bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of the flammability reduction mechanism of polystyrene‐layered silicate nanocomposite: layered silicate reinforced carbonaceous char
Authors: Gilman Jeffrey W. , Harris Richard H. , Shields John R. , Kashiwagi Takashi , Morgan Alexander B.
Published: March 2006

Polymer‐layered silicate nanocomposites (PLSNs) have been shown to have significantly reduced flammability. Based upon numerous studies to date, the proposed mechanism by which flammability reduction occurs is through formation of a silicate‐reinforced char layer that protects the underlying polymer. To further understand this condensed phase phenomena, polystyrene (PS) PLSN was studied during various states of decomposition. The materials were exposed to non‐oxidizing pyrolysis conditions using the National Institute of Standards and Technology (NIST) gasification apparatus. Samples were exposed for a range of pyrolysis times. The resulting partially decomposed PS PLSNs were analyzed by wide angle X‐ray diffraction (XRD), and thermogravimetric analysis (TGA). Sampling was done at different depths in each sample. The results show that as the PLSN was heated, the PS in the layered silicate galleries decomposed and volatilized, resulting in a collapse of the layer spacing, which yielded a stable silicate‐carbon char layer. This layered silicate or clay appears to catalyze formation of carbonaceous char which yields a clay reinforced carbon char layer with a d‐spacing of 1.3 nm; this unique structure forms quickly under pyrolysis conditions, and is stable even after extended pyrolysis times. TGA data suggest that there are two types of carbonaceous materials formed in the carbon phase of the clay‐carbon char; a carbon that can be decomposed and volatilized by heating in nitrogen, and a second fraction of material which requires more aggressive conditions, that is, heating (>700°C) in the presence of air. Copyright © 2006 John Wiley & Sons, Ltd.
Treatment of Wilms tumor relapsing after initial treatment with vincristine and actinomycin D: A report from the National Wilms Tumor Study Group
Authors: Green Daniel M. , Cotton Cecilia A. , Malogolowkin Marcio , Breslow Norman E. , Perlman Elizabeth , Miser James , Ritchey Michael L. , Thomas Patrick R.M. , Grundy Paul E. , D'Angio Giulio J. , Beckwith J. Bruce , Shamberger Robert C. , Haase Gerald M. , Donaldson Milton , Weetman Robert , Coppes Max J. , Shearer Patricia , Coccia Peter , Kletzel Morris , Macklis Roger , Tomlinson Gail , Huff Vicki , Newbury Robert , Weeks Douglas
Published: March 2006

Purpose

NWTS‐5 was a multi‐institutional clinical trial for patients less than 16 years of age at diagnosis with specific renal neoplasms who were diagnosed between August 1, 1995 and May 31, 2002. A uniform approach to the treatment of patients with relapse was employed.

Patients and Methods

Seventy‐two patients who relapsed after immediate nephrectomy (stages I and II), initial chemotherapy with vincristine (VCR) and actinomycin D and no radiation therapy were registered on stratum B of the NWTS‐5 relapse protocol. Four patients were not evaluable: one due to insufficient data and three due to major protocol violations. Among the 68 remaining patients, one who was 19 years of age at initial diagnosis of Wilms tumor, five with bilateral Wilms tumor at diagnosis, three who developed a contralateral relapse, and one with persistent disease were not included in this analysis. Relapse treatment included surgical excision, when feasible, radiation therapy and alternating courses of VCR, doxorubicin and cyclophosphamide and etoposide and cyclophosphamide.

Results

The outcomes of 58 patients were analyzed. The lung was the only site of relapse for 31 patients. Event‐free survival 4 years after relapse was 71.1% and 4‐year overall survival was 81.8% for all patients and were 67.8 and 81.0% for those who relapsed only to their lungs. The most frequent toxicities were hematological.

Conclusions

These results demonstrate that a significant proportion of children with Wilms tumor who relapse after initial treatment with VCR and actinomycin D can be successfully re‐treated. Pediatr Blood Cancer 2007;48:493–499. © 2006 Wiley‐Liss, Inc.
Interpolymer complexes of hydroxypropylmethylcellulose with polycarboxylic acids in aqueous solutions
Authors: Mangazbaeva Rauash A , Mun Grigoriy A , Nurkeeva Zauresh S , Khutoryanskiy Vitaliy V
Published: March 2006

The interactions between hydroxypropylmethylcellulose (HPMC) and poly(acrylic acid) (PAA) as well as poly(methacrylic acid) (PMAA) resulting in formation of hydrophobic interpolymer complexes (IPC) via hydrogen bonding have been studied in aqueous solutions in acidic medium. The formation of IPC of two different compositions (2:1 and 4:1) has been detected for complexes of PAA and HPMC. The critical pH values for complexation of HPMC with PAA and PMAA were determined by the turbidimetric method. It was found that PAA shows the lower complexation ability compared to PMAA due to the more hydrophobic nature of the latter polyacid. The temperature‐induced phase separation in HPMC–PAA solution mixtures depends greatly on the components ratio and PAA molecular weight. The complexation ability of hydroxypropylmethylcellulose with respect to poly(acrylic acid) was found to be similar to the complexation ability of methylcellulose, lower than that of hydroxypropylcellulose and higher than that of hydroxyethylcellulose. Copyright © 2006 Society of Chemical Industry
Synthesis of polypropylene graft copolymers from a hydroxyl‐groups‐containing polypropylene precursor via atom‐transfer radical polymerization
Authors: Zhang Liaoyun , Fan Guoqiang , Guo Cunyue , Dong Jin‐Yong , Hu Youliang , Huang Mingbao
Published: March 2006

Isotactic polypropylene graft copolymers, isotactic[polypropylene‐graft‐poly(methyl methacrylate)] (i‐PP‐g‐PMMA) and isotactic[polypropylene‐graft‐polystyrene] (i‐PP‐g‐PS), were prepared by atom‐transfer radical polymerization (ATRP) using a 2‐bromopropionic ester macro‐initiator from functional polypropylene‐containing hydroxyl groups. This kind of functionalized propylene can be obtained by copolymerization of propylene and borane monomer using isospecific MgCl2‐supported TiCl4 as catalyst. Both the graft density and the molecular weights of i‐PP‐based graft copolymers were controlled by changing the hydroxyl group contents of functionalized polypropylene and the amount of monomer used in the grafting reaction. The effect of i‐PP‐g‐PS graft copolymer on PP‐PS blends and that of i‐PP‐g‐PMMA graft copolymer on PP‐PMMA blends were studied by scanning electron microscopy. Copyright © 2006 Society of Chemical Industry
Biodegradable aliphatic thermoplastic polyurethane based on poly(ε‐caprolactone) and L‐lysine diisocyanate
Authors: Hassan Mohammad K. , Mauritz Kenneth A. , Storey Robson F. , Wiggins Jeffrey S.
Published: March 2006

A biodegradable aliphatic thermoplastic polyurethane based on L‐lysine diisocyanate and 1,4‐butanediol hard block segments, and 2000 g/mol poly(ε‐caprolactone) diol soft block segments was synthesized. The resulting polymer was a tough thermoplastic with ultimate tensile strength of 33 MPa and elongation of 1000%. The polymer displayed classic segmented thermoplastic elastomer morphology with distinct hard block and soft block phases. Thermal and dynamic mechanical analyses determined that the material has a useful service temperature range of around −40 °C to +40 °C, making it an excellent candidate for low‐temperature elastomer and film applications, and potentially as a material for use in temporary orthopedic implant devices. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 2990–3000, 2006
Chiral soluble polymers and microspheres for enantioselective crystallization
Authors: Menahem Tali , Mastai Yitzhak
Published: March 2006

A series of chiral polymers based on poly(N‐acryl) amino acids was synthesized using a convergent synthetic approach. These chiral polymers have been used as chiral additives to induce enantioselective crystallization of racemic or conglomerate amino acids in solutions. These polymeric additives showed strong capabilities to enhance highly enantioselective resolution during the crystallization of amino acids. In addition, these polymers caused unusual modifications of amino acid crystal morphologies. Furthermore, spherical microparticles of those same chiral polymers were also shown active in similar chiral discriminations during amino acid crystallizations occurring on microparticle surfaces. Our study demonstrates the high potential of chiral polymers and microparticles to resolve amino acids throughout crystallization processes. High enantiomeric excesses in one targeted enantiomer of amino acids can also be maximized via time‐dependent kinetic control of crystallizations. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 3009–3017, 2006
Comprehensive 2D NMR analysis: Acrylonitrile/ethyl methacrylate copolymers synthesized by ATRP at ambient temperature
Authors: Brar A. S. , Saini Tripta
Published: March 2006

Copolymerization of acrylonitrile and ethyl methacrylate using atom transfer radical polymerization (ATRP) at ambient temperature was carried out under optimized reaction conditions using 2‐bromopropionitrile as initiator and CuBr/2,2′‐bipyridine as the catalyst system. The copolymer composition, obtained from 1H NMR spectra, were used to determine the monomer reactivity ratios (rA = 0.68 and rE = 1.75) involved in ATRP. Two‐dimensional NMR (heteronuclear single quantum correlation and total correlated spectroscopy) experiments were employed to resolve the highly overlapping and complex 1H and 13C{1H} NMR spectra of copolymers. The complete spectral assignments of the quaternary carbons viz. carbonyl and nitrile carbons were done with the help of heteronuclear multiple bond correlation spectra. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 2955–2971, 2006
Grafting of polymers onto and/or from silica surface during the polymerization of vinyl monomers in the presence of γ‐ray‐irradiated silica
Authors: Tsuchida Akiko , Suda Makoto , Ohta Masatoshi , Yamauchi Takeshi , Tsubokawa Norio
Published: March 2006

The effects of radicals on silica surface, which were formed by γ‐ray irradiation, on the polymerization of vinyl monomers were investigated. It was found that the polymerization of styrene was remarkably retarded in the presence of γ‐ray‐irradiated silica above 60 °C, at which thermal polymerization of styrene is readily initiated. During the polymerization, a part of polystyrene formed was grafted onto the silica surface but percentage of grafting was very small. On the other hand, no retardation of the polymerization of styrene was observed in the presence of γ‐ray‐irradiated silica below 50 °C; the polymerization tends to accelerate and polystyrene was grafted onto the silica surface. Poly(vinyl acetate) and poly(methyl methacrylate) (MMA) were also grafted onto the surface during the polymerization in the presence of γ‐ray‐irradiated silica. The grafting of polymers onto the silica surface was confirmed by thermal decomposition GC‐MS. It was considered that at lower temperature, the grafting based on the propagation of polystyrene from surface radical (“grafting from” mechanism) preferentially proceeded. On the contrary, at higher temperature, the coupling reaction of propagating polymer radicals with surface radicals (“grafting onto” mechanism) proceeded to give relatively higher molecular weight polymer‐grafted silica. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 2972–2979, 2006
Responses to inhaled bronchodilators in infancy are not linked with asthma in later childhood
Authors: Hyvärinen Mari K. , Kotaniemi‐Syrjänen Anne , Reijonen Tiina M. , Korhonen Kaj , Kiviniemi Vesa , Korppi Matti
Published: March 2006

Many doctors consider wheezing infants and young children who respond to β‐adrenergic agents to be asthmatics, or at least at risk for later asthma. The aim of this study was to compare responses to inhaled albuterol and racemic epinephrine in infancy between children with and without asthma later in childhood. In a crossover study setting, 100 acutely wheezing infants aged less than 24 months were randomized to receive inhalations of either racemic epinephrine and placebo, or albuterol and placebo. Clinical evaluation consisted of measurements of respiratory rate, heart rate, and oxygen saturation, and clinical assessment of the respiratory distress assessment instrument (RDAI) score, consisting of wheezing and chest indrawings. The asthma status of the children was evaluated at three clinical follow‐up visits, at 4.0, 7.2, and 12.3 (median) years of age. Responses to bronchodilating agents, when respiratory rates and RDAI scores were used as outcome measures, were not different in future asthmatics compared to nonasthmatics. However, oxygen saturation was significantly higher after albuterol inhalation in children who had asthma at all three visits (92.67% confidence interval (CI), 91.39–93.96) than in those without asthma at these visits (92.52% CI, 91.79–93.25), but lower, correspondingly, after racemic epinephrine (91.97% CI, 90.74–93.19 vs. 93.04% CI, 92.29–93.79) and placebo (91.38% CI, 90.49–92.28 vs. 93.12% CI, 92.60–93.65) inhalations (P = 0.04). In conclusion, we were not able to confirm that future asthmatics respond better than future nonasthmatics to bronchodilating agents during wheezing in infancy. More studies are needed to characterize the subset of infants who benefit from bronchodilating treatment in infancy. Pediatr Pulmonol. 2006; 41:420–427. © 2006 Wiley‐Liss, Inc.
Expired tidal volumes measured by hot‐wire anemometer during high‐frequency oscillation in preterm infants
Authors: Zimová‐Herknerová Magdalena , Plavka Richard
Published: March 2006

We sought to determine the normocapnic values of expiratory tidal volume measured by hot‐wire anemometer, and to evaluate how often expiratory tidal volume exceeds estimated anatomical dead space during high‐frequency oscillatory ventilation (HFOV) in preterm infants. We also sought to determine the relationship between expiratory tidal volume and other respiratory parameters. The neonatal respiration monitor SLE 2100 VPM, a hot‐wire anemometer, was used to measure expired tidal volume (VT,E) in patients ventilated by the Sensormedics 3100A during routine clinical use of HFOV. Two hundred and fourteen simultaneous measurements of PaCO2, VT,E, fraction of inspired oxygen (FiO2), continuous distending pressure (CDP), frequency, and amplitude were obtained from 28 patients. The median birth weight was 852 g (range, 435–3,450 g), and median gestational age was 27.2 weeks (range, 23.3–41.0 weeks). One hundred and eighteen (55%) normocapnic measurements, 42 (20%) hypocapnic measurements, and 54 (25%) hypercapnic measurements were recorded in which the median VT,E was 1.67 ml/kg (95% confidence interval (CI), 1.55–1.79), 1.94 ml/kg (95% CI, 1.74–2.14), and 1.54 ml/kg (95% CI, 1.42–1.66), respectively. The measured VT,E exceeded 2.0 ml/kg in 30 instances of normocapnic VT,E (14%) and 54 of all VT,E (25%), and 3 ml/kg only in 7 (3%) and 11 (5%) instances of normocapnic and all VT,E. There was a significant difference in median normocapnic VT,E obtained when FiO2 was between 0.21–0.35, compared to values obtained when FiO2 was 0.36–1.0 (1.61 ml/kg (95% CI, 1.52–1.70) vs. 2.06 ml/kg (95% CI, 1.93–2.19), P < 0.002). The calculated values of PaCO2 between 35–47, using the calculated regression equation for prediction of PaCO2 (mmHg), correctly predicted normocapnic values in 60% of measurements. Values >47 should predict hypercapnia in 81% of cases. In conclusion, expired tidal volume measurement by heated double‐wire anemometer sensor is feasible, provides useful real‐time information about tidal volume changes, and may improve the clinical management of HFOV. Pediatr Pulmonol. 2006; 41:428–433. © 2006 Wiley‐Liss, Inc.
Intrapulmonary application of a 5‐lipoxygenase inhibitor using surfactant as a carrier reduces lung edema in a piglet model of airway lavage
Authors: Ankermann Tobias , Reisner Anja , Wiemann Tina , Koehler Heike , Krams Matthias , Krause Martin F.
Published: March 2006

Leukotriene‐generated effects on microvascular integrity and polymorphonuclear leukocytes (PMNL) play a key role in the inflammatory process of the alveolar‐capillary unit in neonatal acute respiratory distress syndrome. We asked if intrapulmonary application of MK886, a 5‐lipoxygenase inhibitor, and the use of a porcine surfactant preparation (Curosurf™) as a carrier substance would improve lung function in a neonatal piglet model of airway lavage. Anesthetized, mechanically ventilated newborn piglets (n = 19) underwent repeated airway lavage to induce acute lung injury. Piglets then received either surfactant alone (S, n = 6), or MK886 admixed with surfactant (S + MK, n = 7), or an air‐bolus injection as control (C, n = 6). Measurements of gas exchange, lung function, extravascular lung water (EVLW), cell counts, and leukotriene B4 (LTB4) concentrations in bronchoalveolar lavage fluid (BAL) were performed during 6 hr of mechanical ventilation. Arterial oxygen partial pressure (PaO2) (S, 13.8 ± 4.2 kPa, vs. S + MK, 20 ± 6.6; P < 0.05), functional residual capacity (S, 15.1 ± 6.8 ml/kg, vs. S + MK, 18.8 ± 3.7 ml/kg; P < 0.05), and EVLW (S, 29 ± 14 ml/kg, vs. S + MK 24 ± 4 ml/kg; P < 0.05) were significantly improved in the MK886 group. This clinical effect was linked with a decrease in LTB4 concentration in BAL (S, 3.5 (1.9–5.4) pg/ml, vs. S + MK, 1.6 (0.7–4.7) pg/ml; P < 0.05) and an increase in IL‐8 (S, 2,103 (852–4,243) pg/ml, vs. S + MK, 3,815 (940–26,187) pg/ml; P < 0.05). PMNL counts in BAL were reduced (S, 570 ± 42 cells/ml, vs. 275 ± 35 cells/ml; P < 0.05). In conclusion, intrapulmonary application of the 5‐lipoxygenase inhibitor MK886 with surfactant as a carrier improves lung function by decreasing EVLW as the main response to LTB4 reduction. Pediatr Pulmonol. 2006; 41:452–462. © 2006 Wiley‐Liss, Inc.
Exhaled carbon monoxide levels in school‐age children with episodic asthma
Authors: Ohara Yoichiro , Ohrui Takashi , Morikawa Toshio , He Mei , Yasuda Hiroyasu , Yamaya Mutsuo , Sasaki Hidetada
Published: March 2006

Carbon monoxide (CO) can be detected in exhaled air and is increased in adult and childhood persistent asthmatic patients. However, little is known about the exhaled CO concentration in episodic childhood asthma. This study aimed to clarify whether measurement of exhaled CO is useful in monitoring disease activity in children with episodic asthma. We measured exhaled CO concentration by modified Micro‐Smokerlyzer in 217 elementary school children (132 boys; mean age, 10 ± 1 (SE) years; range, 9–12 years), in whom 29 had infrequent episodic asthma without current exacerbations. We also measured exhaled CO concentrations in 22 children with episodic asthma (13 boys; mean age, 10 ± 3 years; range, 8–12 years), who had acute mild asthmatic attacks during examination. In these patients with mild asthmatic attacks, exhaled CO was measured both before and after combination therapy with salbutamol and sodium cromoglycate (SCG) by powered nebulizer. Among 217 schoolchildren, exhaled CO levels in infrequent episodic asthmatic children (1.1 ± 0.1 parts per million (ppm), n = 29) were not significantly different from those in healthy schoolchildren (1.0 ± 0.1 ppm, n = 188, P > 0.68). The exhaled CO concentrations during asthma attacks in children with episodic asthma were significantly higher (5.1 ± 0.4 ppm, n = 22) compared with those in healthy children (P < 0.001) or those in asymptomatic asthmatic children (P < 0.001). The elevated exhaled CO levels were significantly decreased after inhalation therapy of a combination of salbutamol and SCG (3.2 ±  0.5 ppm, n = 22, P < 0.02). In conclusion, exhaled CO levels were significantly elevated during acute asthma exacerbations, and partially recovered after treatment with β2‐agonist and SCG in children with mild episodic asthma. These findings indicate that measurement of exhaled CO might provide another noninvasive measurement of asthma exacerbations that would be suitable for use in children with acute mild episodic asthma. Pediatr Pulmonol. 2006; 41:470–474. © 2006 Wiley‐Liss, Inc.
Haemophilus influenzae type b vaccination and reported atopic disorders in 8–12‐year‐old children
Authors: Bernsen Roos M.D. , Koes Bart W. , de Jongste Johan C. , van der Wouden Johannes C.
Published: March 2006

Because Haemophilus influenzae type b (Hib) vaccination was added recently to most vaccination programs, no conclusive data on the relationship with atopic disorders are yet available. We sought to assess the risk of atopic disorders at ages 8–12 years associated with Hib vaccination in the first year of life, in addition to diphtheria‐tetanus‐pertussis‐inactivated poliomyelitis vaccination (DTP‐IPV) and other childhood vaccinations. Parents of 1,201 children attending Orthodox Reformed (Protestant) primary schools in The Netherlands returned questionnaires reporting data on vaccination status, atopic symptoms and physician‐diagnosed lifetime atopic disorders (asthma, hay fever, eczema, and food allergy), and possible confounders. This study was conducted within the framework of a larger study on the relationship between the DTP‐IPV and reported atopic disorders. The adjusted odds ratio of any atopic disorder (Hib‐vaccinated/unvaccinated) was 1.09 (95% confidence interval (CI), 0.79–1.50). For asthma, hay fever, eczema, and food allergy, the results were, respectively, 0.89 (95% CI, 0.55–1.43), 0.94 (95% CI, 0.47–1.90), 1.09 (95% CI, 0.75–1.58), and 0.68 (95% CI, 0.38–1.19). In conclusion, in the Dutch population, there is no indication for a higher risk of reported physician‐diagnosed atopic disorders at primary schools age after Hib vaccination in the first year of life, in addition to other vaccinations. Pediatr Pulmonol. 2006; 41:463–469. © 2006 Wiley‐Liss, Inc.
Differences in prevalence of asthma, rhinitis, and eczema between parental and self‐completed questionnaires in adolescents
Authors: Mallol Javier , Castro‐Rodríguez José A.
Published: March 2006

This study was undertaken to compare, for the first time in a developing country, the prevalence of asthma, rhinitis, and eczema in children aged 13–14 years when questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were independently completed by children and parents. A random sample of 3,178 children completed the ISAAC questionnaire at school, while in another sample of 3,387 children, the questionnaire was completed by their parents at home. The prevalence of asthma, rhinitis, and eczema symptoms was significantly higher when questionnaires were completed by adolescents themselves rather than by the parents, particularly for those symptoms that could be better perceived by children or that were more severe, e.g., wheezing with exercise, severe episodes of wheezing, nocturnal cough, and awaking with wheezing in the last 12 months. The diagnosis of hay fever and eczema was also reported more frequently by adolescents compared to their parents. The prevalence of asthma ever and wheezing in the last 12 months was not significantly different between the two samples. In a randomly selected subset of 550 pairs where adolescents and parents came from the same family, asthma ever had the highest agreement (kappa = 0.72, 95% CI: 0.64–0.80), but agreement was poor for rhinitis and eczema ever. In conclusion, the prevalence of asthma, rhinitis, and eczema symptoms varied according to whether the information was reported by independent samples of adolescent or parents. However, the prevalence of wheezing in the last 12 months and asthma ever was quite similar between adolescents and parents, suggesting that these questions are crucial for assessing asthma in epidemiological studies. Pediatr Pulmonol. 2006; 41:482–487. © 2006 Wiley‐Liss, Inc.
Prevalence and impact of gastroesophageal reflux in adolescents with asthma: A population‐based study
Authors: Debley Jason S. , Carter Edward R. , Redding Gregory J.
Published: March 2006

We determined the prevalence of gastroesophageal reflux disease (GERD) symptoms and the associations between GERD symptoms and asthma morbidity in a population of adolescents with asthma. Two thousand, three hundred and ninety‐seven students attending six middle schools in Seattle completed the International Study of Asthma and Allergy in Children (ISAAC) written and video survey that included additional questions pertaining to GERD symptoms and asthma morbidity. Based on their responses, children were categorized as having undiagnosed current asthma, physician‐diagnosed current asthma, or no asthma symptoms. The prevalence of GERD symptoms occurring at least weekly or daily was determined for each group. The asthma morbidity outcomes were emergency department visits, physician visits, missed school days, and use of inhaled medications for respiratory symptoms within the past year. Associations between GERD symptoms and asthma morbidity outcomes were determined using logistic regression. The prevalence of GERD symptoms was significantly higher among students with current asthma (19.3%; 95% confidence interval (CI), 14.9–24.2) than students with no asthma symptoms (2.5%; 95% CI, 1.8–3.4). In children with current asthma (n = 296), symptoms of GERD that occurred at least weekly were strongly associated with emergency department visits (odds ratio (OR), 5.0; 95% CI, 2.6–9.6), physician visits (OR, 2.5; 95% CI, 1.3–4.6), missed school (OR, 2.0; 95% CI, 1.1–3.7), and inhaled medication use (OR, 2.5; 95% CI, 1.3–4.7). The associations between GERD symptoms and emergency department visits, physician visits, and inhaled medication use were stronger among children with asthma who reported daily GERD symptoms (n = 14) than among children reporting weekly GERD symptoms (n = 57). The prevalence of GERD symptoms was greater in adolescents with current asthma than in those without asthma. In addition, the presence of at least weekly GERD symptoms was strongly associated with greater asthma morbidity and the use of asthma medications. Pediatr Pulmonol. 2006; 41:475–481. © 2006 Wiley‐Liss, Inc.
Pathogenesis of apparent life‐threatening events in infants with esophageal atresia
Authors: Cozzi D.A. , Zani A. , Conforti A. , Colarizi P. , Moretti C. , Cozzi F.
Published: March 2006

Many infants with a repaired esophageal atresia (EA) undergo fundoplication, aortopexy, or glossopexy because the mechanisms most responsible for airway obstruction and/or apparent life‐threatening event (AO/ALTE) syndrome are considered to be gastroesophageal reflux (GER), tracheal compression (TC), or obstructive apnea, respectively. In the present study, we investigated whether these mechanisms are independent or interrelated. We developed a database of 120 consecutive patients with EA treated by the senior author between 1967–2002. We studied the clinical manifestations of patients with a cervical esophagostomy and/or blind lower esophageal stump, which ruled out TC and/or proximal esophageal GER as a mechanism for AO/ALTE. Of 25 neonates who underwent section/ligation of lower tracheo‐esophageal fistula and/or feeding gastrostomy, 10 critically ill neonates died. Of 15 survivors, 9 infants had a feeding gastrostomy without an esophagostomy. Of these, 6 infants presented one or more episodes of AO, and 8 presented ALTE with or without AO. Subsequently, 5 of the 9 infants underwent an esophagostomy. Eventually, 11 infants had a feeding gastrostomy with an esophagostomy. Of the latter, 5 infants presented one or more episodes of AO, and 6 presented ALTE without AO. In conclusion, oral feeding, proximal esophageal GER, and TC are not essential for AO/ALTE syndrome to occur. They are probably factors which offer evidence of an underlying problem with control of upper airway patency. Pediatr Pulmonol. 2006; 41:488–493. © 2006 Wiley‐Liss, Inc.
Reproducibility of manual pressure force on provocation of the sacroiliac joint
Authors: Levin Ulla , Nilsson‐Wikmar Lena , Stenstruöm Christina H. , Lundeberg Thomas
Published: March 2006

Background and Purpose

Previous studies of pain‐provocation sacroiliac (SI) joint tests have revealed conflicting results. The aim of the present study was to evaluate the intra‐ and inter‐test reliability of pressure force applied during distraction test, compression test and pressure on the apex sacralis.

Methods

Seventeen physiotherapists (PTs), median age 43 years and median clinical experience 11 years, all experienced in musculoskeletal evaluation and therapy, participated in the study. Each PT performed each test on the same healthy volunteer for 20 s, on three separate occasions, at intervals of one week using a specially constructed examination table which registered pressure force.

Results

The PTs were capable of maintaining a relatively constant pressure force for 20s. The intra‐test reliability was acceptable even though there were individual differences on different occasions between those PTs who used the SI joint tests often and those who seldom or never used them. The inter‐test reliability was insufficient.

Conclusions

The findings indicate the advantage of registering pressure force as a complement for standardized methods for pain‐provoking tests and when learning provocation tests, since individual variability was considerable. Copyright © 1998 Whurr Publishers Ltd.
A model for the prediction of time to union in fractures of the tibia
Authors: Fourie Jeanette Ann , Thompson Mary Lou
Published: March 2006

Background and Purpose

This report covers the second arm of a trial, the main focus of which was to assess the effect of interferential currents (IFCs) on time to union in tibial fractures. No significant improvement was found with the use of IFCs for the parameters employed (Fourie & Bowerbank, 1997).

Methods

The focus of this study is the development of logistic regression models which used subject characteristics to predict non‐union of fracture within 24, 32 and 40 weeks. Such models could be used to identify clients for consideration of alternative interventions, for example, electric current stimulation, bone grafting or the injection of bone morphogenic proteins (BMPs). The usefulness of such models would depend on their ability to correctly identify subjects whose fractures do or do not unite. These models were validated with respect to their sensitivity and specificity to predict non‐union for a separate data set.

Results

The results indicated, for instance, that use of a model to predict non‐union of fracture within 24 weeks would lead to 27% of subjects being correctly classified (as union or non‐union), 51% of subjects whose fractures did not unite within 24 weeks were identified and 65% of subjects (diagnosed as non‐union) whose fractures did not unite within 24 weeks (the closer these values are to 100% the more accurate the model).

Conclusion

The conclusion reached was that the models may have value for low‐cost, non‐invasive interventions, but that they could not be used to predict those cases where surgical involvement would be necessary, due to the high false‐positive rate. Copyright © 1998 Whurr Publishers Ltd.
Physical therapists' perception of patients' pain and its affect on management
Authors: Askew Rod , Kibelstis Carolyn , Overbaugh Stephanie , Walker Sheri , Nixon‐Cave Kim , Shepard Katherine F.
Published: March 2006

Background and Purpose

The purpose of this qualitative study was twofold: (1) to determine the factors that affected physical therapists' (PTs) perception of patients' pain and (2) to determine how this perception affected the management of patients.

Methods

Forty‐six PTs with at least two years' experience practicing in pain management clinics, outpatient clinics or sports medicine clinics were interviewed. The data collected were transcribed, coded and analyzed for main themes.

Results

The most predominant factors found to affect PTs' perception of patients' pain were the therapist's personal and professional experience, area of practice and evaluative findings.

Conclusions

In this sample there exists a common link between experience and evaluative findings: the longer PTs have been practicing the more proficient they become in performing and interpreting a thorough subjective and objective evaluation. PTs practicing in pain clinics were found to have a more holistic and multidisciplinary approach to patient care, whereas therapists practicing in out‐patient and sports medicine facilities were more apt to focus on patients' physical symptoms and complaints. Four main themes of perceived patient pain and their corresponding management were developed: (1) patients presenting with legitimate/acute pain profiles render a slow, conservative approach by the PT; (2) patients presenting with debilitating/chronic pain were most often treated with an approach that stressed functional gains and patient independence; (3) the preferred treatment of patients characterized with a non‐legitimate pain profile was an aggressive and multidisciplinary approach; (4) ‘special cases’ and their management were dependent upon the patient's functional level and pain tolerance. Copyright © 1998 Whurr Publishers Ltd.
Test–retest reliability of the Fukuda Stepping Test
Authors: Bonanni Maureen , Newton Robert A
Published: March 2006

Background and Purpose

Although the Fukuda Stepping Test (FST) is commonly used to assess individuals with peripheral vestibular dysfunction or balance instability, test–retest reliability has not been examined.

Methods

Sixteen males and 14 females, ranging in age from 23 to 56 years (mean 32.8 years), with no known vestibular dysfunction were tested. The subjects stood in the center of two concentric circles with eyes blindfolded. They stepped in place with outstretched arms for the prescribed number of steps. Subjects were tested on two consecutive days. Their angle of rotation, angle of displacement and distance of displacement were measured.

Results

Inter‐class correlation coefficients were moderate for the 50‐step protocol but lower for the 100‐step protocol.

Conclusions

If practitioners use the FST they should use the 50‐step protocol. In addition, practitioners should interpret the results of the FST with caution if it is used as a screening tool. The test should be used in conjunction with other tests for vestibular function. Copyright © 1998 Whurr Publishers Ltd.
Breathing patterns and heart rate during simulated occupational upper limb tasks in normal subjects
Authors: Mackey Martin , Ellis Elizabeth , Nicholls Max
Published: March 2006

Background and Purpose

Despite the arms being used extensively in the performance of many occupational tasks, little is known about the pattern of breathing and physiological cost of such work. The purpose of this study was to establish whether a simple change in arm support could alter the workload, pattern of breathing and respiratory muscle recruitment during a low intensity arm task.

Methods

Ten normal subjects performed a simulated work task when sitting, once with the arms supported and once unsupported. Subjects were required, over a five‐minute period, to repeatedly pick up a 2 kg object, inspect and hold it for 15 seconds and then pack it in a box. Breathing pattern responses, measured by pneumotachograph and respiratory inductive plethysmography, were minute ventilation (VE), respiratory frequency (Rf), tidal volume (VT) and change in functional residual capacity (FRC).

Results

The main findings were that unsupported arm work was more physiologically demanding than supported arm work. During work VE increased as a result of a change in respiratory frequency but not VT which was much more limited when the arms were unsupported. At the completion of activity, when the arms were unloaded, VT initially increased as VE decreased. FRC and VT were reduced during arm work and increased during recovery, mainly as a result of a change in ribcage excursion.

Conclusions

These findings support the theory that during arm activity, intercostal and accessory respiratory muscles act to stabilize the arms and torso, impeding chest wall movement and shifting the respiratory load from these muscles to the diaphragm. This may adversely effect performance of workers who have ventilatory limits to arm work tasks. Copyright © 1998 Whurr Publishers Ltd.
Curricular content on urinary incontinence in entry‐level physical therapy programmes in three countries
Authors: Walker Joan M.
Published: March 2006

Background and Purpose

Urinary incontinence (UI) is a significant psychological, social and healthcare problem across the lifespan. Although there is evidence of physical therapy (PT) efficacy, no literature was located pertaining to UI in PT curricula. The aim was to compare curricular content on UI (of non‐neuropathic origin) in PT programmes in Canada, the UK and the USA. The study subjects were PT educators in entry‐level programmes.

Methods

All Canadian PT programmes (13) were surveyed. Stratification was used to make random samples of PT programmes: 50% of UK (13/26) and 50% of USA (69/136). A questionnaire was used to obtain information on: degree level, programme length, specific courses, time allotted, UI topics, teaching method(s), the professional teaching patients with UI and reasons for non‐inclusion in the study. One follow‐up letter was sent. Results are presented as frequencies and percentages.

Results

Overall, the response rate was 62.8%; country response rates were: Canada 92.3%; UK 76.9% and USA 53.6%. UI was taught in 80% of Canadian, 90% of UK (which gave the most time to teaching on UI: 70% >60 minutes) and 78.4% of USA PT programmes. Kegel exercises were taught in all three countries (>81.1%) and electrical stimulation in >65%. Theory only was the primary method of teaching in all countries (>64.9%). Physical therapists were reported to have a major role in treating patients with UI (Canada >75%; UK 100%; USA 70.3%).

Conclusions

With Kegel exercises and electrical stimulation taught in two‐thirds of all programmes physical therapy graduates may have some knowledge of UI management. However, for the UK and USA programmes data are from only 38.5% and 27% respectively. As the common method of teaching on UI was by theory only, graduating physical therapists may lack the clinical skills to apply assessment and treatment techniques. Copyright © 1998 Whurr Publishers Ltd.
Inter‐ and intra‐tester reliability of the balance performance monitor in a non‐patient population
Authors: Haas Bernhard M , Whitmarsh Tracy E
Published: March 2006

Background and Purpose

There is a growing interest in the measurement and evaluation of balance deficits and a number of instruments for measurement are now available. However, few data exist that accurately describe the reliability when using these measurement tools. This study was designed to evaluate the inter‐ and intra‐tester reliability of using the Balance Performance Monitor (BPM) (SMS Healthcare) in a non‐patient population.

Methods

A total of 58 subjects (mean age 29.83 years (±9.44 years)) and three testers participated in two separate experiments. Intra Class Correlation Coefficients (ICCs) and coefficients of variation were used to describe the reliability of two different protocols for positioning subjects on the footplates of the BPM.

Results

Measurements of weight distribution showed high and significant inter‐ and intra‐tester reliability for both protocols (ICCs ranging from 0.720 to 0.868). Sway measurements showed more limited reliability (ICCs ranging from 0.183 to 0.775). Coefficients of variation were low for weight distribution measurements and high for sway measurements.

Conclusions

Taking the mean of three measurements is recommended for both the weight distribution and the sway measurements as it has shown to produce acceptable measurement results. Copyright © 1998 Whurr Publishers Ltd.
Falls reported among elderly Norwegians living at home
Authors: Bergland Astrid , Pettersen Anne Marie , Laake Knut
Published: March 2006

Background and Purpose

Norway has the highest reported incidence of hip fractures in western Europe. Little is known about the epidemiology of falls in Norway where the winter season is long and dark. The objective of this work was to study reported falls and their consequences among elderly Norwegians living at home.

Methods

A cross‐sectional design was used for the study. Interviews were performed in the homes of 431 subjects, aged 67–97 years, living at home. Information on falling was gathered through six questions: whether the subject had fallen during the last six months, and if so, how many falls they had, where the last fall occurred, its perceived reason, the activity the subject had been engaged in when the fall occurred, and the resulting injury.

Results

In all, 24.1% of subjects reported falling during the last six months, and 9.5% had suffered more than one fall. Falls were most frequently linked to external events (63.1%). Outdoor falls were more frequent (59.0%; 95% CI=51.2–82.0) than indoor falls. Older subjects were associated with more frequent indoor falls (p<0.05), but gender was not significant. Fifty‐one per cent of subjects had fallen while walking and 53% had suffered an injury from the last fall. In 13.4% of the women and 16.2% of the men, the last fall had resulted in a fracture.

Conclusions

Compared to the results of other studies from industrialized Western countries, a similar crude fall rate, similar frequency and similar type of injury were found. However, in contrast to other studies, no gender difference was observed with regard to falling, place of falling and fracture rate. Copyright © 1998 Whurr Publishers Ltd.
Recovery of walking function in stroke patients after minimal rehabilitation
Authors: Hale Leigh Anne , Eales Cecelia J.
Published: March 2006

Background and Purpose

Independent walking function is a highly desired goal amonst stroke victims, and has been well reported in Western literature. However, few studies have investigated the recovery of gait following stroke in Third World countries, where rehabilitation is often minimal or non‐existent.

Methods

A descriptive survey, using a structured questionnaire, was conducted on stroke victims, 12–14 weeks post‐discharge from the Chris Hani Baragwanath Hospital, Soweto, South Africa. Although the questionnaire included a number of aspects of impairment, disability and handicap, this paper only reports on the recovery of walking function.

Results

A total of 361 patients were screened initially. Only 54 fulfilled all inclusion criteria, 38 (70%) were over 50 years of age and 16 (30%) were aged under 50 years. The average length of stay in hospital of the older group was eight days, and in the younger group, 11.5 days. All 54 subjects interviewed were able to walk prior to their stroke. Twelve to fourteen weeks post‐discharge, 23 (66%) subjects in the older group and all (100%) of the younger group said they could walk. Half of the older group and nearly all of the younger group could walk outside their homes, unassisted and without appliances. One‐third of the subjects experienced knee pain during walking, but only a small percentage said that this pain prevented them from walking. The ability to catch a taxi in Soweto was used as a measurement of the handicap of gait. Twenty (54%) older group subjects and five (31%) of the younger group never caught a taxi.

Conclusions

Although the recovery of gait in these subjects appears to have been good, the results cannot be extrapolated to the stroke population in general due to the stringent selection criteria of the study. Further studies are required to acquire a broader cross‐section of the stroke population, including longer follow‐up periods to gain insight into the continuation of walking function. This information is necessary in order to plan effective and appropriate rehabilitation services. Copyright © 1998 Whurr Publishers Ltd.
A survey of UK manual therapists' practice of and attitudes towards manipulation and its complications
Authors: Adams Georgina , Sim Julius
Published: March 2006

Background and Purpose

Little is known about the practice of manipulation by UK physiotherapists. This study was conducted to discover current practice of, and attitudes towards, manipulation among UK manipulative therapists.

Methods

A postal questionnaire was sent to 300 UK manipulative therapists who were members of two professional associations representing differing approaches to manual therapy: the Society of Orthopaedic Medicine (SOM) and the Manipulation Association of Chartered Physiotherapists (MACP).

Results

A 50% response rate was achieved and 129 respondents identified themselves as ‘users’ of manipulation. Anxiety about possible complications was a prominent reason adduced by ‘non‐users’ and ‘partial users’ for their avoidance of manipulative procedures. The thoracic spine was the region most often manipulated, followed by the lumbar spine. Nineteen per cent of users had encountered complications from manipulation, which were most common in the cervical region and were predominantly non‐serious. The majority of SOM members and a minority of MACP members used generalized cervical rotary manipulations — thought by some to be potentially dangerous. Attitudes to manipulation were generally positive, although overall respondents were uncertain as to whether its benefits outweighed its risks. Members of the SOM emerged as more frequent users of manipulation and as less conservative in their attitudes to certain aspects of manipulation.

Conclusions

Allowing for possible under‐reporting or other response biases, spinal manipulation emerged as a relatively safe and widely practised technique among this sample. Copyright © 1998 Whurr Publications Ltd.
The accuracy of predicting functional recovery in patients following a stroke by physiotherapists and patients
Authors: Jones Fiona
Published: March 2006

Background and Purpose

The potential for post‐stroke recovery and the range of predictive variables has been studied extensively. Knowledge of these variables alongside other factors, such as performance in therapy and professional experience, enable ongoing predictions to be made by members of the rehabilitation team. Patients' own predictions for their recovery has yet to receive much attention in this area of research. The aim of this study was to compare the predictive accuracy of the physiotherapist and the stroke patient with regard to functional change during a period 6–12 weeks post‐stroke.

Method

The stroke sample (N=29) came from two National Health Service Trusts as did the physiotherapists (N=4). No comparisons were made between the hospitals and data was coded for anonymity. Estimations were made by both physiotherapists and patients regarding items on each of the three sections of The Rivermead Motor Assessment (RMA). Intra‐class correlation coefficients (ICCs) were used to describe agreement of each set of predictions with the achieved RMA scores. The results reported here represent the main emphasis of the research; however, other areas were also screened (for example, change in cognition, language and quality of life) by use of basic standardized measures. Recovery was also compared to other known predictive variables, such as age, severity of stroke and urinary incontinence.

Results

At follow‐up assessment it was found that both physiotherapists' and patients' predictions demonstrated high and significant agreement with the achieved RMA scores at 12 weeks (ICCs ranging from 0.727 to 0.968). Physiotherapists' predictions demonstrated marginally higher levels of agreement than patients' predictions.

Conclusions

The degree of accuracy demonstrated by both physiotherapists and patients was considerable. The patient group was perhaps the more notable as no subject had had prior knowledge of a stroke. The implications in respect of lay persons' involvement in decision making and in the rehabilitative process, alongside the health professionals, are perhaps worthy of closer consideration. Copyright © 1998 Whurr Publications Ltd.