presenting with severe pulmonic stenosis in which balloon valvuloplasty was attempted were reviewed. Thirty-four dogs (79 per cent) were symptomatic at initial presentation. All patients were selected for balloon valvuloplasty on the basis of a Doppler-derived trans-stenotic pressure gradient of over 80 mmHg and concurrent evidence of mild to severe right ventricular hypertrophy. Forty dogs underwent balloon valvuloplasty; the procedure was not performed in three dogs because of an aberrant coronary artery in two cases and because catheterisation of the pulmonary artery was not possible in the third. Overall, 37 out of the 40 dogs (93 per cent) were successfully ballooned, resulting in a mean reduction in the pressure gradient of 46 per cent, with a mean pressure gradient of 124 mmHg on presentation and 67 mmHg six months after the procedure. Three dogs died during balloon valvuloplasty (all of which had a concurrent defect) and three dogs showed a poor clinical response to the procedure. Thus balloon valvuloplasty was successful and resulted in a sustained clinical improvement in 80 per cent of previously symptomatic cases. This study was undertaken to document the results of balloon valvuloplasty in a larger population of dogs than has previously been published. [source] Student views on the effective teaching of physical examination skills: a qualitative studyMEDICAL EDUCATION, Issue 2 2009Merel J C Martens Objectives, The lack of published studies into effective skills teaching in clinical skills centres inspired this study of student views of the teaching behaviours of skills teachers. Methods, We organised focus group discussions with students from Years 1,3 of a 6-year undergraduate medical curriculum. A total of 30 randomly selected students, divided into three groups, took part in two sessions. They discussed what teaching skills helped them to acquire physical examination skills. Results, Students' opinions related to didactic skills, interpersonal and communication skills and preconditions. Students appreciated didactic skills that stimulate deep and active learning. Another significant set of findings referred to teachers' attitudes towards students. Students wanted teachers to be considerate and to take them seriously. This was reflected in student descriptions of positive behaviours, such as: ,responding to students' questions'; ,not exposing students' weaknesses in front of the group', and ,[not] putting students in an embarrassing position in skill demonstrations'. They also appreciated enthusiasm in teachers. Important preconditions included: the integration of skills training with basic science teaching; linking of skills training to clinical practice; the presence of clear goals and well-structured sessions; good time management; consistency of teaching, and the appropriate personal appearance of teachers and students. Conclusions, The teaching skills and behaviours that most facilitate student acquisition of physical examination skills are interpersonal and communication skills, followed by a number of didactic interventions, embedded in several preconditions. Findings related to interpersonal and communication skills are comparable with findings pertaining to the teaching roles of tutors and clinical teachers; however, the didactic skills merit separate attention as teaching skills for use in skills laboratories. The results of this study should be complemented by a study performed in a larger population and a study exploring teachers' views. [source] Peak energy of the prompt emission of long gamma-ray bursts versus their fluence and peak fluxMONTHLY NOTICES OF THE ROYAL ASTRONOMICAL SOCIETY, Issue 2 2008L. Nava ABSTRACT The spectral-energy (and luminosity) correlations in long gamma-ray bursts are being hotly debated to establish, first of all, their reality against possible selection effects. These are best studied in the observer planes, namely the peak energy Eobspeak versus the fluence F or the peak flux P. In a recent paper, we have started to investigate this problem considering all bursts with known redshift and spectral properties. Here, we consider instead all bursts with known Eobspeak, irrespective of redshift, adding to those a sample of 100 faint BATSE bursts representative of a larger population of 1000 objects. This allows us to construct a complete, fluence-limited, sample, tailored to study the selection/instrumental effects we consider. We found that the fainter BATSE bursts have smaller Eobspeak than those of bright events. As a consequence, the Eobspeak of these bursts is correlated with the fluence, though with a slope flatter than that defined by bursts with z. Selection effects, which are present, are shown not to be responsible for the existence of such a correlation. About six per cent of these bursts are surely outliers of the Epeak,Eiso correlation (updated in this paper to include 83 bursts), since they are inconsistent with it for any redshift. Eobspeak also correlates with the peak flux, with a slope similar to the Epeak,Liso correlation. In this case, there is only one sure outlier. The scatter of the Eobspeak,P correlation defined by the BATSE bursts of our sample is significantly smaller than the Eobspeak,F correlation of the same bursts, while for the bursts with known redshift the Epeak,Eiso correlation is tighter than the Epeak,Liso one. Once a very large number of bursts with Eobspeak and redshift will be available, we thus expect that the Epeak,Liso correlation will be similar to that currently found, whereas it is very likely that the Epeak,Eiso correlation will become flatter and with a larger scatter. [source] Does ageing influence deep brain stimulation outcomes in Parkinson's disease?MOVEMENT DISORDERS, Issue 10 2007Fabienne Ory-Magne MD Abstract We sought to define the influence of ageing in clinical, cognitive, and quality-of-life outcomes after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD). We performed motor assessment (UPDRS), mood tests, cognitive, and quality of life evaluation (PDQ-39) on PD patients before surgery, and 12 and 24 months after, and we recorded adverse events. The variations of these parameters after surgery were correlated with age using regression statistical tests. Cerebral bleeding risk was evaluated by a nonparametric test. We enrolled 45 patients (mean age 60 ± 9 years, range 40,73). No significant correlation was found between age and motor scores and PDQ-39 improvements at 12 months. At 24 months, there was a significant negative correlation between age and the improvement of three dimensions of PDQ 39 (mobility, activities of daily life, and cognition). Cognitive impairment showed no correlation, but apathy and depression were positively correlated with age. Significant statistical difference was observed between cerebral bleeding and age. STN-DBS is an effective treatment for elderly patients with advanced PD. A longer follow-up duration and a larger population seem necessary to better assess the quality of life perception in elderly patients and to determinate the real risk of hemorrage. © 2007 Movement Disorder Society [source] Needs assessment of runaway females in Iran from an occupational therapy perspectiveOCCUPATIONAL THERAPY INTERNATIONAL, Issue 4 2008Maryam Malekpour Abstract The purpose of this descriptive study was to assess, from an occupational therapy perspective, the occupational performance needs of runaway females between 15 and 33 years old, residing in the state-run shelters in Mashhad, Iran. The inclusion criteria were: (1) participants who were 15 years old or above; (2) participants who resided in one of the state-run shelters in Mashhad; and (3) participants who could read, comprehend and write in Farsi. A written survey was completed by 44 runaway females (response rate: 36.6%). The findings revealed the occupational needs of this population to be as follows: vocational needs to find a meaningful job, emotional needs to manage depression and hopelessness, social participation needs to manage family and peer/friend relationships and peer interactions with the opposite sex to find an appropriate mate and educational needs to continue their education. Participants were from one area of Iran, so the results of the study cannot be generalized to runaway females residing in shelters in other areas of the country. Future research could include a qualitative design to explore more in-depth needs of this population. Also, a larger population of runaway females nationwide should be included in a study to increase generalizability. Copyright © 2008 John Wiley & Sons, Ltd. [source] Low-dose doxapram therapy for idiopathic apnea of prematurityPEDIATRICS INTERNATIONAL, Issue 2 2001Toshio Yamazaki AbstractBackground: Doxapram is contraindicated for newborn infants in Japan because of its serious side effects. However, because of encouraging results of recent studies regarding the efficacy and safety of therapy for apnea of prematurity (AOP) with lower doses of doxapram than those previously proposed, approximately 60% of Japanese neonatologists continue to use doxapram at small doses. Caution is warranted because the sample sizes of the former studies are inadequate to evaluate doxapram for both its beneficial and harmful effects. Therefore, we conducted the present study in order to investigate the efficacy and harmful events of low-dose doxapram therapy for idiopathic AOP in very low-birth weight (VLBW) infants in a larger population. Methods: One hundred and six VLBW infants with idiopathic AOP were treated with doxapram at a dose of 0.2,1.0 mg/kg per h in combination with methylxanthines and the frequency of apnea and secondary outcomes were compared with a group of control infants. Results: An approximate 80% reduction in the frequency of apnea was found with only minimal side effects following low-dose doxapram. Although there were no significant differences in secondary outcomes between the doxapram-treated and control groups, mortality in doxapram-treated infants was significantly lower than that in control infants. Conclusions: Patients with AOP unresponsive to treatment with methylxanthines may benefit from the addition of low-dose doxapram. [source] Medication use and risk of fallsPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2002C. Ineke Neutel PhD, FACE Abstract Purpose Injuries due to falls are an important public health concern, particularly for the elderly, and effective prevention is an ongoing endeavour. The present study has two related objectives: (1) to describe associations between drug use and falls in an institutionalized population, and (2) to identify a high risk subgroup within the larger population. Methods The initial analysis was based on a population of 227 residents who were followed over a 1-year period. Logistic regression techniques were used to estimate odds ratios (ORs) of the association of falls and drug use. The study of potential ,high-risk' groups employed a case,crossover design to estimate the risk of falling associated with starting a new drug course. Results Relatively weak ORs for risk of falling were observed for various drug classes; the highest OR was for benzodiazepines (BZD) at OR=1.8, (unadjusted). Residents taking multiple drugs were at particular risk for falling, e.g. an OR of 6.1, for those using 10+ drugs. The case,crossover analysis indicated that residents starting a new BZD/antipsychotic were at very high risk (OR,=,11.4,) for experiencing a fall. Conclusions Residents who took many different types of medications, as well as residents starting a new BZD/antipsychotics were at greatly increased risk of falling. These are high risk groups where increased monitoring or adjustments to drug regimens could lead to prevention of falls. Copyright © 2002 John Wiley & Sons, Ltd. [source] An attempt to create an ethic of transfer after conflict resolution in fractured communities: a modified formal grounded theory shaped by meta-ethnographyPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 2 2007Maurice Apprey Abstract A modified formal grounded theory on the ethic of transfer after conflict resolution has been established. There are two parts to this account. First a phenomenologically driven set of basic assumptions is deployed to shape the praxis. Then a meta-ethnographic synthesis is used to combine different approaches to conflict resolution in order to create another discrete interventional practice in ways that make us uneasy about each of the prior practices. The result is an interventional approach that allows practitioners of conflict resolution in fractured communities to begin their interventions with an understanding of the cultural habitus in the first instance, followed up with processes of transformation through psychopolitical dialogues and ending with grassroots projects that return the conflict-resolution project into the hands of the stakeholders whose cultural habitus was determined at the onset. Finally, psychopolitical dialogue with the select group of stakeholders ends with the choice of a number of grassroots projects that in turn generalize the results from small groups into the larger population. Such an ethic of transfer then starts with gatekeepers to sanction the psychopolitical dialogues and returns to the same gatekeepers who guide the selection of grassroots projects. The result is a recursive loop that treats the ethic of transfer of a conflict resolution project as part of an organic whole rather than an addendum. Copyright © 2007 John Wiley & Sons, Ltd. [source] Mother,child joint activity and behaviour problems of pre-school childrenTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 7 2003Kumari Chandani Galboda-Liyanage Background: Behaviour problems are common among pre-school children, and a substantial proportion persist, causing significant burden to the family, schools and health services. Relatively little research has addressed the effects of positive parenting on behaviour disorder in pre-school children, particularly in larger population-based studies. Method: A cross-sectional postal survey of a representative, population-based sample of 800 mothers of 3½-year-old children living in an outer London Borough was carried out to assess the association between mother,child joint activity and behaviour problems of pre-school children. The response rate was 70%. Results: Lower levels of mother,child joint activity remained independently associated with behaviour problems of pre-school children both on a binary and a continuous scale after adjusting for a wide range of household, maternal and child circumstances. The association between low levels of mother,child joint activities and behaviour problems of the children was stronger in the presence of social problems in the family. Conclusion: Possible causal pathways and directions for future research and intervention are discussed. [source] Stemming the tide: Cognitive aging theories and their implications for continuing education in the health professionsTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 3 2003Dr. Kevin W. Eva PhD Assistant Professor Abstract As demographic drift among health care providers mimics that of the larger population, it becomes increasingly clear that theory pertaining to the impact of aging on cognitive processing should inform the continuing education efforts designed for health care professionals. The purpose of this article is to offer a critical review of the major theories in this area and outline a sample of the implications that can be derived from these views. Research articles examining the relationship between age and physician performance were identified using MEDLINE, PsychLit, and ERIC. In addition, the psychology literature on age-related changes in cognitive processing was reviewed. Evidence from the medical education literature and psychological theory suggest the importance of increased environmental supports, decreased time demands, and peer review programs as barriers against the impact of aging. The implications of these findings include the potential to tailor continuing education (and physician remediation) efforts toward the age-related abilities/deficiencies of individual physicians. [source] The Quality of Health Insurance Service Delivery for Kidney Transplant Recipients: A Patient PerspectiveAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2010E. J. Gordon Increased attention has been devoted to improving quality care in kidney transplantation. The discourse on quality care has focused on transplant center metrics and other clinical parameters. However, there has been little discussion on the quality of health insurance service delivery, which may be critical to kidney recipients' access to transplantation and immunosuppression. This paper describes and provides a framework for characterizing kidney transplant recipients' positive and negative interactions with their insurers. A consecutive cohort of kidney recipients (n = 87) participated in semistructured interviews on their interactions with insurance agencies. Patients reported negative (37%) and/or neutral or positive (79%) interactions with their insurer (a subset [16%] reported both). Perceived negative experiences included: poor service, logistical difficulties with confusing and time-consuming paperwork, poor communication, rude behavior and concerns about adequate coverage. Positive experiences related to: having good coverage, a simple application process, straightforward transactions and helpful communication. Findings suggest that even when patients have insurance coverage, difficult interactions with insurers and limited skills in navigating insurance options may limit their access to needed medications and health services. Future research is needed to test this hypothesis in a larger population. [source] Randomized trial of two different doses of pyridoxine in the prevention of capecitabine-associated palmar-plantar erythrodysesthesiaASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2010T CHALERMCHAI Abstract Aim: The aim of the present study was to compare the efficacy of 200 mg versus 400 mg daily of pyridoxine in preventing or delaying the onset of palmar-plantar erythrodysesthesia (PPE) in capecitabine-treated patients. Methods: Patients with histologically confirmed breast cancer or colorectal cancer receiving single agent capecitabine started at 2000 to 2500 mg/m2 daily from day 1 to 14 every 3 weeks were randomly assigned to receive 200 mg or 400 mg daily of pyridoxine for PPE prophylaxis. The primary endpoint was the reduction of incidence of grade 2 or greater PPE. Secondary endpoints were reduction of severe PPE and prolongation of time to development of grade 2 or greater PPE. Results: There were 56 patients in this study. The baseline characteristics were generally similar in both groups. The high dose arm had less PPE than the low dose arm (11 of 28 or 39% vs 20 of 28 or 71%, relative risk = 0.26 [0.08, 0.79], P = 0.031). Grade III PPE developed in 3 of 28 (10.7%) versus none in patients receiving 200 mg versus 400 mg pyridoxine, respectively (relative risk 2.12 [1.594, 2.819], P = 0.24). High dose pyridoxine had a longer time to development of grade 2 or greater PPE compared to the low dose arm, 87 days versus 62 days. The 400 mg pyridoxine group had, however, a worsened tumor response and tended to have greater tumor treatment failure and shorter time to treatment failure. Conclusion: With the limitation of sample size in this study, there was a trend to improve PPE incidence and time to event with a higher dose of pyridoxine. Further validation of these results in a larger population is warranted. [source] A pilot survey of the impact of menstrual cycles on adolescent healthAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009Cynthia M. FARQUHAR Background: The experience of menstruation and reproductive health by adolescent girls has been poorly studied in New Zealand. Aims: To develop and pilot a Web-based survey of 16-year-olds' experience of menstruation and reproductive health with the eventual objective of conducting a larger population-based survey. A secondary aim was to report on the experience of menstrual and reproductive health in a group of 16-year-old girls in an urban setting. Methods: A Web-based survey was developed and tested in 2006 with assistance of a multidisciplinary advisory group. The final version of the questionnaire had 146 questions in 11 sections and the topics were menstrual history, general health including use of medications, access to medical care or health information, sexual health, family history and personal information including smoking, height, weight, ethnicity, paid employment of parents, drug and alcohol use and exercise patterns. Results: Seventy-five 16-year-old students completed the survey. Twenty-five per cent considered that their periods were quite a bit or a lot of trouble and 10% avoided certain activities during their menstrual periods, nearly 50% of girls always experienced some pain with every period, and 30% had seen a health professional about their period pains. Thirty-three stated that menstruation was moderately to severely painful and that daily activity was affected. Fifty per cent of girls were sexually active and of these 80% described it as painful. Conclusions: The Web-based survey was a successful approach to collecting information and could be used in a larger study. [source] Need for syphilis screening and counselling in HIV counselling and testing centres: A curtain raiser study from north IndiaAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2009Vijaya Lakshmi Nag Abstract Background:,Voluntary counselling and testing centres (VCTC) are important HIV screening points for the population with suspicion or apprehension for HIV, because of high-risk exposures. Theoretically, these are also at the risk of having co-infections, commonest being syphilis. The present short-term study was aimed at knowing the sero-reactivity of syphilis among a study cohort attending the VCTC in King George's Medical University, Lucknow, India. Method:,During a 2.5-month period, 49 HIV-positive and 171 HIV-negative sera were tested for venereal disease research laboratory (VDRL). The positive sera were further tested for treponema pallidum haemagglutination (TPHA). Result:,Eleven (22.4%) HIV-positive sera and 104 (60.8%) HIV-negative sera were VDRL-reactive (,1:8 dilutions). Of these, TPHA was reactive in three (27.3%) and four (3.9%), respectively. Conclusion:,The result might suggest the need for routine screening and counselling for syphilis at VCTC. Studies from other centres on larger population are required. [source] Hypoxia enhances proliferation of mouse embryonic stem cell-derived neural stem cellsBIOTECHNOLOGY & BIOENGINEERING, Issue 2 2010Carlos A.V. Rodrigues Abstract Neural stem (NS) cells can provide a source of material with potential applications for neural drug testing, developmental studies, or novel treatments for neurodegenerative diseases. Herein, the ex vivo expansion of a model system of mouse embryonic stem (mES) cell-derived NS cells was characterized and optimized, cells being cultivated under adherent conditions. Culture was first optimized in terms of initial cell plating density and oxygen concentration, known to strongly influence brain-derived NS cells. To this end, the growth of cells cultured under hypoxic (2%, 5%, and 10% O2) and normoxic (20% O2) conditions was compared. The results showed that 2,5% oxygen, without affecting multipotency, led to fold increase values in total cell number about twice higher than observed under 20% oxygen (20-fold vs. 10-fold, respectively) this effect being more pronounced when cells were plated at low density. With an optimal cell density of 104,cells/cm2, the maximum growth rates were 1.9,day,1 under hypoxia versus 1.7,day,1 under normoxia. Cell division kinetics analysis by flow cytometry based on PKH67 tracking showed that when cultured in hypoxia, cells are at least one divisional generation ahead compared to normoxia. In terms of cell cycle, a larger population in a quiescent G0 phase was observed in normoxic conditions. The optimization of NS cell culture performed here represents an important step toward the generation of a large number of neural cells from a reduced initial population, envisaging the potential application of these cells in multiple settings. Biotechnol. Bioeng. 2010;106: 260,270. © 2009 Wiley Periodicals, Inc. [source] Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunctionACTA NEUROLOGICA SCANDINAVICA, Issue 2 2009G. Luef Objective,,, To collect data on sexual dysfunction in a larger population of male patients with epilepsy treated with oxcarbazepine in a naturalistic setting. Patients and methods,,, Six hundred seventy-three adult male patients with partial epilepsy in whom monotherapy with oxcarbazepine was indicated were evaluated at baseline and after approximately 12 weeks of treatment with regard to the number of seizures and occurrence of any adverse drug reactions. All patients were questioned regarding their sexual function. Results,,, Out of 228 patients with pre-existing sexual function impairment at baseline, an improvement was observed in 181 (79.4%) patients, 23 (10.1%) patients experienced no impairment at the final visit. The improvements were more marked in those patients, who were pretreated with enzyme-inducing antiepileptic drugs. No worsening of the sexual dysfunction was observed. Conclusions,,, Oxcarbazepine was found to have beneficial effects on sexual dysfunction and to be effective and well tolerated in male patients with partial epilepsy. [source] 2146: Intracorneal lenses for the treatment of presbyopia using femtosecond laser: visual outcomes and safetyACTA OPHTHALMOLOGICA, Issue 2010IG PALLIKARIS Purpose To investigate the visual outcomes and safety of Intracorneal lenses (Flexivue Micro-Lens, Presbia, CA)) for the treatment of presbyopia. Methods This was a prospective clinical study. An intrastromal corneal tunnel was created using femtosecond laser (Intralase 150, AMO , CA). The lens was inserted within the cornea tunnel of the non-dominant eye of 10 presbiopian patients. Mean age was 51,23 years old ± 3,11 (5 males and 5 females). The follow-up was up to 12 months. Results In the operated eye, mean uncorrected visual acuity for distance (UVA-D) preoperatively, one day, one week one month, three months and six months, and 1 year after surgery was 20/20, 20/40, 20/40, 20/32, 20/32, 20/32 and 20/32 respectively, whereas for near (UVA-N) was 20/50, 20/40, 20/30, 20/30, 20/25, 20/25 and 20/30. Binocular far vision was not altered. No tissue alterations of the cornea were found using corneal confocal microscopy. No intra or post-operative complications were demonstrated up to one year after surgery. Conclusion Intracorneal lenses for the correction of presbyopia using femtosecond laser seems to be a safe and effective method to correct presbyopia in patients aged between 45 to 55 years old; a target group which is considered too old for refractive laser surgery and too young for clear lens extraction. Longer follow-up and a larger population are necessary in order to draw more significant results of this new surgical approach for the treatment of presbyopia. Commercial interest [source] Investigating the influence of wavelength, light intensity and macular pigmentation on retinal straylightACTA OPHTHALMOLOGICA, Issue 2009J ROZEMA Purpose To investigate the influence of wavelength, light intensity and macular pigmentation on retinal straylight. This will be tested in both phakic and pseudophakic eyes by means of color filters, as well as by comparing postoperative straylight results of eyes implanted with either clear or blue-blocking IOLs. It has also been suggested in the literature that the yellow macular pigment reduces the effects of the short wavelength components of retinal straylight. Methods In this prospective study the straylight is measured on two groups of pseudophakic subjects: one group of 25 subjects implanted with a clear IOL (Alcon AcrySof SA60AT) and another group of 25 subjects implanted with a yellow IOL (AcrySof Natural SN60AT) using white light as well as with blue, green and red filters. These measurements are repeated on a group of age matched 25 phakic subjects. All retinal straylight measurements will be performed using the Oculus C-Quant straylight meter. In the normal and clear IOL subjects the macular pigment is measured as well using the Tinsley M|Pod device. Results The first, preliminary results demonstrate that in healthy eyes the retinal straylight measured by the Oculus C-Quant depends on the wavelength of the stimulus light. Measurements performed with blue light were lower than those performed in green or red light. Conclusion Stimulus light wavelength appears to have an influence on straylight measurements. Further study on a larger population is required to confirm this trend and to study how IOL color may influence this result in pseudophakic eyes. The possible influence of macular pigment on retinal straylight will be studied simultaneously. [source] Participatory evaluation (II) , translating concepts of reliability and validity in fieldworkCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2007B. Crishna Abstract Background In developing countries participatory methods are a viable way of evaluating social development projects. It provides a means to look constructively at the strengths and weaknesses in projects, and use the lessons learned to improve planning and implementation. One of the challenges faced, however, is being able to ensure that the study is sound, reliable and valid, and that it is free from bias, thus making the final results trustworthy and of use to a larger population. Methods This article looks at five steps involved in a participatory evaluation process and the ways in which reliability and validity have been considered. Results Participatory studies may be different, but all have similar underlying principles as traditional quantitative and qualitative studies. Examples from fieldwork in Asia have been used to demonstrate how studies can be made credible, so that they have value, influence or the ability to encourage changes in thinking, while evaluating social development projects. At every stage, the role of the external evaluator remains crucial, and has to be that of a facilitator, encouraging participation from everyone. Conclusion Hence project evaluations using such a method must be clear in how to remove bias and ensure reliability and validity in all the stages of the evaluation, from planning to making recommendations. Imaginative and alternative strategies need to be developed to examine reliability and validity in the qualitative evaluation. [source] The prediction of coronary atherosclerosis employing artificial neural networksCLINICAL CARDIOLOGY, Issue 6 2000Jacob George M.D. Abstract Background: Atherosclerosis is a complex histopathologic process that is analogous to chronic inflammatory conditions. Several factors have been shown to correlate with the extent of atherosclerosis. Whereas hypertension, obesity, hyperlipidemia, diabetes, smoking, and family history are all well documented, recent literature points to additional associated factors. Thus, antibodies to oxidized low-density lipoprotein (oxLDL), cytomegalovirus (CMV), Chlamydia pneumonia, Helicobacter pylori, as well as homocysteine and C-reactive protein (CRP) levels have all been implicated as independent markers of accelerated atherosclerosis. Hypothesis: In the current study we attempted to formulate a system by which to predict the extent of coronary atherosclerosis as assessed by angiographic vessel occlusion. Methods: The 81 patients were categorized as having single-, double-, triple-, or no vessel involvement. The clinical data concerning the "classic" risk factors were obtained from clinical records, and sera were drawn from the patients for determination of the various parameters that are thought to be associated with atherosclerosis. Results: Using four artificial neural networks, we have found the most effective parameters predictive of coronary vessel involvement were (in decreasing order of importance) antibodies to oxLDL, to cardiolipin, to CMV, to Chlamydia pneumonia, and to ,2-glycoprotein I (,2GPI). Although important in the prediction of vessel occlusion, hyperlipidemia, hypertension, CRP levels, and diabetes were less accurate. Conclusion: The results of the current study, if reproduced in a larger population, may establish an integrated system based on the creation of artificial neural networks by which to predict the extent of atherosclerosis in a given subject fairly and noninvasively. [source] Population Size, Genetic Variation, and Reproductive Success in a Rapidly Declining, Self-Incompatible Perennial (Arnica montana) in The NetherlandsCONSERVATION BIOLOGY, Issue 6 2000Sheila H. Luijten In 26 populations in The Netherlands we investigated the relationship between population size and genetic variation using allozyme markers. Genetic variation was low in A. montana ( He = 0.088). There were positive correlations between population size and the proportion of polymorphic loci, the number of effective alleles, and expected heterozygosity, but not with observed heterozygosity. There was a significantly positive correlation between population size and the inbreeding coefficient. Generally, small populations showed heterozygote excess, which decreased with increasing population size. Possibly, the heterozygous individuals in small populations are survivors from the formerly larger populations with relatively high fitness. The F statistics showed a moderately high level of differentiation among populations ( FST = 0.140 ± 0.02), implying a low level of gene flow. For three out of four allozyme loci, we found significant inbreeding ( FIS = 0.104 ± 0.03). Only 14 of 26 populations were in Hardy-Weinberg equilibrium at all four polymorphic loci. In a subset of 14 populations of various size, we investigated natural seed production and offspring fitness. Population size was positively correlated with seed set, seedling size, number of flowering stems and flowerheads, adult survival, and total relative fitness, but not with the number of florets per flowerhead, germination rate, or the proportion of germination. Offspring performance in the greenhouse was not associated with genetic diversity measured on their mothers in the field. We conclude that the fitness of small populations is significantly reduced, but that there is as yet no evidence that this was caused by inbreeding. Possibly, the self-incompatibility system of A. montana has been effective in reducing selfing rates and inbreeding depression. Resumen:Arnica montana es una especie de planta rara, en declinación rápida y autoincompatible. En 26 poblaciones de los Países Bajos investigamos la relación entre el tamaño poblacional y la variación genética mediante el uso de alozimas marcadoras. La variación genética fue baja en A. montana ( He = 0.088). Existió una correlación positiva entre el tamaño poblacional y la proporción de emplazamientos polimórficos, el número de alelos efectivos y la heterocigocidad esperada, pero no con la heterocigocidad observada. Existió una correlación positiva significativa entre el tamaño poblacional y el coeficiente de endogamia. Generalmente, las poblaciones pequeñas mostraron una heterocigocidad excesiva con disminuciones en el tamaño poblacional. Posiblemente, los individuos heterocigóticos de poblaciones pequeñas son sobrevivientes de poblaciones anteriormente grandes con una adaptabilidad relativamente alta. Las pruebas de F mostraron un nivel de diferenciación moderadamente alto entre poblaciones ( FST = 0.140 ± 0.02) lo que implica un nivel bajo de flujo de genes. Para tres de cuatro de los emplazamientos de alozimas encontramos una endogamia significativa ( FIS = 0.104 ± 0.03). Solamente 14 de las 26 poblaciones estuvieron en equilibrio Hardy-Weinberg para los cuatro emplazamientos polimórficos. En un subconjunto de 14 poblaciones de varios tamaños, investigamos la producción natural de semillas y la adaptabilidad de la descendencia. El tamaño poblacional estuvo positivamente correlacionado con el juego de semillas, el tamaño del almácigo, el número de tallos en flor y de inflorescencias, la supervivencia de adultos y la adaptabilidad total relativa, pero no con el número de flores por inflorescencia, la tasa de germinación ni la proporción de la germinación. El rendimiento de la descendencia en invernaderos no estuvo asociado con la diversidad genética medida en sus madres en el campo. Concluimos que la adaptabilidad de poblaciones pequeñas está significativamente reducida, pero no existe aún evidencia de que esto sea ocasionado por endogamia. Es posible que el sistema de autoincompatibilidad de A. montana haya sido efectivo en la reducción de tasas de autofecundación y depresión de la endogamia. [source] Regional and local influence of grazing activity on the diversity of a semi-arid dung beetle communityDIVERSITY AND DISTRIBUTIONS, Issue 1 2006Jorge M. Lobo ABSTRACT This study analyses the effect of resource availability (i.e. sheep dung) on dung beetle communities in an arid region of Central Spain, both at regional and at local scales. A total of 18 sites within 600 km2 were sampled for the regional analysis and 16 sites within the 30 km2 of an Iberian municipality were sampled for the local analysis. Spatial and environmental characteristics of sampling sites were also compiled at both scales, including measures of grazing activity (livestock density at regional scale, and two counts of rabbit and sheep dung at local scale). At a regional scale, any environmental or spatial variable can help to explain the variation in abundance. However, species richness was related to summer precipitation and composition was related to elevation. At local scale, abundance is not significantly related to any of the environmental variables, but species richness was related to the local amount of sheep dung (27% of variance). The amount of dung in a 2-km buffer around the site accounts for 27,32% of variance in abundance and 60,65% of variance in species richness. The presence of the flock with the highest sheep density explains 53% of abundance variability and 73% of species richness variance. A cluster analysis of localities identified two main groups, one characterized by a lower abundance and species richness that can be considered a nested subsample of the species-rich group. The mean and maximum amount of sheep dung in the sites separated by less than 2 km are the only significant explanatory variables able to discriminate both groups. These results suggest that grazing intensity (and the associated increase in the amount of trophic resources) is a key factor in determining local variation in the diversity and composition of dung beetle assemblages. However, dung beetle assemblages are not spatially independent at the analysed resolution, and the amount of dung in the surroundings seems to be more important for locally collected species than the dung effectively found in the site. Although differences in the availability and quantity of trophic resources among nearby sites could be affecting the population dynamics and dispersion of dung beetles within a locality, sites with larger populations, and greater species numbers would not be able to exercise enough influence as to bring about a complete local faunistic homogenization. [source] | ||||||||||||||||||||||||||||||||||