bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cost–effectiveness analysis of a multimedia learning education program for stoma patients
Authors: Lo Shu‐Fen , Wang Yun‐Tung , Wu Li‐Yue , Hsu Mei‐Yu , Chang Shu‐Chuan , Hayter Mark 
Published: September 2009

Study aims. The purpose of this study was to compare the costs and effectiveness of enterostomal education using a multimedia learning education program (MLEP) and a conventional education service program (CESP).Background. Multimedia health education programs not only provide patients with useful information in the absence of health professionals, but can also augment information provided in traditional clinical practice. However, the literature on the cost–effectiveness of different approaches to stoma education is limited.Design. This study used a randomised experimental design.Methods. A total of 54 stoma patients were randomly assigned to MLEP or CESP nursing care with a follow‐up of one week. Effectiveness measures were knowledge of self‐care (KSC), attitude of self‐care (ASC) and behavior of self‐care (BSC). The costs measures for each patient were: health care costs, MLEP cost and family costs.Results. Subjects in the MLEP group demonstrated significantly better outcomes in the effectiveness measures of KSC, ASC and BSC. Additionally, the total social costs for each MLEP patient and CESP patient were US$7396·90 and US$8570·54, respectively. The cost–effectiveness ratios in these two groups showed that the MLEP model was better than the CESP model after one intervention cycle. In addition, the Incremental Cost Effectiveness Ratio was −20·99.Conclusion. This research provides useful information for those who would like to improve the self‐care capacity of stoma patients. Due to the better cost–effectiveness ratio of MLEP, hospital policy‐makers may consider these results when choosing to allocate resources and develop care and educational interventions.Relevance to clinical practice. This study provides a cost effective way of addressing stoma care in the post‐operative period that could be usefully transferred to stoma care settings internationally.
Trajectory and determinants of nutritional health in older patients during and six‐month post‐hospitalisation
Authors: Chen Cheryl C‐H , Tang Siew T , Wang Charlotte , Huang Guan‐Hua 
Published: September 2009

Aim.  The aim of this study was to characterise the trajectory and to identify determinants of nutritional health over time in a sample of older hospitalised patients, using the Generalized Estimating Equation.Background.  Nutritional health deteriorates and may fluctuate over time during and post‐hospitalisation. To develop a target intervention it is essential that we first have a clear picture of how the nutrition changes and examine the determinants of nutritional health during and post‐hospitalisation.Design.  A prospective cohort study was conducted on 306 older hospitalised patients aged 65 years and older.Methods.  Subjects were recruited from five surgical and medical wards at a tertiary medical center in northern Taiwan and assessed at four points in time: within 48 hours after admission, before discharge and 3–6 months post‐discharge.Results.  Nutritional health fluctuated significantly over time. The curve dropped during hospitalisation, returned at three months and rose slightly at six months post hospitalisation. After controlling for length of stay and surgical treatment, patients showed decreased cognitive capacity, worsening oral health, increased use of medications, increased functional limitations and raised depressive symptoms, all of which affects their nutritional health over time. The extent of functional status impacting on nutrition varies at different points in time while the predictability of other determinants remained stable.Conclusion.  The trajectory of nutritional health is a reflection of the patients’ cognitive status, oral health, medication taken, functional status and depressive symptoms. The findings of our study should provide guidance in the development of intervention for the nutritional health of older patients during inpatient as well as transitional care.Relevance to clinical practice.  Multi‐faceted packages of interventions targeting a range of determinants for managing undernutrition and subsequent decline during and post‐hospitalisation need to be tested.
A review of nutrition in Duchenne muscular dystrophy
Authors: Davidson Z. E. , Truby H. 
Published: September 2009

AbstractDuchenne muscular dystrophy (DMD) is a recessive X linked genetic disorder characterised by progressive muscle weakness and reduced muscle tone. Affecting only boys, it limits life expectancy to approximately 20 years. A literature review was conducted using MEDLINE and the Cochrane Library, employing the term ‘Duchenne muscular dystrophy’. A total of 1491 articles in English were recovered. These papers were searched thematically under the headings: body composition (n = 10), energy expenditure (n = 10), nutrition (n = 6), corticosteroid therapy (n = 55) and gene therapy (n = 199). Key dietetic practice points were identified relevant to nutritional management. Papers supporting these key themes were assigned a level of evidence and grade of recommendation. There is limited high‐quality evidence to guide the nutritional management of boys with DMD. Currently, the majority of evidence is based on expert opinion and clinical expertise. Delayed growth, short stature, muscle wasting and increased fat mass are characteristics of DMD and impact on nutritional status and energy requirements. The early introduction of steroids has altered the natural history of the disease, but can exacerbate weight gain in a population already susceptible to obesity. Prior to commencing steroids, anticipatory guidance for weight management should be provided. Malnutrition is a feature of end stage disease requiring a multidisciplinary approach, such as texture modification and supplemental feeding. Micronutrient requirements are yet to be determined but, as a result of corticosteroid treatment, vitamin D and calcium should be supplemented. Some evidence exists supporting supplementation with creatine monohydrate to improve muscle strength. More research is needed to provide a higher quality of evidence for dietitians working within this area.
The use of oral nutritional supplements in an Irish community setting
Authors: Kennelly S. , Kennedy N. P. , Flanagan Rughoobur G. , Glennon Slattery C. , Sugrue S. 
Published: September 2009

AbstractBackground:  The frequency of oral nutritional supplement (ONS) prescribing has been increasing steadily in the Republic of Ireland (ROI). Available evidence indicates that health professionals in the community setting in the ROI have a poor level of knowledge about ONS. The objectives of the present study were to investigate ONS prescribing practices and to identify the types of patient who were prescribed these products.Methods:  Ten of 17 eligible general practitioners were recruited and asked to refer all patients (aged > 16 years) who were prescribed ONS during a 3‐month period. Patients were interviewed by a community dietitian, using a questionnaire incorporating the Malnutrition Universal Screening Tool (MUST). ONS prescriptions were judged either to fulfil or not to fulfil a set of criteria developed for ONS prescribing in the community.Results:  The majority of patients were female (62/78). Their mean (SD) age was 79 (10.5) years. According to MUST criteria, 31 of 78 patients were at ‘low risk’, 18 of 78 were at ‘medium risk’ and 29 of 78 were at ‘high risk’ of malnutrition. Less than half of the patients (36/78) had a body mass index of < 20 kg m−2. Only 21 of 78 patients reported having received dietary advice in addition to their ONS prescription. Almost one‐third (31%) of ONS prescriptions did not fulfil the criteria. Social factors, such as living alone, and difficulties with cooking and shopping, influenced the need for ONS in almost 70% of cases.Conclusions:  ONS were prescribed in accordance with the prescribing criteria in the majority of cases; however, some patients who were prescribed ONS were not ‘at risk’ of malnutrition. Social circumstances played an important part in determining the need for ONS prescriptions.
Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults
Authors: Vincent H. K. , Bourguignon C. M. , Taylor A. G. 
Published: September 2009

AbstractBackground: Phytochemicals are bioactive nutrients that help reduce disease risk. A high intake of these compounds is important for optimal health and prevention of disease, but quantification of these nutrientsin vivois costly and time consuming. The present examined whether an alternative, simple ‘phytochemical index’ (PI) ratio calculation (PI = the ratio of the energy from high‐nutrient phytochemical‐rich foods to overall daily energy consumed [kJ phytochemical rich foods/total kJ consumed]) was related to several precursors of future disease: annual weight gain, adiposity, oxidative stress and inflammation.Methods: This was a cross‐sectional, quantitative, descriptive study (n = 54, age range 18–30 years). Participants were stratified into normal weight and overweight groups. Three‐day dietary records were analysed for food items, food groups, energy and the PI score at repeated time points. Blood plasma samples were analysed by colorimetric or an enzyme‐linked immunoabsorbent assay for cholesterol subfractions, glycated haemoglobin, total antioxidant status, lipid hydroperoxides, cytokines (interleukins‐1β and ‐6) and C‐reactive protein).Results: PI values were higher in the overweight‐obese group. Correlation values between the PI score and body mass index, waist circumference, waist‐to‐hip ratio and plasma oxidative stress were significant. The PI score did not correlate with any cytokine levels. The PI score was a significant contributor to yearly weight gain.Conclusions: The PI is inversely related to adiposity and oxidative stress in healthy young adults, and is responsive to body weight changes. This simple, easy to administer index might be useful as a dietary target for appropriate proportion consumption of nutrient‐rich foods in weight reduction or management programmes.
Estimating food intakes in Australia: validation of the Commonwealth Scientific and Industrial Research Organisation (CSIRO) food frequency questionnaire against weighed dietary intakes
Authors: Lassale C. , Guilbert C. , Keogh J. , Syrette J. , Lange K. , Cox D. N. 
Published: September 2009

AbstractBackground:  There is a dearth of knowledge about the foods that Australian adults eat and a need for a flexible, easy‐to‐use tool that can estimate usual dietary intakes. The present study was to validate a commonly used Australian Commonwealth Scientific and Industrial Research Organisation (CSIRO) food‐frequency questionnaire (C‐FFQ) against two 4‐day weighed food records (WFR), as the reference method.Methods:  The C‐FFQ, as the test item, was administrated before the WFR. Two 4‐day WFR were administrated 4 weeks apart. Under‐reporting was established using specific cut‐off limits and estimated basal metabolic rate. Seventy‐four women, aged 31–60 years, were enrolled from a free‐living community setting.Results:  After exclusion for under‐reporting, the final sample comprised 62 individuals. Correlations between protein intake from the WFR and urinary urea were significant. Overall agreement between FFQ and WFR was shown by ‘levels of agreement’ (LOA) and least products regressions. There was presence of fixed and proportional bias for almost half the nutrients, including energy, protein, fat and carbohydrates. For most of the nutrients that did not present bias, the LOA were 50–200%. Agreement was demonstrated for percentage dietary energy protein and fat; carbohydrate; and absolute amounts of thiamine, riboflavin, magnesium and iron. However, relative intake agreement was fair to moderate, with approximately 70% of (selected) nutrients exact or within ±1 quintile difference.Conclusion:  The C‐FFQ is reasonable at measuring percentage energy from macronutrients and some micronutrients, and comprises a valuable tool for ranking intakes by quintiles; however, it is poor at measuring many absolute nutrient intakes relative to WFR.
Fibre content of enteral feeds for the older child
Authors: Evans S. , Daly A. , Davies P. , MacDonald A. 
Published: September 2009

AbstractBackground:  There is currently a lack of clinical data on fibre requirements in UK children. Subsequently, the ideal fibre profile for enteral formulae designed to meet the requirements of older children is unknown. The present study aimed to investigate the effect of fibre supplementation on gastrointestinal function of children aged 7–12 years (or weight 21–45 kg) receiving an age‐specific high‐energy enteral feed.Methods:  In this double‐blind randomised crossover study, 25 home enterally tube‐fed children with a range of medical conditions (including cystic fibrosis, neurological conditions, liver transplant and bone marrow transplant) were given a 1.5 kcal mL−1 formula with or without added dietary fibre (1.13 g per 100 mL). Each formula was taken for 6 weeks, followed by 6 months on the second randomly assigned formula. Anthropometry, blood biochemistry, stool characteristics, tolerance and oral dietary intake were assessed.Results:  Despite a higher median fibre intake on the fibre‐containing formula (84% versus 26% of recommended intake; P = 0.003), most children did not meet existing international recommendations for fibre as a result of small feed volumes (median 800 mL day−1; 9 g fibre day−1). There was some evidence of reduced constipation, laxative reliance and abdominal pain on the fibre‐containing formula.Conclusions:  Given the poor fibre intakes and absence of adverse effects, the use of fibre‐containing formulae should become standard practice for the majority of children on enteral feeds. Larger trials in children are required to further evaluate the effect of amount and blend of fibre in enteral formulae for older children. However, it is likely that current formulae require higher levels of fibre.
A method of PSF generation for 3D brightfield deconvolution
Authors: TADROUS P.J. 
Published: September 2009

SummaryThis paper addresses the problem of 3D deconvolution of through focus widefield microscope datasets (Z‐stacks). One of the most difficult stages in brightfield deconvolution is finding the point spread function. A theoretically calculated point spread function (called a ‘synthetic PSF’ in this paper) requires foreknowledge of many system parameters and still gives only approximate results. A point spread function measured from a sub‐resolution bead suffers from low signal‐to‐noise ratio, compounded in the brightfield setting (by contrast to fluorescence) by absorptive, refractive and dispersal effects. This paper describes a method of point spread function estimation based on measurements of aZ‐stack through a thin sample. ThisZ‐stack is deconvolved by an idealized point spread function derived from the sameZ‐stack to yield a point spread function of high signal‐to‐noise ratio that is also inherently tailored to the imaging system. The theory is validated by a practical experiment comparing the non‐blind 3D deconvolution of the yeastSaccharomyces cerevisiaewith the point spread function generated using the method presented in this paper (called the ‘extracted PSF’) to a synthetic point spread function. Restoration of both high‐ and low‐contrast brightfield structures is achieved with fewer artefacts using the extracted point spread function obtained with this method. Furthermore the deconvolution progresses further (more iterations are allowed before the error function reaches its nadir) with the extracted point spread function compared to the synthetic point spread function indicating that the extracted point spread function is a better fit to the brightfield deconvolution model than the synthetic point spread function.
Clinical stem cell therapies for severe autoimmune diseases
Authors: Snowden J. A. , Martin‐Rendon E. , Watt S. M. 
Published: September 2009

summary.Severe autoimmune diseases (ADs) are a major source of disability and reduced quality of life and may result in shortened life expectancy, particularly in treatment‐resistant patients. For several decades, allogeneic and autologous haematopoietic stem cell transplantation (HSCT) has been the focus of scientific investigation as a potential means of delivering ‘one‐off’ intensive treatment in severe ADs. Improvements in the clinical safety of HCST were followed by its increasing use in recent years as an experimental treatment for severe and resistant ADs. European and North American registries have accumulated between one and two thousand procedures. Retrospective analyses and prospective studies have demonstrated the feasibility, safety and initial efficacy data in various ADs. Profound cell biological changes induced by HSCT leading to stabilization or reversal of organ damage have been characterized. These have also shed light on basic disease mechanisms and support investigation of more specific cellular therapy in ADs. There is clear potential for harnessing a profound immunological effect through HSCT. However, there is a need for an ongoing balance against evolving non‐transplant treatments for ADs. Ideally, these issues should be resolved in phase III studies, in which HSCT approaches are compared with the best comparator.
Retrospective surveillance of HIV prevalence in blood donors can help in the selection of the best social group for blood donation in Mali
Authors: Tounkara A. , Diakite M. , Noumsi G. T. , Sarro Y. D. S. , Siddiqui S. , Parta M. 
Published: September 2009

summary.The National Centre for Blood Transfusion, Bamako, Mali has collected data that characterizes trend in HIV prevalence over 10 years by gender, age, occupation, marital status and donor category. These data help to describe national HIV prevalence and assist in formulating blood donation policies. Donations from 1993 to 2002 were categorized by donor age (decade), occupation (student, military and other), marital status (single, married and other), gender and donor status (volunteer, occasional and family). Comparisons were made using conservative estimates of donation frequency/donor category. Donations increased by more than 400%. By 1999, increased HIV prevalence in donations from women was consistently present. Donations from the age group of 30–39 years showed an increased prevalence beginning in 2000, which by 2002 was almost 10 times greater than in the low‐prevalence (<20 years) group (5.9 vs. 0.6%). By 2000, both categories ‐ students and military were less likely to be HIV positive than those from other occupational categories, and donations from married persons were less likely to be HIV positive by 1997. The highest prevalence was observed in the ‘occasional’ donor category, which increased to >14% by 2001; volunteer donation HIV positive peaked at 2.3% in 1999. HIV prevalence in blood donations in Bamako, Mali, demonstrates important trends from 1993 to 2002. The prevalence of > 14% in donations from occasional donors and significant trends by decade, gender, marital status and occupation argue for increased analysis of the blood donor population to improve blood safety and to understand the demographics of HIV infection in Mali.
Two novel null alleles of the KEL gene detected in two Chinese women with the Knull phenotype
Authors: Yang Ying , Wang LingLing , Wang Chen , Chen HePing , Guo ZhongHui , Zhang YuXian , Zhu ZiYan 
Published: September 2009

summary.In screening 87665 unrelated healthy blood donors in China, serology studies resulted in the detection of two K0 probands, both female. To explore the molecular basis of the Knull phenotype in the Chinese population, genomic DNA, total RNA, and reticulocyte RNA were subsequently prepared from the two probands, five family members of proband 1, four unrelated normal controls, and one unrelated KEL1 control. Nucleic acids were analyzed for the KEL gene by DNA and RNA sequencing, while antigens were analyzed by flow cytometry with BRIC18, BRIC68, anti‐k, and anti‐Kpb. Two novel Knull alleles were identified in both probands: in exon 3, 185insT (Ser62Phe and a premature stop codon in exon 4, GenBank accession number, EF208900), and in exon 7, 715G>T (Glu239Stop, GenBank accession number EF208901). Alternative splicing patterns were observed in RNA obtained from whole blood versus from a reticulocyte fraction. Our study identified these two novel Knull alleles resulting in the Knull phenotype, the frequency of the Knull phenotype amongst Chinese mainlanders is only 0.00228%.
Factors associated with death among HIV‐uninfected TB patients in Thailand, 2004–2006
Authors: Amnuaiphon Waraya , Anuwatnonthakate Amornrat , Nuyongphak Prungsri , Sinthuwatanawibool Chalinthorn , Rujiwongsakorn Sadudee , Nakara Prapa , Komsakorn Sitijate , Wattanaamornkiet Wanpen , Moolphate Saiyud , Chiengsorn Navarat , Kaewsaard Samroui , Nateniyom Sriprapa , Varma Jay K. 
Published: September 2009

SummaryObjectives  In countries with both TB and human immunodeficiency virus (HIV) epidemics, HIV is known to be the most powerful risk factor for death during tuberculosis (TB) treatment. Few recent studies have evaluated risk factors for death among HIV‐uninfected TB patients in these countries. We analysed data from a multi‐province demonstration project in Thailand to answer this question.Method  We prospectively collected data from HIV‐uninfected TB patients treated for TB in four provinces and the national infectious diseases hospital in Thailand from 2004–2006. Standard WHO definitions were used to classify treatment outcomes. We used log‐binomial multivariate regression to calculate adjusted relative risk (aRR) and 95% confidence intervals (CI) for factors associated with death.Results  Of 5318 cases, 441 (8%) died during TB treatment. The mean age was 47 years (range 8 months–97 years). Multidrug‐resistant (MDR)‐TB was diagnosed in 62 (1%). In multivariate analysis, patients older than 44 years were significantly more likely to die than patients aged 15–44 years [age 45–64, aRR 2.9 (CI 2.2–3.8)] [age > 64 years, aRR 5.0 (CI 3.9–6.6)]. Other independent risk factors for death included Thai nationality [aRR 3.9 (CI 1.6–9.5)], MDR‐TB [aRR 2.8 (CI 1.7–4.8)], not being married [aRR 1.4 (CI 1.2–1.7)], and living in Chiang Rai province [aRR 2.7 (CI 1.7–4.4)].Conclusions  The death rate was high among HIV‐uninfected TB patients in Thailand. Efforts to improve TB diagnosis and treatment in the elderly and to improve MDR‐TB treatment may help reduce mortality.