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Scientific Basis (scientific + basis)
Selected AbstractsScientific Basis of Health Care, 1st edition edited by O. Westwood, Harcourt Health Services, London, 1999, 595 pages, £19·95, ISBN: 0 723 42440 3.JOURNAL OF ADVANCED NURSING, Issue 2 2001Dinah Gould No abstract is available for this article. [source] Protein intake, growth and lung function of infants with chronic lung diseaseJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2009E. Cillié Background:, The increased survival rate of extremely preterm infants has not improved the incidence or outcome of infants diagnosed with chronic lung disease (CLD) (Riley, 2008). The relationship between optimal nutrition (particularly protein intake) and chronic lung disease has not been established. The aim of this study was to investigate the association between protein intake, growth and lung function in infants with CLD. Methods:, A CLD database, maintained for the past 10 years, was used to select participants that had reached 1 year of corrected age. Infants who were born during 2001,2006 with a birth weight of <1500 g, and who subsequently had a diagnosis of CLD, were included. Infants with evidence of intra-uterine growth restriction and abnormal cerebral pathology were excluded. Demographic, mean weight gain, protein intake and respiratory support data were collected retrospectively from the medical notes. Growth parameters and need for oxygen and inhalers up to 1 year of corrected age were collected from the CLD follow-up database. SPSS, version 15 (SPSS Inc., Chicago, IL, USA) were used for Pearson's or Spearmans correlation analysis and analysis of variance or the Wilcoxon test, as appropriate. Results:, Sixty infants were studied: 25 females and 35 males. The median (range) post-menstrual age at birth was 26 (22,31) weeks. The most common feed was breast milk; fortified breast milk was used for 37% of the total days studied. The mean (SD) protein intake was 2.28 (0.33) g kg,1 day,1 and the mean (SD) weight gain was 11.67 (1.77) g kg,1 day,1. There was a positive correlation between protein intake and weight gain (r = 0.32, P = 0.013), which was stronger in females (r = 0.51, P = 0.009). Protein intake was significantly associated with head circumference growth in females only (r = 0.47, P = 0.038). Protein intake was inversely related to the number of days spent mechanically ventilated (r = ,0.32, P = 0.015). There was no relationship between protein intake and growth at 1 year corrected age, time spent on continuous positive airway pressure, age weaned off oxygen, or the use of inhalers. There was an inverse correlation between total weeks of oxygen dependence and head circumference at 1 year (r = ,0.35, P = 0.022). Discussion:, The mean protein intake was <3 g kg,1 day,1, which is the minimum requirement for preterm infants (Tsang et al., 2005). This was associated with a sub-optimal weight gain in our participants of <15 g kg,1 day,1 (Steward & Pridham, 2002). The study demonstrates the known association between low protein intake and poor growth with ventilator dependence (Loui et al., 2008). Conclusions:, Low birth weight and low gestational age infants at risk of CLD should receive special attention to optimise their protein intake because sub-optimal protein intake potentially leads to poor growth when on a neonatal intensive care unit. References Loui, A., Tsalikaki, E., Maier, K., Walch, E., Kamarianakis, Y. & Obladen, M. (2008) Growth in high risk infants <1500 g birth weight during the first 5 weeks. Early Hum. Dev. 84, 645,650, Doi: 10.1016/j.earlhumdev.2008.04.005. Riley, K., Roth, S., Sellwood, M. & Wyatt, J.S. (2008) Survival and neurodevelopmental morbidity at 1 year of age following extremely preterm delivery over a 20-year period: a single centre cohort study. Acta Paediatr.97, 159,165. Steward, D.K. & Pridham, K.F. (2002) Growth patterns of extremely low-birth-weight hospitalised preterm infants. JOGN Nurs31, 57,65. Tsang, R.C., Uauy, R., Koletzko, B. & Zlotkin, S.H., eds. (2005) Nutrition of the Preterm Infant: Scientific Basis and Practical Guidelines. Cincinnati: Digital Educational Publishing. [source] Smoking Cessation Counseling for Pregnant Women Who Smoke: Scientific Basis for Practice for AWHONN's SUCCESS ProjectJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2004FAAN, Susan A. Albrecht PhD Objectives: To review the literature addressing smoking cessation in pregnant women. To develop the project protocol for the Association of Women's Health, Obstetric and Neonatal Nurse's (AWHONN) 6th research-based practice project titled "Setting Universal Cessation Counseling, Education and Screening Standards (SUCCESS): Nursing Care of Pregnant Women Who Smoke." To evaluate the potential of systematic integration of this protocol in primary care settings in which women seek care at the preconception, pregnant, or postpartum stages. Literature Sources: Computerized searches in MEDLINE and CINAHL, as well as references cited in articles reviewed. Key concepts in the searches included low-birth-weight infants and effects of prenatal smoking on the infant and the effects of preconception and prenatal smoking cessation intervention on premature labor and birth weight. Literature Selection: Comprehensive articles, reports, and guidelines relevant to key concepts and published after 1964 with an emphasis on new findings from 1996 through 2002. Ninety-eight citations were identified as useful to this review. Literature Synthesis: Tobacco use among pregnant women and children's exposure to tobacco use (secondhand smoke) are associated with pregnancy complications such as placental dysfunction (including previa or abruption), preterm labor, premature rupture of membranes, spontaneous abortions, and decreased birth weight and infant stature. Neonates and children who are exposed to secondhand smoke are at increased risk for developing otitis media, asthma, other respiratory disorders later in childhood; dying from sudden infant death syndrome; and learning disorders. The "5 A's" intervention and use of descriptive statements for smoking status assessment were synthesized into the SUCCESS project protocol for AWHONN's 6th research-based practice project. Conclusions: The literature review generated evidence that brief, office-based assessment, client-specific tobacco counseling, skill development, and support programs serve as an effective practice guideline for clinicians. Implementation and evaluation of the guideline is under way at a total of 13 sites in the United States and Canada. [source] How should corporations deal with environmental scepticism?CORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 1 2006Peter Jacques Abstract Environmental scepticism, or the effort to ,debunk' environmental claims, is gaining visibility in world affairs. This complicates the position of corporations that are genuine in their efforts for conscientious productive work. This article explains some of the primary movements found in scepticism and argues that the truth of the sceptical claims is sufficiently contested that corporations should err on the side of caution and treat environmental scepticism as a political movement with a narrow support base, not as a scientific basis for policy. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment. [source] Neuropsychological and neurophysiological findings in individuals suspected to be at risk for schizophrenia: preliminary results from the Basel early detection of psychosis study , Früherkennung von Psychosen (FEPSY)ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2003U. Gschwandtner Objective: Our study aims to establish a scientific basis for the very early detection of patients at risk for schizophrenia during the nonspecific prodromal phase of the disorder and to predict its outbreak. Method: A multidomain approach is used. After screening, approved psychopathological, neurophysiological, neuropsychological and neuroradiological investigations are used to assess a sample of individuals suspected to be at risk for schizophrenia. Results: Neuropsychological and fine motor functioning tests as well as eye movement measurements showed statistically significant differences (P<0.01) between individuals suspected to be at risk for schizophrenia and healthy controls. Conclusion: Individuals suspected to be at risk for schizophrenia show specific impairments in various investigations including neuropsychological and fine motor functioning tests as well as eye movement measurements. A set of methods sensitive to even subtle changes in normal functioning may prove useful in predicting the subsequent outbreak of schizophrenia. [source] Nutrition in patients with Type 2 diabetes: are low-carbohydrate diets effective, safe or desirable?DIABETIC MEDICINE, Issue 7 2005R. L. Kennedy Abstract Low-carbohydrate diets have been around for over 100 years. They have become very popular recently but the scientific basis for their use remains to be fully established. This article reviews the recent trials that have been published and also what is known about the effects of low-carbohydrate, high-protein diets on energy expenditure and body composition. Although many controversies remain, there is now mounting evidence that these diets can lead to effective weight loss and may thus be a useful intervention for patients who have, or are at risk of, diabetes. The practical aspects of using these diets as a short- to medium-term intervention are discussed. [source] Microevolution in agricultural environments: how a traditional Amerindian farming practice favours heterozygosity in cassava (Manihot esculenta Crantz, Euphorbiaceae)ECOLOGY LETTERS, Issue 2 2005Benoît Pujol Abstract We demonstrate a novel case of selection for heterozygosity in nature, involving inadvertent human selection on a population of domesticated plants. Amerindian farmers propagate cassava (Manihot esculenta) clonally by cuttings. Seedlings also appear spontaneously in fields, and farmers allow them to grow, later using some for cuttings. These ,volunteers' contribute new genotypes. However, many are inbred, whereas multiplied clones are highly heterozygous. We demonstrate the selective retention of heterozygous volunteers. When farmers weeded fields, they killed small volunteers, but retained large ones. Plant size and heterozygosity were correlated, and both increased after weeding. The process we document allows maintenance of genotypically diverse and heterozygous clonal stocks. Demonstrating heterosis in nature usually requires large sample sizes, but novel features of our system allowed escape of this constraint. Traditional agroecosystems offer unusual opportunities for the microevolutionary studies required to give on-farm conservation of genetic resources a solid scientific basis. [source] Carbamylated erythropoietin increases frataxin independent from the erythropoietin receptorEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 6 2010Brigitte Sturm Eur J Clin Invest 2010; 40 (6): 561,565 Abstract Background, Friedreich's ataxia (FRDA) is a neurodegenerative disorder caused by decreased expression of the mitochondrial protein frataxin. Recently we showed in a clinical pilot study in Friedreich's ataxia patients that recombinant human erythropoietin (rhuEPO) significantly increases frataxin-expression. In this in vitro study, we investigated the role of the erythropoietin receptor (EPO-R) in the frataxin increasing effect of rhuEPO and if nonerythropoietic carbamylated erythropoietin (CEPO), which cannot bind to the classical EPO-R increases frataxin expression. Materials and methods, In our experiments human erythroleukaemic K562 cells (+ EPO-R), human monocytic leukemia THP-1 cells (, EPO-R) and isolated primary lymphocytes from healthy control and FRDA patients were incubated with different concentrations of rhuEPO or CEPO. Frataxin-expression was detected by an electrochemical luminescence immunoassay (based on the principle of an ELISA). Results, We show that rhuEPO increases frataxin-expression in K562 cells (expressing EPO-R) as well as in THP-1 cells (without EPO-R expression). These results were confirmed by the finding that CEPO, which cannot bind to the classical EPO-R increased frataxin expression in the same concentration range as rhuEPO. In addition, we show that both EPO derivatives significantly increase frataxin-expression in vitro in control and Friedreich's ataxia patients primary lymphocytes. Conclusion, Our results provide a scientific basis for further studies examining the effectiveness of nonerythropoietic derivatives of erythropoietin for the treatment of Friedreich's ataxia patients. [source] Landings, logbooks and observer surveys: improving the protocols for sampling commercial fisheriesFISH AND FISHERIES, Issue 2 2007A J R Cotter Abstract The sampling of commercial marine fisheries for management purposes often displays a key weakness in the form of poor documentation of the scientific basis of sampling and estimation, the assumptions made, and the practical constraints. This paper reviews systematically the theoretical and practical options that can remedy this situation and recommends that decisions be archived in regularly updated ,Sampling Approach and Modifications' (SAM) documents. Defining the target population, the observable population (usually a subset of the target), and the assumed links between them is important, along with the distinction between design- and model-based sampling approaches. Fleet-targeted and stock-targeted sampling strategies are contrasted, the latter being much harder to implement. Sampling protocols aimed at estimating quantities of fish landed and discarded, length,frequency distributions, length-related variables such as age, weight and maturity, and ratio variables such as catch per unit of effort and the proportions of discards are discussed, together with the raising of estimates to fleet and/or stock levels. The ideas are summarized in the specific contexts of landings sampling, logbook schemes and sea-going observer surveys. SAMs are commended for enhancing the scientific value of fishery sampling, and for encouraging methodological discussions among users and producers of the data. [source] THE OMISSION OF CONFLICTING EVIDENCE FROM THE PAPER BY GOLLEDGE ET AL. (2008)GEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 4 2009DEREK FLINN ABSTRACT. In their paper on the last glaciation of Shetland, Golledge et al. (2008) concluded on the basis of a remote sensing study that during that period Shetland had been overrun by ice from Scandinavia. Since the method of study they used does not reveal the sense of the direction in which the ice flowed and since they ignored earlier ground-based work involving striations which do reveal the sense of direction of ice flow their conclusions have no scientific basis. [source] Less-oxidative hemodialysis solution rendered by cathode-side application of electrolyzed waterHEMODIALYSIS INTERNATIONAL, Issue 3 2007Masaaki NAKAYAMA Abstract Electrolyzed water (EW) generated on the cathode side reportedly displays anti-oxidative properties, and application of EW to hemodialysis (HD) systems supposedly suppresses oxidative markers in patients on HD. However, most of the chemical properties and biological effects of such solutions remain unclear. This study aimed to examine those issues to clarify the scientific background for the clinical use of EW solution. Reverse osmosis water comprising EW from the cathode side (e-RO) was prepared and used to process a test HD solution (e-HD). Chemical and biological properties of these solutions were compared with controls. Redox properties were examined by chemiluminescence (CL) of the luminol-H2O2 system. Biological effects of e-RO on human polymorphonuclear leukocytes (PMNs) were tested with respect to the cellular protection against methylglyoxal, and with respect to the preservation of cellular function as to radical generation. Control HD solution presented the highest CL, followed by e-HD, control RO, suggesting a lower oxidative capacity for EW-based solutions. Increased levels of dissolved hydrogen were characteristic of e-RO and e-HD. Application of e-RO tended to be associated with less injury of PMNs by methylglyoxal, and with significantly higher levels of radical generation compared with the control. Compared with control HD, e-RO-based HD solution displays less-oxidative capacity in chemical terms, and may at least partly facilitate preservation of PMN viability. These results appear to offer a scientific basis for supporting the clinical challenge of applying this technology to HD treatment. [source] Factors influencing implementation of occupational safety and health management systems by enterprises in PolandHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2006Daniel Podgórski Implementing legal regulations in occupational safety and health (OSH) as well as other actions aimed at improving working conditions in industry in many countries run in parallel with promoting nonobligatory OSH management systems (OSH MS). To define a scientific basis for working out a set of guidelines for promoting OSH MS, a survey was conducted in 40 companies. This research aimed to identify motivational factors for decisions to introduce OSH MS. Four groups of professionals who participated in the decision-making process related to implementing OSH MS were interviewed: (a) the most senior managers of the enterprise, (b) representatives of top management for implementation and maintenance of OSH MS, (c) safety and health managers, and (d) workers' safety representatives. The results indicate the need for: (1) improving the efficiency of programs promoting implementation of OSH MS; (2) considering the role of economic incentives in promoting these systems; (3) developing and promoting training packages related to OSH management, adjusted particularly to the needs of employees and their representatives to increase their involvement in OSH activities; and (4) modifying legal solutions establishing a system of differentiated premium rates for social insurance against occupational accidents and diseases. © 2006 Wiley Periodicals, Inc. Hum Factors Man 16: 255,267, 2006. [source] Effect of caregiver feeding behaviours on child nutritional status in rural GhanaINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2007Christina A. Nti Abstract A six-month observational study involving 100 mothers with infants between the ages of 6 and 12 months was conducted in the Manya Krobo district of Ghana. The objective was to assess the role of caregiver feeding behaviours on child nutritional status using a modified positive deviance approach. Each child was in the study for 6 months, during which they were observed at home once a month. On each visit, data were collected on the child anthropometry, child meal frequency, diet diversity, responsiveness of caregiver during feeding, child's appetite and feeding atmosphere as well as caregiver hygienic practices related to feeding. Using weight-for-age (WAZ) and length-for-age (LAZ) scores, the children were classified as positive or negative deviant children. The study revealed significant differences between the two groups of children in terms of caregiver feeding behaviours. Positive deviant children had significantly higher meal frequencies (3.1 ± 0.4 vs. 2.4 ± 0.6, P = 0.001), diet diversity scores (6.3 ± 0.6 vs. 3.7 ± 1.1, P = 0.001), were fed under better hygienic conditions (7.2 ± 0.9 vs. 4.2 ± 1.1, P = 0.001) and were much more interested in food during feeding (85.8% vs. 59.3%). Caregiver responsiveness during feeding was also significantly higher among the positive deviant group (6.5 ± 0.8 vs. 4.5 ± 0.9, P = 0.001). This study has demonstrated the tremendous effect of caregiver feeding behaviours on child nutritional outcomes and provides a scientific basis for introducing care during feeding as a component of intervention to improve child nutritional status in Ghana. [source] Nitric oxide and pain: ,Something old, something new'ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009A. MICLESCU Challenges have emerged following the revival of nitric oxide (NO) from ,something old', a simple gas derived from nitrogen and oxygen with a role in the early stages of evolution, into ,something new', an endogenously formed biological mediator regulating a wide variety of physiological functions. Although pain is a common sensation, it encompasses multiple neurobiologic components, of which NO is only one. In pain research, the study of NO is complicated by convoluted problems related mostly to the effects of NO, which are pro- or anti-nociceptive depending on the circumstances. This dual function reflects the multi-faceted roles of the NO molecule described in physiology. This review covers current information about NO and its implications in pain mechanisms. In addition, it follows the pain pathways, demonstrating the role of NO in peripheral nociceptive transmission as well in central sensitization. This knowledge may provide the scientific basis for developing new drugs that are indicated for different types of pain, drugs that may be related to the chemical links of NO. A comprehensive approach to understanding the effects of NO will help clinicians identify novel agents that combine the pharmacological profile of native drugs with a controllable manner of NO release. Inhibitors of NO synthesis may have analgesic effects and would be of interest for treating inflammatory and neuropathic pain. Unfortunately, only a few of these compounds have reached the stage of clinical pain trials. [source] Measurement Bias in the HICP: What do we know and What do we need to know?JOURNAL OF ECONOMIC SURVEYS, Issue 1 2004Mark A. Wynne Abstract. The Harmonized Index of Consumer Prices (HICP) is the primary measure of inflation in the euro area, and plays a central role in the policy deliberations of the European Central Bank (ECB). The ECB defines its Treaty mandate of price stability as ,, a year-on-year increase in the Harmonised Index of Consumer Prices (HICP) for the euro area of below 2%[,] to be maintained over the medium term.' Among the rationales given for defining price stability as prevailing at some positive measured inflation rate is the possibility that the HICP as published incorporates measurement errors of one sort or another that may cause it to systematically overstate the true rate of inflation in the euro area. This paper reviews what currently is known about the scope of measurement error in the HICP. We conclude that given the vague conceptual framework of the HICP, the scant research on price measurement issues in the EU and the ongoing improvements in the HICP, there is very little scientific basis at this time for a point (or even an interval) estimate of a positive bias in the HICP. [source] INFLUENCE OF FROZEN PERIOD ON THE PROXIMATE COMPOSITION AND MICROBIOLOGICAL QUALITY OF NILE TILAPIA FISH (OREOCHROMIS NILOTICUS)JOURNAL OF FOOD PROCESSING AND PRESERVATION, Issue 4 2010SHIMELIS A. EMIRE ABSTRACT The rationale of the study was to investigate the influence of frozen period on quality of fish fillet. The proximate composition and microbiological analyses were carried out at 15 days interval on tilapia fish fillets during frozen storage. It was found that the protein, moisture and ash contents decreased significantly (P < 0.05) during the entire storage period. However, the fat content increased from 0.37 ± 0.01 to 0.56 ± 0.01 g/100 g of fillet. The total volatile bases nitrogen and pH values also increased significantly The total bacterial load in fresh fillets was reduced from 2.57 × 106 to 8.2 × 105 cfu/g after 90 days of frozen storage. The total coliforms decreased from 460 to 23 MPN/g and the fecal coliforms decreased from 23 MPN/g to undetectable level, respectively. Thus, a significant quality loss was observed for tilapia during storage. However, the present frozen conditions retained the fish material under acceptable microbiological conditions for human consumption. PRACTICAL APPLICATIONS The main challenge that fish industries face in developing countries like Ethiopia is to comply with consumer expectations, particularly on product quality. The quality of fresh fish is one of the key factors that govern the shelf life of the final product at low temperature preservation. The Ethiopian fish production and marketing enterprise is vested with the responsibility of inland fisheries processing and marketing. The enterprise, without any scientific basis, labeled the frozen tilapia fish shelf life to be 9 months. Therefore, the aim of this study was to investigate the low-temperature (,18C) preservation technique practiced by the enterprise in order to evaluate the influence of frozen period on quality of a fish fillet. The results on changes in proximate composition and microbial load of Nile tilapia fish fillet enabled to determine the frozen period of a fish fillet that can be fit for human consumption devoid of deterioration. The results can also be used for further investigation and detailed research is required to help commercial processors beyond 90 days of frozen storage. [source] Skeletal Estimation and Identification in American and East European Populations,JOURNAL OF FORENSIC SCIENCES, Issue 3 2008Erin H. Kimmerle Ph.D. Abstract:, Forensic science is a fundamental transitional justice issue as it is imperative for providing physical evidence of crimes committed and a framework for interpreting evidence and prosecuting violations to International Humanitarian Law (IHL). The evaluation of evidence presented in IHL trials and the outcomes various rulings by such courts have in regard to the accuracy or validity of methods applied in future investigations is necessary to ensure scientific quality. Accounting for biological and statistical variation in the methods applied across populations and the ways in which such evidence is used in varying judicial systems is important because of the increasing amount of international forensic casework being done globally. Population variation or the perceived effect of such variation on the accuracy and reliability of methods is important as it may alter trial outcomes, and debates about the scientific basis for human variation are now making their way into international courtrooms. Anthropological data on population size (i.e., the minimum number of individuals in a grave), demographic structure (i.e., the age and sex distribution of victims), individual methods applied for identification, and general methods of excavation and trauma analysis have provided key evidence in cases of IHL. More generally, the question of population variation and the applicability of demographic methods for estimating individual and population variables is important for American and International casework in the face of regional population variation, immigrant populations, ethnic diversity, and secular changes. The reliability of various skeletal aging methods has been questioned in trials prosecuted by the International Criminal Tribunal for the Former Yugoslavia (ICTY) in The Prosecutor of the Tribunal against Radislav Krsti, (Case No. IT-98-33, Trial Judgment) and again in the currently ongoing trial of The Prosecutor of the Tribunal against Zdravko Tolimir, Radivolje Mileti,, Milan Gvero, Vinko Pandurevi,, Ljubisa Beara, Vujadin Popovi,, Drago Nikoli,, Milorad Trbi,, Ljubomir Borovcanin (IT-05-88-PT, Second Amended Indictment). Following the trial of General Krsti,, a collaborative research project was developed between the Forensic Anthropology Center at The University of Tennessee (UT) and the United Nations, International Criminal Tribunal for the Former Yugoslavia, Office of the Prosecutor (ICTY). The purpose of that collaboration was to investigate methods used for the demographic analysis of forensic evidence and where appropriate to recalibrate methods for individual estimation of age, sex, and stature for specific use in the regions of the former Yugoslavia. The question of "local standards" and challenges to the reliability of current anthropological methods for biological profiling in international trials of IHL, as well as the performance of such methods to meet the evidentiary standards used by international tribunals is investigated. Anthropological methods for estimating demographic parameters are reviewed. An overview of the ICTY-UT collaboration for research aimed at addressing specific legal issues is discussed and sample reliability for Balkan aging research is tested. The methods currently used throughout the Balkans are discussed and estimated demographic parameters obtained through medico-legal death investigations are compared with identified cases. Based on this investigation, recommendations for improving international protocols for evidence collection, presentation, and research are outlined. [source] Opioids and opiates: analgesia with cardiovascular, haemodynamic and immune implications in critical illnessJOURNAL OF INTERNAL MEDICINE, Issue 2 2006P. E. MOLINA Abstract. Traumatic injury, surgical interventions and sepsis are amongst some of the clinical conditions that result in marked activation of neuroendocrine and opiate responses aimed at restoring haemodynamic and metabolic homeostasis. The central activation of the neuroendocrine and opiate systems, known collectively as the stress response, is elicited by diverse physical stressor conditions, including ischaemia, glucopenia and inflammation. The role of the hypothalamic,pituitary,adrenal axis and sympathetic nervous system in counterregulation of haemodynamic and metabolic alterations has been studied extensively. However, that of the endogenous opiates/opioid system is still unclear. In addition to activation of the opiate receptor through the endogenous release of opioids, pharmacotherapy with opiate receptor agonists is frequently used for sedation and analgesia of injured, septic and critically ill patients. How this affects the haemodynamic, cardiovascular, metabolic and immune responses is poorly understood. The variety of opiate receptor types, their specificity and ubiquitous location both in the central nervous system and in the periphery adds additional complicating factors to the clear understanding of their contribution to the stress response to the various physical perturbations. This review aims at discussing scientific evidence gathered from preclinical studies on the role of endogenous opioids as well as those administered as pharmacological agents on the host cardiovascular, neuroendocrine, metabolic and immune response mechanisms critical for survival from injury in perspective with clinical observations that provide parallel assessment of relevant outcome measures. When possible, the clinical relevance and corresponding scenarios where this evidence can be integrated into our understanding of the clinical implications of opiate effects will be examined. Overall, the scientific basis to enhance clinical judgment and expectations when using opioid sedation and analgesia in the management of the injured, septic or postsurgical patient will be discussed. [source] Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiationJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2008J Corry Summary Percutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGT) for nutritional support of patients with head and neck cancer undergoing curative (chemo)radiotherapy without any good scientific basis. A randomized trial was conducted to compare PEG tubes and NGT in terms of nutritional outcomes, complications, patient satisfaction and cost. The study was closed early because of poor accrual, predominantly due to patients' reluctance to be randomized. There were 33 patients eligible for analysis. Nutritional support with both tubes was good. There were no significant differences in overall complication rates, chest infection rates or in patients' assessment of their overall quality of life. The cost of a PEG tube was 10 times that of an NGT. The duration of use of PEG tubes was significantly longer, a median 139 days compared with a median 66 days for NGT. We found no evidence to support the routine use of PEG tubes over NGT in this patient group. [source] Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix researchJOURNAL OF NURSING MANAGEMENT, Issue 6 2009BSc (Hons), MARIA FLYNN RGN Aim, This paper revisits the published evidence relating to how nurse staffing levels impact on patient, nurse and service outcomes and considers the implications of this body of research for nurse managers in their quest to determine optimum nursing numbers. Background, Within the context of the recognized global nursing shortage and particular local pressures within international health services, questions of appropriate nurse staffing levels and skill mix are once again becoming increasingly important. It would seem that the determination of optimum nurse staffing levels and skill mix is a central issue in relation to health service governance, service user involvement, as well as in the recruitment, retention and well-being of nursing staff across the service sectors. Methods, A review of published evidence was carried out, applying key principles of the systematic method, in order to facilitate the identification of current factors and issues in nurse staffing levels research. The review did not seek to address a specific research question. The search covered 10 years from 1998 to 2008 and identified more than 500 relevant papers, giving a wide international perspective. Key issues, The majority of research in the field relates to the acute service sector and there are considerable similarities in issues that transcend international boundaries. Much of the research focuses on the impact on patients and nurses of ,poor' nurse staffing levels. More recent studies have explored the impact of nurse staffing levels on the service organization itself. However, while there may be an association between models of nurse staffing and outcomes, there is insufficient evidence to establish a causal relationship between these factors. In this context it is perhaps time to reconsider how nursing outcomes are defined and measured. Implications for nursing management and conclusion, Nurse managers, commissioners of services and workforce planners need to be cognisant of key issues and analyses in the consideration of nurse staffing levels. Not least of these is the need for a healthy degree of caution regarding the supposed objectivity, scientific basis, or evidence base, for rational calculation of optimum nurse staffing levels. [source] Osteogenesis induced by extracorporeal shockwave in treatment of delayed osteotendinous junction healingJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2010Ling Qin Abstract Healing at the osteotendinous junction (OTJ) is challenging in orthopedic surgery. The present study aimed to test extracorporeal shockwave (ESW) in treatment of a delayed OTJ healing. Twenty-eight rabbits were used for establishing a delayed healing (DH) model at patella-patellar-tendon (PPT) complex after partial patellectomy for 4 weeks and then were divided into DH and ESW groups. In the ESW group, a single ESW treatment was given at postoperative week 6 to the PPT healing complex. The samples were harvested at week 8 and 12 for radiographic and histological evaluations with seven samples for each group at each time point. Micro-CT results showed that new bone volume was 1.18 ± 0.61,mm3 in the ESW group with no measurable new bone in the DH group at postoperative week 8. Scar tissue formed at the OTJ healing interface of the DH group, whereas ESW triggered high expression of VEGF in hypertrophic chondrocytes at week 8 and regeneration of the fibrocartilage zone at week 12 postoperatively. The accelerated osteogenesis could be explained by acceleration of endochondral ossification. In conclusion, ESW was able to induce osteogenesis at OTJ with delayed healing with enhanced endochondral ossification process and regeneration of fibrocartilage zone. These findings formed a scientific basis to potential clinical application of ESW for treatment of delayed OTJ healing. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:70,76, 2010 [source] Bacopa monniera protects rat heart against ischaemia,reperfusion injury: role of key apoptotic regulatory proteins and enzymesJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 9 2010Ipseeta Ray Mohanty Abstract Objectives, Rat isolated hearts were perfused in a Langendorff model to study the cardioprotective effects of Bacopa monniera, a medicinal herb used in the Indian system of medicine, on cardiomyocyte apoptosis and antioxidant status following ischaemia,reperfusion (I-R) injury. Methods, Forty-eight rats were randomly divided into four groups (12 in each group): sham group (no ischaemia,reperfusion injury), B. monniera control group (orally fed B. monniera at a dose of 75 mg/kg, for three weeks); ischaemia,reperfusion control group(subjected to ischaemia,reperfusion-induced myocardial injury) and B. monniera -treated group (same protocol as ischaemia,reperfusion control group except that rats also fed B. monniera). Key findings, Post-ischaemic reperfusion injury resulted in significant cardiac necrosis, apoptosis, depression of heart rate, decline in antioxidant status and elevation in lipid peroxidation. Oral administration of B. monniera per se for three weeks to healthy rats caused augmentation of myocardial antioxidants, superoxide dismutase, catalase and glutathione, along with induction of heat shock protein 72 (HSP72). Ischaemia,reperfusion-induced biochemical and histopathological perturbations were significantly prevented by B. monniera (75 mg/kg) pre-treatment. Interestingly, B. monniera also restored the antioxidant network of the myocardium and reduced myocardial apoptosis, caspase 3 and Bax protein expression. Conclusions, Histopathological studies and myocardial creatine phosphokinase content further confirmed the cardioprotective effects of B. monniera (75 mg/kg) in the experimental model of ischaemia,reperfusion injury. The study provides scientific basis for the putative therapeutic effect of B. monniera in ischaemic heart disease. [source] Medicinal plants in Suriname: hypotensive effect of Gossypium barbadenseJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 3 2004J. A. Hasrat ABSTRACT In traditional medicine Gossypium barbadense L. is used against hypertension. Looking for a scientific basis for this use, the blood-pressure-lowering effect of the decoction of the leaves was confirmed. Fraction II (frII) of the crude extract of G. barbadense showed a dose-dependent hypotensive effect in anaesthetized rats. In hexamethonium-treated rats, the blood-pressure-lowering effect of frII was almost abolished. A small decrease of the blood-pressure-lowering effect was followed by an increase in the blood pressure. Phentolamine antagonized the increase in blood pressure in hexamethoniumtreated rats. High doses of atropine (4 mg/rat) suppressed both depressor and heart effects. In-vitro experiments revealed that atropine did not antagonize the contraction of the ileum of the rat. Tripelennamine in a concentration of 100 ,g could not influence the contraction either, whereas 300 ,g did. In the guinea-pig ileum 10 ,g tripelennamine did not reduce the contraction significantly. In the mechanism of action of frII, acetylcholine receptors could be involved, but not histaminergic or adrenergic receptors. Although it is still not known which compound(s) in G. barbadense is (are) the active substance(s), the results obtained may explain the use of this plant in traditional medicine in Suriname. [source] Incubation period in the 2,2,4,4-tetramethyl-1-piperidinyloxy-mediated thermal autopolymerization of styrene: Kinetics and simulationsJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 24 2006Enrique Saldívar-Guerra Abstract Mechanisms and simulations of the induction period and the initial polymerization stages in the nitroxide-mediated autopolymerization of styrene are discussed. At 120,125 °C and moderate 2,2,4,4-tetramethyl-1-piperidinyloxy (TEMPO) concentrations (0.02,0.08 M), the main source of radicals is the hydrogen abstraction of the Mayo dimer by TEMPO [with the kinetic constant of hydrogen abstraction (kh)]. At higher TEMPO concentrations ([N,] > 0.1 M), this reaction is still dominant, but radical generation by the direct attack against styrene by TEMPO, with kinetic constant of addition kad, also becomes relevant. From previous experimental data and simulations, initial estimates of kh , 1 and kad , 6 × 10,7 L mol,1 s,1 are obtained at 125 °C. From the induction period to the polymerization regime, there is an abrupt change in the dominant mechanism generating radicals because of the sudden decrease in the nitroxide radicals. Under induction-period conditions, the simulations confirm the validity of the quasi-steady-state assumption (QSSA) for the Mayo dimer in this regime; however, after the induction period, the QSSA for the dimer is not valid, and this brings into question the scientific basis of the well-known expression kth[M]3 (where [M] is the monomer concentration and kth is the kinetic constant of autoinitiation) for the autoinitiation rate in styrene polymerization. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 6962-6979, 2006 [source] COOKING BEHAVIOR OF RICE AND BLACK GRAM IN THE PREPARATION OF IDLI, A TRADITIONAL FERMENTED PRODUCT OF INDIAN ORIGIN, BY VISCOGRAPHYJOURNAL OF TEXTURE STUDIES, Issue 1 2009BONG KYUNG KOH ABSTRACT Pasting profile of coarse rice, fine rice as well as black gram was carried out individually, in combination, in flour as well as in batter form, before and after fermentation by Brabender Viscoamylograph. Lowest gelatinization temperature was seen in black gram among the three commodities studied. Coarse rice registered a peak viscosity (PV) of 1,300 BU, fine rice 1,030 BU and black gram 1,080 BU. Cold paste viscosity (CPV) was highest in fine rice, lowest in black gram and intermediate in coarse rice. Breakdown (BD) was least in fine rice, highest in coarse rice and black gram lay in between. Values of total setback indicated the strong reason for use of coarse rice in parboiling as well as in idli and dosa preparations. Physical combination of black gram, with fine as well as coarse rice, reduced PV on an average to an extent of 26,30%. CPV was highest in fine rice and black gram combination compared with that of coarse rice and black gram. BD was high in the physical mix of coarse rice and black gram. In comparison with physical mix of fine rice and black gram, in the batter form before fermentation, the PV and CPV reduced by 23 and 34%, respectively, but there was no BD in this mix, indicating restricted swelling behavior in the batter before fermentation. Almost all viscographic parameters reduced before fermentation in coarse rice and black gram compared with their physical combination. Highest relative BD (BDr) was noticed in the pasting profile of black gram alone, probably because of the presence of mucilaginous principle. BDr values increased in batter form to various extents, before and after fermentation, compared with physical combination of rice and black gram. After fermentation, in coarse rice and black gram, the BDr value was low compared with that in fine rice and black gram. PRACTICAL APPLICATIONS Fermented products are commonly ingested in India, especially in the southern states. Nowadays, batter is sold in public for the sake of convenience, as it is a common breakfast preparation. The practice is to use coarse rice for the preparation of idli, a steamed fermented product. It is generally not known how the rice behaves before and after fermentation while cooking. Hence, this work was planned, and results indicated the scientific basis for the usage of coarse rice in the preparation of rice products. The behavior of batter prepared from fine rice has also been described, although it is not an economically viable option. [source] New developments in the chemistry and biology of the bioactive constituents of tanshen,MEDICINAL RESEARCH REVIEWS, Issue 1 2007Xihong Wang Abstract Tanshen, the rhizome of Salvia miltiorrhiza Bunge, has been used in Chinese traditional medicine (TCM) for multiple therapeutic remedies. The major constituents of Tanshen include water-soluble phenolic acids and lipophilic tanshinones. Phenolic acids possess antioxidant and anticoagulant activities, whereas tanshinones show antibacterial, antioxidant, and antineoplastic activities. This review will focus on recent developments concerning the chemical constituents of Tanshen and their biological activities. These chemical and biological studies continue to increase our understanding about a scientific basis for the traditional clinical use of Tanshen and can also contribute to the development of new drug candidates. Recently, in the author's laboratory, a new compound, neo-tanshinlactone, was discovered to have potent selective antibreast cancer activity. This compound might serve as a lead for developing promising antibreast cancer clinical trials candidates. © 2006 Wiley Periodicals, Inc. Med Res Rev, 27, No. 1, 133,148, 2007 [source] Cariogenic Bacteria as Biomarkers for Sugar IntakeNUTRITION REVIEWS, Issue 3 2007Karin E. Vågstrand MS Cariogenic bacteria (lactobacilli and mutans streptococci) in saliva are possible biomarkers for sugar intake. We evaluated the strength of the evidence for an association between sugar intake and the two groups of bacteria, and concluded that there is a limited to moderately scientific basis for this association. Because of many confounding factors, bacteria counts can never be used as a precise measurement of sugar intake, but might still be useful on a group level. [source] When is an Individual an Individual Versus a Member of a Group?NUTRITION REVIEWS, Issue 5 2006An Issue in the Application of the Dietary Reference Intakes The Institute of Medicine (IOM) reports on Dietary Reference Intakes (DRIs) present a new paradigm for the description of nutrient requirements. Tradition and the DRI reports themselves have created an erroneous impression that the Recommended Dietary Allowance (RDA) is intended for use with individuals and the Estimated Average Requirement (EAR) is to be used with populations. Two recent IOM committee reports (one on nutrition labeling and one on Women, Infants and Children [WIC] food packages) challenge that interpretation, revealing the critical issues surrounding individuals versus groups or populations. The present paper examines the issues and concludes that the median requirement and Tolerable Upper Limit (UL) are the critical reference values for both individuals and populations. The RDA is both unneeded and lacking a sound scientific basis. [source] Modulation of Monocyte-Macrophage Function with ,-Tocopherol: Implications for AtherosclerosisNUTRITION REVIEWS, Issue 1 2002Sridevi Devaraj PhD Cardiovascular disease is the leading cause of morbidity and mortality in the Western world. Monocyte-macrophages are crucial cells in atherogenesis. Several lines of evidence suggest that antioxidants, especially , -tocopherol, have beneficial effects with regard to cardiovascular disease. , -Tocopherol has beneficial effects on cell functions that are pivotal in atherogenesis. , -Tocopherol inhibits platelet aggregation and proinflammatory activity of monocytes. In vitro data also support an effect of , -tocopherol on smooth muscle cell proliferation and endothelial function. Finally, recent data support an effect of , -tocopherol on macrophage function. The mounting evidence from in vitro and in vivo studies provides a sound scientific basis for , -tocopherol supplementation. Further clinical trials are required, however, before a definitive recommendation can be made for primary and secondary prevention of heart disease. [source] Pediatric lung disease: From proteinases to pulmonary fibrosisPEDIATRIC PULMONOLOGY, Issue 5 2005Felix Chua MRCP Abstract One distinctive outcome of interstitial lung diseases in childhood is the abnormal accumulation of pulmonary extracellular matrix. The clinical consequence of such excessive connective tissue accumulation is known as pulmonary fibrosis. While numerous aspects of its pathogenesis have become familiar, many key events involved in its inception and progression still remain unclear. There is now compelling evidence that lung damage due to uncontrolled proteolysis may help drive critical processes that regulate fibrotic matrix remodeling. In this regard, a number of proteinases have been implicated in promoting both the initial lung injury and the fibroproliferative repair that follows. This review summarizes the knowledge of how different matrix-targeting enzymes may act to influence the development of pediatric pulmonary fibrosis. Understanding the scientific basis of this complex process may highlight opportunities to limit unwanted proteolysis and the intensity of its fibrotic sequelae. © 2005 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||||||||