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Results Difficult (result + difficult)
Selected AbstractsA systematic review of work-place interventions for alcohol-related problemsADDICTION, Issue 3 2009Gloria Webb ABSTRACT Aims The aims of this study were to (1) gauge any improvement in methodological quality of work-place interventions addressing alcohol problems; and (2) to determine which interventions most effectively reduce work-place-related alcohol problems. Methods A literature search was undertaken of the data bases, Ovid Medline, PsychINFO, Web of Science, Scopus, HSELINE, OSHLINE and NIOSHTIC-2 for papers published between January 1995 and September 2007 (inclusive). Search terms varied, depending on the database. Papers were included for analysis if they reported on interventions conducted at work-places with the aim of reducing alcohol problems. Methodological adequacy of the studies was assessed using a method derived from the Cochrane Collaboration guidelines. Results Ten papers reporting on work-place alcohol interventions were located. Only four studies employed randomized controlled trials (RCT), but all these had methodological problems. Weaknesses in all studies related to representativeness of samples, consent and participation rates, blinding, post-test time-frames, contamination and reliability, and validity of measures used. All except one study reported statistically significant differences in measures such as reduced alcohol consumption, binge drinking and alcohol problems. Conclusions The literature review revealed few methodologically adequate studies of work-place alcohol interventions. Study designs, types of interventions, measures employed and types of work-places varied considerably, making comparison of results difficult. However, it appears from the evidence that brief interventions, interventions contained within health and life-style checks, psychosocial skills training and peer referral have potential to produce beneficial results. [source] Sublethal effects of methylmercury on fecal metabolites of testosterone, estradiol, and corticosterone in captive juvenile white ibises (Eudocimus albus),ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 5 2009Evan M. Adams Abstract Methylmercury (MeHg) is a globally distributed neurotoxin, endocrine disruptor, and teratogen, and its effects on birds are poorly understood, especially within an environmentally relevant exposure range. In an effort to understand the potential causal relationship between MeHg exposure and endocrine development, we established four dietary exposure groups (0 [control], 0.05, 0.1, and 0.3 mg/kg wet wt/d of MeHg) of postfledging white ibises (Eudocimus albus) in a divided, free-flight aviary that spanned the estimated range of environmental exposure for this species. Fecal samples were collected from individually identified ibises over six months in 2005 and processed for hormone evaluation. Significant sex-related differences in fecal estradiol concentrations, though unpredicted in direction, suggest that this steroid could be related to juvenile development in this species. Using repeated-measures general linear models, we tested a set of candidate models to explain variation in endocrine expression. We found that MeHg exposure led to significant differences in fecal estradiol concentrations between the control and medium-dose groups, whereas differences in fecal corticosterone concentrations were observed between the control and both the low- and high-dose groups. These results suggest highly nonlinear dose-response patterns for MeHg. Many endocrine-disrupting contaminants are theorized to affect multiple endpoints in a nonlinear manner, making results difficult to interpret using a traditional toxicological approach. The evidence presented here suggests that endocrine effects of MeHg exposure could behave similarly. [source] Quality of life in adult enteral tube feeding patientsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2007A. M. Brotherton Abstract Background, Enteral tube feeding may impact significantly on patients' quality of life (QoL). The aim of this paper is to review studies that have measured QoL in adult patients receiving enteral tube feeding to determine the factors that are associated with feeding that impact on the patients' QoL. Methods, An electronic search of CINAHL, MEDLINE and EMBASE was undertaken to identify articles that had measured QoL in adults receiving enteral tube feeding. Results, Ten studies were included in the review. Quality of life in patients receiving enteral tube feeding generally appeared poor compared with control groups. Factors that were found to impact on patients' quality of life included symptoms such as nausea, vomiting, diarrhoea and fatigue. Issues around body image, inability to go out and discomfort while carrying out activities of daily living also impacted on QoL. Conclusions, Although the presence of underlying disease and the use of different QoL measures made comparison of the results difficult, issues requiring further consideration in clinical practice include effective symptom management, assessment of psychological and emotional issues and support for patients to enable them to cope with the resulting social isolation. [source] The identification of Parkinson's disease subtypes using cluster analysis: A systematic review,MOVEMENT DISORDERS, Issue 8 2010Stephanie M. van Rooden MSc Abstract The clinical variability between patients with Parkinson's disease (PD) may point at the existence of subtypes of the disease. Identification of subtypes is important, since a focus on homogeneous groups may enhance the chance of success of research on mechanisms of disease and may also lead to tailored treatment strategies. Cluster analysis (CA) is an objective method to classify patients into subtypes. We systematically reviewed the methodology and results of CA studies in PD to gain a better understanding of the robustness of identified subtypes. We found seven studies that fulfilled the inclusion criteria. Studies were limited by incomplete reporting and methodological limitations. Differences between studies rendered comparisons of the results difficult. However, it appeared that studies which applied a comparable design identified similar subtypes. The cluster profiles "old age-at-onset and rapid disease progression" and "young age-at-onset and slow disease progression" emerged from the majority of studies. Other cluster profiles were less consistent across studies. Future studies with a rigorous study design that is standardized with respect to the included variables, data processing, and CA technique may advance the knowledge on subtypes in PD.© 2010 Movement Disorder Society [source] Vascular reconstruction in lower limb musculoskeletal tumoursANZ JOURNAL OF SURGERY, Issue 9 2009J. Ian Spark Abstract Background:, Individual experience in the investigative, planning and operative aspects of lower limb musculoskeletal tumours is often small, making comparison between results difficult. The aim of the study was to describe the recent experience of a single tertiary referral unit performing limb salvage surgery, to identify areas of concern that are amenable to intervention and to provide clinicians an understanding of the surgical options. Methods:, Nine patients with peripheral limb musculoskeletal tumours are described. Four patients had a leiomyosarcoma, and one each of osteosarcoma, synovial chondrosarcoma, synovial sarcoma, liposarcoma and recurrent malignant peripheral nerve sheath tumour. Results:, Thirty-day mortality was nil. Two patients (one with a leiomyosarcoma and one with an osteosarcoma) died at 6 months follow-up because of pulmonary metastases. One patient with synovial chondrosarcoma developed a local recurrence and underwent an above-knee amputation. Six patients at 18 months follow-up are alive with no evidence of local recurrence and a functional lower limb. Conclusion:, These cases are a challenge to the clinicians, radiologists and pathologists. Review by a multidisciplinary team can produce successful results with low post-operative morbidity and mortality. Longer follow-up is required to determine the long-term implications. [source] Dietary vitamin C and E supplementation and reproduction of milkfish Chanos chanos ForsskalAQUACULTURE RESEARCH, Issue 7 2000A C Emata Milkfish Chanos chanos Forsskal broodstock (11 years old, average body weight 5.23,5.73 kg) reared in 10-m-diameter by 3-m-deep floating net cages (31,36 fish per cage) at SEAFDEC AQD's Igang Marine Substation in Guimaras Island, central Philippines, were fed daily at 3% of total body weight formulated diets (36% protein, 7,8% lipid) supplemented with 0.1% vitamin C, 0.05% vitamin E, both vitamin C and E or no vitamin supplementation (control) for 3 years. Reproductive performance was assessed in an attempt to determine the optimum nutrition for successful spawning of milkfish. The total egg production, mean number of eggs per spawning, number of spawns and mean egg diameter were not affected by dietary vitamin C and E supplementation. However, broodstock given dietary supplementation of vitamin C alone or in combination with vitamin E had a higher percentage of spawns with higher (> 90%) percentage egg viability, hatching and cumulative survival rate than those of the control. Broodstock given dietary vitamin E supplementation alone had few spawns, which made the results difficult to analyse. The results confirm the essentiality of vitamin C supplementation in producing more spawns with good egg and larval quality. The production of an adequate volume of good quality eggs and larvae to support hatchery operation is necessary to offset the huge investment in broodstock development, as it takes at least 5 years for milkfish to attain sexual maturation and spawning. [source] | ||||||||||