bluuebunny/crossref_metadata_2025_split huggingface dataset:
A quasi‐experimental study on a community‐based stroke prevention programme for clients with minor stroke
Authors: Sit Janet WH , Yip Vera YB , Ko Stanley KK , Gun Amy PC , Lee Judy SH 
Published: January 2007

Aim.  The aim of this study was to determine the effectiveness of a community‐based stroke prevention programme in (1) improving knowledge about stroke; (2) improving self‐health‐monitoring practice; (3) maintaining behavioural changes when adopting a healthy lifestyle for stroke prevention.Background.  People with minor stroke (or transient ischaemic attack) tend to under‐estimate the long‐term impact of this on their health. The challenge for nurses is to prevent subsequent strokes by finding ways to promote and sustain appropriate behaviours. Educational intervention is of paramount importance in equipping those at risk with relevant knowledge and self‐care strategies for secondary stroke prevention.Design.  This study adopted a quasi‐experimental design.Method.  One hundred and ninety subjects were recruited, of whom 147 (77 in the intervention group and 70 in the control group) completed the study. Data were obtained at three time points: baseline (T0); one week after (T1) and three months after (T2) the intervention. The intervention programme consisted of eight weekly two‐hour sessions, with the aims of improving the participants’ awareness of their own health signals and of actively involving them in self‐care management of their own health for secondary stroke prevention.Results.  Significant positive changes were found among participants of the intervention group in the knowledge on stroke warning signs (P < 0·001); treatment seeking response in case of a stroke (P < 0·001); medication compliance (P < 0·001); self blood pressure monitoring (P < 0·001) as well as lifestyle modification of dietary habits (reduction in salted food intake, P = 0·004). No significant improvement was found in walking exercise participation in the intervention group, yet a significant decrease was detected among the control group.Conclusion.  This study found a three‐month‐sustained effect of positive changes in knowledge and skill from participants who undertook a nurse‐led community‐based stroke prevention programme.Relevance to clinical practice:  Effective educational intervention by professional nurses helped clients integrate their learned knowledge into their real‐life practice. This empowering, that is, the taking of responsibility by clients for their own self‐care management on a daily basis, affirms that patient education has moved beyond teaching people facts.
The efficacy of acupressure for decreasing agitated behaviour in dementia: a pilot study
Authors: Yang Man‐Hua , Wu Shiao‐Chi , Lin Jaung‐Geng , Lin Li‐Chan 
Published: January 2007

Aims and objectives.  To investigate the efficacy of acupressure in decreasing agitated behaviours associated with dementia.Background.  Agitated behaviour is found in nearly half of all patients who have dementia. The presence of these behaviours increases the likelihood of injury, weakness, dehydration and lack of sleep and contributes to caregiver frustration and fatigue.Design.  This pilot study was designed with subjects receiving both acupressure and the control treatment. Each subject served as his or her own control. Subjects received four weeks of acupressure protocols; to avoid a carry‐over effect there was a treatment‐free period of one week. Subjects then were visited by one of the investigators for a six‐week period.Methods.  Participants were recruited from a nursing home caring specifically for patients with dementia. Twenty of the 31 subjects (64·5%) completed the study, while 11 were discharged or hospitalized. All the subjects were assigned to an experimental protocol and had a six‐week acupressure treatment program. Baseline data were collected in the first week. Individual treatment sessions began at the second week of the study and lasted 15 minutes, twice a day, five days a week for four weeks. After a treatment‐free period of one week, all the subjects served as controls undergoing a four‐week control protocol consisting of companionship and conversation.Results.  Comparison between the control and experimental phases indicated significant differences between the two groups on all outcome measures (Cohen–Mansfield Agitation Inventory, daily agitation records about physical attack, verbal and non‐verbal attack and non‐physical attack) with better results found during the acupressure phase.Conclusions.  Acupressure is recommended as an efficacious and non‐intrusive method for decreasing the agitation behaviours in patients with dementia.Relevance to clinical practice.  Conducting the acupressure treatment takes 15 minutes. It could provide caregivers with a viable alternative to deal with patients with dementia.
‘Sorting the wheat from the chaff’: investigating overload in educational discussion systems
Authors: Kear K.L. , Heap N.W. 
Published: January 2007

Abstract  This paper reports on research to investigate design features of asynchronous discussion systems for higher education. The research aims to identify features that increase the benefits of discussion systems and reduce the problems. The paper focuses on a major theme that emerged from interviews with learners and teachers: information overload.Interview findings, together with literature and system reviews, were used to identify four areas of possible system enhancement aimed at alleviating overload: branched message threading; user recommendations of messages; message filtering; and a personal ‘clippings’ area for useful messages. The paper discusses these enhancements and their evaluation in a prototype discussion system used on a UK Open University course.Data from the student evaluation indicated that students preferred branched threading to linear threading; they thought filtering and clippings were helpful in principle, although they did not use them very much; and they felt uncomfortable with the idea of recommending each others' messages. Students felt less overloaded in the second part of the course, which was when the system enhancements were made available.
The leaf size/number trade‐off in trees
Authors: KLEIMAN DAVID , AARSSEN LONNIE W. 
Published: January 2007

Summary

Using a sample of 24 common deciduous angiosperm trees of the Eastern Deciduous Forest region of North America, we tested the hypothesis that leaf size variation across species can be interpreted in terms of a trade‐off between individual leaf mass and the number of leaves produced.
The true nature of a resource allocation trade‐off is detectable only if variation in the total amount of growth is accounted for. We controlled for this effect by measuring all of the components of annual growth associated with leaf production at the individual terminal shoot level. Hence, number of leaves produced was expressed as ‘leafing intensity’, i.e. the number of leaves produced by newly emerged (current year's) shoots, divided by the total volume of these shoots.
Ninety per cent (r2 = 0.90) of the variation in mean individual leaf mass across species, spanning two orders of magnitude, could be accounted for by proportional variation in mean leafing intensity, i.e. representing an isometric trade‐off, with a slope for log‐transformed data that did not deviate significantly from −1.0.
We suggest that this isometric relationship may represent a generalized trade‐off strategy for leaf deployment at the shoot level within temperate deciduous woody species. Following traditional interpretations, adaptation here may involve a fitness benefit associated with a particular leaf size. The present results also suggest an alternative, i.e. selection may instead favour high leafing intensity, with small leaf mass resulting not as a direct adaptation, but simply as a trade‐off.
According to this ‘leafing intensity premium’ hypothesis, the fitness benefits of higher leafing intensity are associated primarily with the fitness benefits of a larger pool of lateral meristems, because each leaf is usually associated with an axillary bud. This may in turn provide greater facility for wide phenotypic plasticity in the allocation of these meristems to vegetative vs. reproductive functions. This represents a plausible hypothesis, we suggest, in accounting for why most woody deciduous angiosperms, even some of the largest/tallest ones, have relatively small leaves.
Over the (range) edge: a 45‐year transplant experiment with the perennial forest herbHyacinthoides non‐scripta
Authors: VAN DER VEKEN SEBASTIAAN , ROGISTER JULES , VERHEYEN KRIS , HERMY MARTIN , NATHAN RAN 
Published: January 2007

SummaryMost experimental populations of perennial forest herbs have been monitored for only a few years and thus only apply to germination and early seedling survival. Moreover, there is a lack of long‐term, quantitative data on the rates of spread of populations.We report the results of a cross‐range‐edge transplant experiment established in 1960 with the perennial forest herbHyacinthoides non‐scripta.We evaluated determinants of survival/extinction, performance and migration distances and patterns of 27 transplanted populations after a period of 45 growing seasons.Of 27 experimental populations ofHyacinthoides non‐scriptaimplanted in 1960, 11 (41%) were still found in 2005–06. Population survival was independent of soil type and changes in the vegetation layer. In contrast, physical disturbance of the soil and major changes in the tree layer as a result of forest management were the main determinants of population extinction. Current population surface areas ranged from 0.23 to 26.23 m2. Plant height, leaf length, number of flowers and seed size were generally lower in the introduced populations than in the source populations. However, densities and proportions of non‐flowering adults were higher, especially in the larger populations. This suggests that these populations are still expanding with more but younger, and thus smaller, individuals.Observed migration rates were very low, ranging from 0.006 my−1to 0.06 my−1. Migration occurred by the establishment of isolated individuals, which were later absorbed by the advancing wave of the main population. The spread projected for the largest population in the next 45 years is only 14 m for the main population front and 42 m for the furthest individual.Our results may be representative of population spread for slow dispersing forest plant species after occasional long‐distance dispersal events across a range edge. However, the slow rates of spread indicate that, even if such events occur, it can take a very long time to establish viable population sizes.
Co‐occurrence of birth defects and intellectual disability
Authors: Petterson Beverly , Bourke Jennifer , Leonard Helen , Jacoby Peter , Bower Carol 
Published: January 2007

SummaryThis study used population‐based databases to ascertain birth defects and intellectual disability (ID), defined as full IQ < 70, in children born in Western Australia during 1980–99. Of the children surviving to 1 year (n = 474 285), 4.9% had birth defects and 1.3% ID. ID was identified in 7.9% of children with birth defects. After adjusting for sex, mother’s age, race, parity, plurality, birthweight and gestational age the prevalence ratio (PR) [95% confidence interval (CI)] for ID in children with birth defects compared with those with no birth defects was 7.6 [7.2, 8.0]. Those with chromosomal anomalies comprised 3.2% of the group with birth defects. The percentage ID (and PR [95% CI]) in specific categories were: Down’s syndrome 97% (84.5 [79.4, 90.0]), sex chromosome anomalies 30.3% (31.0 [23.8, 40.3]), other chromosomal anomalies 64.2% (54.2 [47.2, 62.3]). Birth defects were categorised according to system in the 96.8% of children with non‐chromosomal anomalies. The percentage with ID (and PR [95% CI]) for birth defects in each system were: spina bifida 18.8 (16.7 [12.2, 23.0]); nervous (except spina bifida) 38.6 (33.4 [30.3, 36.9]); cardiovascular 4.2 (4.1 [3.5, 4.8]); gastro‐intestinal 2.2 (2.0 [1.5, 2.7]); urogenital 2.6 (2.4 [2.0, 2.8]; musculo‐skeletal 3.6 (4.0 [3.5, 4.6]); other non‐chromosomal 7.0 (7.3 [6.5, 8.3]); and multiple systems 12.3 (10.2 [8.6, 12.2]).Birth defects were present in 30.2% of children with ID (27.7% of children with mild/moderate ID (IQ 40–69) and 54% of children with severe ID (IQ < 40)). Adjusted PRs for birth defects in children with any ID, mild/moderate ID and severe ID compared with children with normal intellectual function were 6.0 [5.8, 6.3], 5.5 [5.3, 5.8] and 10.5 [9.7, 11.4] respectively. The data are useful for those providing services for children with developmental disabilities especially for predicting family support and respite and accommodation requirements for children and adults with severe ID.
Data collected on maternal dietary exposures in the Danish National Birth Cohort
Authors: Olsen Sjúrdur Fródi , Mikkelsen Tina Broby , Knudsen Vibeke Kildegaard , Orozova‐Bekkevold Ivanka , Halldórsson Thórhallur Ingi , Strøm Marin , Østerdal Marie Louise 
Published: January 2007

SummaryRecent research suggests that the diet consumed in, or shortly before, pregnancy can potentially lead to maldevelopment and diseases in the offspring, which may become apparent at any time from the embryonic stage until old age. For example, maternal diet may affect the chance of twinning (and associated complications), malformation risk, brain development, and the offspring’s fecundity and risk of contracting cardiovascular dieases and cancer in adult life. Prospectively designed longitudinal studies with sufficient size and data quality are much needed to substantiate or refute these hypotheses.At present, the Danish National Birth Cohort is likely to be the largest epidemiological database containing extensive information on maternal dietary exposures. By October 2002, 100 000 women had been recruited in early pregnancy, for long‐term follow‐up of themselves and their offspring. The present paper details the information available in the database on early nutritional exposures with emphasis on maternal dietary intake. We also present distributions of selected nutritional exposures.
Lower mortality but higher neonatal morbidity over a decade in very preterm infants
Authors: De Kleine Martin J. K. , Den Ouden A. Lya , Kollée Louis A. A. , Ilsen Adri , Van Wassenaer Aleid G. , Brand Ronald , Verloove‐Vanhorick S. Pauline 
Published: January 2007

SummaryBetter perinatal care has led to better survival of very preterm children, but may or may not have increased the number of children with cerebral and pulmonary morbidity. We therefore investigated the relationship between changes in perinatal care during one decade, and short‐term outcome in very preterm infants. Perinatal risk factors and their effects on 28‐day and in‐hospital mortality, and on intraventricular haemorrhage and bronchopulmonary dysplasia (BPD) in survivors, were compared in two surveys of very preterm singleton infants in the Netherlands.Between 1983 and 1993, 28‐day mortality decreased from 52.1% to 31.8% in infants of 25–27 weeks’ gestation and from 15.2% to 11.3% in infants of 28–31 weeks’ gestation. The incidence of intraventricular haemorrhage in survivors did not change (44.4% and 43.3% in infants of 25–27 weeks’ gestation, and 29.0% and 24.0% in infants of 28–31 weeks’ gestation). The incidence of BPD in survivors increased from 40.3% to 60.0% in infants of 25–27 weeks’ gestation and remained similar in infants of 28–31 weeks’ gestation (8.5% and 9.8% respectively). In multivariable analysis, higher mortality was associated with congenital malformation, low gestational age, low birthweight, no administration of steroids before birth, low Apgar scores and intraventricular haemorrhage, in 1983 as well in 1993, and with male gender in 1993. The effect of maternal age on mortality diminished significantly between 1983 and 1993. Intraventricular haemorrhage in surviving children was associated with low gestational age and artificial ventilation, both in 1983 and in 1993. The effect of artificial ventilation on the incidence of intraventricular haemorrhage diminished significantly between 1983 and 1993. BPD was associated with low gestational age and artificial ventilation, both in 1983 and in 1993, and with low birthweight and caesarean section in 1993.We conclude that the better survival of very preterm infants, especially of those of 25–27 weeks’ gestation, has been accompanied by a similar incidence (and thus with an increased absolute number) of children with intraventricular haemorrhage and by an increased incidence of children with BPD.
The relationship between birthweight, weight gain in infancy, and educational attainment in childhood
Authors: Corbett Sally S. , Drewett Robert F. , Durham Matthew , Tymms Peter , Wright Charlotte M. 
Published: January 2007

SummaryPrevious studies have examined the relationship between low weight gain (failure to thrive) in infancy and later cognitive ability, but no study to date appears to have examined the relationship between weight gain in infancy across the ‘normal’ range and later cognitive ability. We report results for a large prospective birth cohort of the relationship between weight gain in infancy and educational attainment at age 10.Routinely recorded weights from child health clinic records for an annual birth cohort of 3418 children born with gestation >36 weeks were collected, as well as gestation in weeks, birthweight and the postcode, for which the Townsend Deprivation Score was identified. At 10 years of age, those attending schools within the Newcastle Education Authority were given a picture vocabulary and a non‐verbal ability test, and tests of educational attainment in maths and reading. These were successfully linked to the infant weight data for 2294 (63%) of the children, and complete growth data were available for 1724 (47%) of the children who had completed at least one educational test.There was a significant positive relationship between weight gain in infancy and picture vocabulary, adjusted for economic deprivation, gestational age and birthweight, but not with any of the other outcomes. There was a statistically significant association between birthweight and all four outcomes, which was positive up to about one SD above average birthweight, and negative above.In this population, the association between early growth and cognitive outcomes is stronger for growth before birth, postnatal weight gain having a relatively minor impact.
Maternal age and parity‐associated risks of preterm birth: differences by race/ethnicity
Authors: Schempf Ashley H. , Branum Amy M. , Lukacs Susan L. , Schoendorf Kenneth C. 
Published: January 2007

SummaryThere is a well‐known interaction between maternal age and parity in the risk of adverse perinatal outcomes, including preterm birth (PTB), such that young multiparae and older primiparae have greater risks. Yet it is not known whether this interaction varies by race/ethnicity. US birth records for singleton births from 2000 to 2002 were used to examine the incidence of PTB by maternal age and parity within non‐Hispanic White, non‐Hispanic Black and Hispanic subgroups. PTB was categorised as moderately (32–36 weeks), very (28–31 weeks), or extremely (<28 weeks) preterm. Odds ratios of PTB according to age and parity were calculated in racial/ethnic specific multinomial logistic regression models. Within each race/ethnicity, comparisons were made relative to 25‐ to 29‐year‐old primiparae.Young teenagers (<18), particularly multiparae, generally had a higher risk of each degree of PTB among all three racial/ethnic groups. However, Black teenagers did not have a higher risk of extremely PTB. For very and extremely PTB, teenagers had considerably higher risk among Whites than Blacks or Hispanics. Within each racial/ethnic group, older (35+ years) primiparae had similarly higher risk of each category of PTB relative to 25‐ to 29‐year‐old primiparae. Older multiparae had higher risk of moderately and very PTB among Black and Hispanic women only. Adjustment for education did not alter these findings. Teenagers and older primiparae are already widely regarded as having greater perinatal risks. This study suggests that, among Black and Hispanic women, older multiparae may also have a higher risk of moderately and very PTB.
Interprofessional education of medical students and paramedics in emergency medicine
Authors: Hallikainen J. , Väisänen O. , Rosenberg P. H. , Silfvast T. , Niemi‐Murola L. 
Published: January 2007

Background:  Emergency medicine is team work from the field to the hospital and therefore it is also important for physicians to understand the work of paramedics, and vice versa. Interprofessional emergency medicine education for medical and paramedic students in Helsinki was started in 2001. It consisted of a 15 European credit transfer system (ECTS) credits programme combining 22 students in 2001. In 2005, the number of students had increased to 25. The programme consisted of three parts: acute illness in childhood and adults (AI), advanced life support (ALS) and trauma life support (TLS). In this paper, we describe the concept of interprofessional education of medical students and paramedics in emergency medicine.Methods:  After finishing the programmes in 2001 and in 2005, the students’ opinions regarding the education were collected using a standardized questionnaire.Results:  There were good ratings for the courses in AI (2001 vs. 2005, whole group; 4.3 ± 0.7 vs. 4.2 ± 0.4, P= 0.44) ALS (4.7 ± 0.5 vs. 4.4 ± 0.5, P= 0.06) and TLS (3.9 ± 0.7 vs. 4.4 ± 0.5, P= 0.01) in both years. Most of the medical students considered that this kind of co‐education should be arranged for all medical students (2001 vs. 2005; 4.8 ± 0.6 vs. 4.4 ± 0.5, P= 0.02) and should be obligatory (3.5 ± 1.5 vs. 3.1 ± 1.3, P= 0.35).Conclusions:  Co‐education was well received and determined by the students as an effective way of improving their knowledge of emergency medicine and medical skills. The programme was rated as very useful and it should be included in the educational curriculum of both student groups.
Circumscribed palmar hypokeratosis
Authors: Jarrett Paul , Sutton Timothy 
Published: January 2007

SUMMARYA 66‐year‐old woman presented with a 40‐year history of a slowly enlarging erythematous patch on the left thenar eminence. Histopathology showed a sharp ‘step’ between the uninvolved and involved skin. Epidermal dysplasia and a cornoid lamella were not seen. These are the typical features of circumscribed palmar hypokeratosis.
Therapeutic options for Bowen’s disease
Authors: Moreno Gilberto , Chia Alvin LK , Lim Adrian , Shumack Stephen 
Published: January 2007

SUMMARYMultiple therapeutic options are available for treatment of Bowen’s disease. The choice of therapy depends on clinical circumstance and medical practitioner experience. Newer therapies have more extensive support from the literature, but more established therapies may be preferred because of accessibility, cost and efficacy. An overview of the current therapeutic options for Bowen’s disease is presented.