bluuebunny/crossref_metadata_2025 huggingface dataset:
Chaperones in cell cycle regulation and mitogenic signal transduction: a review
Authors: Helmbrecht K. , Zeise E. , Rensing L.
Published: March 2003

Chaperones/heat shock proteins (HSPs) of the HSP90 and HSP70 families show elevated levels in proliferating mammalian cells and a cell cycle‐dependent expression. They transiently associate with key molecules of the cell cycle control system such as Cdk4, Wee‐1, pRb, p53, p27/Kip1 and are involved in the nuclear localization of regulatory proteins. They also associate with viral oncoproteins such as SV40 super T, large T and small t antigen, polyoma large and middle S antigen and EpsteinBarr virus nuclear antigen. This association is based on a J‐domain in the viral proteins and may assist their targeting to the pRb/E2F complex. Small HSPs and their state of phosphorylation and oligomerization also seem to be involved in proliferation and differentiation. Chaperones/HSPs thus play important roles within cell cycle processes. Their exact functioning, however, is still a matter of discussion.

HSP90 in particular, but also HSP70 and other chaperones associate with proteins of the mitogen‐activated signal cascade, particularly with the Src kinase, with tyrosine receptor kinases, with Raf and the MAP‐kinase activating kinase (MEK). This apparently serves the folding and translocation of these proteins, but possibly also the formation of large immobilized complexes of signal transducing molecules (scaffolding function).
Vitamin E inhibition of normal mammary epithelial cell growth is associated with a reduction in protein kinase Cα activation
Authors: Sylvester P. W. , McIntyre B. S. , Gapor A. , Briski K. P.
Published: March 2003

Tocopherols and tocotrienols represent the two subclasses within the vitamin E family of compounds. However, tocotrienols are significantly more potent than tocopherols in suppressing epidermal growth factor (EGF)‐dependent normal mammary epithelial cell growth. EGF is a potent mitogen for normal mammary epithelial cells and an initial event in EGF‐receptor mitogenic‐signalling is protein kinase C (PKC) activation. Studies were conducted to determine if the antiproliferative effects of specific tocopherol and tocotrienol isoforms are associated with a reduction in EGF‐receptor mitogenic signalling and/or PKC activation. Normal mammary epithelial cells isolated from midpregnant BALB/c mice were grown in primary culture, and maintained on serum‐free media containing 10 ng/mL EGF as a mitogen, and treated with various doses (0–250 µm) of α‐, γ‐, or δ‐tocopherol or α‐, γ‐, or δ‐tocotrienol. Treatment with growth inhibitory doses of δ‐tocopherol (100 µm), α‐tocotrienol (50 µm), or γ‐ or δ‐tocotrienol (10 µm) did not affect EGF‐receptor levels, EGF‐induced EGF‐receptor tyrosine kinase activity, or total intracellular levels of PKCα. However, these treatments were found to inhibit EGF‐induced PKCα activation as determined by its translocation from the cytosolic to membrane fraction. Treatment with 250 µmα‐ or γ‐tocopherol had no affect on EGF‐receptor mitogenic signalling or cell growth. These findings demonstrate that the inhibitory effects of specific tocopherol and tocotrienol isoforms on EGF‐dependent normal mammary epithelial cell mitogenesis occurs downstream from the EGF‐receptor and appears to be mediated, at least in part, by a reduction in PKCα activation.
Leaving children unattended at home: decision‐making on the use of self‐care in Hong Kong
Authors: Tam
Published: March 2003

This paper examines decisions among low‐income mothers in Hong Kong on the use of self‐care, or the arrangement of leaving children unattended at home. An analysis of individual interviews with 23 mothers, based on a family ecology perspective, highlighted the contexts in which mothers make decisions based on economic, social and technical grounds. Findings showed that self‐care was used with family orientated demands, in spite of the worries and fears associated with the self‐care arrangement. Self‐care was generally favoured when it was felt to be an efficient way of carrying out family and domestic tasks. An argument was also made that self‐care encouraged appropriate independence in children. Nevertheless, mothers recognised the risks involved in self‐care and planned to minimise the potential dangers of young children being left unattended. The views of the children themselves, as well as their fathers, often influenced the care arrangements made by mothers. Social policies in relation to unattended children are also examined. This analysis reveals ideological assumptions about the nature of good parenting that places great pressure on mothers to fulfil their responsibilities even though they often lack adequate economic, social and technical support. Rather than deploy deterrent legal measures, it is suggested that social measures, including the provision of `family life education', occasional child care services and enhancement of community support, be developed to help parents carry out their child‐rearing roles effectively.
Working with children in women's refuges
Authors: Mullender  , Debbonaire  , Hague  , Kelly  , Malos
Published: March 2003

At a time when there is increasing interest amongst child care professionals in how to respond to children living with domestic violence, this paper derives from a study of a specialist context for such work: child work in women's refuges. The qualitative aspect of the research, which is reported on here, consisted of in‐depth visits to eight refuges. Group and individual interviews with children, women and workers covered the needs (and also the strengths) presented by a wide range of children, and the scope of work undertaken with them and their mothers.A child‐centred and non‐violent ethos was found to be offering high levels of support to children and young people, despite low levels of resourcing. Certain groups were identified as still requiring developments in particular responses to their needs. Greater recognition of refuge child work is called for from statutory agencies, including those with access to funding.
Child and family social work: organizational context and identity
Authors: Bilton Keith
Published: March 2003

In the years since 1948, child and family social work has, to differing degrees at different times, sought to identify itself with a national centrally directed service, with the local service organization, with its clientele and with an independent source of professional regulation. Changes in the organizational context in which the work has been carried out over this period have affected the prospects for the development of a secure identity. The effects of the following are considered: national structures, particularly in relation to children's departments between 1948 and 1971; the corporate local authority; the managerial function in social services departments; social care; specialization; the detailed scrutiny of practice; care management and the Children Act 1989.
No place like home: lessons learned and lessons forgotten –the Children Act 1948
Authors: Wilson Kate , Petrie Steph
Published: March 2003

The Children Act 1948 emphasizes foster care as the alternative provision for children who cannot be cared for by their own families; it also underlines the responsibility of the state to provide good alternative homes where necessary. The Act reflects contemporary developments in psychological thinking about the importance of attachment relationships, and a recognition, derived in part from the experiences of evacuation, of the harmful effects on children of separation from their families. However, greater awareness, from the 1970s on, of the deficiencies of the state as parent and the complexity of relationships between children, their birth parents and foster families led to the promulgation of ‘inclusive’ and ‘task‐centred’ models of foster care, reflected in the shift of nomenclature from foster ‘parenting’ to foster ‘caring’. These approaches may, however, be in danger of minimizing both the attachment needs of many children and young people within the foster placement and the parenting role which is appropriate in many placements. A model of foster care, derived directly from the first Children Act, which stresses these core relationships, should be developed alongside that which emphasizes task‐centred, time‐limited provision.
Enhancing the resilience of children and young people in public care by mentoring their talents and interests
Authors: Gilligan
Published: March 2003

It is argued that the progress and resilience of young people in public care can be greatly enhanced by attention to the value of cultural, sporting and other activities in their lives. Sensitive mentoring of the young person in these activities by concerned adults – members of the child’s social network or volunteers – can foster the potential of the young person, build self‐esteem, strengthen mental health and open new social relationships beyond the care system. A series of case illustrations are used to demonstrate how such involvement in activities can greatly improve the prospects for a more successful transition out of care. It is suggested that the potential of this neglected dimension of care can only be fully realized through alert professional practice, imaginative engagement with potential ‘natural’ mentors, supportive agency policy, effective care planning systems, and relevant training and professional supervision for social workers.
Love and money: payment, motivation and the fostering task
Authors: Kirton Derek
Published: March 2003

Although the payment of foster carers has attracted greater attention in recent writing and research, coverage of the issues has been limited. In this study, based on interviews with 20 female carers, the place of payment within foster care is explored in greater depth. The focus is on charting how carers perceive their task as ‘parenting’ or ‘job’, whether and how they experience payment as compensation or as an appropriate reward for their skills. Also examined are the ways in which payment may impact upon the practice of foster care, for example in decision making over the taking or ending of placements and the provision of aftercare support for care leavers. The study highlights the distinctive nature of foster care as an institution that straddles the public and private domains, and examines the resulting complexities. It concludes by suggesting that while payment issues provide important threads that run throughout foster care, their influence is ultimately limited by the latter's base within the family.
Giving voice to experiences: parental maltreatment of black children in the context of societal racism
Authors: Bernard Claudia
Published: March 2003

ABSTRACT This paper seeks to explore the ways in which black children who have been maltreated within their families come to voice to tell their stories. A discussion of black children's recovery from maltreatment necessitates understanding how they interpret and name their experiences as abusive. Research indicates that while many factors mediate the effects of abuse on children's development, telling your story about childhood trauma is critical in the healing process for promoting psychological well‐being. However, what does the naming and speaking of trauma entail for black children when the broader context of their lived realities is embedded in racism that confers on them a stigmatized status? Where black children's lived experiences encompass the complexity of societal racism as a mutually reinforcing and contradictory reality in their lives, their capacity to name the maltreatment they experience will be particularly problematic. Essentially, parents’ issues silence children and can encourage them to block out painful emotions, ultimately putting their emotional and psychological well‐being at risk. Taking race and gender as benchmarks for analysis, the complexities involved in giving voice to childhood maltreatment are discussed to consider how these dynamics contribute to black children's resilience and adaptive behaviours in the aftermath of abuse.
Family support and the Scottish children's hearings system
Authors: McGhee Janice , Waterhouse Lorraine
Published: March 2003

ABSTRACT Evidence from a study of 1155 children referred to the children's hearings system in Scotland in 1995 found many of the children could be characterized as ‘children in need’. As found in other child care research, limited voluntary help was available to them, the majority received ‘no action’ and a substantial group a compulsory supervision requirement. The critical need for the strategic development of family support services in child welfare policy in Scotland for children referred to the hearings system is argued. The potential misuse of compulsory measures of supervision as a key to accessing resources is examined.
Physical and personality traits of preschool children in Fuzhou, China: only child vs sibling
Authors: Wang D , Kato N , Inaba Y , Tango T , Yoshida Y , Kusaka Y , Deguchi Y , Tomita F , Zhang Q
Published: March 2003

Concern about the healthy growth and development of an only child has been voiced since the 1970s, when the Chinese government launched the only child policy. In this study, the physical and personality traits of rural Chinese preschool only‐children (onlies) whose age ranged from 3 to 6 years old were evaluated. The sample included 197 onlies and 367 children with siblings who came from seven kindergartens in rural areas in Fuzhou, Fujian province. The results showed no statistically significant differences in height, mass or BMI between the onlies and siblings. Regarding the personality traits, the significant difference was that the onlies exhibited more somatic complaints, however, the data didn’t indicate any other undesirable personality traits for the onlies. These results suggest that Chinese preschool children grow normally with or without siblings.
Implications of attachment style for patterns of health and illness
Authors: Feeney J A
Published: March 2003

There is substantial evidence that health status and health outcomes are related to the availability and quality of personal relationships. The proposition that attachment relationships in childhood and adolescence have health‐related implications fits within this research tradition, and has guided recent attempts to develop models linking attachment style with emotional regulation, coping mechanisms, and illness behaviours. The present paper discusses these theoretical models, together with relevant empirical findings. It is argued that measures of attachment security are related to symptom‐reporting, health‐care utilization, and restriction of normal activities, and that these links can be explained, in part, by individual differences in emotional and behavioural responses to stress. It is further noted that researchers have proposed physiological and biochemical pathways which may explain some of the effects of attachment style on physical health. The quality of parent–child attachment also predicts family responses to children’s illness, as reflected in parents’ visitation rates and in family participation in studies of health and illness. The implications of the findings for research and for practice in the health professions are briefly discussed.
Factors affecting language development in West African children: a pilot study using a qualitative methodology
Authors: Law J
Published: March 2003

Data on referral patterns to pre‐school facilities for speech‐ and language‐delayed children suggest that West African children are over represented relative to other ethnic/language groups. This study was set up as a pilot to explore some of the issues which distinguish this group of children and their families. A qualitative methodology was adopted to access the views of a small group of parents (nine) and professionals with direct experience of these services (three). Between them the parents had a total of 11 children who had received speech and language therapy services. Extensive in‐depth interviews were transcribed and coded. The families are predominantly well educated with high expectations for their children. Their beliefs about child development in general and language development often differed from those of the professionals interviewed. For example, parents saw little direct link between very early language stimulation and subsequent school performance. West African parents also perceived that they had different (higher) expectations of behaviour than other families. It was generally accepted by all parties that the West African community experiences a high degree of stress resulting from a combination of interacting factors, namely pressures relating to employment, to immigration status, to matters financial and to expectations from family back in their own country. It is unclear exactly how these impact on the development of the child but there is an awareness that there may be a negative effect of such stress and that children's speech and language development may be one aspect of development that is affected. As a result of this pilot study a number of mechanisms relating to the relationship between environment factors and language development are proposed and suggestions are made regarding service provision for this community.
Cause‐specific perinatal death rates, birth weight and deprivation in the West Midlands, 1991–93
Authors: Bambang S , Spencer N J , Logan S , Gill L
Published: March 2003

Objectives To study the relationship between cause‐specific perinatal death rates, material deprivation and birthweight among births in 3 consecutive years in the West Midlands Health Region.

Study design Retrospective cohort study.

Setting West Midlands Health Region (WMHR).

Study population All births (live and stillbirths) to mothers with addresses in the WMHR in 1991, 1992 and 1993.

Main outcome measures Cause‐specific perinatal death rates — crude and stratified by birthweight.

Methods Perinatal deaths in the WMHR in 1991–93, collected as part of the national Confidential Enquiry into Stillbirths and Deaths in Infancy, were classified into causes of death by the extended Wigglesworth classification. Crude rates for cause‐specific perinatal deaths and rates stratified by birthweight < 2500 g and ≥ 2500 g were calculated for each enumeration district (ED) quintile derived by ranking enumeration districts for the whole of the region by Townsend Deprivation Index. Cause‐specific rates of death were investigated for a linear trend across ED quintiles. The relative risk of death (most vs least deprived) from specific causes was calculated. Using rates for the least deprived quintile as the reference, deaths from each cause ‘attributable’ to social inequality were calculated.

Results Positive linear trends in perinatal deaths were noted with increasing deprivation for each specific cause of death except those classified as ‘other causes’ (Wigglesworth Class E). Relative risk (most vs least deprived) of perinatal death with a congenital anomaly was 1.98 (confidence interval, CI: 1.36,2.89). For deaths related to antepartum events, intrapartum events and immaturity the risks were 1.81 (CI: 1.39,2.38), 1.48 (CI: 1.10,1.98) and 1.92 (CI 1.45,2.56), respectively. Forty‐three (35.7%) perinatal deaths per year were due to congenital anomalies, 63 (29.7%) antepartum events, 36 (21.9%) intrapartum events and 61 (32.7%) immaturity and these were statistically ‘attributable’ to social inequality. Cause‐specific perinatal death rates for babies < 2500 g showed no correlation with deprivation; however, for babies ≥ 2500 g the association with deprivation persisted.

Conclusions All cause‐specific rates except those due to ‘other causes’ showed a positive linear trend with increasing deprivation. These trends were found for infants born ≥ 2500 g but were not seen for low birthweight infants (< 2500 g). Almost 30% of deaths were statistically ‘attributable’ to social inequality. The results of this study suggest that material deprivation plays an important role in the causal pathway leading to perinatal death and needs to be addressed in preventive programmes aimed at the reduction of perinatal deaths.
Comparison between two common methods for reporting cold and diarrhoea symptoms of children in daycare centre research
Authors: Carabin H , Gyorkos T W , Soto J C , Joseph L , Collet J‐P
Published: March 2003

Background

The increasing number of children attending day care centres (DCCs) in industrialized countries has refocused attention on the occurrence of infections and infectious diseases in these settings.

Objective

To evaluate the agreement between two methods (parent method vs. educator method) for reporting the occurrence of respiratory and diarrhoeal infections.

Methods

Fifty‐two DCCs in Québec, Canada, participated. Both educators and parents were invited to fill in calendars on which they would indicate the occurrence of colds and diarrhoea. For the parents' method, parents were telephoned biweekly to record their calendar information. For the educators' method, educators returned their calendar pages monthly (following prompting by phone, when necessary).

Results

Three hundred and thirty‐three parents of toddlers participated in the 15‐month reporting period between September 1996 and November 1997. The average agreement between the two methods was low (13.5% for colds and 9.8% for diarrhoea). Overall estimates of the incidence rates of respiratory and diarrhoeal infections based on parents' method were higher than those based on educators' method.

Conclusions

Parents' data lead to larger estimations of incidence rates and are probably more valid than educators' data.
Detecting language disorders in 4‐year‐old French children. An application of the ERTL‐4
Authors: Maeder C , Roy B
Published: March 2003

This paper discusses the development of the ERTL‐4 (Epreuve de repérage des troubles du langage lors du bilan medical de l’enfant de quatre ans), a measure developed in Nancy, France specifically for the purpose of identifying children with language difficulties in the 3.9–4.6 years age range. The test has been designed to identify 10–15% of the population and allows the assessing primary care doctor to ascertain whether difficulties occur in language, voice, fluency, hearing or perception on the basis of a 5‐min assessment.
The effectiveness of routine health examinations at 2, 6, 9 and 12 months of age: experiences based on data from a Swedish county
Authors: Magnusson M , Persson K , Sundelin C
Published: March 2003

Aim The aim of this study was to elucidate the role of health surveillance for infants during the first year of life in detecting severe health problems. Two central questions were addressed: (1) what health problems were detected by routine health examinations at the Child Health Centre at the 2‐, 6‐ and 12‐month check‐ups by a physician and at the 9‐month check‐up by a nurse; and (2) to what extent did the health examinations contribute to early identification of children with following key abnormalities: congenital heart disease, congenital dislocation of the hip, abnormalities as registered at the habilitation centre and severe hearing impairments?

Material and inclusion criteria The study population included all children in Uppsala county, born January 1995 to October 1996, who had participated in at least one of the four health check‐ups. There were 3107–3487 children in the respective check‐ups.

Method Data from a county health register as well as child health records and information regarding referrals were analysed to categorize the health problems by type, severity and action taken. Data on children with key abnormalities were obtained from specialist units.

Results The rate of suspected new health problems varied between 1.9% and 2.8% at the respective check‐ups. Of the new problems detected by the physician, 21%–36% were false‐positive, 34%–44% were minor and 10%–15% were moderate. Only two severe health problems were detected among all the children during the four check‐ups. Of all key abnormalities, 20% were detected by way of child health surveillance during the first year of life.

Implications Severe health problems and key abnormalities in infants were detected only to a limited extent through routine health examinations at 2, 6, 9 and 12 months of age. The minor and moderate problems detected justify a health surveillance programme, but the organization and content of the programme could be reconsidered.
Growth of working boys in Jordan: a cross‐sectional survey using non‐working male siblings as comparisons
Authors: Hawamdeh H. , Spencer N.
Published: March 2003

Objectives
To study the effects of work on growth of Jordanian boys, aged 10–16 years, using non‐working male siblings as controls.

Setting
The Jordanian areas of Irbid, Jarash and the North Jordan Valley.

Study design
Cross‐sectional survey of working boys and their non‐working brothers.

Main outcomes
Height‐for‐age z‐score; weight‐for‐age z‐score.

Methods
Working boys (103) and non‐working male siblings (103) (nearest in age to the working child) were interviewed, with their mothers, in the family home. Heights and weights of the working boys and their non‐working male siblings were measured, and capillary blood was taken for packed‐cell volume estimation. Heights and weights were converted to z‐scores, and means for all three outcomes were compared between working boys and non‐working siblings, using independent sample t‐tests. The effect of the proportion of household income contributed by the working child’s income on the main outcomes, among non‐working siblings, was estimated by simple linear regression.

Results
Means for height‐for‐age z‐score (p < 0.001), weight‐for‐age z‐score (p < 0.001), and packed‐cell volume (p < 0.001) among working boys were significantly lower than means for their non‐working siblings. The main outcomes among non‐working siblings were not significantly correlated with the proportion of household income contributed by the working child.

Conclusions
The results of this study suggest that work among boys aged 10–16 years in Jordan puts them at increased risk of stunting, wasting and anaemia. Previous studies have suggested this relationship but have suffered from confounding by socioeconomic status. Comparison with non‐working siblings reduces the chances of socioeconomic status confounding.
Citizens advice in primary care for families with young children
Authors: Reading R. , Steel S. , Reynolds S.
Published: March 2003

BackgroundCitizens advice can help clients avoid the worst consequences of poverty and hence has the potential to reduce inequalities in health. Previous studies of providing citizens advice from primary care have concentrated largely on older clients.

AimTo measure the benefits obtained by families with young children from a citizens advice service in primary care.

MethodAn advice worker was placed in three practices. Eligible families had a child less than 1 year of age. Quantitative analysis of data on benefits obtained by all families using the service was performed. Qualitative analysis of interviews with five users and five non‐users of the service was undertaken.

ResultsOut of 107 families recruited, 23 used the CAB service, seeking advice on 49 different problems and obtaining benefit on 32 of these, most frequently on welfare benefits, debt management and housing. One‐off financial benefits totalled £17 857 with annual recurring payments of £6480. The interviews raised five general themes: (1) the stresses surrounding the birth of a child; (2) factors associated with uptake of the service; (3) the content and value of the advice received; (4) the benefits to their health of the advice; and (5) their perception of the links between health and financial adversity.

CondusionsCitizens advice offers considerable benefits to families with young children. It may have positive effects on maternal and child health. An advice service is a useful component of primary health care for young families.
Child/parent‐assessed population health outcome measures: a structured review
Authors: Schmidt L. J. , Garratt A. M. , Fitzpatrick R.
Published: March 2003

Aims To identify generic measures of health‐related quality of life (HRQL) for children and adolescents developed for use within general populations. Instruments are evaluated on the basis of evidence relating to their reliability and validity.

Methods Systematic literature searches were used to identify instruments, which were then assessed against predefined criteria. Information relating to instrument content, population, reliability and validity was extracted from published papers.

Results Sixteen instruments were identified that had been evaluated among a general population of children or adolescents. Four instruments had reported data on both internal consistency and test–retest reliability. All except two instruments had undergone some degree of construct validation.

Conclusions The evidence suggests that the Child Health Questionnaire (CHQ) has been the most extensively evaluated for younger populations but is available as a parent‐completed measure only. The new version of the Child Health and Illness Profile (CHIP‐CE) is particularly promising and has parallel child‐ and parent‐completed versions for young ages. The weight of evidence suggests that versions of these two instruments are suitable for older children. The Warwick Child Health and Morbidity Profile could be used where information on morbidity and health service contacts is required. Once basic psychometric criteria are fulfilled, instruments should be chosen by assessing their content and design in the light of the prospective application.
Omission of active commuting to school and the prevalence of children's health‐related physical activity levels: the Russian Longitudinal Monitoring Study
Authors: Tudor‐Locke C. , Neff L. J. , Ainsworth B. E. , Addy C. L. , Popkin B. M.
Published: March 2003

Background  Active commuting to school by walking or bicycle is a potential source of continuous moderate activity for children that has been largely ignored in surveys of physical activity. The purpose of this study was to evaluate the analytical impact of omitting active commuting to school (walking or bicycling) on conclusions about children's physical activity levels.

Methods The Russian Longitudinal Monitoring Study (RLMS) is the first nationally representative household survey in the Russian Federation. More than 6400 households from all regions of Russia were surveyed eight times between 1992 and 1998. Analysis was conducted using physical activity data (school physical education classes, out‐of‐school active pursuits and active commuting to school) obtained by parent‐proxy on 1094 (572 boys, 522 girls) school‐aged Russian children (mean age 10.2 ± 1.9 years) participating in the November 1998 round of the RLMS. Data were examined according to prevalence of achievement of health‐related physical activity guidelines, active commuting to school behaviours included then omitted.

Results Omitting active commuting to school resulted in a statistically significant decrease in the prevalence of achievement of health‐related guidelines from 12% to 20%, similar for both genders. Likewise, the prevalence of sedentarism (defined as not meeting any of the guidelines) was increased by 17–22%.

Conclusions The present findings suggest that, in order to avoid misclassification bias of children's physical activity levels, it is necessary to include questions about mode of commuting to school. The findings also carry practice implications: the commonplace need to get to and from school may be a missed opportunity for children's health‐related physical activity in motorized societies.
Domestic allergens in public places III: house dust mite, cat, dog and cockroach allergens in British hospitals
Authors: Custovic  , Fletcher  , Pickering  , Francis  , Green  , Smith  , Chapman  , Woodcock
Published: March 2003

Background

Exposure and sensitization to indoor allergens is a major cause of asthma.

Objectives

This study investigated the levels of house dust mite, cat, dog and cockroach allergens in the dust and air in hospitals and the effects of regular vacuum cleaning on allergen levels in hospital chairs.

Methods

Der p 1, Fel d 1, Can f 1 and Bla g 2 were measured in the dust collected by vacuuming upholstered chairs and a 1 m2 area of carpet and mattress in 14 hospitals. Air samples were collected using an air sampler (flow rate 60 L/min) on 10 separate days for 4 h in the outpatient department in one of the hospitals during busy clinics when patients were waiting for their appointments. In addition, dust samples were collected on four occasions, at 4‐weekly intervals, from 36 fabric covered chairs in the outpatient area of a busy chest clinic by vacuuming each chair for 2 min. During the intervening weeks, 18 of the chairs (active group) were each cleaned by vacuuming for 1 min, three times per week. Der p 1, Fel d 1, Can f 1 and Bla g 2 were assayed using monoclonal antibody‐based ELISA.

Results

In total, 83 carpets, 69 mattresses and 42 upholstered chairs were sampled. The levels of dust mite allergen Der p 1 and cockroach allergen Bla g 2 found in the hospital setting were low. High levels of Fel d 1 (GM 22.9 μg/g, range 4.5–58) and Can f 1 (GM 21.6 μg/g, range 4–63) were found in upholstered chairs. Airborne Can f 1 was detected on every occasion (range 0.12–0.56 ng/m3), whilst detectable airborne Fel d 1 was found on 7 out of the 10 sampling days (range 0.09–0.22 ng/m3). Der p 1 and Bla g 2 were below the detection limit in all airborne samples. Following repeated vacuuming the mean cat and dog allergen levels decreased significantly (P < 0.001) and were almost fivefold lower in the vacuumed chairs compared with the control group.

Conclusions

Low levels of mite allergen are unlikely to be of any clinical significance to mite‐sensitive asthmatic patients. However, upholstered chairs in hospitals constitute a significant reservoir of cat and dog allergen. Inhalation of airborne allergen in patients attending their hospital appointment may exacerbate asthma in those highly allergic to cats or dogs. These results question the wisdom of introducing soft furnishings and carpets into hospitals. Three‐times weekly vacuuming significantly reduces allergen levels in upholstered chairs.
Expression of aminopeptidase N and dipeptidyl peptidase IV in the healthy and asthmatic bronchus
Authors: Van Der Velden  , Wierenga‐Wolf  , Adriaansen‐Soeting  , Overbeek  , MÖller  , Hoogsteden  , Versnel
Published: March 2003

Background

Asthma is characterized by reversible airway obstruction, airway hyperresponsiveness, and chronic inflammation of the airways. Since peptides are able to produce many of the pathophysiological features which are characteristic of asthma, peptide‐mediated inflammation is thought to play a role in this disease. The effects of peptides are modulated by peptidases, which are able to degrade peptides, mostly resulting in their inactivation.

Objectives

In this study, we investigated the distribution of two peptidases, aminopeptidase N and dipeptidyl peptidase IV, in the human bronchus and determined whether their expression was altered in allergic asthmatics.

Methods

We first determined the distribution of aminopeptidase N and dipeptidyl peptidase IV in the human bronchus using immuno‐ and enzymehistochemistry and compared this with the distribution of neutral endopeptidase. Secondly, the expression of aminopeptidase N and dipeptidyl peptidase IV was determined in bronchial biopsies of healthy subjects (n = 8) and allergic asthmatics (n = 12).

Results

Aminopeptidase N was localized in connective tissue, blood vessels, gland ducts, perichondrium, nerves and leucocytes (mainly mononuclear phagocytes, dendritic cells, and eosinophils). Dipeptidyl peptidase IV was localized in serosal glands, blood vessels, and T cells. Immunohistochemistry and enzymehistochemistry gave similar results. Comparison of the expression of aminopeptidase N and dipeptidyl peptidase IV in bronchial biopsies of healthy controls and atopic asthmatics revealed no significant differences in the lamina propria. In contrast, in the bronchial epithelium of atopic asthmatics an increased number of aminopeptidase N‐positive cells could be found. Double‐staining identified these cells as L25+ dendritic cells and eosinophils.

Conclusions

We conclude that expression of aminopeptidase N and dipeptidyl peptidase IV is restricted to specific sites within the human bronchus. Furthermore, in the bronchial epithelium of allergic asthmatics an increased number of aminopeptidase N‐expressing dendritic cells and eosinophils can be found.
β2‐adrenoceptor polymorphisms are in linkage disequilibrium, but are not associated with asthma in an adult population
Authors: Dewar  , Wheatley  , Venn  , Morrison  , Britton  , Hall
Published: March 2003

Objective

To determine the association between the β2‐adrenoceptor polymorphisms at amino acids 16 and 27 and markers of allergic disease and asthma per se in a random adult population, and to determine the degree of linkage disequilibrium existing between polymorphisms at amino acid positions 16, 27, 164 and nucleic acid residue 523.

Methods

We measured serum IgE, skin‐prick test positivity, atopy, bronchial hyperreactivity, wheeze and asthma (self‐reported and doctor‐diagnosed), and determined β2‐adrenoceptor genotype by allele specific oligonucleotide hybridization, in 630 adults aged between 18 and 70, selected from the electoral role in a local health authority in Nottingham.

Results

Homozygotes for the Glycine 16 polymorphism had a significantly higher incidence of atopy (χ2 = 6.44 (Pearson's), P = 0.04). We also observed a significant association between the Glycine 16 allele and atopy (χ2 = 4.13 (Pearson's), P = 0.04), when we assumed the Glycine 16 allele to operate in a dominant mode. No other significant associations between β2‐adrenoceptor polymorphisms and markers of allergic disease and asthma per se were observed. Marked linkage disequilibrium exists between the β2‐adrenoceptor polymorphisms at amino acid 16 and 27 (D = 0.38, χ2P < 0.0001), and between the β2‐adrenoceptor polymorphisms at amino acid 27 and nucleic acid residue 523 (C‐A) (D = 0.36, χ2P < 0.0001).

Conclusion

There is no consistent association between β2‐adrenoceptor polymorphisms and the risk of developing allergic disease or asthma per se in this adult sample. Marked linkage disequilibrium exists between the amino acid 16 and 27 polymorphisms, and also between the amino acid 27 polymorphism and the nucleic acid residue 523 (C‐A) polymorphism. This polymorphism accounts for the Ban 1 RFLP previously described at the β2‐adrenoceptor locus on chromosome 5q 31.
Indoor airborne fungal spores, house dampness and associations with environmental factors and respiratory health in children
Authors: Garrett  , Rayment  , Hooper  , Abramson  , Hooper
Published: March 2003

Background

Children living in a damp house are more likely to suffer from respiratory symptoms and it has been suggested that exposure to fungi is an important contributing factor. However, more knowledge about underlying mechanisms for the association are needed.

Objective

To identify associations between measures of house dampness, levels of airborne fungal spores, housing factors and health outcomes in children.

Methods

Eighty households with 148 children between 7 and 14 years of age were recruited in the Latrobe Valley, Victoria, Australia. Some 36% of participating children were asthmatic. Six sampling visits were made to each house between March 1994 and February 1995 on a 2‐monthly cycle. Samples for airborne total and viable fungal spores were collected from bedrooms, living rooms, kitchens and outdoors. A detailed dwelling characterization, using a questionnaire and inspection surveys, was carried out. Skin‐prick tests were performed with extracts of common aeroallergens and a respiratory questionnaire was completed for each child.

Results

Large airborne fungal spore concentrations were recorded in association with: musty odour, water intrusion, high indoor humidity, limited ventilation through open windows, few extractor fans and failure to remove indoor mould growth. Visible mould growth or condensation evidence was associated with large concentrationsof Cladosporium spores, but not with large total spore concentrations. Penicillium exposure was a risk factor for asthma, while Aspergillus exposure was a risk factor for atopy. Fungal allergies were more common among children exposed to Cladosporium or Penicillium in winter or to musty odour. Respiratory symptoms were marginally more common with exposure to Cladosporium or total spores in winter.

Conclusion

Indoor exposure to certain fungal genera in winter was a risk factor for asthma, atopy and respiratory symptoms in children. On the other hand, no significant associations were seen between average viable or total spore concentrations and child health. Actual measurements of fungal spores predict health outcomes better than reported dampness.
Exclusion of chromosome 11q and the FcεRI‐β gene as aetiological factors in allergy and asthma in a population of Dutch asthmatic families
Authors: Amelung  , Postma  , XU  , Meyers  , Bleecker
Published: March 2003

Background

The β subunit of the high‐affinity receptor for IgE (FcεRI‐β) is localized to chromosome 11q13 and has been reported by Cookson et al. to be in close genetic linkage with a gene for atopy. A maternally inherited association was found between the presence of a variant of FcεRI‐β, Ile181Leu, and high total serum IgE levels (IgE  >  100 IU). In a previous study of 20 Dutch families, we found no evidence for linkage of atopy or bronchial hyperresponsiveness (BHR) to chromosome 11q.

Objective

Recently segregation analysis in 92 families has given us evidence for two independent major loci accounting for 78% of the observed variance in total serum IgE levels, and linkage analysis using both sib‐pair and LOD score methods has identified one major locus for regulation of IgE levels and BHR near the cytokine gene complex on chromosome 5q. The objective of this study is to pursue the identification of the second major locus.

Methods

We have studied markers in the area of the high affinity IgE receptor (FcεRI‐β) on chromosome 11q (D11S1314, FcεRI‐β and D11S987) in 83 families for whom DNA was available. Furthermore, our families have been examined for variance in the FcεRI‐β gene, specifically for Leu181 and Leu181/Leu183 mutations.

Results

By sib‐pair analysis, there is no evidence for linkage of total serum IgE levels or number of positive skin tests to these markers in our population. Similar negative results were obtained for affected sib‐pair analysis of BHR, with the exception of D11S1314, which was significant at P  =  0.046. The FcεR1‐β gene in 36 female probands, 44 male probands and 46 female spouses was sequenced for these mutations. For each of these 126 individuals sequencing of FcεRI‐β demonstrated a wild‐type sequence pattern, with no mutations found in anyone, male or female.

Conclusion

We are unable to confirm the presence of significant mutations in FcεR1‐β gene in our population, and we cannot confirm that the FcεR1‐β gene is crucial to the pathogenesis of allergic inflammation in asthma.
Increased nitric oxide in nasal lavage fluid and nitrotyrosine formation in nasal mucosa — indices for severe perennial nasal allergy
Authors: Sato  , Fukuyama  , Sakai  , Nakazawa
Published: March 2003

Background

The nose contributes the large amount of nitric oxide (NO) to exhaled air. NO is a mediator of vasodilation and yields peroxynitrite (ONOO−) by reacting with superoxide (O−2). ONOO− attacks tyrosine residues to form nitrotyrosine.

Objective

The aim of this study was to examine the pathophysiological role of NO in nasal mucosa in patients with perennial nasal allergy.

Methods

We measured nitrite and nitrate (NO−2/NO−3) and 3′,5′‐guanosine monophosphate (cyclic GMP) in nasal lavage fluid, and also measured haemoglobin concentration in nasal mucosa as an indicator of blood volume in the patients and healthy volunteers. The deleterious role of NO was also investigated by measuring nitrotyrosine in nasal mucosa.

Results

The NO−2/NO−3 concentration in the nasal lavage fluid was 39.5 ± 2.8 μM in healthy volunteers (n = 40), 42.4 ± 3.0 μM in patients with mild allergy (mild group, n = 32), and 88.7 ± 6.6 μM in patients with severe allergy (severe group, n = 61). In the patients whose symptoms were improved with treatment, NO−2/NO−3 levels decreased to 45.7 ± 10.4 μM. The concentration of cyclic GMP in nasal lavage fluid was higher in the severe group than in the healthy volunteers. The mucosal haemoglobin index was 88 ± 4 in the healthy volunteers, 67 ± 4 in the mild group, and 53 ± 2 in the severe group. The formation of nitrotyrosine was expressed 0.58 ± 0.10% to total tyrosine in the severe group (n = 11), but was not found in non‐allergy patients (n = 9).

Conclusions

The production of NO was increased in patients with perennial nasal allergy, but the blood flow in the nasal mucosa of patients was reduced. Nitrotyrosine formation suggests that there is a process of ONOO−‐induced damage in mucosa of patients with the perennial nasal allergy and this damage may limit the dilatation of blood vessels, despite the presence of excessive NO.
Increased production of endogenous nitric oxide in patients with bronchial asthma and chronic obstructive pulmonary disease
Authors: Kanazawa  , Shoji  , Yoshikawa  , Hirata  , Yoshikawa
Published: March 2003

Background

Nitric oxide (NO) plays an important role as an inflammatory mediator in the airways. Though direct measurement of endogenous NO has been difficult in humans, we have recently found that measurement of NO derivatives in induced sputum may be useful for assessing airway inflammation in asthmatic patients.

Objective

This study was designed to determine the direct in vivo evidence of increased production of endogenous NO in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD).

Methods

We have investigated simultaneous assessment of NO using two non‐invasive methods, such as NO level in exhaled air and induced sputum, in these patients. We determined the concentration of stable end‐products of NO (nitrite plus nitrate) in induced sputum and exhaled NO concentration using a chemiluminescence analyser in 10 normal controls, 10 asthmatic patients and 11 patients with COPD, and evaluated whether endogenous NO levels correlate with percentage of neutrophils and interleukin‐8 (IL‐8) level in induced sputum in patients with COPD.

Results

We found significantly higher concentrations of exhaled NO in patients with bronchial asthma (25.1 [5.1] p.p.b.) than in patients with COPD (12.1 [1.9] p.p.b.) and normal controls (5.2 [1.4] p.p.b.). However, higher concentrations of NO derivatives in induced sputum were found in patients with bronchial asthma (1190 [106] μmol/L) and COPD (950 [105] μmol/L) than in normal controls (514 [30] μmol/L). In patients with asthma, but not in those with COPD, concentrations of NO derivatives in induced sputum were significantly correlated with concentrations of exhaled NO (r = 0.64, P < 0.05). Moreover, in patients with COPD, concentrations of NO derivatives in induced sputum were significantly correlated with percentage of neutrophils (r = 0.71, P < 0.05) and IL‐8 level (r = 0.80, P < 0.01).

Conclusion

We conclude the increased production of endogenous NO in patients with asthma and COPD, and that NO derivatives in induced sputum are more valuable than exhaled NO in assessing airway inflammation in patients with COPD.