bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting the life‐time benefit of school‐based smoking prevention programmes
Authors: Jit Mark , Aveyard Paul , Barton Pelham , Meads Catherine A. 
Published: March 2010

ABSTRACTAim School‐based smoking prevention programmes may delay the age of smoking initiation, but do not appear to achieve lasting reductions in smoking prevalence beyond school‐leaving age. We explored whether delaying the age at which someone initiates smoking may have life‐time benefits by increasing the likelihood of quitting in later life.Design and setting Data from the General Household Survey of Great Britain were used in a logistic regression model to examine the association between age at which someone initiates regular smoking and the probability that the person will quit smoking later in life. The effect of confounding variables (sex, ethnicity, socio‐economic class, education and geographical location) was taken into account. The predicted relationship was used in a cohort model to estimate the life‐time reduction in smoking prevalence and all‐cause mortality of a school‐based smoking prevention programme.Results Age of regular smoking initiation was associated strongly with the probability of quitting later in life (coefficient −0.103, P < 0.001). The strength of the association was slightly reduced but still significant when confounding variables were included (coefficient −0.075, P < 0.001). An intervention that delays smoking initiation without decreasing smoking prevalence at age 18 may reduce adult smoking prevalence by 0.13–0.32% (depending on age) and all‐cause mortality by 0.09% over the life‐time of the sample.Conclusion School‐based smoking prevention programmes have potential for a beneficial effect over the life‐time of the participants even if they have no apparent effect at school‐leaving age.
Monitoring heparin anticoagulation in the acute phase response
Authors: Uprichard James , Manning Richard A. , Laffan Michael A. 
Published: March 2010

SummaryThe anticoagulant effect of unfractionated heparin (UFH) is monitored using the activated partial thromboplastin time (APTT). An APTT of 1·5–2·5 times the control is usually taken as the therapeutic range and assumed to reflect an anti‐activated factor X (anti‐Xa) level of 0·35–0·7 u/ml. However, in some cases, despite administration of sufficient heparin to achieve a therapeutic anti‐Xa assay level, the APTT remains sub‐therapeutic. This ‘apparent heparin resistance’ is commonly due to high levels of factor VIII (FVIII). In these situations, the anti‐Xa is usually preferred for monitoring in order to avoid, what might be, dangerously high levels of heparin. We hypothesized that at high FVIII levels, the heparin resistance encountered may be genuine rather than apparent and that higher doses of heparin may indeed be needed for an equivalent anticoagulant effect. The relationship between heparin level, APTT and anticoagulant effect at different FVIII concentrations was determined using thrombelastography and the thrombin generation assay. Thromboelastographic and thrombin generation parameters concurred with APTT, demonstrating a genuine heparin resistance in the presence of high FVIII levels. This suggests that APTT may be a more accurate measure of anticoagulant effect in vivo than anti‐Xa.
A United Kingdom Haemophilia Centre Doctors’ Organization guideline approved by the British Committee for Standards in Haematology: guideline on the use of prophylactic factor VIII concentrate in children and adults with severe haemophilia A
Authors: Richards Michael , Williams Michael , Chalmers Elizabeth , Liesner Ri , Collins Peter , Vidler Vicky , Hanley John 
Published: March 2010

SummaryConsensus‐based guidelines supported by the literature are presented on the role of prophylactic administration of factor VIII concentrate in children and adults with severe haemophilia A. The timing of initiation of prophylaxis, the choice of prophylactic regimen, monitoring, management of breakthrough bleeding and education of the patient and family are discussed.
Advances in the understanding of myeloma bone disease and tumour growth
Authors: Yaccoby Shmuel 
Published: March 2010

SummaryAdvances in multiple myeloma support the notion that the associated bone disease, characterized by increased osteoclastogenesis and suppressed osteoblastogenesis, is both a consequence and necessity of tumour progression. Osteoblastogenesis is suppressed by secreted inhibitors and dysregulation of cell‐surface ‘coupling’ factors on osteogenic cells. Osteoclastogenesis is increased as a consequence of osteoblast deactivation and of production of osteoclast‐activating factors. Osteoclasts express soluble and cell‐surface factors that stimulate myeloma growth, while osteoblasts produce bone‐building factors that restrain growth of myeloma cells that are dependent on the microenvironment; detailed molecular mechanisms are discussed. Experimental and clinical findings indicate that pharmacological and experimental osteoblast‐activating agents that effectively promote bone formation also reduce growth of myeloma cells within bone, seemingly by simultaneously stimulating osteoblastogenesis and restraining osteoclastogenesis. Unravelling mechanisms of myeloma bone disease expands horizons for developing novel interventions and also facilitates better understanding of the association between induction of osteolysis and disease progression.
Therapeutic effects of an indoor gardening programme for older people living in nursing homes
Authors: Tse Mimi Mun Yee 
Published: March 2010

Aims.  To explore the activities of daily living and psychological well‐being of older people living in nursing homes and also to examine the effectiveness of a gardening programme in enhancing socilaisation and life satisfaction, reducing loneliness and promoting activities of daily living for older people living in nursing homes.Background.  Life in nursing homes can mean very limited physical and social activity, leading to further decline in function for many older people.Design.  This was a quasi‐experimental pre and posttest control group design.Methods.  Older people from nursing homes were invited to join the eight week indoor gardening programme (experimental group), while older people in other nursing homes were treated as the control group; they received regular care without the eight week indoor gardening programme. There were 26 older people (25 female and one male; mean age 85 years) in the experimental group and 27 (20 female and seven male; mean age 82 years) in the control group. Demographic data including age, gender, educational level and financial situation were collected, in addition to information regarding life satisfaction, loneliness, physical activity and social network situation, before and after the eight week indoor gardening programme for both the experimental and control groups. Also, details of experimental group subjects’ experience of the indoor gardening programme were elicited using open‐ended questions.Results.  There were significant improvements in life satisfaction and social network and a significant decrease in perception of loneliness for older people in the experimental group after the eight week indoor gardening programme, while the activities of daily living were unchanged for both groups after the programme.Relevance to clinical practice.  Given the positive effects of gardening activities, it is suggested that they be promoted more widely among nursing home residents.
Effects of music intervention on physiological stress response and anxiety level of mechanically ventilated patients in China: a randomised controlled trial
Authors: Han Lin , Li Ji P , Sit Janet W H , Chung Loretta , Jiao Zuo Y , Ma Wei G 
Published: March 2010

Aim.  To examine the effects of music intervention on the physiological stress response and the anxiety level among mechanically ventilated patients in intensive care unit.Background.  Despite the fact that previous studies have found music interventions to be effective in stress and anxiety reduction, effects of music on the Chinese population are inconclusive and warranted systematic study to evaluate its effect fully for a different Asian culture.Design.  A randomised placebo‐controlled trial.Methods.  A total of 137 patients receiving mechanical ventilation were randomly assigned to either music listening group, headphone group or control group. Outcome measures included the Chinese version of Spielberger State‐Trait Anxiety Scale and physiological parameters (heart rate, respiratory rate, saturation of oxygen and blood pressure).Results.  Comparison of mean differences (pretest score–posttest score) showed significant differences in heart rate, respiratory rate, systolic blood pressure and diastolic blood pressure as well as the Chinese version of Spielberger State‐Trait Anxiety Scale, but not in SaO2 among the three groups (ranging from p < 0·001 to p = 0·007), of which greater mean differences were found in music listening group. A significant reduction in physiological stress response (heart rate and respiratory rate) over time was found in music listening group (p < 0·001 for both variables) and a significant increase in heart rate and respiratory rate over time in control group (p < 0·001 and p = 0·032), with no significant change over time in headphone group. Within group pretest–posttest comparison of the Chinese version of Spielberger State‐Trait Anxiety Scale demonstrated a significant reduction in anxiety for the music listening group (p < 0·001) and headphone group (p < 0·001) but not the control group.Conclusions.  Our findings confirm that short‐term therapeutic effects of music listening results in substantial reduction in physiological stress responses arising from anxiety in mechanically ventilated patients.Relevance to clinical practice.  Music as a non‐pharmacological nursing intervention can be used as complementary adjunct in the care of patients with low‐energy states who tire easily, such as those requiring mechanical ventilator support.
Attitudes toward and education about complementary and alternative medicine among adult patients with depression in Taiwan
Authors: Hsu Mei‐Chi , Moyle Wendy , Creedy Debra , Venturato Lorraine , Ouyang Wen‐Chen , Sun Gwo‐Ching 
Published: March 2010

Aims.  To investigate patients’ attitudes toward complementary and alternative medicine, the education nurses provided about complementary and alternative medicine for treating depression and to test whether such education mediates the effect of complementary and alternative medicine use and attitudes toward complementary and alternative medicine.Background.  Although we know that attitudes influence behaviour, very few studies simultaneously explore the relationship between attitudes, education and complementary and alternative medicine use.Design.  Survey.Methods.  This study was conducted as part of a larger survey, using face‐to‐face survey interviews with 206 adult patients aged 50 years or over and hospitalised in conventional hospitals in Taiwan for treatment of depression. The attitudes toward complementary and alternative medicine and patient education about complementary and alternative medicine instruments were specially developed for the study.Results.  Participants expressed slightly favourable attitudes toward complementary and alternative medicine. Many participants (50%) expressed that they were willing to try any potential treatment for depression. They believed that complementary and alternative medicine helped them to feel better and to live a happier life. However, 66·5% of participants reported that they had inadequate knowledge of complementary and alternative medicine. Participants with a higher monthly income, longer depression duration and religious beliefs hold more positive attitudes toward complementary and alternative medicine. Most participants were not satisfied with the education they received about complementary and alternative medicine. Patient education about complementary and alternative medicine was found to be a mediator for the use of complementary and alternative medicine.Conclusion.  Patient education from nurses may predict patients’ attitudes toward complementary and alternative medicine. Continuing nursing education is needed to enable nurses to respond knowledgeably to concerns patients may have about complementary and alternative medicine and treatment options.Relevance to clinical practice.  This study highlights the potential role of patient education about complementary and alternative medicine as an effective way of adjusting patients’ attitudes toward complementary and alternative medicine and to link both patients’ preferences for complementary and alternative medicine and health professionals’ concerns about the proper use of complementary and alternative medicine for depression management and adverse drug interactions.
The effect of Chinese food therapy on community dwelling Chinese hypertensive patients with Yin‐deficiency
Authors: Shen CuiZhen , Pang Samantha Mei‐Che , Kwong Enid Wai‐Yung , Cheng ZhiQing 
Published: March 2010

Objectives.  The objectives of this study are to evaluate the effectiveness of Chinese food therapy in correcting the Yin‐deficiency and to examine its impact on the patients’ quality of life and hypertension control.Background.  Epidemiological studies have shown 14–50% of people with hypertension have Yin‐deficiency. Whether restoring the Yin–Yang balance by means of Chinese food therapy can help to better manage patients with hypertension has yet to be examined.Design.  Two groups randomised controlled trial.Methods.  Eighty‐five hypertensive patients recruited from two community health service centre were divided into two groups. The intervention group (n = 48) received specific dietary instructions and corresponding management of their antihypertensive medication if indicated and brief health education, whilst the control group (n = 37) received routine support involving only brief health education. Data were collected at baseline, after intervention at four, eight, 12 and 16 weeks follow‐up. Comparisons were made to examine the effects of Chinese food therapy on Yin‐deficiency symptoms, blood pressure and quality of life of hypertensive patients.Results.  The intervention group had reduction in the numbers of antihypertensive medication taken as well as improvement in most of the Yin‐deficiency symptoms after 12 weeks of Chinese food therapy and mean scores of several SF‐36 dimensions were higher than that of in the control group after 12 and 16 weeks follow‐up. Significant difference was found in systolic blood pressure in the intervention group when it was compared from baseline to after four and eight weeks respectively.Conclusion.  Chinese Food Therapy can restore body constitution with Yin–Yang imbalance and may potentially improve hypertensive patients’ quality of life. It is also beneficial in controlling blood pressure in hypertensive patients.Relevance to clinical practice.  Chinese food therapy may become a complementary therapy in health care and it should be a component of nursing education and health education.
Chinese medicine: its role and application in the institutionalised older people
Authors: Wong Eliza Lai Yi , Lam Jasmine Kwok Man , Griffiths Sian , Chung Vincent , Yeoh Eng Kiong 
Published: March 2010

Aims.  The aim of the study was to explore the need for and application of Chinese medicine services and factors which impact on the accessibility of Chinese medicine among the institutionalised older people.Background.  Although complementary and alternative medicine is widely used by older Chinese both in Hong Kong and elsewhere, little is known about its use by the institutionalised older people. This study breaks new ground by exploring how Chinese medicine, the most popular form of complementary and alternative medicine used by older people, is used and accessed by the institutionalised older people in Hong Kong.Design.  Qualitative method.Methods.  Semi‐structured interviews were conducted in 2007 with 18 older individuals aged between 63–93 and living in three long‐term care facilities in Hong Kong.Results.  Three main categories emerged from the data: (1) the role of Chinese medicine in the care of the aged; (2) barriers to the use of Chinese medicine in residences; and (3) factors facilitating the accessibility of Chinese medicine services in residences. Most of the older individuals interviewed claimed that Chinese medicine played a crucial role in their self‐health management. The availability of Chinese medicine depended crucially on the support of the health care system, individual institutions and nursing staff.Conclusions.  The value of Chinese medicine in the care of the institutionalised older people was highlighted. Chinese medicine as a complement to western medicine was perceived as an important component of self‐health management. Attitudes towards the use of Chinese medicine in nursing homes therefore need to be reviewed and developed further in accordance with the health strategy policy.Relevance to clinical practice.  This research focuses on the role of complementary and alternative medicine in health care for the institutionalised older people. It provides health practitioners, researchers and policy makers with an additional perspective in the provision of quality client‐centred care for older people living in long‐term care.
Therapist effects in randomised controlled trials: what to do about them
Authors: Walters Stephen J 
Published: March 2010

Aims and objectives. The aim of this study is to describe and compare three statistical methods to allow for therapist effects in individually randomised controlled trials.Background. In an individually randomised controlled trial where the intervention is delivered by a health professional it seems likely that the effectiveness of the intervention, independent of any treatment effect, could depend on the skill of the health professional delivering it. This leads to a potential clustering of the outcomes for the patients being treated by the same health professional.Design. Retrospective statistical analysis of outcomes from four example randomised controlled trial datasets with potential clustering by health professional.Methods. Three methods to allow for clustering are described: cluster level analysis; random effects models and marginal models. These models were fitted to continuous outcome data from four example randomised controlled trial datasets with potential clustering by health professional.Results. The cluster level models produced the widest confidence intervals. Little difference was found between the estimates of the regression coefficients for the treatment effect and confidence intervals between the individual patient level models for the datasets. The conclusions reached for each dataset match those published in the original papers. The intracluster correlation coefficient ranged from <0·001–0·04 for the outcomes, which shows only minor levels of clustering within the datasets.Conclusions. The models, which use individual level data are to be preferred. Treatment coefficients from these models have different interpretations. The choice of model should depend on the scientific question being asked.Relevance to clinical practice. We recommend that researchers should be aware of any potential clustering, by health professional, in their randomised controlled trial and use appropriate methods to account for this clustering in the statistical analysis of the data.
Use of complementary and alternative medicine by patients with arthritis
Authors: Ünsal Ayla , Gözüm Sebahat 
Published: March 2010

Aims and objectives.  The aims of this study were to determine the prevalence of complementary and alternative medicine use in patients with arthritis, the types of complementary and alternative medicine used, pertinent socio‐demographic factors associated with complementary and alternative medicine use and its perceived efficacy.Background.  Arthritis is a major health issue, and the use of complementary and alternative medicine among patients with arthritis is common.Design.  This is a descriptive cross‐sectional study.Methods.  Data were obtained from 250 patients with arthritis at the physiotherapy and immunology clinics Atatürk University Hospital in eastern Turkey between May–July 2005 using a questionnaire developed specifically for this study. The instrument included questions on socio‐demographic information, disease specifics and complementary and alternative medicine usage.Results.  Seventy‐six per cent of participants reported use of at least one form of complementary and alternative medicine in the previous year. Complementary and alternative medicine users and non‐users were not significantly different in most socio‐demographic characteristics including age, gender, marital status and education level with the exception of economic status. We categorised treatment into six complementary and alternative medicine categories: 62·6% of patients used thermal therapies; 41·5% used oral herbal therapies; 40·5% used hot therapies; 32·6% used externally applied (skin) therapies; 28·4% used massage and 12·6% used cold therapies. All forms of complementary and alternative medicine except thermal and oral herbal therapies were perceived as very effective by more than half of study participants.Conclusions.  Complementary and alternative medicine therapy is widely used by patients with arthritis and has perceived beneficial effects.Relevance to clinical practice.  It is important for nurses and other health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing care to patients with arthritis because of possible interactions with other treatments, delays in seeking care and the potential for poor quality products. It is also essential for health professionals to discuss treatment options with patients and to monitor treatment efficacy.
Population demography influences climatic niche evolution: evidence from diploid American Hordeum species (Poaceae)
Authors: JAKOB SABINE S. , HEIBL CHRISTOPH , RÖDDER DENNIS , BLATTNER FRANK R. 
Published: March 2010

AbstractIn this study, we explore the interplay of population demography with the evolution of ecological niches during or after speciation in Hordeum. While large populations maintain a high level of standing genetic diversity, gene flow and recombination buffers against fast alterations in ecological adaptation. Small populations harbour lower allele diversity but can more easily shift to new niches if they initially survive under changed conditions. Thus, large populations should be more conservative regarding niche changes in comparison to small populations. We used environmental niche modelling together with phylogenetic, phylogeographic and population genetic analyses to infer the correlation of population demography with changes in ecological niche dimensions in 12 diploid Hordeum species from the New World, forming four monophyletic groups. Our analyses found both shifts and conservatism in distinct niche dimensions within and among clades. Speciation due to vicariance resulted in three species with no pronounced climate niche differences, while species originating due to long‐distance dispersals or otherwise encountering genetic bottlenecks mostly revealed climate niche shifts. Niche convergence among clades indicates a niche‐filling pattern during the last 2 million years in South American Hordeum. We provide evidence that species, which did not encounter population reductions mainly showed ecoclimatic niche conservatism, while major niche shifts occurred in species which have undergone population bottlenecks. Our data allow the conclusion that population demography influences adaptation and niche shifts or conservatism in South American Hordeum species.