Home About us Contact
|
Home About us Contact | ||
|
|
||
Small Sample Size (small + sample_size)
Selected AbstractsThe effects of ECT on cognitive functioning in the elderly: a reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2008Caroline E. M. Tielkes Abstract Background Electroconvulsive therapy (ECT) as a single course or in maintenance form (M-ECT) is an effective treatment in depressed elderly. However, ECT may have adverse effects on cognition. Objective To review all studies from 1980,2006 on ECT and cognition in the elderly with a minimum age of 55 years or a mean age of 55 years, and with valid measurements of cognition before and after ECT. Results Nine out of the 15 eligible studies were focused exclusively on the elderly. Three studies reported verbal learning- and recall problems post ECT, while three studies found positive effects of ECT on memory, speed of processing and concentration. Global cognitive functioning in patients with cognitive impairment improved in all studies. At follow up, most studies reported improvement of cognitive functions. Learning verbal information and executive functioning were impaired in M-ECT patients whereas global cognition remained stable after M-ECT over a year. Conclusions To date research of ECT on cognitive functioning in the elderly is very limited. Small sample size, lack of controls, use of a single screening instrument and a short follow up period may explain the conflicting results. Given the clinical importance, more extensive research on cognition in elderly treated with ECT is urgently needed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Do community-based support services benefit bereaved children?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2001A review of empirical evidence Abstract Aims To consider the evidence of effect from English language, empirically based quantitative evaluations of community-based interventions for bereaved children; community-based interventions being understood as those taking place outside a clinical setting. Methods MedLine, PsychInfo, Applied Social Sciences Index and Sociological Abstracts were searched for documents containing the words ,child', ,bereavement' and ,program', ,group', ,intervention', ,support' or ,evaluation'. The criterion for inclusion was that studies use a control group or pre- and post-test measurements using a standardized instrument. Results Nine relevant studies were identified. However, empirical evidence of positive outcomes for children was limited and compromised by methodological weaknesses in the design of the studies. Small sample sizes, irregular attendance, high levels of attrition, short time scales between pre- and post-testing and difficulty in developing appropriate instrumentation, including assessment of adherence to the agreed intervention programme, all created problems. Conclusions The case for universal inclusion of this group of children in such support programmes remains unproven, and further exploration of the outcomes of a range of different community interventions is required, with a specific focus on long-term and/or unwanted effects and evaluation of the basis for referral. [source] Psychopathy and offence severity in sexually aggressive and violent youthCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2009Amber Fougere Background,A large proportion of violent crimes are committed by youths. Youths with psychopathic traits may have a higher risk for recidivism and violence. Aims/hypotheses,Our aim was to compare sexually aggressive with violent young men on offence severity and psychopathy. Three hypotheses were proposed: first, young men with previous offences would display a progressive increase in seriousness of offence during their criminal career; secondly, the sexually aggressive and violent young men would not differ in scores on the Hare Psychopathy Checklist: Youth Version (PCL:YV); but, thirdly, PCL:YV scores would be positively correlated with the severity of the index crime, as measured by the Cormier,Lang System for Quantifying Criminal History. Methods,Information was collected from the files of 40 young men in conflict with the law, and the PCL:Youth Version (YV) rated from this by trained raters. Results,The offences of these young men became more serious over time, but we found no association between PCL:YV scores and offence type or seriousness. Conclusions and implications,This exploratory research suggests the importance of understanding the progression in offending careers, but a limited role for the PCL:YV in doing so. Given the small sample size, however, and the limit on access to information about details of age, the findings need replication. Copyright © 2009 John Wiley & Sons, Ltd. [source] Using the SWAP-200 in a personality-disordered forensic population: is it valid, reliable and useful?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2005Luisa E. Marin-Avellan Background Treatment and risk management of forensic patients relies heavily on diagnosing psychopathology, yet the reliability of clinical diagnoses of personality disorder has been found to be only fair to low. Structured instruments for the global assessment of personality disorder are infrequently used in clinical assessments possibly due to their limited validity and clinical utility. Aims/methods The Shedler-Westen Assessment Procedure-200 (SWAP-200) was developed in an effort to address these limitations. Although good reliability and validity in relation to clinicians' diagnosis of personality disorder has been reported, to date the validity of this instrument has not been assessed in relation to other standardized instruments or in a personality-disordered, forensic population. This study aims to establish the reliability and validity of the SWAP-200 against other diagnostic instruments and measures of interpersonal functioning in a personality disordered forensic population. Results This paper reports the results of 30 subjects from a high secure hospital in the UK who were assessed with the SWAP-200, the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II), the Adult Attachment Interview (AAI) and the Chart of Interpersonal Reactions in Closed Living Environments (CIRCLE). Preliminary results suggest that the SWAP-200 is a reliable instrument for the diagnosis of personality disorder in forensic patients. Conclusions Although the small sample size allows only preliminary conclusions about the validity of this instrument, early results show a reduction of the diagnosis of comorbidity compared with the SCID-II, together with an increased number of expected associations between independent measures of interpersonal functioning and categories of personality disorder. Copyright © 2005 Whurr Publishers Ltd. [source] Prevalence of Methicillin-Resistant Staphylococcus aureus in the Setting of Dermatologic SurgeryDERMATOLOGIC SURGERY, Issue 3 2009ROGER S. SICA DO BACKGROUND The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the postoperative setting of dermatologic surgery is unknown. Such data could influence the empirical treatment of suspected infections. OBJECTIVE To examine the period prevalence of MRSA infections in the postoperative setting of dermatologic surgery. METHODS We performed chart reviews of 70 patients who had bacterial cultures taken from January 2007 to December 2007. In the 21 postsurgical cases, we analyzed age, risk factors, sites of predilection, method of repair, and pathogen of growth. RESULTS The mean age of the overall study population was 57, with the mean age of postsurgical MRSA-positive cases being 75.5. Of the 21 postsurgical cultures taken, 16 cultures grew pathogen, and two of the 16 (13%) pathogen-positive cultures grew MRSA. LIMITATIONS This is a retrospective chart review of a relatively small sample size in one geographic location. Our patient population is known to contain a large number of retirees. CONCLUSION The increasing prevalence of MRSA skin and soft tissue infections and recommendation to modify empirical antibiotic therapy have been well documented in particular patient populations, but we caution against the empirical use of MRSA-sensitive antibiotics in the postoperative setting of dermatologic surgery. We advocate culturing all infectious lesions upon presentation and reserve empirical use of MRSA-sensitive antibiotics for high-risk patients or locations. [source] Urinary bladder biopsy with denuded mucosa: Denuding cystitis,Cytopathologic correlatesDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2004Anil V. Parwani M.D., Ph.D. Abstract Denuding cystitis is often encountered in tissue biopsies of bladder mucosa performed by either cold-cup forceps or wire loop electrocautery to evaluate hematuria or to rule out recurrent urothelial carcinoma. Lack of urothelium in these biopsies is often a frustrating experience, leading to a nonspecific interpretation. In this study, 151 cases of denuding cystitis were retrieved from the surgical pathology files of The Johns Hopkins Hospital over a 4-year period (1996,1999). Patients under the age of 40 years and outside consultation material were excluded. Of the 151 cases of denuding cystitis, 48 patients were identified who had concurrent urinary cytologic studies. Of these patients, 35 were male (73%) and 13 were female (27%). Patient ages ranged from 43 to 85 years (mean, 67). Twenty-six of these 48 patients (54%) had at least one concurrently positive urinary cytology, which was histologically confirmed. All except three cases were high-grade urothelial carcinoma with the following histologic subtypes: flat carcinoma in situ (n = 11), noninvasive papillary (n = 9), and invasive urothelial carcinoma (n = 3). We conclude that urinary cytology is a sensitive modality that detects exfoliated carcinoma cells in patients with a histologic diagnosis of denuding cystitis. An inconclusive diagnosis of denuding cystitis on tissue might be related to biopsy method and technique, small sample size, or biopsy of cystoscopically abnormal urothelium that is denuded. A cytologic diagnosis of high-grade urothelial carcinoma in these cases leads to a timely clinical intervention for optimal patient management. Diagn. Cytopathol. 2004;30:297,300. © 2004 Wiley-Liss, Inc. [source] Coupling long-term studies with meta-analysis to investigate impacts of non-native crayfish on zoobenthic communitiesFRESHWATER BIOLOGY, Issue 2 2006JULIA M. MCCARTHY Summary 1. Biological invasions are widely recognised as a significant component of human-caused environmental change and a primary threat to native biodiversity. The negative impacts of species invasions are particularly evident for freshwater crayfish faunas. 2. This study provides novel insight into the ecological effects of native and non-native crayfish on zoobenthic communities (with emphasis on the non-native rusty crayfish, Orconectes rusticus) across broad scales by combining a meta-analysis of small-scale experimental studies with a long-term observational study conducted over a 24 year period in Sparkling Lake, Wisconsin, U.S.A. (46°00,N, 89°42,W). 3. The meta-analysis summarised quantitatively the results of cage experiments for seven species of crayfish spanning four continents. We found that total zoobenthos densities (primarily Gastropoda and Diptera) were significantly lower in treatments containing crayfish relative to controls; a result that was significant for non-native crayfish but not for crayfish in their native range, perhaps owing to a small sample size. In contrast to other species, rusty crayfish were also negatively associated with Ephemeroptera. 4. Results from the time series analysis comparing temporal trends in rusty crayfish and invertebrate abundances from Sparkling Lake were consistent with the findings from the meta-analysis. Rusty crayfish were negatively correlated with the abundance of total zoobenthos, Diptera, Ephemeroptera and Odonata, as well as families of Trichoptera. 5. By coupling the results from short and long-term research, our study offers greater insight into the nature of crayfish-invertebrate interactions in aquatic systems, revealing consistent effects of invasive crayfish on native fauna. The control and management of invasive species is facilitated by the knowledge that well executed small-scale studies may be extrapolated to understand larger-scale ecological interactions. [source] The impact of mineralocorticoid receptor ISO/VAL genotype (rs5522) and stress on reward learningGENES, BRAIN AND BEHAVIOR, Issue 6 2010R. Bogdan Research suggests that stress disrupts reinforcement learning and induces anhedonia. The mineralocorticoid receptor (MR) determines the sensitivity of the stress response, and the missense iso/val polymorphism (Ile180Val, rs5522) of the MR gene (NR3C2) has been associated with enhanced physiological stress responses, elevated depressive symptoms and reduced cortisol-induced MR gene expression. The goal of these studies was to evaluate whether rs5522 genotype and stress independently and interactively influence reward learning. In study 1, participants (n = 174) completed a probabilistic reward task under baseline (i.e. no-stress) conditions. In study 2, participants (n = 53) completed the task during a stress (threat-of-shock) and no-stress condition. Reward learning, i.e. the ability to modulate behavior as a function of reinforcement history, was the main variable of interest. In study 1, in which participants were evaluated under no-stress conditions, reward learning was enhanced in val carriers. In study 2, participants developed a weaker response bias toward a more frequently rewarded stimulus under the stress relative to no-stress condition. Critically, stress-induced reward learning deficits were largest in val carriers. Although preliminary and in need of replication due to small sample size, findings indicate that psychiatrically healthy individuals carrying the MR val allele, gene, which has been recently linked to depression, showed a reduced ability to modulate behavior as a function of reward when facing an acute, uncontrollable stressor. Future studies are warranted to evaluate whether rs5522 genotype interacts with naturalistic stressors to increase the risk of depression and whether stress-induced anhedonia might moderate such risk. [source] Association between genetic variants of the metabotropic glutamate receptor 3 (GRM3) and cognitive set shifting in healthy individualsGENES, BRAIN AND BEHAVIOR, Issue 5 2010B. T. Baune Set-shifting and maintenance are complex cognitive processes, which are often impaired in schizophrenia. The genetic basis of these processes is poorly understood. We aimed to investigate the association between genetic variants of the metabotropic glutamate receptor 3 (GRM3) and cognitive set-shifting in healthy individuals. The relationship between 14 selected single nucleotide polymorphisms (SNPs) of the GRM3 gene and cognitive set-shifting as measured by perseverative errors using the modified card sorting test (MCST) was analysed in a sample of N = 98 young healthy individuals (mean age in years: 22.7 ± 0.19). Results show that SNP rs17676277 is related to the performance on the MCST. Subjects with the TT genotype showed significantly less perseverative errors as compared with the AA (P = 0.025) and AT (P = 0.0005) and combined AA/AT genotypes (P = 0.0005). Haplotype analyses suggest the involvement of various SNPs of the GRM3 gene in perseverative error processing in a dominant model of inheritance. The findings strongly suggest that the genetic variation (rs17676277 and three haplotypes) in the metabotropic GRM3 is related to cognitive set-shifting in healthy individuals independent of working memory. However, because of a relatively small sample size for a genetic association study, the present results are tentative and require replication. [source] The major- and trace-element whole-rock fingerprints of Egyptian basalts and the provenance of Egyptian artefactsGEOARCHAEOLOGY: AN INTERNATIONAL JOURNAL, Issue 7 2001John D. Greenough Discrimination diagrams have been developed that source Egyptian basaltic artefacts using whole-rock major element geochemistry. These include K2O versus SiO2, TiO2 and P2O5 against MgO/Fe2O3t (total Fe as Fe2O3), and a discriminant analysis diagram using SiO2, Fe2O3t, CaO, and MnO. A complementary set of diagrams uses easily obtained trace element data (Nb/Y versus Zr/Nb; Zr [ppm] versus Rb/Sr; TiO2 [wt % volatile free] versus V; and Cr [ppm] versus Zr/Y) to determine the bedrock sources. These diagrams have been applied to seven First Dynasty basalt vessels (Abydos), two Fourth Dynasty basalt paving stones (Khufu's funerary temple, Giza), and two Fifth Dynasty paving stones (Sahure's complex, Abu Sir). They show that the bedrock source for all the artefacts was the Haddadin flow in northern Egypt. Multidimensional scaling and cluster analysis applied to the whole-rock data (major elements and trace elements together) and previously published mineral fingerprinting studies confirm these results. Comparing mineral versus whole-rock fingerprinting techniques, a major advantage of the former is the small sample size required (0.001 g compared to , 0.1 g). Analytical costs are similar for both methods assuming that a comparison (bedrock) database can be assembled from the literature. For most archaeological problems, a whole-rock bedrock database is more likely to exist than a mineral database, and whole-rock analyses on artefacts will generally be easier to obtain than mineral analyses. Whole-rock fingerprinting may be more sensitive than mineral-based fingerprinting. Thus, if sample quantity is not an issue, whole-rock analysis may have a slight cost, convenience, and technical advantage over mineral-based methods. Our results also emphasize that the Egyptians cherished their Haddadin basalt flow and used it extensively and exclusively for manufacturing basalt vessels and paving stones for at least 600 years (,3150 B.C. to 2500 B.C., approximate ages of the vessels and Abu Sir paving stones, respectively). © 2001 John Wiley & Sons, Inc. [source] Importance of molecular analysis in detecting cervical lymph node metastasis in head and neck squamous cell carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2006Mohamed N. Elsheikh MD Abstract Background. Because of the impact of nodal status on treatment and survival in squamous cell carcinoma of the head and neck, accurate staging of cervical lymph nodes is critical. This article explores the value of molecular analyses in the detection of cervical lymph node metastasis. Methods. A review of the literature was carried out and combined with our own experience regarding the role of molecular analyses in detecting cervical lymph node metastasis. Results. Few studies have demonstrated the diagnostic and prognostic relevance of molecular analysis in detecting tumor cells in lymph nodes. Nodal staging was improved by the use of molecular techniques; when compared with histopathologic examination, however, the small sample size of these studies did not allow definitive conclusions. Conclusions. Molecular analysis is exquisitely sensitive in detecting very small cancer deposits within lymph nodes. It provides an oncologic basis that may be used to guide therapy and influence outcomes. It should be recommended for diagnostic use in controlled studies of patients without evidence of lymph node metastasis on routine hematoxylin,eosin,stained sections. The clinical significance of these types of metastases, however, must be determined with carefully designed and controlled prospective clinical trials. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] Efficacy of amisulpride in treating primary negative symptoms in first-episode psychosis: a pilot studyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2006Brendan P. Murphy Abstract Objective Negative symptoms are debilitating and associated with poor role functioning and reduced quality of life. There is a paucity of research on antipsychotic efficacy against the primary negative symptoms, particularly in first-episode psychosis (FEP). We undertook a prospective, open-label pilot trial to investigate the use of amisulpride in the treatment of young people with FEP characterised by primary negative symptoms. Method Twelve male and two female first-episode patients with primary negative symptoms (aged 16,26) were commenced on low-dose amisulpride (mean 250,mg/day) and followed-up over a 6-month period. Primary outcome measures were the Scale for the Assessment of Negative Symptoms (SANS), the Quality of Life Survey (QLS) and their respective subscales. Results For the 12 completers there was a statistically significant improvement in SANS summary score (p,=,0.036), Affective Flattening subscale global score (p,=,0.046), QLS total score (p,=,0.021), QLS subscales of Instrumental Role (p,=,0.018) and Intra-psychic Foundations (p,=,0.009) from baseline to week 24. Conclusions Amisulpride appears to be associated with less severe negative symptoms and improved quality of life. Generalisabilty of the findings is limited by the small sample size and open-label design of our study, however the positive findings suggest that further controlled trials are warranted. Copyright © 2006 John Wiley & Sons, Ltd. [source] Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 8 2005Craig A Solem MD Abstract Introduction: We sought to examine the relationship between C-reactive protein (CRP) and clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease (IBD). Methods: All IBD patients at our institution between January 2002 and August 2003 who had a CRP, colonoscopy, and either small bowel follow-through (SBFT) or CT enterography (CTE) performed within 14 days were identified. Clinical activity was assessed retrospectively through review of the medical record. Logistic regression was used in Crohn's disease (CD) patients to estimate the odds ratio (OR) with 95% confidence intervals for an elevated CRP. Associations were assessed using Fisher exact test in ulcerative colitis (UC) patients due to small sample size. Results: One-hundred four CD patients (46% males) and 43 UC and indeterminate colitis patients (44% males) were identified. In CD patients, moderate-severe clinical activity (OR, 4.5; 95% CI, 1.1-18.3), active disease at colonoscopy (OR, 3.5; 95% CI, 1.4-8.9), and histologically severe inflammation (OR, 10.6; 95% CI; 1.1-104) were all significantly associated with CRP elevation. Abnormal small bowel radiographic imaging was not significantly associated with CRP elevation. In UC patients, CRP elevation was significantly associated with severe clinical activity, elevation in sedimentation rate, anemia, hypoalbuminemia, and active disease at ileocolonoscopy, but not with histologic inflammation. Conclusions: CRP elevation in IBD patients is associated with clinical disease activity, endoscopic inflammation, severely active histologic inflammation (in CD patients), and several other biomarkers of inflammation, but not with radiographic activity. [source] Treatment of cellulite with LPG endermologieINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2009A. Tülin Güleç MD Background, LPG endermologie is a FDA-approved massage system in use worldwide for cellulite treatment that lacks clinical study. Objective, To determine the efficacy and safety of LPG endermologie in treating cellulite. Methods, Thirty-three healthy women (cellulite grades, 1,3 based on the 4-stage Nurnberger,Muller scale) had LPG treatments twice weekly for a total of 15 sessions. Clinical evaluation was performed by digital photography for cellulite grade assessment, and perimetric measurements of eight body sites for the evaluation of body contours. Results, Significant differences were found regarding mean cellulite grades before and after treatment. However, improved cellulite appearance occurred in only 5 women (15%). All patients showed a significant circumference loss at every measured body site. Weight losers had significantly greater loss of total and average body circumference than weight gainers. Limitations, Relatively small sample size and lack of more-objective methods for assessing treatment success. Conclusion, LPG endermologie is a well-tolerated and effective method for reducing the diameter of body circumference, however, it is mildly effective in reducing the cellulite grade and so, improving its orange-peel appearance. [source] An investigation of associations between alcohol use disorder and polymorphisms on ALDH2, BDNF, 5-HTTLPR, and MTHFR genes in older Korean menINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2010Sangmoon Shin Abstract Background This study aimed to investigate the association of alcohol use disorder (AUD) with four candidate genes in older Korean men: aldehyde dehydrogenase 2 (ALDH2, 1/2), brain-derived neurotrophic factor (BDNF, val66met), serotonin transporter gene linked polymorphic region (5- HTTLPR, s/l), and methylenetetrahydrofolate reductase (MTHFR, c.677C,>,T). Methods A community sample of 300 men aged 65 or over were categorized into 68 subjects with AUD and 232 controls according to clinical examinations and DSM-IV criteria. Genotype distributions and allele frequencies were compared. Results Men with AUD had significantly higher ALDH2*1 and BDNF met allele frequencies compared to controls (p -values,<,0.05). No significant differences in genotype or allele frequencies were found for 5- HTTLPR or MTHFR (p -values,>,0.3). Conclusions AUD was associated with ALDH2*1 and BDNF met alleles in older Korean men. The first is consistent with previous research and likely to be explained by a protective effect of unpleasant symptoms following alcohol consumption associated with ALDH2*2. The second finding is novel and might be accounted for by BDNF -mediated serotonin or dopamine pathways. However, given the relatively small sample size, the results should be regarded as preliminary and requiring independent replication. Copyright © 2009 John Wiley & Sons, Ltd. [source] Mechanisms and management of gingival overgrowth in paediatric transplant recipients: a reviewINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2003D. Chabria Summary. Increasing numbers of children are receiving solid organ transplants namely kidney, liver, heart and lung. Patient survival rates following such transplants are essentially good with much of the success attributable to the development of Cyclosporine A (CyA), an immunosuppressive drug, that minimizes organ rejection. However the gingival overgrowth (GO) associated with the use of CyA is not only disfiguring but in paediatric recipients, may interfere with normal oral development and function. Objective. The aim of this review is to summarize current knowledge concerning the aetiology, pathogenesis and management of gingival overgrowth. Methods. Literature pertaining to gingival overgrowth is reviewed with particular reference to the paediatric population. Emphasis is placed on summarizing the evidence pertaining to the effectiveness of intervention. Conclusion. CyA undoubtedly causes gingival overgrowth, the effects and levels of which appears to be more severe in younger patients. There is conflicting evidence as to the effectiveness of oral hygiene regimes, antibiotics and surgery in reducing overgrowth. The introduction of an alternative immunosuppressive agent (Tacrolimus) offers potential as it does not appear to cause overgrowth, although research to date is limited by the small sample size of many of the studies. This is an area in which multicentre studies would be of great value. [source] Dehydroepiandrosterone Combined with Exercise Improves Muscle Strength and Physical Function in Frail Older WomenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2010Anne M. Kenny MD OBJECTIVES: To investigate the effects of dehydroepiandrosterone (DHEA) combined with exercise on bone mass, strength, and physical function in older, frail women. DESIGN: Double-blind, randomized, placebo-controlled trial. SETTING: A major medical institution. PARTICIPANTS: Ninety-nine women (mean age 76.6 ± 6.0) with low sulfated DHEA (DHEAS) levels, low bone mass, and frailty. INTERVENTION: Participants received 50 mg/d DHEA or placebo for 6 months; all received calcium and cholecalciferol. Women participated in 90-minute twice-weekly exercise regimens. MEASUREMENTS: Hormone levels, bone mineral density (BMD), bone turnover markers, body composition, upper and lower extremity strength, physical performance. RESULTS: Eighty-seven women (88%) completed 6 months. There were no significant changes in BMD or bone turnover markers. DHEA supplementation resulted in gains in lower extremity strength (from 459 ± 121 N to 484 ± 147 N; P=.01). There was also improvement in Short Physical Performance Battery score, a composite score that focuses on lower extremity function, in those taking DHEA (from 10.1 ± 1.8 to 10.7 ± 1.9; P=.02). There were significant changes in all hormone levels, including DHEAS, estradiol, estrone, and testosterone, and a decline in sex hormone-binding globulin levels in those taking DHEA. CONCLUSION: DHEA supplementation improved lower extremity strength and function in older, frail women involved in a gentle exercise program of chair aerobics or yoga. No changes were found in BMD either due to small sample size, short duration of study or no effect. The physical function findings are promising and require further evaluation as frail women are at high risk for falls and fracture. [source] Muscle Strength After Resistance Training Is Inversely Correlated with Baseline Levels of Soluble Tumor Necrosis Factor Receptors in the Oldest OldJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Helle Bruunsgaard MD Objectives:, To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low-grade inflammation. Design:, A 12-week controlled resistance-training study. Setting:, Nursing homes in Copenhagen, Denmark. Participants:, Twenty-one frail nursing home residents aged 86 to 95 completed the study. Intervention:, Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist. Measurements:, Muscle strength, plasma levels of TNF-,, soluble TNF receptor (sTNFR)-1, and interleukin (IL)-6 were measured before and at the end of the intervention period. Results:, The training program improved muscle strength but did not affect plasma levels of TNF-, and sTNFR-I or IL-6. However, plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength. Conclusion:, Low-grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that theantiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation. [source] Epistatic kinship a new measure of genetic diversity for short-term phylogenetic structures , theoretical investigationsJOURNAL OF ANIMAL BREEDING AND GENETICS, Issue 3 2006C. Flury Summary The epistatic kinship describes the probability that chromosomal segments of length x in Morgan are identical by descent. It is an extension from the single locus consideration of the kinship coefficient to chromosomal segments. The parameter reflects the number of meioses separating individuals or populations. Hence it is suggested as a measure to quantify the genetic distance of subpopulations that have been separated only few generations ago. Algorithms for the epistatic kinship and the extension of the rules to set up the rectangular relationship matrix are presented. The properties of the epistatic kinship based on pedigree information were investigated theoretically. Pedigree data are often missing for small livestock populations. Therefore, an approach to estimate epistatic kinship based on molecular marker data are suggested. For the epistatic kinship based on marker information haplotypes are relevant. An easy and fast method that derives haplotypes and the respective frequencies without pedigree information was derived based on sampled full-sib pairs. Different parameters of the sampling scheme were tested in a simulation study. The power of the method decreases with increasing segment length and with increasing number of segments genotyped. Further, it is shown that the efficiency of the approach is influenced by the number of animals genotyped and the polymorphism of the markers. It is discussed that the suggested method has a considerable potential to allow a phylogenetic differentiation between close populations, where small sample size can be balanced by the number, the length, and the degree of polymorphism of the chromosome segments considered. [source] Psychological Stress and Oxidative Damage in Lymphocytes of Aerobically Fit and Unfit Individuals,JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 1 2008Kelly Z. Knickelbein Habitual aerobic exercise has a beneficial effect on many systems of the body, and psychological stress has a negative influence on several of the same systems. One possible pathway is through those systems that account for the detrimental effects of stress; by buffering these harmful effects, exercise may reduce the consequences of stress. This study examined increased resistance of cells to stress-induced oxidative damage as a result of fitness. Forty healthy participants were assigned to either a stress group or a no-stress control group, and measures of stress and oxidative damage were collected. Variation in fitness level across participants was also measured. Oxidative damage increased as a function of stress, but this was not buffered by fitness level. These results should be interpreted with caution because of the small sample size and the limited variability of cardiorespiratory fitness levels in the sample. [source] Patterns of density, diversity, and the distribution of migratory strategies in the Russian boreal forest avifaunaJOURNAL OF BIOGEOGRAPHY, Issue 11 2008Russell Greenberg Abstract Aim, Comparisons of the biotas in the Palaearctic and Nearctic have focused on limited portions of the two regions. The purpose of this study was to assess the geographic pattern in the abundance, species richness, and importance of different migration patterns of the boreal forest avifauna of Eurasia from Europe to East Asia as well as their relationship to climate and forest productivity. We further examine data from two widely separated sites in the New World to see how these conform to the patterns found in the Eurasian system. Location, Boreal forest sites in Russia and Canada. Methods, Point counts were conducted in two to four boreal forest habitats at each of 14 sites in the Russian boreal forest from near to the Finnish border to the Far East, as well as at two sites in boreal Canada. We examined the abundance and species richness of all birds, and specific migratory classes, against four gradients (climate, primary productivity, latitude, and longitude). We tested for spatial autocorrelation in both dependent and independent variables using Moran's I to develop spatial correlograms. For each migratory class we used maximum likelihood to fit models, first assuming uncorrelated residuals and then assuming spatially autocorrelated residuals. For models assuming unstructured residuals we again generated correlograms on model residuals to determine whether model fitting removed spatial autocorrelation. Models were compared using Akaike's information criterion, adjusted for small sample size. Results, Overall abundance was highest at the eastern and western extremes of the survey region and lowest at the continent centre, whereas the abundance of tropical and short-distance migrants displayed an east,west gradient, with tropical migrants increasing in abundance in the east (and south), and short-distance migrants in the west. Although overall species richness showed no geographic pattern, richness within migratory classes showed patterns weaker than, but similar to, their abundance patterns described above. Overall abundance was correlated with climate variables that relate to continentality. The abundances of birds within different migration strategies were correlated with a second climatic gradient , increasing precipitation from west to east. Models using descriptors of location generally had greater explanatory value for the abundance and species-richness response variables than did those based on climate data and the normalized difference vegetation index (NDVI). Main conclusions, The distribution patterns for migrant types were related to both climatic and locational variables, and thus the patterns could be explained by either climatic regime or the accessibility of winter habitats, both historically and currently. Non-boreal wintering habitat is more accessible from both the western and eastern ends than from the centre of the boreal forest belt, but the tropics are most accessible from the eastern end of the Palaearctic boreal zone, in terms of distance and the absence of geographical barriers. Based on comparisons with Canadian sites, we recommend that future comparative studies between Palaearctic and Nearctic faunas be focused more on Siberia and the Russian Far East, as well as on central and western Canada. [source] The Existential Loneliness Questionnaire: Background, development, and preliminary findingsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2002Aviva M. Mayers We described the background and the development of a new measure of existential loneliness, the Existential Loneliness Questionnaire (ELQ). Specifically, we analyzed the items of the preliminary version of the ELQ (ELQ-P) using methods based on item response theory (the Rasch model) and examined the convergent and discriminative validity of the ELQ in a sample of 47 HIV-infected women. Item analysis produced an ELQ version consisting of 22 items that were internally consistent and performed well in measuring an underlying construct conceptualized as existential loneliness. In addition, the ELQ discriminated well between symptomatic and asymptomatic HIV-infected women. The ELQ correlated strongly with measures of depression, loneliness not identified as existential and purpose-in-life and moderately strongly with a measure of hopelessness. Holding constant depression scores, the correlation between the ELQ and loneliness not identified as existential was significantly attenuated. Limitations of the study include the small sample size, which precluded an analysis of the dimensional structure of the ELQ. © 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 1183,1193, 2002. [source] The Placement of the Human Eyeball and Canthi in Craniofacial IdentificationJOURNAL OF FORENSIC SCIENCES, Issue 3 2008Carl N. Stephan Ph.D. Abstract:, An accurate understanding of the spatial relationships between the deep and superficial structures of the head is essential for anthropological methods concerned with the comparison of faces to skulls (superimposition) or the prediction of faces from them (facial approximation). However, differences of opinion exist concerning: (i) the position of the eyeball in planes other than the anteroposterior plane and (ii) the canthi positions relative to the bony orbital margins. This study attempts to clarify the above relationships by dissection of a small sample of adult human cadavers (N = 4, mean age = 83 years, s = 12 years). The most notable finding was that the eyeballs were not centrally positioned within the orbits as the more recent craniofacial identification literature expounds. Rather, the eyeballs were consistently positioned closer to the orbital roof and lateral orbital wall (by 1,2 mm on average); a finding consistent with the earlier anatomical literature. While these estimation errors are small ipsilaterally, several factors make them meaningful: (i) the orbital region is heavily used for facial recognition; (ii) the width error is doubled because the eyes are bilateral structures; (iii) the eyes are sometimes used to predict/assess other soft tissue facial structures; and (iv) the net error in facial approximation rapidly accumulates with the subsequent prediction of each independent facial feature. While the small sample size of this study limits conclusive generalizations, the new data presented here nonetheless have immediate application to craniofacial identification practice because the results are evidence based. In contrast, metric data have never been published to support the use of the central positioning guideline. Clearly, this study warrants further quantification of the eyeball position in larger samples and preferably of younger individuals. [source] New growth factor therapies aimed at improving intestinal adaptation in short bowel syndromeJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 6 2006Prue M Pereira Abstract Short bowel syndrome (SBS) is used to describe a condition of malabsorption and malnutrition resulting from the loss of absorptive area following massive small bowel resection. The key to improved clinical outcome after massive small bowel resection is the ability of the residual bowel to adapt. Although still in experimental stages, a major goal in the management of SBS may be the augmented use of growth factors to promote increased adaptation. A number of growth factors have been implicated in promoting the adaptation process. The best-described growth factors are reviewed: glucagon-like peptide-2 (GLP-2), epidermal growth factor (EGF), and growth hormone (GH). This article reviews the ability of recombinant GLP-2, EGF and GH to modulate structural and functional aspects of intestinal adaptation following small bowel resection. Although these growth factors have shown promise, small sample size, inconsistent measurement parameters and uncontrolled study designs have hampered the acquisition of strong data advocating the use of growth factor treatment for SBS. Multicenter trials using well-defined outcome measures to assess clinical efficacy are needed to direct the clinical indications, timing and duration of therapy and assess potential risks associated with growth factor therapies. [source] Dynamics of Dot-Like Hemosiderin Spots on T2*-Weighted MRIs Associated with Stroke RecurrenceJOURNAL OF NEUROIMAGING, Issue 3 2007Toshio Imaizumi MD ABSTRACT Background and Purpose. Dot-like low-intensity spots (dot-like hemosiderin spots: dotHSs) on gradient echo T2*-weighted (-w) brain magnetic resonance imaging (MRIs) are frequently associated with cerebral small vessel disease (SVD), including deep intracerebral hemorrhages and lacunar infarctions. This study investigated how numbers of newly appeared dotHSs contribute to recurrent SVD. Methods. We prospectively analyzed numbers of newly appeared dotHSs in 12 patients with prior SVD (8 males, 4 females; mean 67.6 ± 10.7 years old) readmitted with recurring SVD between October 2001 and March 2003. Numbers of appeared dotHSs per year were counted on T2*-w MRI scans after SVD recurrence and compared to previous MRIs. Seventy-one outpatients (35 males, 36 females; mean 64.3 ± 9.6 years old) with histories of intracerebral hemorrhages (ICH) that came to the hospital during the study period served as controls. The hazard ratio (HR) for recurrence was estimated from a multivariate logistic regression model, using the number of appeared dotHSs (per year) and other risk factors. Results. Multivariate analyses revealed that an elevated rate of recurrence was found in patients with substantial numbers of appeared dotHSs (,5/year) (HR, 7.34; P= 0.0008). We also analyzed factors associated with the numbers of appeared dotHSs. A number of appeared dotHSs (,5/year) was significantly and independently associated with the initial number of dotHSs (,10) on T2*-w MRIs following the first SVD (HR, 18.6; P= 0.0001). Conclusions. Though a small sample size limited the power of our analyses, our findings suggest that a number of newly appeared dotHSs may be associated with SVD recurrence. [source] The Effects of Heparin Versus Normal Saline for Maintenance of Peripheral Intravenous Locks in Pregnant WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2003Kathryn M. Niesen MSN, RN director of clinical nursing Objective: To compare the efficacy of two available preparations (heparin, 10 U/mL, 1 mL, vs. normal saline, 1 mL) used for maintaining patency in peripheral intravenous (IV) locks during pregnancy. Design: Prospective, randomized, and double-blind. Eligible patients who were to receive a peripheral intermittent IV lock were randomly assigned to receive either heparin flushes or normal saline flushes for IV lock maintenance. IV locks were flushed after each medication administration, or at least every 24 hours, with the assigned blinded flush solution. Intermittent IV lock sites were also evaluated every 12 hours for the development of phlebitis. Setting: A large academic medical center in the Midwest that has both community-based and regional-referral obstetric practices with more than 2,000 deliveries per year. Participants: A convenience sample included 73 hospitalized pregnant women who were between 24 and 42 weeks gestation. Exclusions from the study were women with significant abnormalities in the fetal heart tracing on admission, cervical dilation > 4 cm, presence of hypersensitivity to heparin, presence of clotting abnormalities, and anticoagulation therapy (including low-dose aspirin). Results: Data indicate there were no statistically significant differences in IV lock patency nor in phlebitis between heparin or normal saline flushes. Conclusions: This study provides support that both normal saline and heparin in the doses studied may be equally effective in the maintenance of peripheral IV locks. Due to small sample size, additional studies are needed to determine optimal therapy over time. [source] Diagnostic sub-types, psychological distress and psychosocial dysfunction in southern Chinese people with temporomandibular disordersJOURNAL OF ORAL REHABILITATION, Issue 3 2008L. T. K. LEE Summary, The study aimed to assess the distribution of temporomandibular disorders (TMD) sub-types, psychological distress and psychosocial dysfunction in southern Chinese people seeking treatment for TMD using Research Diagnostic Criteria for TMD (RDC/TMD) and investigate potential cross-cultural differences in sub-type prevalence and psychosocial impact. Eighty-seven consecutive patients (77 females; 10 males) with a mean age of 39·3 years (s.d. 12·8) newly referred to the specialist TMD clinic at the Prince Philip Dental Hospital, Hong Kong over a 20-month period took part in the study. RDC/TMD history questionnaire and clinical assessment data were used to derive Axis I and II findings. Group I muscle disorders were the most common and found in 57·5% of patients. Group II (disc displacement) disorders were found in 42·5% and 47·1% of the right and left temporomandibular joints (TMJ) respectively. Group III disorders (arthralgia/arthrosis/arthritis) were revealed in 19·5% and 23·0% of right and left TMJ's respectively. In the Axis II assessment, 42·5% of patients had moderate/severe depression scores, 59·7% had moderate/severe somatization scores and based on graded chronic pain scores 15·0% had psychosocial dysfunction (grade III and IV). While acknowledging the small sample size, the distribution of RDC/TMD Axis I and II diagnoses was fairly similar in Chinese TMD patients compared with Western and other Asian patient groups. However, in Chinese patients, myofascial pain with limited jaw opening and TMJ disc displacement with reduction were more common and a significant number experienced psychological distress and psychosocial dysfunction. The findings have implications for the management of TMD in Chinese people. [source] A systematic review and meta-analysis of randomised controlled trials evaluating interventions in adult literacy and numeracyJOURNAL OF RESEARCH IN READING, Issue 3 2003Carole J. Torgerson This paper reports a systematic review of the trial literature in the field of adult literacy and numeracy. The review was undertaken to investigate the effectiveness of teaching strategies and pedagogies designed to increase adult literacy and numeracy. The objectives were to search for and locate, synthesise and quality appraise all the randomised controlled trials aiming to evaluate interventions in adult literacy and/or numeracy, published between 1980 and 2002. Fifty-nine papers were included in the descriptive map. Twelve papers were included that contained nine randomised controlled trials. All of the trials included in the review were of high quality in the sense that they had adopted an appropriate study design for assessing effectiveness. However, within that study design many of the studies had methodological problems, for example: small sample size and lack of justification of sample size calculation; unclear method of random allocation; high attrition rate and lack of ,intention to teach' analysis. There was evidence of publication bias. Pooling three studies that compared teaching against no teaching showed a strong, positive and statistically significant effect on outcome. Two other studies examined the use of computer-assisted instruction (CAI) on literacy among imprisoned adults. Pooling these two studies showed a modest but not statistically significant benefit. There is a dearth of rigorous RCTs in the field of adult literacy and numeracy. The evidence is suggestive of a benefit of adult literacy and numeracy interventions; however, because of the heterogeneity of studies, the precise role of any intervention is uncertain and this finding may be undermined by the presence of substantial publication bias. We recommend that a series of large, well-designed and well-conducted randomised trials should be undertaken in the field of adult literacy and numeracy. [source] Effects of Alcohol on Polysomnographically Recorded Sleep in Healthy SubjectsALCOHOLISM, Issue 9 2006Bernd Feige Background: After studying the sleep of alcohol-dependent patients at the beginning and over the course of abstinence in earlier studies, our interest in the current study focused on the direct effect of 2 doses of alcohol [0.03 and 0.1% blood alcohol level (BAL)] on healthy sleep. This is the first polysomnographic study testing the impact of 2 doses of alcohol ingestion (thus reflecting "normal" social drinking and alcohol abuse) in a single-blind randomized design in healthy volunteers. The study evaluated a short-term acute drinking period for 3 and 2 days of withdrawal from alcohol not only for polysomnographic variables but also for subjective estimates of sleep quality. Methods: In a crossover design with a 1-week interval, healthy subjects received alcohol to raise their blood alcohol to either 0.03 or 0.1% BAL at bedtime for 3 consecutive nights after an alcohol-free baseline night. Objective (polysomnography) and subjective sleep (questionnaires) was recorded each night. During the following 2 days, alcohol was discontinued with simultaneous measurements of sleep to gauge withdrawal effects. Results: At a dose of alcohol leading to BAL of 0.03%, no clear effects could be detected. Following an evening BAL of 0.1%, a hypnotic-like effect (shortened sleep latency, reduced number of wake periods, decreased stage 1 sleep) occurred primarily during the first half of the night with signs of rebound effects being already present during the second half of the night (increased stage 1 sleep). At this dose, alcohol significantly increased slow-wave sleep (SWS) in the first half of the night and reduced REM density in the beginning of the night. After discontinuation of the higher alcohol dose, REM sleep amount increased. No significant withdrawal or rebound effects could be observed for parameters of sleep continuity during the 2 nights after discontinuation from alcohol at a BAL of 0.1%. Conclusions: Owing to the small sample size, the results of this study need to be interpreted with caution. Short-term moderate alcohol consumption (BAL 0.03%) did not significantly alter objective or subjective parameters of sleep. Higher doses of alcohol resulting in a BAL level of 0.10% immediately before going to bed mainly influenced sleep in the first half of the night, resembling the effects of a short-acting hypnotic drug, including a suppression of phasic aspects of REM sleep (REM density). Interestingly, analysis of the latter part of these nights indicated the immediate presence of withdrawal effects (increased light sleep). No statistically significant effects on sleep parameters were observable during the 2 nights of withdrawal from alcohol at the higher BAL. Interpreted carefully, our data indicate that negative effects on sleep occur already with short-term use of alcohol at doses of BAL of 0.10%, despite hypnotic-like effects during the first hours of sleep, especially during the latter part of the night. [source] Psychiatric Comorbidity in Treatment-Seeking Alcoholics: The Role of Childhood Trauma and Perceived Parental DysfunctionALCOHOLISM, Issue 3 2004Willie Langeland Abstract: Background: This study among treatment-seeking alcoholics examined the relationship between childhood abuse (sexual abuse only [CSA], physical abuse only [CPA], or dual abuse [CDA]) and the presence of comorbid affective disorders, anxiety disorders, and suicide attempts, controlling for the potential confounding effects of other childhood adversities (early parental loss, witnessing domestic violence, parental alcoholism, and/or dysfunction) and adult assault histories. Method: We assessed 155 (33 females, 122 males) treatment-seeking alcoholics using the European Addiction Severity Index, the Structured Trauma Interview, and the Composite International Diagnostic Interview. Results: The severity of childhood abuse was associated with posttraumatic stress disorder (PTSD) and suicide attempts in females and with PTSD, social phobia, agoraphobia, and dysthymia in males. Among men, multiple logistic regression models showed that CPA and CDA were not independently associated with any of the examined comorbid disorders or with suicide attempts. However, CSA independently predicted comorbid social phobia, agoraphobia, and PTSD. For the presence of comorbid affective disorders (mainly major depression) and suicide attempts, maternal dysfunctioning was particularly important. CSA also independently contributed to the number of comorbid diagnoses. For females, small sample size precluded the use of multivariate analyses. Conclusion: Childhood abuse is an important factor in understanding clinical impairment in treated alcoholics, especially regarding comorbid phobic anxiety disorders, PTSD, and suicidality. These findings underline the importance of routine assessment of childhood trauma and possible trauma-related disorders in individuals presenting to alcohol treatment services. More studies with bigger samples sizes of female alcohol-dependent patients are needed. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||