bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subjective judgements of quality of life: a comparison study between people with intellectual disability and those without disability
Authors: Hensel E. , Rose J. , Kroese B. Stenfert , Banks‐Smith J. 
Published: March 2003

AbstractBackground The present study investigated the relationship between objective and subjective measures of quality of life (QoL), and in particular, health status and primary care services.Methods Thirty‐one people with intellectual disability (ID) were interviewed using a QoL questionnaire. Thirty‐one matched controls from the general population filled in a parallel questionnaire.Results The results in both groups support the findings of many researchers which indicate that satisfaction with aspects of life is generally high (i.e. ≈ 75% of maximum possible satisfaction). The present study also confirms previous findings which indicate that satisfaction with aspects of life does not generally correlate with objective circumstances in either group. The importance that people attach to aspects of their lives did not generally correlate with their objective circumstances or their satisfaction with life. However, people with ID attached greater importance to all aspects of their lives than those without disability. This may be linked to their aspirations, preferences and opportunities for choice, and therefore, these factors may be a more meaningful way of considering their QoL.Conclusions The present findings call into question the use of satisfaction as a general measure of QoL, and also indicate that the use of importance as a mediating variable in understanding satisfaction may not be a solution. The participants with ID had poorer health than the controls, and were significantly less satisfied with their health. Contrary to other findings, the present participants with ID reported that they had received more health checks than the controls over the previous year. Half of these checks had been carried out by ‘special’ services rather than primary care services.
Contraception of women with intellectual disability: prevalence and determinants
Authors: Servais L. , Jacques D. , Leach R. , Conod L. , Hoyois P. , Dan B. , Roussaux J. P. 
Published: March 2003

AbstractBackground The contraception of women with intellectual disability (ID) is a major concern for caregivers. However, the prevalence of contraception and the frequency of use of different methods (e.g. sterilization) remain generally unknown. Moreover, indications specific to women with ID are controversial.Methods The present authors conducted a population‐based study among 97% of the women with ID aged between 18 and 46 years attending government‐funded facilities in Brussels and the nearby province of Walloon Brabant in Belgium.Results Out of 397 subjects, 40.8% did not use any contraceptive method, 22.2% were sterilized, 18.4% used an oral contraceptive agent, 17.6% used depotmedroxyprogesterone acetate and 1% used an intrauterine device. These figures differ widely from those of the general Belgian population. Binary logistic regression for ‘contraceptive utilization’ showed the strong influence of institutional factors such as sleeping environment (i.e. institutional or parental), sexual relationship policy and contraception policy. Having or having had a boyfriend is also correlated with a stronger probability of contraceptive use. Other factors have a smaller influence (e.g. a milder level of ID). Very few factors, none of which are medical, are correlated with an increased use of a specific method. The present results are discussed in the light of the general medical application of contraception and the commonly assumed specific indications for women with ID.
Changes in explicit memory associated with early dementia in adults with Down’s syndrome
Authors: Krinsky‐McHale S. J. , Devenny D. A. , Silverman W. P. 
Published: March 2003

AbstractBackgroundA modified version of the Selective Reminding Test (SRT) (Buschke 1973) was used to examine the changes in memory that occur with early‐stage dementia of the Alzheimer’s type (DAT) in adults with intellectual disability (ID) and Down’s syndrome (DS), and to compare these changes to those occurring with ‘normal’ ageing.MethodHierarchical linear modelling analyses showed steep declines in the performance of participants who had met the criteria for the onset of DAT. Non‐demented participants also showed declines in performance which were related to their age. However, the absolute magnitude of these declines was consistent with a ‘normal’ ageing pattern and not with undetected dementia.ResultsIn analysing the specific memory components that are compromised, the present authors found that participants with early‐stage DAT showed severely diminished long‐term storage and retrieval processing abilities compared to their non‐demented peers. Notably, these declines preceded other symptoms of dementia, in most cases by more than a full year and sometimes by as much as 3 years.ConclusionsThus, the present results clearly confirm that memory processes are affected during early dementia in adults with DS, and that the SRT has promise as a clinical tool.
Feasibility, reliability and validity of the Spanish version of Psychiatric Assessment Schedule for Adults with Developmental Disability: a structured psychiatric interview for intellectual disability
Authors: Gonzalez‐Gordon R. G. , Salvador‐Carulla L. , Romero C. , Gonzalez‐Saiz F. , Romero D. 
Published: March 2003

AbstractBackground Over 30% of people with intellectual disability (ID) have a comorbid psychiatric disorder. However, there are few assessment instruments available for international use and cross‐cultural validation studies of these instruments are rare. The aim of the present study was to standardize the Spanish version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS‐ADD‐10), a semi‐structured interview for people with ID.Methods After a conceptual translation, feasibility (i.e. applicability, acceptability and practicality) and reliability analyses were carried out. The predictive validity of the PAS‐ADD‐10 CATEGO‐5 codings was also examined (i.e. positive and negative predictive values). Four independent raters with wide‐ranging experience in quantitative evaluation and psychiatric assessment of ID evaluated a sample of 80 subjects with ID and borderline intellectual functioning at the AFANAS occupational centre in Jerez, Southern Spain. The ICD‐10 codes were used for psychiatric diagnosis.Results The practicality of the PAS‐ADD‐10 is limited because of the need for previous standardization of SCAN interviews. Nevertheless, its overall feasibility was judged adequate by raters and the PAS‐ADD‐10 was considered extremely useful for training. Test–retest and inter‐rater reliability kappa values were moderate to high. The CATEGO coding showed limited validity because of overdiagnosis of anxiety disorders and underdiagnosis of mood and psychotic disorders (positive predictive value = 74%, negative predictive value = 76%).Conclusions The PAS‐ADD‐10 is a useful tool for standard psychiatric assessment of people with ID; however, CATEGO codings show low validity and a series of modifications should be considered before this instrument is used extensively in Spain. In this regard, a study on the clinical usefulness of the PAS‐ADD‐10 in patients with ID and severe mental disorders has been undertaken.
Motion analysis of stereotyped hand movements in Rett syndrome
Authors: Wright M. , Van Der Linden M. L. , Kerr A. M. , Burford B. , Arrowsmith G. , Middleton R. L. 
Published: March 2003

AbstractBackgroundRett syndrome is a genetic developmental disorder, and stereotyped hand movements are a striking feature of this condition. The aim of the present study was to subject these movements to objective analysis and compare the results in one girl at different ages.MethodThe hand movements of a 10‐year‐old girl with Rett syndrome were subjected to accurate, three‐dimensional (3D) computerized motion analysis and compared to two‐dimensional (2D) video analysis of the same girl at 3 years of age.ResultsThree‐dimensional computerized analysis revealed regular patterns with strong coupling between the hands. Frequency analysis showed a dominant frequency at 1.2 Hz, with a higher component at 2.4 Hz that may relate to the activity of basic rhythm generators. The same coupling characteristics were extracted from standard, 2D video recordings made at the same time as the 3D capture.ConclusionAn informal video of the same girl taken when she was 3 years of age was analysed in the same way as the 2D video and showed the same characteristics, indicating the possible future use of automated video analysis for early screening and intervention evaluation.
Determinants of negative emotional reactions and causal beliefs about self‐injurious behaviour: an experimental study
Authors: Hastings R. P. , Tombs A. K. H. , Monzani L. C. , Boulton H. V. N. 
Published: March 2003

AbstractBackground  Caregivers’ emotional and cognitive reactions to challenging behaviours have been identified as potential determinants of their reinforcing responses towards such behaviours. However, few studies have explored factors affecting caregivers’ emotional and cognitive responses to challenging behaviours.Methods  Sixty students inexperienced in work with people with challenging behaviours and 60 experienced staff watched one of two carefully matched, acted videotapes depicting self‐injury maintained by attention or escape‐from‐task demands. The participants were also told whether the self‐injury depicted typically led to mild or severe consequences for the person filmed. The subjects completed measures of their negative emotional reactions to the self‐injury and their behavioural causal beliefs about the behaviour depicted.Results  Analyses of variance revealed that students reported more negative emotional reactions and were less likely to endorse behavioural causal hypotheses. Those who watched the severe self‐injury videotape also reported more negative emotional reactions. Two effects of the behavioural function of the depicted self‐injury were also found: (1) attention‐maintained self‐injury was associated with higher levels of endorsement of behavioural causal hypotheses; and (2) severe attention‐maintained self‐injury led to the strongest negative emotional reactions, but only from students.Conclusions  The effects of experience and behavioural function on emotional reactions and behavioural causal beliefs need to be explored in more detail in future research. If replicated, the present results have significant implications for theory and practice in the remediation of challenging behaviours and the support of care staff.
Has hospital mortality from acute myocardial infarction been markedly reduced since the introduction of thrombolytics and aspirin?
Authors: Reikvam  , Abdelnoor  , Sivertssen  
Published: March 2003

Reikvam Å, Abdelnoor M , Sivertssen E for the European Secondary Prevention Study Group (Ullevål University Hospital, Oslo, Norway). Has hospital mortality from acute myocardial infarction been markedly reduced since the introduction of thrombolytics and aspirin?J Intern Med 1998; 243: 259–63.ObjectivesThere are conflicting views on how hospital mortality with respect to acute myocardial infarction (AMI) has changed since the introduction of thrombolytics and aspirin. Our purpose therefore was to explain this by studying hospital mortality in a nonselected AMI population, and then assess how patients allocated to different treatment groups contribute to overall mortality.DesignExtensive data were collected on all AMI patients admitted to the 10 hospitals in health region 1 (population 850 000) in Norway during a 2 month period. A protocol approved by the European Secondary Prevention Study Group was used.ResultsOf the 487 patients, 32% received thrombolytics, 72% aspirin and 22% none of the treatments. Average in‐hospital mortality was 18%. Mortality within the different groups was as follows: no thrombolytics nor aspirin group 35.0% (39/111), aspirin group 13.7% (30/218), thrombolytics group 17.3% (4/23), and thrombolytics plus aspirin group 11.0% (15/135). The characteristics of the non‐treated group compared to the aspirin and aspirin plus thrombolytics groups were more females, older, increased frequency of previous AMI, left ventricular failure, cardiopulmonary resuscitation, history of stroke and peptic ulcer, and electrocardiogram (ECG) findings other than ST elevation.ConclusionIn a nonselected AMI population, a patient group receiving neither thrombolytics nor aspirin contributed most significantly to an overall high mortality. This indicates a modest reduction in total AMI mortality after the new therapies were introduced, as the mortality for this group, with a high risk profile, has presumably remained unchanged.
Associations between aldosterone synthase gene polymorphism and the adrenocortical function in males
Authors: HAUTANEN A. , HAUTANEN A. , LANKINEN L. , KUPARI M. , JÄNNE O. A. , ADLERCREUTZ H. , NIKKILÄ H. , WHITE P. C. 
Published: March 2003

Abstract. Hautanen A, Lankinen L, Kupari M, Jänne OA, Adlercreutz H, Nikkilä H, White PC (Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland. University of Texas Southwestern Medical Center, Dallas, TX, USA). Associations between aldosterone synthase gene polymorphism and the adrenocortical function in males. J Intern Med 1998; 244: 11–18.ObjectivesTwo diallelic polymorphisms, one in the transcriptional regulatory region (promoter) and the other in the second intron, have been identified in the aldosterone synthase (CYP11B2) gene encoding aldosterone synthase, the enzyme catalysing the last steps of aldosterone biosynthesis. We have examined the associations between these genetic variations and adrenocortical function in a cohort of Finnish males.DesignA cross‐sectional study.SettingHelsinki University Central Hospital, Finland.SubjectsNinety‐two males aged 30–55 years.Main outcome measuresBasal adrenocortical function was assessed by measuring urinary excretion of aldosterone and cortisol. Functional activity was determined by responses of several adrenal steroids to dexamethasone suppression followed by ACTH stimulation. Polymerase chain reactions were used to identify the polymorphisms in the CYP11B2 gene.ResultsThe –344TT genotype group in the CYP11B2 promoter had lower systolic blood pressures (P= 0.039), but higher urinary aldosterone excretion (P= 0.016), and 11‐deoxycortisol responses to ACTH stimulation (P= 0.021) than the –344CC genotype group. Urinary aldosterone excretion (P= 0.033), 11‐deoxycortisol (P= 0.026), and aldosterone (P= 0.013) responses to ACTH were higher in the intron 2 conversion than the nonconversion genotype groups.ConclusionsPolymorphisms in or near the aldosterone synthase gene are associated with variations in aldosterone and 11‐deoxycortisol production in males. This may modulate the activity of the renin–angiotensin system and thereby contribute to blood pressure regulation.
Seasonal changes in symptomatic duodenal ulcer activity in Taiwan: a comparison between subjects with and without haemorrhage
Authors: Tsai  , Lin  
Published: March 2003

Abstract. Tsai C‐J, Lin C‐Y (Chi Mei Foundation Hospital, Tainan, Taiwan). Seasonal changes in symptomatic duodenal ulcer activity in Taiwan: a comparison between subjects with and without haemorrhage. J Intern Med 1998; 244: 405–10.ObjectivesTo examine if climatic changes may influence the presentation of pain and haemorrhage in patients with duodenal ulcers.DesignCross‐sectional study.SettingTertiary referral centre.SubjectsA total of 10 331 symptomatic duodenal ulcer diseases were diagnosed from 1989 to 1996. The patients who had any extrinsic factors that might influence the exacerbation of duodenal ulcer were not included. Patients were divided into those whose ulcer bled once or repeatedly as distinct from those whose ulcers caused pain without haemorrhagic complications. Patients with acute cholangitis diagnosed in the same period were studied as controls.ResultsDuring the 7‐year period, 10 331 symptomatic duodenal ulcer diseases were diagnosed. Amongst these, 5328 showed active duodenal ulcer without haemorrhage, 2088 showed acute duodenal ulcer with stigmata of recent haemorrhage, and 2915 showed a deformed bulb. The incidence of total duodenal ulcers showed significant monthly variation and was found to be more common from November to March (P < 0.001). The monthly incidence of total episodes of upper gastrointestinal tract bleeding peaked from November to March (P < 0.001) with significant variation. The monthly incidence of bleeding episodes from duodenal ulcer only was the same (P < 0.001). In patients whose duodenal ulcers repeatedly caused pain without haemorrhage, there were significant monthly fluctuations, with peak months from December to March (P < 0.001). In the control diagnosis, there were no significant calendar variations (P = 0.85).ConclusionsOur study has shown that both groups of patients demonstrated similar monthly fluctuations. The incidence is significantly higher during the cold seasons. These data suggest that climatic changes may influence the presentation of pain and haemorrhage in duodenal ulcer patients.
A nurse‐managed weight reduction programme for obstructive sleep apnoea syndrome
Authors: Lojander  , Mustajoki  , Rönkä  , Mecklin  , Maasilta  
Published: March 2003

Lojander J, Mustajoki P, Rönkä S, Mecklin P, Maasilta P (Helsinki University Central Hospital, Helsinki, Finland). A nurse‐managed weight reduction programme for obstructive sleep apnoea syndrome. J Intern Med 1998; 244: 251–55.ObjectivesThis longitudinal, clinical intervention study was designed to investigate whether pulmonary departments can set up a cost‐effective weight and lifestyle programme as primary treatment of obstructive sleep apnoea syndrome (OSAS).SettingA weight reduction programme (1 year) in a pulmonary department for outpatients in Helsinki University Central Hospital.SubjectsA total of 24 (23 men) moderately obese (body mass index [BMI], 30–40 kg m−2) patients with newly diagnosed OSAS.InterventionsThe first 6 weeks consisted of a very low‐calorie diet (VLCD, 500 kcal day−1) and thereafter normal food low in calories. There were altogether 12 group meetings for behavioural management.Main outcome measuresDaytime somnolence, BMI and oxygen desaturation index of 4% (ODI4) were measured prior to the programme, at the end of the VLCD phase and at 1 year.ResultsThe programme was easy to administer without any serious side‐effects. At 1 year, patients had lost a mean of 33% of their overweight (mean weight at baseline 110 kg, after 99 kg) and their ODI4 indexes improved significantly (P < 0.005). There was no correlation between the amount of weight loss and improvement in ODI4 indexes. The cost per patient was about half the cost of treatment with nCPAP (nasal continuous positive airway pressure) for 1 year at our hospital.ConclusionsA nurse‐managed programme with VLCD and behavioural management is safe and effective on an outpatient basis. Weight loss should be encouraged in OSAS in patients with moderate overweight. The amount of weight loss needed for improvement of OSAS is unique to each individual.
Short stature and prognosis of coronary heart disease in women
Authors: Wamala S. P. , Mittleman M. A. , Horsten M. , Schenck‐Gustafsson K. , Orth‐Gomér K. 
Published: March 2003

Abstract.Objectives.  To investigate the effect of short stature on prognosis following an acute event of coronary heart disease (CHD) in women.Setting.  All women who were hospitalized for an acute event of CHD in any of the 10 cardiology clinics in greater Stockholm were investigated for the first time in the Stockholm Female Coronary Risk Study between 1991 and 1994, and were followed until August 1997 for recurrent coronary events.Design.  A follow‐up study of women with either acute myocardial infarction (AMI) or unstable angina pectoris. Median follow‐up period was 4.8 years.Subjects.  A total of 292 Swedish women, aged 65 years or younger.Main outcome measures.  Recurrent AMI, death from CHD or revascularization procedure (percutaneous transluminal coronary angioplasty and coronary artery bypass grafting).Results.  Independent of the confounding effects of other risk factors of clinical importance for CHD (age, socioeconomic status, menopausal status, index event, congestive heart failure, angina severity, diabetes, hypertension, smoking, triglycerides and HDL cholesterol), the shortest 25% of women (< 160 cm) had a 2.1‐fold (95% CI = 1.0–4.4) increased rate of developing adverse cardiac events (cardiovascular death, recurrent AMI or revascularization procedure) compared with the tallest 25% (> 165 cm). In addition, an increased rate was observed for each 10 cm difference in height (hazard ratio = 1.7, 95% CI = 1.4–2.7). Similar results were observed when analysing each outcome separately.Conclusions.  These data indicate that short stature is a strong predictor of poor prognosis after an acute coronary event in women, independent of socioeconomic status and other risk factors for CHD.
Oral anticoagulation in peripheral vascular surgery: how intense, for how long, or at all?
Authors: Kretschmer G. , Hölzenbein T. J. 
Published: March 2003

Abstract.To evaluate the influence of postoperative pharmacotherapy (antiplatelet therapy with acetylsalicylic acid (ASA) or oral anticoagulation) following various peripheral vascular surgical interventions (femoro‐popliteal reconstruction, femoro‐popliteo‐tibial venous bypass;) two clinical series of patients were analysed (A1–2) and we made the hypothesis that adjuvant therapy may be beneficial. Thereafter two clinical trials were carried out (B1–2), to assess the value of postoperative antiaggregant and anticoagulant treatment. It was not possible to demonstrate any influence of ASA on improving patency at the iliaco‐popliteal level or on patient survival. It was concluded that the ASA dosage of 1500 mg daily was too high, and produced severe side‐effects, probably leading to insufficient patient compliance to therapy. In the B2 trial 130 patients received a femoro‐popliteal above‐ or below‐knee vein bypass, and were assigned to the therapy group (n = 66) and treated with anticoagulants or to the control group (n = 64) which received no therapy. During the follow‐up, for a maximum of 10 years, the probability of bypass function, limb salvage and patient survival were significantly in favour of the treatment. The described single centre clinical trial B‐2 produced in accordance with other trials a level II evidence in favour of postoperative pharmacotherapy. Level 1 trials assessing the direct comparison of antiaggregant versus anticoagulant therapy are underway, but results are unavailable yet, similarly the results of the Antithrombotic Trialist’s Collaboration (ATT) are currently unknown.
Relapsing pneumonia due to a migrating intrathoracic foreign body in a World War II veteran shot 53 years ago
Authors: Langer D. , Petermann C. , Lübbers H. , Lankisch P. G. 
Published: March 2003

Abstract.In the great majority of cases of long‐standing intrathoracic foreign bodies, patients are asymptomatic. However, symptoms may occur years later from the migration of the foreign body. We report on a 70‐year‐old patient who developed relapsing pneumonia due to obstruction of a bronchial branch of the left apical group by a migrating infantry bullet impacting 53 years ago. This was not diagnosed until the second attack of pneumonia in 1998. The bullet remains were removed bronchoscopically and the pneumonia resolved completely without further complications.