bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promoting healthy diet and exercise patterns amongst primary school children: a qualitative investigation of parental perspectives
Authors: Hart K. H. , Herriot A. , Bishop J. A. , Truby H. 
Published: December 2004

AbstractParents represent a potentially powerful intermediary in behaviour change strategies aimed at improving the lifestyle behaviours of young children. However, to fulfil this role, parents need to have the necessary knowledge and motivation to assimilate dietary guidelines. This study aimed to assess these psychosocial constructs, and subsequent parental receptiveness to nutrition education, through investigation of the barriers and benefits perceived by parents to the provision of a healthy diet and adequate exercise for their children. A qualitative methodology was employed and 41 parents took part in seven focus groups separated by socio‐economic status (SES).Across the groups, a combination of reported external barriers and unconscious internal barriers, stemming from high optimistic bias, low perceived control and unrealistic health expectations, were observed. SES differences were suggested in restrictive feeding practices, the responsibility attributed to the school and in the level and format of desired nutrition education. Overall a demand for interventions focusing on behavioural techniques rather than fact transmission was uncovered, in particular the promotion of parental self‐awareness to reduce negative influences within the family food environment. Providing realistic definitions of appropriate behaviour and empowering parents to tackle children's weight issues were indicated as important targets for future education programmes.
Nurses' knowledge of current guidelines for infant feeding and weaning
Authors: Williams A. , Pinnington L. L. 
Published: December 2004

AbstractBackground  Poor infant feeding practices are common causes of nonorganic failure to thrive and may exacerbate the effects of many chronic conditions. It is important therefore that parents receive correct and consistent feeding advice from health professionals. The aim of this study was to determine whether hospital paediatric nursing staff are familiar with the recommendations of the Department of Health (DOH) Weaning Report (DOH, 1994).Methods  A total of 127 members of nursing staff (79%) at Derbyshire Children's Hospital were interviewed. Knowledge of recommended practices for the introduction and use of cow's milk, gluten, milk products, mashed foods, vitamin supplements and drinks was assessed.Results  Overall, 42 people (33%) answered all questions correctly. In each clinical area, six outpatient (64%), 19 special care baby unit (61%) and 17 ward (20%) staff provided correct answers to all questions. No significant difference was found between staff at each grade in the number of questions answered correctly.Conclusions  Knowledge of national infant feeding and weaning guidelines was limited suggesting that DOH recommendations are not widely understood or recognized. Further nutrition education and local dissemination of information is required if nurses are to continue to advise parents on aspects of infant feeding.
Survival and trends of occurrence of left ventricular hypertrophy, gender differences, 1967–92: The Reykjavik Study
Authors: Thrainsdottir I. S. , Hardarson Th. , Thorgeirsson G. , Sigvaldason H. , Sigfusson N. 
Published: December 2004

Abstract.  Thrainsdottir IS, Hardarson Th, Thorgeirsson G, Sigvaldason H, Sigfusson N (National University Hospital, Reykjavik, Iceland). Survival and trends of occurrence of left ventricular hypertrophy, gender differences, 1967–92: The Reykjavik Study. J Intern Med 2003; 253: 418–424.Objective.  We estimated the prevalence, incidence and risk factors of left ventricular hypertrophy (LVH) in a prospective cohort study of 26 489 participants.Material and methods.  The LVH was defined as Minnesota Code 310 on electrocardiogram (ECG). Everyone with this code at first visit was defined as a prevalence case and those who developed it between subsequent visits were incidence cases. The comparison cohort were all other participants in the Reykjavik Study stages I–V.Results.  A total of 297 men and 49 women were found to have LVH of 3.2% and 0.5%, respectively. The incidence was 25 per 1000 per year amongst men and six per 1000 per year amongst women. Prevalence in both genders increased with increasing age. Risk factors at the time of diagnosis were systolic blood pressure [odds ratio (OR) per mmHg 1.02; 95% confidence interval (CI): 1.01–1.03], age (OR per year 1.04; 95% CI: 1.02–1.05), silent myocardial infarction (MI) (OR 3.18; 95% CI: 1.39–7.27) and ST‐T changes (OR 3.06; 95% CI: 2.14–4.38) amongst men and systolic blood pressure and age for women with similar odds ratio. Predictive factors for acquiring LVH were systolic blood pressure [incidence ratio (IR) 1.01; 95% CI: 1.01–1.02] and angina with ECG changes (IR 2.33; 95% CI: 1.08–5.02) amongst men and systolic blood pressure amongst women (IR 1.03; 95% CI: 1.01–1.04). The risk for coronary mortality was significantly increased amongst women with hypertrophy [hazard ratio (HR) 3.07; 95% CI: 1.5–6.31] and their total survival was poorer with increasing time from diagnosis of LVH (HR 2.17; 95% CI: 1.36–3.48).Conclusions.  We conclude that the presence of LVH and its appearance is associated with age and increased blood pressure amongst both genders. Women with LVH have poorer survival than other women and they are at threefold risk of dying of ischaemic heart disease.
Plasma oxidized LDL: a predictor for acute myocardial infarction?
Authors: Nordin Fredrikson G. , Hedblad B. , Berglund G. , Nilsson J. 
Published: December 2004

Abstract.  Nordin Fredrikson G, Hedblad B, Berglund G, Nilsson J (Malmö University Hospital, Lund University; and Biomedical Laboratory Science, Malmö University, Sweden). Plasma oxidized LDL: a predictor for acute myocardial infarction? J Intern Med 2003; 253: 425–429.Objectives.  Oxidized LDL has been attributed a key role in the development of atherosclerosis. Previous studies have demonstrated increased plasma levels of oxidized LDL in patients with established coronary artery disease. The aim of the present study was to investigate if plasma oxidized LDL also predicts risk for development of coronary heart disease (CHD).Design.  We used a nested case–control design to study the association between plasma levels of oxidized LDL and risk for development of acute myocardial infarction (AMI) and/or death by CHD.Subjects.  Oxidized LDL was analysed by ELISA in cases (n = 26), controls (n = 26) and controls with LDL cholesterol >5.0 mmol L−1 (n = 26).Results.  Oxidized LDL correlated with total plasma and LDL cholesterol in both cases (r = 0.72, P < 0.01, r = 0.69, P < 0.01, respectively) and controls (r = 0.71, P < 0.01, r = 0.77, P < 0.01, respectively). The oxidized LDL/plasma cholesterol ratio was higher amongst cases (13.5, range 10.7–19.8) than in controls (12.6, range 9.5–15.8, P < 0.05) and hypercholesterolaemic controls (12.2, range 8.0–16.0, P < 0.01).Conclusions.  These findings identify high plasma oxidized LDL/total cholesterol ratio as a possible indicator of increased risk for AMI.
Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome
Authors: Resta O. , Foschino Barbaro M. P. , Bonfitto P. , Giliberti T. , Depalo A. , Pannacciulli N. , De Pergola G. 
Published: December 2004

Abstract.  Resta O, Foschino‐Barbaro MP, Bonfitto P, Giliberti T, Depalo A, Pannacciulli N, De Pergola G (Respiratory Pathophysiology, University of Bari, School of Medicine, Bari, Italy; University of Foggia, School of Medicine, Foggia, Italy; and Internal Medicine, Endocrinology, and Metabolic Diseases, University of Bari, Bari, Italy). Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome. J Intern Med 2003; 253: 536–543.Objectives.  To evaluate sleep quality, sleep‐related symptoms, and degree of excessive daytime sleepiness (EDS) in severe obesity, independently of obstructive sleep apnoea syndrome (OSAS).Design.  A cross‐sectional study.Setting.  Primary‐care setting.Subjects, main outcome measures.  Anthropometric parameters, respiratory function data and sleep related symptoms were evaluated in 78 severely obese patients (aged 16–75 years) without OSAS and in 40 healthy sex‐ and age‐matched normal weight subjects, who underwent a full‐night polysomnography.Results.  Obese patients and control subjects had similar sleep latency and rapid eye movement (REM) latency, but they showed lower percentage of REM (P < 0.01) and sleep efficiency (P < 0.05) than controls. All sleep‐related symptoms (observed or reported apnoea, awakenings, choking and unrefreshing sleep) were significantly more frequent in obese patients than in control subjects. Loud snoring was present in 46.7% of the obese patients and in 8.1% of the control individuals (P < 0.01). Excess daytime sleepiness was reported by 34.7% of the obese patients and by 2.7% of the normal weight subjects (P < 0.01). The Epworth Sleepiness Scale (ESS) was higher in the obese group than in the control group (P < 0.01), whereas arousals were not different between the two groups.Conclusions.  This study clearly shows that severe obesity, even in the absence of OSAS, is associated with sleep‐related disorders and EDS. All these alterations may be partly responsible for a lower quality of life, a higher prevalence of medical complications, an increased risk of occupational injury, and both social and family problems characterizing obese patients, independently of the presence of OSAS.
Experience with lamivudine therapy for hepatitis B virus infection before and after liver transplantation, and review of the literature
Authors: Ben‐Ari Z. , Mor E. , Tur‐Kaspa R. 
Published: December 2004

Abstract. Ben‐Ari Z, Mor E, Tur‐Kaspa R (Beilinson Campus, Petah Tikva, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel). Experience with lamivudine therapy for hepatitis B virus infection before and after liver transplantation, and review of the literature.J Intern Med2003;253:544–552.Objectives. To analyse the results of lamivudine therapy on suppression of hepatitis B virus (HBV) replication before transplantation and on preventing graft reinfection postoperatively.Design. Long‐term clinical study.Setting. Liver Institute and Department of Transplantation of a tertiary‐care university‐affiliated centre.Subjects. (1) 14 candidates for liver transplantation with decompensated liver disease caused by active replication of HBV; (2) six patients with recurrent HBV infection after transplantation.Intervention. Lamivudine 100 mg daily; administered in group 1 before surgery and continued after in nine patients who underwent transplantation; administered in group two postoperatively only. antihepatitis B surface antigen immunoglobulin (HBIg) was administered postoperatively in both groups.Main outcome measures. Immunoassay evaluation of serum hepatitis B surface antigen, serum hepatitis Be antigen and serum HBV DNA (hybridization and PCR); sequencing through the tyrosine‐methionine‐aspartate‐aspartate locus of the HBV polymerase gene in patients with lamivudine breakthrough; inflammation and fibrosis scoring on liver biopsy before and at least 2 years after lamivudine therapy in group 2.Results. Pretransplantation therapy (group 1) significantly suppressed HBV replication and enabled nine patients (64.2%) to undergo transplantation. Only one patient (7.1%) had lamivudine breakthrough, and one (7.1%) had recurrent HBV. Lamivudine administration begun after transplantation (mean 48.0 months, range 30–60 months) because of graft reinfection (group 2) was associated, over the long‐term, with the emergence of high mutation rates (83.3%), histological disease progression (66.6%), and hepatic failure (33.3%).Conclusions. In patients with chronic HBV infection and active viral replication, lamivudine therapy is effective when started before transplantation. However, its long‐term administration after transplantation for recurrent HBV leads to high resistance rates. Combination therapy with lamivudine and HBIg immunoglobulin can substantially reduce the recurrence rate. Further studies on combination antiviral therapy are needed in this patient population.
Health economics in the Hypertension Optimal Treatment (HOT) study: costs and cost‐effectiveness of intensive blood pressure lowering and low‐dose aspirin in patients with hypertension
Authors: Jönsson B. , Hansson L. , Stålhammar N.‐O. 
Published: December 2004

Abstract. Jönsson B, Hansson L, Stålhammar N‐O (Stockholm School of Economics, Stockholm; University of Uppsala, Uppsala, Sweden; and AstraZeneca Pharmaceuticals, DE, USA). Health economics in the Hypertension Optimal Treatment (HOT) study costs and cost‐effectiveness of intensive blood pressure lowering and low‐dose aspirin in patients with hypertension.J Intern Med2003;253:472–480.Objectives. To investigate the marginal cost‐effectiveness of different targets for the reduction of blood pressure and the cost‐effectiveness of adding acetylsalicylic acid (ASA) to the treatment of hypertension.Design. Patients with hypertension were randomized to three target groups for blood pressure; ≤90, ≤85 and ≤80 mmHg. Patients were also randomly assigned ASA and placebo. The average follow‐up time was 3.8 years. The direct costs for drugs, visits, hospitalizations, and side‐effects were calculated and related to clinical outcome.Setting. Resource utilization data from all the 26 countries in the study were pooled, and Swedish unit costs were applied to the aggregated resource utilization.Subjects. A total of 18 790 patients, 50–80 years of age (mean 61.5 years), with a diastolic blood pressure between 100 and 115 mmHg (mean 105 mmHg).Interventions. Antihypertensive treatment with the long‐acting calcium antagonist felodipine was given to all patients. Additional therapy and dose increments in four further steps were prescribed to reach the randomized target blood pressure. Fifty per cent of the patients were randomized to a low dose, 75 mg daily, of acetylsalicylic acid.Main outcome measures. Direct health care costs, major cardiovascular (CV) events (myocardial infarction and stroke) and CV death.Results. The average cost of drugs and visits increased with more intensive treatment. The increase in treatment costs was partly but not fully offset by a nonsignificant reduction in the cost of CV hospitalizations. For patients with diabetes there were no significant differences in total cost between the target groups. The cost of avoiding a major CV event was negative in the base case analysis, SEK −10 360 (CI: −78 195, 75 630), and SEK 18 450 (CI: −88 789, 192 980) in a sensitivity analysis. For patients on ASA, costs were slightly but significantly higher than for patients on placebo. The estimates of the cost of avoiding a major CV event varied between SEK 41 600 and SEK 477 400, with very wide confidence intervals.Conclusions. The treatment cost increases as the target for hypertension treatment is lowered. In patients with diabetes, intensive treatment to a lower target is cost‐effective. Because of the nonsignificant difference in events, no conclusion can be made for all patients in the study. Furthermore, no conclusive evidence was found regarding the cost‐effectiveness of adding ASA to the treatment of hypertension.
Prediction of coronary heart disease: a comparison between the Copenhagen risk score and the Framingham risk score applied to a Dutch population
Authors: De Visser C. L. , Bilo H. J. G. , Thomsen T. F. , Groenier K. H. , Meyboom‐De Jong B. 
Published: December 2004

Abstract.  de Visser CL, Bilo HJG, Thomsen TF, Groenier KH, Meyboom‐de Jong B (University of Groningen, Groningen; Isala Clinics, Weezenlanden location, Zwolle, The Netherlands; Glostrup University Hospital, Glostup, Denmark). Prediction of coronary heart disease: a comparison between the Copenhagen risk score and the Framingham risk score applied to a Dutch population. J Intern Med 2003; 253: 553–562.Objectives.  To compare the estimation of coronary heart disease (CHD) risk by the Framingham risk score (FRS) and the Copenhagen risk score (CRS) using Dutch population data.Design.  Comparison of CHD risk estimates from FRS and CRS. CHD risk‐estimations for each separate risk factor.Setting.  Urk, the Netherlands.Subjects.  A total of 408 fishermen from Urk, aged 30–65 years, without pre‐existing cardiovascular disease.Main outcome measures.  Absolute CHD risk estimates.Results.  The average 10‐year risk for CHD was significantly different between the FRS (4.6%, SD 5.0) and the CRS (3.2%, SD 4.1). The correlation between the two estimates was 0.94 (P < 0.001). The Bland–Altman figure shows a large proportion of agreement, but with an increasing difference with increasing average risk. When examining the separate risk factors age, total cholesterol, HDL cholesterol and systolic blood pressure and smoking, there appear differences between the two risk functions.Conclusion.  Using Dutch population data, differences were found for the calculation of CHD risk with the FRS and the CRS. Further research must be carried out to examine the validity of these risk functions in the Dutch population.
Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study
Authors: Engström G. , Hedblad B. , Nilsson P. , Wollmer P. , Berglund G. , Janzon L. 
Published: December 2004

Abstract.  Engström G, Hedblad B, Nilsson P, Wollmer P, Berglund G, Janzon L (University of Lund, Malmö University Hospital, Malmö, Sweden). Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study. J Intern Med 2003; 253: 574–581.Objectives.  To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD).Design.  Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow‐up examination after 13.9 ± 2.6 and 9.4 ± 3.6 years for men and women, respectively. After the follow‐up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years.Setting.  Populations‐based cohort study.Subjects.  Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years).Results.  Prevalence of IR at the follow‐up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend <0.0001). The corresponding values for women were 30, 29, 25 and 17%, respectively (P for trend <0.001). Adjusted for potential confounders, the odds ratio (OR) for IR (per 10% increase in FVC) was 0.91 (CI: 0.84–0.99) for men and 0.89 (CI: 0.80–0.98) for women. FVC was similarly significantly associated with the incidence of diabetes (OR = 0.90, CI: 0.81–1.00), adjusted for sex and other confounders.The incidence of CVD after the follow‐up examination was significantly increased only amongst subjects with low FVC who had developed IR (RR = 1.7, CI: 1.02–2.7).Conclusion.  Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD.
Prognosis of hepatocellular carcinoma in anti‐HCV positive cirrhotic patients: a single‐centre comparison amongst four different staging systems
Authors: Giannini E. , Risso D. , Botta F. , Romagnoli P. , Malfatti F. , Fumagalli A. , Testa E. , Podestà E. , Chiarbonello B. , Polegato S. , Testa R. 
Published: December 2004

Abstract.Background.  Epidemiological studies have foreseen an increase in the incidence of hepatocellular carcinoma (HCC) in the near future and it is estimated that this trend will mostly affect hepatitis C virus (HCV) positive cirrhotic patients. Therefore, accuracy of HCC staging is an important clinical issue.Aim.  To investigate the prognostic usefulness of a series of newly proposed HCC prognostic systems such as the Cancer of the Liver Italian Program (CLIP) score, the Groupe d'Etude et de Traitement du Carcinome Hépatocellulaire (GRETCH) model and the Barcelona Clinic Liver Cancer (BCLC) staging classification when compared with the usefulness of a known staging system such as the Okuda staging system in a group of anti‐HCV positive cirrhotic patients with HCC seen at a single centre.Methods.  Okuda stage, CLIP score, GRETCH model and BCLC stages were retrospectively computed in 81 anti‐HCV positive cirrhotic patients with HCC. We evaluated and compared the ability of these methods to assess survival prognosis.Results.  As of December 2001, 51 patients had died and overall median survival was 18 months. All the staging systems were able to identify various patient subgroups with different survival. The CLIP score, the GRETCH model and the BCLC staging classification were better at characterizing the 1‐year prognosis of the patients when compared with the Okuda staging system, whilst the 3‐year prognostic evaluation was improved only by using the CLIP score or the BCLC staging classification.Conclusions.  The prognostic value and usefulness of the CLIP score, the GRETCH model and the BCLC staging classification was reproduced in a single‐centre analysis of anti‐HCV positive HCC cirrhotic patients. These scores provided a prognostic assessment of our patients which is superior to what was obtained by the Okuda staging system.
Pharmacokinetics and pharmacodynamics of clemastine in healthy horses
Authors: Törneke K. , Ingvast‐Larsson C. , Pettersson K. , Bergvall K. , Hedeland M , Bondesson U , BrostrÖm H. 
Published: December 2004

Clemastine is an H1 antagonist used in certain allergic disorders in humans and tentatively also in horses, although the pharmacology of the drug in this species has not yet been investigated. In the present study we determined basic pharmacokinetic parameters and compared the effect of the drug measured as inhibition of histamine‐induced cutaneous wheal formation in six horses.The most prominent feature of drug disposition after intravenous dose of 50 μg/kg bw was a very rapid initial decline in plasma concentration, followed by a terminal phase with a half‐life of 5.4 h. The volume of distribution was large, Vss = 3.8 L/kg, and the total body clearance 0.79 L/h kg. Notably, oral bioavailability was only 3.4%. There was a strong relationship between plasma concentrations and effect. The effect maximum (measured as reduction in histamine‐induced cutaneous wheal formation) was 65% (compared with controls where saline was injected) and the effect duration after i.v. dose was approximately 5 h. The effect after oral dose of 200 μg/kg was minor.The results indicate that clemastine is not appropriate for oral administration to horses because of low bioavailability. When using repeated i.v. administration, the drug has to be administered at least three to four times daily to maintain therapeutic plasma concentrations because of the short half‐life. However, if sufficient plasma concentrations are maintained the drug is efficacious in reducing histamine‐induced wheal formations.
Factors affecting the distribution of small mammals in an urban area
Authors: BAKER PHILIP J. , ANSELL RACHEL J. , DODDS PHILLIPPA A. A. , WEBBER CLAIRE E. , HARRIS STEPHEN 
Published: December 2004

ABSTRACTWe investigated the distribution of a range of small mammal species in five urban habitats in north‐west Bristol: residential gardens, woodlands, allotment gardens, scrub and a cemetery. Wood mouse Apodemus sylvaticus abundance in residential gardens was negatively related to the abundance of cats and the distance to the nearest patch of natural or seminatural vegetation. These results suggest that urban small mammal populations may be limited by predation and habitat fragmentation, although the effects of the latter may be offset by the availability of good quality gardens.