bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial effects of river blindness in a rural community in Nigeria
Authors: Wagbatsoma V A , Okojie O H
Published: November 2005

Onchocerciasis (river blindness) is a serious public health problem with important socioeconomic consequences. The presence of onchocercal skin lesions is unsightly and has a psychosocial effect on the affected.

This cross-sectional study was undertaken to assess the perception and social implication of onchocerciasis in the village of Apana in Nigeria. Apana is a rural community, hyper-endemic for onchocerciasis and currently receiving ivermectin treatment. The village is one of the ten communities of Uzairue district of Etsako West Local Government Area (LGA), Edo State, Nigeria. There are many water streams in the community which serve the domestic needs of the inhabitants but also provide the breeding sites for the vector flies of onchocerciasis.

Multi-stage sampling methods were used to select the 385 respondents that participated after informed consent was obtained. A structured researcher-administered questionnaire was the tool for data collection. Of the 385 respondents that participated in the survey, 240 (62.3%) were male while 145 (37.7%) were female. The awareness of the disease among the respondents was fair. They were aware of the nuisance value of blackflies (‘Uja-ini’) and associated the bite with itching. The signs and symptoms of onchocerciasis were recognised as specific diseases with specific local names. They called itching and rashes ‘Erhue’, nodules and leopard skin ‘Evbiomu-Ogui’, worm in the eye ‘Okogho-Ikpalo’ and blindness ‘Orunalo’. The attitude of the non-affected towards the affected was partially discriminatory and suspicious. The affected were socially withdrawn, probably due to the frustration of their health condition. There is a need to improve people’s attitude towards the disease and improve disease awareness through appropriate health education, which will encourage the acceptance of ivermectin as adequate treatment and compliance to the treatment regimen to reduce morbidity and promote self-esteem.
Gastrointestinal disorders: are health care professionals missing zoonotic causes?
Authors: Warwick Clifford
Published: November 2005

Acute gastrointestinal disorders (AGIDs) of presumed infectious origin are common illnesses and among the most frequent infective diseases referred to hospital. Much is known about the diagnosis and aetiology of AGIDs, but relatively little work appears to have been done regarding the assessment of relevant general practitioner (GP) history-taking and the potential for under-recognition of sources such as zoonoses. Established sources of zoonosis (for example exotic pet-keeping, farmyards and zoological parks) seem either rarely considered or annotated. Surveillance of food-borne illness and its aetiology attracts rapidly increasing attention in the public health community and these infections have been targeted for serious reduction. Zoonoses may present as food-borne illness.

The aim of this study was to assess the potential for under-ascertainment and under-reporting of important sources of gastrointestinal infection. The study examined history-taking habits among GPs with reference to their general scope for either detecting or missing diverse sources of acute gastrointestinal infections. From a medical practice perspective, more specific identification of pathogenic factors may potentially promote wider preventive measures by alerting the public to unconsidered or recurrent problems. The study was conducted at a busy British health centre that currently accommodates eight GPs and several training personnel. The health centre has approximately 12,000-13,000 patients.

The patient presentation records and GP notes were accessed via the health centre’s computer database. Data on acute gastrointestinal disorders were obtained using the Read codes for both ‘diarrhoea of presumed infectious origin’ (DPI) and ‘gastroenteritis of presumed infectious origin’ (GPI). The first 35 cases were selected from the DPI list (10% of ‘names’), and the first 24 cases were selected from the GPI list (10% of ‘names’).

Symptoms were unspecified in 11 out of the 24 GPI presentations compared to four unspecified out of 35 DPI presentations. Potentially significant history was unspecified in 22 out of the 24 GPI presentations compared to 27 unspecified out of 35 DPI presentations.

Among potential sources of infection are: pet shops; exotic and domestic pets; farm animals/environments; and zoos and other wildlife centres. These established sources of potential infection are, however, only infrequently enquired into by GPs; thus their pathological significance may be easily overlooked. By using a standard setting ‘pathogen source questionnaire’ GPs might alert themselves to domestic or wider media of infection as well as enable more precise cues regarding when to sample and when to refer to hospital.
Infantile colic: a review
Authors: Leung Alexander K C , Lemay Jean François
Published: November 2005

Infantile colic is characterised by episodes of uncontrollable crying or fussing in an otherwise healthy and well-fed infant less than three months of age. The episodes of crying in an infant with colic last more than three hours per day and more than three days per week for at least three weeks.

The condition can be very stressful for the family. Cows’ milk proteins appear to be associated with the prevalence of infantile colic in a significant number of cases. Supportive counselling, reassurance, and dietary modifications if necessary, are the core measures used for the treatment of this condition. In most infants, infantile colic resolves by three to four months of age.
Erectile dysfunction: a need for greater awareness
Authors: Lau David H W , Mumtaz Faiz H , Thompson Cecil S , Mikhailidis Dimitri P
Published: November 2005

Research has led to effective treatment regimes for erectile dysfunction (ED). Convincing evidence links vascular risk factors (hypertension, diabetes mellitus, hyperlipidaemia and smoking) with ED. This association is not surprising since the corpus cavernosum is a modified vascular tissue. This review presents a brief account of the aetiology, diagnosis and treatment of ED. There is a need to raise awareness of this condition and to make appropriate treatment available to patients.
Benign prostatic hyperplasia
Authors: Shabbir Majid , Mumtaz Faiz H
Published: November 2005

Benign prostatic hyperplasia (BPH) is a common condition, which increases with increasing age. Although not a life-threatening condition, BPH can significantly affect quality of life. BPH manifests clinically with lower urinary tract symptoms (LUTS) and may be associated with sexual dysfunction. As many as 60% of men aged 60 years have some degree of clinical BPH. With the projected increases in the distribution of people over the age of 60, BPH is set to become an even greater problem in men’s health.
It’s a Goal!: basing a community psychiatric nursing service in a local football stadium
Authors: Pringle Alan , Sayers Pete
Published: November 2005

This paper describes the development of a community mental health project in a local football stadium.

Funded for three years by the Laureus Foundation’s ‘Sport for Good’ initiative, the project provides mental health promotion and mental health awareness input targeted initially at young men, a group who are often very difficult to engage in this type work.

Using group interventions and utilising football as a metaphor, the project helps young men address issues around depression, self-esteem and inclusion, and addresses the subject of suicide which remains the second biggest cause of death in young men in Britain.

The paper describes the development of the project, the structure of the groups and the evaluation of the first two groups to complete the process.

The work takes place in the Moss Rose stadium, home of Macclesfield Town, a team in the English Football League.
The role of the military in post-conflict situations
Authors: Court Bruce V
Published: November 2005

This article considers the possible role of the military in relation to ‘post-conflict situations’ and helping to improve the health of affected civilian populations. The opinions expressed are personal reflections which draw upon the author’s recent military medical experience in southern Iraq in 2004. The perspective of humanitarian aid agencies that have strong reservations about any involvement with the military is recognised, as they seek to maintain neutrality and the safety of their staff.

The environment itself, however, may represent an unacceptable level of threat to humanitarian aid agencies, if their personnel are at risk of serious intimidation, e.g. kidnap or murder. Where terrorist and insurgent para-military groups emerge in a post-war fighting phase, it may be that the military is best placed to help co-ordinate efforts to ensure public health and health care provision until a satisfactory level of security is attained and humanitarian aid agencies are able to operate with confidence.
Missing persons in post-conflict settings: best practices for integrating psychosocial and scientific approaches
Authors: Keough Mary Ellen , Simmons Tal , Samuels Margaret
Published: November 2005

This paper argues the importance of establishing integrated systems to meet the needs of forensic investigations as well as the needs of families of the missing in post-conflict situations. Meeting the psychosocial needs of families to resolve uncertainty and to recover the remains of their loved ones must be part of a multidisciplinary team approach to a transparent and standardised scientific investigative protocol.

The authors present several case studies from the former Yugoslavia illustrating community-based interventions combining education projects and participation in antemortem data collection as well as providing a support network for families of the missing. The participation of the scientific investigators (pathologists, anthropologists, crime scene investigators, etc), many of whom are unprepared for the presence of family members at the scene, is critical to the success of the integrated process. Providing for and sustaining a long term follow-up programme with families, who may require ongoing mental health and social support, is also essential.
Disposal of children's faeces and implications for the control of childhood diarrhoea
Authors: Jinadu Musa K , Esmai Olapeju A , Adegbenro Caleb A
Published: November 2005

Unhygienic disposal of children’s faeces is one of the key factors responsible for the high incidence of childhood diarrhoea in developing countries. The aim of this project was to study household behaviours relating to the disposal of faeces of children under the age of five.

The study was conducted in Ife South Local Government Area of Osun State, Nigeria, where 320 households, containing 540 mothers with children under the age of five were randomly selected. Data was collected by observation using a schedule specifically designed for the study. Our findings show that while over 80% of children under the age of seven months defecated on a napkin, the majority of older children (over seven months of age) defecated on either the floor of the household and their surroundings or outside in the household's vicinity.

Mothers usually cleaned up the children's faeces which were then thrown into a pit latrine. In some cases dogs were used to clean up the faecal matter on the floor. In either case faecal residue remained on the floor.

The authors recommend educational interventions to change the unhygienic practices relating to clean up and disposal of children's faeces. The interventions include encouraging children to defecate in plastic chamber pots, promoting the practice of hand washing with soap and water after cleaning up the children's faeces and the construction of affordable and ventilated latrines by members of the communities.
Randomised-controlled trial of a fibre supplement on the symptoms of irritable bowel syndrome
Authors: Rees Gail , Davies Jill , Thompson Richard , Parker Mike , Liepins Peter
Published: November 2005

The aim of this study was to assess the effect of coarse wheat bran on specific bowel function parameters and symptoms in patients with irritable bowel syndrome (IBS). A longitudinal, prospective, randomised, placebo-controlled trial was undertaken. The duration of treatment was eight to 12 weeks and this consisted of 10-20g/day of coarse wheat bran or a low fibre placebo taken in addition to the normal diet. Twenty-eight outpatients fulfilling the Rome criteria for constipation-predominant IBS were recruited to the trial (14 in the treatment group; 14 in the placebo group). Twelve people completed the trial in the treatment group and ten in the placebo group.

The main outcome measures included changes in symptoms recorded in a diary, changes in objective measurements of bowel function and subjective overall feelings of improvement. The bran group significantly increased their non-starch polysaccharide (NSP) intake over that of the placebo group (p<0.05). Mean stool wet weight increased significantly more in the bran group than in the placebo group (p<0.05), but other bowel function measurements and all recorded symptoms were not different. Many patients reported changes in bowel habit that were not reflected in the objective measurements. The addition of coarse wheat bran to the diet increased NSP ingestion and stool wet weight in this group of IBS patients, but no evidence was obtained that such treatment was of benefit to these patients, other than a placebo effect on symptoms.
Effectiveness of saliva substitute products in the treatment of dry mouth in the elderly: a pilot study
Authors: Matear David W , Barbaro John
Published: November 2005

The aging population is susceptible to developing dry mouth (xerostomia). Elderly patients present all of the major risk factors to acquiring dry mouth which include systemic diseases and disorders, such as diabetes and depression, and the use of numerous medications, including anti-hypertensives and anti-depressants. The consequences of untreated dry mouth are severe limitations of masticatory function and speech, and increased risk of developing caries, periodontal diseases and fungal infections. Assessment of xerostomia, which includes a set of signs and symptoms that impact on the individual, can only be fully explored through a thorough medical history, intra-oral examination and recording the subjective views of patients.

This study suggests a methodology for the assessment of xerostomia through a xerostomia questionnaire, which was used to evaluate the effectiveness and acceptability of a saliva substitute product (BiotèneTM) in the treatment of xerostomia in 20 elderly patients exhibiting both severe and moderate symptoms. Wilcoxon signed-ranked tests revealed significant improvements in the number and severity of symptoms between the pre-test and the post-test groups. Biotène products were also found to be effective in the treatment of both severe and moderate symptoms of xerostomia. Biotène saliva substitutes are an acceptable and effective method of treatment for elderly people suffering from dry mouth.
Risks and benefits of the single versus the triple MMR vaccine: how can health professionals reassure parents?
Authors: McGreevy Deborah
Published: November 2005

Measles, mumps and rubella (MMR) are all preventable but infectious diseases caused by viruses. A particular study by Wakefield et al1 suggests that there are potentially adverse effects of having the triple MMR vaccine. This has been reported widely by the media and has caused alarm to parents of young children, probably contributing to the decline in its uptake.2-5 In order to provide the context for the debate regarding the single versus the triple vaccine, this paper briefly appraises firstly, the Wakefield et al research paper1 that has led to public health concerns and secondly, a more rigorous research study (Madsen et al6) that contradicts the findings; the paper then explores the risks and benefits of the single and the triple MMR vaccine programmes, finally providing a short discussion on factors that might influence the decision-making process by parents when faced with the dilemma of not having their child vaccinated, or opting for either the single or triple vaccination programme.
Anxiety, depression and smoking in schoolchildren - implications for smoking prevention
Authors: Dudas Robert B , Hans Katalin , Barabas Katalin
Published: November 2005

The prevalence of smoking among 14 to 18-year-old adolescents (one out of three) is as high as in the general population in Hungary. Depression and anxiety disorders are also major public health problems. Our objective was to investigate the correlations between smoking status and anxiety and depressive symptoms, as well as to identify potential implications for the prevention of nicotine dependence.

We used a self-developed questionnaire to survey smoking behaviour, and standard self-evaluation tests (the Hungarian version of the Spielberger’s State-Trait Anxiety Inventory for Children and the Children’s Depression Inventory) to capture anxiety and depressive symptoms in 215 students from randomly selected technical and high schools.

Smoking students showed significantly more anxiety and depressive symptoms compared to their non-smoking peers. Importantly, occasional smokers appeared to be more anxious than non-smokers, whereas daily smokers scored higher on the depression inventory than either non-smokers or occasional smokers. The majority of students with high scores suggestive of anxiety or depressive disorders were smokers. Interestingly, levels of anxiety and depression were associated with smoking status in boys but not in girls.

The strong association found between anxiety and depressive symptoms and youth smoking, particularly in boys, suggests that reducing these symptoms (especially high, school-related anxiety) may be preventive against the onset of addictive smoking. This, together with the high level of anxiety and depression found in girls, makes it essential for all professionals dealing with adolescents and education to recognise these symptoms and their significance, and to be aware of the ways of reducing them by changes in the educational system, or medically, if necessary.
Catering for health: a review
Authors: Hartwell Heather , Symonds Catherine
Published: November 2005

Food, nutrition and health are currently under scrutiny. British eating patterns have radically changed over the past few decades, with the emergence of a ‘grazing’, ‘snacking’ culture. Simultaneously, more food is eaten outside the home and therefore the nutritional composition of foods/meals provided by catering establishments is of increasing relevance to the diet overall. Consumers are aware of the need for a healthy lifestyle and are encouraged to follow improved eating habits to avoid ‘diseases of affluence’ such as coronary heart disease, obesity, diet-related cancer and type 2 diabetes. For both economic and health reasons caterers should be encouraged to provide healthy options; however, often misconceptions exist and gaps are evident in the nutritional knowledge of this profession. Training curricula require revision. With the right information, training and support caterers can play a vital role in improving the health of the population.
Technological developments and the need for technical competencies in food services
Authors: Rodgers Svetlana
Published: November 2005

The growing scale of institutional and commercial food services poses a technological challenge of producing large quantities of high quality meals in terms of their safety, sensory and nutritional attributes. Developments in food service technology and systems (cook-freeze, cook-chill and others) allow the replacement of fast food with the service of cooked meals, which are often nutritionally superior.

Reliance on equipment, packaging and technological ‘know-how’ makes food service operations more complex. Operators have to minimise the impact of the numerous steps in the production process, the fundamental weaknesses of cook-chill food safety design, coupled with the practical limitations of Hazard Analysis Critical Control Points management, the potential unevenness of temperature distribution and product deterioration during storage. The fundamental knowledge of food science and microbiology, engineering and packaging technologies is needed. At present, the ‘high tech’ options, which can improve a product’s nutritional value, such as natural preservation hurdles or functional meals, are not used in practice.
The role of the consumption of beverages in the obesity epidemic
Authors: Bawa Sa'eed
Published: November 2005

This paper is intended to demonstrate to nutritionists, dietitians, paediatricians and other health care professionals as well as parents, primary and secondary school authorities, nutritional concerns pertaining to the consumption of soft drinks. High intake of soft drinks is associated with: 1) overweight or obesity because of the intake of additional calories in the diet; 2) increased risk of osteoporosis due to displacement of milk consumption, resulting in calcium deficiency and subsequent bone resorption; and 3) increased risk of dental caries and potential enamel erosion. School officials and parents should be aware of the health implications of vended drinks in schools before making a decision about pupils’ and students’ access to them.
Increasing HACCP awareness: a training intervention for caterers
Authors: Worsfold Denise , Worsfold Philip
Published: November 2005

The European Union Food Hygiene Regulations, which will apply to member states from 2005/06, will replace the existing body of food hygiene legislation with more modern, risk-based requirements. Food businesses (except those in primary production) will be required to put in place food safety management procedures based on Hazard Analysis Critical Control Point (HACCP) principles. In the UK, the Food Standards Agency (FSA) has set itself the target of reducing foodborne disease by 20% by 2006. It plans to do this by improving food safety through the food chain and has formulated an action plan for the catering industry which includes training, provision of guidance materials, business support and monitoring. In Wales, the FSA and the Welsh Development Agency have jointly funded local authorities to raise the HACCP awareness of caterers.

This paper reviews the approach used to raise HACCP awareness by the Local Authorities South East Wales Food Group. The Group commissioned the design, delivery and evaluation of a Hygiene and HACCP training course for caterers. Questionnaires were used to evaluate caterers’ knowledge and perceptions of, and attitudes towards, hygiene and HACCP before, during and after training. A final questionnaire was mailed out to participants several months after the training course had finished.

The results show that prior to training, the understanding of HACCP, hazards, risk and risk management was low. The results also show that caterers were not hostile to this system of food hygiene management. Following training, participants showed a greater awareness of HACCP but their perceptions of risk were still low. Some participants claimed to have implemented the HACCP system in their business following training.

Many caterers believed that additional assistance would be required to help them proceed with HACCP implementation.
What does the food handler in the home know about salmonellosis and food safety?
Authors: Gauci Charmaine , Gauci Andrew Amato
Published: November 2005

Food-borne illness causes a significant burden of disease globally. The majority of confirmed cases of food-borne illness in Malta are caused by salmonellosis. Detailed case investigations by the Disease Surveillance Unit, Malta, revealed that most of the notified cases of infectious intestinal disease are most likely to be due to poor food safety practices in the home. Consumer awareness studies have shown that, in general, consumers are aware of the recommended food safety precautions, yet still adopt high-risk behaviours.

Three focus groups and a small case control group were formed to gather information on local consumer knowledge and attitudes towards safe food handling in the home. The responses from the three focus groups were analysed and grouped into general themes. The information obtained from these results was then used to plan a local food safety health promotion strategy.

The results show that individuals who had been exposed to salmonellosis, or who had a dependant who had been exposed, had developed a higher level of food safety knowledge and awareness. Variations between knowledge and self-reported practices make it apparent that persons have to be convinced that food safety measures are effective before they take action to change their behaviour.

In conclusion, consumer education strategies need to emphasise the burden of illness, making safe food handling meaningful to consumers. Continuous reinforcement of the messages may be effective in empowering the consumer to foster behaviour change.
The Effects of Walking Poles on Shoulder Function in Breast Cancer Survivors
Authors: Sprod Lisa K. , Drum Scott N. , Bentz Ann T. , Carter Susan D. , Schneider Carole M.
Published: November 2005

Breast cancer treatment often results in impaired shoulder function, in particular, decrements in muscular endurance and range of motion, which may lead to decreased quality of life. The purpose of this investigation was to determine the effects of walking pole use on shoulder function in female breast cancer survivors. Participants had previously been treated with 1 or a combination of the following: mastectomy, breast conservation therapy, axillary lymph node dissection, chemotherapy, or radiation. Participants were randomly placed in experimental (n = 6) and control (n = 6) groups and met with a cancer exercise specialist 2 times each week for 8 weeks. The experimental group used walking poles during the 20-minute aerobic portion of their workout, whereas the control group did not use walking poles but performed 20 minutes of aerobic exercise per workout session. Both groups participated in similar resistance training programs. Testing was done pre- and postexercise intervention to determine upper body muscular endurance and active range of motion at the glenohumeral joint. Repeated-measures analysis of variance (ANOVA) revealed significant improvements in muscular endurance as measured by the bench press ( P = .046) and lat pull down ( P = .013) in the walking pole group. No within-group improvements were found in the group that did not use walking poles. The data suggest that using a walking pole exercise routine for 8 weeks significantly improved muscular endurance of the upper body, which would clearly be beneficial in helping breast cancer survivors perform activities of daily living and regain an independent lifestyle.
Protective Effect of Thuja occidentalis Against Radiation-Induced Toxicity in Mice
Authors: Sunila E. S. , Kuttan G.
Published: November 2005

The effect of Thuja occidentalisagainst damage induced by γ radiation was studied. Whole-body exposure of Swiss albino mice to γ-rays (6 Gy) reduced the total white blood cell count to 1900 cells/mm3on the third day, which was elevated to 2050 cells/mm3by the administration of alcoholic extract of T occidentalis(5 mg/dose/animal, intraperitoneally). Six animals from each group were killed after 2, 7, and 11 days of irradiation to detect the bone marrow cellularity and radiation-induced toxicity. The number of bone marrow cells andα-esterase positive cells in control animals after 11 days was reduced to 12.2 × 106cells/femur and 693.5/4000 cells, respectively. In T occidentalis-treated animals, bone marrow cellularity was increased to 16.9 × 106cells/femur and α-esterase positive cells were 940/4000 cells, a nearly normal level. Alcoholic extract of T occidentalisreduced the elevated levels of GPT and alkaline phosphatase in liver and serum after irradiation. The lipid peroxidation levels were also lowered in the irradiated animals treated with the Thuja extract.
Reasons for and Characteristics Associated With Complementary and Alternative Medicine Use Among Adult Cancer Patients: A Systematic Review
Authors: Verhoef Marja J. , Balneaves Lynda G. , Boon Heather S. , Vroegindewey Annette
Published: November 2005

Purpose:To conduct a systematic review of reasons for and sociodemographic and disease characteristics associated with complementary and alternative medicine (CAM) use in cancer patients. Methods:Eligible studies were identified by searching the following databases: Alt Health Watch, AMED, CINAHL, CancerLit, PremMEDLINE, MEDLINE, Pub-Med, Ingenta, EMBASE, and Health Star, as well as reference lists in review articles. Only English-language articles published between 1994 and 2004 were included. Search terms included CAM and oncology/cancer, decision making and CAM and oncology/cancer, treatment decision making and CAM and oncology/cancer, and health care choices and CAM and oncology/cancer. Results:Fifty-two eligible studies were identified and summarized. These studies were conducted in 14 different countries, with the largest number of studies being completed in the United States (34.6%). A therapeutic response, wanting control, a strong belief in CAM, CAM as a last resort, and finding hope were the most commonly cited reasons for using CAM. Age, socioeconomic status, and gender were the dominant characteristics associated with CAM use. Conclusion:Reasons for and characteristics associated with CAM use among cancer patients have been studied extensively. Future CAM research among cancer patients should focus on identifying decision-making processes and building theoretical decision-making models. These can be used in the development of decisional aids for patients when confronted with the choice to use CAM as part of their cancer treatment.
Multifocal Angiostatic Therapy: An Update
Authors: McCarty Mark F. , Block Keith I.
Published: November 2005

Multifocal angiostatic therapy (MAT) is a strategy that seeks to impede cancer-induced angiogenesis by addressing multiple targets that regulate the angiogenic capacity of a cancer and/or the angiogenic responsiveness of endothelial cells, using measures that are preferentially, but not exclusively, nutraceutical. A prototype of such a regimen has been proposed previously, composed of green tea polyphenols, fish oil, selenium, and high-dose glycine, complementing a low-fat vegan diet, exercise training, and the copper-sequestering drug tetrathiomolybdate (TM). A review of more recent evidence suggests additional agents that could appropriately be included in this regimen and clarifies to some extent the mechanisms of action of its constituents. Diindolylmethane, a widely available crucifera-derived nutraceutical, has inhibited cancer growth in several mouse xenograft models; this effect may be largely attributable to an angiostatic action, as concentrations as low as 5 to 10 μM inhibit proliferation, migration, and tube-forming capacity of human endothelial cells in vitro, and a parenteral dose of 5 mg/kg markedly impairs matrigel angiogenesis in mice. Silymarin/silbinin, which has slowed the growth of human xenografts in a number of studies, suppresses the proliferation, migration, and tube-forming capacity of endothelial cells and inhibits vascular endothelial growth factor (VEGF) secretion by a range of human cancer cell lines, in concentrations that should be clinically feasible. The angiostatic activity of orally administered green tea now appears likely to reflect inhibition of the kinase activity of VEGFR-2. Glycine’s angiostatic activity may be attributable to a hyperpolarizing effect on endothelial cells that decreases the activity of NADPH oxidase, now known to promote tyrosine kinase signaling in endothelial cells. The ability of TM to suppress cancer cell production of a range of angiogenic factors results at least in part from a down regulation of NF-κB activation. Dual-purpose molecular targets, whose inhibition could be expected to decrease the aggressiveness and chemoresistance of cancer cells while simultaneously impeding angiogenesis, include NF-κB, cox-2, c-Src, Stat3, and hsp90; drugs that can address these targets are now in development, and salicylates are notable for the fact that they can simultaneously inhibit NF-κB and cox-2. The potential complementary of the components of MAT should be assessed in nude mouse xenograft models.
First Trimester Antenatal Screening for Down's Syndrome: A Review of Reliability and Validity
Authors: Stenberg B. , Lee R. , Dixon A. M.
Published: November 2005

This review is based on a third-year undergraduate project undertaken by Ben Stenberg and submitted as part of a BSc (Honours) Radiography award at the University of Teesside. The project and this report reviews the concept of antenatal screening for Down's syndrome, it explores the role of ultrasound and other available tests, and considers sensitivities and potential for errors in a first trimester screening service. The review employs library based literature review methodology and its limitations reflect the size and scope of projects performed within undergraduate research regulations.
Unusual linkage patterns of ligands and their cognate receptors indicate a novel reason for non-random gene order in the human genome
Authors: Hurst Laurence D , Lercher Martin J
Published: November 2005

Background

Prior to the sequencing of the human genome it was typically assumed that, tandem duplication aside, gene order is for the most part random. Numerous observers, however, highlighted instances in which a ligand was linked to one of its cognate receptors, with some authors suggesting that this may be a general and/or functionally important pattern, possibly associated with recombination modification between epistatically interacting loci. Here we ask whether ligands are more closely linked to their receptors than expected by chance.

Results

We find no evidence that ligands are linked to their receptors more closely than expected by chance. However, in the human genome there are approximately twice as many co-occurrences of ligand and receptor on the same human chromosome as expected by chance. Although a weak effect, the latter might be consistent with a past history of block duplication. Successful duplication of some ligands, we hypothesise, is more likely if the cognate receptor is duplicated at the same time, so ensuring appropriate titres of the two products.

Conclusion

While there is an excess of ligands and their receptors on the same human chromosome, this cannot be accounted for by classical models of non-random gene order, as the linkage of ligands/receptors is no closer than expected by chance. Alternative hypotheses for non-random gene order are hence worth considering.
The zebrafish progranulin gene family and antisense transcripts
Authors: Cadieux Benoît , Chitramuthu Babykumari P , Baranowski David , Bennett Hugh PJ
Published: November 2005

Background

Progranulin is an epithelial tissue growth factor (also known as proepithelin, acrogranin and PC-cell-derived growth factor) that has been implicated in development, wound healing and in the progression of many cancers. The single mammalian progranulin gene encodes a glycoprotein precursor consisting of seven and one half tandemly repeated non-identical copies of the cystine-rich granulin motif. A genome-wide duplication event hypothesized to have occurred at the base of the teleost radiation predicts that mammalian progranulin may be represented by two co-orthologues in zebrafish.

Results

The cDNAs encoding two zebrafish granulin precursors, progranulins-A and -B, were characterized and found to contain 10 and 9 copies of the granulin motif respectively. The cDNAs and genes encoding the two forms of granulin, progranulins-1 and -2, were also cloned and sequenced. Both latter peptides were found to be encoded by precursors with a simplified architecture consisting of one and one half copies of the granulin motif. A cDNA encoding a chimeric progranulin which likely arises through the mechanism of trans-splicing between grn1 and grn2 was also characterized. A non-coding RNA gene with antisense complementarity to both grn1 and grn2 was identified which may have functional implications with respect to gene dosage, as well as in restricting the formation of the chimeric form of progranulin. Chromosomal localization of the four progranulin (grn) genes reveals syntenic conservation for grna only, suggesting that it is the true orthologue of mammalian grn. RT-PCR and whole-mount in situ hybridization analysis of zebrafish grns during development reveals that combined expression of grna and grnb, but not grn1 and grn2, recapitulate many of the expression patterns observed for the murine counterpart. This includes maternal deposition, widespread central nervous system distribution and specific localization within the epithelial compartments of various organs.

Conclusion

In support of the duplication-degeneration-complementation model of duplicate gene retention, partitioning of expression between grna and grnb was observed in the intermediate cell mass and yolk syncytial layer, respectively. Taken together these expression patterns suggest that the function of an ancestral grn gene has been devolved upon four paralogues in zebrafish.
Correlation between human papillomavirus infection and bladder transitional cell carcinoma
Authors: Barghi MR , Hajimohammadmehdiarbab A , Moghaddam SMM Hosseini , Kazemi B
Published: November 2005

Background

To determine the association of human papillomavirus infection (HPV) and transitional cell carcinoma (TCC).

Methods

Using polymerase chain reaction, fifty-nine bladder tissue specimens of patients with transitional cell carcinoma of bladder compared with 20 bladder samples of cases with non-neoplastic disorders.

Results

Male to female ratio was similar in the two groups (50/9 vs. 16/4, P = 0.62). Mean age was 67 ± 10.8 years and 52 ± 20.3 years in the case and control groups, respectively (P = 0.6). Of the 59 tissue specimens with diagnosis of transitional cell carcinoma, HPV DNA was detected in 21 (35.6%) samples, while it was present in only one sample (5%) in the control group (P = 0.008). HPV18 was the most common type of virus with the incidence rate of 17/21(81%).

Conclusion

HPV might play a causative role in transitional cell carcinoma of bladder in our geographic area.
Lithuanian health care in transitional state: ethical problems
Authors: Jakušovaitė Irayda , Darulis Žilvinas , Žekas Romualdas
Published: November 2005

Background

Throughout the economic and political reforms in post-communist countries, significant changes have also occurred in public morality. One of the tasks of the Lithuanian health policy is to create mechanisms for strengthening the significance of ethical considerations in the decision-making processes concerning health care of individuals and groups of individuals, as well as considering the positions of physicians and the health care system itself in a general way. Thus, health care ethics could be analyzed at two levels: the micro level (the ethics of doctor-patient relationships) and the macro level (the ethics of health policy-making, which can be realized by applying the principles of equal access, reasonable quality, affordable care and shared responsibilities). To date, the first level remains dominant, but the need arises for our attention to refocus now from the micro level to the patterns of managing and delivering care, managing the health care resources, and conducting business practices.

Discussion

In attempting to increase the efficiency of health services in Lithuania, a common strategy has been in place for the last fifteen years. Decentralization and privatization have been implemented as part of its policy to achieve greater efficiency. Although decentralization in theory is supposed to improve efficiency, in practice the reform of decentralization has still to be completely implemented in Lithuania. Debates on health policy in Lithuania also include the issue of private versus public health care. Although the approach of private health care is changing in a positive way, it is obvious that reduced access to health services is the most vulnerable aspect. In the Lithuanian Health Program adopted in July 1998, the target of equity was stressed, stating that by 2010, differences in health and health care between various socio-economic groups should be reduced by 25%.

The restructuring of health care system in Lithuania should be based on a balance between decentralization and centralization, and between public and private health care sectors. Successful transition requires a balanced role of the government. Today it is obvious in Lithuania that continuous encouragement to make sacrifices was not enough to induce the system to function well, and in an ethical manner.
Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics
Authors: Goldenberg Maya J
Published: November 2005

Background

The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics.

Discussion

The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked.

The "empirical turn" in bioethics signals a need for reconsideration of the methods used for moral evaluation and resolution, however the options should not include obscuring normative content by seemingly neutral technical measure.
"Saying no is no easy matter" A qualitative study of competing concerns in rationing decisions in general practice
Authors: Carlsen Benedicte , Norheim Ole Frithjof
Published: November 2005

Background

The general practitioner in Norway is expected to ensure equity and effectiveness through fair rationing. At the same time, due to recent reforms of the Norwegian health care sector, both the role of economic incentives and patient autonomy have been strengthened. Studies indicate that modern general practitioners, both in Norway and in other countries are uncomfortable with the gatekeeper role, but there is little knowledge about how general practitioners experience rationing in practice.

Methods

Through focus group interviews with Norwegian general practitioners, we explore physicians' attitudes toward factors of influence on medical decision making and how rationing dilemmas are experienced in everyday practice.

Results

Four major concerns appeared in the group discussions: The obligation to ration health care, professional autonomy, patient autonomy, and competition. A central finding was that the physicians find rationing difficult because saying no in face to face relations often is felt uncomfortable and in conflict with other important objectives for the general practitioner.

Conclusion

It is important to understand the association between using economic incentives in the management of health care, increasing patient autonomy, and the willingness among physicians to contribute to efficient, fair and legitimate resource allocation.
The Swiss cheese model of safety incidents: are there holes in the metaphor?
Authors: Perneger Thomas V
Published: November 2005

Background

Reason's Swiss cheese model has become the dominant paradigm for analysing medical errors and patient safety incidents. The aim of this study was to determine if the components of the model are understood in the same way by quality and safety professionals.

Methods

Survey of a volunteer sample of persons who claimed familiarity with the model, recruited at a conference on quality in health care, and on the internet through quality-related websites. The questionnaire proposed several interpretations of components of the Swiss cheese model: a) slice of cheese, b) hole, c) arrow, d) active error, e) how to make the system safer. Eleven interpretations were compatible with this author's interpretation of the model, 12 were not.

Results

Eighty five respondents stated that they were very or quite familiar with the model. They gave on average 15.3 (SD 2.3, range 10 to 21) "correct" answers out of 23 (66.5%) – significantly more than 11.5 "correct" answers that would expected by chance (p < 0.001). Respondents gave on average 2.4 "correct" answers regarding the slice of cheese (out of 4), 2.7 "correct" answers about holes (out of 5), 2.8 "correct" answers about the arrow (out of 4), 3.3 "correct" answers about the active error (out of 5), and 4.1 "correct" answers about improving safety (out of 5).

Conclusion

The interpretations of specific features of the Swiss cheese model varied considerably among quality and safety professionals. Reaching consensus about concepts of patient safety requires further work.