bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction: innovation in Chinese firms
Authors: Assimakopoulos Dimitris
Published: April 2010

Purpose

This introduction aims to set the scene for this special issue on innovation in Chinese firms.

Design/methodology/approach

There is no research design and methodology for data collection and analysis as such.

Findings

This introduction sets the special issue in the context of the European Academy of Management (EURAM) track with the same theme. It also provides an outline for the special issue highlighting the main topics in terms of technology and innovation management in large and small firms in China; as well as lessons drawn from academic institutions involved in provision of management education both at research and taught – MBA‐level degree programs.

Research limitations/implications

This special issue is limited in the number of contributions that they are submitted to the EURAM Conference and track on “innovation in Chinese firms” in 2008 and 2009. The research implications for firm strategy and government policy draw on limited empirical evidence mainly from case studies and interviews with selected experts.

Originality/value

The originality of this special issue is that it brings together empirical findings from a broad range of large state owned companies, small and medium enterprises, and Chinese and foreign universities and business schools interested in management education in China.
Assessment of after‐sales service behaviors of Ethiopia Telecom customers
Authors: Mouly Potluri Rajasekhara , Hawariat Hailemichael W.
Published: April 2010

Purpose

The primary purpose of this paper is to assess and review fixed‐line telecom customers' perception of the quality of after‐sales services provided by Ethiopian Telecom.

Design/methodology/approach

The paper was conducted on telecom customers who are in Addis Ababa using self‐administered questionnaires sent to a sample of 450 respondents. In addition to this, interviews were conducted with managers and selected employees to provide supporting data. The data were processed, analyzed and interpreted using Statistical Package for the Social Sciences.

Findings

The results show some degree of customer dissatisfaction, but not to the extent expected. Dissatisfied customers point at lack of clarities of bills and delays in making decisions on complaints as some of the main reasons for their dissatisfactions. Other reasons include telephone interruptions during rainy seasons, old cables and networks, and damaged and stolen cables, which combined, increase the frequency of faults and interruptions. Nearly 40 percent of respondents have negative assessments of the role of employees in delivering good quality after‐sales service.

Practical implications

Despite the fact that some improvements have been shown in recent reports, Ethiopian Telecom has a long way to go in achieving its objectives with respect to customers' satisfaction.

Originality/value

Previous studies on telecommunication in Africa have not focused on service delivery and customer satisfaction. The paper, therefore, contributes to filling a research gap in telecommunication studies in Africa in general and in Ethiopia in particular.
Lean Six Sigma – getting better all the time
Authors: Snee Ronald D.
Published: April 2010

Purpose

The purpose of this paper is to assess Lean Six Sigma to identify important advances over the last ten to 15 years and discuss emerging trends that suggest how the methodology needs to evolve. The goal is to aid those who want to use the method to improve performance as well as assist those developing improvement methodologies.

Design/methodology/approach

The use and development of Lean Six Sigma is reviewed including the origins of the method, the what, why and benefits of the method, how the approach is different, the integration of Lean and Six Sigma, implementation mistakes made, lessons learned and developments needed in the future.

Findings

It is found that organizations have many different improvement needs that require the objectives and methods contained in the lean and Six Sigma methodologies. It is also found that deployment and sustaining improvements are major issues that can be overcome by building a sustaining infrastructure and making improvement a business process. Critical issues include using Lean Six Sigma to generate cash in difficult economic times, development of data‐based process management systems and the use of working on improvement as a leadership development tool.

Practical implications

These findings suggest that improvement is most effective when approached in an holistic manner addressing improvement in all parts of the organization using a holistic improvement methodology such as Lean Six Sigma. Improvement must address the flow of information and materials thorough processes as well as the enhancement of value‐adding process steps that create the product for the customer. This leads naturally to making improvement a business process that is planned for, operated and reviewed as any other important business process is.

Originality/value

The roadmaps, guiding principles, and deployment pitfalls identified will be of value to those initiating and operating improvement processes in their organizations enabling them to rapidly create useful and sustainable improvements. The discussion of needed enhancements will be of value to those who are working to improve the effectiveness of the approach.
A modern framework for achieving enterprise excellence
Authors: Montgomery Douglas C.
Published: April 2010

Purpose

This paper aims to present a quality and business improvement framework based on Six Sigma/design, measure, analyze, improve, and control (DMAIC); design for Six Sigma (DFSS); and Lean principles. An historical perspective on these methods is also provided.

Design/methodology/approach

Through a discussion of the fundamental components of Six Sigma, DFSS and Lean a deployment strategy is developed. This approach is consistent with Deming's philosophy of quality improvement and is based on his system of profound knowledge.

Findings

A quality/process improvement effort that utilizes Six Sigma and DMAIC, DFSS, and Lean can form two of the three basic building blocks of a company‐wide quality management system.

Research limitations/implications

Some implications for education of future business leaders in a variety of disciplines including engineering, statistics and business administration are discussed. More widespread education about DMAIC and the associated problem‐solving tools is needed.

Originality/value

This paper provides practical guidance for implementing quality and productivity improvement across a wide range of industrial and business endeavors.
Ontogenetic changes in schooling behaviour during larval and early juvenile stages of Pacific bluefin tuna Thunnus orientalis
Authors: Fukuda H. , Torisawa S. , Sawada Y. , Takagi T.
Published: April 2010

Schooling was first observed at 25–27 days after hatching (26· 2–33· 8 mm, total length) in the Pacific bluefin tuna Thunnus orientalis. At this time, the mode of swimming changed from intermittent sprinting to continuous cruising, and this allowed the fish to adjust to an inertial hydrodynamic environment.
The sources of disease‐related information for Estonia’s rheumatoid arthritis patients: a qualitative study
Authors: Tammaru Marika , Polluste Kaja , Lember Margus
Published: April 2010

Objective.  To describe rheumatoid arthritis patients’ perceptions of being informed and of the value of the information obtained.

Background.  About the accessibility of the disease‐specific information to the patients, a prerequisite for any kind of the patient empowerment, can be considered as a priority area for investigation.

Design.  Six focus groups (involving 27 patients) were conducted. For analysing the data, thematic analysis was applied.

Results.  The participants referred to the media and the Internet, in‐patient units, physicians at out‐patient consultations, patients organisations, fellow patients and their own experience as the sources of disease‐related information. The information delivered by the physicians was valued highest; satisfaction with the information received from the in‐patient units was expressed. The knowledge acquired through the experience was mentioned as being important for coping with the disease. The media was an easily accessible information channel, although the information from this source was less trusted. The access to the Internet was seen as being limited for certain patients groups. The availability of physician‐delivered information was described as unsatisfactory due to the organisation of information transmittal in out‐patient settings.

Conclusions.  The results indicated the current balance of information sources as being incongruous with the provision of systematic and reliable disease‐related information. The available information may also be qualitatively incomplete.

Relevance to clinical practice.  Recognition of the weak and strong points of the structure of information provision is valuable when considering the development of educational opportunities for rheumatoid arthritis patients.
The inner door: toward an understanding of suicidal patients
Authors: Tzeng Wen‐Chii , Yang Cheng‐I , Tzeng Nian‐Sheng , Ma Hei‐Shan , Chen Lin
Published: April 2010

Aims and objectives.  To describe the suicide care dilemmas that psychiatric nurses experience and how they respond to suicidal patients.

Background.  Psychiatric nurses play a major role in helping patients after suicide attempts. Little is known, however, about the ways nurses resolve their suicide care dilemmas.

Design.  Focused ethnography was used to describe the meanings and patterns of actions of psychiatric nurses in a medical centre in Taipei, Taiwan.

Methods.  Fieldwork included two years of participant observation and individual interviews with 18 psychiatric nurses. Data from transcripts of observation field notes and interviews were transcribed verbatim and analysed.

Results.  An important factor, the inner door (an invisible door inside the nurse’s mind), determined the nurse’s ability to understand the inner worlds of suicidal patients and the nurse himself or herself. In the absence of such understanding, nurses felt discouraged, labelled the patients and even restrained them, thus closing their inner doors. On the other hand, the nurses’ willingness to reflect on their own experiences and receive the patients’ teaching helped them understand the defensive patients and nurses themselves, thus opening the inner doors and enabling them to treat patients as their family or friends.

Conclusions.  The opening and closing of the inner door is a dynamic process. Nurses need to understand the essential meaning of a suicide experience to develop the insight to open the door and keep it open.

Relevance to clinical practice.  The concept of an inner door helps nurses better understand why they distance themselves from patients when they encounter clinical dilemmas and offers a way to resolve their inner conflicts through self‐reflection and appreciation of the patient’s experiences.
A review of the cultural competence view of cardiac rehabilitation
Authors: Davidson Patricia M , Gholizadeh Leila , Haghshenas Abbas , Rotem Arie , DiGiacomo Michelle , Eisenbruch Maurice , Salamonson Yenna
Published: April 2010

Aims and objectives.  This paper describes cultural competence issues within the scientific and scholarly discourse surrounding cardiac rehabilitation (CR).

Background.  CR is an important secondary prevention strategy, improving health‐related outcomes and reducing the risks of subsequent cardiovascular events. Internationally, it is widely accepted as a discrete health service model and is endorsed by government and professional bodies. Over past decades, low participation rates in CR remain a concern, particularly among minority groups and culturally and linguistically diverse populations.

Design.  Systematic review.

Methods.  Search of electronic databases.

Conclusions.  Few studies to date have described cultural competence in CR service design and as a consequence, there are minimal data to assist CR professionals and policy makers in tailoring health service delivery models. The limited scholarly debate and discussion regarding cultural competence in the CR literature limits the development and evaluation of culturally appropriate interventions.

Relevance to clinical practice.  There needs to be greater attention to the concept of cultural competence, both in practice and research settings, to ensure access to CR for people from culturally and linguistically diverse backgrounds.
The information and support needs of Faroese women hospitalised with an acute coronary syndrome
Authors: Askham Jórun , Kuhn Lisa , Frederiksen Kirsten , Davidson Patricia , Edward Karen‐Leigh , Worrall‐Carter Linda
Published: April 2010

Aim and objectives.  The aim of this study was to describe the information and support needs of Faroese women after their hospitalisation for acute coronary syndrome. The Faroe Islands are located between Iceland and Norway. There are no published studies examining recovery for women following an acute cardiac event.

Background.  Coronary heart disease remains the greatest killer of women worldwide, including on the Faroe Islands. Describing women’s experiences of their recovery processes following acute coronary syndrome can enable timely information and support for the women who are affected. It is important that this information is tailored to the cultural context of women.

Design.  This qualitative study used a descriptive‐exploratory approach.

Method.  Data were obtained by semi‐structured interviews with participants three to four weeks after hospital discharge for their first acute coronary syndrome event.

Results.  Eight women aged from 48–70 years diagnosed with acute coronary syndrome participated in the research. Two key themes emerged from the data: (1) ‘Discharged home, now what?’: illustrated the difficulties experienced by these women following discharge and (2) risk factor management and lifestyle adjustments: related to perceptions relating to risk, loss, recovery and support.

Conclusions.  The findings from this study highlight these women had minimal understanding of the risks and management of heart disease. Participants revealed their in‐hospital and postdischarge information and support needs were generally unmet.

Relevance to clinical practice.  The experience of Faroese women parallels those of women in other published studies. Nurses are well placed in healthcare to facilitate individualised support and information requirements to this clinical group. Assessing information and support needs of women is of primary importance in preparing for discharge following acute coronary syndrome.
A preliminary study to evaluate a patient‐centred asthma education programme on parental control of home environment and asthma signs and symptoms in children with moderate‐to‐severe asthma
Authors: Tzeng Li‐Fen , Chiang Li‐Chi , Hsueh Kai‐Chung , Ma Wei‐Fen , Fu Lin‐Shien
Published: April 2010

Aims and objectives.  To evaluate the effectiveness of a nurse‐led patient‐centred asthma education programme on home environmental control behaviours of parents of children with moderate or severe asthma.

Background.  Reducing allergic triggers is important self‐management behaviour for preventing asthma attacks and patient‐centred asthma education has been shown to effectively manage chronic disease.

Design.  A preliminary quasi‐experimental, non‐equivalent control group design was used.

Method.  Dyads (n = 75) of parents and their children with moderate or severe asthma (ages 6–14 years) were purposively recruited from the asthma clinics of two hospitals in central Taiwan. The experimental group of 38 children/parents from one hospital received patient‐centred asthma education. The comparison group of 37 children/parents from the other hospital received routine individual education. At pretest and at the end of the three‐month patient‐centred asthma education programme, we measured parents’ control of home environmental triggers, children’s asthma signs/symptoms and children’s pulmonary function. Data were analysed by the general linear model for repeat measures.

Results.  The level of improvement in dust and cleaning methods was significantly greater among parents in the experimental group than among those in the comparison group (p < 0·05). Children with moderate or severe asthma in the experimental group had fewer signs/symptoms of asthma and better lung function than children in the comparison group.

Conclusions.  Our patient‐centred asthma education programme improved parents’ home environmental control and children’s asthma sign/symptoms and lung function.

Relevance to clinical practice.  Nurses can play primary roles as patient educators in asthma clinics. Well‐trained patient educators can continuously monitor self‐management behaviours to improve patients’ compliance with home environmental control, thus leading to better physical outcomes in children with asthma than routine individual asthma education alone.
Nurses’ experiences of caring for non‐catheterised older infirmed patients: a descriptive study of what nurses actually do?
Authors: Ling Man Elaine Siu , Le Low Lisa Pau
Published: April 2010

Aims.  This study aims to explore nurses’ experiences of caring for non‐catheterised older infirmed patients who had suffered from recurrent urinary tract infection and strategies adopted to prevent and manage the problem.

Background.  Urinary tract infection is a complex and significant infection affecting frail older patients. Most literature focuses on prescribing treatment to treat the micro‐organisms causing the infection, with less emphasis to understand nursing perspectives of caring for frail and highly dependent older patients suffering from this condition.

Design.  Qualitative.

Methods.  A qualitative research methodology was conducted in a hospital‐based infirmary unit (composing of four wards) in Hong Kong. Fourteen nurses were interviewed using a semi‐structured interview guide.

Results.  When managing recurrent urinary tract infection of non‐catheterised older patients, nurses described the need to promptly recognise the urinary tract infection symptoms and to know the causes of the symptoms before administering any care. These formed the basis for deciding whether the patient’s urinary condition should be managed by nurses themselves or be referred to the physician for medical treatment. Based on this initial judgement, subsequent non‐invasive measures perceived by nurses to be effective were undertaken to manage the non‐medically intervened problem. Ways to improve nurses’ existing roles and work practices to better manage recurrent urinary tract infection of non‐catheterised older patients were also identified.

Conclusion.  Nurses working in infirmary wards refocused on the value of providing basic nursing care to manage this emergent and overlooked clinical problem.

Relevance to clinical practice.  Asymptomatic urinary tract infection cases should continue to receive ‘basic urinary tract infection care’ on a daily basis, as ignoring these symptoms could bring on adverse consequences. Prior knowledge and experiences acquired by nurses who cared for previously infected patients can assist in the development of interventions, so comparison of different nursing measures is possible to determine which one is the most effective in managing this clinical issue.
Walking a fine line: managing the tensions associated with medication non‐adherence in an acute inpatient psychiatric setting
Authors: Wijnveld Anne‐Marie , Crowe Marie
Published: April 2010

Aims.  The aim of this study was to use a phenomenological methodology to examine mental health nurses’ experiences of administering medications to patients who were non‐adherent in an acute inpatient service.

Background.  There is a large body of literature focused on exploring the issue of non‐adherence to prescribed medication, but there is very little examining this from mental health nurses’ perspectives. Many of the medications prescribed for patients diagnosed with a psychiatric disorder have serious side effects and limited efficacy. Mental health nurses in acute inpatient environments are regularly confronted with the difficulties inherent in the conflicting roles associated with the need to maintain therapeutic relationships and the expectation that they ensure patients take their medications.

Design.  This is a qualitative study exploring mental health nurses' descriptions of managing medication adherence in an acute inpatient unit.

Methods.  The interpretive phenomenological methodology of Van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy, 1990) was used in this study to capture the experiences of a group of nurses. This research process involves a dynamic interplay between the following six research activities: (1) turning to the nature of the lived experience; (2) investigating the experience as we live it; (3) reflecting on essential themes; (4) a description of the phenomenon through the art of writing and rewriting; (5) maintaining a strong and oriented pedagogical relation to the phenomenon; and (6) balancing the research context by considering parts and whole.

Results.  Four themes emerged from the existential analysis that described the mental health nurses’ experiences: doing the job for doctors (relationality); stopping and listening (temporality); stepping in (corporeality); and walking a fine line (spatiality).

Conclusions.  It is proposed that models of therapeutic interventions offering alternative or conjunctive treatment to medications could be incorporated into acute inpatient care and provide an enhanced therapeutic model.

Relevance to clinical practice.  Nurses in many areas struggle to manage the tensions between a medical model and a nursing model of care. This study describes how one group of nurses manage these tensions and suggests a more patient‐centred model of care.
Relationship between depression and health‐related quality of life in older Korean patients with chronic obstructive pulmonary disease
Authors: Kil Suk Yong , Oh Won Oak , Koo Bon Jin , Suk Min Hyun
Published: April 2010

Aims and objectives.  The aims are to determine the prevalence of depression and examine its impact on the health‐related quality of life (HRQoL) among older Korean patients with chronic obstructive pulmonary disease (COPD).

Background.  Realising the effects of depression on HRQoL, many studies have reported the prevalence of depression and its negative impacts on HRQoL in COPD patients. However, the majority of the studies were performed in developed countries, with very few studies occurring in developing or non‐developed countries.

Design.  Survey with the comparison of HRQoL between the COPD patients with and without depression.

Methods.  A total of 91 COPD patients completed the St. George respiratory questionnaire (SGRQ), Medical outcomes short form‐36 (SF‐36) and Beck depression inventory (BDI).

Results.  The prevalence of depression was 15·4%. The SGRQ total and impact subscores were significantly worse in the patients with depression (p < 0·05). The physical functioning, bodily pain, vitality and general health dimensions from the SF‐36 were statistically poor in the patients with depression (p < 0·05). The patients with severe and very severe lung function defects showed significantly worse total, activity and impact scores of the SGRQ and significantly poor physical functioning, role physical, bodily pain, social functioning, mental health, role emotional and general health scores on the SF‐36 (p < 0·05).

Conclusion.  In South Korea, the prevalence of depression is considerable, and depression has a negative impact on the HRQoL among older COPD patients.

Relevance to clinical practice.  The study results suggest that depression is prevalent in older COPD patients in South Korea. The presence of depression negatively impacts on the HRQoL of the COPD patients. Considering the importance of the relationship between psychological problems and HRQoL in caring for and promoting the welfare of COPD patients, this study provides fundamental information and a basis for further evaluation of this issue in developing and non‐developed countries.
A systematic review of care needs of people with traumatic brain injury (TBI) on a cognitive, emotional and behavioural level
Authors: Jennekens Natasja , De Casterlé Bernadette Dierckx , Dobbels Fabienne
Published: April 2010

Aims and objectives.  To gain an insight into the neuropsychological care needs on a cognitive, emotional and/or behavioural level from the perspective of the person living with minor traumatic brain injury.

Design.  A systematic literature review.

Method.  Medline, Psychlit, CINAHL, Cochrane and Scholar databases (1995–2007) were searched.

Results.  The research has lead to three large‐scale, American surveys on people with minor, moderate or severe traumatic brain injury. None of the surveys focused only on minor traumatic brain injury. The surveys did not made a distinction with respect to seriousness of the brain damage and the corresponding needs. In general, people with traumatic brain injury prove to have important continuing neuropsychological care needs in the chronic phase. On a cognitive level, there seems to be a particular need for aid with memory problems and problem‐solving skills. The main emotional needs are help with one’s ‘mood’, mood swings and learning how to deal with stress. For the behavioural problems, there is a particular need to help control one’s temperament. The need for care, especially for cognitive and behavioural problems, seems to increase with time. The professional help offered in the long term after the traumatic event likewise seems to be inadequate.

Conclusion.  The results of this systematic review show that we know very little about the precise needs of people with minor chronic traumatic brain injury. To change this, qualitative research is needed, allowing an in‐depth analysis of the needs and experiences of patients currently living with traumatic brain injury.

Relevance to clinical practice.  A better knowledge and understanding of the neuropsychological needs of patients with traumatic brain injury will help health care providers to offer more effective care.
The effect of crossing legs on blood pressure in hypertensive patients
Authors: Pinar Rukiye , Ataalkin Sıddıka , Watson Roger
Published: April 2010

Aims.  The aim of this study was to examine whether there is any difference between BP readings with patients crossing a leg at the knee level and uncrossing during BP measurement.

Background.  It is clear that numerous factors influence an individual’s blood pressure (BP) measurement. However, guidelines for accurately measuring BP inconsistently specify that the patient should keep feet flat on the floor.

Design.  Repeated measures.

Method.  Using a mercury‐filled column sphygmomanometer, BP was measured at uncrossed leg position, crossed leg position and again at uncrossed leg position in 283 unmedicated or medicated patients. Three experienced nurses specially trained for the study performed BP measurements.

Results.  The results indicated that BP increased significantly with the crossed leg position. Systolic and diastolic BP significantly increased approximately 10 and 8 mmHg, respectively.

Conclusion.  Crossing the leg at knee results in a significant increase in BP.

Relevance to clinical practice.  Leg position during measurement of BP should be standardised and mentioned in publications.
Women’s postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesarean section
Authors: Karlström Annika , Engström‐Olofsson Regina , Nystedt Astrid , Sjöling Mats , Hildingsson Ingegerd
Published: April 2010

Aim.  The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.

Background.  Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.

Design.  Comparative patient survey.

Methods.  Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi‐square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.

Results.  The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.

Conclusions.  Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.

Relevance to clinical practice.  The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.
Adult‐Onset Hypothyroidism Induces the Amyloidogenic Pathway of Amyloid Precursor Protein Processing in the Rat Hippocampus
Authors: Ghenimi N. , Alfos S. , Redonnet A. , Higueret P. , Pallet V. , Enderlin V.
Published: April 2010

Thyroid dysfunction and dementia are conditions that become more prevalent with advancing age. Localised hypothyroidism of the central nervous system has been sugested in some patients with Alzheimer’s disease. We investigated the consequence of adult‐onset hypothyroidism on β‐amyloid precursor protein (APP) degrading pathways in rats treated with propylthiouracyl over a period of 5 weeks. We evaluated the amount of 3,5,3′‐triiodothyronine nuclear receptors (TRα1 and TRβ) and the expression of some APP processing indicators (i.e. APP, ADAM 10, BACE and PS1). The activity of secretases and Aβ peptides has been also quantified. The results obtained show that hypoactivity of the thyroid signalling pathway in the hippocampus induced an increase in the APP770‐751/APP695 ratio accompanied by a modification in the amyloidogenic pathway for APP processing, leading to an increased amount of Aβ peptides. In this area of the brain, modification in the non‐amyloidogenic pathway of APP processing characterised by α‐secretase activity was only approximately 10% in hypothyroid rats compared to control rats. We suggest that hypothyroidism, which becomes more prevalent with advancing age, increased the vulnerability to the formation of amyloid deposits.
Left ventricle remodelling is associated with sleep‐disordered breathing in non‐ischaemic cardiopathy with systolic dysfunction
Authors: DAMY THIBAUD , PAULINO ALEXANDRA , MARGARIT LAURENT , DROUOT XAVIER , STOICA MARIA , VERMES EMMANUELLE , GUERET PASCAL , ADNOT SERGE , DUBOIS RANDE JEAN‐LUC , D'’ORTHO MARIE‐PIA , HITTINGER LUC
Published: April 2010

Sleep‐disordered breathing (SDB) is associated with left ventricle (LV) remodelling in patients with normal LV function. Sleep‐disordered breathing is common in chronic heart failure (CHF) with systolic LV dysfunction, and may contribute to LV remodelling and CHF progression. Our aim was to determine the consequence of SDB on LV geometry in patients with CHF. We hypothesised that SDB severity was correlated with the degree of LV hypertrophy (LVH). One‐hundred and sixty patients with CHF with a non‐ischaemic systolic LV dysfunction were assessed by overnight polygraphy and echocardiography. Patients were classified in four groups according to their apnoea–hypopnoea index (AHI): <5 (no‐SDB); 5–14 (mild); 15–29 (moderate); ≥30 (severe). Left ventricular mass index (LVM Ind) was calculated using the usual echocardiographic M‐Mode parameters. Their mean age, New York Heart Association and left ventricular ejection fraction were, respectively: 56 ± 13 years, 2.4 ± 0.8 and 30 ± 10%, and 77% were men. Body mass index, interventricular septal and posterior LV wall thicknesses, and LVM Ind were significantly increased in severe SDB versus no‐SDB. LVM Ind was correlated to the AHI (R = 0.27, P = 0.0006) and, using logistic regression, AHI was the unique independent factor of LVH in this population. In non‐ischaemic CHF, SDB severity is associated with LV remodelling.
Maternal use of nicotine replacement therapy during pregnancy and offspring birthweight: a study within the Danish National Birth Cohort
Authors: Lassen Tina H. , Madsen Mia , Skovgaard Lene T. , Strandberg‐Larsen Katrine , Olsen Jørn , Andersen Anne‐Marie N.
Published: April 2010

Lassen TH, Madsen M, Skovgaard LT, Strandberg‐Larsen K, Olsen J, Andersen A‐MN. Maternal use of nicotine replacement therapy during pregnancy and offspring birthweight: a study within the Danish National Birth Cohort. Paediatric and Perinatal Epidemiology 2010; 24: 272–281.

Smoking is a well‐established risk factor for fetal growth restriction and other adverse pregnancy outcomes, and nicotine may be one of the chemical compounds that drive these associations. Nicotine replacement therapy (NRT) is a smoking cessation aid, which can facilitate smoking cessation. It is, however, unknown whether NRT used during pregnancy impairs fetal growth. The aim of this study was to estimate the association between the use of NRT during pregnancy and offspring birthweight. The study population consisted of 72 761 women enrolled in the Danish National Birth Cohort between 1996 and 2002. Information on NRT and potential confounders was obtained from two computer‐assisted telephone interviews conducted in the second and third trimesters, respectively. Multiple linear regression in a multilevel model was used to estimate the association between NRT use and birthweight adjusted for gestational age and potential confounders.

The adjusted analyses showed no significant association between the duration of NRT use and birthweight (b = 0.25 g per week of NRT use [95% CI −2.31, 2.81]) and neither was the type of NRT product (patch, gum, inhaler) associated with reduced birthweight. However, simultaneous use of more than one NRT product was associated with reduced birthweight (b = −10.73 g per week of NRT use [95% CI −26.51, 5.05]), although the association was not statistically significant. The results of this study suggest that maternal use of NRT in pregnancy does not seriously affect birthweight, but there could be a negative effect on birthweight associated with simultaneous use of more than one type of NRT product.
Mothers' and fathers' birth characteristics and perinatal mortality in their offspring: a population‐based cohort study
Authors: Nordtveit Tone I. , Melve Kari K. , Skjaerven Rolv
Published: April 2010

Nordtveit TI, Melve KK, Skjaerven R. Mothers' and fathers' birth characteristics and perinatal mortality in their offspring: a population‐based cohort study. Paediatric and Perinatal Epidemiology 2010; 24: 282–292.

There is increasing interest in the associations between parental birthweight and gestational age with their perinatal outcomes. We investigated perinatal mortality risk in offspring in relation to maternal and paternal gestational age and birthweight. We used population‐based generational data from the Medical Birth Registry of Norway, 1967–2006. Singletons in both generations were included, forming 520 794 mother–offspring and 376 924 father–offspring units.

Perinatal mortality in offspring was not significantly associated with paternal gestational age or birthweight, whereas it was inversely associated with maternal gestational age. A threefold increased risk in perinatal mortality was found among offspring of mothers born at 28–30 weeks of gestation relative to offspring of mothers born at term (37–43 weeks) (relative risk: 2.9, 95% CI 1.9, 4.6). There was also an overall association between maternal birthweight and offspring perinatal mortality. Relative risk for mothers whose birthweight was <2000 g was 1.5 (95% CI 1.1, 1.9), relative to mothers whose birthweight was 3500–3999 g. However, confined to mothers born at ≥34 weeks of gestation, the birthweight association was not significant. Weight‐specific perinatal mortality in offspring was dependent on the birthweight of the mother and the father, that is, offspring who were small relative to their mother's or father's birthweight had increased perinatal mortality. In conclusion, a mother's gestational age, and not her birthweight, was significantly associated with perinatal mortality in the offspring, while there was no such association for the father.
Association of maternal prenatal depressive symptoms with child cognition at age 3 years
Authors: Tse Alison C. , Rich‐Edwards Janet W. , Rifas‐Shiman Sheryl L. , Gillman Matthew W. , Oken Emily
Published: April 2010

Tse AC, Rich‐Edwards JW, Rifas‐Shiman SL, Gillman MW, Oken E. Association of maternal prenatal depressive symptoms with child cognition at age 3 years. Paediatric and Perinatal Epidemiology 2010; 24: 232–240.

We examined the association of prenatal depressive symptoms at mid‐pregnancy with child cognition at age 3 years in Project Viva, a pre‐birth cohort study of 1030 mother–child pairs in eastern Massachusetts. We measured maternal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS), a self‐report measure validated for use during pregnancy. Measures of child cognition included the Peabody Picture Vocabulary Test (PPVT) and the Wide Range Achievement of Visual Motor Abilities (WRAVMA).

At mid‐pregnancy, 81 mothers (7.9%) scored 13 or above on the EPDS, indicating probable depression. In the unadjusted model, children born to mothers with prenatal depressive symptoms had PPVT scores that were 3.8 points lower [95% confidence interval (CI) −7.1, −0.5]. With adjustment for sociodemographic variables, the association substantially attenuated [adjusted regression coefficient b for PPVT score = −0.7 (95% CI −3.6, 2.3)]. In both unadjusted and multivariable models, prenatal depressive symptoms were not associated with WRAVMA scores [adjusted b for total WRAVMA score = −0.5 (95% CI −3.0, 2.1)]. We found no evidence to suggest that maternal prenatal depression is independently associated with early child cognition.
Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort
Authors: de Moura Danilo R. , Costa Jaderson C. , Santos Iná S. , Barros Aluísio J. D , Matijasevich Alicia , Halpern Ricardo , Dumith Samuel , Karam Simone , Barros Fernando C.
Published: April 2010

de Moura DR, Costa JC, Santos IS, Barros AJD, Matijasevich A, Halpern R, Dumith S, Karam S, Barros FC. Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort. Paediatric and Perinatal Epidemiology 2010; 24: 211–221.

Many children are at risk of not achieving their full potential for development. Epidemiological studies have the advantage of being able to identify a number of associated factors potentially amenable to intervention. Our purpose was to identify risk factors for suspected developmental delay (SDD) at age 2 years among all children born in the city of Pelotas, Brazil, in 2004. This study was part of the 2004 Pelotas Birth Cohort. The Battelle Screening Developmental Inventory (BSDI) was administered to cohort children at age 2 years. A hierarchical model of determination for SDD with confounder adjustment was built including maternal sociodemographic, reproductive and gestational characteristics, as well as child and environmental characteristics. Multivariable analysis was carried out using Poisson regression. Prevalence ratios (PR) and 95% confidence intervals [95% CI] were calculated.

In the results, 3.3% of the 3869 children studied screened positive for SDD. After confounder control, children more likely to show SDD were: those with positive BSDI at age 12 months (PR = 5.51 [3.59, 8.47]); with 5‐min Apgar <7 (PR = 3.52 [1.70, 7.27]); with mothers who had <4 years of schooling (PR = 3.35 [1.98, 5.66]); from social classes D and E (PR = 3.00 [1.45, 6.19]); with a history of gestational diabetes (PR = 2.77 [1.34, 5.75]); born <24 months after the last sibling (PR = 2.46 [1.42, 4.27]); were not told child stories in the preceding week (PR 2.28 [1.43, 3.63]); did not have children's literature at home (PR = 2.08 [1.27, 3.39]); with low birthweight (PR = 1.75 [1.00, 3.07]); were born preterm (PR = 1.74 [1.07, 2.81]); with <6 antenatal care appointments (PR = 1.70 [1.07, 2.68]); with history of hospitalisation (PR = 1.65 [1.09, 2.50]); and of male sex (PR = 1.43 [1.00, 2.04]). These risk factors may constitute potential targets for intervention by public policies and may provide help to paediatricians in preventing developmental delay.
Chromodomain proteins in development: lessons from CHARGE syndrome
Authors: Layman WS , Hurd EA , Martin DM
Published: April 2010

Layman WS, Hurd EA, Martin DM. Chromodomain proteins in development: lessons from CHARGE syndrome.

In humans, heterozygous mutations in the adenosine triphosphate‐dependent chromatin remodeling gene CHD7 cause CHARGE syndrome, a common cause of deaf–blindness, balance disorders, congenital heart malformations, and olfactory dysfunction with an estimated incidence of approximately 1 in 10,000 newborns. The clinical features of CHARGE in humans and mice are highly variable and incompletely penetrant, and most mutations appear to result in haploinsufficiency of functional CHD7 protein. Mice with heterozygous loss of function mutations in Chd7 are a good model for CHARGE syndrome, and analyses of mouse mutant phenotypes have begun to clarify a role for CHD7 during development and into adulthood. Chd7 heterozygous mutant mice have postnatal delayed growth, inner ear malformations, anosmia/hyposmia, and craniofacial defects, and Chd7 homozygous mutants are embryonic lethal. A central question in developmental biology is how chromodomain proteins like CHD7 regulate important developmental processes, and whether they directly activate or repress downstream gene transcription or act more globally to alter chromatin structure and/or function. CHD7 is expressed in a wide variety of tissues during development, suggesting that it has tissue‐specific and developmental stage‐specific roles. Here, we review recent and ongoing analyses of CHD7 function in mouse models and cell‐based systems. These studies explore tissue‐specific effects of CHD7 deficiency, known CHD7 interacting proteins, and downstream target sites for CHD7 binding. CHD7 is emerging as a critical regulator of important developmental processes in organs affected by human CHARGE syndrome.
Different cytokine profile and eosinophil activation are involved in rhinovirus‐ and RS virus‐induced acute exacerbation of childhood wheezing
Authors: Kato Masahiko , Tsukagoshi Hiroyuki , Yoshizumi Masakazu , Saitoh Mika , Kozawa Kunihisa , Yamada Yoshiyuki , Maruyama Kenichi , Hayashi Yasuhide , Kimura Hirokazu
Published: April 2010

To cite this article: Kato M, Tsukagoshi H, Yoshizumi M, Saitoh M, Kozawa K, Yamada Y, Maruyama K, Hayashi Y, Kimura H. Different cytokine profile and eosinophil activation are involved in rhinovirus‐ and RS virus‐induced acute exacerbation of childhood wheezing.Pediatr Allergy Immunol 2011; 22: e87–e94.

Because little information is available on eosinophil activation and cytokine response in virus‐induced wheezing, we attempted to detect respiratory viruses and measure eosinophil cationic protein (ECP), and 27 types of cytokines/chemokines in both serum and nasal secretions from children with wheezing. This study was an observational, case–control investigation of 267 subjects, who were visited and/or hospitalized with acute respiratory symptoms (with wheezing: men, 115; women, 59; mean/median age, 3.6/3.0 years) or who were visited for regular physical examination and treatment (non‐symptomatic wheezing: men, 48; women, 31; mean/median, 5.0/4.7 years), and 14 control subjects (controls: men, 9; women, 5; mean/median, 3.6/3.7 years). We detected viruses in nasal secretions from 174 patients with acute exacerbations of wheezing using antigen detection kits or reverse transcription‐polymerase chain reaction, followed by direct DNA sequencing analysis. We measured peripheral eosinophil counts, and serum concentrations of ECP and 27 cytokines/chemokines using a multiplex bead‐based assay in patients with wheezing or non‐symptomatic wheezing. We also examined nasal ECP and 27 cytokines/chemokines in patients with wheezing. Of 174 samples from wheezing exacerbations, rhinovirus was detected in 59; respiratory syncytial (RS) virus in 44; enterovirus in 17; other viruses in 19; and no viruses in 35. Serum concentrations of ECP, IL‐5, IL‐6, IL‐1ra, and IP‐10 were significantly elevated in rhinovirus‐induced wheezing compared with non‐symptomatic wheezing. Similarly, serum ECP, IL‐5, and IP‐10 were significantly higher in rhinovirus‐induced wheezing than in controls. On the other hand, IL‐1ra and IP‐10, but not ECP and IL‐5 were significantly higher in RS virus‐induced wheezing than in controls. Furthermore, only IL‐5 was significantly elevated in the rhinovirus group compared with the RS virus group in both serum and nasal secretions. Different cytokine profile and eosinophil activation might be involved in rhinovirus‐ and RS virus‐induced acute exacerbation of childhood wheezing.
Morph‐specific selection on floral traits in a polymorphic plant
Authors: VANHOENACKER D. , TORÄNG P. , ÅGREN J. , EHRLÉN J.
Published: April 2010

Correlations between phenotypic traits are common in many organisms, but the relative importance of nonadaptive mechanisms and selection for the evolution and maintenance of such correlations are poorly understood. In polymorphic species, morphs may evolve quantitative differences in additional characters as a result of morph‐specific selection. The perennial rosette herbPrimula farinosais polymorphic for scape length. The short‐scaped morph is less damaged by grazers and seed predators but is more strongly pollen limited than the long‐scaped morph. We examined whether morph‐specific differences in biotic interactions are associated with differences in selection on two other traits affecting floral display (number of flowers and petal size) and on one trait likely to affect pollination efficiency (corolla tube width) in threeP. farinosapopulations. Differences in selection between morphs were detected in one population. In this population, selection for more flowers and larger petals was stronger in the short‐scaped than in the long‐scaped morph, and although there was selection for narrower corolla tubes in the short‐scaped morph, no statistically significant selection on corolla tube width could be detected in the long‐scaped morph. In the study populations, the short‐scaped morph produced more and larger flowers and wider corolla tubes. Current morph‐specific selection was thus only partly consistent with trait differences between morphs. The results provide evidence of morph‐specific selection on traits associated with floral display and pollination efficiency, respectively.