bluuebunny/crossref_metadata_2025 huggingface dataset:
Home-based trunk-strengthening exercise for osteoporotic and osteopenic postmenopausal women without fracture –a pilot study
Authors: Chien M Y , Yang R S , Tsauo J Y
Published: January 2005

Objectives: To investigate whether a 12-week home-based programme of trunk-strengthening exercise could benefit spinal mobility, function and quality of life for osteoporotic and osteopenic postmenopausal women without fracture.

Designs: Randomized controlled clinical trial.

Setting: Department of Physical Therapy in National Taiwan University Hospital.

Subjects: Twenty-eight postmenopausal women (mean age 60.39=9.3 years) diagnosed with osteoporosis or osteopenia without fracture history were recruited for this study. Subjects were randomly assigned into exercise or control groups, each consisting of 14 subjects.

Interventions: The 12-week exercise programme included strengthening routines for the trunk extensor and flexor muscles. The subjects performed three sets of 10 repetitions for each of the exercises, with programmes carried out three times per day at home.

Main outcome measurements: Muscular strength, spinal range of motion (ROM) and motion velocity, Oswestry Disability Questionnaire (ODQ) and quality of life (QOL) were measured before the start and after completion of the exercise programme.

Results: Statistically significant improvements were demonstrated in spinal ROM and motion velocity in the sagittal and frontal planes for the exercise group (pB=0.05). Further, the strength of the trunk flexors and extensors increased after exercise training (pB=0.05). ODQ measure was significantly reduced in the exercise group (pB=0.05), while the controls showed no significant change. Subjects in the exercise group showed better satisfaction in some domains of the Short-Form-36 Health Survey quality of life questionnaire (pB=0.05).

Conclusions: This 12-week home-based trunk-strengthening exercise programme could improve trunk mobility and strength, and enhance QOL in osteoporotic and osteopenic postmenopausal women without vertebral fracture. Future study should recruit more cases or more severe subjects to verify the results.
Investigating the effectiveness of rehabilitation professions - a misguided enterprise?
Authors: Wade Derick
Published: January 2005

Some research studies investigate the effects of ‘professional therapies’ (such as physiotherapy) given to certain classes of patient. This presupposes that therapists (a) only deliver treatments and (b) all deliver the same treatment(s), and neither assumption is true. Moreover the study design usually ignores the fact that rehabilitation is or should be a team activity. It is rarely valid to investigate one part of a team's activity in isolation from the activities of other team members. Therefore the research is often flawed, and cannot answer the question(s) posed. Two consequences arise. First, invalid conclusions may be drawn, especially that the input of a therapy profession is ineffective. Second, purchasers may fail to learn that rehabilitation is a team activity, where the team needs to encompass a range of knowledge and skills rather than comprise specific professions, and may stop funding effective rehabilitation by not funding (enough) input from specific professions. The better approach is to investigate the rehabilitation processes and specific interventions that should be specifically described.
A national survey of health professionals and volunteers working in voluntary hospice services in the UK. I. Attitudes to current issues affecting hospices and palliative care
Authors: Addington-Hall Julia M , Karlsen Saffron
Published: January 2005

This paper reports results from a national survey in 1999 of voluntary hospice services in the UK. It focuses on volunteer and staff views of the purposes of hospice care, and on current debates within palliative care. Twenty-five hospice services, stratified by region, services provided (inpatient care, day care and/or home care) and number of beds were randomly sampled from amongst 175 voluntary hospices in the UK. Nineteen participated. Seventy per cent of a random sample of professional and voluntary staff within these hospices returned a postal questionnaire. Both volunteers and professionals considered care of the whole person, pain and symptom control, quality of life and dying peacefully to be important aspects of hospice care. Most doctors chose care of the whole person as the most important aspect, and they were more likely to choose this option than other staff. Hospice volunteers were less positive than hospice staff (particularly doctors and nurses) in their attitudes to extending hospice care to noncancer patients (where many volunteers held no strong view), to restricting care to patients with specialist palliative care needs, and less negative about euthanasia. These findings illustrate the importance of including hospice volunteers and the general public, as well as hospice staff, in debates about the future of hospice and palliative care in the UK. Further research is needed into lay and professional views of the role of hospices and palliative care services.
A qualitative evaluation of the impact of palliative care day services: the experiences of patients, informal carers, day unit managers and volunteer staff
Authors: Low Joe , Perry Rachel , Wilkinson Susie
Published: January 2005

Objectives: To explore the experiences of people involved in UK palliative care day services (PCDS) and identify the important outcomes of this service. Methods: Focus groups were carried out separately with patients, informal carers and volunteers from four purposively selected palliative care day units and with day unit managers from 11 units. Results: Patients benefited from both the support of PCDS professionals and social support of fellow PCDS patients, which contributed to a perceived improvement in their quality of life. Carers appreciated both the respite and support from PCDS, but acknowledged that they still had a poor quality of life. The challenges facing PCDS include the difficulties of discharging patients and the future role of volunteers. Discussion: PCDS improved patients' perceived quality of life and future evaluations on patient outcomes could use concepts such as self-esteem, selfworth and confidence. Future service provision could explore the possibility of a mixed service using both the traditional and appointment-based system.
Self-administered nitrous oxide for the management of incident pain in terminally ill patients: a blinded case series
Authors: Parlow Joel L , Milne Brian , Tod Deborah A , Stewart G Ivan , Griffiths Jane M , Dudgeon Deborah J
Published: January 2005

The treatment of incident pain in terminally ill cancer patients receiving long-term opioid therapy remains a challenge. Self-administered inhaled nitrous oxide has been used for short-term analgesia in this setting, with mixed results. It is unclear whether nitrous oxide exhibits cross-tolerance with opioids, and there is the possibility of a strong placebo effect in previous unblinded reports. We report on a double-blind crossover case series, in which seven patients received either nitrous oxide/oxygen or a placebo air/oxygen mixture on each day of a two-day trial. Outcome indices were obtained before, during and after each use of the gas for anticipated incident pain. The patient population was very heterogeneous with respect to disease, pain scores and concurrent treatments. Nitrous oxide was beneficial during incidents in five of seven patients; the remaining two patients reported an overall preference for the nitrous oxide day. We conclude that a trial of self-administered inhaled nitrous oxide should be considered in patients with difficult incident pain.
Variations in and factors influencing family members' decisions for palliative home care
Authors: Stajduhar Kelli I , Davies Betty
Published: January 2005

The purpose of this paper is to describe the variations in and factors influencing family members' decisions to provide home-based palliative care. Findings were part of a larger ethnographic study examining the social context of home-based palliative caregiving. Data from participant observations and in-depth interviews with family members (n=13) providing care to a palliative patient at home, interviews with bereaved family members (n=47) and interviews with health care providers (n=25) were subjected to constant comparative analysis. Findings indicate decisions were characterized by three types. Some caregivers made uninformed decisions, giving little consideration to the implications of their decisions. Others made indifferent decisions, whereby they reluctantly agreed to provide care at home, and still others negotiated decisions for home care with the dying person. Decisions were influenced by three factors: fulfilling a promise to the patient to be cared for at home, desiring to maintain a ‘normal family life’ and having previous negative encounters with institutional care. Findings suggest interventions are needed to better prepare caregivers for their role, enhance caregivers' choice in the decision-making process, improve care for the dying in hospital, and consider the development of alternate options for care.
Vitamin C deficiency in cancer patients
Authors: Mayland Catriona R , Bennett Michael I , Allan Keith
Published: January 2005

Purpose: To assess the prevalence of vitamin C deficiency within a group of hospice patients. To assess the relationship between plasma vitamin C, dietary intake and subsequent survival. Methods: Patients with advanced cancer were recruited from a large hospice. Data were collected on demographic details, physical functioning and smoking history. An estimate was obtained of the number of weekly dietary portions consumed equivalent to 40 mg of vitamin C, the recommended daily intake. Plasma vitamin C was measured by a single blood sample. The study had local ethical approval. Results: Fifty patients were recruited (mean age 65.2 years, 28 female). Plasma vitamin C deficiency was found in 15 (30%). Dietary intake of vitamin C was correlated to plasma vitamin C (r=0.518, PB0.0001). Low dietary intake, low albumin, high platelet count, high CRP level and shorter survival were all significantly associated with low plasma vitamin C concentrations (B11 μmol/L). There was no correlation between plasma vitamin C, smoking history or physical functioning. Conclusion: Vitamin C deficiency is common in patients with advanced cancer and the most important factors determining plasma levels are dietary intake and markers of the inflammatory response. Patients with low plasma concentrations of vitamin C have a shorter survival.
Low-dose levomepromazine in refractory emesis in advanced cancer patients: an open-label study
Authors: Eisenchlas Jorge H , Garrigue Nicolás , Junin Marta , De Simone Gustavo G
Published: January 2005

Seventy patients with advanced cancer and refractory emesis were treated with subcutaneous boluses of levomepromazine (median daily dose: 6.25 mg; range: 3.12-25) in an open-label prospective study. Treatment was associated with a decrease in nausea from a median of 8/10 at baseline (IQR 7-8) to a median of 1 (IQR 0-2) after two days of treatment (P<0.0001); vomiting ceased in 92% of cases. It was possible to remove the nasogastric tube from all 11 patients who had one. The most frequently reported side effect was sedation, with a median of 2/10 (25-75% percentile 1-3), which was not correlated with the dose of levomepromazine. This study suggests that treatment with low-dose levomepromazine is an effective and safe option for advanced cancer patients who fail to respond to first-line antiemetic treatment.
Palliative care in the community for cancer and end-stage cardiorespiratory disease: the views of patients, lay-carers and health care professionals
Authors: Exley Catherine , Field David , Jones Linda , Stokes Tim
Published: January 2005

Primary care plays an important role in delivering care to people who are dying. However, providing palliative care to people dying with conditions other than cancer may be more problematic, because it may be more difficult to establish an exact prognosis or to identify their needs. This article draws on qualitative research, which explored the views of health professionals, patients and their carers about care provided at the end of life. Differences between the care of people with cancer and those with end-stage cardiorespiratory disease were found in four main areas: management and progression of disease, communication and information, health care in the community and awareness of dying. The research shows that even in PHCTs (primary health care teams) committed to the delivery of palliative care, people dying with end-stage cardiorespiratory disease are less likely than those with cancer to receive full, and easily understood, information, to be aware that they are dying or to receive district nursing care. There is an increasing call for palliative care to be extended to all, but further work is needed to develop appropriate packages of care for those dying with conditions other than cancer.
Patterning function ofhomothorax/extradenticlein the thorax ofDrosophila
Authors: Aldaz Silvia , Morata Ginés , Azpiazu Natalia
Published: January 2005

In Drosophila, the morphological diversity is generated by the activation of different sets of active developmental regulatory genes in the different body subdomains. Here, we have investigated the role of the homothorax/extradenticle (hth/exd) gene pair in the elaboration of the pattern of the anterior mesothorax (notum). These two genes are active in the same regions and behave as a single functional unit. We find that their original uniform expression in the notum is downregulated during development and becomes restricted to two distinct, α and βsubdomains. This modulation appears to be important for the formation of distinct patterns in the two subdomains. The regulation of hth/exdexpression is achieved by the combined repressing functions of the Pax gene eyegone (eyg) and of the Dpp pathway. hth/exd is repressed in the body regions where eyg is active and that also contain high levels of Dpp activity. We also present evidence for a molecular interaction between the Hth and the Eyg proteins that may be important for the patterning of the α subdomain.
Two contrasting roles for Notch activity in chick inner ear development:specification of prosensory patches and lateral inhibition of hair-cell differentiation
Authors: Daudet Nicolas , Lewis Julian
Published: January 2005

Lateral inhibition mediated by Notch is thought to generate the mosaic of hair cells and supporting cells in the inner ear, but the effects of the activated Notch protein itself have never been directly tested. We have explored the role of Notch signalling by transiently overexpressing activated Notch (NICD) in the chick otocyst. We saw two contrasting consequences, depending on the time and site of gene misexpression: (1)inhibition of hair-cell differentiation within a sensory patch; and (2)induction of ectopic sensory patches. We infer that Notch signalling has at least two functions during inner ear development. Initially, Notch activity can drive cells to adopt a prosensory character, defining future sensory patches. Subsequently, Notch signalling within each such patch mediates lateral inhibition, restricting the proportion of cells that differentiate as hair cells so as to generate the fine-grained mixture of hair cells and supporting cells.
Drosophila valois encodes a divergent WD protein that is required for Vasa localization and Oskar protein accumulation
Authors: Cavey Matthieu , Hijal Sirine , Zhang Xiaolan , Suter Beat
Published: January 2005

valois (vls) was identified as a posterior group gene in the initial screens for Drosophila maternal-effect lethal mutations. Despite its early genetic identification, it has not been characterized at the molecular level until now. We show that vls encodes a divergent WD domain protein and that the three available EMS-induced point mutations cause premature stop codons in the vls ORF. We have generated a null allele that has a stronger phenotype than the EMS mutants. The vlsnull mutant shows that vls+ is required for high levels of Oskar protein to accumulate during oogenesis, for normal posterior localization of Oskar in later stages of oogenesis and for posterior localization of the Vasa protein during the entire process of pole plasm assembly. There is no evidence for vls being dependent on an upstream factor of the posterior pathway, suggesting that Valois protein (Vls)instead acts as a co-factor in the process. Based on the structure of Vls, the function of similar proteins in different systems and our phenotypic analysis,it seems likely that vls may promote posterior patterning by facilitating interactions between different molecules.
CNTF/LIF/gp130 receptor complex signaling maintains a VZ precursor differentiation gradient in the developing ventral forebrain
Authors: Gregg Christopher , Weiss Samuel
Published: January 2005

The extrinsic signaling pathways responsible for the formation and maintenance of the unique laminar organization of the forebrain germinal zones are largely unknown. In the present study, we asked whether ciliary neurotrophic factor (CNTF)/leukemia inhibitory factor (LIF)/gp130 signaling plays a role in the development of the germinal layers in the lateral ganglionic eminence. We found that CNTF/LIF/gp130 receptor signaling promotes the self-renewal/expansion of a subpopulation of fibroblast growth factor-responsive ventricular zone (VZ) precursors in the ventral forebrain. Analysis of Lifr-/- mice suggests that CNTF/LIF/gp130 signaling maintains a subpopulation of GSH2+ VZ precursors, which are necessary for normal growth of the early ventral forebrain and for maintaining a gradient of VZ precursor differentiation in the lateral ganglionic eminence,as defined by GSH2, MASH1 and DLX2 expression. Furthermore, addition of exogenous CNTF to embryonic forebrain explant cultures deprived of choroid plexus-derived CNTF, was sufficient to promote a VZ differentiation gradient. In contrast to the forebrain, CNTF/LIF/gp130 signaling reduced, rather than enhanced, precursor self-renewal/expansion in the spinal cord. These results demonstrate a novel region-specific role for CNTF/LIF/gp130 signaling in the development of the germinal layers of the embryonic telencephalon.
Genetic and molecular identification of genes required for female gametophyte development and function inArabidopsis
Authors: Pagnussat Gabriela C. , Yu Hee-Ju , Ngo Quy A. , Rajani Sarojam , Mayalagu Sevugan , Johnson Cameron S. , Capron Arnaud , Xie Li-Fen , Ye De , Sundaresan Venkatesan
Published: January 2005

The plant life cycle involves an alternation of generations between sporophyte and gametophyte. Currently, the genes and pathways involved in gametophytic development and function in flowering plants remain largely unknown. A large-scale mutant screen of Ds transposon insertion lines was employed to identify 130 mutants of Arabidopsis thaliana with defects in female gametophyte development and function. A wide variety of mutant phenotypes were observed, ranging from defects in different stages of early embryo sac development to mutants with apparently normal embryo sacs, but exhibiting defects in processes such as pollen tube guidance, fertilization or early embryo development. Unexpectedly, nearly half of the mutants isolated in this study were found to be primarily defective in post-fertilization processes dependent on the maternal allele, suggesting that genes expressed from the female gametophyte or the maternal genome play a major role in the early development of plant embryos. Sequence identification of the genes disrupted in the mutants revealed genes involved in protein degradation, cell death, signal transduction and transcriptional regulation required for embryo sac development, fertilization and early embryogenesis. These results provide a first comprehensive overview of the genes and gene products involved in female gametophyte development and function within a flowering plant.
XPACE4 is a localized pro-protein convertase required for mesoderm induction and the cleavage of specific TGFβ proteins inXenopusdevelopment
Authors: Birsoy Bilge , Berg Linnea , Williams P. Huw , Smith James C. , Wylie Christopher C. , Christian Jan L. , Heasman Janet
Published: January 2005

XPACE4 is a member of the subtilisin/kexin family of pro-protein convertases. It cleaves many pro-proteins to release their active proteins,including members of the TGFβ family of signaling molecules. Studies in mouse suggest it may have important roles in regulating embryonic tissue specification. Here, we examine the role of XPACE4 in Xenopusdevelopment and make three novel observations: first, XPACE4 is stored as maternal mRNA localized to the mitochondrial cloud and vegetal hemisphere of the oocyte; second, it is required for the endogenous mesoderm inducing activity of vegetal cells before gastrulation; and third, it has substrate-specific activity, cleaving Xnr1, Xnr2, Xnr3 and Vg1, but not Xnr5,Derrière or ActivinB pro-proteins. We conclude that maternal XPACE4 plays an important role in embryonic patterning by regulating the production of a subset of active mature TGFβ proteins in specific sites.
Four-cell stage mouse blastomeres have different developmental properties
Authors: Piotrowska-Nitsche Karolina , Perea-Gomez Aitana , Haraguchi Seiki , Zernicka-Goetz Magdalena
Published: January 2005

Blastomeres of the early mouse embryo are thought to be equivalent in their developmental properties at least until the eight-cell stage. However, the experiments that have led to this conclusion could not have taken into account either the spatial origin of individual blastomeres or the spatial allocation and fate of their progeny. We have therefore readdressed this issue having defined cell lineages in mouse embryos undergoing different patterns of cleavage in their second division cycle. This has enabled us to identify a major group of embryos in which we can predict not only the spatial origin of each given four-cell blastomeres, but also which region of the blastocyst is most likely to be occupied by its progeny. We show that a pattern of second cleavage divisions in which a meridional division is followed by one that is equatorial or oblique allows us to identify blastomeres that differ in their fate and in their developmental properties both from each other and from their cousins. We find that one of these four-cell stage blastomeres that inherits some vegetal membrane marked in the previous cleavage cycle tends to contribute to mural trophectoderm. The progeny of its sister tend to donate cells to part of the ICM lining the blastocyst cavity and its associated trophectoderm. Chimaeras made entirely of these equatorially or obliquely derived blastomeres show developmental abnormalities in both late preimplantation and early postimplantation development. By contrast, chimaeras made from four-cell stage blastomeres from early meridional divisions develop normally. The developmental defects of chimaeras made from the most vegetal blastomeres that result from later second cleavages are the most severe and following transplantation into foster mothers they fail to develop to term. However, when such individual four-cell blastomeres are surrounded by blastomeres from random positions, they are able to contribute to all embryonic lineages. In conclusion, this study shows that while all four-cell blastomeres can have full developmental potential, they differ in their individual developmental properties according to their origin in the embryo from as early as the four-cell stage.
Foxd1-dependent signals control cellularity in the renal capsule, a structure required for normal renal development
Authors: Levinson Randy S. , Batourina Ekatherina , Choi Christopher , Vorontchikhina Marina , Kitajewski Jan , Mendelsohn Cathy L.
Published: January 2005

Development of the metanephric kidney involves the establishment of discrete zones of induction and differentiation that are crucial to the future radial patterning of the organ. Genetic deletion of the forkhead transcription factor, Foxd1, results in striking renal abnormalities, including the loss of these discrete zones and pelvic fused kidneys. We have investigated the molecular and cellular basis of the kidney phenotypes displayed by Foxd1-null embryos and report here that they are likely to be caused by a failure in the correct formation of the renal capsule. Unlike the single layer of Foxd1-positive stroma that comprises the normal renal capsule, the mutant capsule contains heterogeneous layers of cells, including Bmp4-expressing cells, which induce ectopic phospho-Smad1 signaling in nephron progenitors. This missignaling disrupts their early patterning,which, in turn, causes mispatterning of the ureteric tree, while delaying and disorganizing nephrogenesis. In addition, the defects in capsule formation prevent the kidneys from detaching from the body wall, thus explaining their fusion and pelvic location. For the first time, functions have been ascribed to the renal capsule that include delineation of the organ and acting as a barrier to inappropriate exogenous signals, while providing a source of endogenous signals that are crucial to the establishment of the correct zones of induction and differentiation.
Staff attitudes to a daily otolaryngology ward round
Authors: Montague M.-L. , Lee M.S.W. , Hussain S.S.M.
Published: January 2005

This survey investigates the attitudes of medical and nursing staff towards the daily otolaryngology ward rounds in a teaching hospital.

Initial, open-ended questionnaires generated themes from which a structured questionnaire was constructed. Respondents indicated on a Likert scale the extent to which they agreed or disagreed with statements concerning their attitudes towards the ward round.

Thirty-five members of staff were surveyed. The overall response rate was 74.3 per cent (n = 26). The majority of staff agreed that the ward round was a constructive use of their time and served to promote team spirit. It allowed for adequate communication between medical and nursing staff but there was uncertainty about the provision of adequate patient communication. The nursing staff agreed that the ward round provided a valuable learning experience. There was uncertainty about this among the medical staff. There was agreement in both groups that patients find the ward round to be reassuring. A significant majority of staff expressed concerns over maintenance of patient confidentiality.

These findings could be used to inform changes in the departmental ward round structure. Specific attention should be directed to discussing sensitive issues in a more private setting and maximizing educational opportunities for junior medical staff.
External failures as descriptor of quality in clinical microbiology laboratory services
Authors: Saarela Ulla , Kivinen Tuula , Sarkkinen Hannu
Published: January 2005

This study employed customer feedback surveys to assess the quality of the laboratory services provided by an accredited clinical microbiology laboratory. The purpose of the study was to classify external failures and determine the quantity of such errors, and to establish how much time was spent processing and correcting these errors, together with the costs arising. The study indicates that the quality of laboratory test results can be regarded as good based on the accuracy of the result. Customer needs were also well taken into account in practice because of the good quality of the service. However, improvements are required in providing customers with test results without delay. The cost of processing and correcting such errors was negligible. The use of a customer feedback system allows systematic monitoring of external failures. In the accredited laboratory under study, it is unnecessary to monitor continually the costs and working time involved in processing and correcting external failures. The most essential point is to monitor the effects of the quality measures taken to reduce the number of failures.
The effects of extracorporeal cardiopulmonary circulation on serum total and free prostate specific antigen levels
Authors: Aksoy Yılmaz , Aksoy Hülya , Ceviz Münacettin , Yavuz Balcı Ahmet , Okyar Güray , Akçay Fatih
Published: January 2005

The aim of this study was to investigate whether or not there is an increase in serum total and free prostate specific antigen levels (t-PSA, f-PSA) in patients with and without benign prostatic hyperplasia (BPH) undergoing extracorporeal circulation during cardiovascular bypass. The study included a total of 50 men. Of these, 35 patients underwent elective coronary artery bypass grafting with extracorporeal circulation [with (n=20, group I) and without (n=15, group II) BPH]. Another 15 patients underwent renal or ureteral surgery (group III) and served as a control group. Serum t-PSA and f-PSA levels were measured before surgery and 3h and 3days after surgery. All patients underwent urethral catheterization 24h before surgery. In groups I and II, patients had an increase in t-PSA 3h after surgery compared to baseline values (p=0.0001 and p=0.011, respectively). Also, 3days after surgery, mean t-PSA levels were higher than baseline levels (p=0.004) in group I. Serum t-PSA levels were higher at 3h than at day 3 in groups I and II (p=0.003 and p=0.02, respectively). Mean serum f-PSA levels obtained 3h after surgery were increased in both groups I and II when compared to baseline values (p=0.0001 and p=0.001, respectively). There was no significant difference between f-PSA values before and 3days after surgery in all groups. In the control group, there was no significant increase in either serum t-PSA or f-PSA levels obtained at different times. There was a modest increase in the percentage of free prostate specific antigen (% f-PSA) 3h after the operation in group II (p=0.025); the values returned to baseline within 3days. It was suggested that t-PSA and f-PSA serum levels increase due to extracorporeal cardiopulmonary circulation as a consequence of ischemic damage to the prostate. In patients with BPH, this rise may be higher than in those without BPH, because BPH patients generally have larger prostate volumes that may be more vulnerable to ischemic damage. Because f-PSA has a shorter half-life, postsurgical levels of f-PSA may not show this ischemic damage to the prostate during the late postoperative period and f-PSA appears to be cleared more rapidly than t-PSA.
Evaluation of a new automated electrochemiluminescent sex hormone-binding globulin (SHBG) immunoassay
Authors: Reynders Marijke , Anckaert Ellen , Schiettecatte Johan , Smitz Johan
Published: January 2005

Serum sex hormone-binding globulin (SHBG) regulates the cellular bioavailability of SHBG-bound steroid hormones. Since variations in SHBG levels may affect the concentration of free, i.e., biologically active testosterone in serum, SHBG levels are commonly measured as a supplement to total testosterone determination. The recently developed electrochemiluminescence Elecsys
Profiles in Driver Distraction: Effects of Cell Phone Conversations on Younger and Older Drivers
Authors: Strayer David L. , Drew Frak A.
Published: January 2005

Our research examined the effects of hands-free cell phone conversations on simulated driving. We found that driving performance of both younger and older adults was influenced by cell phone conversations. Compared with single-task (i.e., driving-only) conditions, when drivers used cell phones their reactions were 18% slower, their following distance was 12% greater, and they took 17% longer to recover the speed that was lost following braking. There was also a twofold increase in the number of rear-end collisions when drivers were conversing on a cell phone. These cell-phone-induced effects were equivalent for younger and older adults, suggesting that older adults do not suffer a significantly greater penalty for talking on a cell phone while driving than compared with their younger counterparts. Interestingly, the net effect of having younger drivers converse on a cell phone was to make their average reactions equivalent to those of older drivers who were not using a cell phone. Actual or potential applications of this research include providing guidance for recommendations and regulations concerning the use of mobile technology while driving.
Conversation Limits the Functional Field of View
Authors: Atchley Paul , Dressel Jeff
Published: January 2005

The purpose of these two experiments is to investigate one possible mechanism that might account for an increase in crash risk with in-car phone use: a reduction in the functional field of view. In two between-subjects experiments, college undergraduates performed a task designed to measure the functional field of view in isolation and while performing a hands-free conversational task. In both experiments, the addition of the conversational task led to large reductions in the functional field of view. Because similar reductions have been shown to increase crash risk, reductions in the functional field of view by conversation may be an important mechanism involved in increased risk for crashes with in-car phone use. Actual or potential applications of this research include improving driver performance.
Maximum Isometric Lifting Strengths of Men in Teamwork
Authors: Lee Tzu-Hsien
Published: January 2005

This study reexamined the additivity of maximum isometric teamwork lifting strength using experienced and height-matched young male participants. The maximum isometric lifting strength was measured for four exertion heights (45, 75, 105, and 140 cm) and four lifting styles (one-, two, three-, and four-person exertions). The results showed that actual teamwork strength could be greater or lower than the sum of individual strengths. If it was greater, the difference between the two could be either significant or nonsignificant, but if it was lower, there was no significant difference between the two. Actual teamwork strength ranged from 90.0% to 134.8% of the sum of individual strengths, indicating that experienced and height-matched participants could overcome the problem of lack of coordination in isometric teamwork lifting. The results also showed that some teamwork members, especially weaker members, might be forced to exert strengths higher than their maximum individual voluntary strengths in teamwork lifting. To avoid such overexertion in teamwork, it is recommended that the weight of the handled load be controlled and lower than the sum of all members' strengths. Additionally, members with significantly different strength abilities should not be assigned to the same team. Actual or potential applications of this research include designing member assignments in teamwork lifting tasks.
Prevalence of and Risk Factors for Intimate Partner Violence in China
Authors: Xu Xiao , Zhu Fengchuan , O’Campo Patricia , Koenig Michael A. , Mock Victoria , Campbell Jacquelyn
Published: January 2005

Objectives. We estimated the prevalence of and risk factors for intimate partner violence in China.

Methods. Our cross-sectional, comparative prevalence study used a face-to-face survey of randomly selected women attending an urban outpatient gynecological clinic at a major teaching hospital in Fuzhou, China. Multiple logistic regression models were used to assess risk factors for intimate partner violence.

Results. Of the 600 women interviewed, the prevalence of lifetime intimate partner violence and violence taking place within the year before the interview was 43% and 26%, respectively. For lifetime intimate partner violence, partners who had extramarital affairs and who refused to give respondents money were the strongest independent predictors. For intimate partner violence taking place within the year before the interview, frequent quarreling was the strongest predictor.

Conclusions. Intimate partner violence is prevalent in China, with strong associations with male patriarchal values and conflict resolutions. Efforts to reduce intimate partner violence should be given high priority in health care settings where women can be reached.
Life-Years Gained From Modern Cardiological Treatments and Population Risk Factor Changes in England and Wales, 1981–2000
Authors: Ünal Belgin , Critchley Julia A. , Fidan Dogan , Capewell Simon
Published: January 2005

Objectives. We estimated life-years gained from cardiological treatments and cardiovascular risk factor changes in England and Wales between 1981 and 2000.

Methods. We used the IMPACT model to integrate data on the number of coronary heart disease patients, treatment uptake and effectiveness, risk factor trends, and median survival in coronary heart disease patients.

Results. Compared with 1981, there were 68230 fewer coronary deaths in 2000. Approximately 925415 life-years were gained among people aged 25–84 years (range: 745 195–1 138 655). Cardiological treatments for patients accounted for approximately 194145 life-years gained (range: 142505–259225), and population risk factor changes accounted for approximately 731270 life-years gained (range; 602695–879430).

Conclusions. Modest reductions in major risk factors led to gains in life-years 4 times higher than did cardiological treatments. Effective policies to promote healthy diets and physical activity might achieve even greater gains.
Effective HIV Case Identification Through Routine HIV Screening at Urgent Care Centers in Massachusetts
Authors: Walensky Rochelle P. , Losina Elena , Malatesta Laureen , Barton George E. , O’Connor Catherine A. , Skolnik Paul R. , Hall Jonathan M. , McGuire Jean F. , Freedberg Kenneth A.
Published: January 2005

Think HIV offered HIV counseling, testing, and referral to patients at 4 Massachusetts urgent care centers from January to September 2002. We compared the positive diagnosis yield of Think HIV with that of state-funded HIV counseling, testing, and referral sites. Think HIV found an HIV prevalence of 2.0% compared with 1.9% identified by self-referral testing. Urgent care center–based routine HIV counseling, testing, and referral programs are feasible, can have high positive diagnosis yields, and should be the standard of care in high HIV prevalence areas.
Global Trade and Public Health
Authors: Shaffer Ellen R. , Waitzkin Howard , Brenner Joseph , Jasso-Aguilar Rebeca
Published: January 2005

Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services.

Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date.
Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities
Authors: McCoy David , Chopra Mickey , Loewenson Rene , Aitken Jean-Marion , Ngulube Thabale , Muula Adamson , Ray Sunanda , Kureyi Tendayi , Ijumba Petrida , Rowson Mike
Published: January 2005

We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS “treatment activism” provides an opportunity to catalyze comprehensive health systems development and reduce health care inequities.

However, these positive benefits will only happen if we explicitly set out to achieve them. We call for a greater commitment toward health activism that tackles the broader political and economic constraints to human and health systems development in Africa, as well as toward the resuscitation of inclusive and equitable public health systems.
Workforce Issues in Rural Areas: A Focus on Policy Equity
Authors: Ricketts Thomas C.
Published: January 2005

Rural communities in the United States are served by relatively fewer health care professionals than urban or suburban areas.

I review the geographic distribution of 6 classes of health professionals and describe the multiple government and private policies and programs intended to affect their geographic distribution. These programs can be classified into 3 categories—coercive, normative, and utilitarian—that characterize the major policy levers used to influence practice location decisions.

Health workforce policies must be normative to ensure equity for rural communities, but goals in this area can be achieved only through a balance of utilitarian and coercive mechanisms.
Thep‐Version of the Finite Element Method
Authors: Szabó Barna , Düster Alexander , Rank Ernst
Published: January 2005

The basic algorithmic structure and performance characteristics of thep‐version of the finite element method are surveyed with reference to elliptic problems in solid mechanics. For this class of problems, the theoretical basis of thep‐version is fully established, and a very substantial amount of engineering experience covering linear and nonlinear applications is available. It is shown thatp‐extensions on properly designed meshes make realization of exponential rates of convergence in practical computations possible and provide for the estimation and control of relative errors in terms of any data of interest. Given the growing demand for verified numerical solutions, thep‐version is expected to play an increasingly important role in the development of future finite element software products.
Boundary Element Methods: Foundation and Error Analysis
Authors: Hsiao G. C. , Wendland W. L.
Published: January 2005

This chapter gives an expository introduction to the Galerkin‐BEM for the elliptic boundary value problems from the mathematical point of view. Emphasis will be placed on the variational formulations of the boundary integral equations and the general error estimates for the approximate solution in appropriate Sobolev spaces. A classification of boundary integral equations will be given on the basis of the Sobolev index. The simple relations between the variational formulations of the boundary integral equations and the corresponding partial differential equations under consideration will be indicated. Basic concepts such as stability, consistency, and convergence, as well as the condition numbers and ill‐posedness, will be discussed by using elementary examples.
Finite Volume Methods: Foundation and Analysis
Authors: Barth Timothy , Ohlberger Mario
Published: January 2005

Finite volume methods are a class of discretization schemes that have proven highly successful in approximating the solution of a wide variety of conservation law systems. They are extensively used in fluid mechanics, meteorology, electromagnetics, semi conductor device simulation, models of biological processes, and many other engineering areas governed by conservative systems that can be written in integral control volume form.

This article reviews elements of the foundation and analysis of modern finite volume methods. The primary advantages of these methods are numerical robustness through the obtention of discrete maximum (minimum) principles, applicability on very general unstructured meshes, and the intrinsic local conservation properties of the resulting schemes. Throughout this article, specific attention is given to scalar nonlinear hyperbolic conservation laws and the development of high‐order accurate schemes for discretizing them. A key tool in the design and analysis of finite volume schemes suitable for discontinuity capturing is discrete maximum principle analysis. A number of building blocks used in the development of numerical schemes possessing local discrete maximum principles are reviewed in one and several space dimensions, for example, monotone fluxes, TVD discretization, positive coefficient discretization, nonoscillatory reconstruction, slope limiters, etc. When available, theoretical results concerning a priori and a posteriori error estimates are given. Further advanced topics are then considered such as high‐order time integration, discretization of diffusion terms, and the extension to systems of nonlinear conservation laws.
Mesh Generation and Mesh Adaptivity
Authors: George P. L. , Borouchaki H. , Frey P. J. , Laug P. , Saltel E.
Published: January 2005

In this chapter, we are concerned with mesh‐generation methods and mesh‐adaptivity issues. Many techniques are nowadays available to complete meshes of arbitrary domains for computational purposes. Planar, surface, and volume meshing have been automated to a large extent. Over the last few years, meshing activities have been focused on adaptive schemes, where the features of a solution field must be accurately captured. To this end, meshing techniques must be revisited in order to be capable of completing high‐quality meshes conforming to these features. Error estimates are therefore used to analyze the solution field at a given stage, and, on the basis of the results of the infunction they yield, adapted meshes are created before computing the next stage of the solution field. A number of novel meshing issues must be addressed, including how to construct a mesh that can adapt to what the error estimate prescribes, how to handle large‐size meshes, how to consider moving boundary problems, and so on.
Computational Visualization
Authors: Schroeder William J. , Shephard Mark S.
Published: January 2005

Visualization is an essential part of the computational sciences. While today's complex numerical techniques produce results of unparalleled accuracy, they also produce prodigious amounts of data. To realize the true potential of this information, visualization techniques are required to efficiently convey the meaning of the data to the analyst. In this chapter, we explore basic concepts, terminology, and visualization techniques. We conclude by describing methods for integrating the results of computational analysis data with the visualization system.
Linear Algebraic Solvers and Eigenvalue Analysis
Authors: van der Vorst Henk A.
Published: January 2005

This chapter gives an overview of the most widely used numerical methods for the solution of linear systems of equations and for eigenproblems, including direct methods and iterative methods. Iterative methods are often used in combination with the so‐called preconditioning operators. We will give a brief overview of the various preconditioners that exist. For eigenproblems of the typeAx = λx, the QR method is discussed. The QR method is expensive for larger values ofn, and for these larger values, a number of iterative methods, including the Lanczos method, Arnoldi's method, and the Jacobi–Davidson method are shown.
Adaptive Computational Methods for Parabolic Problems
Authors: Eriksson K. , Johnson C. , Logg A.
Published: January 2005

We present a unified methodology for the computational solution of parabolic systems of differential equations with adaptive selection of discretization in space and time, based on a posteriori error estimates involving residuals of computed solutions and stability factors/weights, obtained by solving an associated linearized dual problem. We define parabolicity as boundedness in time (up to logarithmic factors) of a certain strong stability factor measuring theL1(L2)‐norm in time–space of the time derivative of the dual solution withL2‐normalized initial data.