bluuebunny/crossref_metadata_2025 huggingface dataset:
Expertise and the Spatio-Temporal Characteristics of Anticipatory Information Pick-up from Complex Movement Patterns
Authors: Müller Sean , Abernethy Bruce , Eid Michael , McBean Rohan , Rose Matthew
Published: June 2010

Groups of high- ( n = 14), intermediate- ( n = 12), and low-skilled ( n = 15) cricket batsmen participated in two experiments to examine expertise-related differences in anticipatory information pick-up that combined temporal and spatial occlusion methodologies. In experiment 1 participants were shown video displays of a bowler delivering one of three different types of delivery with the display manipulated so that only selected local features of the bowler's movement pattern (bowling hand, bowling hand and arm, trunk, lower body, or whole body) were visible and then only for specific time periods prior to ball release. Only the highly-skilled players were able to produce better-than-chance predictions of ball type and then only under a limited set of display conditions. Information from bowling hand and arm cues was particularly critical although continuous visibility of these cues was apparently not essential for information pick-up. In experiment 2 the order in which particular features were made visible throughout the bowler's movement pattern was varied in an attempt to find the sequence of cues that was most favourable for effective information pick-up. The necessity in this experiment to switch vision between different features eliminated the highly-skilled players' capability to anticipate. Expert anticipation is dependent on sensitivity to information arising from a select set of local cues, and forced attentional switches between different cues negate effective information pick-up and, with it, the expert advantage.
Learning Perceptual Organization in Infancy: The Effect of Simultaneous versus Sequential Variability Experience
Authors: Quinn Paul C , Bhatt Ramesh S
Published: June 2010

Infants do not readily organize using form similarity: 6- to 7-month-olds familiarized with horizontal or vertical bars (filled rectangles) do not display a subsequent preference for a novel column versus row organization of X–O elements (Quinn and Bhatt, 2006 Journal of Experimental Psychology: Human Perception and Performance32 1221–1230). In experiment 1, infants were familiarized with more complex bars composed of beads or crosshatches, and performance was again unsuccessful. In experiment 2, all three bar types were presented during familiarization and infants performed successfully, indicating that variability in pattern information depicting an invariant structure enhances the learning of perceptual organization. In experiment 3, we examined whether the manner in which variability is experienced (simultaneous versus sequential contrast) impacts this learning. One group of infants was familiarized with a single pattern containing the three different bar types (within-trial variability), and another was presented with the same three bar types, but with each appearing on a different trial (across-trial variability). Only the across-trial variability group performed successfully, suggesting that trial-to-trial change in local element information induced by sequential presentation is a significant factor in facilitating the learning of perceptual organization.
Comparison of early life‐stage strategies in temperate freshwater fish species: trade‐offs are directed towards first feeding of larvae in spring and early summer
Authors: Teletchea F. , Fontaine P.
Published: June 2010

Based on the analysis of 12 egg and larval variables and temperature of 65 temperate freshwater fish species, the possible relationships between oocyte diameter, larval size at hatch, time and temperature were reassessed and the main early life‐stage strategies were described and compared. Time and degree‐days required to reach hatching and mixed feeding were weakly related to oocyte diameter and strongly to temperature. These results are chiefly because oocyte diameter and yolk reserves are weakly related and temperature strongly increases tissue differentiation rate, activity of hatching glands and embryo motility. Strong positive relationships were found between larval size and oocyte diameter and degree‐days for incubation. No relationship was found between larval size and degree‐days from hatching to mixed feeding and between degree‐days for incubation and degree‐days from hatching to mixed feeding. These last two results are chiefly because the developmental stages at hatching and at the onset of exogenous feeding are not fixed in ontogeny and are not directly related to either larval size or degree‐days for incubation, but more probably are species specific. Whatever the spawning season, which can occur almost all year long, the different trade‐offs at the early life‐stages ensure that most larvae are first feeding during spring, when food size and abundance are the most appropriate.
Anti‐infliximab antibody status and its relation to clinical response in psoriatic patients: A pilot study
Authors: ADIŞEN Esra , ARAL Arzu , AYBAY Cemalettin , GÜRER Mehmet Ali
Published: June 2010

Although the mechanisms underlying the loss of response to infliximab are not completely understood, the formation of antibodies to infliximab (ATI) are thought to play a role. The aim of this study was to investigate the presence of ATI in psoriatic patients and to evaluate its relationship to the clinical response. Fifteen patients with psoriasis were treated with infliximab (5 mg/kg) every 8 weeks after an initial three‐dose induction treatment. An enzyme linked immunosorbent assay kit was used for analyzing the presence of ATI in sera. Effectiveness assessments included the change in Psoriasis Area and Severity Index (PASI) compared with study entry. Five (33.3%) patients developed ATI. While 5.9 ± 3.2 infliximab infusions achieved a fall in the PASI score from a mean of 20.4 ± 8.3 to 5.3 ± 2.4 in ATI‐negative patients, these values changed from 23.3 ± 11 to 10 ± 4.9 after 9 ± 5.2 infusions in ATI‐positive patients. Our results suggested that ATI measured in psoriatic patients are of clinical importance. Therefore, monitoring for the induction of ATI and rescue strategies should be developed to avoid or to maintain a delay in ATI development.
Expression of bovine (Bos indicus) interleukin‐18 in Escherichia coli and its biological activity
Authors: Siva Reddy Kotla , Muralidhar Rao Dowlathabad. , Dechamma Hosur Joyappa , Suryanarayana Veluvarthy V.S. , Reddy Golla Ramalinga
Published: June 2010

IL‐18 modulates immune functions by inducing IFN‐γ production and promoting Th1 immune responses. In the present study, we amplified and cloned the sequence (582 bp) encoding full‐length bovine IL‐18 from PBMC stimulated with PHA. The nucleotide and the deduced amino acid sequence of Bos indicus IL‐18 showed an identity of 86–98% compared with IL‐18 sequences of other ruminants. The insert was subcloned into a pET 32a vector and expressed in Escherichia coli as a fusion protein and the matured protein was obtained by caspase I treatment. The specificity of these proteins was confirmed by western blotting. The biological activity of the purified protein was analyzed by its ability to induce IFN‐γ production in PBMC measured by ELISA and qPCR.
Multicenter evaluation of prototype real‐time PCR assays for Epstein‐Barr virus and cytomegalovirus DNA in whole blood samples from transplant recipients
Authors: Ito Yoshinori , Takakura Shunji , Ichiyama Satoshi , Ueda Mitsuharu , Ando Yukio , Matsuda Kazuyuki , Hidaka Eiko , Nakatani Kaname , Nishioka Junji , Nobori Tsutomu , Kajiyama Naoki , Kimura Hiroshi
Published: June 2010

Quantitative PCR is becoming widespread for diagnosing and monitoring post‐transplantation diseases associated with EBV and CMV. These assays need to be standardized to manage patients in different facilities. Five independent laboratories in Japan compared home‐brew assays and a prototype assay system to establish a standard quantitative procedure for measuring EBV and CMV. Reference standards and a total of 816 (642 EBV and 174 CMV) whole blood samples from post‐transplantation recipients were used for this multicenter evaluation. The prototype reference standard for EBV was compared to a panel of samples, with a theoretical expected value made using EBV‐positive cells containing two virus genome copies per cell. The mean ratio of the reference standard at each site to the standard of the prototype assay was ≤4.15 for EBV among three different sites and ≤3.0 for CMV between two laboratories. The mean of the theoretical expected number of the EBV genome: prototype reference was close to 1.0. The correlation coefficients between the viral copy numbers determined using the prototype assay and those using each home‐brew assay were high (EBV, 0.73–0.83, median = 0.78; CMV, 0.54–0.60, median = 0.57). The dynamics of the EBV and CMV loads in transplant recipients were similar between the assay types. There was an inter‐laboratory difference among the quantification results, indicating that a unified protocol and kit are favorable for standardizing the quantification of EBV and CMV. Such standardization will help to standardize the diagnosis and monitoring of diseases associated with EBV and CMV.
Salted roads and sodium limitation in a northern forest ant community
Authors: KASPARI MICHAEL , CHANG CHARLOTTE , WEAVER JOHANNA
Published: June 2010

1. Road salt is a common, anthropogenic source of NaCl in many temperate ecosystems. Sodium is also an essential and potentially limiting element for inland animal populations. This suggests that Na limitation in inland ecosystems, and hence attraction to Na sources, should increase with distance from salted roads.

2. In a North Temperate forest, we tested the prediction that Na recruitment would increase, as soil [Na] decreased, with distance from a salted two‐lane highway. We presented ants with three concentrations of NaCl and sucrose solution along four pairs of transects ca 1, 10, 100, and 1000 m from the road.

3. Consistent with the Na‐limitation hypothesis, the ratio of NaCl to sucrose use increased with distance from the road from 1:13 vials at 1 m to 1:5 vials at 1 km. Genera characterised by high Na use did not accumulate farther from the road. For the common and widespreadTapinoma sessile(Say), a 10‐fold increase in distance from the road resulted in ants doubling their use of NaCl relative to sucrose.

4. Road salt is a well‐known pollutant, especially of freshwater ecosystems. However, by suppressing plants and potentially promoting consumers, road salt may have more complex effects on terrestrial ecosystems, especially those far inland from oceanic aerosols.
A multi‐scale analysis of fragmentation effects on remnant plant species richness in Phoenix, Arizona
Authors: Stiles Arthur , Scheiner Samuel M.
Published: June 2010

Aim  Understanding complex ecological phenomena, such as the determinants of species richness, is best achieved by investigating their properties at different spatial scales. Factors significantly affecting the number of species occurring at one scale may not impact on richness at other scales. While this scale dependence has become increasingly recognized, there still remains a need to elucidate exactly how richness is structured across scales, and which mechanisms are influential for determining this important community property. This study explores how woody plant species richness varies in a fragmented system at multiple scales, and which factors are primarily responsible for these patterns.

Location  The study area is located in the Sonoran Desert within the bounds of metropolitan Phoenix, Arizona, which is the locus of the Central Arizona–Phoenix Long‐Term Ecological Research (CAP‐LTER) site.

Methods  Estimates of local and fragment plant species richness were generated from field data collected from 22 sites. Independent variables describing fragment sites were also calculated, including area, habitat heterogeneity, density of individuals, mean elevation, and extent of isolation. Structural equation modelling, multiple regression, and analysis of covariance were used to assess the contribution of independent variables to richness at the fragment and local scales.

Results  Fragment species richness was significantly influenced by area, though not isolation, habitat heterogeneity, mean elevation, or density of individuals. Local richness was not significantly related to fragment area, but was positively related to fragment richness, plant density, and elevation.

Main conclusions  The fragment species–area effect resulted from larger remnants supporting higher numbers of individuals at comparable densities, increasing richness through either passive sampling of progressively less common species and/or lower extinction rates among larger populations. Without using multi‐temporal data it is not possible to disentangle these mechanisms. We found that patterns evident at one scale are not necessarily apparent at other scales, as elevation and density of individuals significantly affected richness at the local scale but not at the fragment scale. These results lend support to the concept that mechanisms influencing the species richness of natural communities may be operable only within certain domains and that relevant scales should be specified.
Treatment decision‐making in cancer care: the role of the carer
Authors: Hubbard Gill , Illingworth Nicola , Rowa‐Dewar Neneh , Forbat Liz , Kearney Nora
Published: June 2010

Aims and objectives.  This study explores the role of the carer in treatment decision‐making in cancer care.

Background.  Literature about involvement in treatment decision‐making tends to focus on patients and clinicians, with the carer rarely included. The absence of carers is problematic because the management of illness is often carried out in the context of complex networks of relationships. Although current policy encourages health care practitioners to work in partnership with family members, implementation is troubled by a lack of understanding of the significance of interpersonal relationships and interactions and the role of the relationship throughout the course of the illness experience. Despite awareness, there is little systematic, coherent analysis of the complexity of these interactional dynamics and, in particular, consideration of the implications for involvement and treatment decision‐making.

Design.  Qualitative, longitudinal.

Methods.  Three serial semi‐structured interviews with 66 patients and 43 carers within the first year following a diagnosis of cancer. A descriptive and thematic approach to data analysis was adopted.

Results.  Carers are involved in treatment decision‐making in cancer care and contribute to the involvement of patients through their actions during, before and after consultations with clinicians. Carers can act as conduits for information from patient to clinician and from clinician to patient. They can also act as facilitators during deliberations, helping patients to consider whether to have treatment or not and which treatment.

Conclusions.  Our study has highlighted the deficiency of models that fail to acknowledge the role of the carer in the treatment decision‐making process. We propose the adoption of a relational approach by the inclusion of the carer in conceptual frameworks and recommend triadic (patient, carer and professional) models of involvement.

Relevance to clinical practice.  Cancer care clinicians should recognise and actively involve the carer as well as the patient in treatment decision‐making.
Parental management of childhood complaints: over‐the‐counter medicine use and advice‐seeking behaviours
Authors: Trajanovska Misel , Manias Elizabeth , Cranswick Noel , Johnston Linda
Published: June 2010

Aims and objectives. To explore parental management of childhood complaints with respect to factors associated with the purchase of over‐the‐counter medicines and sources of information accessed by parents.

Background. The use of over‐the‐counter medicines is extensive, but this practice is not without risks. To ensure safe use, nurses and other healthcare providers need to understand parental reasons for purchase and sources of information they access regarding management practices.

Design. A cross‐sectional survey.

Method. Three‐hundred and twenty‐five parents of children (aged birth to 24 months) were recruited between September 2006–June 2007 from three recruitment sites across Melbourne, Australia. These included the following: outpatient clinics at a major paediatric hospital, maternal and child health centres and a childcare service of a tertiary education institution. Data were collected using a self‐administered questionnaire.

Result. Most parents (82%) purchased over‐the‐counter medicines if suggested by the doctor and if it had been effective in the past. Doctors were the most frequently cited source of advice for management of complaints such as an ear ache (95%), wheeziness (90%) and rash (77%). Advice from maternal and child health nurses was frequently sought for sleep difficulties (60%), while family or friends were sought for advice on irritability or crankiness (47%) and teething pain (44%).

Conclusions. The findings revealed the impact of healthcare provider recommendations on parental purchase of over‐the‐counter medicines. Parents mainly sought information and advice from doctors, followed by maternal and child health nurses and family or friends, which appeared to be dependent on the type of childhood complaint.

Relevance to clinical practice. The use of over‐the‐counter medicines for symptom management is likely to increase with enhanced focus on self‐care. It is important for all healthcare providers to proactively provide accurate, consistent and evidence‐based information to parents regarding appropriate management of symptomatic and behavioural complaints.
A comprehensive training programme for nurse endoscopist performing flexible sigmoidoscopy in Hong Kong
Authors: Shum Nga F , Lui Yau L , Choi Hok K , Lau So C , Ho Judy WC
Published: June 2010

Aims.  To describe the process and explore the feasibility of training a colorectal nurse in Hong Kong to perform flexible sigmoidoscopy.

Background.  Given the shortage and high turnover rate of medical staff, a pilot programme was designed to train and expand the role of colorectal nurse clinicians. It was hoped that such nurses could share some of the clinical duties of the medical staff. An advanced practice nurse was selected for the programme. One of the training components was the performance of flexible sigmoidoscopy.

Design.  This was a descriptive, case review study.

Method.  A one‐year‐structured endoscopic training programme was designed for the nurse clinician. Weekly sessions were conducted by one of the trainers. The training process included the following: (1) procedural observation; (2) supervised withdrawal, advancement and manipulation of the sigmoidoscope and (3) a final assessment of the nurse’s competency in performing sigmoidoscopy independently.

Results.  In total, 119 outpatients (58 male and 61 female) with a mean age of 57·02 years (SD 14·6 years; range: 18–83 years) underwent flexible sigmoidoscopy by the nurse over 11 months. The mean procedural time was 9·38 minutes (SD 3·5 minutes; range 3–26 minutes). The procedure was terminated prematurely if it could not be tolerated by the patient or if the bowel preparation was inadequate. The mean depth of insertion was 53·5 cm (SD 12·2 cm; range 6–60 cm). In total, 82 patients had a normal exam, 32 patients had abnormalities. There were no procedural complications, and no patient required an unplanned hospital admission after the procedure.

Conclusion.  In Queen Mary Hospital, nurses can be trained to perform flexible sigmoidoscopy in a safe and effective manner.

Relevance to clinical practice.  Nurse endoscopists could increase the use of flexible sigmoidoscopy in colorectal cancer screening and can also enhance the professional development of colorectal nurses.
Satisfaction with care in oncology outpatient clinics: psychometric characteristics of the Icelandic EORTC IN‐PATSAT32 version
Authors: Hjörleifsdóttir Elísabet , Hallberg Ingalill Rahm , Gunnarsdóttir Elín Díanna
Published: June 2010

Aim and objectives. To assess the psychometric characteristics of the Icelandic European Organisation for Research and Treatment of Cancer IN‐PATSAT32 (EORTC IN‐PATSAT32) version and to compare satisfaction with care between gender and different age groups.

Background. The majority of patients with cancer receive either chemotherapy or radiotherapy on an outpatient basis. There is a need to evaluate satisfaction with care and service for these patients using reliable and valid instruments.

Design. Cross‐sectional comparative study.

Method. Participants (n = 217) who received treatment for cancer as outpatients answered the EORTC IN‐PATSAT32 questionnaire. Participants were 22–91 years old and 57% of them were female.

Results. Overall high satisfaction was found with communication, information and care that patients receive from doctors and nurses. Principal component analysis extracted four factors: ‘satisfaction with nurses’ conduct’, ‘satisfaction with doctors’ conduct’, ‘satisfaction with information’ and ‘satisfaction with service and care organisation’. Patients were most satisfied with nurses’ conduct but least satisfied with service and care organisation. Cronbach’s alpha for the four factors ranged from 0·95–0·67.

Conclusion. Although the validity of this instrument including its sensitivity to patients’ level of dissatisfaction as well as satisfaction with care and service was evident, this needs to be further explored in future studies. The psychometric strengths of the EORTC IN‐PATSAT32 are its internal consistency and its construct validity, but there are several issues indicating a need to change and develop the instrument and specifically adopting it to outpatient care.

Relevance to clinical practice. Outpatient treatment options offered to cancer patients have increased, and this calls for knowledge of their satisfaction with care and service. Sparse studies are available, and there is a need for further development of reliable instruments. Our study indicates that outpatients with cancer are quite satisfied with the care they receive. Findings may contribute to improvement in outpatients’ clinics that provide treatment to patients with cancer.
Mothers’ experience with 1st–3rd‐grade children with asthma assisting their child’s adaptation of school life in Taiwan
Authors: Cheng Shu‐Chen , Chen Yu‐chih , Liou Yiing Mei , Wang Kai‐Wei Katherine , Mu Pei‐Fan
Published: June 2010

Aims and objectives.  This study used purposive sampling through semi‐structured interviews to obtain the experiences of mothers of 7–11‐year‐old children with asthma who were assisting their child’s adaptation to school life.

Background.  Children with asthma often have problems with social adaptation, including school absenteeism, limits to their activity and bullying by peers. From kindergarten to elementary school, it is a transitional process where the child experiences multiple changes in the body, mind and social situations. It can be difficult for mothers of children with asthma to assist their children with their adaptation to school life.

Design.  A qualitative enquiry design was used.

Methods.  A total of 15 mothers having elementary school children with asthma in grades 1–3 were interviewed. Participants were contacted at the outpatient department of a medical centre in Taiwan. Verbatim transcriptions of the interviews were examined by the content analysis method. After analysis of the interview data of the 15 informants, no new themes had emerged. Lincoln and Guba’s trustworthiness criteria were employed to evaluate methodological rigour.

Results.  There were four themes that formed part of the mothers’ experiences. Those were: (1) being concerned about the child’s adaptation to school life, (2) improving attitudes and relieving symptoms, (3) establishing the child’s self‐management abilities and (4) bearing role strain and normalising the life of the child.

Conclusions.  The findings of this study should help health professionals and schoolteachers to understand the needs of families and mothers who have a child with asthma. The findings provide appropriate information and resources to assist the children’s adjustment to school life.

Relevance to clinical practice.  The findings indicate that nursing professionals should provide child‐focused and family‐centred care that will assist parents of children with asthma to adjust to school life.
Perceptions of breastfeeding and planned return to work or school among low‐income pregnant women in the USA
Authors: Rojjanasrirat Wilaiporn , Sousa Valmi D
Published: June 2010

Aims and objectives.  To describe the perceptions of breastfeeding in low‐income pregnant women to understand their needs better as they plan to return to work or school.

Background.  Maternal employment has a negative impact on breastfeeding duration. Yet there is insufficient research on challenges and facilitators regarding breastfeeding and employment issue among low‐income women in the USA. Knowing the perceptions of breastfeeding among low‐income pregnant women and their plan to return to work or school may have implications for nurses and midwives in providing quality care.

Design.  Qualitative study using focus group interviews.

Methods.  The research setting consisted of three Women, Infants and Children clinics (WIC) in a midwestern city of the USA. Seventeen pregnant women (aged 19–35) participated in focus group interviews. Data were coded and analysed for themes and patterns using the QSR software – NVivo 6.

Results.  Eleven participants were single. Ten women were primigravida, and seven were multipara. The following five themes were identified: (1) perceived benefits of breastfeeding; (2) general perceptions of breastfeeding; (3) maternal concerns; (4) having the right support; and (5) anticipated challenges of combining breastfeeding and work.

Conclusions.  Low‐income women anticipated substantial barriers for breastfeeding when they planned to combine breastfeeding and work or school. The results of this study have many implications for public health practice, research and policy. Educating employers and the public at large about the health and economic benefits derived from long‐term breastfeeding could help promote breastfeeding awareness.

Relevance to clinical practice.  Strategies supporting breastfeeding among low‐income working women must be provided at multiple levels to help overcome the barriers they concern. Health care providers should help women gain confidence by minimising their uncertainties and fears about breastfeeding to prepare them to continue breastfeeding successfully after returning to work.
Nurses’ experiences in the relief of postoperative nausea and vomiting
Authors: Sussanne Börjeson , Arweström Carina , Baker Angelica , Berterö Carina
Published: June 2010

Aim.  The aim of the study was to illuminate the experience of nurses in relieving postoperative nausea and vomiting.

Background.  Postoperative nausea and vomiting has been shown to be one of the most common and distressing side effects of surgery. In spite of this, there has been little research on the role of nurses in caring for patients with postoperative nausea and vomiting.

Design.  Qualitative approach using narratives.

Methods.  Ten female nurses from two general surgical departments were interviewed. The transcribed interviews were analysed using the hermeneutic narrative method inspired by Polkinghorne.

Results.  The nurses report that they have what may be described as a set of different tools at their disposal. These tools can be entitled ‘listen and understand’, ‘information’, ‘the clinical eye’ and ‘availability’, all of which can be used in solving several needs. However, some nurses have better skills or more opportunities to use the available tools than do others. By using these tools, the nurses can increase their possibilities for enhancing the patients’ efforts to gain control over their own situation and thereby increase the quality of their care.

Conclusion.  Nurses use different types of tools to relieve postoperative nausea and vomiting and it is possible to create a positive nursing care situation if patients are given the opportunity to be in control and handle their own situation.

Relevance to clinical practice.  When it comes to relieving postoperative nausea and vomiting, the findings of this study are important as the study highlights the practical actions taken by nurses and their experiences. When nurses have the possibility to use their nursing tools in an optimal way, together with their experience and knowledge and then follow their nursing actions by being able to reflect on them, they can further develop their approach to nursing and thereby increase their competence as nurses.
Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland
Authors: Westergren Albert , Torfadóttir Ólina , Ulander Kerstin , Axelsson Carolina , Lindholm Christina
Published: June 2010

Aim.  The aim of this study was to explore the point prevalence of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk before and after an intervention.

Background.  Malnutrition risk and the precision in targeting nutritional treatment are indicators of quality of care. Knowledge regarding the in‐hospital prevalence of malnutrition and nutritional treatment is meagre for Iceland.

Design.  Pre‐ and postintervention study.

Methods.  The study was performed during one day in 2006 (March) and one day in 2007 (April). In total, 95 (89%) and 92 (88%) patients agreed to participate. Moderate/high undernutrition risk was defined as the occurrence of at least two of the following: involuntary weight loss, body mass index below limit and eating difficulties according to Minimal Eating Observation Form – Version II. Being overweight was graded based on body mass index. Specific nutritional care actions were recorded. Intervention: A five‐point programme for nutrition and eating was implemented.

Results.  Moderate/high risk for undernutrition was found in 25 and 17% in the two years (ns, not significant). A high body mass index was found in 53 and 54% (ns). The number of patients with a documented body mass index significantly increased between the two surveys (1 and 30%, p‐value <0·0005). The use of oral supplements increased from 11–40% (p < 0·0005) and especially among those at no/low undernutrition risk, with ingestion or deglutition difficulties (p < 0·0005 in both cases) but not among those with appetite and energy problems (ns).

Conclusion.  Implementing a nutritional programme does not necessarily affect the number of in‐patients with malnutrition, but it is likely to increase the precision of nutritional care to some extent.

Relevance to clinical practice.  Greater efforts need to be taken to increase the precision of nutritional care among patients at moderate/high undernutrition risk and among those with appetite and energy problems.
Perception of risk of coronary heart disease among Jordanians
Authors: Ammouri Ali A , Neuberger Geri , Mrayyan Majd T , Hamaideh Shaher H
Published: June 2010

Aims and objectives.  The purpose of this study was to assess perceptions of risk of coronary heart disease among Jordanians and its association with demographic variables and health behaviours.

Background.  Lack of accurate risk perception may prevent adults from considering the need for early preventive behaviours or seeking early life‐saving interventions in the presence of coronary heart disease symptoms.

Design.  A descriptive study.

Methods.  Using descriptive statistics and regression analysis, a convenience sample of 300 adults was used.

Results.  Older Jordanians had higher perception of risk of coronary heart disease (β = 0·237, p < 0·001). Jordanian women (β = −0·121, p < 0·05) perceived coronary heart disease more as unobservable, unknown, new and delayed in manifestation of harm than Jordanian men. Also, adult Jordanians who reported not having family member with coronary heart disease (β = 0·129, p < 0·05) perceived coronary heart disease more as unobservable, unknown, new and delayed in manifestation of harm. Adults with higher level of education indicated higher perception of risk of coronary heart disease. There were no significant associations between perception of risk of coronary heart disease and health behaviours among adult Jordanians.

Conclusions.  Our data indicate the need for heart disease education programmes for all adults, including programmes targeted for younger adults, women and persons with low levels of education. It is important to emphasise that adopting healthy lifestyle behaviours can influence their risk for developing long‐term disease.

Relevance to clinical practice.  Perception of risk of heart disease can greatly influence the decisions taken by adults in regard to their health care. Lack of accurate risk perception may prevent adults from considering the need for early preventive behaviours or seeking early life‐saving interventions in the presence of coronary heart disease symptoms.
Specificity and trade‐offs in the induced plant defence of common milkweed Asclepias syriaca to two lepidopteran herbivores
Authors: Bingham Robin A. , Agrawal Anurag A.
Published: June 2010

1. We studied induced defences in common milkweed (Asclepias syriaca) to two specialist caterpillars (Danaus plexippus and Euchaetes egle) to test several hypotheses about co‐evolution and defence allocation.

2. Latex, a potent defence of milkweed, showed nearly fivefold variation in the amount exuded among genetic families and more than doubled production in response to herbivory by D. plexippus; this induced latex response was fourfold stronger than the latex response to E. egle herbivory. In contrast, D. plexippus and E. egle equivalently induced foliar cardenolide concentration (an average increase of 26%).

3. We found broad‐sense heritable variation for the induced plant responses, and there was a genetic correlation between the responses induced by the two herbivores for cardenolides, but not for latex. We found no genetic correlation between investment in latex and cardenolides in any of the treatments.

4. Using a bias‐corrected Monte Carlo procedure, we found strong evidence for a trade‐off between constitutive and induced cardenolides, but not for latex.

5. Synthesis. As natural selection by specific herbivores varies in space and time, we expect that these defence traits in A. syriaca will evolve independently, with the expression of cardenolides showing less specificity, as well as being constrained by a trade‐off between constitutive and induced defence.
The impact of diabetes education on blood glucose self‐monitoring among older adults
Authors: Millar Adam , Cauch‐Dudek Karen , Shah Baiju R.
Published: June 2010

Objectives  To determine whether attending diabetes education is associated with blood glucose self‐monitoring among unselected older adults in routine clinical care.

Method  A cross‐sectional population‐based study was carried out on 15 190 people with diabetes aged 65–79 years. Subjects were identified using a registry of doctor‐diagnosed diabetes derived from administrative data, and attendance at diabetes education centres (DECs) was determined from a separate registry of DEC utilization for 2006. Outcomes were derived using administrative data. The primary outcome was prescriptions filled for glucose self‐monitoring supplies. The secondary outcomes were prescriptions for antihypertensive drugs, prescriptions for lipid‐lowering drugs and eye examinations.

Results  DEC attendance was associated with glucose self‐monitoring, after adjusting for baseline differences between attendees and non‐attendees (adjusted odds ratio 6.45, 95% confidence interval 5.61 to 7.42). All of the secondary outcomes were also independently associated with DEC attendance.

Conclusions  This study suggests that diabetes education is associated with self‐management behaviour in real‐world clinical care. These findings support the effectiveness of self‐management education programmes to increase self‐care behaviours.
Preferences for communication in clinic from deaf people: a cross‐sectional study
Authors: Middleton Anna , Turner Graham H. , Bitner‐Glindzicz Maria , Lewis Peter , Richards Martin , Clarke Angus , Stephens Dafydd
Published: June 2010

Aims and objectives  To explore the preferences of deaf people for communication in a hospital consultation.

Methods  Design – cross‐sectional survey, using a structured, postal questionnaire. Setting – survey of readers of two journals for deaf and hard of hearing people. Participants – 999 self‐selected individuals with hearing loss in the UK, including those who use sign language and those who use speech. Main outcome measures – preferred mode of communication.

Results  A total of 11% of participants preferred to use sign language within everyday life, 70% used speech and 17% used a mixture of sign and speech. Within a clinic setting, 50% of the sign language users preferred to have a consultation via a sign language interpreter and 43% indicated they would prefer to only have a consultation directly with a signing health professional; 7% would accept a consultation in speech as long as there was good deaf awareness from the health professional, indicated by a knowledge of lip‐reading/speech‐reading. Of the deaf speech users, 98% preferred to have a consultation in speech and of this group 71% indicated that they would only accept this if the health professional had good deaf awareness. Among the participants who used a mixture of sign language and speech, only 5% said they could cope with a consultation in speech with no deaf awareness whereas 46% were accepting of a spoken consultation as long as it was provided with good deaf awareness; 30% preferred to use an interpreter and 14% preferred to have a consultation directly with a signing health professional.

Conclusions  The hospital communication preferences for most people with deafness could be met by increasing deaf awareness training for health professionals, a greater provision of specialized sign language interpreters and of health professionals who can use fluent sign language directly with clients in areas where contact with deaf people is frequent.
Indicators of anxiety and depression in women with the fragile X premutation: assessment of a clinical sample
Authors: Lachiewicz A. , Dawson D. , Spiridigliozzi G. , Cuccaro M. , Lachiewicz M. , McConkie‐Rosell A.
Published: June 2010

Background  Current research suggests that depression and anxiety may be common problems in women with the fragile X (FMR1) premutation.

Methods  To learn more about this in a clinical setting, we asked 33 women with the FMR1 premutation and 20 women without the FMR1 premutation to complete the Brief Carroll Depression Scale (Brief CDS) and the Multidimensional Anxiety Questionnaire (MAQ) and to provide information about mental health medication use. Questionnaire findings were compared between groups and with normative samples. Trinucleotide (CGG) repeat counts were also correlated to checklist findings.

Results  Both women with the FMR1 premutation and the comparison group had high current mental health medication use (33% vs. 35%). Approximately 1/3 of the women from both groups had high Brief CDS Total T‐scores (33% vs. 30%). More women with the FMR1 premutation had at least one elevated MAQ Total or sub‐scale T‐score than the comparison group (39% vs. 10%, P = 0.03). Twenty‐one per cent of women with the FMR1 premutation had all three of the indicators of distress targeted in this study vs. none of the women in the comparison samples (P < 0.05). There was no statistically significant correlation between CGG repeat size and abnormal checklist findings using the Spearman rank correlation, although a higher percentage of women with >100 CGG repeats (57%) had an elevated Brief CDS Total T‐score than women with ≤100 CGG repeats (16%) (P = 0.02). More women with >100 CGG repeats also had all three indicators of anxiety and depression (P = 0.03).

Conclusions  Women with the FMR1 premutation appear to have a high incidence of depression and increased symptoms of anxiety. Screening tools like the Brief CDS and the MAQ may be useful to identify these women in the clinic setting. Positive identification could lead to increased mental health care and treatment.
The role of marital quality and spousal support in behaviour problems of children with and without intellectual disability
Authors: Wieland N. , Baker B. L.
Published: June 2010

Background  Children with intellectual disability (ID) have been found to be at an increased risk for developing behavioural problems. The purpose of this study was to examine the relationship between the marital domain, including marital quality and spousal support, and behaviour problems in children with and without ID.

Methods  The relationship between the marital domain and child behaviour problems was examined in 132 families of 6‐year‐olds with and without ID. Using hierarchical regression, these relationships were also studied over time from child ages 6–8 years. Child behaviour problems were assessed with mother‐reported Child Behavior Checklist. The marital domain was measured using the Dyadic Adjustment Scale‐7 and the Spousal Support and Agreement Scale. Mother‐reported parenting stress and observed parenting practices were tested as potential mediators of the relationship between the marital domain and child behaviour problems.

Results  Mean levels of the marital domain were not significantly different between typically developing (TD) and ID groups, but there were significantly greater levels of variance in reported marital quality in the ID group at ages 6, 7 and 8. The marital domain score at child age 6 years predicted child behaviour problems at age 8 for the TD group only. This predictive relationship appeared to be a unidirectional effect, as child behaviour problems at age 6 were not found to predict levels of the marital domain at age 8. Parenting stress partially mediated this relationship for the TD group.

Conclusions  The marital domain may have a greater impact on behavioural outcomes for TD children. Implications for future research and interventions are discussed.
The Influence of Upstream IL‐2 ‐330 (T/G) and TNF‐α ‐308 (A/G) Polymorphisms on Glutamine‐Supplemented Cytokine Release
Authors: Müller T. , Topp T. , Weismüller K. , Kwapisz M. , Engel J.
Published: June 2010

Various studies have shown that dietary glutamine can modify the course of an immune response, through altering the release of cytokines. Nutritional supplementation of glutamine may therefore be of advantage to patients, particularly those with compromised immunity. Given that polymorphisms in cytokine genes can also affect cytokine levels, we have undertaken a study to identify whether there was a differential effect of glutamine supplementation in the context of different IL‐2 ‐330 (T/G) and TNF‐α ‐308 (A/G) genotypes. Overall, there was no significant impact of glutamine supplementation on IL2 release. However, analysing low, medium and high expressors independently, there was an effect of high glutamine levels on cytokine release from the low and medium expressors. Likewise, there was no effect of glutamine supplementation on the TNF‐α release, although a tendency to lower cytokine release at high levels of glutamine. Irrespective of the glutamine concentrations, there was no difference in IL2 release between the IL2 ‐330 genotypes; there was an effect of the TNF‐α genotypes, with the AG and GG genotypes showing greater cytokine release than from the AA genotype.
Simultaneous Administration of Vitamin A and DTP Vaccine Modulates the Immune Response in a Murine Cerebral Malaria Model
Authors: Hein‐Kristensen L. , Jørgensen M. J. , Ravn H. , Wiese L. , Kurtzhals J. , Benn C. S.
Published: June 2010

The World Health Organisation recommends vitamin A supplementation (VAS) to children aged 6 months to 5 years in low‐income countries, and for logistic reasons, this has been linked to routine childhood immunizations. Observational studies suggest that VAS given with diphtheria–tetanus–pertussis (DTP) vaccine may increase mortality from non‐targeted diseases. We investigated the non‐targeted effect of pretreatment with VAS and DTP vaccine in a murine model of experimental cerebral malaria. Our a priori hypothesis was that VAS/DTP would aggravate the infection. We found that the effect of VAS and DTP depended on pathogenesis; VAS/DTP tended to increase parasitaemia and significantly depressed cytokine responses in mice, which developed cerebral malaria, but this was not seen in mice dying of anaemia. The divergent effect according to pathogenesis may help elucidate why VAS has divergent effects on different diseases in humans. Our results support the hypothesis that immunological effects of VAS/DTP may have detrimental implications for disease outcomes.
Evolutionary Development and Expression Pattern of the Myeloid Lectin‐Like Receptor Gene Family Encoded Within the NK Gene Complex
Authors: Sattler S. , Ghadially H. , Reiche D. , Karas I. , Hofer E.
Published: June 2010

The myeloid cluster within the natural killer (NK) gene complex comprises several C‐type lectin‐like receptor genes of diverse and highly important functions in the immune system such as LOX‐1 and DECTIN‐1. Based on sequences that have become available by whole genome sequencing, we conducted a comparison of the human, chimpanzee, mouse and rat NK gene complex to better characterize this gene family and additional genes of this region in regard of their phylogenetic relationship and evolution within the complex. We found that the arrangement of genes within the primate cluster differs from the order and orientation of the corresponding genes in the rodent complex which can be explained by evolutionary duplication and inversion events. Analysis of individual genes revealed a high sequence conservation supporting the prime importance of the encoded proteins. Expression analyses of the more recently described CLEC12B and CLEC9A genes displayed not only mRNA expression in monocytic and dendritic cells, but in contrast to other members of the family also in lymphocytes. Further, two additional genes were identified, which do not encode proteins with lectin‐like domain structure and seem to be widely expressed.
Menopausal asthma: a new biological phenotype?
Authors: Foschino Barbaro M. P. , Costa V. R. , Resta O. , Prato R. , Spanevello A. , Palladino G. P. , Martinelli D. , Carpagnano G. E.
Published: June 2010

To cite this article: Foschino Barbaro MP, Costa VR, Resta O, Prato R, Spanevello A, Palladino GP, Martinelli D, Carpagnano GE. Menopausal asthma: a new biological phenotype? Allergy 2010; 65: 1306–1312.

Background:  Female hormones play an important role in women’s lung health, especially in asthma pathophysiology. Although a growing interest has recently been aroused in asthma related to short‐term reproductive states, menopausal asthma has been little studied in the past. The aim of the present study was to explore airway inflammation in menopausal asthmatic women in a noninvasive manner.

Methods:  Forty consecutive women with menopausal asthma, 35 consecutive women with premenopausal asthma and 30 age‐matched healthy controls were enrolled in the study. Urinary LTE‐4, induced sputum inflammatory cells, and exhaled LTE‐4, IL‐6, pH, and NO levels were measured in all the subjects enrolled.

Results:  Women with menopausal asthma showed decreased estradiol concentrations, high sputum neutrophils, and exhaled IL‐6. Women with premenopausal asthma presented instead an essentially eosinophilic inflammatory pattern. Higher urine and breath condensate LTE‐4 concentrations were found in premenopausal and menopausal asthma compared to controls.

Conclusion:  Our results substantiate the existence of a new biological phenotype of menopausal asthma that is mainly characterized by neutrophilic airways inflammation and shares several characteristics of the severe asthma phenotype.