bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nocturnal haemoglobin oxygen saturation variability is associated with vitamin C deficiency in Tanzanian children with sickle cell anaemia
Authors: Cox SE , L’Esperance V , Makani J , Soka D , Hill CM , Kirkham FJ 
Published: November 2010

AbstractAim:  To compare pulse oximetry in children with sickle cell anaemia (SCA) and controls and test the hypothesis that vitamin C deficiency (VCD; <11.4 μmol/L) is associated with nocturnal haemoglobin oxygen desaturation in SCA.Methods:  We undertook nocturnal and daytime pulse oximetry in 23 children with SCA (median age 8 years) with known steady‐state plasma vitamin C concentrations and 18 siblings (median 7 years).Results:  Median nocturnal delta 12 s index (delta12 s), a measure of haemoglobin oxygen saturation (SpO2) variability, was 0.38 (interquartile range 0.28–0.51) in SCA and 0.35 (0.23–0.48) in controls, with 9/23 and 6/18, respectively, having a delta12 s >0.4, compatible with obstructive sleep apnoea (OSA). Eleven of twenty‐three with SCA had VCD; logged vitamin C concentrations showed a 66% decrease per 0.1 unit increase in delta12 s ([95% CI −86%, −15%]; p = 0.023) and delta12 s >0.4 was associated with VCD (odds ratio 8.75 [1.24–61.7], p = 0.029). Daytime and mean nocturnal SpO2 were lower in SCA but there was no association with vitamin C.Conclusion:  Obstructive sleep apnoea (OSA), detected from nocturnal haemoglobin oxygen saturation variability, is common in Tanzanian children and associated with vitamin C Deficiency in SCA. The direction of causality could be determined by comparing OSA treatment with vitamin C supplementation.
Breastfeeding after assisted conception: a prospective cohort study
Authors: Hammarberg K , Fisher JRW , Wynter KH , Rowe HJ 
Published: November 2010

AbstractAim:  The aims were to investigate the prevalence of breastfeeding after conception with assisted reproductive technology (ART) and identify risk factors for breastfeeding duration <6 weeks and cessation of breastfeeding before the baby is 8 months old.Methods:  A consecutive cohort of women who had conceived at one of two ART centres in Melbourne, Australia, was recruited in early pregnancy. The women completed telephone interviews and postal questionnaires in pregnancy and 3, 8 and 18 months after the birth.Results:  Of 239 eligible women, 183 (77%) agreed to take part. Participants were more likely than the general population of childbearing Australian women to initiate breastfeeding (89% vs 83.3%, p = 0.05) but by 3 months, a smaller proportion was breastfeeding exclusively (46% vs 57.3%, p = 0.004). The proportions not providing any breast milk at 6 weeks and 8 months were 23% and 57%, respectively. More anxiety in late pregnancy and sub‐optimal breastfeeding advice predicted breastfeeding duration <6 weeks and breastfeeding cessation before 8 months.Conclusion:  The predictors of less favourable breastfeeding outcomes after ART identified may be modifiable. Antenatal strategies to reduce anxiety in pregnancy and postnatal strategies to ensure consistent breastfeeding advice may improve breastfeeding outcomes among women who give birth after ART.
Interventions for Preventing and Managing Aggressive Patients Admitted to an Acute Hospital Setting: A Systematic Review
Authors: Kynoch Kate , Wu Chiung‐Jung , Chang Anne M. 
Published: November 2010

ABSTRACT Background: Violence in health care has been widely reported and health care workers, particularly nurses in acute care settings, are ill‐equipped to manage patients who exhibit aggressive traits. Aim: The aim of this systematic review was to establish best practice in the prevention and management of aggressive behaviours in patients admitted to acute hospital settings. Data Sources: An extensive search of the major databases was conducted from 1990 to 2007. The search included published and unpublished studies and papers in English. Review Methods: This review considered any quantitative research study design that evaluated the effectiveness of interventions in the prevention and management of patients who exhibit aggressive behaviours in an acute hospital setting. Each included study was quality assessed by two independent reviewers and data were extracted using the relevant tools developed by the Joanna Briggs Institute. Results: Ten studies met the inclusion criteria and were included in the review. The evidence identified from the studies includes: the benefit of education and training of acute care nurses in aggression management techniques; use of “as required” medications is effective in minimising harm to patients and staff; and that specific interventions such as physical restraint may play a role in managing aggressive behaviours from patients in the acute care setting. Conclusions: This review makes several recommendations for the prevention and management of aggressive behaviours in acute hospital patients. However, due to the lack of high‐quality studies conducted in the acute care setting there is huge scope for future research in this area.
Root canal therapy for the prevention of osteonecrosis of the jaws: An evidence‐based clinical update
Authors: Kyrgidis Athanassios , Arora Amit , Lyroudia Kleoniki , Antoniades Konstantinos 
Published: November 2010

AbstractOsteonecrosis of the jaws is an adverse effect of bone preservation treatment. There is a sufficient body of evidence to associate osteonecrosis of the jaws development with dental extractions and trauma caused from ill‐fitting dentures. In this review, we critically appraise available evidence about the clinical efficacy of root canal therapy in patients receiving bisphosphonates. We review a series of theories to explain why endodontic treatment is a safe clinical intervention to prevent osteonecrosis of the jaws in patients receiving bisphosphonates. Root canal therapy could postpone or even eradicate the need for dental extractions of carious teeth in patients on bisphosphonates who may develop osteonecrosis of the jaws. Patients receiving bisphosphonates should be offered the full range of preventive care to reduce their risk to both dental caries and periodontal disease, so that the need for both endodontic therapy and dental extractions will be reduced. Implementing such a strategy would require both practitioner and patient education through the combined efforts of medical and dental societies. Such an approach is justified, as the risk of compromising the oral health of patients on bisphosphonates undertaking endodontic treatment is negligible compared with the benefit from avoiding dental extractions.
Adapt, discover and engage: a qualitative interview study with patients living with chronic pain
Authors: Skjutar Åsa , Müllersdorf Maria 
Published: November 2010

skjutar å & müllersdorf m (2010)
Journal of Nursing and Healthcare of Chronic Illness2, 254–261 Adapt, discover and engage: a qualitative interview study with patients living with chronic painAim.  This paper reports a study that aimed to advance the understanding of needs related to chronic pain management by describing these needs as they are experienced by people living with chronic pain.Methods.  Data during 2008 were collected by interviews with ten Swedish adults living with musculoskeletal chronic pain and analysed using thematic content analysis.Findings.  Three themes were found: Need to handle the painful body and the eager mind, need for transformation of self‐image, and need for affirmation through communion and enjoyment. The first theme describes how the body and mind are in conflict with each other and how participants constantly have to weigh the consequences of their actions. The second highlights the need to let go of a former self and to discover a new self. The third illustrates the participants’ needs for social engagement and for performance of valued occupations that provide hope and support.Conclusions.  Findings show that participants experience internal needs, and they also have needs that can only be met through interaction with the surrounding context. Furthermore, findings show that some of the experienced needs can create inner conflict because they can be contradictory.Relevance to clinical practice.  Findings from this study provide health care professionals with information about how patients with chronic pain experience needs. In turn, this can constitute a base that to enable evaluation of how closely the patients’ experiences of need correspond to the interventions that health care in general provides this group of patients. Patients should be supported to manage their possibly incompatible needs and to prioritise occupations that generate energy and satisfaction.
‘Listening to my body’ to ‘Look after my body’: a theory of information use for self‐management of chronic obstructive pulmonary disease
Authors: Ehrlich Carolyn , St John Winsome , Kendall Elizabeth 
Published: November 2010

ehrlich c, st john w & kendall e (2010)
Journal of Nursing and Healthcare of Chronic Illness2, 262–270 ‘Listening to my body’ to ‘Look after my body’: a theory of information use for self‐management of chronic obstructive pulmonary diseaseAim.  To report how people with chronic obstructive pulmonary disease (COPD) gather, interpret and apply health affecting information.Background.  Some people with COPD manage more effectively than others, presumably because they have better coping skills, life skills and self‐management strategies. A considerable amount of healthcare time and money is invested in delivering information and self‐management training to people with COPD, based on an assumption that education effectively and efficiently promotes positive self‐management behaviour. This assumption is not based on sound knowledge about how individuals acquire and use information to guide their self‐management behaviours.Method.  A grounded theory design was used to gather and analyse interview data collected from people with COPD in 2007. An iterative theory‐building approach was used to develop a model that represents how participants used information in their daily self‐management.Conclusions.  Everyday self‐management decisions for people with COPD are more than simple treatment choices or compliance with medical regimens. Rather they result from intricate and purposeful interactions between cycles of ‘Listening to my body’ and ‘Looking after my body’ within the context of their daily lives.Relevance to clinical practice.  Understanding individual information use patterns will assist health professionals to tailor effective and supportive healthcare information. Health professionals need to consider not only the healthcare needs of an individual, but also the social context within which that person acquires and uses information.
An examination of the postdischarge recovery experience of patients who have had heart surgery
Authors: Fredericks Suzanne , DaSilva Monica 
Published: November 2010

fredericks s & dasilva m (2010)
Journal of Nursing and Healthcare of Chronic Illness2, 281–291 An examination of the postdischarge recovery experience of patients who have had heart surgeryAim.  This review was conducted to address the clinically relevant question: What is the postoperative recovery experience of the individual who has had Coronary Artery Bypass Graft and Valve Replacement surgery?Background.  Although resources to promote recovery following Coronary Artery Bypass Graft and Valve Replacement surgery are provided, over a quarter of all patients are being readmitted to hospitals with postoperative complications experienced during the first 3 months of recovery. A possible reason for the high rate of readmission following heart surgery is the quality of patient engagement in the performance of self‐care behaviours. In particular, patients who have had CABG and/or VR may not be fully engaged in the required self‐care behaviours during their first 3 months of recovery.Methods.  A review of studies that examined the postoperative recovery experience of patients who had CABG and/or VR was conducted.Results.  Findings suggest the type of post‐operative complication identified during the first 3 months of recovery following Coronary Artery Bypass Graft and Valve Replacement was either cognitive or cardiac in nature. As well, the number of self‐care behaviours patients engage in during their hospital discharge was slightly less than the number of behaviours patients performed while in hospital.Conclusion and relevance to clinical practice.  As close to half of the sample reported some form of cognitive impairment within the first 3 months following surgery, it is possible that this impairment may have influenced the type and number of self‐care behaviours performed. Therefore, further research is needed to determine the best time to educate patients during their recovery following hospital discharge.
The lived experience of sleep disturbance in people with Parkinson’s disease
Authors: Suddick Kitty M , Chambers Simon 
Published: November 2010

suddick km & chambers s (2010)
Journal of Nursing and Healthcare of Chronic Illness2, 292–301 The lived experience of sleep disturbance in people with Parkinson’s diseaseAims and objectives.  This paper reports on an exploratory study of the lived experience of sleep disturbance in a group of men with Parkinson’s disease (PD).Background.  Research into sleep disturbance in PD has focused on determining prevalence, causative factors, and relationships between the signs and symptoms. Sleep disturbance has not been previously explored from the perspective of the person experiencing it.Design.  An interpretive phenomenological approach, aligned with Heideggerian hermeneutics was used.Method.  A convenience sample of five people from the UK with PD participated in interviews in 2007–2008. Interviews were transcribed and data thematically analysed.Results.  The themes that emerged regarding sleep disturbance in PD were: ‘good and bad’ sleep, a worsening journey, the experience of uncertainty, and the experience of loss.Conclusions.  Sleep disturbance and ‘good and bad’ sleep, had significant implications for the person with PD and their carer. People with PD may accept or fight their sleep disruption, use, restrict, or avoid activity, and give up hobbies and sharing the marital bed. Sleep disturbance meant being part of a worsening journey, and experiencing loss and uncertainty. These may be inseparable essences of living with a progressive neurological condition.Relevance to clinical practice.  Sleep disturbance needs more recognition and improved management. Health professionals may need to better consider issues around uncertainty and loss, and coping with the worsening journey. Services that develop coping styles, self efficacy, and self management, and introduce structured ways of providing education, advice, and ongoing support are needed. This supports the nurse specialist role in PD.
β‐cell mass in people with type 2 diabetes
Authors: Cho Jae‐Hyoung , Kim Ji‐Won , Shin Jeong‐Ah , Shin Juyoung , Yoon Kun‐Ho 
Published: November 2010

AbstractThe early occurrence of β‐cell dysfunction has been broadly recognized as a critical determinant of the development and progression of type 2 diabetes. β‐cell dysfunction might be induced by insufficient β‐cell mass, by a dysfunction of the β‐cells, or both. Whether or not β‐cell dysfunction constitutes a cause of reduced β‐cells or vice‐versa currently remains unclear. The results of some studies have measured the loss of β‐cells in type 2 diabetic patients at between 22 and 63% by planimetric measurements. Because β‐cell hypertrophy has been noted in type 2 diabetic patients, the loss of β‐cell number should prove more profound than what has thus far been reported. Furthermore, β‐cell volumes are reduced even in patients with impaired fasting glucose. Such defects in β‐cell mass are associated with increased apoptosis rather than insufficient replication or neogenesis of β‐cells. With these results, although they still require clarification, the peak β‐cell mass might be determined at quite an early stage of life, and then might decline progressively over time as the result of exposure to harmful environmental influences over one’s lifetime. In this review, we have summarized the relevant studies regarding β‐cell mass in patients with type 2 diabetes, and then presented a review of the various causes of β‐cell loss in adults. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00072.x, 2010)
Plasma pH does not influence the cerebral metabolic ratio during maximal whole body exercise
Authors: Volianitis S. , Rasmussen P. , Seifert T. , Nielsen H. B. , Secher N. H. 
Published: November 2010

Non‐technical summaryExercise is known to promote the use of lactate as metabolic fuel for the brain. As a result the cerebral metabolic ratio, an index of the brain's metabolism, is reduced compared to rest. It is not known whether the exercise‐induced metabolic acidosis affects cerebral metabolism and the reduction of the cerebral metabolic ratio. We manipulated the metabolic acidosis by infusing bicarbonate in well trained rowers during a maximal rowing ergometer effort. We show that elimination of acidosis does not affect the reduction of the cerebral metabolic ratio. Furthermore, the data indicate that the capacity of the brain to take up lactate may have a limit. This indication requires further evaluation.
Morphological and functional changes in guinea‐pig neurons projecting to the ileal mucosa at early stages after inflammatory damage
Authors: Nurgali Kulmira , Qu Zhengdong , Hunne Billie , Thacker Michelle , Pontell Louise , Furness John B. 
Published: November 2010

Non‐technical summaryInflammation in the gut causes changes in neurons that control its movement and secretion. This leads to symptoms of pain and functional disorders that may persist long after the resolution of inflammation, which in humans manifests as the irritable bowel syndrome. In this study we demonstrate an association between hyperexcitability of neurons in the gut wall, damage to the nerve terminals in the mucosa and inflammation close to neurons and their terminals. These results increase our understanding of the triggering mechanisms that contribute to post‐inflammatory gut dysfunctions.
Overestimation of force during matching of externally generated forces
Authors: Walsh Lee D. , Taylor Janet L. , Gandevia Simon C. 
Published: November 2010

Non‐technical summaryIf a weight is applied to a finger and the subject asked to produce the same force, the subject generates a force larger than the weight. That is, subjects overestimate the force applied by an external target when matching it. Details of this force overestimation are not well understood. We show that subjects overestimate small target weights, but not larger ones. Furthermore we show for the first time that the force overestimation consists of two components. The first component is a constant. The second component depends on the precise magnitude of the weight and is only present when subjects hold the target weight against gravity. We suggest that the two components are generated in different phases of the force‐matching task, are due to different processes, and must have an influence on all proprioceptive judgements of force.
Plasticity in human motor cortex is in part genetically determined
Authors: Missitzi Julia , Gentner Reinhard , Geladas Nickos , Politis Panagiotis , Karandreas Nikos , Classen Joseph , Klissouras Vassilis 
Published: November 2010

Non‐technical summaryNeuronal plasticity refers to the ability of the brain to change in response to different experiences. Plasticity varies between people, but it is not known how much of this variability is due to differences in their genes. In humans, plasticity can be probed by a protocol termed paired associative stimulation and the changes in the motor system that are brought about by such stimulation are thought to be due to strengthening synapses which connect different neurons. We examined pairs of sisters which were either genetically identical (monozygotic) or different (dizygotic). We found that the variability within the monozygotic sister pairs was less than the variability within the dizygotic sister pairs. That plasticity in human motor cortex is in a substantial part genetically determined may be relevant for motor learning and neurorehabilitation, such as after stroke.
Morphological and electrical properties of oligodendrocytes in the white matter of the corpus callosum and cerebellum
Authors: Bakiri Yamina , Káradóttir Ragnhildur , Cossell Lee , Attwell David 
Published: November 2010

Non‐technical summaryIn the central nervous system, electrical signals passing along nerve cells are speeded by cells called oligodendrocytes, which wrap the nerve cells with a fatty layer called myelin. This layer is important for rapid information processing, and is often lost in disease, causing mental or physical impairment in multiple sclerosis, stroke, cerebral palsy and spinal cord injury. The myelin speeds the information flow in two ways, by decreasing the capacitance of the nerve cell and by increasing its membrane resistance, but little is known about the latter aspect of myelin function. By recording electrically from oligodendrocytes and imaging their morphology we characterised the geometry and, for the first time, the resistance of myelin in the brain. This revealed differences between the properties of oligodendrocytes in two brain areas and established that the resistance of myelin is sufficiently high to prevent significant slowing of the nerve electrical signal by current leakage through the myelin.
In Silico
Children and the Glass Mouse Model: Clinical Trial Simulations To Identify and Individualize Optimal Isoniazid Doses in Children with Tuberculosis
Authors: Jeena Prakash M. , Bishai William R. , Pasipanodya Jotam G. , Gumbo Tawanda 
Published: November 2010

ABSTRACT

Children with tuberculosis present with high rates of disseminated disease and tuberculous (TB) meningitis due to poor cell-mediated immunity. Recommended isoniazid doses vary from 5 mg/kg/day to 15 mg/kg/day. Antimicrobial pharmacokinetic/pharmacodynamic studies have demonstrated that the ratio of the 0- to 24-h area under the concentration-time curve (AUC
0-24
) to the MIC best explains isoniazid microbial kill. The AUC
0-24
/MIC ratio associated with 80% of maximal kill (80% effective concentration [EC
80
]), considered the optimal effect, is 287.2. Given the pharmacokinetics of isoniazid encountered in children 10 years old or younger, with infants as a special group, and given the differences in penetration of isoniazid into phagocytic cells, epithelial lining fluid, and subarachnoid space during TB meningitis, we performed 10,000 patient Monte Carlo simulations to determine how well isoniazid doses of between 2.5 and 40 mg/kg/day would achieve or exceed the EC
80
. None of the doses examined achieved the EC
80
in ≥90% of children. Doses of 5 mg/kg were universally inferior; doses of 10 to 15 mg/kg/day were adequate only under the very limited circumstances of children who were slow acetylators and had disease limited to pneumonia. Each of the three disease syndromes, acetylation phenotype, and being an infant required different doses to achieve adequate AUC
0-24
/MIC exposures in an acceptable proportion of children. We conclude that current recommended doses for children are likely suboptimal and that isoniazid doses in children are best individualized based on disease process, age, and acetylation status.