bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled trial of adding the nicotine patch to rimonabant for smoking cessation: efficacy, safety and weight gain
Authors: Rigotti Nancy A. , Gonzales David , Dale Lowell C. , Lawrence Daniel , Chang Yuchiao 
Published: January 2009

ABSTRACTAims Because smoking cessation rates might be improved by combining drugs and by reducing post‐cessation weight gain, we tested the smoking cessation efficacy, safety and effect on body weight of adding the nicotine patch to rimonabant, a cannabanoid type‐1 receptor antagonist that reduces body weight.Design Randomized double‐blind placebo‐controlled trial.Setting Fifteen US research centers.Participants A total of 755 smokers (≥15 cigarettes/day).Intervention Rimonabant (20 mg daily) was given open‐label for 9 weeks. The 735 participants completing week 1 were randomized at day 8 (target quit day) to add a nicotine patch (n = 369) or placebo patch (n = 366) for 10 weeks (21 mg daily for 8 weeks plus a 2‐week taper). Participants received weekly smoking counseling and were followed for 24 weeks.Measurements Biochemically validated 4‐week continuous abstinence at end‐of‐treatment (weeks 6–9; primary end‐point); 7‐day point prevalence abstinence at weeks 9 and 24; sustained abstinence (weeks 6–24); change in body weight; and adverse events.Findings Rimonabant plus nicotine patch was superior to rimonabant plus placebo in validated continuous abstinence at weeks 6–9 (39.0% versus 21.3%; odds ratio 2.36, 95% confidence interval: 1.71–2.37;P < 0.01) and in all other efficacy measures. Mean end‐of‐treatment weight gain among quitters did not differ between groups (0.04 kg for combination versus 0.49 kg for rimonabant only,P = 0.15) and was similar in weight‐concerned smokers. Serious adverse event rates did not differ between groups. Depression‐ and anxiety‐related adverse events occurred in 32 (4.2%) and 44 (5.8%) subjects, respectively; eight (1.1%) and nine (1.2%) subjects stopped the drug due to depression and anxiety, respectively.Conclusions Adding a nicotine patch to rimonabant was well tolerated and increased smoking cessation rates over rimonabant alone. There was little post‐cessation weight gain in either group, even among weight‐concerned smokers, during drug treatment.
Buprenorphine tapering schedule and illicit opioid use
Authors: Ling Walter , Hillhouse Maureen , Domier Catherine , Doraimani Geetha , Hunter Jeremy , Thomas Christie , Jenkins Jessica , Hasson Albert , Annon Jeffrey , Saxon Andrew , Selzer Jeffrey , Boverman Joshua , Bilangi Richard 
Published: January 2009

ABSTRACTAims To compare the effects of a short or long taper schedule after buprenorphine stabilization on participant outcomes as measured by opioid‐free urine tests at the end of each taper period.Design This multi‐site study sponsored by Clinical Trials Network (CTN, a branch of the US National Institute on Drug Abuse) was conducted from 2003 to 2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits to the end of the taper periods, and at 1‐month and 3‐month post‐taper follow‐up visits.Setting Eleven out‐patient treatment programs in 10 US cities.Intervention Non‐blinded dosing with Suboxone® during the 1‐month stabilization phase included 3 weeks of flexible dosing as determined appropriate by the study physicians. A fixed dose was required for the final week before beginning the taper phase.Measurements The percentage of participants in each taper group providing urine samples free of illicit opioids at the end of the taper and at follow‐up.Findings At the end of the taper, 44% of the 7‐day taper group (n = 255) provided opioid‐free urine specimens compared to 30% of the 28‐day taper group (n = 261;P = 0.0007). There were no differences at the 1‐month and 3‐month follow‐ups (7‐day = 18% and 12%; 28‐day = 18% and 13%, 1 month and 3 months, respectively).Conclusion For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper.
The humanized CD40 antibody SGN‐40 demonstrates pre‐clinical activity that is enhanced by lenalidomide in chronic lymphocytic leukaemia
Authors: Lapalombella Rosa , Gowda Aruna , Joshi Trupti , Mehter Najma , Cheney Carolyn , Lehman Amy , Chen Ching‐Shih , Johnson Amy J. , Caligiuri Michael A. , Tridandapani Susheela , Muthusamy Natarajan , Byrd John C. 
Published: January 2009

SummaryAntibody‐based therapies, such as rituximab and alemtuzumab, have contributed significantly to the treatment of Chronic Lymphocytic leukaemia (CLL). The CD40 antigen is expressed predominantly on B‐cells and represents a potential target for immune‐based therapies. SGN‐40 is a humanized IgG1 monoclonal antibody currently in Phase I/II clinical trials for indolent lymphomas, diffuse large B cell lymphomas and Multiple Myeloma. Its biological effect on CLL cells has not been studied. The present study demonstrated that SGN‐40 mediated modest apoptosis in a subset of patients with secondary cross‐linking but did not mediate complement‐dependent cytotoxicity. SGN‐40 also mediated antibody‐dependent cellular cytotoxicity (ADCC) predominantly through natural killer (NK) cells. Previous studies by our group and others have demonstrated that lenalidomide upregulates CD40 expression on primary B CLL cells and activates NK‐cells. We therefore examined for the combinatorial effect of lenalidomide and SGN‐40 and demonstrated that both enhanced direct apoptosis and ADCC against primary CLL B cells. These data together provide justification for clinical trials of SGN‐40 and lenalidomide in combination for CLL therapy.
Treeline shifts in the Ural mountains affect soil organic matter dynamics
Authors: KAMMER ADRIAN , HAGEDORN FRANK , SHEVCHENKO ILYA , LEIFELD JENS , GUGGENBERGER GEORG , GORYACHEVA TAMARA , RIGLING ANDREAS , MOISEEV PAVEL 
Published: January 2009

AbstractHistorical photographs document that during the last century, forests have expanded upwards by 60–80 m into former tundra of the pristine Ural mountains. We assessed how the shift of the high‐altitude treeline ecotone might affect soil organic matter (SOM) dynamics. On the gentle slopes of Mali Iremel in the Southern Urals, we (1) determined the differences in SOM stocks and properties from the tundra at 1360 m above sea level (a.s.l.) to the subalpine forest at 1260 m a.s.l., and (2) measured carbon (C) and nitrogen (N) mineralization from tundra and forest soils at 7 and 20 °C in a 6‐month incubation experiment. C stocks of organic layers were 3.6±0.3 kg C m−2 in the tundra and 1.9±0.2 kg C m−2 in the forest. Mineral soils down to the bedrock stored significantly more C in the forest, and thus, total soil C stocks were slightly but insignificantly greater in the forest (+3 kg C m−2). Assuming a space for time approach based on tree ages suggests that the soil C sink due to the forest expansion during the last century was at most 30 g C m−2 yr−1. Diffuse reflective infrared spectroscopy and scanning calorimetry revealed that SOM under forest was less humified in both organic and mineral horizons and, therefore, contained more available substrate. Consistent with this result, C mineralization rates of organic layers and A horizons of the forest were two to four times greater than those of tundra soils. This difference was similar in magnitude to the effect of increasing the incubation temperature from 7 to 20 °C. Hence, indirect climate change effects through an upward expansion of forests can be much larger than direct warming effects (Δ0.3 K across the treeline). Net N mineralization was 2.5 to six times greater in forest than in tundra soils, suggesting that an advancing treeline likely increases N availability. This may provide a nutritional basis for the fivefold increase in plant biomass and a tripling in productivity from the tundra to the forest. In summary, our results suggest that an upward expansion of forest has small net effects on C storage in soils but leads to changes in SOM quality, accelerates C cycling and increases net N mineralization, which in turn might stimulate plant growth and thus C sequestration in tree biomass.
The role of climate in the dynamics of a hybrid zone in Appalachian salamanders
Authors: WALLS SUSAN C. 
Published: January 2009

AbstractI examined the potential influence of climate change on the dynamics of a previously studied hybrid zone between a pair of terrestrial salamanders at the Coweeta Hydrologic Laboratory, U.S. Forest Service, in the Nantahala Mountains of North Carolina, USA. A 16‐year study led by Nelson G. Hairston, Sr. revealed thatPlethodon teyahaleeandPlethodon shermanihybridized at intermediate elevations, forming a cline between ‘pure’ parentalP. teyahaleeat lower elevations and ‘pure’ parentalP. shermaniat higher elevations. From 1974 to 1990 the proportion of salamanders at the higher elevation scored as ‘pure’P. shermanideclined significantly, indicating that the hybrid zone was spreading upward. To date there have been no rigorous tests of hypotheses for the movement of this hybrid zone. Using temperature and precipitation data from Coweeta, I re‐analyzed Hairston's data to examine whether the observed elevational shift was correlated with variation in either air temperature or precipitation from the same time period. For temperature, my analysis tracked the results of the original study: the proportion of ‘pure’P. shermaniat the higher elevation declined significantly with increasing mean annual temperature, whereas the proportion of ‘pure’P. teyahaleeat lower elevations did not. There was no discernable relationship between proportions of ‘pure’ individuals of either species with variation in precipitation. From 1974 to 1990, low‐elevation air temperatures at the Coweeta Laboratory ranged from annual means of 11.8 to 14.2 °C, compared with a 55‐year average (1936–1990) of 12.6 °C. My re‐analyses indicate that the upward spread of the hybrid zone is correlated with increasing air temperatures, but not precipitation, and provide an empirical test of a hypothesis for one factor that may have influenced this movement. My results aid in understanding the potential impact that climate change may have on the ecology and evolution of terrestrial salamanders in montane regions.
Nurse practitioners substituting for general practitioners: randomized controlled trial
Authors: Dierick‐van Daele Angelique T.M. , Metsemakers Job F.M. , Derckx Emmy W.C.C. , Spreeuwenberg Cor , Vrijhoef Hubertus J.M. 
Published: January 2009

AbstractTitle.  Nurse practitioners substituting for general practitioners: randomized controlled trial. Aim.  This paper is a report of a study conducted to evaluate process and outcomes of care provided to patients with common complaints by general practitioners or specially trained nurse practitioners as first point of contact.Background.  Studies in the United States of America and Great Britain show that substituting nurse practitioners for general practitioners results in higher patient satisfaction and higher quality of care. As the American and British healthcare system and settings differ from that in the Netherlands, a Dutch trial was conducted.Methods.  A total of 1501 patients in 15 general practices were randomized to consultation by a general practitioner or a nurse practitioner. Data were collected over a 6‐month period in 2006 by means of questionnaires, extracting medical records from practice computer systems and recording the length of consultations.Findings.  In both groups, the patients highly appreciated the quality of care. No statistically significant differences were found in health status, medical resource consumption and compliance of practical guidelines in primary care in the Netherlands. Patients in the NP intervention group were more often invited to re‐attend, had more follow‐up consultations and their consultations took statistically significantly longer.Conclusion.  Nurse practitioners and general practitioners provide comparable care. Our findings support an increased involvement of specially trained nurse practitioners in the Dutch primary care and contribute to knowledge of the effectiveness of care provision by nurse practitioners from a national and international perspective.
Jordanian nurses’ knowledge and practice of breast self‐examination
Authors: Alkhasawneh Israa M. , Akhu‐Zaheya Laila M. , Suleiman Samah M. 
Published: January 2009

AbstractTitle.  Jordanian nurses’ knowledge and practice of breast self‐examination. Aim.  This paper is a report of a study to evaluate the knowledge and practice of Jordanian nurses in relation to breast self‐examination.Background.  Studies have shown that women who have learned about breast self‐examination have positive attitudes toward breast cancer and practise breast self‐examination more frequently, and that nurses who teach their clients about methods of early detection and breast self‐examination are more knowledgeable about breast cancer screening and breast self‐examination techniques than those who do not. Therefore, it is important to understand nurses’ knowledge about breast cancer and its early detection.Methods.  A cross‐sectional design was used, with a convenience sample of 347 Registered Nurses at three large cities in Jordan (response rate 95%). Data collection took place in 2005 using a self‐administrated questionnaire with three parts and based on the American Cancer Society’s guidelines: demographics, knowledge, and practice of breast self‐examination.Results.  Nurses reported high levels of knowledge of breast self‐examination (M = 7·6, sd. 2·7). A high proportion of nurses reported doing breast self‐examination in the past 12 months (85%), but only 17·7% reported doing so on a monthly basis. None of the demographic characteristics was found to be associated with the practice of breast self‐examination.Conclusion.  More health education about monthly breast self‐examination and prevention strategies is needed for nurses and their women patients, especially for Arabic women.
Patient and public involvement: models and muddles
Authors: Forbat Liz , Hubbard Gill , Kearney Nora 
Published: January 2009

Aims and objectives.  This paper explores the range of models of involvement which are drawn upon in an empirical study and which are invoked in the literature and policy. The results and discussion of the study help to excavate and explore the muddle of conceptualisations of involvement and how this leads to difficulties for practitioners, patients and managers in implementing the relevant policy.Background.  Patient and public involvement has developed an important profile internationally within health and social care policy. However, its importance as a rhetorical device has not been accompanied by adequate developments in how it is operationalised.Design.  Cross‐sectional study, with an intervention conducted at three sites, and non‐intervention measures taken at two control sites.Methods.  This paper draws on an empirical study of involvement. Focus groups were conducted with a lung cancer team and people affected by cancer at five health boards across Scotland. Chief executives of each of these five health boards also took part in individual interviews. Participants were asked to describe their ideas of what involvement is and their application of it.Results.  A range of ways of conceptualising involvement were apparent. Few of these moved beyond the use of patient satisfaction questionnaires. At times, troubling understandings were articulated, for example, using public meetings to communicate decisions about service closures to the public.Conclusion.  The slow escalation of involvement is in part because of the myriad ways in which it is conceptualised and discussed. Thus, we conclude that one of the greatest barriers to truly integrating patient involvement into health services, policy and research is the conceptual muddle with which involvement is articulated, understood and actioned.Relevance to clinical practice.  Clinicians need to be supported to seek clarity in the use and operationalisation of involvement if the agenda is to be truly adopted and strengthened.
Menstrual and menarche experience among pubescent female students in Taiwan: implications for health education and promotion practice
Authors: Chang Yu‐Ting , Chen Yueh‐Chih , Hayter Mark , Lin Mei‐Ling 
Published: January 2009

Aims and objectives.  This study aimed to explore the menarche and menstruation experiences of young females aged 10–12 years in elementary education in Taiwan.Background.  Menarche is a significant milestone in a woman’s life and for female adolescents it is a sharply defined biological event that can be a traumatic and uncomfortable time. If used, school nurses can make a significant contribution in educating young people and help to ameliorate these problems. Understanding how young women feel about menstruation is a central element to sexual health education practice.Design.  A qualitative research design was employed using focus groups.Methods.  Data were collected from 20 female students, aged between 10–12 years. Focus groups were recorded, transcribed and subject to a thematic analysis.Results.  Three themes emerged from the data analysis reflecting the menstrual experience of participants. These were: ‘Changing bodies: the physical effects of menarche and menstruation’, ‘Emotional issues: the psychological impact of menarche and menstruation’ and ‘Social dimensions of the menarche and menstruation’.Conclusion.  Our findings show that young females can experience significant physical and emotional difficulties around menstruation – many of which stem from poor information and the reactions of their peer group to menstrual activity. The potential for school nurses to contribute to this education is significant and schools should explore the manner in which nurses can contribute to this area of health education.Relevance to clinical practice.  Nurses involved in health education work with young people and ensure that menstruation education addresses the social and psychological impact of the menarche as well as the physical elements of menstruation. Boys should not be absent from this education and the impact of their attitudes towards menstruation upon their female peers should be addressed in health education work.
Factors influencing women in seeking help from a health care professional on self discovery of a breast symptom, in an Irish context
Authors: O’Mahony Mairin , Hegarty Josephine 
Published: January 2009

Aim.  To identify the extent of delay and the factors influencing women in seeking help from a health care professional on self discovery of a breast symptom, in an Irish context.Background.  Breast cancer is the most common malignancy among women in the developed world. In Ireland, 2700 women are diagnosed with breast cancer and over 900 die from it annually. A longer delay in presenting with breast symptoms is associated with a lower rate of survival from breast cancer. However, many women wait for longer than three months before presenting to a health care professional on self discovery of a breast symptom.Design.  A quantitative correlational design was used.Methods.  Data were collected using the ‘Women’s help seeking for breast symptoms’ questionnaire. Women were recruited in the breast clinic prior to their visit with the consultant.Results.  A total of 100 women participated, 99 of whom fully completed the questionnaire. Mean age was 40 years. It was found that 72·7% (n = 73) of women visited their GP within one month, 14·1% (n = 14) within one to three months and 10% (n = 12) after three months. Delay time was significantly related to women’s knowledge and beliefs and social issues. Conversely, help seeking also correlated to women’s knowledge and beliefs about the symptom and the anxiety surrounding the initial symptom discovery period.Conclusion.  Despite breast health promotion campaigns, many women delay for one month or more, in seeking help from a health care professional for self discovered breast symptoms. Prolonged delay has potential to impact on survival from breast cancer. This highlights the need for continued education and breast health promotion for women.Relevance to clinical practice.  Health care professionals need to be aware of possible reasons for delay in seeking help for self discovered breast symptoms and explore new ways to address these barriers.
Relationship between familiar environment and wandering behaviour among Korean elders with dementia
Authors: Hong Gwi‐Ryung Son , Song Jun‐Ah 
Published: January 2009

Aim.  To explore the relationship between wandering behaviour and familiar environment in community‐residing persons with dementia in Korea.Background.  Numerous non‐pharmacological interventions have been developed to decrease behavioural symptoms and to increase the quality of life among persons with dementia. Although the concept of familiarity is very important and environmental interventions using the concept should have been developed for persons with dementia, no study examining even the direct relationship between familiar environment and wandering has yet been published.Design.  A descriptive, cross‐sectional survey design.Methods.  A convenience sample was gathered of 77 non‐institutionalised, community‐dwelling persons with dementia and their family caregivers in Seoul and Wonju, South Korea. Descriptive statics, Pearson’s correlations, t‐tests, and multiple regressions were used in the data analysis.Results.  The mean age of persons with dementia was 76·9 years (SD 8·0) and their mean cognitive level score using the Mini‐Mental State Examination was 13·51 (SD 6·10). Most persons with dementia (71·4%) had been diagnosed with known types of dementia such as Alzheimer’s disease, multiple infarct dementia, mixed type or Parkinson’s disease with dementia. A familiar feeling with the environment was associated with cognitive impairment (r = 0·32, p < 0·01) and physical dependency in activities of daily living (r = −0·38, p <0·01). In addition, a familiar feeling with the environment (r = −0·56, p < 0·001) and physical dependency in activities of daily living (r = 0·56, p < 0·001) were strongly related to wandering behaviour. Familiarity and physical dependency in activities of daily living were the significant predictors for overall wandering and they explained 45% of the total variance. Cognitive impairment was the only significant predictor on the subscale of spatial disorientation.Conclusions.  It was found that a familiar feeling with the environment was an important factor affecting persons with dementia’s cognitive and functional abilities as well as specific features of wandering. However, future research using a more reliable method is necessary to confirm the findings obtained in this study.Relevance to clinical practice.  This study suggested that providing persons with dementia with a familiar feeling in daily clinical practice through establishment of familiar physical as well as psychosocial environment may have benefit to decrease wandering behaviour.