bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pneumonia: The Demented Patient's Best Friend? Discomfort After Starting or Withholding Antibiotic Treatment
Authors: Van Der Steen Jenny T. , Ooms Marcel E. , Van Der Wal Gerrit , Ribbe Miel W. 
Published: October 2002

OBJECTIVES: To assess suffering in demented nursing home patients with pneumonia treated with antibiotics or without antibiotics. This study should provide the first empirical data on whether pneumonia is a “friend” or an “enemy” of demented patients and promote a debate on appropriate palliative care.DESIGN: Prospective cohort study.SETTING: Psychogeriatric wards of 61 nursing homes in the Netherlands.PARTICIPANTS: Six hundred sixty‐two demented patients with pneumonia treated with (77%) or without (23%) antibiotics.MEASUREMENTS: Using an observational scale (Discomfort Scale—Dementia of Alzheimer Type), discomfort was assessed at the time of the pneumonia treatment decision and periodically thereafter for 3 months or until death. (Thirty‐nine percent of patients treated with antibiotics and 93% of patients treated without antibiotics died within 3 months.) Physicians also offered a retrospective judgment of discomfort 2 weeks before the treatment decision. In addition, pneumonia symptoms were assessed at baseline and on follow‐up. Linear regression was performed with discomfort shortly before death as an outcome.RESULTS: A peak in discomfort was observed at baseline. Compared with surviving patients treated with antibiotics, the level of discomfort was generally higher in patients in whom antibiotic treatment was withheld and in nonsurvivors. However, these same patients had more discomfort before the pneumonia. Breathing problems were most prominent. Shortly before death from pneumonia, discomfort increased. Discomfort was higher shortly before death when pneumonia was the final cause of death than with death from other causes.CONCLUSION: Irrespective of antibiotic treatment, pneumonia causes substantial suffering in demented patients. Adequate symptomatic treatment deserves priority attention.
Smoking Patterns Among Seniors and the Medicare Stop Smoking Program
Authors: Arday David R. , Lapin Pauline , Chin Joseph , Preston Jeanette A. 
Published: October 2002

OBJECTIVES: To characterize smoking patterns in the older U.S. community‐dwelling Medicare population at the national level and in states chosen to participate in the new Medicare Stop Smoking Program (MSSP) demonstration. To describe the MSSP.DESIGN: Data from the Behavioral Risk Factor Surveillance System (BRFSS) 1996 to 1999 were analyzed.SETTING: The BRFSS is a cross‐sectional random‐digit‐dialed telephone survey conducted in all states plus the District of Columbia and Puerto Rico.PARTICIPANTS: BRFSS respondents aged 65 and older who self‐identified as receiving Medicare benefits.MEASUREMENTS: Using BRFSS core questionnaire variables, recent trends in prevalence of current smoking and smoking cessation were estimated, as were prevalences by various demographic characteristics, for both the nation and the MSSP states as a group.RESULTS: As of 1999, an estimated 10.2% of this population were current smokers, with those aged 65 to 74 smoking at twice the rate (12.9%) of those aged 75 and older (6.1%) and blacks (14.7%) smoking more than whites (10.0%). Between 1996 and 1999, the prevalence of everyday smokers indicating they had attempted to quit for 1 day or longer in the past year rose from 37.1% to 42.2%. National patterns were mirrored in the states chosen to participate in the MSSP.CONCLUSIONS: Young‐old Medicare recipients have a higher smoking prevalence, although interest in quitting appears to be rising. The chosen MSSP states appear to be a representative of national smoking patterns in the older Medicare population.
Preoperative Supraphysiological Testosterone in Older Men Undergoing Knee Replacement Surgery
Authors: Amory John K. , Chansky Howard A. , Chansky Kari L. , Camuso Matthew R. , Hoey Chris T. , Anawalt Bradley D. , Matsumoto Alvin M. , Bremner William J. 
Published: October 2002

OBJECTIVES: Older patients undergoing knee replacement surgery can recover more slowly than younger patients and require extended rehabilitation. Because administration of supraphysiological testosterone (T) dramatically increases strength, we hypothesized that preoperative T therapy would improve functional recovery and reduce hospital stay in older men undergoing knee replacement surgery.DESIGN: Double‐blinded, placebo‐controlled pilot trial.SETTING: A Veterans Affairs orthopedics clinic and inpatient postoperative unit.PARTICIPANTS: Twenty‐five men, mean age 70, undergoing elective knee replacement.INTERVENTION: Preoperative, supraphysiological T administration (600 mg T enanthate intramuscularly weekly for 4 weeks) or sesame oil placebo.MEASUREMENTS: Length of hospital stay and functional ability by Functional Independence Measure (FIM) score.RESULTS: Mean length of hospital stay ± standard deviation was nonsignificantly reduced in the T group (5.9 ± 2.4 days vs 6.8 ± 2.5 days; P = .15). At postoperative Day 3, there was a significant improvement in ability to stand (mean FIM score 5.2 ± 1.0 vs 4.0 ± 1.1; P = .04) and trends towards improvements in walking and stair climbing in the T group. There were no complications attributable to T therapy.CONCLUSIONS: In older men undergoing knee replacement surgery, preoperative supraphysiological T administration may confer some clinical benefit. Future studies using longer courses of preoperative T administration in larger numbers of older men undergoing knee replacement surgery are warranted.
Floor‐Rise Strategy Training in Older Adults
Authors: Hofmeyer Mark R. , Alexander Neil B. , Nyquist Linda V. , Medell Jodi L. , Koreishi Aaleya 
Published: October 2002

OBJECTIVES: To determine the effect of a 2‐week (six‐session) training intervention to improve the ability of disabled older adults to rise from the floor.DESIGN: Prospective intervention trial.SETTING: Congregate housing in Michigan.PARTICIPANTS: Subjects aged 65 and older who admitted to requiring assistance (such as from a person, equipment, or device) in performing at least one of the following mobility‐related activities of daily living: transferring, walking, bathing, and toileting.INTERVENTION: Participants were randomly allocated to individual training (n = 17, mean age 81) in strategies to rise from the floor (using for example, certain key intermediate body positions) or a control chair‐based flexibility intervention (n = 18, mean age 80).MEASUREMENTS: At baseline and postintervention, residents were queried regarding their rise difficulty (difficulty scale) and symptoms (symptoms scale) associated with the rise and were tested in their ability to perform timed floor‐rise tasks. These tasks varied in starting position (supine vs all fours) and in use of a support to assist in rising (no support, use of an end table, use of a chair).RESULTS: Using baseline performance as the covariate, by analysis of covariance (ANCOVA), the training group showed a significant (P < .05) improvement in mean number of rise tasks completed (baseline mean 6.6, postintervention mean 7.3) versus essentially no improvement in the controls. Similarly, by ANCOVA, the training group (compared with controls) showed a significant (P < .05) improvement on the difficulty and symptoms scales. There was no intervention effect for rise time.CONCLUSIONS: A short‐term, strategy‐based intervention improved floor‐rise ability and perceived difficulty and symptoms associated with the rise. This approach, focusing on key intermediate body positions, may be useful in training floor‐rise skills, particularly in older adults at risk for falls.
Proton Magnetic Resonance Spectroscopy Reveals Similar White Matter Biochemical Changes in Patients with Chronic Hypertension and Early Alzheimer's Disease
Authors: Catani Marco , Mecocci Patrizia , Tarducci Roberto , Howard Robert , Pelliccioli Gian Piero , Mariani Elena , Metastasio Antonio , Benedetti Claudia , Senin Umberto , Cherubini Antonio 
Published: October 2002

OBJECTIVES: Hypertension is a risk factor for dementia and is associated with some of the brain changes that are found in Alzheimer's disease and other neurodegenerative diseases, such as atrophy and neurofibrillary tangles. We evaluated the cerebral white matter biochemical pattern in healthy older subjects, older patients with chronic hypertension, and patients with Alzheimer's disease (AD) using proton magnetic resonance spectroscopy (1H‐MRS).DESIGN: Cross‐sectional study.SETTING: University‐affiliated outpatient clinic.PARTICIPANTS: Ten healthy older subjects, 10 cognitively intact older patients with chronic hypertension, and 10 older patients with early AD.MEASUREMENTS: All subjects underwent clinical examination, neuropsychological assessment, and 1H‐MRS to measure N‐acetylaspartate (NAA), myoinositol, choline, and creatine resonance signals in an 8‐cm3 voxel located in the paratrigonal white matter region bilaterally. NAA/creatine, myoinositol/creatine, and choline/creatine ratios were measured, and the mean values were compared using one‐way analysis of variance with Tukey test for post hoc analysis.RESULTS: A significantly higher mean myoinositol/creatine (ratio ± standard deviation) was found in hypertensive patients (0.67 ± 0.05) and in AD patients (0.68 ± 0.08) than in controls (0.56 ± 0.04) (P < .001). Conversely neither NAA/creatine ratio nor choline/creatine ratio differed among the three groups.CONCLUSIONS: In this study, cognitively intact chronic hypertensive older patients had a higher white matter myoinositol/creatine ratio compared with healthy older subjects, suggesting that myoinositol may be a sensitive marker of the effects of chronic hypertension on the brain. Moreover, the similar increase of myoinositol/creatine ratio in patients with hypertension and in those with early AD provides further evidence of common brain changes with these conditions.
Knowledge and Beliefs About Influenza, Pneumococcal Disease, and Immunizations Among Older People
Authors: Santibanez Tammy A. , Nowalk M. Patricia , Zimmerman Richard K. , Jewell Ilene Katz , Bardella Inis J. , Wilson Stephen A. , Terry Martha A. 
Published: October 2002

OBJECTIVES: Despite the burden of disease caused by influenza and pneumococcus, immunization rates are moderate and have not reached national goals set for 2010. This study's objective was to identify patient knowledge, attitudes, and beliefs that serve as facilitators of and barriers to influenza and pneumococcal vaccination.DESIGN: A survey conducted in 2000 by computer‐assisted telephone interviewing.SETTING: To encounter a broad spectrum of patients and healthcare systems, we sampled patients at inner‐city health centers, Department of Veterans Affairs outpatient clinics, and rural and suburban practices.PARTICIPANTS: Inclusion criteria were patients aged 66 and older and an office visit after September 30, 1998.MEASUREMENTS: Responses to questionnaire.RESULTS: Overall, 1,007 (82%) interviews were completed among 1,234 people contacted by phone. Vaccination against pneumococcal disease was significantly related to being able to accurately describe one or more classic symptoms of pneumonia (P = .05). Vaccination against influenza and pneumococcal disease was significantly related to belief that vaccination was the best way to prevent these diseases (P < .001). The unvaccinated reported that they felt they were not likely to contract influenza and that they did not know they needed the pneumococcal vaccine. Access was not related to vaccination status.CONCLUSIONS: Educational campaigns to increase vaccination rates among older adults should focus on symptoms of, risk for, and severity of influenza and pneumococcal diseases and encouraging physicians to recommend the vaccines to their patients.
The Alcohol‐Related Problems Survey: Identifying Hazardous and Harmful Drinking in Older Primary Care Patients
Authors: Fink Arlene , Morton Sally C. , Beck John C. , Hays Ron D. , Spritzer Karen , Oishi Sabine , Moore Alison A. 
Published: October 2002

OBJECTIVES: Older adults can incur problems at low levels of alcohol consumption because of age‐related physiological changes, declining health and functional status, and medication use. We have developed and tested a screening measure specifically for older people, the Alcohol‐Related Problems Survey (ARPS), to identify older adults with these risks.DESIGN: Survey.SETTING: Academic and community primary care clinics.PARTICIPANTS: Five hundred forty‐nine current drinkers aged 65 and older, mostly white with high school or more education.MEASURES: Alcohol use was classified as harmful, hazardous, or nonhazardous depending upon consumption alone or combined with selected comorbidities and medication use. Harmful drinking (including alcohol abuse or dependence) means the presence of problems (e.g., hypertension, adverse drug events, legal problems) due to drinking. Hazardous drinking means risks for problems are likely. Nonhazardous drinking poses no known risks for problems.RESULTS: Eleven percent of subjects were harmful drinkers and 35% were hazardous drinkers. Harmful drinking was more common in men than women and in persons younger than 75 than those aged 75 and older. Similar proportions of men and women and younger and older age groups were hazardous drinkers. Most harmful drinkers were identified by their use of alcohol with their comorbidity, whereas most hazardous drinkers were identified by their use of alcohol with medications. Test‐retest reliability was substantial (κ = 0.65).CONCLUSION: Physicians are urged to screen for alcohol‐related problems in older persons. The ARPS reliably identifies harmful, hazardous, and nonhazardous drinking in older adults resulting most often from the interaction between alcohol and disease and medication use.
Classification and Expression Analysis of Arabidopsis F-Box-Containing Protein Genes
Authors: Kuroda Hirofumi , Takahashi Naoki , Shimada Hiroaki , Seki Motoaki , Shinozaki Kazuo , Matsui Minami 
Published: October 2002

AbstractF-box proteins regulate diverse cellular processes, including cell cycle transition, transcriptional regulation and signal transduction, by playing roles in Skp1p-cullin-F-box protein (SCF) complexes or non-SCF complexes. F-box proteins are encoded by a large gene family. Our database search revealed that at least 568 F-box protein genes are present in the Arabidopsisthaliana (Arabidopsis) genome. Domain search analysis using SMART and Pfam-A databases revealed that 67 of the F-box proteins contained Kelch repeats and 29 contained leucine-rich repeats (LRRs). Interestingly only two F-box proteins contained WD40 repeats that are found in many F-box proteins of other organisms. Kelch repeats, LRRs and WD40 repeats are implicated in protein–protein interactions. This analysis also resulted in the finding of several unique functional domains; however, 448 of the F-box proteins did not contain any known domains. Therefore, these proteins were used to search the Pfam-B database to find novel domains, and three putative ones were found. These domain search analyses led us to classify the Arabidopsis F-box proteins into at least 19 groups based on their domain structures. Macro array analysis showed that several F-box protein genes are expressed in a tissue-specific manner.
CLASSICAL ODE AND PDE WHICH OBEY QUANTUM DYNAMICS
Authors: WERBOS PAUL J. 
Published: October 2002

It is well known that classical systems governed by ODE or PDE can have extremely complex emergent properties. Many researchers have asked: is it possible that the statistical correlations which emerge over time in classical systems would allow effects as complex as those generated by quantum field theory (QFT)? For example, could parallel computation based on classical statistical correlations in systems based on continuous variables, distributed over space, possibly be as powerful as quantum computing based on entanglement? This paper proves that the answer to this question is essentially "yes," with certain caveats. More precisely, the paper shows that the statistics of many classical ODE and PDE systems obey dynamics remarkably similar to the Heisenberg dynamics of the corresponding quantum field theory (QFT). It supports Einstein's conjecture that much of quantum mechanics may be derived as a statistical formalism describing the dynamics of classical systems. Predictions of QFT result from combining quantum dynamics with quantum measurement rules. Bell's Theorem experiments which rule out "classical field theory" may therefore be interpreted as ruling out classical assumptions about measurement which were not part of the PDE. If quantum measurement rules can be derived as a consequence of quantum dynamics and gross thermodynamics, they should apply to a PDE model of reality just as much as they apply to a QFT model. This implies: (1) the real advantage of "quantum computing" lies in the exploitation of quantum measurement effects, which may have possibilities well beyond today's early efforts; (2) Lagrangian PDE models assuming the existence of objective reality should be reconsidered as a "theory of everything." This paper will review the underlying mathematics, prove the basic points, and suggest how a PDE-based approach might someday allow a finite, consistent unified field theory far simpler than superstring theory, the only known alternative to date.
Independent course of childhood auditory hallucinations: A sequential 3-year follow-up study
Authors: Escher Sandra , Romme Marius , Buiks Alex , DELESPAUL PHILIPPE , Van Os Jim 
Published: October 2002

BackgroundChildhood hallucinations of voices occur in a variety of contexts and have variable long-term outcomes.AimTo study the course of experience of voices sequentially over a 3-year period in those with and those without a need for mental health care (patient status).MethodIn a group of 80 children of mean age 12.9 years (s.d.=3.1), of which around 50% were not receiving mental health care, baseline measurement of voice characteristics, voice attributions, psychopathology, stressful life events, coping mechanisms and receipt of professional care were used to predict 3-year course and patient status.ResultsThe rate of voice discontinuation over the 3-year period was 60%. Patient status was associated with more perceived influence on behaviour and feelings and more negative affective appraisals in relation to the voices. Predictors of persistence of voices were severity and frequency of the voices, associated anxiety/depression and lack of clear triggers in time and place.ConclusionsNeed for care in the context of experience of voices is associated with appraisal of the voices in terms of intrusiveness and ‘omnipotence’. Persistence of voices is related to voice appraisals, suggesting that experience of voices by children should be the target of specific interventions.
Family history of psychiatric disorders and age at first contact in schizophrenia: An epidemiological study
Authors: Byrne Majella , Agerbo Esben , Mortensen Preben Bo 
Published: October 2002

BackgroundThe risk for schizophrenia has been associated with a family history of this and other psychiatric disorders. The relationship between age at first contact and family history of psychiatric illness is not certain.AimsTo estimate the risks for schizophrenia associated with a range of psychiatric diagnoses in family members and to investigate the relationship between these risks and age at first contact for schizophrenia.MethodA nested case–control study design was employed. Psychiatric admission data and socio-economic data were available for 7704 cases admitted between 1981 and 1998 in Denmark, 192 590 gender- and age-matched controls, and for the parents and siblings of all subjects.ResultsControlling for socio-economic factors, risk for schizophrenia was associated with a family history of all psychiatric disorders except substance misuse and independently with a family history of suicide. The risk for schizophrenia associated with a family history of psychiatric disorders decreased as age at first contact increased.ConclusionsRisk for schizophrenia is associated with a range of psychiatric disorders in family members and these risks are not constant across the risk period.
Distinguishing characteristics of subjects with good and poor early outcome in the Edinburgh High-Risk Study
Authors: Johnstone Eve C. , Cosway Richard , Lawrie Stephen M. 
Published: October 2002

BackgroundHigh-risk’ studies of schizophrenia have the potential to clarify the pathogenesis of schizophrenia. Here, results of extreme outcome groups in the Edinburgh High-Risk Study are presented.AimsTo compare groups of good and poor outcome from the Edinburgh High-Risk Study and clarify the nature of the change from the state of vulnerability to that of developing psychosis.MethodThe recruitment procedure is described. Good and poor outcome are defined. These groups are compared in terms of genetic liability and of baseline and change in neuropsychology and neuroanatomy.ResultsDemographic characteristics and genetic liability do not differ between the groups. The good outcome group perform better at baseline in some neuropsychological tests, but there is little neuroanatomical difference. The poor outcome group show consistently impaired memory function and a tendency to reduction in temporal lobe size.ConclusionsIn genetically predisposed subjects, the change from vulnerability to developing psychosis may be marked by a reduced size and impaired function of the temporal lobe.
First-episode schizophrenia, bipolar disorder and other psychoses in a rural Irish catchment area: Incidence and gender in the Cavan–Monaghan study at 5 years
Authors: Scully Paul J. , Quinn John F. , Morgan Maria G. , Kinsella Anthony , O'Callaghan Eadbhard , Owens John M. , Waddington John L. 
Published: October 2002

BackgroundThe potential of first-episode studies in schizophrenia is maximised through systematic epidemiological, clinical and biological comparisons between homogeneous populations of the psychoses.AimsTo conduct prolonged accrual of ‘all’ cases of non-affective and affective psychotic illness on an epidemiologically complete basis.MethodWithin the region covered by Cavan–Monaghan psychiatric service (population 102 810), all putative cases of first-episode psychosis were diagnosed using DSM–IV.ResultsFrom 1995 to 2000, 69 cases of psychosis were ascertained, the incidence being 2.3-fold lower in females than in males. On resolving the ‘core’ diagnoses of schizophrenia and bipolar disorder, incidence of schizophrenia among women was 7.5-fold lower than among men whereas incidence of bipolar disorder among women was 6.6-fold lower than among men.ConclusionsThis homogeneous population, which eliminates factors associated with urbanicity and minimises confounding factors such as socioeconomic, ethnic and geographical diversity, shows a markedly reduced incidence among females both of schizophrenia and of bipolar disorder.