bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a nurse practitioner on a multidisciplinary consultation team
Authors: Van Der Sluis Corry K. , Datema Linetta , Saan Ingrid , Stant Dennis , Dijkstra Pieter U.
Published: February 2009

Title. Effects of a nurse practitioner on a multidisciplinary consultation team.

Aim. This paper is a report of a study to evaluate the impact on office hours capacity, patient satisfaction, quality of life and costs of including a nurse practitioner in a multidisciplinary consultation team for patients with hand problems caused by rheumatoid arthritis.

Background. Over 90% of patients with rheumatoid arthritis suffer symptoms in their hand joints and may be seriously disabled in performing daily, work or leisure activities. A recent promising development in the treatment of patients with a chronic disease is the co‐ordinating and accompanying role of a nurse, such as a nurse practitioner, in a multidisciplinary treatment team.

Methods. A two successive group time‐series design was adopted. The intervention group (n = 78) visited a clinic with a nurse practitioner assigned to the team during 2003–2004. The control group (n = 69) was seen before inclusion of the nurse practitioner. Office hours capacity, patient satisfaction, quality of life and costs were assessed using questionnaires directly after consulting the team, and 3 and 6 months later.

Results. Between‐group comparisons of patient satisfaction and quality of life revealed no statistically significant differences. Changes within groups over time were not demonstrable. Mean office hour capacity increased by 17% (t = −1·906, d.f. = 32·879,P = 0·065). The costs for professional home care or informal care were equal in the two groups.

Conclusion. Evaluation of clinical practice using pre‐ and post‐test design was impeded by changes in clinical practice, which made concrete conclusions difficult to draw. In future studies the satisfaction of participating clinicians should be evaluated, in addition to that of patients.
The use of conversational analysis: nurse–patient interaction in communication disability after stroke
Authors: Gordon Clare , Ellis‐Hill Caroline , Ashburn Ann
Published: February 2009

Title. The use of conversational analysis: nurse–patient interaction in communication disability after stroke.

Aim. This paper is a report of a study to explore how nursing staff and patients with aphasia or dysarthria communicate with each other in natural interactions on a specialist stroke ward.

Background. Nursing staff often talk with patients in a functional manner, using minimal social or affective communication. Little nursing research has been carried out with patients who have communication difficulties. Conversational analysis, used in other healthcare settings, is a way to explore these interactions in depth in order to gain further understanding of the communication process.

Method. An observational study was carried out in 2005 and the data were 35·5 hours of videotape recording and field notes with 14 nursing staff and five patients with aphasia or dysarthria. The recordings were analysed using conversation analysis.

Findings. Nursing staff controlled the conversations by controlling the topic and flow of conversations, creating asymmetry in all interactions. Patients had very little input because of taking short turns and responding to closed questions. These behaviours are related to the institutional context in which they occur.

Conclusion. In rehabilitation, the focus for interaction may be thought to be patient goals, worries or plans for the future, but in this study nursing staff controlled the conversations around nursing tasks. This may be because they do not have the confidence to hold conversations with people with communication problems. Nursing staff need to receive training to reinforce communication rehabilitation programmes and to engage more fully with patients in their care, but also that a wider institutional culture of partnership is developed on stroke wards.
Menstrual Attitude Questionnaire: confirmatory and exploratory factor analysis with Turkish samples
Authors: Firat Mehmet Z. , Kulakaç Özen , Öncel Selma , Akcan Arzu
Published: February 2009

Title.  Menstrual Attitude Questionnaire: confirmatory and exploratory factor analysis with Turkish samples.

Aim.  This study is a report of an investigation of the psychometric properties of the Turkish version of the Menstrual Attitude Questionnaire.

Background.  Cultural, social and family environments influence women’s beliefs about and attitudes towards menstruation. Awareness of these beliefs and/or attitudes and their cultural origins is necessary to understand women and their reactions to menstruation when offering health care. Although the Menstrual Attitude Questionnaire has been used in several studies, the psychometric properties of the Turkish version have not been investigated.

Methods.  Confirmatory factor analyses were carried out with two different samples – high school (n = 650) and undergraduate university students (n = 569) – in Turkey in the spring semester of 2006. Exploratory factor analyses were then used to modify the factor structure.

Results.  Confirmatory factor analysis did not confirm the factor model reported in the United States of America. However, compared with British and Indian samples, Turkish attitudes showed better fit than both British and Indian samples with comparative fit index values of 0·776 and 0·797 for the high school and university samples respectively. Finally, exploratory factor analysis yielded a 28‐item measure for the high school sample and 31‐item measure for the university sample, with a 5‐factor solution. Reliability estimates of both scales were satisfactory, being 0·73 for the high school and 0·79 for the university sample.

Conclusion.  The modified 5‐factor Menstrual Attitude Questionnaire could be a useful tool for assessing menstrual attitudes among Turkish high school and university students. The overall score permits comparison with results from earlier studies using the original instrument.
The phenomenological focus group: an oxymoron?
Authors: Bradbury‐Jones Caroline , Sambrook Sally , Irvine Fiona
Published: February 2009

Title.  The phenomenological focus group: an oxymoron?.

Aim.  In this paper we explore the congruence of focus group interviews within a phenomenological framework.

Background.  Focus groups as a research method are popular in nursing. Similarly, phenomenology is a dominant methodology for nurse researchers globally. A number of nurse researchers have combined focus groups and phenomenology, but there are others who argue that they are incompatible.

Discussion.  The argument against using focus groups in phenomenological research is that phenomenology seeks essential characteristics or ‘essences’ of phenomena in a manner that requires an individual to describe their experiences in an ‘uncontaminated’ way. We recognize that traditionally most phenomenological interviews are conducted with only one interviewer and one respondent, but we question whether this needs to continue. We suggest means by which individual lived experience can be preserved within a group context. We draw on our own experience and the phenomenological literature to argue that focus groups are congruent with phenomenological research and extend this argument further by proposing that group interviews in phenomenology are actually beneficial because they stimulate discussion and open up new perspectives. Our observation is that some researchers who combine focus groups and phenomenology appear to do so uncritically and we argue that this is unacceptable.

Conclusions.  It is important for nurse researchers to develop critical awareness of the research methodologies and methods they employ. We argue that the phenomenological focus group is not an oxymoron. Rather, the use of focus groups can provide a greater understanding of the phenomenon under study.
A social constructionist analysis of talk in episodes of psychiatric student nurses conversations with clients in community clinics
Authors: Middleton Lyn , Uys Leana
Published: February 2009

Title.  A social constructionist analysis of talk in episodes of psychiatric student nurses conversations with clients in community clinics.

Aim.  This paper is a report of a study of the ‘discursive doings’ of psychiatric nursing students’ practice as they are jointly constructed in conversations with clients in community psychiatric clinics.

Background.  This construction of psychiatric nursing as a therapeutic, holistic, person‐centred, interactional process is central to the identity of psychiatric nursing as a discipline. However, recent studies are beginning to suggest a dissonance between the person‐centred rhetoric and institutional practice.

Methods.  A discourse analysis was conducted in 2002–03 using the transcripts of seven conversations between nursing students and clients visiting psychiatric community clinics on a monthly basis. These were selected from a sample of 20 conversations based on their clarity and completeness. Texts were analysed using the notational systems of Silverman and Mishler and some of Fairclough’s analytic text structure features.

Findings.  In all the transcripts, an agenda for surveillance was explicitly established in the students’ opening sequences of each text. Almost all exchanges in the texts were organized around cycles of questions from students and responses from clients, which allowed students to control the conversations. Information delivery was also found to be at work within the texts, although it is not as prominent or as persistent as the question and answer structure. Students took up the responses of clients selectively as though working to a pre‐set agenda.

Conclusion.  These discursive activities manifest a symptom‐like approach to nursing care and have the effect of disabling the development of client‐authorized expressions of agency.
A comparison of native and invasive populations of three clonal plant species in Germany and New Zealand
Authors: Beckmann Michael , Erfmeier Alexandra , Bruelheide Helge
Published: February 2009

Aim Our aim was to test for changes in growth patterns of three clonally growing plant species (Achillea millefolium,Hieracium pilosellaandHypericum perforatum) between native and invaded regions. We addressed the hypotheses that with differing important life‐history traits, invasive populations perform better than native populations, and that this expected better performance is linked to weakened trade‐offs between individual growth and sexual and clonal reproduction.

Location Germany and New Zealand.

Methods We conducted field surveys for the three above‐mentioned species in both native German and invasive New Zealand populations, and collected data at both population and individual levels.

Results At the population level, the proportion of flowering plants, population size and population density were all higher in invasive populations. Similarly, at the individual level, the number of stolons per plant, stolon–biomass ratio and population crowdedness (local plant density in a specified area around a target plant) were significantly higher in New Zealand. Plant height did not differ between countries, and plant biomass was lower in New Zealand than in Germany forAchillea millefoliumandHypericum perforatum. These two species showed significant trade‐offs between individual growth and sexual and clonal reproduction.Achillea millefoliumexhibited a weakened trade‐off in its invaded range, where the same proportion of flowering plants was sustained at much higher levels of population crowdedness than in its native range.

Main conclusions The apparent invasion success of the three study species is generally due to better overall performance in their respective invaded ranges. In respect of bothAchillea millefoliumandHypericum perforatum, this is driven primarily by increased vegetative reproduction. In contrast,Hieracium pilosellaseems to benefit more from increased sexual reproduction in its invaded range. Shifts in trade‐offs as a general trend seem to be of minor importance.
Influence of ghrelin on the gastric accommodation reflex and on meal‐induced satiety in man
Authors: Ang D. , Nicolai H. , Vos R. , Mimidis K. , Akyuz F. , Kindt S. , Vanden Berghe P. , Sifrim D. , Depoortere I. , Peeters T. , Tack J.
Published: February 2009

Abstract  Ghrelin increases gastric tone in the fasting state and enhances gastric emptying in gastroparesis. The aims of the study were to evaluate the effect of ghrelin on postprandial gastric tone and on meal‐induced satiety in health. Ten healthy volunteers underwent a barostat study on two occasions. After determination of intra‐abdominal pressure (minimal distending pressure, MDP), isobaric volume measurement was performed for 90 min at MDP + 2 mmHg. After 20 min, ghrelin (40 μg) or saline was administered i.v. over 30 min in a double‐blind‐randomized cross‐over design, followed 10 min later by a liquid meal (200 mL, 300 kcal). Stepwise isobaric distentions (+2 mmHg per 2 min) were performed 60 min after the meal. Data (mean ± SEM) were compared using paired Student’s t‐test and anova. Separately, a satiety drinking test (15 mL min−1 until satiety score 5) was performed on 10 subjects twice, after treatment with placebo or ghrelin. Ghrelin infusion significantly inhibited gastric accommodation (mean volume increase adjusted means 108.0 ± 50 vs 23.0 ± 49 mL, P = 0.03, ancova with the premeal postinfusion volume as covariate) and reduced postprandial gastric volumes (197.2 ± 24.6 vs 353.5 ± 50.0 mL, P = 0.01). Pressures inducing perception or discomfort during postprandial gastric distentions were not altered. During satiety testing, ghrelin did not alter nutrient volume ingested till maximal satiety (637.5 ± 70.9 vs 637.5 ± 56.2 mL, ns). Ghrelin administered during the meal significantly inhibits gastric accommodation in health, but this is not associated with early satiation.
The multi‐herbal drug STW 5 (Iberogast®) has prosecretory action in the human intestine
Authors: Krueger D. , Gruber L. , Buhner S. , Zeller F. , Langer R. , Seidl S. , Michel K. , Schemann M.
Published: February 2009

Abstract  There is growing evidence that STW 5 (Iberogast®, fixed combination of hydroethanolic herbal extracts), besides being effective in functional dyspepsia, also improves symptoms in irritable bowel syndrome (IBS). Clinical data indicate that modulation of mucosal secretion is a promising approach to treat intestinal disorders associated with IBS. We therefore explored the effect of STW 5 on secretion in the human intestine and the mechanisms by which it acts. The Ussing chamber technique was used to measure mucosal secretion in human intestinal mucosa/submucosa preparations and in human epithelial cell line T84. In addition, we recorded STW 5 effects on human enteric neurons with voltage sensitive dye imaging. In human tissue and T84 cells STW 5 induced a dose‐dependent increase in ion secretion that was significantly reduced by the Na–K–Cl cotransporter blocker bumetanide, the adenylate cyclase inhibitor MDL‐12 330, the non‐specific and selective cystic fibrosis transmembrane conductance regulator (CFTR) inhibitors glibenclamide and CFTRinh‐172, respectively, and the blocker of calcium dependent Cl− channels (ClCa) SITS (4‐acetamido‐4‐isothiocyanatostilbene‐2,2‐disulphonic acid). It was unaffected by amiloride, a blocker of epithelial Na+ channels. In human tissue, the nerve blocker tetrodotoxin significantly suppressed the STW 5 response. STW 5 evoked an increased spike discharge in 51% of human submucous neurons. Results suggest that STW 5 is a secretogogue in the human intestine by direct epithelial actions and through activation of enteric neurons. The prosecretory effect is due to increased epithelial Cl− fluxes via CFTR and Ca‐dependent ClCa channels. STW 5 may be a novel option to treat secretory disorders associated with IBS and constipation.
Plant mitochondria electron partitioning is independent of short‐term temperature changes
Authors: MACFARLANE CRAIG , HANSEN LEE D. , FLOREZ‐SARASA IGOR , RIBAS‐CARBO MIQUEL
Published: February 2009

We tested the hypotheses that relative activity of the less efficient alternative oxidase (AOX) path changes with diurnal temperature changes, and thus changes carbon use efficiency with temperature. The activities of the alternative and cytochrome oxidase (COX) paths in plant tissues of three species were determined by measuring 18O/16O discrimination and total respiration from 17 to 36 °C. A new, more accurate method for calculating oxygen uptake rate from the mass spectrometry data was developed. Total carbon use efficiency was calculated from the ratio of respiratory heat and CO2 rates measured from 10 to 35 °C. Oxygen isotope discrimination (22.9 ± 0.4‰) and AOX participation were invariant with temperature in leaf tissue of Cucurbita pepo, Nicotiana sativa and Vicia faba, thus falsifying the first part of the hypothesis. Stress responses of respiration at the temperature extremes limited the range for which carbon use efficiency could be accurately measured to 15–30 °C in N. sativa, to 10–25 °C in C. pepo and to 20–30 °C in V. faba. Carbon‐use efficiency was invariant at these temperatures in these species, demonstrating that changes in other pathways that would vary carbon‐use efficiency were also invariant with temperature.
Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis
Authors: Ehnhage A. , Olsson P. , Kölbeck K‐G. , Skedinger M. , Dahlén B. , Ålenius M. , Stjärne P. ,   for the NAFS Study Group
Published: February 2009

Background:  Nasal polyposis is a disease known to be associated with asthma. The management is anti‐inflammatory, with topical and oral corticosteroids as the first‐line treatment. The effect of surgical treatment on lower airway inflammation has not been sufficiently studied.

Aim:  The aim of this study is to investigate the effects of functional endoscopic sinus surgery (FESS) as well as fluticasone proprionate nasal drops (FPND) 400 μg b.i.d. on nasal and lower airway parameters in asthmatics with nasal polyposis.

Methods:  This was a prospective 21‐week study of 68 patients with asthma and nasal polyposis, on the benefits of FESS on nasal ‘(butanol test, subjective olfaction, peak nasal inspiratory flow, congestion, rhinorrhoea, and polyp score)’, and on the lower airway parameters (dyspnea, cough, mean daily peak expiratory flow rate (PEFR), and lung function tests). It also included a randomized, double‐blind, placebo‐controlled 14 weeks phase on FPND.

Results:  Functional endoscopic sinus surgery significantly improved mean asthma symptom scores and daily PEFR and all nasal parameters including subjective and objective olfaction tests. This is the first study that shows the benefits of FESS on butanol tests in patients with nasal polyposis. We found no significant difference between topical treatment with FPND or placebo in the nasal or lower airway variables.

Conclusion:  Functional endoscopic sinus surgery improved nasal and asthma symptoms in patients with nasal polyposis. Functional endoscopic sinus surgery could be considered early in the natural course of nasal polyposis with concomitant asthma, as well as a second‐line treatment in nasal polyposis patients with a reduced sense of smell. The potential benefits of FPND 400 μg b.i.d. were probably overshadowed by FESS.
Early intervention with suplatast tosilate for prophylaxis of pediatric atopic asthma: A pilot study
Authors: Yoshihara Shigemi , Ono Mika , Yamada Yumi , Fukuda Hironobu , Abe Toshio , Arisaka Osamu
Published: February 2009

The onset of asthma may be related to Th2 cytokine dominance at the time when food allergies occur several months after birth. This study investigated the effectiveness of early intervention with a Th2 cytokine inhibitor (suplatast tosilate) for prevention of asthma in infants with food allergies and atopic dermatitis. Suplatast tosilate dry syrup (6 mg/kg daily) or a histamine H1‐blocker (ketotifen fumarate dry syrup: 0.06 mg/kg daily) was administered randomly to 53 infants with atopic dermatitis caused by food allergies. The primary endpoints were the incidence of asthma and the time to the onset of wheezing. The peripheral blood Th1/Th2 ratio, total IgE level, and eosinophil count were measured before and after treatment. After 24 months of treatment, the prevalence of asthma was significantly lower in the suplatast group (20.8%) than in the ketotifen group (65.6%, p < 0.01). Additionally, the time from the start of treatment to the initial episode of wheezing for infants who developed asthma was significantly longer in the suplatast group than the ketotifen group (p < 0.01). Furthermore, the eosinophil count was significantly decreased by suplatast treatment (p < 0.05), and there was a significant difference between the suplatast and ketotifen groups with respect to both the eosinophil count (p < 0.01) and the Th1/Th2 ratio (p < 0.05). The results of the present pilot study suggest that suplatast tosilate is useful for the primary prevention of wheezing and asthma in children.
New Necrotic Isolates of Pepino mosaic virus Representing the Ch2 Genotype
Authors: Hasiów‐Jaroszewska B. , Pospieszny H. , Borodynko N.
Published: February 2009

New necrotic isolates of Pepino mosaic virus (PepMV) were found in 2007 infecting greenhouse tomato plants in Poland. The isolates differ from previously identified PepMV isolates in host range and symptomatology. They induce severe necrosis on tomato plants (Solanum lycopersicum) and local necrotic lesions on Datura inoxia. Phylogenetic analysis, based on three distinct regions, triple gene block 1, the coat protein gene and a part of polymerase gene, revealed that the new necrotic isolates share high nucleotide sequence identity with isolates of the Ch2 genotype. This is the first report describing a necrotic type of PepMV of the Ch2 genotype.
Molecular Identification of Stolbur Phytoplasma Associated with Red Clover Dwarf Disease Symptoms
Authors: Fránová Jana , Navrátil Milan , Jakešová Hana
Published: February 2009

Trifolium pratense plants exhibiting dwarf symptoms without flower abnormalities were frequently observed in the breeding nurseries in North Moravia, Czech Republic. Direct and nested polymerase chain reaction with phytoplasma‐specific primers and subsequent restriction fragment length polymorphism analyses of 16S rDNA, as well as sequence analyses of the 16S–23S ribosomal operon, identified phytoplasmas belonging to the ribosomal subgroup 16SrXII‐A. Identical analyses of the dnaB gene and the transcription factor tuf gene were used for further differentiation. The primer/enzyme‐combination of TufAYf,r/HpaII revealed the grouping of the phytoplasmas into stolbur tuf‐type II in all examined samples. Stolbur phytoplasmas have not been reported previously in red clover.
Pathogenicity of Phaeoacremonium Species on Grapevines
Authors: Aroca Angeles , Raposo Rosa
Published: February 2009

Several Phaeoacremonium species have been recently described to include some species involved in disease of decline of woody plants and others associated with human infections. Thirteen species are currently reported on grapevines and they are suspected to be involved in Esca and Petri disease. The pathogenic character of new defined species is still unknown and, therefore, pathogenicity studies were conducted in this work. The pathogenicity of the following species was studied on grapevine seedlings and cuttings: Phaeoacremonium aleophilum, P. angustius, P. inflatipes, P. krajdenii, P. mortoniae, P. parasiticum, P. scolyti, P. venezuelense, P. viticola, and Phaeomoniella chlamydospora included as positive control. Two‐month‐old grapevine seedlings of Vitis vinifera cv. Malvar and cv. Airen were inoculated by watering 10 individual pots with a spore suspension (107 spores/ml) of each Phaeoacremonium species. All inoculated seedlings showed typical symptoms of a vascular disease 2 months after inoculation. Grapevine cuttings of Vitis vinifera cv. Monastrell were vacuum‐inoculated with a spore suspension (108 spores/ml) and individually planted. Plants rated after 5 months showed that all Phaeoacremonium species and P. chlamydospora (used as positive control) caused a significant vascular discoloration, while only Phaeomoniella chlamydospora, Phaoeacremonium mortoniae and P. aleophilum caused a significant root weight reduction compared with a non‐inoculated control. Phaoeacremonium parasiticum, P. angustius, P. inflatipes and P. venezuelense caused significant foliar symptoms that included interveinal chlorosis and stunted leaves.
Clinical characteristics of respiratory syncytial virus infection‐associated acute otitis media
Authors: Tomochika Kiyoko , Ichiyama Takashi , Shimogori Hiroaki , Sugahara Kazuma , Yamashita Hiroshi , Furukawa Susumu
Published: February 2009

Background:  It is known that children with respiratory syncytial virus (RSV) infection frequently have complications of acute otitis media (AOM).

Methods:  The hospital records of 148 inpatients aged 6–35 months who had RSV infection between January 2004 and December 2007, were retrospectively investigated.

Results:  Forty‐six out of 148 children (31%) had AOM. There was a significantly greater number of children with fever who had AOM (P = 0.005). The percentage of children with β‐lactamase‐non‐producing ampicillin‐resistant (BLNAR) Haemophilus influenzae in nasopharyngeal culture who had AOM showed a tendency to be greater than that of those who did not have AOM, but this was not statistically significant (P = 0.068). Moreover, BLNAR H. influenzae was positive in middle ear fluid specimens from four of five children with AOM who underwent tympanocentesis. There were no significant differences in the incidence of lower airway infection, leukocytes counts, or serum C‐reactive protein levels between children with and without AOM.

Conclusions:  Children who had RSV infection with AOM had a higher incidence of fever than those without AOM.
Interferon‐α for alarming hemangiomas in infants: Experience of a single institution
Authors: Chao Yu‐Hua , Liang Der‐Cherng , Chen Shu‐Huey , Wang Lin‐Yen , Yeh Ting‐Chi , Liu Hsi‐Che
Published: February 2009

Background:  Hemangioma is the most common tumor in infancy. ‘Alarming hemangiomas’ refer to the lesions that potentially impair vital structures or cause life‐endangering complications, and which warrant vigorous treatment. Interferon‐α has been used for alarming hemangiomas at Mackay Memorial Hospital, Taipei, Taiwan, since 1994.

Methods:  The records of 21 consecutive infants treated between January 1994 and December 2005 were retrospectively reviewed. The initial dose of interferon‐α was 50 000 IU/kg per day, which was increased to 100 000 IU/kg per day in the second week of therapy if tolerated. It was tapered depending on response, with total treatment lasting no longer than 12 months. Treatment response was evaluated depending on the size of the lesion and resolution of complications.

Results:  The duration of therapy ranged from 6 to 12 months. Six patients (29%) had a reduction in mass of ≥25% after 1 month of therapy. Twenty patients (95%) had achieved a decrease in size of 50% by 12 months, and 15 (71%) had total involution of lesions by a median age of 13.5 months (range 7–50 months). Only mild and transient adverse effects were encountered. No neurologic complications occurred.

Conclusions:  Interferon‐α appears to be an effective and well‐tolerated treatment for alarming hemangiomas in infancy.
Extended‐stay hospitalization for childhood asthma in Japan
Authors: Tani Hidekazu , Matsuda Kentaro , Matsumoto Takao , Hiramoto Ikue , Okamatsu Yuki , Takehiro Satoshi , Kimura Kouichi , Higuchi Sadanobu , Okazaki Reiji , Matsuishi Toyojiro
Published: February 2009

Background:  While recent advances in asthma management have enabled adequate control to be frequently achieved in outpatient settings, children whose asthma remains poorly controlled despite outpatient treatment are often referred to extended‐stay hospitals. The aim of the present study was to examine trends concerning extended‐stay hospitalization and to evaluate the present status of this approach.

Methods:  A retrospective study was conducted to assess changes in the number of admissions among 408 children with extended stays at Kamiamakusa General Hospital between 1989 and 2005. Medical and laboratory data of 236 patients admitted since 1994 were obtained from clinical records.

Results:  The number of children with extended‐stay hospitalizations since 2000 declined dramatically compared with the early 1990s, while the percentage of patients with complications of childhood asthma, such as severe atopic dermatitis, school absenteeism, and obesity, have increased significantly in the recent past. Practical benefits of extended‐stay hospitalization were demonstrated by significant improvement of exercise performance and measurement of pulmonary function parameters and serum IgE concentrations by time of discharge. In addition to improvement in asthmatic symptoms, maintenance drug requirements and frequency of school absenteeism were reduced.

Conclusions:  The medical mission of extended‐stay hospitalizations is currently limited due to the availability of improved pharmacotherapy. Some patients, however, with exceptionally severe asthma or psychological problems that interact with their medical condition still fare poorly under outpatient care and could benefit from group care. Further study is needed to identify the components of long‐term programs essential to produce change.
Placental findings in malnourished term neonates
Authors: Salihoğlu Özgül , Karatekin Güner , Ilhan Rıdvan , Nuhoğlu Asiye
Published: February 2009

Background:  The aim of the present study was to investigate placental pathologies in malnourished term neonates.

Methods:  A group of term newborns was evaluated at birth for fetal malnutrition (FM) using the Clinical Assessment of Nutritional Status (CANS) score. The study group consisted of 37 malnourished neonates and 13 well‐nourished newborns, including their placentas. Infants with FM were subdivided into two groups: appropriate for gestational age (AGA) and small for gestational age (SGA).

Results:  The proportion of subjects having antepartum complications was 18.9% in the FM group, whereas none was found in the control group. Similarly, a significant portion, 83.8% of the study group, had gross placental abnormalities, while the control group had none. The placental microscopic findings in the study group included perivillous fibrin deposition, calcification, necrosis, retroplacental hematoma, and infarction. In contrast, the control group had only perivillous fibrin deposition and calcification. Placental histopathological findings between FM term AGA and SGA neonates were also compared, and no statistically significant differences were found (P < 0.05).

Conclusions:  Placental findings in malnourished term AGA neonates are not different from findings documented in malnourished SGA cases, but they are different from those in well‐nourished term AGA newborns.
Regulation of growth factors in hormone‐ and drug‐resistant prostate cancer cells by synergistic combination of docetaxel and octreotide
Authors: Erten Cigdem , Karaca Burcak , Kucukzeybek Yuksel , Gorumlu Gurbuz , Cengiz Ercument , Gul Mustafa K. , Atmaca Harika , Uzunoglu Selim , Karabulut Bulent , Sanli Ulus A. , Uslu Ruchan
Published: February 2009

OBJECTIVE

To evaluate the effects of combined treatment with docetaxel and octreotide, a somatostatin analogue, on human hormone‐ and drug‐refractory prostate cancer cell lines, PC‐3 and DU‐145, and on some growth factors related to tumour growth and angiogenesis in prostate cancer.

MATERIALS AND METHODS

A cell proliferation assay was used to assess the cytotoxicity of the drugs. To verify apoptosis, both DNA fragmentation (by enzyme‐linked immunosorbent assay) and caspase 3/7 activity were measured. We also investigated the effect of combined docetaxel and octreotide on growth factors secreted from prostate cancer cells using a human growth factor antibody array.

RESULTS

The combination of docetaxel and octreotide resulted in significant synergistic cytotoxic activity and apoptosis, which was dose‐ and time‐dependent. The combined treatment also resulted in significantly less secretion of stem cell factor and platelet‐derived growth factor‐AB in PC‐3 cells, and transforming growth factor‐β and basic fibroblast growth factor in DU‐145 cells, than in untreated controls.

CONCLUSION

Octreotide, a somatostatin analogue, combined with docetaxel might provide a rationale treatment option for hormone‐refractory prostate cancer cells, not only by direct inhibition of cell proliferation but also by inhibiting the secretion of growth factors.
You Wear Me Out
Authors: Ackerman Joshua M. , Goldstein Noah J. , Shapiro Jenessa R. , Bargh John A.
Published: February 2009

Acts of self-control may deplete an individual's self-regulatory resources. But what are the consequences of perceiving other people's use of self-control? Mentally simulating the actions of others has been found to elicit psychological effects consistent with the actual performance of those actions. Here, we consider how simulating versus merely perceiving the use of willpower can affect self-control abilities. In Study 1 , participants who simulated the perspective of a person exercising self-control exhibited less restraint over spending on consumer products than did other participants. In Study 2 , participants who took the perspective of a person using self-control exerted less willpower on an unrelated lexical generation task than did participants who took the perspective of a person who did not use self-control. Conversely, participants who merely read about another person's self-control exerted more willpower than did those who read about actions not requiring self-control. These findings suggest that the actions of other people may either deplete or boost one's own self-control, depending on whether one mentally simulates those actions or merely perceives them.
Multilevel Multivariate Modelling of Childhood Growth, Numbers of Growth Measurements and Adult Characteristics
Authors: Goldstein Harvey , Kounali Daphne
Published: February 2009

A general latent normal model for multilevel data with mixtures of response types is extended in the case of ordered responses to deal with variates having a large number of categories and including count data. An example is analysed by using repeated measures data on child growth and adult measures of body mass index and glucose. Applications are described that are concerned with the flexible prediction of adult measurements from collections of growth measurements and for studying the relationship between the number of measurement occasions and growth trajectories.
The Complexity of School and Neighbourhood Effects and Movements of Pupils on School Differences in Models of Educational Achievement
Authors: Leckie George
Published: February 2009

Traditional studies of school differences in educational achievement use multilevel modelling techniques to take into account the nesting of pupils within schools. However, educational data are known to have more complex non-hierarchical structures. The potential importance of such structures is apparent when considering the effect of pupil mobility during secondary schooling on educational achievement. Movements of pupils between schools suggest that we should model pupils as belonging to the series of schools that are attended and not just their final school. Since these school moves are strongly linked to residential moves, it is important to explore additionally whether achievement is also affected by the history of neighbourhoods that are lived in. Using the national pupil database, this paper combines multiple membership and cross-classified multilevel models to explore simultaneously the relationships between secondary school, primary school, neighbourhood and educational achievement. The results show a negative relationship between pupil mobility and achievement, the strength of which depends greatly on the nature and timing of these moves. Accounting for pupil mobility also reveals that schools and neighbourhoods are more important than shown by previous analysis. A strong primary school effect appears to last long after a child has left that phase of schooling. The additional effect of neighbourhoods, in contrast, is small. Crucially, the rank order of school effects across all types of pupil is sensitive to whether we account for the complexity of the multilevel data structure.
Overeducation and the Skills of UK Graduates
Authors: Chevalier Arnaud , Lindley Joanne
Published: February 2009

During the early 1990s the proportion of a cohort entering higher education in the UK doubled over a short period of time. The paper investigates the effect of the expansion on graduates’ early labour market attainment, focusing on overeducation. We define overeducation by combining occupation codes and a self-reported measure for the appropriateness of the match between qualification and the job. We therefore define three groups of graduates: matched, apparently overeducated and genuinely overeducated. This measure is well correlated with alternative definitions of overeducation. Comparing pre- and post-expansion cohorts of graduates, we find with this measure that the proportion of overeducated graduates has doubled, even though overeducation wage penalties have remained stable. We do not find that type of institution affects the probability of genuine overeducation. Apparently overeducated graduates are mostly indistinguishable from matched graduates, whereas genuinely overeducated graduates principally lack non-academic skills and suffer a large wage penalty. Individual unobserved heterogeneity differs between the three groups of graduates but controlling for it does not alter these conclusions.
Modelling Population-Based Cancer Survival Trends by using Join Point Models for Grouped Survival Data
Authors: Yu Binbing , Huang Lan , Tiwari Ram C. , Feuer Eric J. , Johnson Karen A.
Published: February 2009

In the USA cancer as a whole is the second leading cause of death and a major burden to health care; thus medical progress against cancer is a major public health goal. There are many individual studies to suggest that cancer treatment breakthroughs and early diagnosis have significantly improved the prognosis of cancer patients. To understand better the relationship between medical improvements and the survival experience for the patient population at large, it is useful to evaluate cancer survival trends on the population level, e.g. to find out when and how much the cancer survival rates changed. We analyse population-based grouped cancer survival data by incorporating join points into the survival models. A join point survival model facilitates the identification of trends with significant change-points in cancer survival, when related to cancer treatments or interventions. The Bayesian information criterion is used to select the number of join points. The performance of the join point survival models is evaluated with respect to cancer prognosis, join point locations, annual percentage changes in death rates by year of diagnosis and sample sizes through intensive simulation studies. The model is then applied to grouped relative survival data for several major cancer sites from the ‘Surveillance, epidemiology and end results’ programme of the National Cancer Institute. The change-points in the survival trends for several major cancer sites are identified and the potential driving forces behind such change-points are discussed.
THE INFLUENCE OF PLATONISM ON THE EARLY APOLOGISTS
Authors: GASTON THOMAS E.
Published: February 2009

The influence of Platonism upon the development of Christianity is well‐documented, particularly with regard to the deliberations that took place in the fourth and fifth centuries regarding the nature of Trinity. A topic that has received less attention is the philosophies of the (so‐called) ‘Middle Platonists’ and their influence upon the earliest apologies, such as the Apology of Aristides and the Epistle to Diognetus. Yet tracing these influences is integral to explaining the development of the Christian conception of God.