bluuebunny/crossref_metadata_2025_split huggingface dataset:
High‐altitude treatment: a therapeutic option for patients with severe, refractory asthma?
Authors: Rijssenbeek‐Nouwens L. H. , Bel E. H. 
Published: April 2011

Cite this as: L. H. Rijssenbeek‐Nouwens and E. H. Bel, Clinical & Experimental Allergy, 2011 (41) 775–782.AbstractHigh‐altitude treatment has been applied for more than a century in the treatment of pulmonary diseases including asthma. Many uncontrolled and controlled studies have shown its beneficial effects in children and adolescents with house dust mite allergic asthma. A recent study also showed an improvement in markers of airway inflammation in adult patients with severe intrinsic asthma, suggesting that factors other than HDM avoidance may contribute to the beneficial influence of the high‐altitude climate therapy on asthma. The dry mountain climate not only has decreased levels of mite allergens but also decreased levels of pollens, fungal spores and air pollution, as well as high exposure to UV light with immunomodulatory and anti‐inflammatory effects. Treatments targeting environmental control have never been investigated systematically in severe asthma, which is surprising, as environmental factors have been recognized as important contributors to asthma severity for many years and more evidence has been accumulating ever since. Preliminary evidence shows the beneficial effects of high‐altitude treatment in patients with severe refractory asthma on symptoms, lung function and oral corticosteroid requirement, irrespective of atopic status. In this narrative review, we will discuss why high‐altitude treatment might be a promising therapeutic option for patients who suffer from this disabling disease.
Validation of a self‐questionnaire for assessing the control of allergic rhinitis
Authors: Demoly P. , Jankowski R. , Chassany O. , Bessah Y. , Allaert F‐A. 
Published: April 2011

Cite this as: P. Demoly, R. Jankowski, O. Chassany, Y. Bessah and F‐A. Allaert, Clinical & Experimental Allergy, 2011 (41) 860–868.SummaryBackground
Allergic rhinitis affects the lives of patients for whom discomfort is, in most cases, significantly improved by pharmacological treatment.Objective
To develop and validate a self‐assessment global score for allergic rhinitis control (five items scored from 1 to 5 assessing the rhinitis over the 2 previous weeks).Methods
Study of acceptability, reliability, validity and sensitivity to change during a prospective observational study in 902 patients selected by 411 general practitioners or allergists.Results
The score correlated significantly to the clinical picture and to the impact of the rhinitis on social and sports activities at inclusion (P<0.0001). A significant improvement in the score was observed after 15 days of treatment: 14.9±4.0 at inclusion and 21.5±2.9 at re‐evaluation after 15 days of treatment (P<0.0001). Using receiver operating characteristics curve, a score of 20 was the cut‐off for poor vs. well‐controlled rhinitis; a score strictly higher than 20 (best being 25) had a sensitivity of 67%, a specificity of 82%, a negative predictive value of 32% and a positive predictive value of 95%.Conclusion and Clinical Relevance
The self‐assessment score for allergic rhinitis control appeared to be sensitive to change and correlated to the clinical expression of rhinitis and also to its involvement with treatment. These results suggest that this self‐completion questionnaire could be used in daily practice at each consultation to determine, in a standardized manner, the level of control of the allergic rhinitis of an individual patient.
Plasma FGF21 displays a circadian rhythm during a 72‐h fast in healthy female volunteers
Authors: Andersen Birgitte , Beck‐Nielsen Henning , Højlund Kurt 
Published: April 2011

SummaryObjective  Fibroblast growth factor (FGF21) is a potent regulator of glucose and lipid metabolism. In rodents, the hepatic expression of FGF21 is controlled by fasting and a circadian regulation, but the physiological role and regulation of FGF21 in humans is not well established. Therefore, the objective of this study was to elucidate the 24‐h profiling of plasma FGF21 during a 72‐h fast.Study design  After an initial 12‐h overnight fast, plasma levels of FGF21 together with circulating levels of glucose, insulin, glucagon and free fatty acids (FFA) were measured every 6 h during a 72‐h fast in healthy female volunteers (n = 14).Results  During the fast, plasma glucose and serum insulin gradually decreased whilst glucagon and FFA levels increased. Mean 24‐h plasma FGF21 levels did not increase during the 72‐h fast, but, despite large inter‐individually variations, a significant circadian rhythm was observed. Thus, during the first day, plasma FGF21 increased from 125 pg/ml (16–142) at 8.30 a.m to peak levels of 224 pg/ml (88–326) at 2.30 a.m (P = 0·0215), the second day from 60 pg/ml (7–74) at 8.30 a.m to 268 pg/ml (103–410) at 2.30 a.m. (P = 0·0010) and the third day from 94 pg/ml (9–146) to 151 pg/ml (87–207) at 2.30 a.m. (P = 0·0049). Cortisol also showed circadian regulation and peaked at 8.30 a.m every day, 6 h after the observed FGF21 peak.Conclusion  Plasma FGF21 follows a circadian rhythm during a 72‐h fast in healthy female subjects. The circadian regulation has a stronger impact on plasma FGF21 than the fasting status over 72‐h period.
Identifying metabolically obese but normal‐weight (MONW) individuals in a nondiabetic Korean population: the Chungju Metabolic disease Cohort (CMC) study
Authors: Lee Seung‐Hwan , Ha Hee‐Sung , Park Young‐Jun , Lee Jin‐Hee , Yim Hyeon‐Woo , Yoon Kun‐Ho , Kang Moo‐Il , Lee Won‐Chul , Son Ho‐Young , Park Yong‐Moon , Kwon Hyuk‐Sang 
Published: April 2011

SummaryObjective  To investigate the prevalence and identify the phenotype of individuals suspected to be metabolically obese but normal weight (MONW).Design and subjects  Eight thousand nine hundred and eighty‐seven nondiabetic subjects aged over 40 years were selected from the Chungju Metabolic disease Cohort study performed in 2003–2006 in Korea. Those within the highest quartile in the homeostasis model assessment of insulin resistance (HOMA‐IR) with a normal body mass index (BMI) between 18·5 and 23 kg/m2 were classified as MONW.Measurements  Data on anthropometry, lipid profiles and HOMA‐IR values were analysed.Results  The prevalence of MONW was 14·2% for men and 12·9% for women amongst normal‐weight subjects. Multiple logistic regression analysis showed that total cholesterol (TC) levels over 5·17 mm (odds ratio, OR = 1·481; 95% confidence intervals, CI 1·086–2·021), triglyceride (TG) levels over 1·69 mm (OR = 1·507; 95% CI 1·093–2·077) and high‐density lipoprotein‐cholesterol levels lower than 1·03 mm (OR = 1·580; 95% CI 1·053–2·371) independently had higher odds of diagnosing MONW amongst men. For women, a BMI over 21·5 kg/m2 (OR = 1·405; 95% CI 1·034–1·909), TC levels over 5·17 mm (OR = 1·524; 95% CI 1·112–2·090) and TG levels over 1·69 mm (OR = 1·799; 95% CI 1·302–2·487) were independently associated with a diagnosis of MONW.Conclusions  More than 10% of normal‐weight subjects were classed as MONW in this cohort. Identification of these subjects based on lipid profiles could aid in the early detection of a high risk group of developing cardiometabolic diseases.
A systematic review of the use of volunteers to improve mealtime care of adult patients or residents in institutional settings
Authors: Green Sue M , Martin Helen J , Roberts Helen C , Sayer Avan Aihie 
Published: April 2011

Aims and objectives.  The objective of this review was to locate and assess the evidence obtained from articles reporting empirical research that volunteers improve mealtime care of adults in institutional settings.Background.  Malnutrition in adult patients or residents in institutional care settings is common. Poor standards of mealtime care have been suggested to contribute to the development of malnutrition.Design.  A systematic review of the literature was undertaken.Method.  Key words were identified and used separately and in combination to search the electronic databases MEDLINE®, CINHAL®, BNI and EMBASE and the internet for relevant articles. Searches were undertaken in August 2008, April 2009 and July 1010.Results.  Ten studies fulfilled the criteria for inclusion. The methodologies of five of the 10 studies were unclear due to the brevity of the reports. The validity of the design of the other five studies varied. Generally the results suggested the use of volunteers in mealtime care increased satisfaction of patients, relatives, volunteers and staff concerning meal‐time assistance (assessed using methods such as questionnaires and focus groups) and three studies found increased nutritional intake in groups assisted by volunteers. However, few well designed and reported studies were identified.Conclusions.  There is some evidence that volunteers can improve mealtime care of adult patients or residents in institutional settings, however few well designed studies are reported.Relevance to clinical practice.  This review demonstrates that there is limited evidence that the use of volunteers improves mealtime care of adult patients or relatives in institutional settings.
Placement Development Teams and interprofessional education with healthcare students
Authors: Williamson Graham R , Callaghan Lynne , Whittlesea Emma , Mutton Lauren , Heath Val 
Published: April 2011

Aims and objectives.  The aim was to investigate the impact of a new structure for supporting students and mentors in practice placements (Placement Development Teams) in fostering interprofessional education from the perspective of non‐medical health care students and staff.Background.  Interprofessional education is an important international issue which received significant impetus in the UK as a result of many high‐profile cases where uni‐professional boundaries and cultures have contributed to adverse patient and client outcomes.Design.  This study was part of a longitudinal qualitative evaluation of Placement Development Teams. The design for this stage was cross‐sectional.Methods.  Data were collected using telephone interviews with key educational stakeholders in trusts and Strategic Health Authorities and focus groups with third‐year non‐medical health care students working in the south‐west peninsula of England.Results.  Students’ focus group data indicated that interprofessional support and learning was key. Students had mixed views on how much they valued support gained from staff and students from other professions. Staff data indicated that they facilitated communication. Staff discussed their practical activities which made a difference and helped change the organisational culture in favour of interprofessional education.Conclusion.  If interprofessional education in clinical practice is to be effective, it needs local facilitation and structures that support it. Placement Development Teams can provide this. The ‘best’ means of ‘doing interprofessional education’ in clinical practice and its impact on patient outcomes requires further large‐scale research work with rigorous methodologies at a national level.Relevance to clinical practice.  To embed interprofessional education in practice‐based professions’ curricula and clinical placements requires active, supportive structures and local facilitation. Structures such as Placement Development Teams can help to achieve this where organisational cultures are influenced by committed staff. Students require persuasion concerning the benefits of interprofessional education.
A qualitative meta‐synthesis of adult children of parents with a mental illness
Authors: Murphy Gillian , Peters Kath , Jackson Debra , Wilkes Lesley 
Published: April 2011

Aims and objectives.  This article presents a qualitative meta‐synthesis that explores the experiences of adult children of parents with a mental illness.Background.  There has been growing interest in the experiences of children whose parents have mental illness. However, little literature explores the experiences of adult children.Design.  Qualitative meta‐synthesis.Method.  A review of English language literature search engines was undertaken and identified 905 relevant articles. Articles were excluded if they used quantitative methodology, had other methodological issues or had a focus on parental drug/alcohol issues. Twelve articles were identified as using qualitative or mixed methods studies, which were reviewed using the Critical Appraisal Skills Programme (Public Health Resource Unit 2006). Following this, seven studies were included in the meta‐synthesis. The main findings and themes identified by the original study authors were extracted from the results and discussions sections and further categorised into four main themes using content analysis methods.Results.  There were 26 themes identified by the meta‐synthesis, which were collated into four wider categories and concepts. Issues related to family relationships, external familial relationship changes, the adult child’s emotional reflections and illness‐related concepts were identified.Conclusions.  There is a paucity of qualitative research that considers adult children’s experiences of parental mental illness. In the available studies, issues related to family relationships, external familial wider relationship changes, the adult child’s emotional reflections and illness‐related concepts were identified as being of concern to adults who experienced parental mental illness during childhood.Relevance to clinical practice.  There is a need for all health and social care services to be aware of the experiences/needs of adult children who have experienced parental mental illness. Adult children of parents with mental illnesses should be provided with opportunities to discuss their stories to validate their experiences.
Reliability and validity of Turkish version of attitudes toward old people scale
Authors: Küçükgüçlü Özlem , Mert Hatice , Akpınar Burcu 
Published: April 2011

Aims and objectives.  To assess the reliability and validity of a Turkish version of Kogan’s Attitudes Toward Older People Scale.Background.  To explore nursing students’ attitudes towards older people, standardised, well‐tested instruments are needed. Kogan’s Attitudes Toward Older People is a comprehensive instrument for assessment of attitudes toward older adults and has been validated in several languages. However, a validated Turkish version has not been available until now.Design.  The study used psychometric testing to establish reliability and validity of the Turkish version of Kogan’s Attitudes Toward Older People Scale.Methods.  A convenience sample of 237 nursing students in Turkey was used to collect data regarding attitudes towards older people. Content validity, construct validity, internal consistency and stability reliability of the Kogan’s Attitudes Toward Older People were assessed.Results.  Kogan’s Attitudes Toward Older People scores were between 74–224. All of the 34 items were found to have significant item‐to‐total correlations (p < 0·05). Results of the confirmatory factor analysis established that the scale had a two‐factor construct and was appropriate use in this student population. The Cronbach’s alpha was 0·89 for the total scale (0·82 for negative, 0·85 for positive). In addition, test–retest correlation was 0·83 (negative subscale 0·77, positive subscale 0·73) (p < 0.001).Conclusions.  The Turkish version of the Kogan’s Attitudes Toward Older People was found to be a reliable and valid tool for assessing Turkish nursing students’ attitudes toward older adults.Relevance to clinical practice.  This study provided evidence that the Kogan’s Attitudes Toward Older People is a reliable and valid instrument for assessing Turkish nursing student’s positive and negative attitudes toward older adults. It is easy and practical to use for both informants and investigators and acceptable for Turkish Culture.
An alternative way to think about glaucoma screening, using a questionnaire as a tool, Chinese version
Authors: Kuo Li‐Lin , Tsai Ching‐Yao , Hsiao Ya‐Chuan , Chou Pesus 
Published: April 2011

AbstractRationale, aims and objectives  To develop a short screening test for the detection of preclinical glaucoma.Method  This case–control study involved 690 participants aged 40 years or older: 338 patients with glaucoma or suspected glaucoma and 352 patients without glaucoma, who served as a control group. All participants were interviewed by a single trained research assistant. Patients' basic demographic and clinical information, past ophthalmic history and responses on the National Eye Institute 25‐item Visual Function Questionnaire were collected. Two glaucoma‐trained ophthalmologists examined all the participants using standard procedures to make a diagnosis. The biostatistical differences between the two groups were determined.Results  Five items were selected for glaucoma screening: ‘Sense of worse vision compared with those of the same age’, ‘Ocular pain or discomfort during the past 6 months’, ‘History of cataract’, ‘Family history of glaucoma’ and ‘Hyperopia’. A score of 2 or more was used to define a group of positive cases with the most appropriate values for sensitivity (79.0%), specificity (76.7%) and predictive power (a positive predictive value of 76.5% and a negative predictive value of 79.2%).Conclusion  A five‐item instrument was developed to detect preclinical glaucoma. Anyone with a score of 2 or more may need further ophthalmic examination and treatment.
Increasing heart‐health lifestyles in deprived communities: economic evaluation of lay health trainers
Authors: Barton Garry R. , Goodall Mark , Bower Peter , Woolf Sue , Capewell Simon , Gabbay Mark B. 
Published: April 2011

AbstractRationale, aims and objectives  Cardiovascular disease (CVD) often arises from modifiable lifestyle factors. Health care professionals may lack the skills and resources to sustain behaviour change, lay ‘health trainers’ (LHT) offer a potential alternative. We sought to assess the cost‐effectiveness of using a LHT to improve heart‐health lifestyles in deprived communities.Methods  Participants in this randomized trial were aged ≥18 years with at least one risk factor for CVD (hypertension, raised cholesterol, diabetes, BMI>30 or current smoker). Both groups received health promotion literature. LHT were also able to provide intervention participants with information, advice and support aimed at changing beliefs and behaviour. Costs and quality‐adjusted life year (QALY) changes were estimated over 6 months. The cost‐utility [incremental cost‐effectiveness ratio (ICER)] of LHT was calculated and assessed in relation to the cost‐effectiveness threshold of £20 000–30 000 per QALY. The probability of LHT being cost‐effective was also calculated.Results  Seventy‐two participants were randomized to a LHT, with 38 controls. The mean cost of the LHT intervention was £151. On average, other health and social service costs fell by £21 for controls and £75 for intervention participants giving a LHT mean overall incremental cost of £98. The mean QALY gains were 0.022 and 0.028, respectively. The ICER for LHT was £14 480, yet there was a 61% chance of making the wrong decision at a £20 000/QALY threshold.Conclusion  LHT provision was estimated to be cost‐effective for people at risk of CVD. However, a large level of uncertainty was associated with that decision.
First identification of a sweet potato begomovirus (sweepovirus) in Uganda: characterization, detection and distribution
Authors: Wasswa P. , Otto B. , Maruthi M. N. , Mukasa S. B. , Monger W. , Gibson R. W. 
Published: April 2011

Sweet potato begomoviruses diverge basally from all other begomoviruses and have been named sweepoviruses. In 2009, a sweepovirus was detected for the first time in sweet potato crops in Uganda by using the indicator plant Ipomoea setosa and generic primers in a polymerase chain reaction (PCR). An isolate was cloned and sequenced, the first fully sequenced genome of a sweepovirus from mainland Africa. At the nucleotide level, this isolate differed from other sweepoviruses by at least 13%, discriminating the Ugandan isolate as a new species which has been tentatively named Sweet potato leaf curl Uganda virus (SPLCUV). In infected sweet potato plants, SPLCUV showed an uneven distribution; it was detected more often in samples from the midrib and lamina of middle and lower leaves, and reversion to healthy tissue occurred, especially in shoots of cv. New Kawogo. This appears to be the first report of resistance to a sweepovirus in sweet potato. While it was only detected at relatively low efficiency by PCR, use of I. setosa plants as an indicator of sweepovirus infection in sweet potato plants was as efficient as using real‐time quantitative PCR (qPCR). Storage of dry leaves for 84 days and dried DNA extracts for 21 days did not affect the ability of PCR and qPCR to detect it. Sweepovirus(es) was detected frequently using generic primers in cultivars Ejumula, New Kawogo and 318L in eastern and central Uganda.
The fracture permeability of Hard Rock Aquifers is due neither to tectonics, nor to unloading, but to weathering processes
Authors: Lachassagne Patrick , Wyns Robert , Dewandel Benoît 
Published: April 2011

Terra Nova, 23, 145–161, 2011AbstractThe hydrogeology of superficial (∼0–100 m b.g.l.) Hard Rock Aquifers (HRA; i.e. plutonic and metamorphic rocks) has so far been dominated by a few concepts considered to be relevant by a large majority of the HRA community. One of the most fundamental of these concepts is that their (secondary, fissure/fracture) permeability is either of tectonic origin or related to unloading processes. We will show that these genetic concepts are erroneous. We will demonstrate how the hydraulic conductivity of HRAs is a consequence of the (palaeo) weathering processes, with a stratiform fissured layer located immediately below the unconsolidated saprolite and, to a lesser extent, a verticalized fissured layer at the periphery of (or within) pre‐existing discontinuities (veins, joints, ancient faults, lithological contacts, etc.). This result opens up large perspectives in terms of applied hydrogeology and applied geology. A specifically dedicated methodological toolkit well adapted to the operational survey, management and protection of HRAs is briefly presented.