bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study of teacher's perceptions of an intervention to prevent conduct problems in Jamaican pre‐schools
Authors: Baker‐Henningham H. , Walker S. 
Published: August 2009

AbstractBackground  There is a growing evidence base showing the efficacy of school‐based interventions to prevent conduct problems but few evaluations have addressed teachers' perceptions of these programmes. Teachers' views on the acceptability, feasibility and usefulness of an intervention will influence implementation fidelity and programme sustainability and can help further our understanding of how the intervention works and how it may be improved.Methods  A pilot study of the Incredible Years Teacher Training Programme supplemented by a curriculum unit on social and emotional skills was conducted in inner‐city pre‐schools in Kingston, Jamaica. Three pre‐schools comprising 15 classrooms participated in the intervention which involved seven monthly teacher workshops and 14 weekly child lessons in each class. At the end of the intervention in‐depth individual interviews were conducted with each intervention teacher.Results  Teachers reported benefits to their own teaching skills and professional development, to their relationships with children and to the behaviour, social‐emotional competence and school readiness skills of the children in their class. Teachers also reported benefits to teacher–parent relationships and to children's behaviour at home. A hypothesis representing the teachers' perceptions of how the intervention achieved these benefits was developed. The hypothesis suggests that intervention effects were due to teachers' gains in skills and knowledge in three main areas: (1) a deeper understanding of young children's needs and abilities; (2) increased use of positive and proactive strategies; and (3) explicitly teaching social and emotional skills. These changes then led to the variety of benefits reported for teachers, children and parents. Teachers reported few difficulties in implementing the majority of strategies and strongly recommended wider dissemination of the intervention.Conclusions  The intervention was valued by Jamaican pre‐school teachers and teachers felt they were able to successfully integrate the strategies learned into their regular practice.
Plasma growth factor activity and cardiac wall thickness
Authors: LEMNE C. , VOLK‐JOVINGE S. , NILSSON J. , VESTERQVIST O. , DE FAIRE U. 
Published: August 2009

Abstract. Objectives. The aim of this study was to investigate the growth factor activity in plasma (GFAP) in hypertension, and the correlation of GFAP to blood pressure levels, cardiac structural changes and platelet activation at rest and during exercise.Subjects. Fifteen untreated hypertensive subjects and 15 normotensive controls were recruited from a blood pressure screening programme.Interventions. GFAP before and after 30 min of strenuous exercise was analysed as the ability of patient or control plasma to stimulate incorporation of 3H‐thymidine in cultured human smooth muscle cells. M‐mode echocardiography was performed and platelet activity was measured by the excretion of the urinary metabolite of thromboxane A2.Results. There were no significant differences in GFAP or platelet activation at rest or after exercise between the groups. The fractions of labelled cells were 52.6% vs. 56.6% (HT vs. NT) at rest. Septum and posterior wall end‐diastolic thicknesses (PWT[D]) were significantly increased in the HT group (10.4 ± 0.3 vs. 9.2 ± 0.3 mm and 11.4 ± 0.5 vs. 10.0 ± 0.4 mm, respectively, P < 0.05). PWT(D) was significantly correlated to GFAP (r = 0.40, P = 0.04) and to blood pressure (r = 0.53, P < 0.005) but there was no correlation between blood pressure and GFAP.Conclusion. The data suggest that GFAP could play a role in the early development of cardiac hypertrophy in hypertension, but that this effect does not seem to be directly linked to blood pressure levels alone.
Correlation between blood pressure and plasma insulin in acromegaly
Authors: IKEDA T. , TERASAWA H. , ISHIMURA M. , OCHI H. , OHTANI I. , FUJIYAMA K. , HOSHINO T. , TANAKA Y. , MASHIBA H. 
Published: August 2009

Abstract. Objectives. The aims of this study were to determine the possible role of hyperinsulinaemia in the increase in blood pressure in acromegalic patients.Design. After an overnight fast, blood samples were obtained at 0, 30, 60, 120 and 180 min after 75 g glucose ingestion, and plasma growth hormone (GH) and plasma insulin (IRI) were measured by radioimmunoassay. The blood pressure was measured at 10.00 hours for 3 days in a supine position.Subjects. Nineteen (nine women and 10 men) untreated acromegalic patients, aged 25–69 years.Results. There were no significant correlations between mean blood pressure (MBP; diastolic + one‐third pulse pressure) and basal GH, sum of plasma GH at 0, 30, 60, 120 and 180 min or basal IRI. However, significant correlation was observed between MBP and IRI at 120 min (r = 0.57, P < 0.02) or sum of plasma IRI at 0, 30, 60, 120 and 180 min) (r = 0.58, P < 0.02).Conclusions. We conclude that hyperinsulinaemia may be involved in an increase in blood pressure in active acromegalics.
Individual utilization of anti‐asthma medication by young adults: a prescription database analysis
Authors: HALLAS J. , HANSEN N.‐C. G. 
Published: August 2009

Abstract. Objectives. To analyse and evaluate current practice of asthma therapy by use of computerized prescription data.Design. Descriptive, non‐interventive.Setting. A pharmacoepidemiological database on computerized refund claims from pharmacies in the Odense region in Denmark.Subjects. Persons aged 20–44, presenting prescriptions for asthma drugs during the period 1 October 1990 to 30 September 1991.Main outcome measures. Prevalence of asthma drug use, the regimes chosen, relationship between β‐agonist and steroid use by the individual patient.Results. In all, 3020 persons used anti‐asthma drugs, corresponding to a crude 1‐year prevalence of 3.6%. Sixty per cent were women. The subjects had an average anti‐asthma drug consumption corresponding to 86% of the population's average. The four most common regimes were inhaled β‐agonist monotherapy, inhaled β‐agonist and corticosteroid, oral β‐agonist monotherapy and inhaled corticosteroid monotherapy, altogether accounting for 79% of users. The proportion of corticosteroid users increased with increasing individual use of β‐agonists. With an annual β‐agonist purchase of 100–200 defined daily doses, still less than half also used steroids.Conclusion. The majority of patients use a regime agreeing with current guidelines, except that more patients should be prescribed corticosteroids. The observed large increase in asthma drug use is likely to be explained by an intensified treatment of individual patients, rather than an increased prevalence.
Presenting features of monoclonal gammopathies: an analysis of 684 newly diagnosed cases
Authors: UCCI G. , RICCARDI A. , LUONI R. , ASCARI E. ,   For the Cooperative Group for the Study and Treatment of Multiple Myeloma
Published: August 2009

Abstract. Objectives. The clinical, laboratory and radiologic features at diagnosis of 684 newly diagnosed patients with monoclonal gammopathy were revised in order to underline the differences between monoclonal gammopathies of undetermined significance (MGUS) and stage I multiple myeloma (MM).Design. Patients were screened for inclusion in a prospective controlled protocol for treatment of MM. Those having serum or urine monoclonal component (MC) were diagnosed as MM when they demonstrated osteolysis and/or bone marrow plasma cells (BMPC) > 20%; patients not fulfilling these criteria were considered MGUS.Setting. Patients were recruited from 24 general or university hospitals from the departments of internal medicine, haematology and medical oncology.Subjects. Seven‐hundred‐and‐fifty were enrolled between January 1986 and March 1990; 684 (343 MGUS and 341 MM) were able to be evaluated for this study and 78 were stage I MM.Interventions. Complete clinical, radiologic and laboratory work‐up was carried out at the referral centres.Main outcome measures. The main outcome expected was the confirmation that BMPC > 20% could reliably differentiate stage I MM from MGUS.Results. At a median follow‐up of 36 months (minimum follow‐up: 18 months), MGUS had a lower progression rate to overt MM, longer overall survival and different causes of death than stage I MM. Further differences concerned erythrocyte sedimentation rate (28 vs. 47, P < 0.001), per cent reduction of normal immunoglobulin (86 vs. 60%, P < 0.001), serum MC (1.6 vs. 2.2 g dl−1, P < 0.001) and thymidine kinase level (3.3 vs. 4.5 mU ml−1, P < 0.05).Conclusions. The study suggests that 20% BMPC can be taken as a safe cut‐off point at which to differentiate MGUS from early MM and outlines a few simple parameters which can be of diagnostic aid.
Diurnal blood pressure variations in normoalbuminuric type 1 diabetic patients
Authors: HANSEN K. W. , PEDERSEN M. M. , CHRISTIANSEN J. S. , MOGENSEN C. E. 
Published: August 2009

Abstract. Objective. To test the hypothesis that normoal‐buminuric type 1 diabetic patients segregate into groups with normal and elevated ambulatory blood pressure. To evaluate diurnal variation of blood pressure assessed by individual or fixed night‐time periods.Design. Cross‐sectional study.Setting. Tertiary referral centre.Subjects. Inclusion criteria for type 1 diabetic patients (n = 33): normal urinary albumin excretion (UAE age < 45 < 20 μg min−1), diabetes duration ≤ 20 years, age 45 years. Healthy controls (n = 33) were matched for sex and age.Main outcome measure. Twenty‐four hour, day‐time, night‐time and night/day ratio of ambulatory blood pressure.Results. Twenty‐four‐hour blood pressure in diabetic patients did not differ significantly from a normal distribution. The 24‐h systolic blood pressure was higher in diabetic patients than in healthy controls (difference: 6 mmHg, 95% confidence interval (CI) from 1 to 10 mmHg, P < 0.05), while no significant differences were found for diastolic values. The 24‐h systolic blood pressure in diabetic patients with UAE above the median value (5.8 μg min−1) was higher than for those with lower UAE (difference: 7 mmHg, 95% CI from 0.5 to 13 mmHg, P < 0.05). The night/day ratio of diastolic blood pressure based on individual informations of the night period was (mean ± SD) 80 ± 6% in diabetic patients and 78 ± 8% in controls (difference: 2%, 95% CI from −1 to 5%, not significant [NS]). This ratio increase significantly (P < 0.00001) to 90 ± 5% in diabetes and to 84 ± 7% in controls if a fixed night period from 22.30 hours to 06.30 hours was assumed.Conclusions. It was not possible to identify a well‐separated group of normoalbuminuric type 1 diabetic patients with elevated ambulatory blood pressure. Values of UAE above the median in diabetic patients are associated with higher ambulatory blood pressure. Assessment of the night/day variation from fixed time‐points should be abandoned because this leads to a serious underestimation of the nocturnal reduction in blood pressure.
Effects of age, sex, season and diet on serum ionized calcium, parathyroid hormone and vitamin D in a random population
Authors: RUDNICKI M. , THODE J. , JØRGENSEN T. , HEITMANN B. L. , SØRENSEN O. H. 
Published: August 2009

Abstract. Objectives. To study the influence of age, sex, season and diet on calcium status in normal subjects.Design. A random population study.Setting. Institutional clinic for large population studies.Subjects. The subjects were drawn randomly from the Danish Civil Registration System and represented a random sample of the background population in the area. The sample comprised 127 subjects (54 men and 73 women, aged 35–65 years).Main outcome measures. The effects of age, sex, season and diet on parathyroid hormone (PTH), 1,25‐ dihydroxyvitamin D (1,25(OH)2D) and 25‐hydroxy‐vitamin D (25‐OHD).Results. There was no statistical significant difference for the serum concentrations of ionized calcium, PTH, 1,25(OH)2D and 25‐OHD between the two sexes, nor any influence by age in either sex, in contrast to serum phosphate, which declined significantly in men (P < 0.05), but tended to increase in women. Serum PTH (P < 0.009) showed seasonal fluctuations, whereas serum concentrations of 1,25(OH)2D, 25‐OHD, ionized calcium, phosphate and magnesium remained stable throughout the year. Dietary intake of calcium and vitamin D were not related to any serum variables.Conclusions. In healthy subjects differences between the two sexes exist regarding phosphate metabolism. Serum PTH shows seasonal fluctuations.
High serum insulin, insulin resistance and their associations with cardiovascular risk factors The Northern Sweden MONICA population study
Authors: LINDAHL B. , ASPLUND K. , HALLMANS G. 
Published: August 2009

Abstract. Objectives. To estimate the prevalence of insulin resistance and high serum insulin levels and to investigate their relationship to other cardiovascular risk factors.Design. Cross‐sectional cardiovascular risk factor survey.Setting. Northern Sweden.Subjects. A subsample of the population‐based Northern Sweden MONICA Study. This subsample underwent an oral glucose tolerance test after an overnight fast, and consisted of 354 men and 404 women in the 25–64‐year age range.Main outcome measures. Delineation of low insulin sensitivity and high serum insulin by the diagnostic test technique, prevalence of these variables and their associations with cardiovascular risk factors.Results. The participants were classified into four subgroups by an insulin sensitivity index and fasting serum insulin. The combination of low insulin sensitivity and high serum insulin was present in 17% of the male and in 18% of the female 25–64‐year‐old population. In both sexes this combination was closely associated (P < 0.001) with body mass index, waist‐hip ratio, blood pressure and serum triglycerides, and correlated inversely with serum HDL cholesterol (P < 0.001). When high serum insulin was present as an isolated entity it was as closely associated with other cardiovascular risk factors such as isolated low insulin sensitivity, except that impaired glucose tolerance occurred exclusively in the group with isolated low insulin sensitivity.Conclusions. The combination of insulin resistance and high insulin levels is associated with a marked clustering of cardiovascular risk factors and is present in one‐sixth of the middle‐aged population in the north of Sweden.
Very early risk stratification by electrocardiogram at rest in men with suspected unstable coronary heart disease
Authors: NYMAN I. , ARESKOG M. , ARESKOG N.‐H. , SWAHN E. , WALLENTIN L. ,   RISC STUDY GROUP
Published: August 2009

Abstract. Objectives. To determine the possibility of very early prognostic stratification based on electrocardiograms (ECGs) at rest and/or cardiac enzyme levels after an episode of suspected unstable coronary heart disease.Design and setting. Men with suspected unstable angina or non‐Q‐wave myocardial infarction were studied in the coronary care units of eight hospitals. The ECGs at rest and creatinine kinase were followed.Subjects. In total 911 men were followed for 12 months. Of 8136 consecutively admitted, 3365 fulfilled the inclusion criteria. Excluded were 2454 patients, mainly because of a larger myocardial damage, signs of myocardial dysfunction, other serious cardiac or non‐cardiac disease or an ECG not possible to interprete regarding ST‐T‐segment changes in the precordial leads.Main outcome measures. End‐points at follow‐up were cardiac death, myocardial infarction and severe (class III or IV) angina.Results. Compared to patients with normal a ECG who had an 8% 1‐year risk of myocardial infarction or death, the risk with isolated negative T waves was 14% (P < 0.05), ST elevation 16% (P < 0.05), ST depression 18% (P < 0.01) and the combination of ST elevation and ST depression 26% (P < 0.001). The only finding related to future severe angina was ST depression. The risk of cardiac events was comparably elevated in patients with anterior or inferior site of ECG changes. Cardiac enzyme levels had no predictive value regarding future events.Conclusions. Electrocardiograms at rest obtained during the initial days of hospitalization provide very early and valuble prognostic information in men admitted with suspected unstable coronary heart disease.
Low‐dose warfarin decreases coagulability without affecting prothrombin complex activity
Authors: HOLM J. , BERNTORP E. , CARLSSON R. , ERHARDT L. 
Published: August 2009

Abstract. Objectives. To asses the efficacy of a fixed, low dose of warfarin in lowering factor VII coagulant activity (FVII: C) and to investigate the effects on the plasma coagulation cascade.Design. An open pilot study with two dose levels of warfarin: 1.25 and 2.5 mg day−1 during two consecutive 4‐week periods. All subjects received aspirin 75 mg day−1. Prothrombin fragment 1 + 2 (F(1 + 2)), protein C, protein S, FVII:C, factor X and P‐prothrombin complex activity (P‐PT) were measured at baseline, at 2‐week intervals and 4 weeks after end of treatment. Coagulation activation peptide F(1 + 2) was used as a marker of thrombin formation [13].Subjects. Twelve male patients with a history of myocardial infarction. Inclusion was made through a written questionnaire.Results. Warfarin 1.25 mg day−1 lowered FVII:C from 113 U dl−1 to 107 U dl−1 (P = 0.025) and F(1 + 2) from 1.60 nmol l−1 to 1.27 nmol l−1 (P = 0.013) but had no effect on protein C or P‐PT. A dose of 2.5 mg day−1 induced further lowering of FVII:C (91 U dl−1, P = 0.0042), and also of protein C from 116% to 99% (P = 0.034) and P‐PT from 107% to 81% (P = 0.0096) mean values.Conclusion. Warfarin 1.25 mg day−1 seems to exert an anticoagulant effect without reduction in PT or the natural anticoagulant protein C and is suggested, in combination with aspirin, to be a safe and simple therapy against arterial thrombotic disease, making regular PT controls unnecessary.
The cost‐effectiveness of treating hypertension in elderly people—an analysis of the Swedish Trial in Old Patients with Hypertension (STOP Hypertension)
Authors: JOHANNESSON M. , DAHLÖF B. , LINDHOLM L. H. , EKBOM T. , HANSSON L. , ODÉN A. , SCHERSTÉN B. , WESTER P.‐O. , JÖNSSON B. 
Published: August 2009

Abstract. Objectives. The aim of this study was to estimate the cost‐effectiveness of antihypertensive treatment in elderly people based on the results of the Swedish Trial in Old Patients with Hypertension (STOP Hypertension).Design. The STOP Hypertension study was a randomized trial comparing active antihypertensive treatment with a placebo. The risk of stroke, cardiovascular disease and total mortality was significantly reduced in the actively treated group compared to placebo.Setting. One hundred and sixteen primary health care centres in Sweden.Subjects. A total of 1627 hypertensive patients aged 70–84. No patient was lost to follow‐up.Interventions. Antihypertensive treatment with beta blockers and diuretics for a mean follow‐up of 25 months.Main outcome measure. The cost‐effectiveness ratio estimated as the net cost (the treatment cost minus saved costs of reduced cardiovascular morbidity) divided by the number of life‐years gained (the increase in life expectancy from treatment).Results. The cost per life‐year gained was estimated as SEK 5000 for men and SEK 15000 for women ($1 = SEK6; £1 = SEK10). The cost per life‐year gained did not exceed SEK100000 in any of the sensitivity analyses.Conclusions. It is concluded that treatment of elderly hypertensive patients with beta blockers and/or diuretics is cost‐effective according to the results of the STOP Hypertension study.
Deficiency of erythropoietin is not responsible for the anaemia associated with cyclosporin treatment of insulin‐dependent diabetes mellitus
Authors: NIELSEN O. J. , MANDRUP‐POULSEN T. , NERUP J. ,   CANADIAN‐EUR0PEAN RANDOMIZED CONTROL TRIAL GROUP
Published: August 2009

Abstract. Objectives. To explore the possible pathogenetic role of erythropoietin (EPO) in the anaemia associated with cyclosporin (Cs) in newly diagnosed patients with insulin‐dependent diabetes mellitus (IDDM).Design. A multicentre randomized placebo controlled prospective trial of Cs immunosuppression for 12 months in IDDM patients.Setting. Patients were recruited from the out‐patient clinics of diabetes centres in Europe and Canada.Subjects. Patients 9–35 years old with a clinical diagnosis of ketonuric IDDM entering less than 6 weeks after diagnosis. 188 patients were originally recruited; 105 patients completed the investigation, 52 patients being treated with Cs, and 53 patients receiving placebo.Interventions. Random allocation to receive either Cs or placebo. The initial dose of Cs was 10 mg kg−1 BW day−1. Therapy was maintained for 12 months.Main outcome measures. B‐Haemoglobin, s‐creatinine, and s‐EPO concentrations were monitored before, during and after therapy with either Cs or placebo.Results. Blood‐haemoglobin (Hgb) fell from 8.5 ± 0.8 to a nadir of 7.8 ± 0.9 mmol l−1 at 6 months (P < 0.0001) in IDDM patients treated with Cs but not in the placebo patients (8.5 ± 0.8 to 8.8 ± 0.9 mmol l−1, NS). The mean serum EPO levels remained unaltered throughout the 6‐month period of Cs and placebo therapy. No significant differences in serum EPO levels between Cs and placebo‐treated diabetic patients were found after 6 months of treatment.Conclusions. The light anaemia associated with Cs therapy in IDDM patients is not related to an insufficient production of EPO, but is caused by other, as yet unknown mechanisms, unrelated to the nephrotoxic action of this drug.