bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tertiäre Prävention von Berufsdermatosen
Authors: Skudlik Christoph , Schwanitz Hans Joachim 
Published: May 2004

Zusammenfassung Hintergrund: Die Indikation zur stationären tertiären Prävention bei Berufsdermatosen ist gegeben, wenn ein objektiver Zwang zur Unterlassung der schädigenden Tätigkeit droht. Frühere Untersuchungen haben gezeigt, daß mit einer tertiären Präventionsmaßnahme bei 2/3 solcher Patienten ein langfristiger Berufsverbleib erzielt werden kann. Berufspezifische Daten zur Wirksamkeit der tertiären Prävention liegen bislang nicht vor. Patienten und Methodik: Wir analysierten unser Patientenkollektiv des Jahres 2002 berufsgruppenspezifisch bezüglich Diagnosen, früherer und aktueller Therapie und klinischem Erfolg der tertiären Präventionsmaßnahme. Ergebnisse: Bei den 296 Patienten wurde in 91 % der Fälle primär ein Kontaktekzem der Hände diagnostiziert (75 % primär irritativ bedingte Handekzeme (37 % kumulativ‐toxische Handekzeme, 38 % irritativ‐provozierte atopische Handekzeme, 16 % primär allergische Handekzeme). Klinisch relevante Typ‐IV‐Sensibilisierungen wurden insgesamt in 42 % der Fälle konstatiert, überwiegend im Sinn sekundär aufgepfropfter allergischer Kontaktekzeme. In über 83 % konnte eine vollständige bis weitestgehende Abheilung erzielt werden.Klinisch relevante Sensibilisierungen waren am häufigsten bei Friseuren (66 %). Die Angehörigen der Reinigungsberufe gaben am häufigsten (60 %) eine regelmäßige Kortikosteroid‐Vorbehandlung an; wir dokumentierten bei dieser Berufsgruppe am häufigsten sowohl eine Kortisonentzugssymptomatik (53 %) als auch eine Hautatrophie der Hände (23 %). Schlußfolgerung: Die Daten zur tertiären Prävention von Berufsdermatosen geben Hinweise auf Optimierungsmöglichkeiten der ambulanten Therapie und bezüglich Berufsgruppen‐typischer Risikofaktoren. Die unterschiedlichen Kenndaten der Kollektive der einzelnen Berufsgruppen und die unterschiedlichen Ansprechraten auf die tertiäre Präventionsmaßnahme basieren zumindest teilweise auf Unterschieden in der derzeit gehandhabten Sekundärprävention.
Changes in values cognition after rating values‐associated feelings
Authors: HIROSE HARUJI 
Published: May 2004

Abstract: This study investigated values change as an outcome of assessing feelings elicited by contemplating the actualization of the same values. The subjects were divided into an experimental and a control group. They completed three tests in a single session. In the pretest, all subjects were asked to rate the importance of 20 values items on a 4‐point scale. Subjects in the experimental group were then asked to rate the degree of pleasure they would feel in actualizing each of the values, while those in the control group rated the degree of inequality they considered women suffer in the actualization of each of the values. The post‐test consisted of the same items as the pretest. The subjects in the experimental group completed a second post‐test 3 months later. It was found that the experimental procedure produced significant change in the ratings of 15 values at the post‐test, whereas the control procedure produced change in only five. The results suggest that rating one's emotional response to a value‐related situation can change one's cognition of that value. At the post‐test 3 months later, only 3‐value ratings remained changed.
Institutional changes in fisheries governance: the case of the saimaa ringed seal, Phoca hispida saimensis, conservation
Authors: Tonder M. , Salmi P. 
Published: May 2004

AbstractInstitutional and paradigmatic changes in Finnish fisheries and environmental governance in the light of the protection of the Saimaa ringed seal, Phoca hispida saimensis Nordq., are discussed. The analysis is based on written statements by stakeholder institutions in response to a proposal by the Ministry of Agriculture and Forestry to restrict fishing in the breeding areas of the ringed seal. The controversy about the conservation of the Saimaa ringed seal is a revealing example of transition of an environmental conflict into a larger scale criticism of ongoing transformations in society related to paradigmatic changes of fisheries governance institutions. In addition to changed emphasis in different basic world outlooks, the contexts of the paradigms have changed. The policy restricting fishing by the authorities to support seal conservation is located between the paradigms of conservation and rationalisation. The Government has aligned itself with modern conservation ideas, but at the same time aroused strong resistance from the local level of fisheries governance. The local and regional stakeholders emphasised private water ownership, local knowledge and already established local agreements for seal conservation.
The role of catchment scale environmental management in freshwater fish conservation
Authors: Collares‐Pereira M. J. , Cowx I. G. 
Published: May 2004

AbstractFreshwater fishes are threatened by a wide array of factors, but anthropogenic disturbance, especially species introductions and translocations, impoundment of rivers, pollution, habitat degradation and overexploitation, seem to underlie the decline and extinction of many species. Although actions have been taken to address some precarious situations, traditional methods of conservation management, for example, regulation of exploitation, designation of nature reserves, captive breeding programmes for stock enhancement, do not seem to be as effective for freshwater fishes as for other animal groups. This paper summarises the present threats to freshwater fishes, identifies the underlying issues and reviews the problems relating to current management practices. It uses a case study from an Iberian highly endangered cyprinid fish –Anaecypris hispanica (Steindachner) – to highlight the options for action to protect the freshwater fish natural heritage for future generations. It is concluded that if conducted in a comprehensive manner, involving the wider public and all stakeholders, fish conservation management will confer wider environmental benefits and protect biodiversity for future generations.
Angling impact on conservation of Spanish stream‐dwelling brown trout Salmo trutta
Authors: Almodóvar A. , Nicola G. G. 
Published: May 2004

AbstractSpanish brown trout, Salmo trutta L., populations are currently overexploited as a result of unsuitable management activities, and their genetic uniqueness is threatened by introgression of foreign genes because of stocking. In this study, the status and management of trout fisheries were reviewed and the effects of fishery management on abundance, production and life history of trout in Spain assessed. Angling exploitation has reduced the mean age, the age diversity and number of trout exceeding the minimum size in exploited sections. Likewise, exploited areas show a general decrease in overall abundance parameters and production, as well as a depletion of the breeding stock and population fecundity. Current minimum size limit control reduces the spawning chances in fast‐growing populations because of higher susceptibility to angling harvest. The effects of fishery management on population dynamics, production and life‐history characteristics exhibit different patterns among Spanish rivers, and seem to depend on the environmental and biological characteristics of the populations. The current declining trend of brown trout could be reduced by river‐specific management and alternative fishing regulations.
A review of 47 cases of unerupted maxillary incisors
Authors: Betts A. , Camilleri G.E. 
Published: May 2004

Objectives.To study the prevalence of aetiological factors associated with unerupted maxillary incisors and to follow the outcome of treatment in a study of 47 cases.Design. A retrospective study.Setting. The Dental Department, St Luke's Hospital, Malta, the School Dental Clinic of Malta and the private practices of two orthodontists in Malta.Sample and methods. Forty‐seven patients with a total of 53 unerupted maxillary incisors were classified according to the aetiological factors causing non‐eruption. The relative prevalence of the various aetiologies were ascertained, and the outcome after treatment was recorded to assess the efficacy of the treatment methods being used.Results. The most common cause of lack of eruption was the presence of supernumerary teeth (47% of patients). The other 53% of cases were distributed more or less equally between the remaining aetiological factors, which were odontomes (9%), dilacerations (9%), tooth germ malposition (12%), crowding (4%), one case of a calcifying odontogenic cyst (2%) and one case of trauma to the preceding deciduous tooth (2%). The aetiology of 15% of cases could not be ascertained. Once supernumerary teeth were removed, maxillary incisors usually erupted successfully with the help of conventional treatment methods such as surgical exposure and orthodontics. A relatively large number of incisors that failed to erupt due to other aetiological factors had to be extracted.Conclusions. Maxillary incisors that fail to erupt due to the presence of supernumerary teeth have a better prognosis than unerupted incisors with less common aetiologies.
Cortico‐motoneurone excitability in patients with obstructive sleep apnoea
Authors: Civardi Carlo , Naldi Paola , Cantello Roberto 
Published: May 2004

SummaryA disordered neuromotor control of pharynx muscles may play a role in the genesis of obstructive sleep apnoea syndrome (OSAS). This raises the possibility of a dysfunction of projections descending from the cortex to segmental nuclei. With single pulse transcranial magnetic stimulation (TMS) we studied the physiology of the corticospinal projection to hand muscles in seven OSAS patients. At first, we compared them with nine age‐ and sex‐matched normal controls in the wake state. The only abnormality was a lengthening of the central silent period (P < 0.001). This supports a steady imbalance of motor cortical interneurone activities towards a state of enhanced inhibition. Then we looked at changes of the motor‐evoked potential (MEP) size and latency, according to whether patients were awake, or in a non‐rapid eye movement (REM) 2 sleep stage, or during a typical apnoea. During non‐REM 2 sleep, the average MEP amplitude was significantly (P < 0.05) smaller than in the awake state. The MEP latency was, in turn, significantly longer (P < 0.05). During apnoeas, the MEP size decreased, and the latency increased further (P < 0.05), indicating an extra depression of the cortico‐motoneuronal activity. All TMS changes were detected outside the pharyngeal district, suggesting a widespread dysfunction of the cortico‐motoneuronal system in the OSAS, which is more evident during apnoeas.
The relationship of nightmare frequency and nightmare distress to well‐being
Authors: Blagrove Mark , Farmer Laura , Williams Elvira 
Published: May 2004

SummaryNightmares can be defined as very disturbing dreams, the events or emotions of which cause the dreamer to wake up. In contrast, unpleasant dreams can be defined in terms of a negative emotional rating of a dream, irrespective of whether or not the emotions or events of the dream woke the dreamer. This study addresses whether frequency of unpleasant dreams is a better index of low well‐being than is frequency of nightmares. A total of 147 participants reported their nightmare frequency retrospectively and then kept a log of all dreams, including nightmares, for 2 weeks, and rated each dream for pleasantness/unpleasantness. Anxiety, depression, neuroticism, and acute stress were found to be associated with nightmare distress (ND) (the trait‐like general level of distress in waking‐life caused by having nightmares) and prospective frequency of unpleasant dreams, and less so with the mean emotional tone of all dreams, or retrospective or prospective nightmare frequency. Correlations between low well‐being and retrospective nightmare frequency became insignificant when trait ND was controlled for, but correlations with prospective unpleasant dream frequency were maintained. The reporting of nightmares may thus be confounded and modulated by trait ND: such confounding does not occur for the reporting of unpleasant dreams in general. Thus there may be attributional components to deciding that one has been awoken by a dream, which can affect estimated nightmare frequency and its relationship with well‐being. Underestimation of nightmare frequency by the retrospective questionnaire compared with logs was found to be a function of mean dream unpleasantness and ND.
The effects of bright‐light therapy on actigraphical measured sleep last for several weeks post‐treatment. A study in a nursing home population
Authors: Fetveit Arne , Bjorvatn Bjørn 
Published: May 2004

SummaryWe investigated the time‐course of nocturnal actigraphic measures, following the termination of bright‐light therapy for sleep disturbances in demented nursing home patients. From an earlier study, 11 nursing home patients (86 ± 9 years, Mini‐Mental Status Examination score 12 ± 4) with actigraphically measured sleep efficiency <85%, were recruited to morning bright‐light treatment (6000–8000 lux) 2 h per day for 14 days. Actigraphic measures were registered at pretreatment, treatment and at four monthly post‐treatment periods. Each actigraphic recording period consisted of seven consecutive days. Sleep improved substantially with treatment; sleep efficiency increased from 73% to 86% and total nocturnal wake time was reduced by nearly 2 h. During the 16 weeks post‐treatment period, actigraphic measures gradually returned to pretreatment levels. Sleep efficiency remained significantly higher than the pretreatment level 4 weeks after treatment termination. Sleep onset latency remained significantly reduced up until 12 weeks post‐treatment. This study supports previous findings of beneficial effects of bright‐light therapy for sleep disturbances in demented nursing home patients. Furthermore, these results are the first to suggest that post‐treatment effects of short‐term bright‐light therapy may last longer than previously assumed.
Spontaneous eyelid movements (ELMS) during sleep are related to dream recall on awakening
Authors: Conduit Russell , Crewther Sheila Gillard , Coleman Grahame 
Published: May 2004

SummaryThe present study aimed to test whether spontaneous eyelid movements (ELMs) during stage 2 and rapid eye movement (REM) sleep are related to more frequent and vivid reports of visual mentation on awakening. Participants were awakened 15 s after an ELM was observed during ongoing REM and stage 2 sleep and immediately asked for a mentation report and to rate the visual vividness of any imagery they could remember. These reports were compared with control reports collected after a period of ELM quiescence before awakening (noELM). Significantly greater frequencies of imagery reports were collected after ELM awakenings compared with noELM awakenings from stage 2, but not REM sleep. When imagery was reported, imagery ratings were not significantly different between ELM and noELM conditions, regardless of sleep stage. The average amount of electroencephalogram (EEG) arousal 15 s after stage 2 awakenings was significantly higher in the ELM compared with noELM conditions. In addition, within the stage 2 ELM condition, EEG arousal was significantly higher when visual imagery was reported compared with reports without imagery; suggesting that the observed increase in imagery reporting from the stage 2 ELM condition could have been mediated by the level of brain arousal. Such arousal possibly provides better conditions to attend and recall previous mental activity from NREM sleep. However, there was no ELM/arousal effect within REM sleep, possibly because this state is already at maximum sleeping levels of arousal, attention and resulting dream recall.
Complete immunosuppressive withdrawal as a uniform approach to post‐transplant lymphoproliferative disease in pediatric liver transplantation
Authors: Hurwitz Melissa , Desai Dev M. , Cox Kenneth L. , Berquist William E. , Esquivel Carlos O. , Millan Maria T. 
Published: May 2004

Abstract:Epstein–Barr virus (EBV)‐associated post‐transplant lymphoproliferative disease (PTLD) in pediatric liver transplant recipients is associated with a high mortality (up to 60%) and the younger age groups, who are predominantly EBV‐naïve, are at highest risk for development of this disease. The aim of this study is to assess, in this high‐risk group, patient outcome and graft loss to rejection when complete withdrawal of immunosuppressive agents (IMS) is instituted as the mainstay of treatment in addition to the use of standard therapy. A retrospective analysis of 335 pediatric patients whose liver transplants were performed by our team between September 1988 and September 2002, was carried out through review of computer records, database and patient charts. Fifty patients developed either EBV or PTLD; 80% were ≤2 yr of age. Of these 50 patients, 19 had a positive tissue diagnosis for PTLD and 31 were diagnosed with EBV infection, 14 of whom had positive tissue for EBV. Fifty‐eight percent of patients who developed PTLD and 51.6% of patients with EBV received antibody for induction or treatment of rejection prior to onset of disease. Forty‐six patients (92%) received post‐transplant antiviral prophylaxis with ganciclovir or acyclovir. Antiviral treatment included ganciclovir in 76%, acyclovir in 20% and Cytogam (in addition to one of the former agents) in 44%. In those with PTLD, treatment included chemotherapy (n = 1), Rituximab (n = 2), and ocular radiation (n = 1). IMS was stopped in all patients with PTLD and in 19 with EBV infection and was held as long as there was no allograft rejection. Eight patients have remained off IMS for a mean of 1535.5 ± 623 days. Of the 21 patients who were restarted on IMS for acute rejection, 18 responded to steroids and/or reinstitution of low‐dose calcineurin inhibitors. The mean time to rejection while off IMS in this group was 107.43 ± 140 days (range: 7–476). Two patients were re‐transplanted for chronic rejection; one had chronic rejection that existed prior to discontinuing IMS. The mortality rate in our series was 31.6% in those with PTLD and 6% in those with EBV disease. The cause of death was related to PTLD or sepsis in all cases; no deaths were due to graft loss from acute or chronic rejection. PTLD is associated with high mortality in the pediatric population. Based on this report, we advocate aggressive management of PTLD that is composed of early cessation of IMS, the use of antiviral therapy, and chemotherapy when indicated. Episodes of rejection that occur after stopping IMS can be successfully treated with standard therapy without graft loss to acute rejection.
Non‐compliance in children post‐liver transplant. Who are the culprits?
Authors: Falkenstein Kathleen , Flynn Louise , Kirkpatrick Beverly , Casa‐Melley Adela , Dunn Stephen 
Published: May 2004

Abstract:  Although non‐compliance in pediatric liver transplants is known to be a major cause of late graft loss and patient mortality, follow‐up seems inconsistent. As liver transplant becomes a luxury because of the shortage of organs, the need to maximize graft and patient survival by intense monitoring becomes a necessity. When evaluating children with elevated liver enzymes post‐transplant, early or late non‐compliance should always be suspected. The risk of non‐compliance in children with chronic illness varies from 10 to 89%. In a study by Sudan et al. (Annals of Surgery 1997: 29: 430–431) non‐compliance was one of the leading causes of late mortality in children age 10–17 yr. Although it is well documented that teenagers have a high rate of non‐compliance, the rate in the younger children has not been documented. In our series, we found that parental non‐compliance comprises the majority of our problems with liver dysfunction, hospitalization, and graft loss.The purpose of this study was to evaluate the incidence of non‐compliance in children post‐liver transplant. A retrospective chart review of patient records from admissions and outpatient records was performed for documentation of elevated enzymes and low immunosuppressive levels. From July 1987 to December 2002, our program performed 266 liver transplants in 234 children, with 1‐yr graft survival of 84% and 1‐yr patient survival of 90%. Our overall patient survival was 85% with 77% graft survival. There were 40 children with documented non‐compliance with mild to severe liver dysfunction in this study. Twenty‐eight of these children were younger than 10 yr [28 of 40 (46%) <5 yr], and 12 (30%) were older than 10 yr at the time of rejection. In 10 of 40 children, there was one documented incident of non‐compliance, while 26 of 40 had two to four incidents, and four had five or more documented events. Our children (50%) came from two‐parent households. The remaining 50% were from single households. In 27 of 40 (68%) children, rejection was confirmed by liver biopsy. In children on cyclosporine (Neoral; Novartis, East Hanover, NJ, USA) with a known history of non‐compliance and low immunosuppressive levels, C2 monitoring was performed to verify absorption. Admission for drug monitoring and verification of non‐compliance was accomplished in 32 of 40 (80%). Four of the 40 children (10%) were retransplanted, and one child had died.In conclusion, non‐adherence to medications remains a major source of graft loss and morbidity post‐transplant. We found that non‐compliance crosses all socio‐economic and cultural groups and that flexibility of clinic hours, shortened time between visits, and decreased numbers and times of medication will increase adherence.
Effect of lowered salinity on the survival, condition and reburial of Soletellina alba (Lamarck, 1818) (Bivalvia: Psammobiidae)
Authors: MATTHEWS TY G. , FAIRWEATHER PETER G. 
Published: May 2004

Abstract  Mass mortalities of fauna are known to occur in estuarine environments during flood events. Specific factors associated with these mortalities have rarely been examined. Therefore, the effect of exposing, to lowered salinities, an infaunal bivalve that is susceptible to mass mortalities during winter flooding in a southern Australian estuary was tested in the present study. In a laboratory experiment, low salinities (≤6 parts per thousand [ppt]), which mimicked those expected during flood events in the Hopkins River estuary, were shown to affect Soletellina alba, both lethally and sublethally. All bivalves died at 1 ppt, while those at 6 ppt took longer to burrow and exhibited a poorer condition than those at 14 and 27 ppt. The limited salinity tolerance of S. alba suggests that lowered salinities are a likely cause of mass mortality for this species during winter flooding.