bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Use of Acute Headache Medication: A Qualitative Examination of Behaviors and Barriers to Their Performance
Authors: Seng Elizabeth K. , Holroyd Kenneth A.
Published: June 2013

Objective

This study aims to qualitatively examine the behaviors required to optimally use acute headache medication and the barriers to successful performance of these behaviors.

Background

The efficacy of drug treatment is partly determined by medication adherence. The adherence literature has focused almost exclusively on the behaviors required to optimally use medications that are taken on a fixed schedule, as opposed to medications taken on an as needed basis to treat acute episodes of symptoms, such as headaches.

Methods

Twenty‐one people with headache and 15 health care providers participated in qualitative phenomenological interviews that were transcribed and coded by a multidisciplinary research team using phenomenological analysis.

Results

Interviews revealed 8 behaviors required to optimally use acute headache medication, including cross‐episode behaviors that people with headache regularly perform to ensure optimal acute headache medication use, and episode‐specific behaviors used to treat an individual headache episode. Interviews further revealed 9 barriers that hinder successful performance of these behaviors.

Conclusions

Behaviors required to optimally use acute headache medication were numerous, often embedded in a larger chain of behaviors, and were susceptible to disruption by numerous barriers.
Effects of Acetaminophen and Ibuprofen in Children With Migraine Receiving Preventive Treatment With Magnesium
Authors: Gallelli Luca , Avenoso Tiziana , Falcone Daniela , Palleria Caterina , Peltrone Francesco , Esposito Maria , De Sarro Giovambattista , Carotenuto Marco , Guidetti Vincenzo
Published: June 2013

Aim

The purpose of this study was to evaluate both the effects of ibuprofen and/or acetaminophen for the acute treatment of primary migraine in children in or out prophylactic treatment with magnesium.

Methods

Children ranging from the ages of 5 to 16 years with at least 4 attack/month of primary migraine were eligible for participation the study. A visual analog scale was used to evaluate pain intensity at the moment of admission to the study (start of the study) and every month up to 18 months later (end of the study).

Results

One hundred sixty children of both sexes aged 5‐16 years were enrolled and assigned in 4 groups to receive a treatment with acetaminophen or ibuprofen without or with magnesium. Migraine pain endurance and monthly frequency were similar in the 4 groups. Both acetaminophen and ibuprofen induced a significant decrease in pain intensity (P < .01), without a time‐dependent correlation, but did not modify its frequency. Magnesium pretreatment induced a significant decrease in pain intensity (P < .01) without a time‐dependent correlation in both acetaminophen‐ and ibuprofen‐treated children and also significantly reduced (P < .01) the pain relief timing during acetaminophen but not during ibuprofen treatment (P < .01). In both acetaminophen and ibuprofen groups, magnesium pretreatment significantly reduced the pain frequency (P < .01).

Conclusions

Magnesium increased the efficacy of ibuprofen and acetaminophen with not age‐related effects.
Migraine Management in Community Pharmacies: Practice Patterns and Knowledge of Pharmacy Personnel in Thailand
Authors: Saengcharoen Woranuch , Lerkiatbundit Sanguan
Published: June 2013

Objectives

To describe practice behavior and understanding among pharmacy personnel, both pharmacists and non‐pharmacist staff, in the management of mild and moderate migraines.

Background

Migraine is recognized as a prevalent and chronic neurological disorder. In developing countries, such as Thailand, community pharmacies are a widely used source of health care for various illnesses including migraine. However, the quality of migraine management and knowledge among pharmacy personnel is unclear.

Methods

Cross‐sectional study. The sample comprised 142 randomly selected community pharmacies in a city in the south of Thailand. Simulated clients visited the pharmacies twice, at least 1 month apart, to ask for the treatment of mild and moderate migraines. After the encounters, question asking, drug dispensing, and advice giving by pharmacy staff were recorded. Subsequently, the providers in 135 pharmacies participated in the interview to evaluate their knowledge in migraine management.

Results

The majority of pharmacy personnel were less likely to ask questions in cases of mild migraine when compared with moderate attack (mean score [full score = 12] 1.8 ± 1.6 vs 2.6 ± 1.5, respectively, P < 0.001). Mean difference of question asking between mild and moderate migraines was −0.8 (95% confidence interval −1.1 to −0.5, P < 0.001). Approximately 33% and 54% of the providers appropriately dispensed non‐steroidal anti‐inflammatory drugs for mild attack and ergotamine for moderate migraine, respectively, P < 0.001. Prophylactic medications (eg, atenolol, propranolol, flunarizine) were inappropriately recommended, particularly in moderate attack (28.2% vs 17.6% in mild migraine, P = 0.018). Less than 30% of providers advised the patients on the maximum limit of dose or discontinuity of medications when recovered. Compared with non‐pharmacists, pharmacists tended to ask more questions, give more advice, and dispense less appropriately; however, there were no significant differences. The results from the interview showed that most pharmacy personnel had inadequate knowledge on migraine management. Pharmacists had better knowledge on question asking (mild migraine 5.1 ± 2.1 vs 3.1 ± 1.3, respectively, P < .001; moderate disorder 6.5 ± 3.1 vs 3.9 ± 2.1, respectively, P < .001) and tended to have more knowledge on advice giving but poorer drug dispensing in moderate migraine according to the guidelines, relative to non‐pharmacists (20.5% vs 40.3%, P = .014).

Conclusions

A large number of community pharmacists and non‐pharmacist staff had inappropriate practice behavior and understanding. Continuing education and interventions are important to improve the practice and knowledge of pharmacy personnel, particularly the pharmacists.
The Risk of Headache Attributed to Surgical Treatment of Intracranial Aneurysms: A Cohort Study
Authors: Magalhães João E. , Azevedo‐Filho Hildo R. C. , Rocha‐Filho Pedro A. S.
Published: June 2013

Objectives

The aim of this study was to assess the risk of headache in patients undergoing surgical treatment of intracranial aneurysms.

Background

The risk of the post‐craniotomy headache has never been studied.

Methods

Patients with intracranial aneurysm, who were consecutively admitted to the Hospital da Restauração, Brazil, from May 2009 to October 2010, were interviewed before they underwent surgical or non‐surgical treatment of the aneurysms. The patients were followed for 4 months after intervention. The International Headache Society criteria for post‐craniotomy headache were used after surgery and adapted for headache after embolization (maximum intensity of pain on the same side of the aneurysm). We also used the Headache Impact Test, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale.

Results

Of 101 patients enrolled, 53 patients underwent craniotomy and 48 patients embolization. The surgery group was younger and had fewer women. The incidence of headache was 28/51 cases (54.9%) after surgery and 12/47 cases (25.5%) after embolization (relative risk = 2.15; 95% confidence interval [CI] 1.24‐3.72). The incidence of persistent headache was not different between the 2 groups. The only risk factor for headache after the intervention was craniotomy (odds ratio = 2.6; 95% CI 1.1‐6.7) and for persistent headache was anxiety prior to treatment (odds ratio = 8.5; 95% CI 1.7‐42.3). The headache after treatment was not associated with the risk of anxiety or depression after the intervention.

Conclusions

Patients who underwent craniotomy had an increased risk of headache after treatment of intracranial aneurysms. The incidence of persistent headache after 3 months was higher among patients who had anxiety before the intervention.
Clinical Implications for Breath‐Powered Powder Sumatriptan Intranasal Treatment
Authors: Tepper Stewart J.
Published: June 2013

The acute treatment of migraine requires matching patient need to drug and formulation. In particular, nausea and vomiting, quick time to peak intensity, and the common gastroparesis of migraineurs, all call for a variety of non‐oral formulations for treatment of attacks. A novel breath‐powered powder sumatriptan intranasal treatment offers an improvement, at least in pharmacokinetics, over conventional liquid nasal sumatriptan spray.

The device for delivery in this breath‐powered nasal sumatriptan uses natural nose anatomy to close the soft palate and propel the sumatriptan high up in the nasal cavity on one side with bidirectional airflow coming out the other side. This approach has the potential to reduce adverse events and improve efficacy. Phase 3 data on this system are in press at the time of this writing and results appear promising.

The clinical role for a fast acting non‐oral nasal formulation will be in those for whom tablets are bound to fail, that is, in the setting of nausea and vomiting or when the time to central sensitization, allodynia, and disabling migraine is too short for the patient to respond to a tablet. This review provides a clinical perspective on the breath‐powered powder sumatriptan intranasal treatment.
Population size and survival estimates for the rare damselflies, Coenagrion mercuriale and Ischnura pumilio
Authors: Allen Katherine A. , Thompson David J.
Published: June 2013

Coenagrion mercuriale is rare in the UK and is threatened across Europe. Ischnura pumilio is also threatened in the UK. Both species have suffered population declines in recent years and are vulnerable to habitat fragmentation and loss. Yet, reliable population size and survival estimates are scarce in odonate species. This study provides mark–release–recapture estimates of these parameters for UK stronghold populations of both species.

Surveys were performed at four locations in southern England between 2001 and 2006. A total of 12 071 adult individuals were marked across nine populations. Mark–release–recapture modelling techniques were used to provide survival and recapture probabilities and population size estimates.

This study presents the first Horvitz–Thompson estimates of population size in odonates, which are among the highest reported for damselflies. Maximum estimates for a single site were 63 662 ± 4997 for C. mercuriale and 7453 ± 382 for I. pumilio. More males than females were captured at all sites, but calculated estimates indicated a female‐biased sex ratio in adult I. pumilio at one location.

Daily survival probability is among the highest published for damselflies. Male and female survival was equal or very similar in all populations. Further effects of maturity, age, site, and time on survival were identified.

Estimated population sizes are much greater than previously thought, suggesting that where habitat is maintained, populations of threatened odonates can be very large. Furthermore, greater proportions of females have been estimated where wider searching techniques were employed. This has implications for future study design if estimates are to be reliably used for conservation management.
Accuracy of noninvasive hemoglobin and invasive point‐of‐care hemoglobin testing compared with a laboratory analyzer
Authors: Shah N. , Osea E. A. , Martinez G. J.
Published: June 2013

Introduction

Hemoglobin concentration is assessed to detect anemia and its associated morbidities. Hemoglobin is usually determined from venous or capillary blood samples run on a laboratory analyzer. However, this method requires a needle stick and results can be delayed. It also exposes caregivers to risks associated with needle sticks and blood exposure. Noninvasive hemoglobin determination would be of benefit to patients and caregivers because it would allow for quick and painless point‐of‐care assessment.

Methods

Hemoglobin determination from a noninvasive spot check hemoglobin device (Pronto‐7 with SpHb, Masimo) and an invasive point‐of‐care device (HemoCue) was compared with venous blood samples run on a laboratory hematology analyzer.

Results

A total of 440 outpatients and healthy volunteers were included (mean age 36 years, 62% female). Compared with the hematology analyzer, the bias ± standard deviation of was −0.1 ± 1.1 g/dL for SpHb and −0.1 ± 1.6 g/dL for HemoCue.

Conclusion

Noninvasive hemoglobin testing with SpHb provided similar accuracy as invasive point‐of‐care hemoglobin testing and may enable more efficient and effective patient care.
Determination of the relative bioavailability of salbutamol to the lung following inhalation [see comments]
Authors: Hindle M , Chrystyn H
Published: June 2013

1. The urinary excretion of salbutamol and its sulphate metabolite was measured following oral (4 mg) and inhaled (4 × 100 micrograms) administration of salbutamol. 2. Total urinary recovery of salbutamol and its sulphate conjugate indicated a mean (s.d.) relative bioavailability of 92.2 (24.8) % following inhalation compared with oral administration. 3. The mean (s.d.) elimination half‐lives of salbutamol and its sulphate conjugate were 5.7 (1.4) and 4.1 (2.1) h, respectively, after oral administration and following inhalation they were 6.1 (2.1) and 5.1 (1.0) h, respectively. 4. Following oral and inhaled administration it was found that in the first 30 min the mean (s.d.) percentage of the dose excreted in the urine as unchanged salbutamol was 0.18 (0.14) and 2.06 (0.80) %, respectively (P < 0.01). The drug content of a urine sample taken 30 min after inhalation is, therefore, considered to be representative of the amount of drug delivered to the lungs. It is proposed that this method can be used to evaluate the relative bioavailability of salbutamol to the lung following inhalation by different techniques and devices.
A Comparison of DEM‐Based Indexes for Targeting the Placement of Vegetative Buffers in Agricultural Watersheds
Authors: Dosskey Michael G. , Qiu Zeyuan , Kang Yang
Published: June 2013

Targeted placement of vegetative buffers may increase their effectiveness for improving water quality in agricultural watersheds. The use of digital elevation models (DEMs) enables precise mapping of runoff pathways for identifying where greater runoff loads can be intercepted and treated with buffers. Five different DEM‐based targeting indexes were compared and contrasted for the degree to which they identify similar locations in watersheds: Flow Accumulation [S.K. Jenson and J.O. Domingue (1988). Photogrammetric Engineering and Remote Sensing 54:1593], Wetness Index [I.D. Moore, R.B. Grayson, and A.R. Ladson (1991). Hydrological Processes 5:3], Topographic Index [M.T. Walter, T.S. Steenhuis, V.K. Mehta, D. Thongs, M. Zion, and E. Schneiderman (2002). Hydrological Processes 16:2041], and the Water Inflow and Sediment Retention Indexes [M.G. Dosskey, Z. Qiu, M.J. Helmers, and D.E. Eisenhauer (2011b). Journal of Soil and Water Conservation 66:362]. The indexes were applied in two different watersheds, one in New Jersey and one in Missouri. Results showed that they all tend to target similar locations in both watersheds which traces to the importance of larger contributing area to the rankings by each index. Disagreement among indexes traces to other variables which enable more accurate targeting under particular hydrologic circumstances. Effective use of these indexes poses special challenges, including selecting an index that better describes the hydrologic circumstances in a watershed and is simple enough to use, ensuring the accuracy of the DEM, and determining a maximum index value for the appropriateness of vegetative buffers. When properly applied, each index can provide a standardized basis and effective spatial resolution for targeting buffer placement in watersheds.
Streamflow Responses to Climate Change: Analysis of Hydrologic Indicators in a New York City Water Supply Watershed
Authors: Pradhanang Soni M. , Mukundan Rajith , Schneiderman Elliot M. , Zion Mark S. , Anandhi Aavudai , Pierson Donald C. , Frei Allan , Easton Zachary M. , Fuka Daniel , Steenhuis Tammo S.
Published: June 2013

Recent works have indicated that climate change in the northeastern United States is already being observed in the form of shorter winters, higher annual average air temperature, and more frequent extreme heat and precipitation events. These changes could have profound effects on aquatic ecosystems, and the implications of such changes are less understood. The objective of this study was to examine how future changes in precipitation and temperature translate into changes in streamflow using a physically based semidistributed model, and subsequently how changes in streamflow could potentially impact stream ecology. Streamflow parameters were examined in a New York City water supply watershed for changes from model‐simulated baseline conditions to future climate scenarios (2081‐2100) for ecologically relevant factors of streamflow using the Indicators of Hydrologic Alterations tool. Results indicate that earlier snowmelt and reduced snowpack advance the timing and increase the magnitude of discharge in the winter and early spring (November‐March) and greatly decrease monthly streamflow later in the spring in April. Both the rise and fall rates of the hydrograph will increase resulting in increased flashiness and flow reversals primarily due to increased pulses during winter seasons. These shifts in timing of peak flows, changes in seasonal flow regimes, and changes in the magnitudes of low flow can all influence aquatic organisms and have the potential to impact stream ecology.
Gene–environment interactions in genome‐wide association studies: current approaches and new directions
Authors: Winham Stacey J. , Biernacka Joanna M.
Published: June 2013

Background

Complex psychiatric traits have long been thought to be the result of a combination of genetic and environmental factors, and gene–environment interactions are thought to play a crucial role in behavioral phenotypes and the susceptibility and progression of psychiatric disorders. Candidate gene studies to investigate hypothesized gene–environment interactions are now fairly common in human genetic research, and with the shift toward genome‐wide association studies, genome‐wide gene–environment interaction studies are beginning to emerge.

Methods

We summarize the basic ideas behind gene–environment interaction, and provide an overview of possible study designs and traditional analysis methods in the context of genome‐wide analysis. We then discuss novel approaches beyond the traditional strategy of analyzing the interaction between the environmental factor and each polymorphism individually.

Results

Two‐step filtering approaches that reduce the number of polymorphisms tested for interactions can substantially increase the power of genome‐wide gene–environment studies. New analytical methods including data‐mining approaches, and gene‐level and pathway‐level analyses, also have the capacity to improve our understanding of how complex genetic and environmental factors interact to influence psychologic and psychiatric traits. Such methods, however, have not yet been utilized much in behavioral and mental health research.

Conclusions

Although methods to investigate gene–environment interactions are available, there is a need for further development and extension of these methods to identify gene–environment interactions in the context of genome‐wide association studies. These novel approaches need to be applied in studies of psychology and psychiatry.
Effects of walking on medical cost: A quantitative evaluation by simulation focusing on diabetes
Authors: Kato Masayuki , Goto Atsushi , Tanaka Takahisa , Sasaki Satoshi , Igata Akihiro , Noda Mitsuhiko
Published: June 2013

Aims/Introduction

Recently, the prevalence of lifestyle‐related disease has increased, and its associated medical costs have become considerable. Although walking is thought to prevent lifestyle‐related disease, few studies have evaluated its effect on medical costs in Japanese subjects. We aimed at evaluating the effect of walking on medical costs by simulation mainly focusing on diabetes in the Japanese population.

Materials and Methods

A Markov model focusing on diabetes was constructed. As complications of diabetes, ‘dialysis’, ‘ischemic heart disease’ and ‘stroke’ were included. The model has four states: ‘non‐diabetes’, ‘diabetes’, ‘dialysis’ and ‘dead’, and ‘ischemic heart disease’ and ‘stroke’ were included as events that occurred in each state. The effect of walking was included as changing the rate of transition and incident rates of events.

Results

After 10 years, the numbers of subjects with diabetes were 4.3 and 7.3% lower for daily increase of 3,000 and 5,000 steps, respectively. The numbers of cases of ischemic heart disease and stroke also decreased. Lower medical costs were also seen according to the daily increase in steps. In 10 years, the total medical costs were 5.2 and 8.4% lower for 3,000 and 5,000 steps increase, respectively. The cost reduction associated with a daily increase of 3,000 steps walked was calculated as ¥0.00146 for each step.

Conclusions

Walking is one of the most common and accessible forms of exercises. The present results suggested that walking reduced the medical costs associated with lifestyle‐related disease, which will have a large impact on health policy.
Hospital charitable lotteries: taking a gamble on systems thinking
Authors: Reynolds Jennifer
Published: June 2013

Rationale, aims and objectives

The presence of lotteries can be witnessed worldwide. Charitable lotteries are often portrayed as ‘good works’, and recently, hospitals have utilized them as a popular fundraising vehicle to raise necessary funds to help achieve organizational goals and objectives. Research indicates that lotteries contribute to gambling‐related harms; however, research into charitable lotteries has been underdeveloped. Both the gambling and the health care industries are complex and evolving, consisting of many interacting stakeholders with often different and competing interests. This article seeks to present systems thinking as a conceptual framework to help fill the gap in understanding the use of gambling within hospitals and its possible benefits and unforeseen negative consequences. Addressing the gap in knowledge is important to help inform decision making aimed at reducing gambling‐related harms.

Method

This article proposes how the school of systems thinking, specifically framing hospitals as complex adaptive systems and system dynamics modelling, can be utilized to understand the policy implications of the adoption of lotteries as a revenue source for hospitals.

Conclusion

Hospitals have a duty to care, inform and protect. Hospital charitable lotteries have become big business; however, its incorporation into critical funding strategies needs to be carefully understood. Systems thinking theory and methodologies provide an integrated approach to examine this dynamic and evolving fundraising initiative. Findings from this article can inform the development of action strategies, including policy development at multiple levels.
Selective application of a total variation diminishing term to an implicit method for two‐dimensional flow modelling
Authors: Ransom O. , Younis B.A.
Published: June 2013

An implicit method with selective total variation diminishing (TVD) term inclusion was developed and used to find solutions to the shallow water equations (SWEs) for free‐surface flows in natural and engineered channels. The conservative form of the SWEs was employed, and the method incorporated an algorithm for selectively underrelaxing the iterative process to maintain stability and accuracy in the presence of shock interfaces. The value of theCourant number and the frequency at which theTVDterm was incorporated were constantly updated during the computation to achieve optimal speed of execution while maintaining stability. The method was tested against published results from physical experiments and from computations employing alternative algorithms, and the results obtained demonstrate both the economy and accuracy of the proposed algorithm.
An inventory of flood events in Athens, Greece, during the last 130 years. Seasonality and spatial distribution
Authors: Diakakis M.
Published: June 2013

This work focuses on flooding phenomena in Athens metropolitan area in Greece. To this end, based on a flood‐event database aggregated with civil protection and documentary spatial evidence, an exhaustive inventory of floods in the area is developed, including events not previously studied. Fifty‐two floods are identified between 1880 and 2010, in various locations around Athens basin, which caused 182 casualties and substantial damage. Analysis of the inventory shows an increase in flood occurrence during autumn, especially November, and a rise in flood frequency in recent decades. Spatial information is used to identify the segments of the drainage network that overflowed in each of these flooding episodes. Geographic information system‐based spatial analysis of all the events indicates that certain sections of the drainage network, particularly in the central and north‐western parts of the study area, are the most vulnerable to flood phenomena.
Simulating storm flooding maps over HafenCity under present and sea level rise scenarios
Authors: Ge J. , Much D. , Kappenberg J. , Nino O. , Ding P. , Chen Z.
Published: June 2013

Global climate models have predicted a mean sea level rise between 0.18 m and 0.59 m by the end of the 21st century with high regional variability. The projected sea level rise due to global warming would inundate low‐lying areas. A high‐resolution unstructured‐grid Finite‐Volume Coastal and Ocean Model is applied to perform a simulation and prediction of the flooding process because of storm impacts around HafenCity under today's conditions and under scenarios of future sea level rise. The results show significant flooding under strong storm processes, such as the winter storm ‘Anatol’ in 1999. The flood coverage will be significantly increased under short‐, middle‐ and long‐term sea level rise scenarios. The peak flood levels will rise according to the respective sea level rise while the flood area will increase by 18% (2025), 34% (2055) and 54% (2085). The maximum flood height and area for the three sea level rise scenarios will reach ∼6.8 m and ∼4.1 × 105 m2, respectively. The most impacted area will be the region between the Baakenhafen (zone 12) and the Oberhafen/Oberhafenkanal. In the long‐term scenario (2085), flooding near the Magdeburger Hafen and Norderelbe will also increase. Coastal defence measures should be taken to ensure flood protection around HafenCity.
Liver fibrosis progression in chronic hepatitis B patients positive for hepatitis B e antigen: A prospective cohort study with paired transient elastography examination
Authors: Wong Grace Lai‐Hung , Chan Henry Lik‐Yuen , Yu Zhuo , Chan Hoi‐Yun , Tse Chi‐Hang , Wong Vincent Wai‐Sun
Published: June 2013

Background and Aim

Chronic hepatitis B patients in immune‐reactive hepatitis B e antigen (HBeAg)‐positive phase may have more rapid progression than those in immune‐tolerant phase. We aimed to evaluate the risk of liver fibrosis progression in HBeAg‐positive patients at different phases.

Methods

Two hundred forty‐seven HBeAg‐positive patients without advanced fibrosis at baseline underwent liver stiffness measurement (LSM) by transient elastography in 2006–2008 and again in 2010–2012. Liver fibrosis progression was defined as increase in LSM by 30% or more to levels suggestive of advanced fibrosis at the second assessment.

Results

At baseline, the mean age was 38 ± 11 years, 58% were males, alanine aminotransferase (ALT) was 65 ± 52 IU/L, hepatitis B virus DNA was 4.2 ± 1.2 log IU/mL, and LSM was 6.3 ± 2.1 kPa. At an interval of 42 ± 6 months, 13 patients (5.2%) developed liver fibrosis progression, and 106 patients (42.9%) required antiviral therapy. None of the clinical parameters (e.g. gender, age, ALT, hepatitis B virus DNA, hepatitis B surface antigen level, etc.) was associated with liver fibrosis progression. Among 74 and 137 patients in immune‐tolerant and immune‐reactive phase, 4.1% and 6.6% had liver fibrosis progression, and 12.2% and 67.2% received antiviral therapy respectively (P = 0.45 and P < 0.001). Immune‐tolerant patients with low‐normal (< 0.5× upper limit of normal) or high‐normal ALT (0.5–1× upper limit of normal) also had similar risk of liver fibrosis progression (5.7% vs 2.6%; P = 0.49).

Conclusions

Liver fibrosis progression is uncommon in HBeAg‐positive patients. Patients in immune‐reactive phase treated with antiviral therapy did not have increased risk of liver fibrosis progression.
Aberrant cytokeratin expression as a possible prognostic predictor in poorly differentiated colorectal carcinoma
Authors: Yamagishi Hidetsugu , Imai Yasuo , Okamura Takuya , Fukuda Kazunori , Ono Yuko , Ban Shinichi , Inoue Tohru , Ueda Yoshihiko
Published: June 2013

Background and Aim

The cytokeratin (CK)7−/CK20+ immunoprofile is characteristic of colorectal carcinoma (CRC), although CK7+ or CK20− phenotypes are occasionally encountered, particularly in histologically variant CRCs. We analyzed CK7/CK20 profiles in variant CRCs in association with clinicopathologic parameters and prognosis.

Methods

CK expression in well‐ and moderately differentiated adenocarcinoma (WMDA) (n = 63), poorly differentiated adenocarcinoma (PDA) (n = 91), mucinous adenocarcinoma (MUA) (n = 81), signet‐ring cell carcinoma (SRCC) (n = 15), undifferentiated carcinoma (UDC) (n = 12), and adenosquamous carcinoma (n = 2) was analyzed using immunohistochemistry. Cut‐off scores were set at 1% for CK7 and 25% for CK20 using the receiver operating characteristic curve analysis of PDA. Association between CK20− and better prognosis in PDA was validated in the second cohort (n = 66).

Results

CK7/CK20 immunoprofiling revealed a predominant CK7−/CK20+ profile in WMDA, MUA, and SRCC, while the majority of UDC was characterized by a CK7−/CK20− profile. The CK7/CK20 profile in PDA was variable. Contingency table analysis revealed that CK expression was not significantly associated with any clinicopathologic parameters in WMDA, PDA, and MUA. However, survival analysis demonstrated that CK20− was significantly associated with better prognosis in PDA. Although CK20− was significantly associated with mismatch repair deficiency in PDA, it was an independent prognostic factor in multivariate analysis. Finally, we confirmed that CK20 status, determined using a 25% cut‐off score, was a significant prognostic parameter in the second PDA cohort.

Conclusions

CK20 status may be used as a prognostic predictor of PDA.
Portion weights of food served in English schools: have they changed following the introduction of nutrient‐based standards?
Authors: Pearce J. , Wood L. , Stevens L.
Published: June 2013

Background

Mandatory food‐based and nutrient‐based standards for the food provided in English schools were introduced in 2008 (primary) and 2009 (secondary) and have had a positive impact on pupils' food choice and nutrient intake at school. There are no recommendations for portion sizes in England, although anecdotal evidence suggests that portions of food and drink sold in schools have decreased since the standards were introduced.

Methods

Data were collected from 136 primary and 80 secondary schools in 2009 and 2010/11, respectively. All food and drink items provided at lunchtime were weighed on five consecutive days at each school. The mean and median weight, SD, and 25th and 75th centile for each individual food were calculated. Data were compared with the results obtained from similar surveys in 2004 and 2005, as well as with portion size recommendations for Scottish schools.

Results

The proportion of food items that differed in weight since 2004/05 varied from 13% in primary schools to 29% in secondary schools. Changes in weight were equally likely to be positive or negative, with the exception of portions of fruit and vegetables, which had decreased. Primary schools were more likely to meet portion size recommendations than secondary schools.

Conclusions

Of the items that were directly comparable over time, a limited number showed a significant change in portion size since the standards for school food were introduced. Portion weight recommendations are based on a balanced healthy diet, and pupils should eat all the components of meals offered by schools to meet dietary recommendations.
Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age
Authors: Eeltink Corien M , Incrocci Luca , Witte Birgit I , Meurs Saskia , Visser Otto , Huijgens Peter , Verdonck‐de Leeuw Irma M
Published: June 2013

Aims and objectives

To assess the perceived fertility status and to determine the association between perceived fertility status and sexual function, as reported by young female Hodgkin lymphoma survivors.

Background

Young female Hodgkin lymphoma survivors are at risk of infertility and impaired sexual function. However, little is known about their awareness of infertility and its association with sexual functioning.

Design

A descriptive questionnaire survey.

Methods

In this cross‐sectional study, a survey was completed by female Hodgkin lymphoma survivors (< 40 years). Outcome measures included self‐reported fertility status and sexual problems and the internationally validated Female Sexual Function Index.

Results

In total, 36 survivors were included (mean age 32 years, SD 4). Eighteen women (50%) thought themselves fertile. Eight survivors (22%) who perceived themselves as being infertile were more often treated with alkylator‐based chemotherapy, and 63% reported sexual dysfunction. Ten survivors (28%) were not aware as to whether they were fertile or not; seven of these would like to have children. The reported fertility status was related to age and chemotherapy regimen. Regarding sexuality, 14 (39%) of the female Hodgkin lymphoma survivors reported one or more sexual problem and none reported recovery. Female sexual dysfunction according to the Female Sexual Function Index was reported by 11 (31%) survivors.

Conclusion

Almost 30% of Hodgkin lymphoma survivors do not know whether they are fertile or not. Overall sexual dysfunction is common in Hodgkin lymphoma survivors and comparable to the general population. However, a lack of desire was significantly more often reported in female Hodgkin lymphoma survivors.

Relevance to clinical practice

To prevent assumed infertility and unintended childlessness by postponing parenthood in young female survivors, awareness of fertility status is needed. There is also a need to routinely assess sexual function and provide adequate interventions to improve arousal and lubrication problems.
Hospice nurses' perspectives of spirituality
Authors: Tiew Lay Hwa , Kwee Jian Hui , Creedy Debra K , Chan Moon Fai
Published: June 2013

Aims and objectives

To explore Singapore hospice nurses' perspectives of spirituality and spiritual care.

Design

A descriptive, cross‐sectional design was used.

Background

Spiritual care is integral to providing quality end‐of‐life care. However, patients often report that this aspect of care is lacking. Previous studies suggest that nurses' neglect of this aspect of care could be attributed to poor understanding of what spirituality is and what such care entails. This study aimed to explore Singapore hospice nurses' perspectives about spirituality and spiritual care.

Methods

A convenience sample of hospice nurses was recruited from the eight hospices in Singapore. The survey comprised two parts: the participant demographic details and the Spirituality Care‐Giving Scale. This 35‐item validated instrument measures participants' perspectives about spirituality and spiritual care.

Results

Sixty‐six nurses participated (response rate of 65%). Overall, participants agreed with items in the Spiritual Care‐Giving Scale related to Attributes of Spiritual Care; Spiritual Perspectives; Spiritual Care Attitudes; and Spiritual Care Values. Results from general linear model analysis showed statistically significant main effects between race, spiritual affiliation and type of hospice setting, with the total Spiritual Care‐Giving Scale score and four‐factor scores.

Conclusions

Spirituality was perceived to be universal, holistic and existential in nature. Spiritual care was perceived to be relational and centred on respecting patients' differing faiths and beliefs. Participants highly regarded the importance of spiritual care in the care of patients at end‐of‐life. Factors that significantly affected participants' perspectives of spirituality and spiritual care included race, spiritual affiliation and hospice type.

Relevance to clinical practice

Study can clarify values and importance of spirituality and care concepts in end‐of‐life care. Accordingly, spirituality and care issues can be incorporated in multi‐disciplinary team discussions. Explicit guidelines regarding spiritual care and resources can be developed.
Hedonic Response to Fish in Preschoolers
Authors: Donadini G. , Fumi M.D. , Porretta S.
Published: June 2013

Preschoolers’ hedonic response to fish dishes was investigated by actual tasting in a natural environment of consumption. Cod with tomato sauce (CTS), plaice with tomato sauce (PTS) and oven‐baked breaded plaice (OBBP) were scored during school lunch by 90 preschoolers on a 5‐point nongender facial scale. Liking varied significantly (P < 0.001) across dishes. CTS and OBBP were highly appreciated and significantly preferred to PTS, which was disliked.

Cluster analysis identified four groups of children with homogeneous preference patterns. Nearly 4 children out of 10 equally liked OBBP and CTS, and disliked PTS. Nearly one child out of three equally liked all the dishes. One child out of seven preferred OBBP to fish dishes with tomato sauce. One child out of 10 preferred CTS to dishes with plaice.

Acceptance was related not only to objective sensory properties of fish dishes but also on background characteristics of the children. Familiarity with the fish dish, the reported liking of the target fish types as well as the neophobic status of children modulate the hedonic response to fish dishes.

For nearly 6 children out of 10, liking is positively related to fish odor, fish flavor and greasiness, whereas it is negatively related to softness, jelly‐like texture, fast melting and falling apart easily textures. For one child out of seven, liking is positively related to bread‐related attributes and negatively with tomato‐related attributes. For 1 child out of 10, liking is negatively related to tomato‐related attributes and fish odor.

Practical Applications

Fish is a food rich in valuable nutrients but it is scarcely appreciated by children. Therefore, it is important to identify the drivers of liking for seafood in natural environments of consumption by actual tasting to understand what is to be done to control fish acceptance and formulate more energy‐balanced and sensory‐appealing meals. The identification of specific sensory characteristics that drive preference in subgroups of preschoolers with radically different sensory preferences opens up ways to engineer specific and more versatile interventions to promote fish consumption in preschoolers.
Changes in some blood parameters and production performance of old laying hens due to growth hormone and testosterone injection
Authors: Mohammadi H. , Ansari‐Pirsaraei Z.
Published: June 2013

The experiment was designed to study the changes in some blood parameters and production performance of old laying hens after injection of different doses of growth hormone (GH) and testosterone (Ts). A total of 160 old laying hens (HyLine W‐36) at 73 weeks of age were weighed individually and randomly allocated to four treatments with four replicates and 10 birds in each replicate in a completely randomized design. Growth hormone and Ts hormones were injected subcutaneously. Treatment groups were as follows: treatment 1: injection of 100 μl distiled water (control group), treatment 2: injection of 500 μg Ts/kg live‐weight + 50 μgGH/kg live‐weight, treatment 3: injection of 500 μgTs/kg live‐weight + 100 μgGH/kg live‐weight and treatment 4: injection of 500 μgTs/kg live‐weight + 150 μgGH/kg live‐weight. Plasma levels of oestradiol, T4, LDL, HDL and cholesterol significantly increased in treatment 3 in relation to the control group. All injected hens showed significantly higher levels of glucose in relation to control group. The results showed the positive effects of GH and Ts administration on production performance and blood parameters which are associated with egg production potentiality and in turn may improve reproductivity (egg production) in old laying hens. The positive results of the study may be useful in animal selection and breeding programmes.
A phylogeny of Bromeliaceae (Poales, Monocotyledoneae) derived from an evaluation of nine supertree methods
Authors: ESCOBEDO‐SARTI Jeanett , RAMÍREZ Ivón , LEOPARDI Carlos , CARNEVALI Germán , MAGALLÓN Susana , DUNO Rodrigo , MONDRAGÓN Demetria
Published: June 2013

There are 26 phylogenetic studies for Bromeliaceae based on different sources of evidence. Despite this broad phylogenetic coverage of Bromeliaceae, however, the available phylogenetic data display a scattered sampling, with little overlap among different types of evidence. The aim of this study is to integrate the available phylogenetic information of the Bromeliaceae in one hypothesis using a supertree. To test which of them integrates best the information for Bromeliaceae, nine supertree methods were employed: Avcon, MSS, MinFlip, MMC, MRP, PhySIC_IST, Robinson–Foulds Supertree, Sfit, and SuperFine. Supertrees were compared with a reference tree, generated from the maximum likelihood (ML) analysis of a supermatrix integrated by 120 taxa of Bromeliaceae and seven cpDNA regions. In order to select which method best reconstructs the most robust phylogeny, two different sets of source trees were used: (i) those generated from the analysis of each individual DNA regions; and (ii) four selected phylogenies (from the 26 published works). We used the consensus fork index, normalized partition metric, patristic distance coefficient, and the Shimodaira–Hasegawa test to compare supertrees with the reference tree. The best performing methods were used to construct a supertree using all phylogenies of Bromeliaceae. The SuperFine method generated the best supertree. The lack of overlapping among phylogenies was the major limiting factor for the integration of the phylogenetic information of Bromeliaceae. Nonetheless, supertree methods helped in the identification of poorly sampled groups, as well as to explore levels of agreement among published phylogenetic studies for Bromeliaceae.
Family Home Visiting Outcomes for Latina Mothers With and Without Mental Health Problems
Authors: Garcia Carolyn , McNaughton Diane , Radosevich David M. , Brandt Joan , Monsen Karen
Published: June 2013

Objective

To evaluate outcomes of a public health nursing family home visiting (FHV) intervention for Latina mothers with and without mental health problems.

Design and Sample

Retrospective cohort analysis of de‐identified FHV data. Latina clients served by public health nurses (PHNS) in an urban Midwest public health agency (2007–2010). Of the 680 clients there were 158 with mental health problems (n = 30, 14–17 year olds; n = 128, 18–52 year olds) and 522 without mental health problems (n = 100, 14–17 year olds; n = 422, 18–52 year olds).

Measures

Client age, number of problems, number of visits, length of service, presence of mental health problem, and Omaha System knowledge, behavior, and status scores for all client problems. Analysis included general linear mixed models adjusted for co‐variables (i.e., age, comorbidities).

Results

All groups improved knowledge, behavior, and status. Knowledge improvement was not significantly different across groups. Behavior improved more among adults with mental health problems (p = .013). Status improved more among adolescents with mental health problems (p = .012).

Conclusions

Latina mothers, particularly those with mental health problems, improve after PHN FHV services. Further study should examine intervention patterns associated with these outcomes, and seek explanations for differences in outcomes.
Evaluation and QTL mapping of resistance to powdery mildew in lettuce
Authors: Simko I. , Rauscher G. , Sideman R. G. , McCreight J. D. , Hayes R. J.
Published: June 2013

Lettuce (Lactuca sativa) is the major leafy vegetable that is susceptible to powdery mildew disease under greenhouse and field conditions. Quantitative trait loci (QTLs) for resistance to powdery mildew under greenhouse conditions were mapped in an interspecific population derived from a cross between susceptible L. sativa cultivar Salinas and the highly susceptible L. serriola accession UC96US23. Four significant QTLs were detected on linkage groups LG 1 (pm‐1.1), LG 2 (pm‐2.1 and pm‐2.2) and LG 7 (pm‐7.1), each explaining between 35 to 42% of the phenotypic variation. The four QTLs are not located in the documented hotspots of lettuce resistance genes. Alleles for the disease resistance at the four QTLs originated from both parents (two from each), demonstrating that even highly susceptible accessions may provide alleles for resistance to powdery mildew. These QTLs appeared to operate during limited periods of time. Results of the field trials with F2:3 and F3:4 families derived from a Soraya (moderately resistant) × Salinas cross demonstrated effective transfer of resistance to powdery mildew in this material. An integrated rating approach was used to estimate relative levels of resistance in 80 cultivars and accessions tested in a total of 23 field and greenhouse experiments. Generally, very low resistance was observed in crisphead‐type lettuces, while the highest relative resistance was recorded in leaf and butterhead types. Comparison of two disease assessment methods (percentage rating and the area under the disease progress steps, AUDPS) for detection of QTLs shows that the two approaches complement each other.
Essential Components of an Infection Prevention Program for Outpatient Hemodialysis Centers
Authors: Hess Sally , Bren Virginia
Published: June 2013

Infections are a significant complication for dialysis patients. The CDC estimates that 37,000 central line‐related bloodstream infections occurred in hemodialysis patients in 2008 and dialysis‐associated outbreaks of hepatitis C continue to be reported. While established hospital‐based infection prevention programs have existed since the 1970s, few dialysis facilities have an established in‐center program, unless the dialysis facility is hospital‐associated. This review focuses on essential core components required for an effective infection prevention program, extrapolating from acute‐care programs and building on current dialysis guidelines and recommendations. An effective infection prevention program requires infrastructure, including leaders who place infection prevention as a top priority, active involvement from a multidisciplinary team, surveillance of outcomes and processes with feedback, staff and patient education, and consistent use of evidence‐based practices. The program must be integrated into the existing Quality Assessment and Performance Improvement program. Best practice recommendations for the prevention of infection, specific to dialysis, continue to evolve as the epidemiology of dialysis‐associated infections is further researched and new evidence is gathered. A review of case studies illustrates that with an effective program in place, infection prevention becomes part of the culture, reduces infection risk, and improves patient safety.