bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypersingular boundary integral equations and the approximation of the stress tensor
Authors: Salvadori Alberto 
Published: March 2007

AbstractThe present work deals with the application of the traction hypersingular boundary integral equation to approximate the stress tensor along the boundary, by making use of unit vectors that differ from the normal at the boundary. It is proved that special care is required in the evaluation of the free terms, in order to avoid insidious and unexpected errors. Copyright © 2007 John Wiley & Sons, Ltd.
Pulmonary dendritic cells and alveolar macrophages are regulated by γδ T cells during the resolution of S. pneumoniae‐induced inflammation
Authors: Kirby AC , Newton DJ , Carding SR , Kaye PM 
Published: March 2007

Abstractγδ T cells commonly associate with mucosal and epithelial sites, fulfilling a variety of immunoregulatory functions. While lung γδ T cells have well‐characterized pro‐inflammatory activity, their potential role in the resolution of lung inflammation has yet to be explored in any detail. Indeed, given the importance of minimizing inflammation, the cellular mechanisms driving the resolution of lung inflammation are poorly understood. Using a murine model of acute Streptococcus pneumoniae‐mediated lung inflammation, we now show that resolution of inflammation following bacterial clearance is associated with a > 30‐fold increase in γδ T‐cell number. Although inflammation eventually resolves in TCRδ−/− mice, elevated numbers of alveolar macrophages and pulmonary dendritic cells, and the appearance of well‐formed granulomas in lungs of TCRδ−/− mice, together indicated a role for γδ T cells in regulating mononuclear phagocyte number. Ex vivo, both alveolar macrophages and pulmonary dendritic cells were susceptible to lung γδ T cell‐mediated cytotoxicity, the first demonstration of such activity against a dendritic cell population. These findings support a model whereby expansion of γδ T cells helps restore mononuclear phagocyte numbers to homeostatic levels, protecting the lung from the consequences of inappropriate inflammation. Copyright © 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Patient‐initiated telephone consultations with diabetes specialist nurse: ‘hidden’ appointments?
Authors: Wilbourne JM , Wilson AE 
Published: March 2007

AbstractPatient contact with the diabetes specialist nurse (DSN) is often made by telephone rather than ‘face‐to‐face’, but costs and resources required are rarely formally identified. The aim of the present study was to identify the number, duration and nature of these calls and their impact on the DSN workload, in order to help plan future care requirements for those with diabetes. Weekday calls (09.00–18.00 hr) were logged over a nine week period late in 1994. Information collected included date, time, duration of and reason for call, sex of caller, and whether insulin‐treated. Of an active clinic population of 1,400 adults, 327 calls were made requesting advice on 349 topics. The 256 calls (78%) from insulin‐users were generally of longer duration, 54% needing between five and 15 minutes. Calls concentrated on certain times of day (p<0.001) with 19% between 09.00 and 10.00 hr, and 23% between 10.00 and 11.00 hr. Of identified reasons for calls, 24% were from people recently established on insulin therapy. Other ‘popular’ topics were insulin adjustment (10%) and advice on control (13%), while calls on hypoglycaemia (4%) and for pre‐pregnancy advice (0.6%) were rarer.We conclude that such a telephone service is heavily used in areas appropriate to DSN expertise. Its impact on the DSN workload is significant: formal training and allocation of resources would therefore seem to be indicated.
Alcoholic ketoacidosis associated with hyperglycaemia: A diagnostic dilemma
Authors: Hart SP , Frier BM 
Published: March 2007

AbstractThe acute presentation of alcoholic ketoacidosis accompanied by hyperglycaemia is rare, but it may lead to the misdiagnosis of metabolically decompensated Type 1 (insulin‐dependent) diabetes and to inadvertent treatment with insulin. A case of alcoholic ketoacidosis is described in which recent excessive alcohol consumption was concealed by the patient, which resulted in a diagnosis of diabetic ketoacidosis. The blood glucose concentration in alcoholic ketoacidosis may be determined by the extent to which endogenous insulin secretion is suppressed and the extent of the peripheral insulin resistance induced by alcohol and the concomitant secretion of counter‐regulatory hormones.
Multicentre study to assess quality of life and glycaemic control of Type 2 diabetic patients treated with insulin compared with oral hypoglycaemic agents
Authors: Barnett AH , Jones D Bowen , Burden AC , Janes JM , Sinclair A , Small M , Tindall H 
Published: March 2007

AbstractQuality of life, glycaemic control and frequency of hypoglycaemia were compared in 93 moderate to poorly controlled Type 2 diabetes patients randomly allocated to one of three treatment groups: Group A continued on oral hypoglycaemics, Group B switched to twice‐daily fixed mixture of human insulin using a standard syringe, Group C switched to similar insulin given by a Becton‐Dickinson (B‐D) insulin pen. After 12 weeks patients in Groups B and C were changed to B‐D pen or syringe respectively for a further 12 weeks. Patients in Group A continued on oral hypoglycaemics. At entry, 12 weeks and 24 weeks, subjects completed a ‘well‐being’ and ‘satisfaction with treatment’ questionnaire. At the end of the study, patients in Groups B and C completed an ‘insulin delivery acceptability’ questionnaire.There was no significant difference between scores for the ‘well‐being’ and ‘satisfaction with treatment’ questionnaires but, for those patients on insulin, the ‘insulin delivery acceptability’ questionnaire demonstrated a marked preference in most patients for the pen rather than the syringe as the method of insulin delivery. Patients on insulin showed an improvement overall in HbA1c, with a mean reduction of 1.46% (95% confidence interval–2.76 to −0.16%, p=0.021) compared with tablet treatment, but at the expense of an increased frequency of hypoglycaemia and weight gain.We conclude that in ‘moderately’ controlled Type 2 diabetes there is no significant change in quality of life when patients are switched to insulin, although once on insulin, most prefer an insulin pen to a syringe. The improvement in HbA1c may, however, be of clinical significance given the increasingly powerful evidence associating good diabetes control with reduced risk of long‐term microangiopathic complications.
Audit of referrals for dietary advice from the diabetes clinic at Bedford Hospital
Authors: Blades M. , Morgan J. 
Published: March 2007

AbstractAn audit of people with diabetes mellitus (DM) who were referred for dietary advice from the diabetes outpatient clinic at Bedford Hospital, was made for a four‐week period against local standards. These were set at 100% of newly diagnosed DM patients to receive advice from a dietitian within a year of diagnosis, and annually thereafter.During the audited period 183 patients were seen in the diabetes outpatient clinic by a consultant in diabetes or one of his team. Of these, 66% (121 patients) had seen a dietitian within one year of diagnosis of DM; 19% (35 patients) had been seen for a dietetic update in the last 18 months. A proportion of patients had never seen a state registered dietitian.
Counselling for patient empowerment. Guest Lecture: The 2nd Janet Kinson Lecture Delivered at a BDA Education and Care Section meeting
Authors: Brown Florence 
Published: March 2007

AbstractThis review article explores the concept of empowerment described in the health promotion and health education literature and relates it to the context of diabetes care and to how the nature of the communication, and thus the relationship between health professionals and patients within the consultation, can be disempowering.A second article by Florence Brown in this issue (see Special Review Series) looks at the philosophy of person‐centred counselling and education and how the communication of that philosophy through the use of counselling skills in the diabetic consultation can facilitate self‐empowerment in people with diabetes.
Counselling in practice
Authors: Brown Florence , Coles Professor Colin 
Published: March 2007

AbstractThe review article ‘Counselling for patient empowerment’ (see page 189) described some of the issues in defining empowerment in the context of health, and looked at the traditional paternalistic relationship that often exists between health professionals and patients.This article seeks to describe the person‐centred philosophy and how that philosophy, when communicated by counselling skills, can facilitate self‐empowerment in people with diabetes.
Notes designed as an aid to professional education. A very unusual case of hyperosmolar coma
Authors: Lewis MJ , Ferguson SC , Campbell IW , Nawroz IM 
Published: March 2007

AbstractHyperglycaemic coma without ketoacidosis in the diabetic patient was presumptively first recorded by Dreschfield in 18861 but it was not until 1957 that the concept of hyperosmolar non‐ketotic coma as a distinct clinical syndrome was appreciated2,3. Hyperosmolar non‐ketotic coma (HONK) occurs typically in the elderly diabetic subject. Up to 60% of diabetic patients with HONK have previously undiagnosed diabetes mellitus. In these elderly patients, there are often multiple precipitating factors with infection being the most common4. We present the case of a female with HONK and an unusual infection, the combination of which led to her sudden and unexpected death.
IDDM patients' opinions on the use of glucagon emergency kit in severe episodes of hypoglycaemia
Authors: Yanai O. , Phillip M. , Harman I. , Elitzur‐Leiberman E. , Pilpel D. 
Published: March 2007

AbstractThis study investigated the coping strategies of IDDM patients with mild and severe episodes of hypoglycaemia. One hundred and two IDDM patients, aged 4–62 years old, 59% male and 41% female, were interviewed by telephone using a structured questionnaire.Most of the patients recognised the symptoms of hypoglycaemia and accordingly treated their mild episodes with either Coca Cola or fruit juice (61%), sweets (32%), milk (26%), or a slice of bread (23%). Forty two per cent of the patients treated themselves with additional chocolate, fruit or honey. While 83% of the patients reported that they had received an explanation regarding the use of the glucagon emergency kit, only 60% actually owned it. In only 19% of the patients who had ever experienced a severe episode of hypoglycaemia had this mode of treatment actually been used. Most of the patients (67%) said they would prefer the intranasal route if available and 82% assumed that the people surrounding them would prefer to administer an intranasal spray or drops in emergency hypoglycaemic situations.We conclude that only in a small percentage of patients is subcutaneous or intramuscular glucagon used in an emergency situation, and speculate that other modes of glucagon administration such as the intranasal route would increase the use of glucagon and prevent some of the IDDM patients from waiting for the emergency paramedic teams or from being referred to hospitals.
Social and psychological implications of diabetes mellitus for a group of adolescents
Authors: Gardiner P. 
Published: March 2007

AbstractThe attitudes of young adults towards their diabetes were investigated. Access was via paediatric clinics in Plymouth and the study explored the adolescents' own views, using a questionnaire. Quantitative data was analysed by computer using a software package for scientific statistics (SPSS).Unlike previous studies, attitudes proved generally positive: 97.5% felt normal or only slightly different from non‐diabetics. This correlated with how long they had had diabetes and their view of their diabetes control; 55% perceived control as excellent or good, and this related to frequency of blood‐monitoring. Only seven individuals thought their families were over‐protective.The data suggested a series of stages of acceptance, with a period of rejection sometimes occurring one to five years after diagnosis. Ten individuals (25%) found injections trying and claimed monitoring limited spontaneity. Twelve adolescents described weight problems; these were related to gender. Twelve monitored less than once daily and 11 frequently consumed unsuitable foods. Only 14 had considered future health prospects. Thirty two would prefer to attend specialist adolescent clinics.
Blood glucose: influence of different methods for analysis and procedures for sampling
Authors: Landin‐Olsson M. , Öhlin A‐C , Agardh C‐D 
Published: March 2007

AbstractSmall instruments for self‐monitoring of blood glucose (BG) are now available to the patients, and a continuous quality control of these instruments is necessary. This study compared different small BG monitoring instruments with the Hemo‐Cue instrument, which in turn was compared with the Kodak Ektachem 700 XR‐C, the routine method at our laboratory. We also studied whether venous or capillary blood specimens made any difference, and the influence on the results of the time delay between sampling and analysis.Venous and capillary blood samples were obtained from 191 diabetic patients attending an out‐patient diabetes clinic, and glucose tests were performed in three small instruments (Glucometer Elite [n=112], Accutrend [n=56] or One Touch ll[n=23]) in parallel with HemoCue (n=191) and Kodak Ektachem 700 XR‐C(n=191).Blood glucose analysed with the small instruments often used by patients for self‐monitoring, showed a close relationship with HemoCue. However, one instrument (Accutrend) gave constantly lower values (0.7±1.0 mmol/l: p < 0.001). HemoCue was shown to be in good agreement with the routine method used at the hospital laboratory. The difference between venous and capillary samples was significant (0.12±0.57 mmol/l p < 0.001) but of no practical importance. However, the time between sampling and analysis was important, since blood glucose decreased 1.6±0.8 mmol/l after an average delay of 3.8hr. The glycolysis occurs despite correct sampling in tubes containing heparin‐fluoride.
The prevalence of chronic renal failure in known diabetic and non‐diabetic White Caucasians and South Asians
Authors: Gujral J. S. , Burden A. C. , Iqbal J. , Raymond N. T. , Botha J. L. 
Published: March 2007

AbstractThe prevalence of chronic renal failure (CRF) in people with diabetes mellitus is unknown. This study was undertaken to determine the prevalence of CRF in Leicestershire residents with or without diabetes mellitus in 1991. All serum creatinine values over 200 μmol/l in 1991 were abstracted from the computer records of the central laboratory serving Leicestershire residents (total population 867,521; Indo‐Asians 8.9%). Those with serum creatinine persistently raised ( > 200 μmol/l but < 500 μmol/l) were classified as having CRF. Those with serum creatinine >500 μmol/l or who were on dialysis or had been transplanted, were classified as end stage renal failure (ESRF). Those with diabetes were identified from the central diabetes register, dialysis register and consultants' notes with 100% ascertainment. The prevalence of CRF varied from 0.3/1000 (95% Cl 0.2–0.4/1000) in non‐diabetic non‐Asian females aged 0–44 years to 25.2/1000 (95% Cl 9.3–54.0/1000) in diabetic Asian males, aged >65 years.Multivariate logistic modelling indicated that Asians and males had approximately twice the CRF prevalence of White Caucasians and females respectively, irrespective of diabetes or age. The prevalence of CRF increased with age, and having diabetes increased the CRF prevalence five‐fold in the 0–44 age group, irrespective of ethnicity or sex. The effect of diabetes was not evident in the older age groups. These findings have important implications forthe use and allocation of health care resources.
Footcare advice: what do we tell our patients and what should we tell them?
Authors: Connor H. 
Published: March 2007

AbstractThe objectives of this study were to investigate the extent of agreement on advice about footcare in educational leaflets intended for people with diabetes, and to evaluate the extent of agreement among healthcare professionals on what footcare advice should be given to people with diabetes. Eight footcare leaflets were examined in a cross‐sectional questionnaire study, conducted at a diabetic footcare conference in the UK, using defined criteria for comprehensibility and readability, presentation and content. Ninety one randomly selected delegates (46 chiropodists, 30 nurses, 15 doctors) took part.Only two of the eight leaflets were found to be suitable for partially‐sighted readers. The standard of presentation was ideal in only one, and unacceptable in three leaflets. Five leaflets contained one or more contentious statements, six gave advice which was imprecise, and six contained one or more major omissions. There were 13 statements about footcare on which there was agreement among 75% or more of the delegates, and 12 statements on which agreement was less than 75%. Healthcare professionals should agree on the advice which is to be given to their patients and they should improve the quality of the educational leaflets which they provide for patients.
Prevention is better than cure. The routine examination of the feet of patients with diabetes. Part 2. Structural abnormalities
Authors: Fawcett J. , Widdows C. , Wales J. K. 
Published: March 2007

AbstractThis series of articles describes (with accompanying photographs) some of the more common abnormalities which a routine inspection might reveal. Some indication is given of their importance to the diabetic patient and what action the nurse or GP should take.
Experience of pain from insulin injections and needle‐phobia in young patients with IDDM
Authors: Hanas R. , Ludvigsson J. 
Published: March 2007

AbstractWe studied attitudes towards insulin injections, needle‐phobia and the experience of pain when using syringes, pens, insulin pumps and in‐dwelling subcutaneous catheters (Insuflon®, Maersk Medical, Lynge, Denmark).185 children and adolescents with IDDM aged 14.2±4.1 years with a HbA1c of 6.4±1.4% answered a questionnaire using 10 cm VAS scores (0 cm = hardly noticeable pain/not scared of needles at all, 10 cm=unbearable pain, very scared of needles).The VAS score of injections (median and quartiles) with syringes was 1.9 (1.1, 3.5) cm, with pens 0.4 (0.0, 1.3) cm, with in‐dwelling catheters 0.4 (0.2, 1.7) cm, when taking a bolus dose with insulin pump 0.0 (0.0, 0.0) cm and when taking a blood glucose test 0.7 (0.1, 2.4) cm. The injection pain declined with increasing age but still several teenagers regarded the injection pain as almost unbearable. Injection pain correlated to HbA1c (p=0.033), age (p=0.0003), their own (p<0.0001) and their mother's (p=0.032) needle‐phobia (but not father's) but not to diabetes duration or if parents had tried injections or blood glucose testing. Median needle‐phobia score was 0.4 (0.1, 1.4) cm. Overall, 8.3% of the patients, 16.8% of the mothers and 17.7% of the fathers defined themselves as having pronounced needle‐phobia (⩾5 cm). Those using in‐dwelling catheters reported a higher needle‐phobia but their injection pain was in the same low range as for other individuals.We conclude that, for most patients, the pain when injecting insulin is quite small irrespective of injection mode, but for some it is almost unbearable. Parents' attitudes are important for children's acceptance of injections. Injections through an in‐dwelling injection aid enables children and adolescents to reduce the pain to levels comparable to those who are less needle‐phobic.
Factors determining prescriber's satisfaction with orthotic services
Authors: Connor H. 
Published: March 2007

AbstractIn order to investigate prescribersatisfaction with the footwear services provided for diabetic patients a questionnaire survey of delegates attending a diabetic foot conference in the UK was carried out.The 92 replies from 104 departments showed that prescribes' satisfaction with their orthotic services was closely related to how often the prescriber and orthotist saw their patients in joint consultations (Chi2 for trend, 2p < 0.002). Satisfaction with services provided by orthotists who were employed by the NHS was no different from that with services where the orthotists were employed by a manufacturer. Orthotists must be fully integrated members of the diabetic foot care team, and the service must be provided in such a way as to facilitate joint consultations beween prescriber and orthotist.
Prevention is better than cure. The routine examination of the feet of patients with diabetes. Part 3. General conditions affecting the feet
Authors: Fawcett J. , Widdows C. , Wales J. K. 
Published: March 2007

AbstractThis series of articles describes (with accompanying photographs) some of the more common abnormalities which a routine inspection might reveal. Some indication is given of their importance to the diabetic patient and what action the nurse or GP should take.
Diabetes education session for young IDDM probands and their family members in a developing country: an evaluation
Authors: Shobhana R. , Rao P. Rama , Vijay V. , Snehalatha C. , Ramachandran A. 
Published: March 2007

AbstractThe aim of the study was to investigate whether a diabetes education programme developed and provided at our centre was successful in creating an awareness and imparting knowledge on various aspects of diabetes mellitus. A sample of patients was drawn from the outpatient department of the Diabetes Research Centre and the M V Hospital for Diabetes, Madras, Southern India (n=37). They answered a questionnaire consisting of seven areas of information about diabetes mellitus and its management. The data were collected on three occasions, namely, immediately after exposure to the diabetes education programme, three months later and six months later.The subjects showed significant improvement in the awareness of different aspects related to diabetes mellitus during the follow‐up periods. The mean differences were significant (p < 0.01). It was concluded that the intake of educative material was high, the information was retained and consolidated. The knowledge of diabetes mellitus improved over the time. Participative learning with audio‐visual aids proved beneficial.