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Second Aim (second + aim)
Selected AbstractsAre infants with torticollis at risk of a delay in early motor milestones compared with a control group of healthy infants?DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2009ANNA ÖHMAN PT MSC Recently it has been claimed that infants with congenital muscular torticollis (CMT) are at risk of a delay in early motor milestones. The aim of the present study was to investigate whether infants with CMT are indeed at risk in comparison with a control group of healthy infants. A second aim was to investigate whether the time spent in a prone position and plagiocephaly had any influence on motor development. Eighty-two infants with CMT (35 females and 47 males) were compared with 40 healthy infants (18 females and 22 males). Motor development was assessed with the Alberta Infant Motor scale (AIMS). Multiple regression showed that infants in the CMT group had a significantly lower AIMS score than the control group at 2 months (p=0.03) and 6 months of age (p=0.05). Infants who spent at least three occasions daily in a prone position when awake had significantly higher AIMS scores than infants who spent less time prone at 2 months (p=0.001), 6 months (p<0.001), and 10 months of age (p<0.001). The CMT group achieved early motor milestones significantly later than the control group until the age of 10 months, but the risk of delay seems to be more strongly associated with little or no time prone when awake than with CMT. [source] International Diabetes Federation: a consensus on Type 2 diabetes preventionDIABETIC MEDICINE, Issue 5 2007K. G. M. M. Alberti Abstract Aims, Early intervention and avoidance or delay of progression to Type 2 diabetes is of enormous benefit to patients in terms of increasing life expectancy and quality of life, and potentially in economic terms for society and health-care payers. To address the growing impact of Type 2 diabetes the International Diabetes Federation (IDF) Taskforce on Prevention and Epidemiology convened a consensus workshop in 2006. The primary goal of the workshop and this document was the prevention of Type 2 diabetes in both the developed and developing world. A second aim was to reduce the risk of cardiovascular disease in people who are identified as being at a higher risk of Type 2 diabetes. The IDF plan for prevention of Type 2 diabetes is based on controlling modifiable risk factors and can be divided into two target groups: ,,People at high risk of developing Type 2 diabetes ,,The entire population. Conclusions, In planning national measures for the prevention of Type 2 diabetes, both groups should be targeted simultaneously with lifestyle modification the primary goal through a stepwise approach. In addition, it is important that all activities are tailored to the specific local situation. Further information on the prevention of diabetes can be found on the IDF website: http://www.idf.org/prevention. [source] Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions: the SHEEP case,control studyADDICTION, Issue 10 2003Anders Romelsjö ABSTRACT Aims, Very few studies indicating that low,moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers. Design, Data came from a case,control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45,70 years old. Setting, Stockholm County 1992,94. Participants, There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population. Measurement, Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls. Findings, In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50,69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1,5 g 100% ethanol/day). Men who were abstainers during the previous 1,10 years and with an earlier average consumption of 5,30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations. Conclusion, Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1,10-year-long abstainers influenced the risk of MI. [source] Acute leukaemia or highly malignant lymphoma patients' quality of life over two years: a pilot studyEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2001L. Persson The aim of this study was, first, to investigate the quality of life and sense of coherence for acute leukaemia and malignant lymphoma patients at the start of treatment and over 2 years. A second aim was to compare questionnaire responses with patients' statements in open-ended interviews. A consecutive sample of 16 patients responded to the Quality of Life Questionnaire (QLQ-C30), Lund Gerontological Centre questionnaire and the Sense of Coherence Scale at the start of treatment and after 12 and 24 months. The QLQ-C30 questionnaire was administered also after 4, 8, 16 and 20 months. Tape-recorded open-ended interviews were conducted every 4 months before the patients responded to the questionnaires. Quality of life (QoL) and sense of coherence were scored more highly at the beginning of treatment for patients who did not relapse, than for those who relapsed. This difference remained throughout the study period. There was no correspondence in responses between questionnaire and personal interviews, although the results from the interviews, in some aspects, validated the result from the QLQ-C30. Those patients who relapsed may have had different prerequisites or been in a worse position at the onset of the disease and, reasonably, they needed more compensatory nursing care. More knowledge about the correspondence between a person's perceived QoL when discussed in personal interviews compared with responses given in standardised QoL questionnaires is needed before any assumption about clinical relevance can be made. [source] Impaired Pavlovian fear extinction is a common phenotype across genetic lineages of the 129 inbred mouse strainGENES, BRAIN AND BEHAVIOR, Issue 8 2009M. Camp Fear extinction is impaired in psychiatric disorders such as post-traumatic stress disorder and schizophrenia, which have a major genetic component. However, the genetic factors underlying individual variability in fear extinction remain to be determined. By comparing a panel of inbred mouse strains, we recently identified a strain, 129S1/SvImJ (129S1), that exhibits a profound and selective deficit in Pavlovian fear extinction, and associated abnormalities in functional activation of a key prefrontal-amygdala circuit, as compared with C57BL/6J. The first aim of the present study was to assess fear extinction across multiple 129 substrains representing the strain's four different genetic lineages (parental, steel, teratoma and contaminated). Results showed that 129P1/ReJ, 129P3/J, 129T2/SvEmsJ and 129X1/SvJ exhibited poor fear extinction, relative to C57BL/6J, while 129S1 showed evidence of fear incubation. On the basis of these results, the second aim was to further characterize the nature and specificity of the extinction phenotype in 129S1, as an exemplar of the 129 substrains. Results showed that the extinction deficit in 129S1 was neither the result of a failure to habituate to a sensitized fear response nor an artifact of a fear response to (unconditioned) tone per se. A stronger conditioning protocol (i.e. five × higher intensity shocks) produced an increase in fear expression in 129S1, relative to C57BL/6J, due to rapid rise in freezing during tone presentation. Taken together, these data show that impaired fear extinction is a phenotypic feature common across 129 substrains, and provide preliminary evidence that impaired fear extinction in 129S1 may reflect a pro-fear incubation-like process. [source] Impact of Helicobacter pylori on the Development of Vitamin B12 Deficiency in the Absence of Gastric AtrophyHELICOBACTER, Issue 6 2002Ender Serin Abstract Background. Cobalamin (vitamin B12) deficiency is associated with Helicobacter pylori infection. This study examined how serum vitamin B12 levels relate to gastric mucosa H. pylori density and histology, and to hematological findings in patients with minimal or no gastric atrophy. A second aim was to confirm that H. pylori eradication therapy increases serum B12. Materials and Methods. Biopsies of the gastric mucosa from a population of dyspeptic patients were graded for level of chronic inflammation, neutrophil activity, atrophy, and H. pylori density. A total of 145 H. pylori -infected patients with minimal or no atrophy were included in the study. Serum cobalamin level, hemoglobin level, and mean corpuscular volume were measured in the 145 patients before eradication therapy, and in 65 of the subjects after treatment. The hematologic findings before and after eradication therapy and correlations between serum vitamin B12 level and histologic parameters, hematologic findings, and patient age were statistically analyzed. Results. There was no significant correlation between serum cobalamin level and patient age. Before treatment all the histopathological scores were inversely correlated with serum vitamin B12 level (p < .01) on univariate analysis. Only H. pylori density was significantly associated with B12 level on multivariate analysis. Serum hemoglobin and cobalamin levels were significantly increased after treatment, regardless of H. pylori eradication status (p < .001). Conclusion. The findings provide strong evidence that H. pylori infection is associated with cobalamin deficiency, and show that this is true even in patients with nonulcer dyspepsia and minimal or no gastric atrophy. [source] Improved quality of root fillings provided by general dental practitioners educated in nickel,titanium rotary instrumentationINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2007A. Molander Abstract Aim, To test the hypothesis that an increased utilization of nickel,titanium rotary instrumentation (NTRI) by general dental practitioners will lead to an increased frequency of good quality root fillings. A second aim was to determine whether the educational format would exert influence on the quality. Methodology, Dentists were assigned at random to three intervention groups: a 4-h lecture (L-group, n = 40); a 4-h lecture plus a full day hands-on course (LH-group, n = 40); or a control group receiving no instruction (n = 68). The control group received education later on in the study. Radiographs of two root filled molar teeth per dentist were selected at random before the start of the education program and after a 6-month clinical learning period. Using length, seal and shape of root-fillings a 5-level variable was created. Results, The rate of good quality root fillings increased after the introduction of NTRI. Calculated over all types of roots the frequency of excellent (score 1) root fillings increased from 31% to 51% (P = 0.006) in the L-group and from 27% to 47% (P = 0.016) in the LH-group. The frequency of low quality root-fillings (score 5) dropped in the L-group from 22% to 16% (P = 0.29) and in the LH-group from 13% to 9% (P = 0.48). No statistically significant difference was seen among the controls. Conclusions, When NTRI technology replaced manual stainless steel techniques the rate of good quality root fillings increased. A significant drop in the rate of low quality root fillings was not found. [source] Treatment outcomes and clinicopathologic characteristics of triple-negative breast cancer patients who received platinum-containing chemotherapyINTERNATIONAL JOURNAL OF CANCER, Issue 6 2009Ji Eun Uhm Abstract The aim of this study was to evaluate the role of platinum-containing chemotherapy for metastatic triple-negative breast cancer (TNBC) patients in terms of the response rate (RR) and progression-free survival. A second aim was to characterize the clinical behavior at the time of relapse of TNBC. We retrospectively analyzed the clinical outcomes of patients with metastatic breast cancer who received taxane,platinum chemotherapy as the first- or second-line treatment, focusing on the TN phenotype. In total, 257 patients with metastatic breast cancer received platinum-containing chemotherapy at Samsung Medical Center from 1999 to 2006. Of these patients, 106 patients with available data on estrogen (ER), progesterone (PgR) and human epidermal growth factor receptor-2 (HER2) receptor status received taxane,platinum regimen as the first- or second-line treatment. The overall RR of patients with TNBC was 39%. This rate did not differ significantly from those of patients with other phenotypes. The time to death after chemotherapy (19 vs. 50 months, p = 0.037) and overall survival (OS) (21 vs. 56 months, p = 0.030) differed significantly between patients with TNBC and non-TNBC. TNBC showed a unique locoregional infiltration pattern at relapse, which might reflect its aggressive clinical behavior. Despite the similar response to platinum-containing chemotherapy, patients with TNBC had a shorter OS than patients with non-TNBC. The implication of TN phenotype as poor prognostic factor is uncertain, because it needs to be defined whether poor outcome is related to the rapid growing characteristics of tumor itself or the resistance to drug therapy. Further prospective studies are warranted. © 2008 Wiley-Liss, Inc. [source] The Accession of the UK to the EC: A Welfare AnalysisJCMS: JOURNAL OF COMMON MARKET STUDIES, Issue 3 2002Michael Gasiorek This article provides a decomposition of the welfare impact on the UK arising from the changes in manufacturing trade consequent upon joining the EC. The methodology employed is that of computable general equilibrium (CGE) modelling, where the underlying model is based on trade under imperfect competition with firms producing under conditions of increasing returns to scale. CGE models can be seen as providing numerical illustrations of theory, or as empirical tools providing estimates of policies. A second aim of this article is then to asses the extent to which CGE models can be used as serious tools of policy analysis. We examine this by assessing the success of the model in replicating counterfactual outcomes. The results indicate (i) that the model does reasonably well in replicating complex reality and that such models can be empirically useful; (ii) that a substantial portion of the welfare impact is attributed to distortions associated with imperfect competition, and that the impact is potentially quite large. [source] Realist Versus Anti-Realist Moral Selves,and the Irrelevance of NarrativismJOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR, Issue 2 2009KRISTJÁN KRISTJÁNSSON This paper has three aims. The first is to subject to critical analysis the intractable debate between realists and anti-realists about the status of the so-called (moral) self, a debate that traverses various academic disciplines and discursive fields. Realism about selves has fallen on hard times of late, and the second aim of this paper is to get it back on track. Traditional substantive conceptions of the self contain ontological baggage that many moderns will be loath to carry. This paper settles for a more moderate aim, a "softer" kind of self-realism derived from an unlikely source,Hume,and outlines the Humean moral self and its possible advantages. The third and subsidiary aim is to challenge the view that recent "narrative" conceptions of selfhood have made the old realism versus anti-realism debate redundant. "Narrativism" about selves turns out to do little more than recycle old arguments in fancy new packages. [source] Porosity of human mandibular condylar boneJOURNAL OF ANATOMY, Issue 3 2007G. A. P. Renders Abstract Quantification of porosity and degree of mineralization of bone facilitates a better understanding of the possible effects of adaptive bone remodelling and the possible consequences for its mechanical properties. The present study set out first to give a three-dimensional description of the cortical canalicular network in the human mandibular condyle, in order to obtain more information about the principal directions of stresses and strains during loading. Our second aim was to determine whether the amount of remodelling was larger in the trabecular bone than in cortical bone of the condyle and to establish whether the variation in the amount of remodelling was related to the surface area of the cortical canals and trabeculae. We hypothesized that there were differences in porosity and orientation of cortical canals between various cortical regions. In addition, as greater cortical and trabecular porosities are likely to coincide with a greater surface area of cortical canals and trabeculae available for osteoblastic and osteoclastic activity, we hypothesized that this surface area would be inversely proportional to the degree of mineralization of cortical and trabecular bone, respectively. Micro-computed tomography was used to quantify porosity and mineralization in cortical and trabecular bone of ten human mandibular condyles. The cortical canals in the subchondral cortex of the condyle were orientated in the mediolateral direction, and in the anterior and posterior cortex in the superoinferior direction. Cortical porosity (average 3.5%) did not differ significantly between the cortical regions. It correlated significantly with the diameter and number of cortical canals, but not with cortical degree of mineralization. In trabecular bone (average porosity 79.3%) there was a significant negative correlation between surface area of the trabeculae and degree of mineralization; such a correlation was not found between the surface area of the cortical canals and the degree of mineralization of cortical bone. No relationship between trabecular and cortical porosity, nor between trabecular degree of mineralization and cortical degree of mineralization was found, suggesting that adaptive remodelling is independent and different between trabecular and cortical bone. We conclude (1) that the principal directions of stresses and strains are presumably directed mediolaterally in the subchondral cortex and superoinferiorly in the anterior and posterior cortex, (2) that the amount of remodelling is larger in the trabecular than in the cortical bone of the mandibular condyle; in trabecular bone variation in the amount of remodelling is related to the available surface area of the trabeculae. [source] Plant diversity and endemism in sub-Saharan tropical AfricaJOURNAL OF BIOGEOGRAPHY, Issue 2 2001Linder Aim This paper has as its central aim the location of centres of species richness and endemism in the sub-Saharan African flora. Previous postulation of these centres has been based on an intuitive interpretation of distributional data; this paper provides a test of these centres. A second aim is to establish whether the two indices, richness and endemism, locate the same centres. Thirdly the relationship between species richness and endemism, and latitude and rainfall are explored. Location The study area includes much of sub-Saharan Africa, but excludes the species-poor southern margin of the Sahara and the Namib,Kalahari regions. Methods Analyses were based on 1818 species, scored on a 2.5 × 2.5 degree grid. Species richness was inferred from a simple grid-diversity count; endemism was determined by three measures: the number of species restricted to two grids, the sum of the inverse of the ranges of the component species of each grid, and the proportion of the species in each grid that have restricted ranges. Results The African flora shows a remarkably profound patterning, both in species richness and endemism. The two measures locate largely the same centres, although the rank order among them differs. These centres are: the Cape Floristic Region, East Coast, Congo-Zambezi watershed, Kivu, Upper and Lower Guinea. Richness is strongly related to maximum rainfall, but there are no obvious correlations between modern climate and endemism. Species richness and endemism north of the equator is much more concentrated into centres than south of the equator. Main conclusions There are strongly developed refugia in sub-Saharan Africa. North of the equator, these refugia are sharply delimited and rather small, separated by large areas of very low endemism. South of the equator endemism tends to be more generally distributed. Variation in species richness in sub-Saharan Africa can be explained largely by modern rainfall, while endemism may be related to palaeoclimatic fluctuations. Both species richness and endemism show a strong skewing towards the south, indicating that the fluctuations in the Sahara might have influenced the modern distribution of plants in Africa. [source] Glial Limitans Elasticity Subjacent to the Supraoptic NucleusJOURNAL OF NEUROENDOCRINOLOGY, Issue 8 2004A. K. Salm Abstract Two previous studies from our laboratory have indicated that the ventral glial limitans subjacent to the hypothalamic supraoptic nucleus (SON-VGL) undergoes a reversible thinning upon chronic activation of the magnocellular neuroendocrine cells (MNCs) of the supraoptic nucleus (SON). Numerous other studies have shown that MNC somata hypertrophy with activation. One aim of the current study was to understand better how SON-VGL thinning occurs. A second aim was to quantify overall changes of the MNC somata region due to cellular hypertrophy to compare relative changes in dimensions. Here, we undertook a light microscopic stereological investigation of the SON and the subjacent SON-VGL of Nissl stained material under basal and activated conditions. Astrocyte numbers in the underlying SON-VGL remained stable across hydration state as did the overall volume of the SON-VGL and dendritic zone reference area. How these data are consistent with our earlier observations of SON-VGL thinning was resolved by the finding of a highly significant, 30% increase in the mediolateral dimension of the SON-VGL in dehydrated rats. These observations fit well with previous work from our laboratory that demonstrates a reorientation of SON-VGL astrocytes, from vertical to horizontal, which occurs in the activated SON-VGL. We found a significant, approximately 54%, increase in the overall volume of the MNC region of the SON. No significant rostrocaudal lengthening of the SON was detected, although a trend was evident. All the observed changes reversed with rehydration. These data indicate that elasticity of the SON-VGL acts to accommodate the volume expansion of the MNCs and enables the SON-VGL to continue as an interface between the underlying cerebrospinal fluid in the subarachnoid space and the expanded SON above. [source] Morphine, opioids, and the feline pulmonary vascular bedACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2008A. D. KAYE Background: Opioid-induced vasodepressor responses have been reported in a variety of species and laboratory models. The aim of this study was to ascertain the relative potencies of different clinically relevant opioids compared with traditional vasodepressor agents in the feline pulmonary vascular bed. A second aim was to study the effects of morphine and to identify the receptors involved in the mediation or the modulation of these effects. Methods: This was a prospective vehicle-controlled study involving an intact chest preparation of adult mongrel cats. The effects of various opioids, morphine, fentanyl, remifentanil, sufentanil, and meperidine were compared with other vasodepressor agents. Additionally, the effects of l - N5 -(1-iminoethyl) ornithine hydrochloride (l -NIO) (nitric oxide synthase inhibitor), nimesulide [selective cyclooxygenase (COX)-2 inhibitor], glibenclamide (ATP-sensitive K+ channel blocker), naloxone (non-selective opioid receptor antagonist), and diphenhydramine (histamine H1 -receptor antagonist) were investigated on pulmonary arterial responses to morphine and other selected agonists in the feline pulmonary vascular bed. The systemic pressure and lobar arterial perfusion pressure were continuously monitored, electronically averaged, and recorded. Results: In the cat pulmonary vascular bed of the isolated left lower lobe, morphine, remifentanil, fentanyl, sufentanil, and meperidine induced a dose-dependent moderate vasodepressor response and it appeared that sufentanil was the most potent on a nanomolar basis. The effects of morphine were not significantly altered after administration of l -NIO, nimesulide, and glibenclamide. However, the vascular responses to morphine were significantly attenuated following administration of naloxone and diphenhydramine. Conclusion: The results of the present study suggest that sufentanil appears to have slightly more potency and morphine the least of the five opioid agonists studied on a nanomolar basis. Morphine-induced vasodilatory responses appeared to be mediated or modulated by both opioid receptor and histamine-receptor-sensitive pathways. [source] In Heavy Drinkers Fatty Acid Ethyl Esters in the Serum Are Increased for 44 hr After Ethanol ConsumptionALCOHOLISM, Issue 7 2004Katrin Borucki Background: Fatty acid ethyl esters (FAEEs) have been proposed as a marker of ethanol consumption because they can be detected for up to 24 hr after a moderate intake of ethanol, even though blood ethanol remains increased for only 8 hr. Therefore, this study investigated whether FAEEs can be found during a time period exceeding 24 hr in a group of patients who were hospitalized for ethanol detoxification. A second aim was to study the distribution of FAEEs between lipoproteins during that time. Methods: Serum samples of 12 patients with acute ethanol intoxication were assayed for FAEEs. Blood samples were drawn 8.2, 20.2, 32.2, and 44.2 hr after hospitalization. FAEEs were quantified by gas chromatography-mass spectrometry. Results: Ethanol was no longer detectable after 20.2 hr from hospitalization, whereas FAEEs were still found after 32.2 and 44.2 hr. These late FAEEs were significantly higher than the FAEEs in 15 different healthy men who had abstained from ethanol for 4.5 days (p < 0.001 and p= 0.001). FAEEs were associated mainly with lipid-free serum but tended to accumulate in very-low-density lipoprotein in patients with moderate hypertriglyceridemia. Conclusions: In heavy drinkers, the FAEEs were increased after ethanol consumption for at least 44 hr. It remains to be studied whether they originate from a single ethanol intake or, in addition, from a slow release out of body storage compartments. [source] Use of information feedback and attentional focus of feedback in treating the person with a hemiplegic armPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2009Katherine Durham Abstract Background and Purpose.,Feedback about motor performance can induce either an internal focus of attention (about body movement) or an external focus of attention (about the effects on the environment) in the learner. The main aim of this pilot study was to examine the attentional focus of feedback given by physiotherapists during treatment of the hemiplegic arm. A second aim was to examine the frequency of feedback about motor performance during treatment.,Method.,A multi-methods design was used (quantitative and qualitative). Eight physiotherapists and eight patients with stroke were recruited from two hospitals. Data were collected by video recordings of treatment, interviews (both therapists and patients) and questionnaire (therapists). Information feedback, instructions and motivational statements were identified from the video recordings. Feedback and instructions were further grouped into internal focus, external focus or mixed focus of attention. Themes were drawn from the interview transcripts. Triangulation was used to provide corroborating information from the different data sets.,Results.,Two hundred and forty-six of the total 1914 statements identified in the videos were feedback, the rest comprising instructions and statements of motivation. Of the feedback statements, 236 of the total 247 identified had an internal focus. Therapist interviews and questionnaires revealed more external focus communication than actual treatment.,Conclusions.,Physiotherapists used instructions and statements of motivation more than feedback and directed the patient's attention more to body movement than movement effects. The outcome of this study may prompt clinicians' to examine the amount and the attentional focus of the feedback they use in their clinical practice, and to consider whether it is a most effective approach in light of current evidence. Copyright © 2008 John Wiley & Sons, Ltd. [source] Conceptual bases for quantifying the role of the environment on gene evolution: the participation of positive selection and neutral evolutionBIOLOGICAL REVIEWS, Issue 4 2007Anthony Levasseur Abstract To demonstrate that a given change in the environment has contributed to the emergence of a given genotypic and phenotypic shift during the course of evolution, one should ask to what extent such shifts would have occurred without environmental change. Of course, such tests are rarely practical but phenotypic novelties can still be correlated to genomic shifts in response to environmental changes if enough information is available. We surveyed and re-evaluated the published data in order to estimate the role of environmental changes on the course of species and genomic evolution. Only a few published examples clearly demonstrate a causal link between a given environmental change and the fixation of a genomic variant resulting in functional modification (gain, loss or alteration of function). Many others suggested a link between a given phenotypic shift and a given environmental change but failed to identify the underlying genomic determinant(s) and/or the associated functional consequence(s). The proportion of genotypic and phenotypic variation that is fixed concomitantly with environmental changes is often considered adaptive and hence, the result of positive selection, even though alternative causes, such as genetic drift, are rarely investigated. Therefore, the second aim herein is to review evidence for the mechanisms leading to fixation. [source] Expectation and experiences of childbirth in primiparae with caesarean sectionBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2008I Wiklund Objective, The aim of this study was to examine the expectations and experiences in women undergoing a caesarean section on maternal request and compare these with women undergoing caesarean section with breech presentation as the indication and women who intended to have vaginal delivery acting as a control group. A second aim was to study whether assisted delivery and emergency caesarean section in the control group affected the birth experience. Design, A prospective group-comparison cohort study. Setting, Danderyd Hospital, Stockholm, Sweden. Sample, First-time mothers (n= 496) were recruited to the study in week 37,39 of gestation and follow up was carried out 3 months after delivery. Comparisons were made between ,caesarean section on maternal request', ,caesarean section due to breech presentation' and ,controls planning a vaginal delivery'. Methods, The instrument used was the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Main outcome measures, Expectations prior to delivery and experiences at 3 months after birth. Results, Mothers requesting a caesarean section had more negative expectations of a vaginal delivery (P < 0.001) and 43.4% in this group showed a clinically significant fear of delivery. Mothers in the two groups expecting a vaginal delivery, but having an emergency caesarean section or an assisted vaginal delivery had more negative experiences of childbirth (P < 0.001). Conclusions, Women requesting caesarean section did not always suffer from clinically significant fear of childbirth. The finding that women subjected to complicated deliveries had a negative birth experience emphasises the importance of postnatal support. [source] The relationship between premedical coursework in gross anatomy and histology and medical school performance in gross anatomy and histologyCLINICAL ANATOMY, Issue 2 2002Joseph P. Forester Abstract Many premedical students enroll in courses whose content will be encountered again during their medical education. Presumably, students believe this practice will lead to improved academic performance in corresponding medical school courses. Therefore, this study was undertaken to determine whether a premedical gross anatomy and/or histology course resulted in increased performance in corresponding medical school courses. A second aim of the study was to examine whether the type of premedical gross anatomy and/or histology course differentially affected medical school performance. A survey that assessed premedical gross anatomy and histology coursework was administered to 440 first-year medical students. The results from this survey showed that students with premedical gross anatomy (n = 236) and/or histology (n = 109) earned significantly more points in the corresponding medical school course than students without the premedical coursework (P < 0.05). Analysis of premedical course types revealed that students who took a gross anatomy course with prosected specimens (n = 35) earned significantly more points that those students without premedical gross anatomy coursework (P < 0.05). The results from this study suggest: 1) premedical gross anatomy and/or histology coursework improves academic performance in corresponding medical school courses, and 2) a premedical gross anatomy course with prosected specimens, a specific type of undergraduate course, significantly improves academic performance in medical gross anatomy. Clin. Anat. 15:160,164, 2002. © 2002 Wiley-Liss, Inc. [source] | ||||||||||||||||