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Terms modified by Nonsignificant Selected AbstractsTolerability, Safety, and Efficacy of ,-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective ,-Blocker RegistryCONGESTIVE HEART FAILURE, Issue 1 2007William T. Abraham MD Heart failure (HF) clinical trials suggest different responses of blacks and whites to ,-blockers. Differences between clinical trial and community settings may also have an impact. The Carvedilol Heart Failure Registry (COHERE) observed experience with carvedilol in 4280 patients with HF in a community setting. This analysis compares characteristics, outcomes, and carvedilol dosing of blacks and whites in COHERE. Compared with whites (n=3433), blacks (n=523) had more severe HF symptoms despite similar systolic function. At similar carvedilol maintenance doses, symptoms improved in 33% of blacks vs 28% of whites, while worsening in 10% and 11%, respectively (both nonsignificant), and HF hospitalization rates were reduced comparably in both groups (,58% vs ,56%, respectively; both P<.001). Incidence and hazard ratios of death were similar in blacks and whites (6.9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials. [source] Facial emotion recognition and alexithymia in adults with somatoform disordersDEPRESSION AND ANXIETY, Issue 1 2009Francisco Pedrosa Gil M.D. Abstract Objective: The primary aim of this study was to investigate facial emotion recognition in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Methods: Twenty patients with SFD and twenty healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of facial emotion recognition and the 26-item Toronto Alexithymia Scale (TAS-26). Results: Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistically. Conclusions: This suggests that the deficit in facial emotion recognition observed in the patients with SFD was most likely a consequence of concurrent alexithymia. Impaired facial emotion recognition observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source] Facial emotion recognition and alexithymia in adults with somatoform disordersDEPRESSION AND ANXIETY, Issue 11 2008Francisco Pedrosa Gil M.D. Abstract The primary aim of this study was to investigate facial emotion recognition (FER) in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Twenty patients with SFD and 20 healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of FER and the 26-item Toronto Alexithymia Scale. Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistics. This suggests that the deficit in FER observed in the patients with SFD was most likely a consequence of concurrent alexithymia. It should be noted that neither depression nor anxiety was significantly related to emotion recognition accuracy, suggesting that these variables did not contribute the emotion recognition deficit. Impaired FER observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning. Depression and Anxiety, 2008. © 2007 Wiley-Liss, Inc. [source] Psychometric evaluation of the mini-social phobia inventory (Mini-SPIN) in a treatment-seeking sample,DEPRESSION AND ANXIETY, Issue 6 2007Justin W. Weeks M.A. Abstract The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-item, self-rated screening instrument to assess social anxiety disorder, but its psychometric properties have not yet been examined in a sample seeking treatment for psychiatric disorders. We analyzed responses from 291 adults who telephoned the Adult Anxiety Clinic of Temple (AACT) seeking treatment for social anxiety or generalized anxiety and worry. The Mini-SPIN demonstrated strong internal consistency. Support for the convergent validity of the Mini-SPIN was provided by moderate correlations with several self-report measures and a clinician-administered measure of social anxiety completed by the subsample of callers who later came to the AACT for evaluation. Furthermore, the Mini-SPIN correlated significantly with two of three measures of functional disability, but not with a measure of life satisfaction. Correlations with measures of other constructs were nonsignificant, providing support for the discriminant validity of the Mini-SPIN. In addition, a cutoff score of 6 on the Mini-SPIN yielded strong sensitivity and diagnostic efficiency in the subsample of treatment seekers that later completed pretreatment evaluation, although the specificity of this cutoff score was not optimal in this sample. Overall, the Mini-SPIN demonstrated sound psychometric properties in this treatment-seeking sample. Depression and Anxiety 24:382,391, 2007. Published 2006 Wiley-Liss, Inc. [source] Phylogenetic trends in the abundance and distribution of pit organs of elasmobranchsACTA ZOOLOGICA, Issue 4 2004M. B. Peach Abstract Pit organs (free neuromasts of the mechanosensory lateral line system) are distributed over the skin of elasmobranchs. To investigate phylogenetic trends in the distribution and abundance of pit organs, 12 relevant morphological characters were added to an existing matrix of morphological data (plus two additional end terminals), which was then re-analysed using cladistic parsimony methods (paup* 4.0b10). Character transformations were traced onto the most parsimonious phylogenetic trees. The results suggest the following interpretations. First, the distinctive overlapping denticles covering the pit organs in many sharks are a derived feature; plesiomorphic elasmobranchs have pit organs in open slits, with widely spaced accessory denticles. Second, the number of pit organs on the ventral surface of rays has been reduced during evolution, and third, spiracular pit organs have changed position or have been lost on several occasions in elasmobranch evolution. The concentrated-changes test in macclade (version 4.05) was used to investigate the association between a pelagic lifestyle and loss of spiracular pit organs (the only character transformation that occurred more than once within pelagic taxa). Depending on the choice of tree, the association was either nonsignificant at P = 0.06 or significant at P < 0.05. Future studies, using species within more restricted elasmobranch clades, are needed to resolve this issue. [source] Relevance of the genes for bone mass variation to susceptibility to osteoporotic fractures and its implications to gene search for complex human diseasesGENETIC EPIDEMIOLOGY, Issue 1 2002Hong-Wen Deng Abstract We investigate the relevance of the genetic determination of bone mineral density (BMD) variation to that of differential risk to osteoporotic fractures (OF). The high heritability (h2) of BMD and the significant phenotypic correlations between high BMD and low risk to OF are well known. Little is reported on h2 for OF. Extensive molecular genetic studies aimed at uncovering genes for differential risks to OF have focussed on BMD as a surrogate phenotype. However, the relevance of the genetic determination of BMD to that of OF is unknown. This relevance can be characterized by genetic correlation between BMD and OF. For 50 Caucasian pedigrees, we estimated that h2 at the hip is 0.65 (P < 0.0001) for BMD and 0.53 (P < 0.05) for OF; however, the genetic correlation between BMD and OF is nonsignificant (P > 0.45) and less than 1% of additive genetic variance is shared between them. Hence, most genes found important for BMD may not be relevant to OF at the hip. The phenotypic correlation between high BMD and low risk to OF at the hip (approximately ,0.30) is largely due to an environmental correlation (,E = ,0.73, P < 0.0001). The search for genes for OF should start with a significant h2 for OF and should include risk factors (besides BMD) that are genetically correlated with OF. All genes found important for various risk factors must be tested for their relevance to OF. Ideally, employing OF per se as a direct phenotype for gene hunting and testing can ensure the importance and direct relevance of the genes found for the risk of OF. This study may have significant implications for the common practice of gene search for complex diseases through underlying risk factors (usually quantitative traits). Genet. Epidemiol. 22:12,25, 2002. © 2002 Wiley-Liss, Inc. [source] Use of tree rings to study the effect of climate change on trembling aspen in QuébecGLOBAL CHANGE BIOLOGY, Issue 7 2010MARIE-PIERRE LAPOINTE-GARANT Abstract In this paper, we present a new approach, based on a mixed model procedure, to quantify the tree-ring-based growth-climate relationship of trembling aspen along a latitudinal gradient from 46 to 54 °N in eastern Canada. This approach allows breaking down the growth response into general intersite and local climatic responses, and analyzing variations of absolute ring width as well as interannual variations in tree growth. The final model also integrates nonclimatic variables such as soil characteristics and the occurrence of insect outbreaks into the growth predictions. Tree level random effects on growth were important as intercepts but were nonsignificant for the climatic variables, indicating that a single climate,growth relationship was justified in our case. The response of tree growth to climate showed, however, a strong dependence on the spatial scale at which the analysis was performed. Intersite variations in tree growth were mostly dependent on variations in the thermal heat sum, a variable that showed low interannual and high intersite variation. When variation for a single site was analyzed, other variables showed up to be important while the heat sum was unimportant. Finally, future growth under six different climate change scenarios was simulated in order to study the potential impact of climate change. Results suggest only moderate growth increases in the northern portion of the gradient and a growth decrease in the southern portion under future climatic conditions. [source] Development and Evaluation of a DNA Vaccine Based on Helicobacter pylori urease B: Failure to Prevent Experimental Infection in the Mouse ModelHELICOBACTER, Issue 6 2006Livania Zavala-Spinetti Abstract Background:, The development of a vaccine against Helicobacter pylori has become a priority to prevent major morbidity and mortality associated with this infection. Our goal was to prepare and evaluate a DNA vaccine based on the urease B gene (ureB). Methods:, The ureB gene of H. pylori was amplified and cloned into the eukaryotic expression vector pcDNA3.1/TOPO. Plasmid DNA was purified from transformed Escherichia coli cells and used to immunize mice by the intragastric, intramuscular, intrarectal (40 µg each) and intranasal (16 µg) route, three doses every 2 weeks, with CpG oligodeoxynucleotide (ODN) as adjuvant. Four weeks after the third dose, animals were orally challenged with Helicobacter felis and were sacrificed 6 weeks later. The stomach was stained to detect the presence of infection. Results:, Despite in vitro confirmation of successful cloning and functionality of the ureB gene with expression of a protein morphologically and antigenically identical to urease B, the DNA vaccine did not perform well in vivo. Immunization of mice produced a weak immune response. Overall, intrarectal and intranasal administration seemed more immunogenic than other routes. Protection against challenge was modest and nonsignificant, and slightly better on animals immunized by the intramuscular and intranasal route. Conclusion:, A DNA vaccine based on H. pylori urease B was poorly immunogenic and nonprotective at the conditions evaluated. Higher doses, better adjuvants or a prime-boost approach may circumvent these limitations. [source] Comparison between different dialysate calcium concentrations in nocturnal hemodialysisHEMODIALYSIS INTERNATIONAL, Issue 2 2007Nigel D. TOUSSAINT Abstract Benefits of dialysate with greater calcium (Ca) concentration are reported in nocturnal hemodialysis (NHD) to prevent Ca depletion and subsequent hyperparathyroidism. Studies with patients dialyzing against 1.25 mmol/L Ca baths demonstrate increases in alkaline phosphatase (ALP) and parathyroid hormone (PTH) and increasing dialysate Ca subsequently corrects this problem. However, whether 1.5 or 1.75 mmol/L dialysate Ca is most appropriate for NHD is yet to be determined, and differences in the effect on mineral metabolism of daily vs. alternate daily NHD have also not been well defined. We retrospectively analyzed mineral metabolism in 48 patients, from 2 institutions (30 at Monash and 18 at Geelong), undergoing home NHD (8 hr/night, 3.5,6 nights/week) for a minimum of 6 months. Thirty-seven patients were dialyzed against 1.5 mmol/L Ca bath and 11 patients against 1.75 mmol/L. We divided patients into 4 groups, based on dialysate Ca and also on the hours per week of dialysis, <40 (1.5 mmol/L, n=29 and 1.75 mmol/L, n=8) or ,40 (n=4 and 7). We compared predialysis and postdialysis serum markers, time-averaged over a 6-month period, and the administration of calcitriol and Ca-based phosphate binders between 1.5 and 1.75 mmol/L Ca dialysate groups. Baseline characteristics between all groups were similar, with a slightly longer, but nonsignificant, duration of NHD in both 1.75 mmol/L dialysate groups compared with 1.5 mmol/L. The mean predialysis Ca, phosphate, and Ca × P were similar between the 1.5 and 1.75 mmol/L groups, regardless of NHD hr/week. Postdialysis Ca was significantly greater, with 1.75 vs. 1.5 mmol/L in those dialyzing <40 hr/week (2.64±0.19 vs. 2.50±0.12 mmol/L, p=0.046), but postdialysis Ca × P were similar (2.25±0.44 vs. 2.16±0.29 mmol2/L2, p=0.60). Parathyroid hormone was also lower with 1.75 vs. 1.5 mmol/L baths in the <40 hr/week groups (31.99±26.99 vs. 14.47±16.36 pmol/L, p=0.03), although this difference was not seen in those undertaking NHD ,40 hr/week. Hemoglobin, ALP, and albumin were all similar between groups. There was also no difference in vitamin D requirement when using 1.75 mmol/L compared with the 1.5 mmol/L dialysate. Multivariate analysis to determine independent predictors of postdialysis serum Ca showed a statistically significant positive association with predialysis Ca, dialysate Ca, and total NHD hr/week. An elevated dialysate Ca concentration is required in NHD to prevent osteopenia but differences in serum markers of mineral metabolism between 1.5 and 1.75 mmol/L Ca dialysate in NHD in our study were few. This was similar for patients undertaking NHD <40 or ,40hr/week, although differences in the frequency of NHD may also be as important as dialysate Ca with regard to serum Ca levels. With concerns that prolonged higher Ca levels contribute to increased cardiovascular mortality, the optimal Ca dialysate bath is still unknown and further studies addressing bone metabolism with larger NHD numbers are required. [source] Ionic dialysance: Principle and review of its clinical relevance for quantification of hemodialysis efficiencyHEMODIALYSIS INTERNATIONAL, Issue 2 2005Lucile Mercadal Ionic dialysance (D) is an online measured variable now available on several dialysis monitors to evaluate small-solute clearance. Based on conductivity measurements in the inlet and outlet dialysate, the principle of the measurement and the different measurement methods are described. Studies that have evaluated the reliability of ionic dialysance to assess dialysis efficiency are discussed. These studies are divided into two groups: the first comparing ionic dialysance to urea clearance and the second comparing Dt/V to Kt/Vurea, in which the uncertainties of the measurement of Vurea could have misrepresented the relationship between Dt/V and Kt/Vurea. When Kt/Vurea via the Daugirdas second-generation equation taking the rebound into account is considered, slight,even nonsignificant,differences are evidenced between Kt/Vurea and Dt/V. Therefore, ionic dialysance should be considered as a valid measure in future guidelines for dialysis efficiency. [source] Unionization, Compensation, and Voice Effects on Quits and RetentionINDUSTRIAL RELATIONS, Issue 4 2000John E. Delery This study explores the relationships among unionization, compensation practices, and employee attachment (quit rates and tenure) among trucking companies to assess the applicability of Freeman and Medoff's exit/voice argument. Unionization was associated with lower quit rates, higher tenure, a better compensation package, and stronger voice mechanisms. The relationship of unionization to quit rates and tenure becomes nonsignificant after accounting for compensation (pay and benefits), and voice mechanisms do not add explanatory variance. [source] The Usefulness of Design of Experimentation in Defining the Effect Difficult Airway Factors and Training Have on Simulator Oral,Tracheal Intubation Success Rates in Novice IntubatorsACADEMIC EMERGENCY MEDICINE, Issue 4 2010Frank Thomas MD Abstract Objectives:, This exploratory study examined novice intubators and the effect difficult airway factors have on pre- and posttraining oral,tracheal simulation intubation success rates. Methods:, Using a two-level, full-factorial design of experimentation (DOE) involving a combination of six airway factors (curved vs. straight laryngoscope blade, trismus, tongue edema, laryngeal spasm, pharyngeal obstruction, or cervical immobilization), 64 airway scenarios were prospectively randomized to 12 critical care nurses to evaluate pre- and posttraining first-pass intubation success rates on a simulator. Scenario variables and intubation outcomes were analyzed using a generalized linear mixed-effects model to determine two-way main and interactive effects. Results:, Interactive effects between the six study factors were nonsignificant (p = 0.69). For both pre- and posttraining, main effects showed the straight blade (p = 0.006), tongue edema (p = 0.0001), and laryngeal spasm (p = 0.004) significantly reduced success rates, while trismus (p = 0.358), pharyngeal obstruction (p = 0.078), and cervical immobilization did not significantly change the success rate. First-pass intubation success rate on the simulator significantly improved (p = 0.005) from pre- (19%) to posttraining (36%). Conclusions:, Design of experimentation is useful in analyzing the effect difficult airway factors and training have on simulator intubation success rates. Future quality improvement DOE simulator research studies should be performed to help clarify the relationship between simulator factors and patient intubation rates. ACADEMIC EMERGENCY MEDICINE 2010; 17:460,463 © 2010 by the Society for Academic Emergency Medicine [source] Xeroderma pigmentosum with limited involvement of the UV-exposed areas: a case reportINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2003Mostafa Mirshams-Shahshahani MD A 21-year-old woman with skin type IV, who had developed photophobia and brown, spotty, hyperpigmented lesions on her face from early childhood, presented to our center for treatment of her facial lesions. Examination on admission revealed numerous, freckle-like, hyperpigmented macules and actinic keratoses over the central part of the face, with sparing of the forehead, chin, and peripheral area (Fig. 1). The area involved was approximated to be around 2% of the total body surface. The dorsal parts of the hands showed no lesions (Fig. 2), but guttate hypomelanotic lesions were apparent on both forearms. Figure 1. Limitation of xeroderma pigmentosum lesions to the center of the face Figure 2. Hands are devoid of any lesions Histologic examination of biopsies from four different facial lesions revealed them to be keratoacanthoma (1.5 × 2.5 cm ulcerative nodule on the right cheek), sclerosing basal cell epithelioma (nasal lesion), lentigo simplex, and hypertrophic actinic keratosis. Corneal clouding, conjunctival injection, loss of lashes, and atrophy of the lids were apparent on ophthalmologic examination. Other parts of the physical examination, including examination of the oral cavity, were nonsignificant. In addition, except for the presence of mild eczema in a sibling, the patient's family history regarding the presence of any similar problem and also any other important dermatologic or general disorder was negative. [source] The point prevalence of bulimic disorders from 1990 to 2004INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 6 2008Janis H. Crowther PhD Abstract Objective: This study investigated the point prevalence of probable cases of bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS), and specific eating disorder symptomatology among 6,844 undergraduate women at a single site, examining changes across five 3-year time periods and on a yearly basis from 1990 to 2004. Method: Participants completed a self-report checklist that assessed the diagnostic criteria for BN (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 1994) and the Bulimia Test (Smith and Thelen, J Consult Clin Psychol, 52, 863,872, 1984) (BULIT) or Bulimia Test-Revised (Thelen et al., Psychol Assess, 3, 119,124, 1991) (BULIT-R). Results: Chi-square analyses comparing the percentages of probable cases of BN and EDNOS and the percentages of women who reported frequent binge eating and most compensatory weight control strategies were nonsignificant. Only the percentages of women who endorsed overconcern with weight and shape and diuretic use and excessive exercise as compensatory weight control strategies changed over time. Conclusion: Consistent with Keel et al.'s (Keel et al., Psychol Med, 36, 119,127, 2006) findings regarding the point prevalence rates of BN from 1992 to 2002, results indicated that probable cases of eating disorders remained relatively stable. Methodologically, this research illustrates the importance of examining multiple data points when investigating stability or change in behavior. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Personality pathology and substance abuse in eating disorders: A longitudinal studyINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2008Heather Thompson-Brenner PhD Abstract Objective: Substance abuse has been shown to predict poor outcome in eating disorder (ED) samples, and prior cross-sectional data on personality subtypes of EDs suggest that substance abuse is associated with dysregulated and possibly avoidant-insecure subtypes. This study investigates longitudinal associations between personality and substance use. Method: Personality pathology and substance use were assessed in 213 individuals with anorexia nervosa and bulimia nervosa at baseline; substance use was assessed at regular follow-up intervals over a 9-year period. Results: Of the five personality factors identified, the obsessional-sensitive and high-functioning types were negatively associated with substance abuse at baseline, while the behaviorally dysregulated type was positively associated with substance abuse at baseline. Longitudinal associations were observed, suggesting that obsessional-sensitive personality type was protective against the development of substance abuse. Longitudinal associations between the other personality types and substance abuse were nonsignificant after baseline substance abuse history was included as a covariate in the model. Conclusion: Substance use demonstrates cross-sectional associations with personality style, but substance abuse history appears to be the most important predictor of future substance abuse in women with eating disorders. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Comorbidity between obesity and attention deficit/hyperactivity disorder: Population study with 13,15-year-oldsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 6 2006Luis Rojo MD Abstract Objective: This study analyzes whether obese children have a higher risk of attention deficit/hyperactivity "characteristics" (AD/HD) than do children with other nutritional states. Method: This study included 35,403 participants from 486 community schools. They completed the AD/HD scale of the Strengths and Difficulties Questionnaire (SDQ) and were weighed and measured. 2879 of the participants were obese and 78 were morbidly obese (BMI >40). Results: A discrete, nonsignificant, increment was found in the AD/HD characteristics of male participants with morbid obesity, as compared with the other nutritional states. Among morbidly obese females, the prevalence of AD/HD characteristics was slightly superior, although not significantly, to that found in participants with normal weight, overweight or obese (BMI <40). Conclusion: Among nonclinical populations with a communitarian origin, previous findings reporting high rates of AD/HD in obese children are not replicated. This increment in the prevalence of AD/HD among hospitalized obese children could be the result of selection bias. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006 [source] Twelve-year course and outcome predictors of anorexia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2006Dipl-Psych, Manfred M. Fichter MD Abstract Objective The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Method Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained. Results The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were deceased. At the 12-year follow-up 19.0% had AN, 9.5% had bulimia nervosa-purging type (BN-P), 19.0% were classified as eating disorder not otherwise specified (EDNOS). A total of 52.4% showed no major DSM-IV eating disorder and 0% had binge eating disorder (BED). Systematic,strictly empirically based,model building resulted in a parsimonious model including four predictors of unfavorable 12-year outcome explaining 45% of the variance, that is, sexual problems, impulsivity, long duration of inpatient treatment, and long duration of an eating disorder. Conclusion Mortality was high and symptomatic recovery protracted. Impulsivity, symptom severity, and chronicity were the important factors for predicting the 12-year outcome. © 2005 by Wiley Periodicals, Inc. [source] Oral health-related quality of life of children with oligodontiaINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 1 2010DAVID LOCKER Objectives., To assess the functional and psychosocial impact of oligodontia in children aged 11,14 years. Methods., Children aged 11,14 years with oligodontia were recruited from orthodontic clinics when they presented for orthodontic evaluation. All completed a copy of the Child Perceptions Questionnaire for 11- to 14-year olds, a measure of the functional and psychosocial impact of oral disorders. Information on the number and pattern of missing teeth for each child were obtained from charts and radiographs. Results., Thirty-six children were included in the study. The number of missing teeth ranged from one to 14 (mean = 6.8). Just over three-quarters of the subjects reported experiencing one or more functional and psychosocial impacts ,Often' or ,Everyday/almost everyday'. Correlations between scale and sub-scale scores and the number of missing teeth were weak and nonsignificant. Conclusions., Children with oligodontia experience substantial functional and psychosocial impacts from the condition. When compared with other clinical groups, children with oligodontia appear to have worse oral health-related quality of life than children with dental decay and malocclusion, but better oral health-related quality of life than children with oro-facial conditions. [source] Age-Related Macular Degeneration: Self-Management and Reduction of Depressive Symptoms in a Randomized, Controlled StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2006Barbara L. Brody MPH OBJECTIVES: To assess the effectiveness of a self-management program for age-related macular degeneration (AMD) in reducing depressive symptoms. DESIGN: Analysis of 6-month follow-up for a subset of participants in a randomized, controlled trial who were clinically depressed at baseline. SETTING: University ophthalmology clinic. PARTICIPANTS: Thirty-two depressed older adult volunteers (mean age 81.5) with advanced AMD who had been randomized to a self-management program (n=12) or one of two control conditions (n=20). Subjects were included if at baseline they met criteria from the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Axis, I, Fourth Edition, Research Version, for major or minor depressive disorder with significant depressive symptoms (,5 points) on the 15-item Geriatric Depression Scale (GDS-15). INTERVENTION: AMD self-management program consisting of cognitive and behavioral elements including health education and enhancement of problem-solving skills. MEASUREMENTS: Primary outcome measure was GDS-15. Secondary outcome measures included National Eye Institute Visual Function Questionnaire (NEI-VFQ) and AMD Self-Efficacy Questionnaire. RESULTS: At 6-month follow-up, the self-management group had a significantly greater reduction in depressive symptoms on the GDS-15 than the controls (P=.03). The mean reduction of 2.92 points in the self-management group was more than the 2-point change threshold considered to be clinically meaningful. Change on the NEI-VFQ was nonsignificant. Reduction in depressive symptoms was associated with greater self-efficacy in the self-management group. CONCLUSION: These findings may support the effectiveness of an AMD self-management program for depressed older adults with advanced vision loss from AMD. [source] Evaluation of Nationally Mandated Drug Use Reviews to Improve Patient Safety in Nursing Homes: A Natural ExperimentJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2005Becky Briesacher PhD Objectives: To test whether nationally required drug use reviews reduce exposure to inappropriate medications in nursing homes. Design: Quasi-experimental, longitudinal study. Setting: Data source is the 1997,2000 Medicare Current Beneficiary Survey, a nationally representative survey of Medicare beneficiaries. Participants: Nationally representative population sample of 8 million nursing home (NH) residents (unweighted n=2,242) and a comparative group of 2 million assisted living facility (ALF) residents (unweighted n=664). Measurements: Prevalence and incident use of 38 potentially inappropriate medications compared before and after the policy: 32 restricted for all NH residents and six for residents with certain conditions. Inappropriate medications were stratified by potential for legitimate exceptions: always avoid, rarely appropriate, or some acceptable indications. Results: In July 1999, the Centers for Medicare and Medicaid Services (CMS) mandated expansions to the drug use review policy for nursing home certification. Using explicit criteria, surveyors and consultant pharmacists must evaluate resident records for potentially inappropriate medication exposures and related adverse drug reactions. Nursing homes in noncompliance may receive citations for deficient care. Before the CMS policy, 28.8% (95% confidence interval (CI)=27.3,30.3) of Medicare beneficiaries in NHs and 22.4% (95% CI=19.8,25.0) in ALFs received potentially inappropriate medications. Nearly all prepolicy use came from medications with some acceptable indications: 23.4% in NHs (95% CI=20.4,26.4) and 18.0% in ALFs (95% CI=15.6,20.4). After the policy, exposures in NHs declined to 25.6% (95% CI=24.1,27.1, P<.05), but similar declines occurred in ALFs (19.0%, 95% CI=16.7,21.3, nonsignificant). Postpolicy use of inappropriate medications with exempted indications remained high, and more than half was incident use: 20.6% of NH residents (95% CI=19.0,22.0) and 15.6% of ALF residents (95% CI=15.2,15.7). Use of drugs that are restricted with certain diseases increased 33% in NHs between 1997 and 2000 (from 9.3% to 13.2%; P<.05). Multivariate results detected no postpolicy differences in inappropriate drug use between long-term care facilities with mandatory drug use reviews and those without. Conclusion: Some postpolicy declines were noted in NH use of potentially inappropriate medications, but the decrease was uneven and could not be attributed to the national drug use reviews. This study is the first evaluation of the CMS policy, and it highlights the unclear effectiveness of drug use reviews to improve patient safety in NHs even though state and federal agencies have widely adopted this strategy. [source] Diagnostic Value of Endomyocardial Biopsy Guided by Electroanatomic Voltage Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy/DysplasiaJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2008ANDREA AVELLA M.D. Introduction: To improve the endomyocardial biopsy (EMB) diagnostic sensitivity for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), we hypothesized a biopsy sampling focused on selected right ventricle (RV) low-voltage areas identified by electroanatomic voltage mapping. Methods and Results: The study population (22 patients, 10 men; mean age 34 ± 10 years) included 11 patients with overt ARVC/D (group A) and 11 patients with suspected ARVC/D (group B), according to both arrhythmic profile and standardized noninvasive diagnostic criteria. In all 22 patients, an RV bipolar voltage mapping was performed with CARTOÔ system sampling multiple endocardial sites (262 ± 61), during sinus rhythm, with a 0.5,1.5 mV color range setting of voltage display. All 11 (100%) group A patients and 8 of the 11 (73%) group B patients (P = nonsignificant [NS]) presented RV low-voltage areas (<0.5 mV). In 8 group A patients and in all 8 group B patients with a pathological RV voltage map, an EMB focused on the low-voltage areas was performed. In 6 (75%) group A patients and in 7 (87%) group B patients (P = NS), voltage mapping-guided EMB was diagnostic for ARVC/D. In the remaining 3 patients, only nonspecific histological findings were observed. Conclusions: The results of our study (1) confirm the high diagnostic sensitivity of RV voltage mapping in patients with overt ARVC/D, (2) document a high prevalence of RV low-voltage areas even in patients with suspected ARVC/D, and (3) demonstrate that in patients with clinical evidence or suspicion for ARVC/D, presenting RV low-voltage areas, EMB guided by voltage mapping may provide ARVC/D diagnosis confirmation. [source] Accelerated stability model for predicting shelf-lifeJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 5 2002Robert T. Magari Abstract Second- and higher-order degradation reactions sometimes cannot be approximated with linear or exponential relationships and need to be appropriately modeled. Events above the COULTER® HmX Analyzer white blood cell (WBC) counting threshold were recorded for the HmX PAK reagent system stored at five elevated temperatures. An accelerated stability model for a second-degree polynomial degradation pattern was used. The shelf-life of the reagent, along with 95% lower bound confidence intervals, is predicted using the same pattern of degradation as well as the Arrhenius approximation. Experiments indicated that the degradation of the HmX PAK reagent occurred in two phases, the lag phase and the degradation phase, in all tested temperatures. The phase durations are temperature-dependent, and the Arrhenius approximation is appropriate (P=0.639). The degradation of the reagent during the lag phase was experimentally undetectable. Changes of the reagent were nonsignificant for a predicted period of 164 days at 25°C. The rate of degradation increased significantly later on during the degradation phase. The lower bound of the 95% confidence interval of this prediction indicated that it would take at least 326 days before the HmX PAK reagent would have any performance issue related to aging at storage temperature. J. Clin. Lab. Anal. 16:221,226, 2002. © 2002 Wiley-Liss, Inc. [source] "Moved by the spirit": does spirituality moderate the interrelationships between subjective well-being subscales?JOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2010James Schuurmans-Stekhoven Abstract Despite the recent escalation of research into the spirituality and well-being link, past efforts have been plagued by methodological problems. However, the potential for measurement error within psychometric instruments remains largely unexplored. After reviewing theory and evidence suggesting spirituality might represent an affective misattribution, moderation modeling,with each subjective well-being (SWB) subscale as a dependent variable as predicted by the remaining SWB subscales,is utilized to test the assumption of scale invariance. These interrelationships were shown to vary in conjunction with spirituality; that is the analysis revealed significant spirituality,×,subscale interactions. Importantly, in all models the spirituality main effect was either nonsignificant or accounted for by other predictors. In combination, the findings suggest the interrelationship between the subscales rather than the level of SWB varies systematically with spirituality and casts considerable doubt on the previously reported "belief-as-benefit" effect. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,17, 2010. [source] The relationship between pain tolerance and trait aggression: effects of sex and gender roleAGGRESSIVE BEHAVIOR, Issue 5 2009Dennis E. Reidy Abstract The literature on pain and aggression has indicated that pain elicits aggression. However, research has generally examined pain as a situational variable and focused less on the dispositional ability of an individual to tolerate pain. The dearth of research on pain tolerance and aggression appears to contradict the existing theory on the aggression-eliciting effect of pain, in that studies have found a positive relationship between pain tolerance and aggression. The purpose of this study was to determine whether the relationship between pain tolerance and aggression is moderated by sex and whether the positive relationship could be explained by masculine gender role conformity. A sample of 195 collegiate men and women completed trait measures and a laboratory assessment of pain tolerance. Results indicated that correlations between pain tolerance and trait aggression were significant and positive for men but not women. However, when men's conformity to masculine gender role was controlled for, the relationship between pain tolerance and trait aggression was nil and nonsignificant. Results are discussed in reference to socialization and maintenance of masculine status. Aggr. Behav. 35:422,429, 2009. © 2009 Wiley-Liss, Inc. [source] Microstructural Corpus Callosum Anomalies in Children With Prenatal Alcohol Exposure: An Extension of Previous Diffusion Tensor Imaging FindingsALCOHOLISM, Issue 10 2009Jeffrey R. Wozniak Background:, Several studies have now shown corpus callosum abnormalities using diffusion tensor imaging (DTI) in children with fetal alcohol spectrum disorders (FASD) in comparison with nonexposed controls. The data suggest that posterior regions of the callosum may be disproportionately affected. The current study builds on previous efforts, including our own work, and moves beyond midline corpus callosum to probe major inter-hemispheric white matter pathways with an improved DTI tractographic method. This study also expands on our prior work by evaluating a larger sample and by incorporating children with a broader range of clinical effects including full-criteria fetal alcohol syndrome (FAS). Methods:, Participants included 33 children with FASD (8 FAS, 23 partial FAS, 2 static encephalopathy) and 19 nonexposed controls between the ages of 10 and 17 years. Participants underwent DTI scans and intelligence testing. Groups (FASD vs. controls) were compared on fractional anisotropy (FA) and mean diffusivity (MD) in 6 white matter tracts projected through the corpus callosum. Exploratory analyses were also conducted examining the relationships between DTI measures in the corpus callosum and measures of intellectual functioning and facial dysmorphology. Results:, In comparison with the control group, the FASD group had significantly lower FA in 3 posterior tracts of the corpus callosum: the posterior mid-body, the isthmus, and the splenium. A trend-level finding also suggested lower FA in the genu. Measures of white matter integrity and cognition were correlated and suggest some regional specificity, in that only posterior regions of the corpus callosum were associated with visual-perceptual skills. Correlations between measures of facial dysmorphology and posterior regions of the corpus callosum were nonsignificant. Conclusions:, Consistent with previous DTI studies, these results suggest that microstructural posterior corpus callosum abnormalities are present in children with prenatal alcohol exposure and cognitive impairment. These abnormalities are clinically relevant because they are associated with cognitive deficits and appear to provide evidence of abnormalities associated with prenatal alcohol exposure independent of dysmorphic features. As such, they may yield important diagnostic and prognostic information not provided by the traditional facial characteristics. [source] Body Weight Perception, Unhealthy Weight Control Behaviors, and Suicidal Ideation Among Korean AdolescentsJOURNAL OF SCHOOL HEALTH, Issue 12 2009Dong-Sik Kim DrPH ABSTRACT BACKGROUND: This study examined the mediating function of body weight perception (BWP) in the relation between body mass index (BMI) and unhealthy weight control behaviors (UWCBs; eg, fasting, using diet pills, or laxatives), and between BMI and suicidal ideation. It also explored the correlation between exposure to multiple UWCBs and suicidal ideation among Korean adolescents. METHODS: Data on BMI, BWP, UWCBs, and suicidal ideation were obtained from the 2006 Korean Youth Risk Behavior Web-based Survey, a school-based survey conducted on a nationally representative sample of students in grades 7,12 (36,463 boys and 33,433 girls). Data were analyzed using bivariate and multivariate logistic regression. RESULTS: BMI was significantly associated with both UWCB and suicidal ideation among boys and girls, even after controlling for covariates. However, the significance and magnitude of the association between BMI and UWCB were considerably attenuated when BWP was added to the model. When BWP was included, the association between overweight BMI status and suicidal ideation became nonsignificant in both sexes, whereas the association between underweight BMI status and suicidal ideation remained significant among boys. Adolescent boys and girls engaging in multiple UWCBs were at greater risk for experiencing suicidal thoughts. CONCLUSIONS: This study suggests that BWP represents a potential mediator between BMI and UWCB, and between BMI and suicidal ideation among both boys and girls. Thus, school programs addressing issues related to BWP should be developed and targeted at adolescents to reduce the potential risks for both UWCB and suicidal behavior. [source] Susceptibility loci reported in genome-wide association studies are associated with Crohn's disease in Canadian childrenALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2010D. K. AMRE Aliment Pharmacol Ther,31, 1186,1191 Summary Background, Recent genome-wide association studies based on adult and paediatric populations have implicated >30 genes/loci as susceptibility loci for Crohn's disease (CD). Aims, To investigate whether reported genes/loci were also associated with CD in Canadian children. Design and Methods, A case-control design was implemented at three paediatric gastroenterology clinics in Canada. Children ,18 years of age with a confirmed diagnosis of CD were recruited along with controls. Single nucleotide polymorphisms (SNPs) in five genome-wide association studies reported genes/loci were genotyped. Associations between individual SNPs and CD were examined. Results, A total of 406 cases and 415 controls were studied. The mean (±s.d.) age of the cases was 12.3 (±3.2) years. Most cases were male (56.6%), had ileo-colonic disease (L3 ± L4, 52.0%) and inflammatory behaviour (B1 ± p, 86.9%) at diagnosis. Allelic association analysis (two-tailed) showed that three of the five targeted SNPs were significantly associated with overall susceptibility for CD (ZNF365, r10995271, P = 0.001; PTPN2, rs1893217, P = 0.005; STAT3, rs744166, P = 0.01). Associations with SNP rs4613763 in the PTGER4 locus were marginally nonsignificant (P = 0.07). The ZNF365 and STAT3 SNPs were predominantly associated with ileal disease with or without colonic involvement. Conclusion, The identified susceptibility genes/loci for adult-onset CD also confer risk for paediatric-onset CD. [source] Oral budesonide for maintenance of remission of Crohn's disease: a pooled safety analysisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2009G. R. LICHTENSTEIN Summary Background, Budesonide exhibits similar efficacy to systemic glucocorticosteroids (GCSs) in Crohn's disease (CD), but with fewer adverse events (AEs). Aim, To evaluate budesonide's safety profile in CD patients, in particular, incidences of clinically important AEs known to be associated with systemic GCSs. Methods, Five 1-year, double-blind, placebo-controlled trials evaluating budesonide for mild-to-moderate CD were pooled for analysis. Results, The highest incidence rates of AEs were gastrointestinal- and endocrine systems-related in both groups (budesonide 6 mg/day, n = 208; placebo, n = 209). Incidence rates were similar, except for higher incidence of endocrine disorders in budesonide versus placebo patients (P = 0.0042) caused by a higher overall occurrence of cutaneous GCS symptoms (P = 0.0036) in the budesonide group; differences in individual symptoms were nonsignificant. Percentage of patients with normal adrenal function was significantly lower at 13 weeks (three of five studies), but not at 52 weeks (two studies) in the budesonide versus placebo groups. Occurrence of clinically important or serious AEs associated with systemic GCSs, including sepsis, cataracts, adrenal insufficiency was rare and similar between groups. Conclusions, Budesonide treatment for up to 1 year is well-tolerated in CD patients, with an AE profile similar to placebo and only rare occurrences of clinically important AEs associated with systemic GCSs. [source] Analysis of recent pediatric orthotopic liver transplantation outcomes indicates that allograft type is no longer a predictor of survivals,LIVER TRANSPLANTATION, Issue 8 2008Natasha S. Becker Two strategies to increase the donor allograft pool for pediatric orthotopic liver transplantation (OLT) are deceased donor segmental liver transplantation (DDSLT) and living donor liver transplantation (LDLT). The purpose of this study is to evaluate outcomes after use of these alternative allograft types. Data on all OLT recipients between February 2002 and December 2004 less than 12 years of age were obtained from the United Network for Organ Sharing database. The impact of allograft type on posttransplant survivals was assessed. The number of recipients was 1260. Of these, 52% underwent whole liver transplantation (WLT), 33% underwent DDSLT, and 15% underwent LDLT. There was no difference in retransplantation rates. Immediate posttransplant survivals differed, with WLT patients having improved 30-day patient survivals compared to DDSLT and LDLT patients (P = 0.004). Although unadjusted 1-year patient survivals were better for WLT versus DDSLT (P = 0.01), after risk adjustment, 1-year patient survivals for WLT (94%), DDSLT (91%), and LDLT (93%) were similar (P values > 0.05). Unadjusted allograft survivals were better for WLT and LDLT in comparison with DDSLT (P = 0.009 and 0.018, respectively); however, after adjustment, these differences became nonsignificant (all P values > 0.05). For patients , 2 years of age (n = 833), the adjusted 1-year patient and allograft survivals were also similar (all P values > 0.05). In conclusion, in the current era of pediatric liver transplantation, WLT recipients have better immediate postoperative survivals. By 1 year, adjusted patient and allograft survivals are similar, regardless of the allograft type. Liver Transpl 14:1125,1132, 2008. © 2008 AASLD. [source] Relationship of serum cholesterol levels to atopy in the US populationALLERGY, Issue 7 2010M. B. Fessler To cite this article: Fessler MB, Jaramillo R, Crockett PW, Zeldin DC. Relationship of serum cholesterol levels to atopy in the US population. Allergy 2010; 65: 859,864. Abstract Background:, Cholesterol promotes Th2 immunity and allergic inflammation in rodents; whether this occurs in humans is unclear. Reports of both direct and inverse associations between serum cholesterol and atopy in different populations suggest that race and/or other demographic variables may modify these relationships. Aims of the study:, To determine the relationships between levels of three serum cholesterol measures [total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), and non-HDL-C] and atopy in a sample representative of the US population. Methods:, Cross-sectional study of 6854 participants aged ,6 years from the 2005,2006 National Health and Nutrition Examination Survey. Results:, In the overall population, adjusted odds ratios (AORs) per two-standard deviation increase in TC and non-HDL-C for biochemical atopy (defined as ,1 allergen-specific IgE to 19 allergens) were 1.17 [95% confidence interval (CI), 1.00,1.38] and 1.19 (95% CI, 1.03,1.39), respectively. Interactions by race were noted for the two relationships (interaction P = 0.004 and P = 0.009, respectively) with non-Hispanic Whites (NHWs) having direct relationships [TC: AOR 1.27 (95% CI, 1.03,1.57); non-HDL-C: AOR 1.27 (95% CI, 1.03,1.56)] and non-Hispanic Blacks (NHBs) inverse relationships [TC: AOR 0.77 (95% CI, 0.62,0.95); non-HDL-C: AOR 0.86 (95% CI, 0.69,1.08)]. The adjusted HDL-C,atopy relationship was nonsignificant for NHWs and inverse for NHBs [AOR 0.77 (95% CI, 0.61,0.96)]. Relationships were independent of body mass index and serum C-reactive protein and unmodified by corticosteroid or statin usage. Results were similar using current hay fever/allergy as the atopy outcome. Conclusions:, There are marked inter-racial differences in the relationship between serum cholesterol and atopy in the US population. [source] | ||||||||||||||||||||||||||||||||||