bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protective effects of N‐acetylcysteine on the peroxidative changes of rat lungs exposed to inhalation of thinners
Authors: DILLIOGLUGIL Meltem Ozlen , ILGAZLI Ahmet , MARAL Hale , SENGUL Canan , OZDEMIR Gulsen , ERCIN Cengiz 
Published: October 2005

Objective:  Long‐term inhalation of thinners may cause damage, both to the lungs and to other organ systems. It causes cellular damage via formation of reactive oxygen species. The lung is protected from oxidative stress by the glutathione (GSH) antioxidant system which can be augmented by the thiol drug, N‐acetylcysteine (NAC). This study investigated the protective effect of NAC on peroxidative changes in rat lungs exposed to inhalation of thinners for 8 weeks.Methodology:  Seventy‐two male Wistar albino rats were used and divided into two groups: one group inhaled only thinners (TI), while the other inhaled TI plus NAC. Rats in the TI and TI + NAC groups were divided into four subgroups (each consisting of eight rats) according to the duration of exposure to TI: 2, 4, 6 and 8 weeks. A control group (n = 7) of rats inhaled neither TI nor NAC. Malondialdehyde (MDA) and GSH levels, and superoxide dismutase (SOD) activities were determined in the lung tissues. Histopathological findings were evaluated as acute and chronic changes in the alveoli and interstitium in the TI and TI + NAC groups and compared with those in the control group.Results:  While tissue MDA levels in the groups inhaling TI for 4, 6 and 8 weeks were significantly higher than those in the control groups (P < 0.01, P < 0.01, P < 0.0001, respectively), GSH levels were significantly lower (P < 0.05, P < 0.01, P < 0.01, respectively). Tissue SOD activities in the groups inhaling TI for 6 and 8 weeks were significantly lower than those in the control group (P < 0.05, P < 0.01, respectively). In the TI group, MDA levels were significantly increased (P < 0.01) with increasing duration of inhalation (from the second week through to the eighth week), while GSH levels and SOD activities were significantly decreased (P < 0.01, P < 0.01). Tissue MDA levels were significantly lower in the TI + NAC groups across all inhalation periods, when compared with the TI groups (P < 0.01, P < 0.0001, P < 0.0001, P < 0.0001, respectively). Tissue GSH levels in the TI + NAC groups were significantly higher than those of the TI groups (respective values: P < 0.05, P < 0.01, P < 0.01, P < 0.0001). Tissue SOD activities in the TI + NAC groups were significantly higher than those of the TI groups (respective values: P < 0.05, P < 0.0001, P < 0.05, P < 0.0001). Pathological examinations with light microscopy did not show any beneficial effect of NAC application in terms of deferring or alleviating the negative effects of TIConclusions:  Thinners are agents that cause imbalance between oxidants and antioxidants produced by aerobic cellular systems. This imbalance between oxidant and antioxidant systems is decreased by the effect of NAC. However, ultrastructural studies may be needed to substantiate this evidence morphologically, as light microscopy was inconclusive.
Remodelling of spinal nociceptive mechanisms in an animal model of monoarthritis
Authors: Naeini Reza Sharif , Cahill Catherine M. , Ribeiro‐da‐Silva Alfredo , Ménard Henri A. , Henry James L. 
Published: October 2005

AbstractIntra‐articularly injected complete Freund's adjuvant creates in rats a chronic monoarthritis suitable for studying neuronal plasticity and chronic pain. Using such a model, we report electrophysiological and morphological evidence of alterations in somatosensory synaptic function. In arthritic rats, the baseline activity of dorsal spinal cord wide dynamic range or nociceptive‐specific neurons was greater than in control animals. Moreover, neuronal responses elicited by an innocuous stimulation with von Frey filaments applied to the arthritic joint were greater in amplitude and produced the afterdischarge that normally characterizes a nociceptive response. In contrast to the response in control animals, passive movement of the arthritic joint produced an increase in the amplitude of the response of these neurons to iontophoretic application of glutamate receptor agonists over a time frame of 10–30 min. This potentiation was blocked by pretreatment with a neurokinin‐1 (NK‐1) receptor antagonist, suggesting the involvement of substance P. Ultrastructural analysis of the dorsal horn revealed that movement of the arthritic joint also induced NK‐1 receptor internalization, indicative of nociception. Morphological examination revealed significantly increased expression of substance P and its receptor within the superficial dorsal horn of monoarthritic animals. These unique functional and chemical changes reflect alterations in both presynaptic and postsynaptic mechanisms in nociceptive transmission at the spinal level. Thus, although treatment of arthritis should obviously target its peripheral aetiology, targeting its central components is a logical therapeutic complementary objective.
Prognostic significance of glycaemic control in patients with HBV and HCV‐related cirrhosis and diabetes mellitus
Authors: Kwon S. Y. , Kim S. S. , Kwon O. S. , Kwon K. A. , Chung M. G. , Park D. K. , Kim Y. S. , Koo Y. S. , Kim Y. K. , Choi D. J. , Kim J. H. 
Published: October 2005

AbstractAims  Diabetes mellitus (DM) is frequently observed in patients with cirrhosis, particularly that due to hepatitis C virus (HCV) infection. However, no studies have focused on the clinical significance of glycaemic control in cirrhotic patients because of their short life expectancy and poor hepatic function. The aim of this study was to evaluate the prognostic impact of glycaemic control in patients with hepatitis B virus (HBV) and HCV‐related cirrhosis and DM.Methods  A total of 434 patients with HCV‐related (HCV group, n = 88) or HBV‐related (HBV group, n = 346) cirrhosis were studied retrospectively. We determined the prevalence of DM and treatment methods for hyperglycaemia and status of glycaemic control, and the patients’ outcome.Results  The prevalence of DM was 43.2% (38/88) in the HCV group and 19.7% (68/346) in the HBV group. Patients in the HCV group were older with a female preponderance. DM was detected before the diagnosis of cirrhosis or simultaneously in 92% and 79% in the HCV and HBV groups, respectively. Most patients were treated with insulin or oral hypoglycaemic agents. However, blood glucose levels were maintained within the normal range in 34.2% of the HCV group and in 23.5% of the HBV group. Forty‐six patients died during the observation period in both groups. Hepatic failure was the most common cause of death, and sepsis and variceal bleeding were more frequent in the HCV group than in the HBV group. Multivariate analysis showed that Child–Pugh class was the most important factor for survival in both groups. In the HCV group, the status of glycaemic control was a significant independent factor of survival (P = 0.018). In the HBV group, age and the development of spontaneous bacterial peritonitis were significant.Conclusion  DM is more frequent in patients with HCV‐related cirrhosis than in patients with HBV. Strict control of blood glucose levels could improve survival in HCV patients. A precise assessment of the risks and benefits of glycaemic control is required to reduce the mortality and morbidity of patients with cirrhosis and DM.
Urinary albumin levels in the normal range determine arterial wall thickness in adults with Type 2 diabetes: a FIELD substudy
Authors: Keech A. C. , Grieve S. M. , Patel A. , Griffiths K. , Skilton M. , Watts G. F. , Marwick T. H. , Groshens M. , Celermajer D. S. ,   for the FIELD Vascular Study Investigators
Published: October 2005

AbstractAim  Cardiovascular disease (CVD) rates are substantially higher among patients with Type 2 diabetes than in the general population. The objective of this study was to identify the determinants of carotid intima media thickness (IMT) in patients with Type 2 diabetes.Methods  We measured the thickness of the intima media layer of the carotid artery, a strong predictor of the risk of future vascular events, in 397 Type 2 diabetic patients drawn from the Fenofibrate Intervention and Event Lowering in Diabetes study, prior to treatment allocation.Results  The mean IMT was 0.78 mm [interquartile range (IQR) 0.23 mm], and the maximum IMT was 1.17 mm (IQR 0.36 mm). By multivariate analysis, age, sex, duration of diabetes, triglycerides, and total cholesterol were independently correlated with IMT, as was urine albumin–creatinine ratio (ACR) (P < 0.001). The effect of ACR on IMT was further examined by tertile. Clinically significant differences in IMT were associated with ACR > 0.65 mg/mmol, approximately one‐fifth the standard clinical threshold for microalbuminuria (P < 0.01). Long‐term diabetes, independent of other parameters, was associated with a 50% increase in age‐related thickening.Conclusions  IMT in people with Type 2 diabetes is independently and continuously related to urine albumin levels and to the duration of diabetes. These results support previous data linking urine albumin measurements within the normal range with increased ischaemic cardiac mortality in the setting of Type 2 diabetes, and strongly suggest that urine albumin levels within this range should trigger a formal evaluation for CVD.
Evaluating the therapeutic approach in pregnancies complicated by borderline glucose intolerance: a randomized clinical trial
Authors: Bonomo M. , Corica D. , Mion E. , Gonçalves D. , Motta G. , Merati R. , Ragusa A. , Morabito A. 
Published: October 2005

AbstractAims  Most studies relating minor gestational metabolic alterations to macrosomia refer to glucose intolerance classified on the basis of the National Diabetes Data Group or previous World Health Organization diagnostic thresholds. Our aim was to evaluate the consequences of very mild forms of gestational glucose intolerance, defined by an elevated 50‐g glucose challenge test followed by a normal oral glucose tolerance test, using the more restrictive Carpenter and Coustan's criteria (Borderline Gestational Glucose Intolerance, BGGI).Methods  Three hundred BGGI women were randomly assigned to: Group A (standard management), Group B (dietary treatment and regular monitoring). A control group (C) was also considered. Newborns were classified as macrosomic, large (LGA), or small for gestational age (SGA).Results  The three groups were similar in age, body mass index and parity. Therapy in Group B significantly improved fasting (from 4.68 ± 0.45 to 4.28 ± 0.45 mmol/l) and 2‐h postprandial glycaemia (from 6.01 ± 0.57 to 5.13 ± 0.68 mmol/l). Fasting glycaemia at delivery was significantly lower in B (4.20 ± 0.38 mmol/l) than in A (4.84 ± 0.45 mmol/l), and was also lower than in C (4.31 ± 0.39 mmol/l). Significantly fewer LGA babies were born to Group B (6.0%) than Group A (14.0%) and Group C (9.1%). No difference was found in the SGA rate. The neonatal Ponderal Index was higher (P = 0.030) in group A (2.73 ± 0.35) than in C (2.64 ± 0.30) and B (2.64 ± 0.24).Conclusions  Even very mild alterations in glucose tolerance can result in excessive or disharmonious fetal growth, which may be prevented by simple, non‐invasive therapeutic measures.
Short‐term effects of cognitive behavioural group training (CBGT) in adult Type 1 diabetes patients in prolonged poor glycaemic control. A randomized controlled trial
Authors: van Der Ven N. C. W. , Hogenelst M. H. E. , Tromp‐Wever A. M. E. , Twisk J. W. R. , van Der Ploeg H. M. , Heine R. J. , Snoek F. J. 
Published: October 2005

AbstractAims  To assess the effects of cognitive behavioural group training (CBGT) on glycaemic control, diabetes self‐efficacy and well‐being in Type 1 diabetes patients in persistent poor glycaemic control.Methods  In a randomized controlled trial, a total of 107 patients with Type 1 diabetes in poor glycaemic control (HbA1c≥ 8%) were assigned to a 6‐week CBGT or blood glucose awareness training (BGAT) as control condition. The intervention was preceded by a 3‐month run‐in period. Glycaemic control (HbA1c), diabetes‐specific self‐efficacy (CIDS), diabetes‐related distress (PAID) and depressive symptoms (CES‐D), were assessed at baseline (T1), directly before (T2) and 3 months after (T3) the intervention.Results  No significant changes in HbA1c were found after CBGT, whilst diabetes self‐efficacy increased (mean CIDS score 71.6 ± 14.0 to 74.3 ± 12.2) and diabetes‐related distress (mean PAID score 47.0 ± 21.6 to 42.6 ± 20.8) and depressive symptoms decreased (mean CES‐D score 16.9 ± 12.8 to 13.5 ± 12.6). Changes in psychological outcomes were similar for both treatment groups. Diabetes self‐care behaviours improved equally. Drop‐out rate, which was higher among CBGT participants, was relatively low overall (total n = 15, 17.05%), and both interventions were well‐appreciated by the participants.Conclusions  CBGT was successful in improving self‐efficacy, diabetes‐related distress and mood at 3 months’ follow‐up, but not in improving glycaemic control.
Factors associated with glycaemic outcome of childhood diabetes care in Denmark
Authors: Nordly S. , Mortensen H. B. , Andreasen A. H. , Hermann N. , Jørgensen T. ,   on behalf of the Danish Study Group on Childhood Diabetes
Published: October 2005

AbstractAims  To study how structure and process of care is associated with outcome assessed by HbA1c.Methods  Data for this cross‐sectional study originated from the nationwide Danish Registry for Childhood Diabetes and two questionnaires. One questionnaire was sent to all children under 16 years of age with Type 1 diabetes in the year 2000 (N = 1087, response rate 80%). Another questionnaire was sent to the 19 centres in Denmark treating these children (response rate 100%). Simultaneously the children were asked to take a blood sample for central HbA1c analysis. Linear mixed models were used for analysis of associations between structure and process indicators and HbA1c. Age, diabetes duration, sex, ethnicity, family structure and parents’ occupational status were included as patient factors possibly affecting HbA1c.Results  More visits to the outpatient clinic and higher insulin dosage were significantly associated with higher HbA1c (P = 0.002 and P = 0.0001, respectively). Increased frequency of blood glucose monitoring (BGM/week) and completed nephropathy screening were significantly associated with lower HbA1c value (estimates −0.008 and −0.49, P = 0.02, respectively). The structure indicators were not associated with HbA1c, but telephone hot‐line was positively associated with the process indicator BGM (estimate 4.02, P = 0.04). Children without Danish parents performed BGM significantly less frequently (−7.11, P = 0.0005) and had higher HbA1c (0.41, P = 0.06).Conclusions  Most process indicators were significantly associated with HbA1c, indicating relevant action of staff on glucose regulation. The structure indicators were not associated with outcome, necessitating more detailed studies on the influence of staffing resources, treatment strategies and targets in childhood diabetes management.
Increased risk of diabetes among relatives of female insulin‐treated patients diagnosed at 15–34 years of age
Authors: Åkesson K. , Nyström L. , Färnkvist L. , Östman J. , Lernmark Å. , Kockum I. ,   the DISS study group
Published: October 2005

AbstractAims  This study aimed to determine the risk of developing diabetes among relatives of patients diagnosed between 15 and 34 years of age who were treated with insulin. Our second aim was to determine whether there was a difference in risk of diabetes between relatives of male and female patients.Methods  A questionnaire was sent to patients in the Diabetes Incidence Study in Sweden registry diagnosed between 1983 and 1993 to determine the presence of first‐degree relatives with diabetes.Results  In 3087 index patients treated with insulin, 17.8% (95% confidence interval 16.5, 19.2) had a first‐degree relative (excluding offspring) treated with insulin, the frequency being higher in female (19.8%) than in male (16.5%, P = 0.018) patients. A total of 10.7% had a parent treated with insulin. The prevalence of insulin‐treated diabetes was higher among parents of female (12.5%) than of male (9.5%), insulin‐treated index patients (P = 0.0068). A similar difference was observed using life table analysis (P = 0.0025), which also showed that the risk by 63 years of age was 7.6% for parents of female and 4.9% for parents of male insulin‐treated index patients. In insulin‐treated index patients, 8.4% had a sibling with insulin‐treated diabetes.Conclusions  We conclude that the risk for relatives of women with insulin‐treated diabetes was higher than for relatives of insulin‐treated male patients. We suggest that greater genetic susceptibility is required for females compared with males in the 15–34 age group in order to develop diabetes and hence females might carry more diabetes genes since more of their relatives also develop diabetes.
Diabetes mellitus: clinical presentation and outcome in men and women with acute coronary syndromes. Data from the Euro Heart Survey ACS
Authors: Dotevall A. , Hasdai D. , Wallentin L. , Battler A. , Rosengren A. 
Published: October 2005

AbstractAims  To study clinical presentation, in‐hospital course and short‐term prognosis in men and women with diabetes mellitus and acute coronary syndromes (ACS).Methods  Men (n = 6488, 21.2% with diabetes) and 2809 women (28.7% with diabetes) ≤ 80 years old, with a discharge diagnosis of ACS were prospectively enrolled in the Euro Heart Survey of ACS.Results  Women with diabetes were more likely to present with ST elevation than non‐diabetic women, a difference that became more marked after adjustment for differences in smoking, hypertension, obesity, medication and prior disease [adjusted odds ratio (OR) 1.46 (1.20, 1.78)], whereas there was little difference between diabetic and non‐diabetic men [adjusted OR 0.99 (0.86, 1.14)]. In addition, women with diabetes were more likely to develop Q‐wave myocardial infarction (MI) than non‐diabetic women [adjusted OR 1.61 (1.30, 1.99)], while there was no difference between men with and without diabetes [adjusted OR 0.99 (0.85, 1.15)]. There were significant interactions between sex, diabetes and presenting with ST‐elevation ACS (P < 0.001), and Q‐wave MI (P < 0.001), respectively. Of the women with diabetes, 7.4% died in hospital, compared with 3.6% of non‐diabetic women [adjusted OR 2.13 (1.39, 3.26)], whereas corresponding mortality rates in men with and without diabetes were 4.1% and 3.3%, respectively [OR 1.13 (0.76, 1.67)] (P for diabetes–sex interaction 0.021).Conclusion  In women with ACS, diabetes is associated with higher risk of presenting with ST‐elevation ACS, developing Q‐wave MI, and of in‐hospital mortality, whereas in men with ACS diabetes is not significantly associated with increased risk of either. These findings suggest a differential effect of diabetes on the pathophysiology of ACS based on the patient's sex.
Contributing to the ICNP®: validating the term ‘informal settlement’
Authors: Geyer N. , Mmuwe‐Hlahane S. , Shongwe‐Magongo R. G. , Uys E. 
Published: October 2005

Aim:  The specific aims of this study were to propose a definition of the term informal settlement, validate the term informal settlement, and submit a term and definition for international utilization to the International Council of Nurses (ICN) for consideration for inclusion in the International Classification of Nursing Practice (ICNP®).Background:  South Africa was one of four African countries (Botswana, South Africa, Swaziland and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP® project. South Africa had two research groups. One of the research groups identified the term informal settlement to define.Methods:  This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the ICN was utilized to define and validate the term informal settlement.Findings:  Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN on 12 April 2001 as informal settlement is a type of residential development with the specific characteristics – temporary residential structures, erected with limited or no formal infrastructure, densely populated, no secure tenure for occupants, no property demarcations, often associated with overcrowding/limited or no privacy, and low standard of living, being situated in high risk areas with an increased risk for disease and disasters.Conclusion:  The ICNP® Evaluation Committee recommended inclusion in the ICNP® with minor changes in February 2003.
Nursing shortages and international nurse migration
Authors: Ross S. J. , Polsky D. , Sochalski J. 
Published: October 2005

Background: The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce.Aim: To predict the international migration of nurses to the UK using widely available data on country characteristics.Method: The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country‐level data from sources such as the World Bank and the World Health Organization.Results: The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low‐income, English‐speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK.Conclusion: Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.
How can academics stay in control?
Authors: Nijhuis Gerard Gervedink , Collis Betty 
Published: October 2005

AbstractAs universities transform into enterprises, academics are facing new challenges, especially in their teaching. This is because of the demands for student‐centred programmes that offer more flexibility, the use of Course Management Systems such as Blackboard, and the expectation that instructors will perform (more) efficiently and effectively. In this research, the focus is on teaching‐related activities to support instructors to stay in control, given these increasing pressures. A Personal Performance Model that shows key aspects of academics’ performance relating to teaching tasks was developed. A series of studies relating to gaps between expected and actual performance was carried out using the Human Performance Technology methodology. As an intervention based on these gaps, a Personal Performance Support Tool was developed to support instructors with their time and task management in relation to teaching, as well as to develop an elaborated insight on how to support instructors as they respond to changing expectations for their teaching performance. Key steps to guide universities in implementing such a support tool have been identified as a result of the research.