bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence That Kidney Function but Not Type 2 Diabetes Determines Retinol-Binding Protein 4 Serum Levels
Authors: Henze Andrea , Frey Simone K. , Raila Jens , Tepel Martin , Scholze Alexandra , Pfeiffer Andreas F. H. , Weickert Martin O. , Spranger Joachim , Schweigert Florian J. 
Published: September 2008

OBJECTIVE— It has been suggested that retinol-binding protein 4 (RBP4) links adiposity, insulin resistance, and type 2 diabetes. However, circulating RBP4 levels are also affected by kidney function. Therefore, the aim of this study was to test whether RBP4 serum levels are primarily associated with kidney function or type 2 diabetes.
RESEARCH DESIGN AND METHODS— RBP4 serum concentration was determined by enzyme-linked immunosorbent assay in 126 nondiabetic and 104 type 2 diabetic subjects. The study population was divided according to estimated glomerular filtration rate (eGFR) into the following groups: eGFR &gt;90 ml/min per 1.73 m2 (n = 53), 60–90 ml/min per 1.73 m2 (n = 90), 30–60 ml/min per 1.73 m2 (n = 38), and &lt;30 ml/min per 1.73 m2 (n = 49). Each group was subdivided into nondiabetic and type 2 diabetic subjects.
RESULTS— RBP4 serum concentration was elevated (2.65 vs. 2.01 μmol/l; P &lt; 0.001) and eGFR was reduced (56 vs. 74 ml/min per 1.73 m2; P &lt; 0.001) in type 2 diabetic vs. nondiabetic subjects, respectively. By stratifying for eGFR, no more differences in RBP4 serum concentration were detectable between type 2 diabetic and nondiabetic subjects. A linear regression analysis revealed an influence of eGFR (r = −0.477; P &lt; 0.001) but not A1C (r = 0.093; P = 0.185) on RBP4 serum concentration.
CONCLUSIONS— Existing human data showing elevated RBP4 levels in type 2 diabetic patients may be the result of moderate renal insufficiency rather than support for the suggestion that RBP4 links obesity to type 2 diabetes.
Value of Urinary Albumin-to-Creatinine Ratio as a Predictor of Type 2 Diabetes in Pre-Diabetic Individuals
Authors: Friedman Allon , Marrero David , Ma Yong , Ackermann Ronald , Narayan K.M. Venkat , Barrett-Connor Elizabeth , Watson Karol , Knowler William C. , Horton Edward S. ,   for the Diabetes Prevention Program Research Group
Published: September 2008

OBJECTIVE—The albumin-to-creatinine ratio (ACR) reflects urinary albumin excretion and is increasingly being accepted as an important clinical outcome predictor. Because of the great public health need for a simple and inexpensive test to identify individuals at high risk for developing type 2 diabetes, it has been suggested that the ACR might serve this purpose. We therefore determined whether the ACR could predict incident diabetes in a well-characterized cohort of pre-diabetic Americans.
RESEARCH DESIGN AND METHODS—A total of 3,188 Diabetes Prevention Program (DPP) participants with a mean BMI of 34 kg/m2 and elevated fasting glucose, impaired glucose tolerance, and baseline urinary albumin excretion measurements were followed for incident diabetes over a mean of 3.2 years.
RESULTS—Of the participants, 94% manifested ACR levels below the microalbuminuria range and 21% ultimately developed diabetes during follow-up. Quartiles of ACR (median [range] within quartiles: 1, 3.0 [0.7–3.7]; 2, 4.6 [3.7–5.5]; 3, 7.1 [5.5–9.7]; and 4, 16.5 [9.7–1,578]) were positively associated with age, markers of adiposity and insulin secretion and resistance, blood pressure, and use of antihypertensive agents with antiproteinuric effects and inversely related to male sex and serum creatinine. An elevated hazard rate for developing diabetes with doubling of ACR disappeared after adjustment for covariates. Within the DPP intervention groups (placebo, lifestyle, and metformin), we found no consistent trend in incident diabetes by quartile or decile of ACR.
CONCLUSIONS—An ACR at levels below the microalbuminuria range does not independently predict incident diabetes in adults at high risk of developing type 2 diabetes.
Inflammation and Progressive Nephropathy in Type 1 Diabetes in the Diabetes Control and Complications Trial
Authors: Lin Julie , Glynn Robert J. , Rifai Nader , Manson JoAnn E. , Ridker Paul M. , Nathan David M. , Schaumberg Debra A. 
Published: September 2008

OBJECTIVE—Progressive nephropathy represents a substantial source of morbidity and mortality in type 1 diabetes. Increasing albuminuria is a strong predictor of progressive renal dysfunction and heightened cardiovascular risk. Early albuminuria probably reflects vascular endothelial dysfunction, which may be mediated in part by chronic inflammation.
RESEARCH DESIGN AND METHODS—We measured baseline levels of four inflammatory biomarkers (high-sensitivity C-reactive protein, soluble intercellular adhesion molecule-1 [sICAM-1], soluble vascular cell adhesion molecule-1, and soluble tumor necrosis factor-α receptor-1) in stored blood samples from the 1,441 participants of the Diabetes Control and Complication Trial (DCCT). We used mixed-effects regression models to determine the average annual change in urinary albumin excretion rate (AER) by tertiles of each biomarker. We also used Cox proportional hazards models to estimate the relative risk of incident sustained microalbuminuria according to levels of each biomarker.
RESULTS—After adjustment for baseline age, sex, duration of diabetes, A1C, and randomized treatment assignment, we observed a significantly higher 5.9 μg · min−1 · year−1 increase in AER among those in the highest compared with the lowest tertile of baseline sICAM-1 (P = 0.04). Those in the highest tertile of sICAM-1 had an adjusted relative risk of 1.67 (95% CI 0.96–2.92) of developing incident sustained microalbuminuria (Ptrend = 0.03).
CONCLUSIONS—Higher baseline sICAM-1 levels predicted an increased risk of progressive nephropathy in type 1 diabetes and may represent an early risk marker that reflects the important role of vascular endothelial dysfunction in this long-term complication.
Tobacco Use Among Youth: Findings from the Global Youth Tobacco Survey in Montenegro
Authors: Ljaljević Agima , Zvrko Elvir , Stojiljković Marija 
Published: September 2008

Tobacco Use Among Youth: Findings from the Global Youth Tobacco Survey in MontenegroSmoking is a burning healthcare and economy issue, especially in underdeveloped countries. The aim of this study was to determine the number of smokers among elementary school students in Montenegro and to assess the correlates of tobacco use. The study was done in 2003 using the World Health Organization Global Youth Tobacco Survey. Our data showed that children as young as ten years smoked. There were 3.6 % permanent smokers and one in three students (30.6 %) experimented with smoking. More than two thirds who smoked agreed that they should quit smoking, and three fourths tried to quit. This study has also shown that children talk too little about smoking in schools and are exposed to passive smoking at home and elsewhere. Activities to solve the elementary school smoking problem should include preventive programs to be introduced into regular school curricula because this is the only way to address the issue properly. In addition, legislation prohibiting indoor tobacco smoking should be implemented rigorously to protect children from passive smoking in public places.
Health Education and Communication in Occupational Health Services in Finland
Authors: Palmgren Helena , Jalonen Päivi , Kaleva Simo 
Published: September 2008

Health Education and Communication in Occupational Health Services in FinlandThis article discusses health education and communication in Occupational Health Services (OHS) based on a questionnaire study conducted in Finnish OHS in 2005. The study focused on educational activities carried out by OH professionals and directed at individual employees, work communities and groups, and representatives of client organisations. The questionnaire was sent to 1132 OH professionals - physicians, nurses, physiotherapists and psychologists - working in 130 OHS units, and representing different OHS providers in Finland. 635 respondents (162 physicians, 342 nurses, 96 physiotherapists, 35 psychologists) returned the questionnaire. The overall response rate was 58 %. There were statistically significant differences in educational activities by different professional groups; differences were also related to the length of working experience in OHS. For all OH professionals, individual employees were the primary clients of health education and communication. Education was less often directed at work communities and representatives of client organisations. However, many issues related to health and well-being at work are not within the reach of individual employees. The impact of health education would be more evident if it also reached those organisational stakeholders with discretion in decision-making. Furthermore, OH personnel should pay attention to the social aspect of learning and work more with groups and work communities.
Predictors of Home Exercise Adherence in Older People with Osteoarthritis
Authors: Schoo Adrian M. M. , Morris Meg E. , Bui Quang M. 
Published: September 2008

Purpose: To identify factors associated with adherence to prescribed exercises in elderly, community-dwelling people with knee and/or hip osteoarthritis. Methods: Logistic regression was used to investigate associations among variables at the beginning of a home exercise program, after 4 weeks of performing exercises (test 2), and at the end of the 8-week program (test 3). Outcome measures were self-reported home exercise adherence at tests 2 and 3, and the predictors were exercise adherence behaviour in the clinic, concurrent physical activity, perception of being physically inactive, and correctness of exercise performance. Results: Home exercise adherence at test 2 was associated with “in-clinic” exercise adherence behaviour at test 2 (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.09–2.01). There were significant associations between home exercise adherence at test 3 and (1) home exercise adherence at test 2 (OR = 19.86; 95% CI = 4.84–81.56); (2) concurrent physical activity at test 3 (OR = 5.58; 95% CI = 1.15–27.05); and (3) the perception of not being physically active at test 1 (OR = 0.07; 95% CI = 0.01–0.52). No associations were found between home exercise adherence and correctness of exercise performance or between home exercise adherence at test 2 and concurrent physical activity at test 2. Conclusions: People who closely adhered to prescribed exercises in the clinic were more likely to adhere at home. Home exercise adherence in weeks 1 to 4 was the strongest predictor of home exercise adherence in weeks 5 to 8. Participants who were physically active at the time of the home program were more likely to perform their home exercises, whereas those who perceived themselves to be inactive at the time of exercise prescription were less likely to maintain exercise at home.
Comparison of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lower Extremity Functional Scale (LEFS) Questionnaires in Patients Awaiting or Having Undergone Total Knee Arthroplasty
Authors: Jogi Pankaj , Kramer John F. , Birmingham Trevor 
Published: September 2008

Purpose: The purpose of this study was to determine the relationship between two functionally oriented health status measures, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lower Extremity Functional Scale (LEFS), in patients awaiting or having undergone total knee arthroplasty (TKA). Methods: Patients who were on the waiting list for TKA (n = 150) or who had undergone TKA (n = 150) received a mailed questionnaire. Results: Responses were tabulated for 187 completed questionnaires. Although correlations of r = .87 to .89 were observed between scores on the WOMAC physical function and the LEFS questionnaires, the standard error of estimate associated with using one questionnaire to predict scores on the other was large (F6 to F8). The relative efficiency of the WOMAC and the LEFS was similar, as were their relationships with the patients' ability to walk and ascend or descend stairs. Respondents indicated no clear preference for either questionnaire. Conclusions: Although related, scores from the WOMAC and the LEFS were not directly interchangeable. Both the WOMAC and the LEFS have advantages. Clinicians' use of one or both of these health status measures in patients with TKA depends on their anticipated use of the information.
Test–Retest and Interrater Reliability of Goniometric Tibial Rotation Range of Motion Measurements
Authors: Makowski Agnes , Birmingham Trevor , Kramer John , Jogi Pankaj , Forwell Lorie , Obright Kathy 
Published: September 2008

Purpose: Although suggested to be an important component of physiologic knee function, the ability to accurately assess tibial rotation range of motion (ROM) is currently limited by a lack of reliability data for clinically practical measurement tools. The purpose of the present study was to estimate the reliability of tibial rotation ROM measurements taken with subjects in sitting and supine positions. Methods: Thirty healthy subjects (mean age 37 ± 12 years) completed maximal active internal and external tibial rotation movements in sitting and supine positions. ROM was assessed on two occasions and by two raters using a gravity- and magnetic-referenced goniometer. Results: There were significant differences between internal and external rotation ROM values (p < .05) and between values obtained with subjects in sitting and supine positions (p < .05). Intraclass correlation coefficients (ICCs) suggested that test–retest reliability for all measurements was excellent (ICC = 0.83–0.93), whereas interrater reliability was poor to excellent (ICC = 0.39–0.81). Standard errors of measurement ranged from approximately 1 to 2°. Conclusions: These findings suggest that tibial rotation ROM can be assessed reliably by one rater using one test position. However, caution must be adopted when comparing ROM measurements assessed by different raters or in different test positions.
Home-Based Physiotherapy for the Elderly: A Different World
Authors: Heckman Kristine A. , Cott Cheryl A. 
Published: September 2008

Purpose: Recent changes in health service delivery have resulted in a shift in provision of services from the hospital to the community. These changes require an examination of the knowledge and skills used by physiotherapists working in the home setting. The purpose of this study is to understand the practice of physiotherapy within the context of the elderly client's home. Method: Using semistructured interviews with 12 home-based physiotherapists, a focussed ethnographic approach was used to explore the practice of home care physiotherapy in Ontario. Data were analyzed using a coding/categorizing approach. Results: The client's home as the context in which physiotherapy services are provided has meaning beyond merely the location where the therapeutic intervention occurs. Practicing in the world of the client requires a broad array of knowledge and skills that go far beyond notions of traditional physiotherapy. Physiotherapists in the community rely heavily on their tacit, professional craft knowledge, but, ironically, they often feel that these skills are not “really” physiotherapy. Conclusions: The findings highlight the need to expand our notions of professional knowledge beyond traditional propositional knowledge to include professional craft knowledge.
Influence of Age and Gender of Healthy Adults on Scoring Patterns on the Community Balance and Mobility Scale
Authors: Rocque Rohini , Bartlett Doreen , Brown Janet , Garland S. Jayne 
Published: September 2008

Purpose: The purpose of the study was to describe and compare scoring patterns on the Community Balance and Mobility Scale (CB&M) in healthy men and women between 30 and 59 years of age. Methods: Following criterion testing on 5 individuals, 90 healthy volunteers who met the inclusion criteria and consented to participate in the study were tested on the CB&M. The subjects were recruited through quota sampling in three age categories: 30 to 39 years, 40 to 49 years, and 50 to 59 years, with 15 men and 15 women in each age category. The groups were not matched for any anthropometric variables. Results: Women within the age category of 50 to 59 years had significantly lower scores on the CB&M compared with all other age and gender categories. Conclusions: The results from this study indicate that although the items on the CB&M were appropriate for the 30- to 59-year age categories, some items still posed a challenge to healthy participants because most were unable to score full points on the CB&M. The normative data from the present study could help clinicians put the CB&M scores of middle-aged patients into context. These data may also be useful in making recommendations regarding the safe integration of patients back into the community following mild stroke.
Influence of Exercise-Induced Injury on Knee Extension Torque in the Presence of Long-Standing Quadriceps Atrophy: Case Report
Authors: Mathur Sunita , MacIntyre Donna L. , Forster Bruce B. , Reid W. Darlene 
Published: September 2008

Purpose: The purposes of this case report were (1) to describe muscle volume and torque-generating capacity of the quadriceps muscle in a 46-year-old woman 16 years following tibial plateau fracture and (2) to compare the decline and recovery of quadriceps torque following exerciseinduced muscle damage between the affected and unaffected lower extremity (LE). Methods: Magnetic resonance imaging was used to determine quadriceps volume. Repeated measures of concentric, eccentric, and isometric torque and muscle soreness were acquired for quadriceps bilaterally during four baseline tests, as well as 2 hours and 1, 2, 11, 12, and 13 days after exerciseinduced muscle damage (eccentric exercise). Results: At baseline, the affected quadriceps showed profound atrophy (74% of unaffected quadriceps volume) and deficits in all torque measures. Exercise-induced muscle damage resulted in slight delayed-onset muscle soreness and a decrease in all torque measures bilaterally. In the affected LE at 13 days after exercise, eccentric torque did not recover and isometric torque on the affected side recovered only partially. Conclusions: Quadriceps atrophy and torque deficit can be substantial long after tibial plateau fracture. Eccentric torque was the most sensitive measure of torque deficit, showing only partial recovery after exercise-induced muscle damage.
A Descriptive Survey of Injury Patterns in Canadian Premier Highland Dancers
Authors: Henderson Jaclyn , MacIntyre Donna 
Published: September 2008

Purpose: This descriptive study investigated patterns of injury in various age groups of Canadian Premier-level Highland dancers. Methods: Highland dance teachers were mailed questionnaires to distribute to their students. The questionnaire covered three major topics: demographics, practice habits and non-dance activities, and pain and injury. Dancers were required to be of Premier level and registered under ScotDance Canada. Results: Of the 333 questionnaires distributed, 136 (41%) were returned and completed correctly. Eighty-four percent (n = 114) of the respondents reported experiencing pain and injury as a result of Highland dancing. The number of dancers with pain and injury increased to 100% in the top two age groups (p < .001). The knee, lower leg, ankle, and foot were the most common sites of reported injury. Conclusions: This study suggests that Canadian Highland dancers are at high risk of pain and injury. Further research is required to assist dancers and health professionals in preventing and treating these injuries.
Cardiovascular Fitness and Adaptations to Aerobic Training after Stroke
Authors: MacKay-Lyons Marilyn J. , Macko Richard , Howlett Jonathan 
Published: September 2008

Purpose: This article presents an overview of the current state of knowledge of physiological indicators of cardiovascular fitness after stroke. Clinical tips are presented regarding training protocols appropriate for persons post-stroke. Summary of Key Points: Application of the principles of exercise physiology to stroke rehabilitation has begun to attract the attention of clinicians owing to increased awareness of the profoundly poor fitness levels of persons in the early and chronic post-stroke periods. Contributors to the low exercise capacity range from personal and environmental factors to cardiovascular, neuromuscular, and respiratory dysfunction associated with stroke. Low fitness levels, in turn, negatively influence these factors and, ultimately, health-related quality of life. Nevertheless, there is growing evidence that persons in both the early and chronic post-stroke periods can make cardiovascular adaptations to aerobic training. Conclusions: Given that persons post-stroke respond positively to aerobic exercise if appropriate screening and training protocols are used, implementation of training makes practical sense. However, there is limited information on specific evidence-based guidelines for stroke rehabilitation in clinical and community settings to improve exercise capacity and to protect against further cardiovascular morbidity and mortality.
Validation of Three Shortened Versions of the Chedoke Arm and Hand Activity Inventory
Authors: Barreca Susan R. , Stratford Paul W. , Masters Lisa M. , Lambert Cynthia L. , Griffiths Jeremy , McBay Catherine 
Published: September 2008

Purpose: To estimate the reliability and validity of three shortened versions of the Chedoke Arm and Hand Activity Inventory (CAHAI). Method: The study sample consisted of 39 individuals who had had a stroke. Twenty-four individuals were classified as acute and 15 as chronic. The CAHAI-13 was administered three times: an initial assessment, a second assessment within 36 hours, and a final assessment two to six weeks after the initial assessment. The Action Research Arm Test (ARAT) and the Chedoke-McMaster Stroke Assessment were administered at the first and third time points. Based on the clinical judgment of four therapists, seven-, eight-, and nine-item versions of the CAHAI were produced. Test–retest reliability and cross-sectional and longitudinal validity (sensitivity to change) were evaluated. Results: Test–retest reliability varied from 0.96 for the CAHAI-7 to 0.97 for the CAHAI-8 and CAHAI-9. Cross-sectional validity for the ARAT was 0.95, 0.95, and 0.94, and longitudinal validity was 0.97, 0.93, and 0.94 for the seven-, eight-, and nine-item versions of the CAHAI, respectively. Conclusions: All shortened versions maintained the same high degree of reliability and construct and longitudinal validity as the original CAHAI-13. Therapists and researchers may select from three valid, shorter versions of a new upper limb functional measure to facilitate effective standardized assessment within limited time and resources.