bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negotiating Responsibility: Case Studies of Reproductive Decision‐Making and Prenatal Genetic Testing in Families Facing Huntington Disease
Authors: Downing Claudia 
Published: June 2005

AbstractThree case studies are presented to further our understanding of how responsibility is negotiated in families when making decisions about genetic risk. These draw on a model of responsibility generated in a study of reproductive decision‐making in families facing Huntington disease (HD) to illustrate the impact of prenatal testing on this process. This involves analyzing: how people present themselves as acting responsibly whether or not they utilize genetic testing; who they feel responsible to in their family and elsewhere; the impact that testing has on these relationships; and, how negotiating responsibility changes over time with repeated use of prenatal testing, changing risk status and maturational changes. Two key findings are: how decision‐making is perceived can become as important as what is decided; and, how responsibility is negotiated depends on which of these relationships are prioritized. Implications of the findings for clinical practice are noted and suggestions made for further applications of the model.
Racial‐Ethnic Differences in Genetic Amniocentesis Uptake
Authors: Saucier Jennifer B. , Johnston Dennis , Wicklund Catherine A. , Robbins‐Furman Patricia , Hecht Jacqueline T. , Monga Manju 
Published: June 2005

AbstractThe objective of this study was to determine the role of health beliefs in genetic amniocentesis acceptance in a diverse racial‐ethnic population. Participants completed a previously‐validated questionnaire consisting of three sections: (1) demographics, (2) amniocentesis knowledge, and (3) health beliefs, which assessed perceived susceptibility, seriousness of potential impact, benefits of testing, and barriers to testing. The results showed that Hispanic women were less likely to accept amniocentesis (51.5% vs. Caucasian 82.8%, African American 82.9%, Asian 82.8%). Education level was the only demographic factor higher among acceptors. Women who accepted amniocentesis had higher perceived seriousness, susceptibility, and benefits HBM scores and higher knowledge scores than women who declined. HBM scores and knowledge predicted the amniocentesis decision correctly 91.5% of the time. Individual health beliefs and knowledge play a greater role in genetic amniocentesis acceptance than do demographic factors such as race‐ethnicity.
Assessment of the Use and Feasibility of Video to Supplement the Genetic Counseling Process: A Cancer Genetic Counseling Perspective
Authors: Axilbund J. E. , Hamby L. A. , Thompson D. B. , Olsen S. J. , Griffin C. A. 
Published: June 2005

AbstractCancer genetic counselors use a variety of teaching modalities for patient education. This survey of cancer genetic counselors assessed their use of educational videos and their recommendations for content of future videos. Thirty percent of respondents use videos for patient education. Cited benefits included reinforcement of information for clients and increased counselor efficiency. Of the 70% who do not use videos, predominant barriers included the perceived lack of an appropriate video, lack of space and/or equipment, and concern that videos are impersonal. Most respondents desired a video that is representative of the genetic counseling session, but emphasized the importance of using broad information. Content considered critical included the pros and cons of genetic testing, associated psychosocial implications, and genetic discrimination. The results of this exploratory study provide data relevant for the development of a cancer genetics video for patient education, and suggestions are made based on aspects of information processing and communication theories.
The combined role of topography and overstorey tree composition in promoting edaphic and floristic variation in a Mediterranean forest
Authors: Maltez‐Mouro S. , García L. V. , Marañón T. , Freitas H. 
Published: June 2005

AbstractThis study aimed to address which factors, other than topography, contribute to the floristic variation of forested slopes. The natural forest studied is located in the Sudoeste Alentejano e Costa Vicentina Nature Park (southwestern Portugal). We sampled topographic, edaphic, floristic and community structure variables along three bottom–top hillside transects. Multivariate analyses of soil variables (by PCA), and of woody species composition and floristic–environmental relationships (by CCA and pCCA) were performed. Environmental–floristic trends strongly associated with the elevation gradient were identified. At lower altitudes, the lowest species richness, the highest soil fertility, and the tallest and most dense (least available light) canopy occurred. The spatial variation in woody species composition and abundance was closely associated with Zn availability in the soil and litter groundcover, but these varibles had significant spatial structure in the studied forest. The non‐spatially structured species variance was better predicted by soil NO3− and NH4+. The spatial variation of species data not shared with environmental variables was also calculated. We suggest that the influence of topographic gradient on the variation of edaphic variables and on the distribution and abundance of woody species was mediated by overstorey tree composition. Locally dominant tree species, in particular Quercus faginea and Quercus suber, may function as “ecosystem engineers” promoting environmental changes (i.e., Zn availability in soil, litter accumulation and light availability) that influence overall floristic variation.
Chronic fatigue in a population sample: definitions and heterogeneity
Authors: SULLIVAN PATRICK F. , PEDERSEN NANCY L. , JACKS ANDREAS , EVENGÅRD BIRGITTA 
Published: June 2005

Background. Numerous nosological decisions are made when moving from the common human symptom of unusual fatigue to the rare chronic fatigue syndrome (CFS). These decisions have infrequently been subjected to rigorous evaluation.Method. We obtained telephone interview data on fatiguing symptoms from 31406 individuals twins in the Swedish Twin Registry aged 42–64 years; 5330 subjects who endorsed fatigue and possessed no exclusionary condition formed the analytic group. We evaluated the definition and classification of CFS-like illness using graphical methods, regression models, and latent class analysis.Results. Our results raise fundamental questions about the 1994 Centers for Disease Control criteria as (1) there was no empirical support for the requirement of four of eight cardinal CFS symptoms; (2) these eight symptoms were not equivalent in their capacity to predict fatigue; and (3) no combination of symptoms was markedly more heritable. Critically, latent class analysis identified a syndrome strongly resembling CFS-like illness.Conclusions. Our data are consistent with the ‘existence’ of CFS-like illness although the dominant nosological approach captures population-level variation poorly. We suggest that studying a more parsimonious case definition – impairing chronic fatigue not due to a known cause – would represent a way forward.
SYMPOSIUM ON RATIONALITY AND COMMITMENT: INTRODUCTION
Authors: PETER FABIENNE , SCHMID HANS BERNHARD 
Published: June 2005

In his critique of rational choice theory, Amartya Sen claims that committed agents do not (or not exclusively) pursue their own goals. This claim appears to be nonsensical since even strongly heteronomous or altruistic agents cannot pursue other people's goals without making them their own. It seems that self-goal choice is constitutive of any kind of agency.In this paper, Sen's radical claim is defended. It is argued that the objection raised against Sen's claim holds only with respect to individual goals. Not all goals, however, are individual goals; there are shared goals, too. Shared goals are irreducible to individual goals, as the argument from we-derivativeness and the argument from normativity show. It is further claimed that an adequate account of committed action defies both internalism and externalism about practical reason.
Outpatient misoprostol cervical ripening without subsequent induction of labor to prevent post‐term pregnancy
Authors: Oboro Victor O. , Tabowei Tabs O. 
Published: June 2005

Background.  Interventions that may help shorten the duration of pregnancy in an African setting where facilities for fetal monitoring in post‐term pregnancy are limited, and induction is not without its hazards, are needed.Aim.  To determine whether outpatient administration of intravaginal misoprostol safely decreases the interval to delivery in postdate pregnancies.Design.  Open randomized controlled trial.Setting.  Zonal district hospitals, Kwale, Southern Nigeria (August 2000 to October 2001).Methods.  Seventy‐seven women were randomized at 40 weeks gestation to receive either 25 µg misoprostol intravaginally (38) or gentle cervical assessment only (39) on an outpatient basis. Subjects were then allowed to go into spontaneous labor unless an indication for induction developed.Main outcome measures.  Interval to delivery, duration of labor, and incidence of side‐effects.Results.  Misoprostol was associated with significant decrease in mean time to delivery (4·5 ± 4·1 versus 7·4 ± 5·2 days; P = 0·008), earlier gestational age at delivery (40·6 ± 0·6 versus 41·4 ± 0·05 weeks; P < 0·001) and shorter duration of active labor (6·1 ± 4·0 versus 8·2 ± 5·3 h; P = 0·028), without any significant increase in fetal distress, low Apgar score at delivery or other side‐effects.Conclusion.  Outpatient administration of low‐dose misoprostol can safely shorten the length of gestation in postdate pregnancies.
The effect of magnesium sulfate treatment on serum cardiac troponin I levels in preeclamptic women
Authors: Atalay Cemal , Erden Gönül , Turhan Turan , Yildiran Gülbin , SaraÇoglu Ö. Ferit , Koca Yüksel 
Published: June 2005

Aim.  To investigate serum cardiac troponin I levels before and after magnesium sulfate treatment in preeclamptic pregnant women.Materials and methods.  Fifty‐five pregnant women were included in the prospectively planned study. Study group patients (n = 25) were pregnant women hospitalized with a preeclampsia diagnosis while the control group (n = 30) were pregnant women with no medical or obstetric problem who had been attending the antenatal clinic. Serum cardiac troponin I levels were compared in the normal pregnant women and in preeclamptic pregnant women. These levels were also compared in the preeclamptic women before and after magnesium sulfate treatment. Mann–Whitney U‐test was used for statistical analysis.Results.  Groups were similar with respect to age, gravity, parity, and gestational age. The median serum cardiac troponin I levels in preeclamptic patients was 0.20 ng/ml (0.02–4.53) before treatment and 0.09 ng/ml (0.02–3.91) after treatment, while it was 0.02 ng/ml (0.0–0.05) in the control group. The serum cardiac troponin I level in the preeclamptic group was significantly high (P < 0.01), and pretreatment values in this group were significantly higher compared with post‐treatment values (P < 0.01)Conclusion.  Cardiac troponin I is a sensitive parameter for indicating minor myocardial damage which may occur in preeclampsia and for evaluating the efficiency of magnesium sulfate treatment.
Is preoperative vaginal cleansing necessary for control of infection after first trimester vacuum curettage?
Authors: Varli Ingela Hulthén , Lindelius Anna , Bergström Mats 
Published: June 2005

Background.  Traditionally, the vagina is cleansed, before a curettage is performed. A previous study, comparing cleansing with chlorhexidine solution and cleansing with saline solution before vacuum aspiration in the first trimester, did not show any difference in the frequency of postoperative pelvic inflammatory disease. We wanted to investigate whether this was true also for vaginal cleansing with chlorhexidine, compared to no vaginal cleansing at all.Methods.  Consecutive women having surgical first trimester legal abortions were randomized to vulvar and vaginal cleansing with chlorhexidine or vulvar cleansing only. The frequency of postabortion pelvic inflammatory disease was evaluated with patient questionnaires and study of medical records.Results.  Of the 486 patients included in the study, vaginal cleansing was performed on 246 and no vaginal cleansing on 240. The frequency of probable pelvic inflammatory disease was 2·4% with cleansing and 2·1% without cleansing (no significant difference).Conclusions.  Under certain conditions, preoperative vaginal cleansing can be safely omitted.
Interleukin‐6 in preterm premature rupture of membranes as an indicator of neonatal outcome
Authors: Hatzidaki Eleftheria , Gourgiotis Dimitris , Manoura Antonia , Korakaki Eftychia , Bossios Apostolos , Galanakis Emmanouel , Giannakopoulou Christina 
Published: June 2005

Background.  The aim of this study was to investigate whether the levels of interleukin‐6 (IL‐6) can be used as markers of adverse outcome in preterm neonates born after preterm premature rupture of membranes (PPROM).Methods.  This study involved 109 preterm neonates and their mothers. The PPROM group consisted of 58 neonates who were born after PPROM, and the control group consisted of 51 neonates. IL‐6 levels were measured in umbilical cord blood, maternal blood sampled during delivery and in neonatal blood taken on the fourth day of life.Results.  In the PPROM group, IL‐6 concentrations in maternal blood, cord blood, and neonatal blood were significantly higher in neonates with sepsis, compared with those without sepsis (P < 0.001). Choosing 108.5 pg/ml as a cut‐off concentration of IL‐6 in umbilical cord blood for neonatal sepsis resulted in sensitivity 95%, specificity 100%, positive predictive value 100%, and negative predictive value 97.4%. Concerning IL‐6 in maternal blood, a cut‐off concentration of 81 pg/ml showed sensitivity 90%, specificity 97.4%, positive predictive value 94.7%, and negative predictive value 94.9%. Eighteen of 20 neonates with early sepsis and seven of nine neonates, who died in the PPROM group, were born of mothers with IL‐6 levels above the cut‐off concentration in their blood during delivery.Conclusions.  IL‐6 in umbilical cord blood was the most significant variable for predicting early onset sepsis in preterm neonates. IL‐6 in maternal blood was indicative of intrauterine environmental threats and might be used to identify pregnancies where intervention would be appropriate.
Evaluating the impact of methadone maintenance programmes on mortality due to overdose and aids in a cohort of heroin users in Spain
Authors: Brugal M. T. , Domingo‐Salvany A. , Puig R. , Barrio G. , García de Olalla P. , De La Fuente L. 
Published: June 2005

ABSTRACTAims  To assess the relationship between methadone treatment (MT) and overdose and HIV/AIDS mortality among heroin users resident in Barcelona city.Design  All patients who started treatment in any treatment centre between 1992  and 1997 were included in a cohort the first time they were  admitted for heroin addiction treatment. Follow‐up controls were carried out every 9 months, on average, until 31 December 1999. Variables, both constant and varying over time, were fitted into Cox regression models.Findings  The study recruited 5049 patients, which provided 23 048.2 person‐years. Fifty per cent were in MT during the study period; of the total cohort 1005 patients died: 38.4% due to AIDS, 34.7% to overdose and 27% to other causes. Overall mortality decreased from 5.9 deaths per 100 person‐years in 1992 to 1.6 in 1999. Globally, life expectancy at birth was 39 years, 38 years lower than that of the general population. The main factor for overdose mortality was not being in MT at the time of death [relative ratio (RR) = 7.1]; other factors were being a current injector at baseline and being HIV positive. For AIDS mortality, the main factor was the calendar year (RR for 1996 versus 1999 = 4.6), the next major factor was more than 10 years of heroin consumption, followed by not being in MT, being unemployed, then having a prison record.Conclusions  The observed mortality decline could be linked to the effectiveness of low‐threshold MT. The life expectancy of heroin users increased by 21 years during the study period.
Depressive symptoms and smoking among Hong Kong Chinese adolescents
Authors: Lam T. H. , Stewart Sunita M. , Ho Sai Yin , Lai Man Kin , Mak Kwok Hang , Chau Ka Vai , Rao Uma , Salili Farideh 
Published: June 2005

ABSTRACTAims  To examine associations among depressive symptoms, smoking, smoking trajectories and quitting smoking in Hong Kong.Design  Prospective longitudinal design, with wave 1 at baseline (T1) and wave 2 (T2) 12 months later.Setting and participants  Form 1 (equivalent to 7th grade in the United States) students, mean age = 12.7 years, n = 1894.Measurements  Self‐reported smoking status, attempts to quit and depressive symptoms.Findings  At both waves, current as well as ex‐smokers had higher depressive symptoms than never smokers. T1 smoking predicted T2 depressive symptoms among those with low baseline depressive symptoms. Depressive symptoms at T1 predicted smoking at T2 among non‐smokers at T1. Trajectories were defined by separating participants who were never smokers at both waves (‘non‐smokers’), those who smoked at both waves (‘persistent smokers’), those who smoked at one time but were not smoking at either wave (‘past smokers), and those who had never smoked at T1 but reported smoking a year later (‘new smokers’). Persistent, past and new smokers had higher depressive symptoms at both waves than non‐smokers. Smokers who reported not wanting or trying to quit and those who had been unsuccessful at quitting had higher depressive symptoms at T2 than those who successfully quit.Conclusion  Our results suggest that depressive symptoms promote tobacco use in Asian adolescents by making it more likely that an adolescent will begin smoking and less likely that she or he will quit. These findings elucidate risk factors in Hong Kong for two important public health concerns for adolescents: smoking and depression.
Reimbursement for smoking cessation treatment may double the abstinence rate: results of a randomized trial
Authors: Kaper J. , Wagena E. J. , Willemsen M. C. , Van Schayck C. P. 
Published: June 2005

ABSTRACTAims  Few smokers who try to quit smoking use smoking cessation treatment (SCT), and cost could be one factor. To increase the number of successful quitters, we assessed whether financial reimbursement for SCT would encourage the use of SCT and would as a result increase the 6‐month point abstinence rate.Setting and participants  We recruited smokers aged over 18 years from a random sample of Dutch inhabitants insured by one health insurance company.Intervention and design  The smokers were assigned randomly to the intervention group (n = 632) or control group (n = 634). Respondents in the intervention group received an offer of reimbursement for nicotine replacement therapy, bupropion and behavioural counselling. No reimbursement was offered to the control group. To preclude a change of behaviour due to disappointment in the control group, we used a randomized consent design.Findings  During the reimbursement period, 10.8% smokers in the intervention group reported having used SCT compared with 4.1% in the control group (OR = 2.9, 95% CI 1.8–4.7). In the intervention group, 23.4% smokers tried to stop compared with 20.8% in the control group (OR = 1.2, 95% CI 0.9–2.4). After 6 months, the biochemically validated 7‐day point prevalence abstinence rate was 5.5% in the intervention group and 2.8% in the control group (OR = 2.3, 95% CI 1.2–4.1).Conclusions  Reimbursement for SCT seems efficacious in increasing the use of SCT and may double the number of successful quitters.
The relationship between non‐injection drug use behaviors on progression to AIDS and death in a cohort of HIV seropositive women in the era of highly active antiretroviral therapy use
Authors: Kapadia Farzana , Cook Judith A. , Cohen Marge H. , Sohler Nancy , Kovacs Andrea , Greenblatt Ruth M. , Choudhary Imtiaz , Vlahov David 
Published: June 2005

ABSTRACTAims  To evaluate the effects of longitudinal patterns and types of non‐injection drug use (NIDU) on HIV progression in the highly active antiretroviral therapy (HAART) era.Design  Women's Interagency HIV Study (WIHS), a prospective cohort study conducted at six US sites.Methods  Data were collected semi‐annually from 1994 to 2002 on 1046 HIV+ women. Multivariate Cox proportional hazards modeling was used to estimate relative hazards for developing AIDS and for death by pattern and type of NIDU.Findings  During follow‐up, 285 AIDS events and 287 deaths, of which 177 were AIDS‐related, were reported. At baseline, consistent and former NIDU was associated with CD4+ counts of < 200 cells/µl (43% and 46%, respectively) and viral load > 40 000 copies/ml (53% and 55%, respectively). Consistent NIDU reported less HAART use (53%) compared with other NIDU patterns. Stimulant use was associated with CD4+ cell counts of < 200 cells/µl (53%) and lower HAART initiation (63%) compared with other NIDU types. In multivariate analyses, progression to AIDS was significantly higher among consistent (RH = 2.52), inconsistent (RH = 1.63) and former (RH = 1.56) users compared with never users; and for stimulant (RH = 2.04) and polydrug (RH = 1.65) users compared with non‐users. Progression to all‐cause death was higher only among former users (RH = 1.48) compared with never users in multivariate analysis. NIDU behaviors were not associated with progression to AIDS‐related death.Conclusions  In this study, pattern and type of NIDU were associated with HIV progression to AIDS and all‐cause mortality. These differences were associated with lower HAART utilization among consistent NIDU and use of stimulants, and poor baseline immunological and virological status among former users.
Smoking habits and obesity in young adults
Authors: Zimlichman Eyal , Kochba Ilan , Mimouni Francis B. , Shochat Tzippora , Grotto Itamar , Kreiss Yitshak , Mandel Dror 
Published: June 2005

ABSTRACTAims  The aim of this work was to study the association between obesity and smoking habits in young adults. Specifically, we tested the hypothesis that obesity does not prevent young adults from smoking and conversely smoking does not protect against obesity.Design and setting  Trained nurses interviewed participants concerning demographic data and health behaviors such as smoking. At the time of the interview, weight and height were measured. Data were analyzed retrospectively.Participants  A representative sample of Israel Defense Force (IDF) personnel upon discharge from compulsory service, usually at the age of 20–21 years.Findings  Overall, 29 745 participants were included during the 13‐year study (16 363 males and 13 382 females). Smoking rates were higher among obese participants than among overweight and non‐obese participants (34.9%, 37.1%, 43.6% for non‐obese, overweight and obese, respectively; P < 0.001). Mean number of cigarettes smoked per day were also higher among smokers that were obese and overweight compared to the non‐obese (15.2 ± 9.2, 15.6 ± 10.7, 18.0 ± 9.8, respectively; P < 0.001). Overweight and obesity were associated with the father's lower academic educational level. In logistic regression analysis, obesity, year of study and parental academic education were correlated independently with smoking (P < 0.001).Conclusion  The positive association between obesity and smoking suggests that obesity is not a deterrent to smoking and also that smoking does not help to prevent obesity.