bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of nutrient dilution with high sugar intakes in older South Africans
Authors: Charlton  , Wolmarans  , Lombard  
Published: March 2003

Aims: To investigate the association between added sugar intake and (i) micronutrient intake, (ii) energy profiles and (iii) body mass index (BMI) of a sample of older South Africans.Methods: A sample of 200 free‐living South Africans of mixed ancestry, aged 65 years and older and resident in Cape Town, was randomly drawn using a two‐stage cluster design. Dietary intake was assessed using an interviewer‐administered quantified food frequency questionnaire.Statistical analyses: Spearman correlation coefficients were used to investigate the associations between (i) sugar intake and (ii) total energy intake, and macro‐ and micronutrient intakes and BMI. Differences between the subgroups according to either tertiles of sugar or total energy intake were tested for significance at the
P=0.05 level using analysis of variance (ANOVA ). Age was controlled for in the ANOVA models, according to two groups: 65–74 years and >75 years.Results: For both men and women, the proportion of energy provided by sugars did not differ across the tertiles of energy intake, suggesting that subjects with the highest energy intakes consumed greater quantities of all foods, rather than selecting foods high in sugar. An inverse association was found between the proportion of total energy provided by sugar and (i) the proportion of food energy provided by fat (
r=−0.53; P< 0.0001) and (ii) dietary fibre intake per 4.18 MJ/day (
r=−0.48; P<0.0001). In men the intake of thiamin, vitamin E, iron, zinc, copper and magnesium per 4.18 MJ significantly decreased (
P<0.05) as sugar intake as a percentage of total energy intake (%E) rose. In women, micronutrient intake expressed per 4.18 MJ showed a significant negative trend with sugar intakes as %E for all of the micronutrients investigated, except for vitamins D and E. Body mass index tended to decrease as sugar intake rose, but this difference did not reach significance.Conclusion: The findings of this study did not demonstrate an association between sugar intake and obesity in older South Africans. However, a nutrient‐diluting effect of sugar intake on both micronutrient and fibre intake was observed and needs to be addressed in nutrition intervention strategies for this age group.
Reliability of a qualitative screening tool versus physical measurements in identifying undernutrition in an elderly population
Authors: Pattison R. , Corr J. , Ogilvie M. , Farquhar D. , Sutherland D. , Davidson H. I. M. , Richardson R. A. 
Published: March 2003

Summary Background: This study aimed to assess the validity of a qualitative score derived from a nutritional screening tool when used by a dietitian or nurse against physical markers of nutritional status. Methods: A screening tool designed for elderly patients in use at St John's Hospital was evaluated. Using this, scores derived by dietitian and nurse were compared with physical measurements used in nutritional assessment. The agreement between scores in each of the five categories of the tool (clinical condition, body weight, dietary intake, ability to eat and mental condition) was determined. Results: Sixty‐six subjects (19 male, 47 female, mean age 78.5 years) were recruited. Undernutrition was found in 23% (n=15) of the patient population (≤80% of reference values for one or more physical measurements of nutritional status). A significant correlation between the qualitative score derived by the dietitian using the screening tool and physical markers of nutritional status was evident (body weight expressed as ideal body weight r=0.36, P< 0.005 and arm muscle circumference r=0.53, P< 0.001). Using the screening tool 85% of the under‐nourished patients were correctly classified as nutritionally ‘at risk’ by the dietitian; however, only 58% were correctly identified by the nurse. There was no agreement between scores from the dietitian and nurse in any of the five scoring categories. Conclusion: These results show that the nurse failed to identify over 40% of at‐risk patients when using the screening tool. The lack of agreement between dietitian and nurse within each scoring category may suggest fundamental differences in assessing factors contributing to nutritional risk by these two professions.
Impact of stepped verbal and written reinforcement of fluid balance advice within an outpatient haemodialysis unit: a pilot study
Authors: Casey J. , Johnson V. , McClelland P. 
Published: March 2003

BackgroundThe present pilot study assesses a programme of verbal and written fluid balance advice within an out‐patient haemodialysis unit.MethodsTwenty‐one haemodialysis patients were followed over three separate 6‐week periods. Each 6‐week period assessed dietetic and nursing educational input using a stepped approach with interdialytic weight gain (IDWG) as a barometer of patient compliance. Weight gain was statistically examined using the non‐parametric Friedman test.ResultsForty‐eight per cent of the sample group demonstrated an overall improvement in mean weight gain; however, this was not statistically significant (P=0.504).ConclusionThe pilot study suggests that further studies with greater numbers and a control group would have a useful contribution to make in this field.
Working memory and everyday cognition in adults with Down's syndrome
Authors: Numminen H. , Service E. , Ahonen T. , Ruoppila I. 
Published: March 2003

AbstractA number of previous studies have suggested that young people with Down's syndrome (DS) have a specific deficit of the phonological loop component of the working memory. However, there have also been studies which have proposed a specific deficit of the central executive component of working memory and suggested similarities of working memory functioning with patients with Alzheimer's disease. Fifteen middle‐aged people with DS were matched for their individual scores of non‐verbal intelligence to 15 individuals with mixed aetiology of intellectual disability. A versatile range of tasks was used in order to evaluate the functioning of working memory components. In addition, several everyday cognition skills were assessed. The subjects with DS performed significantly more poorly in all tasks assessing the phonological loop. Performance in other working memory tasks and compound variables representing different working memory components was equal in the groups. In addition, both groups had equal everyday cognition skills. The functioning of the phonological loop seems to be clearly deficient in people with DS. Interestingly, the deficit does not seem to affect the vocabulary or other everyday cognition skills in individuals with DS. No signs of specific deficit of the central executive component of working memory were found.
Behavioural knowledge, causal beliefs and self‐efficacy as predictors of special educators’ emotional reactions to challenging behaviours
Authors: Hastings R. P. , Brown T. 
Published: March 2003

AbstractBackground Theoretical models and emerging empirical data suggest that the emotional reactions of staff to challenging behaviours may affect their responses to challenging behaviours and their psychological well‐being. However, there have been few studies focusing on factors related to staff emotional reactions.Methods Seventy staff working in educational environments with children with intellectual disability and/or autism completed a self‐report questionnaire that measured demographic factors, behavioural causal beliefs, behavioural knowledge, perceived self‐efficacy, and emotional reactions to challenging behaviours.Results Regression analyses revealed that behavioural causal beliefs were a positive predictor, and self‐efficacy and behavioural knowledge were negative predictors of negative emotional reactions to challenging behaviours. Staff with formal qualifications also reported more negative emotional reactions. No other demographic factors emerged as significant predictors.Conclusions The results suggest that behavioural causal beliefs, low self‐efficacy and low behavioural knowledge may make staff vulnerable to experiencing negative emotional reactions to challenging behaviours. Researchers and clinicians need to address these issues in staff who work with people with challenging behaviours.
Understanding challenging behaviour in people with severe and profound intellectual disability: a stress‐attachment model
Authors: Janssen C. G. C. , Schuengel C. , Stolk J. 
Published: March 2003

AbstractBackgroundAdvances in our knowledge of attachment, stress and coping may foster new explanations for the development of challenging behaviour in people with intellectual disability (ID). Method Research on stress and coping among people with ID was reviewed initially, and then studies on the security of the attachment relationships of people with ID with their caregivers were analysed.ResultsThere is evidence that people with ID are more vulnerable to stress and use less effective coping strategies. Furthermore, the body of studies on attachment indicates that people with ID are at risk for developing insecure, especially disorganized attachment. There is evidence from other populations that the combination of stress, and insecure or disorganized attachment may put people at risk for developing behaviour problems.ConclusionA stress‐attachment model of the development of challenging behaviour among people with ID shows promise as an explanatory framework. The uncovering of these developmental mechanisms may be particularly useful for the prevention of behavioural problems.
Word‐length effect in verbal short‐term memory in individuals with Down's syndrome
Authors: Kanno K. , Ikeda Y. 
Published: March 2003

AbstractBackground Many studies have indicated that individuals with Down's syndrome (DS) show a specific deficit in short‐term memory for verbal information. The aim of the present study was to investigate the influence of the length of words on verbal short‐term memory in individuals with DS.Methods Twenty‐eight children with DS and 10 control participants matched for memory span were tested on verbal serial recall and speech rate, which are thought to involve rehearsal and output speed.Results Although a significant word‐length effect was observed in both groups for the recall of a larger number of items with a shorter spoken duration than for those with a longer spoken duration, the number of correct recalls in the group with DS was reduced compared to the control subjects. The results demonstrating poor short‐term memory in children with DS were irrelevant to speech rate. In addition, the proportion of repetition‐gained errors in serial recall was higher in children with DS than in control subjects.Conclusions The present findings suggest that poor access to long‐term lexical knowledge, rather than overt articulation speed, constrains verbal short‐term memory functions in individuals with DS.
Evaluation of communicative and functional abilities in Wolf–Hirshhorn syndrome
Authors: Sabbadini M. , Bombardi P. , Carlesimo G. A. , Rosato V. , Pierro M. M. 
Published: March 2003

AbstractBackgroundWolf–Hirschhorn syndrome (WHS) is a genetic condition characterized by many clinical disorders, learning difficulties, dysphagia, neuromotor deficits and communicative deficits. Up until now, no studies in the literature have described the development of communicative and functional abilities in subjects with WHS.MethodIn the present study of 11 patients with WHS, a descriptive analysis was made of several abilities and three groups of patients were identified on the basis of the severity of their functional deficit.ResultsA non‐homogeneous picture of impairment emerged in various areas of development. Overall, the neuromotor abilities of these patients were more adequate than their abilities related to autonomy in personal life, alimentary function, and cognitive and communicative‐linguistic aspects.ConclusionBased on the identification of specific patterns of communicative and functional impairment in subjects with WHS, rehabilitative intervention strategies can be planned to increase their communicative opportunities, and possibilities for active and autonomous participation in various life contexts (e.g. home, school and the social environment).
Parotid salivary immunoglobulins, recurrent respiratory tract infections and gingival health in institutionalized and non‐institutionalized subjects with Down's syndrome
Authors: Chaushu S. , Yefe Nof E. , Becker A. , Shapira J. , Chaushu G. 
Published: March 2003

AbstractBackground The purpose of the present study was to evaluate the possible correlation between recurrent respiratory infections (RRIs), gingival health and the secretion rates of salivary immunoglobulins (Igs) in institutionalized (I) and non‐institutionalized (NI) individuals with Down's syndrome (DS).Methods Stimulated parotid saliva was collected from nine I and 14 NI subjects with DS. Salivary flow rate, secretion rates of total salivary IgM, IgG and IgA, and the incidence of RRIs were determined. Gingival health was recorded by using the plaque index, the gingival index and the percentage of bleeding surfaces (BS).Results The mean salivary flow rate and parotid Ig secretion rates in the I group were 25% of those of the NI group. The prevalence of RRIs in the I group was more than twice that in the NI group. Oral hygiene and gingival health were significantly better in the NI group.Conclusions The lower parotid Ig secretion rates in I individuals with DS might be a possible factor involved in their susceptibility to recurrent infections compared to NI subjects with DS.
Assessment and diagnosis of depression in people with intellectual disability
Authors: McBrien J. A. 
Published: March 2003

AbstractBackground  Despite widespread acceptance that depression can occur in adults with intellectual disability (ID), the difficulties encountered in its assessment and diagnosis have hampered the individual clinician, and meant that questions of prevalence, treatment choice and outcome remain problematic.Method  The present paper reviews the progress in this field since three reviews, all published in the mid‐1990s, recommended further attention to three interlinked issues: diagnostic criteria, the symptoms of depression in this group and the lack of rating scales.Results  Despite a further 11 published papers and other studies in progress, the method of diagnosis for people with severe and profound ID remains debatable, with some authors advocating adherence to standard criteria, others suggesting adding criteria to the standard ones and yet others believing that substitute criteria are called for. However, for those with mild to moderate ID, a consensus is emerging that standard diagnostic criteria are appropriate. There has been progress in examining some of the symptoms which might constitute depression in people with ID. New diagnostic criteria issued by the Royal College of Psychiatrists are to be welcomed. There is an assumption in much of the research that symptoms of behaviour commonly termed challenging or maladaptive must be atypical symptoms of depression, but none of the studies reviewed demonstrate this effectively. This is compounded by methodological flaws in the way that depressed samples are arrived at for further study. Although new rating scales have emerged, there is as yet no gold standard diagnostic tool for depression amongst people with ID.Conclusions  It is suggested that, given these difficulties, the validity of the conceptual frameworks for depression is still in doubt. It remains the case that large‐scale, collaborative, prospective studies are called for.
The role of serum ferritin in the diagnosis of iron deficiency anaemia in patients with liver cirrhosis
Authors: Intragumtornchai  , Rojnukkarin  , Swasdikul  , Israsena  
Published: March 2003

Intragumtornchai T, Rojnukkarin P, Swasdikul D, Israsena S (Division of Haematology, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand). The role of serum ferritin in the diagnosis of iron deficiency anaemia in patients with liver cirrhosis. J Intern Med 1998; 243: 233–41.Objectives.To determine the diagnostic values of serum ferritin and other conventional laboratory tests in the diagnosis of iron deficiency anaemia in patients with liver cirrhosis.Design.Cross‐sectional study for diagnostic tests.Setting.University hospital.Subjects.Seventy‐two consecutive patients with liver cirrhosis in whom the haemoglobin level was less than 13.0 g dL−1 for men and 12.0 g dL−1 for women. The diagnosis of liver cirrhosis was based on characteristic clinical and hepatic ultrasonographic findings.Main outcome measures.By using absence of bone marrow iron as the standard criterion, the diagnostic powers of mean corpuscular volume, transferrin saturation, serum ferritin and the presence of hypochromic red cells in the diagnosis of iron deficiency were compared by analysing the likelihood ratios, the area under the receiver operating curves (ROC) and the stepwise logistic regression associated with each test.Results.<> Twenty‐nine patients (40.3%) demonstrated no stainable iron in the bone marrow. The likelihood ratios, the area under the ROC and the stepwise logistic regression indicated that serum ferritin was the most powerful test predictive of iron deficiency. Other tests added little further diagnostic values. The likelihood ratios associated with the serum ferritin levels were as follows: <50 μg L−1, 22.3; 51–200 μg L−1, 1.5–1.8; 201–400 μg L−1, 1.0; > 400 μg L−1, <1. These results indicate that serum ferritin level <50 μg L−1 depict a very high probability of iron deficiency anaemia (0.83–0.99) irrespective of the patient's pre‐test probability.Conclusion.Serum ferritin is the most powerful non‐invasive test for the diagnosis of iron deficiency anaemia in patients with liver cirrhosis. It should be the primary test of choice in patients suspected of having the disease. When the level was less than 50 μg L−1, iron supplement may be prescribed without necessitating bone marrow aspiration.
The frequency and severity of retinopathy are related to HbA1c values after, but not at, the diagnosis of NIDDM
Authors: Henricsson  , Gottsäter  , Jeppsson  , Fernlund  , Sundkvist  
Published: March 2003

Henricsson M, Gottsäter A, Jeppsson J‐O, Fernlund P, Sundkvist G (Lund University, Malmö University Hospital, Malmö, Sweden). The frequency and severity of retinopathy are related to HbA1c values after, but not at, the diagnosis of NIDDM. J Intern Med 1998; 244: 149–54.ObjectivesTo examine the relationship between previous glycaemic exposure and prevalence of retinopathy 8 years after diagnosis of diabetes in 58 islet cell antibodies (ICA)‐negative noninsulin‐dependent diabetes mellitus (NIDDM) patients and in a group of 14 ICA‐positive ‘NIDDM’ and insulin‐dependent diabetes mellitus (IDDM) patients.Design and methodsThe Wisconsin retinopathy scale was used to assess the retinopathy which was graded into mild, moderate and severe nonproliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR). The frequency and severity of retinopathy was related to HbA1c levels at diagnosis, and 3 and 5 years later.ResultsThirty of the 58 ICA‐negative NIDDM patients (52%) but only 2 of the 14 ICA‐positive ‘NIDDM’ or IDDM patients (14%) had mild–moderate–severe NPDR 8 years after diagnosis (P= 0.02). None had PDR. Retinopathy 8 years after diagnosis in NIDDM (= 58 ICA‐negative patients) was correlated with the degree of glycaemic control (HbA1c levels) at 3 and 5 years after diagnosis, but not to HbA1c levels at diagnosis. The relative risk for a higher average HbA1c (per percentage) at 3 and 5 years was 1.56 for any retinopathy vs. no retinopathy (95% confidence interval 1.1–2.2; P= 0.01) and 1.68 for moderate to severe NPDR in comparison with no DR and mild NPDR (95% confidence interval 1.0–2.8; P= 0.04).ConclusionsRetinopathy after 8 years of diabetes in NIDDM patients was associated with impaired glycaemic control during previous years but not with glycaemic control at baseline. Good glycaemic control may prevent retinopathy in patients with NIDDM.
The importance of serum lipoprotein (a) as an independent risk factor for premature coronary artery disease in middle‐aged black and white women from the United States
Authors: Dahlén  , Srinivasan  , Srinivasan  , Stenlund  , Wattigney  , Wall  , Berenson  
Published: March 2003

Abstract. Dahlén GH, Srinivasan SR, Stenlund H, Wattigney WA, Wall S, Berenson GS (Umeå University Hospital and University of Umeå, Umeå, Sweden; and Tulane School of Public Health and Tropical Medicine, New Orleans, LO, USA). The importance of serum lipoprotein (a) as an independent risk factor for premature coronary artery disease in middle‐aged black and white women from the United States. J Intern Med 1998; 244: 417–24.ObjectiveTo determine the association of serum levels of lipoprotein (a) (Lp(a)) with coronary artery disease (CAD) in relation to other risk factor variables in black and white women.DesignRetrospective case–control study.SettingCommunity of Bogalusa, Louisiana and Cardiac Catherization Laboratory at the Medical Center of Louisiana, New Orleans, USA.SubjectsThe study included 47 female cases (52% black; mean ± SD age: 50.8 ± 6.3 years) with confirmed myocardial infarction (MI) or at least 75% blockage of one or more major epicardial coronary arteries determined by angiography, and 55 controls (60% black; mean ± SD age: 49.6 ± 7.9 years) with no high grade obstructive lesion (<50% blockage) and no history of CAD.Main outcome measuresLipoprotein variables, homocysteine, body mass index and cigarette smoking.ResultsIn the whole group, mean values of Lp(a), total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), apolipoprotein B (apoB) and very‐low‐density lipoprotein cholesterol (VLDL‐C) were higher (P < 0.05–0.001) and apoA‐I was lower (P < 0.05) in cases than in controls. The multivariate logistic regression analysis showed elevated levels of Lp(a) (>500 mg L−1) and LDL‐C (>3.36 mmol L−1) as strong independent risk factors, with odds ratios (with 95% confidence intervals) of 13.6 (4.00–46.30) and 4.64 (1.31–16.49), respectively. ApoA‐I, with an odds ratio of 0.11 (0.02—0.64), was a protective factor only at high levels (>53.6 μmol L−1). Between races, significant odds ratios were noted in the black women for Lp(a) (OR = 15.98; P < 0.01) and LDL‐C (OR = 7.69; P < 0.05) and in the white women for only Lp(a) (OR = 15.23; P < 0.01).ConclusionsLp(a) is an important risk factor for CAD both in black and in white women.