bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity in South Africa
Authors: Van Der Merwe M.‐T. , Pepper M. S. 
Published: July 2006

SummarySouth Africa has not been spared in the rampant global increase in obesity. Throughout Africa, as elsewhere, ethnicity has a major impact on the incidence and pathogenesis of comorbid diseases, particularly diabetes. Combined figures for obesity and overweight (body mass index [BMI] > 25 kg m−2) obtained across all ethnic groups in the adult population in 1998, were 57% for women and 29% for men. From the 1960s until the late 1980s, the notion of ‘healthy’ or ‘benign’ obesity was propagated in South Africa. Not surprisingly, this led to ignorance around the problem of obesity, and treatment of some of the comorbid diseases was neglected. Fortunately, as an increasing number of seminal studies draw us closer to reality, the misperception of benign obesity is being corrected. This is allowing us to address the real issues underlying the current epidemic, and to recognize and manage the comorbid diseases, in particular type 2 diabetes. A new framework for research is also emerging as we begin to define the factors underlying the impact of ethnicity on obesity.
The management of osteoarthritis in the obese patient: practical considerations and guidelines for therapy
Authors: Bliddal H. , Christensen R. 
Published: July 2006

SummaryObesity and osteoarthritis (OA) co‐exist in an increasing part of the population. The two diseases intertwine in several ways. The evolution in the population shows a tendency towards deterioration of both by increasing general age and weight. The two diseases share pathogenetic features and the development of one disease increases the risk of the other and may be the onset of a vicious circle. There is a link between treatments of these two diseases as well. There is now solid (gold) evidence that by treating effectively the obesity of patients with co‐occurring OA, the functional status is dramatically ameliorated; the short‐term results are equal to that of a joint replacement. The long‐term efficacy of a weight loss remains to be shown. OA is definitely one of many diseases in which obesity must be taken seriously into account when planning a correct treatment of patients. The regimens used in the controlled studies of such patients are reviewed and it may be concluded that practical aspects of the dietary intervention in obese patients with OA are not different from general recommendations.
Habitat specificity and home‐range size as attributes of species vulnerability to extinction: a case study using sympatric rattlesnakes
Authors: Waldron J. L. , Bennett S. H. , Welch S. M. , Dorcas M. E. , Lanham J. D. , Kalinowsky W. 
Published: July 2006

AbstractLarge home‐range size and habitat specificity are two commonly cited ecological attributes that are believed to contribute to species vulnerability. The eastern diamondback rattlesnake Crotalus adamanteus is a declining species that occurs sympatrically with the more abundant canebrake rattlesnake Crotalus horridus in a portion of the south‐eastern Coastal Plain, USA. In this study, we use the ecological similarities of the two species as experimental controls to test the role of home‐range size and habitat specificity in the imperilment of the eastern diamondback rattlesnake. We used analysis of variance to investigate differences in home‐range size between the two species, and home‐range selection was modeled as habitat use versus availability with a case control sampling design using logistic regression. We failed to detect differences in home‐range size between the two species; therefore, we could not identify home‐range size as an attribute contributing to the imperilment of eastern diamondback rattlesnakes. Eastern diamondback rattlesnakes selected pine savannas to a degree that suggests that the species is a habitat specialist. Of the two factors examined, habitat specificity to the imperiled longleaf pine ecosystem may be a significant contributor to the decline of the eastern diamondback rattlesnake.
Effects of an invasive anuran [the cane toad (Bufo marinus)] on the invertebrate fauna of a tropical Australian floodplain
Authors: Greenlees M. J. , Brown G. P. , Webb J. K. , Phillips B. L. , Shine R. 
Published: July 2006

AbstractThe ways in which invasive organisms influence native ecosystems remain poorly understood. For example, feral cane toads Bufo marinus have spread extensively through tropical Australia over the last 70 years, but assessments of their ecological impact remain largely anecdotal. We conducted experimental trials to examine the effect of cane toad presence on invertebrate fauna in relatively small (2.4 × 1.2 m) outdoor enclosures on a floodplain near Darwin in the wet–dry tropics. Toads significantly reduced invertebrate abundance and species richness, but only to about the same degree as did an equivalent biomass of native anurans. Thus, if toads simply replaced native anurans, the offtake of invertebrates might not be substantially different from that due to native anurans before toad invasion. However, our field surveys suggest that toads cause a massive (fourfold) increase in total amphibian biomass. The end result is that cane toads act as a massive nutrient sink in the floodplain ecosystem because they consume vast numbers of invertebrates but (unlike native frogs) are largely invulnerable to predation by frog‐eating predators.
Maternal exposure to low levels of ambient air pollution and preterm birth in Brisbane, Australia
Authors: Hansen C , Neller A , Williams G , Simpson R 
Published: July 2006

Background  There is evidence that maternal exposure to ambient air pollution during pregnancy is associated with adverse birth outcomes.Objective  To assess preterm birth (PTB) in relation to maternal exposure to ambient air pollution.Design  Retrospective cohort.Setting  Brisbane, Australia.Sample  A total of 28 200 singleton live births for the period of 1 July 2000 to 30 June 2003.Methods  Average maternal exposure estimates for ambient particulate matter (PM10 and bsp), ozone (O3) and nitrogen dioxide were calculated over the first 3 months after last menstrual period (LMP) and the last 3 months prior to birth (individually and combined as trimesters).Main outcome measures  PTB was defined as gestation <37 weeks and odds ratios (OR) were calculated for PTB per interquartile range increase in the maternal exposure estimate for each pollutant. Various covariates were controlled for, including season of birth.Results  Exposure to PM10 and O3 during trimester one was associated with an increased risk of PTB (OR = 1.15, 95% CI 1.06–1.25 and OR = 1.26, 95% CI 1.10–1.45, respectively). The PM10 exposure effect associated with trimester one was strongly related to exposure during the first month post‐LMP (PM10, month one; OR = 1.19, 95% CI 1.13–1.26).Conclusion  These results suggest that maternal exposure to low levels of ambient air pollution is associated with PTB.
Referral and attendance at a specialist antenatal clinic: qualitative study of women’s views
Authors: Jackson CJ , Bosio P , Habiba M , Waugh J , Kamal P , Dixon‐Woods M 
Published: July 2006

Objective  To explore women’s views on being referred to and attending a specialist antenatal hypertension clinic.Design  Qualitative interview study.Setting  A pregnancy hypertension clinic in a large teaching hospital in the East Midlands.Population  Twenty‐one women (aged 18 years and above) attending the pregnancy hypertension clinic for the first time during their current pregnancy.Methods  Women who had been referred to and attended a specialist antenatal clinic participated in semi‐structured interviews. Data analysis was based on the constant comparative method.Main outcome measures  Women’s experiences and perceptions of being referred to and attending a specialist antenatal clinic.Results  Being referred to the clinic conferred an ‘at risk’ status on women. Some women welcomed the referral but others experienced it as unsettling. Many were unclear about why they had been identified as being at risk or had difficulties in accepting the legitimacy of the reason for referral. Women were often inadequately informed about why they were referred to the clinic, what they could expect and the benefits of attending the clinic over management in the community. Although attendance at the clinic was cited as a source of reassurance, the reassurance was often made necessary by concern raised by the initial referral.Conclusions  Women’s accounts suggest that the interface between community and secondary antenatal services needs improvement to minimise possible adverse effects from identifying women as being ‘at risk’ during pregnancy.
Which factors determine the sexual function 1 year after childbirth?
Authors: Van Brummen HJ , Bruinse HW , Van De Pol G , Heintz APM , Van Der Vaart CH 
Published: July 2006

Objective  To evaluate which factors determine sexual activity and satisfaction with the sexual relationship 1 year after the first delivery.Design  Prospective longitudinal cohort study.Setting  Ten midwifery practices.Population  Three hundred and seventy‐seven nulliparous women were included.Methods  The Maudsley Marital Questionnaire is a standardised and validated questionnaire with 15 items relating to marital and sexual adjustment, with a nine‐point (0–8) scale appended to each question. Scores on the sexual scale (MMQ‐S) range from 0 to 40. Higher scores are indicative of greater dissatisfaction. Sexual intercourse was dichotomised into having sexual intercourse or not having sexual intercourse. Several obstetric and maternal factors were analysed.Main outcome measurements  Sexual intercourse at 1 year postpartum and dissatisfaction with the sexual relationship as assessed by the MMQ‐S scale.Results  In multiple logistic regression analysis, the main predictive factor for no sexual intercourse 1 year postpartum was no sexual intercourse at 12 weeks of gestation (β 11.0 [4.01–30.4]). Women were five times less likely to be sexually active after a third/fourth degree anal sphincter tear as compared with women with an intact perineum (β 0.2 [0.04–0.93]). Dissatisfaction with the sexual relationship 1 year after childbirth, assessed with the MMQ‐S scale, is associated with not being sexually active at 12 weeks of gestation (β– 0.208, P= 0.004) and with an older maternal age at delivery (β 0.405, P= 0.032).Conclusion  An important prognostic factor for dissatisfaction with the sexual relationship 1 year postpartum was not being sexually active in early pregnancy. Satisfaction with the sexual relationship seems not to depend on pregnancy‐ and parturition‐associated factors.
‘A stronger and clearer perception of self’. Women’s experience of being professional patients in teaching the pelvic examination: a qualitative study
Authors: Siwe K , Wijma B , Berterö C 
Published: July 2006

Objectives  To identify and describe the experience of being a professional patient (PP) in teaching the pelvic examination (PE).Design  Qualitative study using in‐depth interviews.Setting  Participant’s home, place of work or other place of choice.Population  Thirteen female PPs who teach the PE to medical students and student midwives.Method  Semi‐structured interviews analysed with an interpretive phenomenological approach.Main outcome measures  Five themes were identified during the analysis: ‘embodied knowledge’, ‘promoting a proper approach’, ‘redrawing private boundaries’, ‘feeling confident’ and ‘doing something meaningful’. The essence ‘experience of stronger and clearer perception of self’ emerged from the themes and is the described structure of the lived experience of the women who are PP.Conclusions  Being a PP in this setting was beneficial for the women. They acquired increased knowledge about their bodies and PE procedure, which led to a new awareness of their own body. Contributing to students’ learning in such an intimate examination procedure was rewarding and increased self‐esteem.
The effects of social status on biological aging as measured by white‐blood‐cell telomere length
Authors: Cherkas L. F. , Aviv A. , Valdes A. M. , Hunkin J. L. , Gardner J. P. , Surdulescu G. L. , Kimura M. , Spector T. D. 
Published: July 2006

SummaryLow socio‐economic status (SES) is associated with a shortened life expectancy, but its effect on aging is unknown. The rate of white‐blood‐cell (WBC) telomere attrition may be a biological indicator of human aging. We tested the hypothesis that SES is associated with telomere attrition independent of known risk factors influencing the aging process. We studied 1552 female twins. A venous blood sample was taken from each twin and isolated WBCs used for extraction of DNA. Terminal restriction fragment length (TRFL) was measured. Questionnaire data were collected on occupation, education, income, smoking, exercise, height and weight. Standard multiple linear regression and multivariate analyses of variance tested for associations between SES and TRFL, adjusting for covariates. A discordant twin analysis was conducted on a subset to verify findings. WBC telomere length was highly variable but significantly shorter in lower SES groups. The mean difference in TRFL between nonmanual and manual SES groups was 163.2 base pairs (bp) of which 22.9 bp (∼14%) was accounted for by body mass index, smoking and exercise. Comparison of TRFL in the 17 most discordant SES twin pairs confirmed this difference. Low SES, in addition to the harmful effects of smoking, obesity and lack of exercise, appears to have an impact on telomere length.
Blood Pressure Level and Outcomes in Adults Aged 65 and Older with Prior Ischemic Stroke
Authors: Kaplan Robert C. , Tirschwell David L. , Longstreth W.T. , Manolio Teri A. , Heckbert Susan R. , LeValley Aaron J. , Lefkowitz David , El‐Saed Aiman , Psaty Bruce M. 
Published: July 2006

OBJECTIVES: To examine the association between blood pressure (BP) levels and long‐term stroke outcomes in elderly stroke survivors.DESIGN: Observational study.SETTING: The Cardiovascular Health Study (CHS) of 5,888 community‐dwelling adults.PARTICIPANTS: Two hundred fifty‐four adults aged 65 and older (mean age 78.6) who sustained a nonfatal first ischemic stroke.MEASUREMENTS: BP levels assessed at prestroke and poststroke CHS visits were examined as predictors of stroke recurrence, coronary heart disease (CHD), combined vascular events (CVEs), and mortality.RESULTS: Higher poststroke BP level, assessed 261.6 days (mean) after stroke, was associated with higher risk of stroke recurrence over 5.4 years (mean) of follow‐up. The multivariate‐adjusted hazard ratio for stroke recurrence was 1.42 (95% confidence interval (CI)=1.03–1.99) per standard deviation (SD) of systolic BP (P=.04) and 1.39 (95% CI=1.01–1.91) per SD of diastolic BP (P=.04). Mortality was significantly greater in patients with low or high poststroke BP than in those with intermediate BP. Poststroke BP was not associated with risk of CHD or CVE, although further analyses suggested that high systolic BP predicted CHD and CVE in younger but not older subjects. Prestroke BP did not predict poststroke outcomes.CONCLUSION: In this observational study of adults aged 65 and older assessed approximately 8 months after stroke, low BP was associated with favorable risk of recurrent stroke, although high and low poststroke BP levels were associated with greater mortality. Long‐term antihypertensive trials in older stroke survivors would increase knowledge about the benefits of lowering BP in this population.
Postprandial Hypotension in Long‐Term Care Elderly Patients on Enteral Feeding
Authors: Lubart Emily , Segal Refael , Baumoehl Yehuda , Matron Marina , Leibovitz Arthur 
Published: July 2006

OBJECTIVES: To examine the prevalence and nature of postprandial hypotension (PPH) in orally fed (OF), nasogastric tube (NGT)‐fed, and percutaneous endoscopic gastrostomy (PEG)‐fed older people.DESIGN: Prospective comparative study.SETTING: Nursing and skilled nursing wards of three geriatrics hospitals.PARTICIPANTS: Three groups (OF, PEG, NGT) of long‐term care patients (50 in each cohort) were enrolled.MEASUREMENTS: Blood pressure (BP) and heart rate measurements were obtained just before lunch and at 15‐minute intervals for 90 minutes after the completion of the meal. The meals were similar in caloric content and composition.RESULTS: PPH was evidenced in 64 (43%) patients. No significant intergroup (OF, PEG, NGT) differences were present. In 68% of PPH patients, the systolic BP (SBP) drop appeared within 30 minutes, and 70% reached their systolic nadir at 60 minutes. In 31%, the SBP drop was registered on only one measurement, whereas in 25%, the drop was detected on five to six measurements. All parameters were without notable intergroup differences.CONCLUSION: In enterally fed elderly patients (NGT or PEG), the rate and pattern of PPH are similar and not significantly different from that observed in OF patients.
Severe Elder Obesity and 1‐Year Diminished Lower Extremity Physical Performance in Homebound Older Adults
Authors: Sharkey Joseph R. , Ory Marcia G. , Branch Laurence G. 
Published: July 2006

OBJECTIVES: To determine whether severe obesity in older people is independently associated with diminished lower extremity physical performance (LEP) in a random sample of homebound older adults that were considered ambulatory.DESIGN: Prospective cohort with 1 year of follow‐up (2000–02).SETTING: In‐home assessments of homebound older adults in four North Carolina counties.PARTICIPANTS: Random sample of 282 home‐delivered meal recipients aged 60 and older who completed both in‐home assessments (n=253) or were nursing home residents (n=29) at the 1‐year follow‐up assessment of the Nutrition and Function Study.MEASUREMENTS: Objective measures were selected for baseline and 1‐year LEP (timed walking, static and dynamic balance, and chair rise) and baseline body mass index (BMI, based on measured weight and knee height). BMI was categorized as underweight/normal (<25.0 kg/m2), overweight (25.0–29.9 kg/m2), moderately obese (30.0–34.9 kg/m2), and severely obese (≥35.0 kg/m2). Based on summary scores, overall LEP was categorized as poor, intermediate, or good. Sample characteristics included depressive symptomatology, fear of falling, medical conditions, and medication use.RESULTS: Almost 23% of participants were moderately obese and 15% severely obese. Only severe obesity independently increased the odds (odds ratio 2.9–7.0) for diminished performance at 1 year in individual tests and in overall LEP performance. Severe obesity was independently associated with poor LEP at both assessments or with decline in LEP at 1 year.CONCLUSION: These results highlight the need to distinguish between moderate and severe obesity in older people in terms of relationships with key functional outcomes. The findings identify severe obesity in older people as an important target for future interventions. In particular, this calls for greater understanding of intervention goals, whether to primarily target weight reduction or improvement in physical performance.
Energy‐Containing Nutritional Supplements Can Affect Usual Energy Intake Postsupplementation in Institutionalized Seniors with Probable Alzheimer's Disease
Authors: Parrott Matthew D. , Young Karen W. H. , Greenwood Carol E. 
Published: July 2006

OBJECTIVES: To determine whether increases in caloric intake associated with consumption of a mid‐morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response.DESIGN: Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial.SETTING: A fully accredited geriatric care facility affiliated with the University of Toronto.PARTICIPANTS: Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently.MEASUREMENTS: Investigator‐weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory—Nursing Home version; London Psychogeriatric Rating Scale) assessments.RESULTS: Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low‐BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake.CONCLUSION: Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low‐BMI individuals to limit variability in total energy provided and thus prevent lower‐than‐normal intake.
Clinical indices of familial depression in the Swedish Twin Registry
Authors: Kendler K. S. , Gatz M. , Gardner C. O. , Pedersen N. L. 
Published: July 2006

Objective:  Although familial factors certainly contribute to the etiology of major depression (MD), further information is needed about which clinical features of depressive illness index the familial vulnerability in MD.Method:  Lifetime MD and associated clinical features were assessed at personal interview in 27 230 individual twins, including 4080 onsets of MD, from the Swedish National Twin Registry. Analyses were conducted using Cox proportional hazards models.Results:  Three clinical variables in a depressed twin predicted the hazard ratio for MD in the cotwin. In the order of the strength of the association, these were: number of endorsed A criteria, age at onset, and number of episodes.Conclusion:  Certain clinical features of MD are significant, albeit modest, indices of the familial vulnerability to MD. Individuals with a high familial/genetic risk for MD tend to have an early age at onset, meet most of the symptomatic DSM criteria and suffer recurrences.
Increased expression of integrins and decreased apoptosis correlate with increased melanocyte retention in cultured skin substitutes
Authors: Swope Viki B. , Supp Andrew P. , Schwemberger Sandy , Babcock George , Boyce Steven 
Published: July 2006

SummaryLosses of human melanocytes (HM) in transplantation of cultured skin substitutes (CSS) may result from poor cellular attachments. To test this hypothesis, HM integrin expression was measured in four culture media: (a) melanocyte growth medium (MGM), an HM proliferation medium; (b) UCMC 160, a CSS maturation medium; (c) mMGM, modified MGM with 1.8 mM calcium; and (d) modified UCMC 160 with HM supplements (mUCMC 160). HM grew well in all media except UCMC 160. Increased expression of β1, β4, α3β1 and α5 integrins on HM cultured in MGM and mMGM versus UCMC 160 was found by flow cytometry. Annexin V‐allophycocyanin (APC) labeled HM in apoptosis and increased significantly in UCMC 160 (31.1%) compared with MGM (11.9%) or mMGM (13.9%). CSS were incubated in UCMC 160, mMGM or mUCMC 160 media, and grafted to athymic mice. In the mMGM group, grafts were darker as measured with a chromameter through 6 weeks and the average number of basal HM per field was greater at 12 weeks post‐grafting. Increased graft loss was observed in the mMGM group which corresponded with the poor epidermal morphology in vitro. Although HM retention improved in vivo using mMGM to culture the CSS, the stability of the epidermis decreased. These results indicate that expression of integrins on HM in vitro correlates with HM retention in CSS and short‐term survival after transplantation, but that long‐term survival depends also on stable epithelium.