bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of psychiatric drugs in Slovenia in comparison to Scandinavian countries
Authors: Fürst Jurij , Kocmur Margareta 
Published: July 2003

AbstractPurposeTo find out the consumption of psychotropic drugs in Slovenia and the extent to which Slovenian consumption correlates to Scandinavian countries.MethodsData of ambulatory prescribing of psychiatric drugs in Slovenia for the years 1999 and 2000 and data for Norway, Sweden and Denmark are shown. All data are expressed in defined daily doses per thousand inhabitants per day (DDD's).ResultsThe use of all neuroleptics in Slovenia is lower (5.3 vs 6.1–7.6 DDD's), however the share of atypicals (34%) is comparable to Scandinavian countries. Use of anticholinergics is up to five times greater (1.6 vs 0.3–0.5 DDD's). The use of lithium is five time lower (0.2 vs 1.1–1.4). Regarding the use of antidepressants, Slovenia is behind Scandinavia (12.2 vs 30–47 DDD's), whereas the share of SSRI's (73%) is at the same level. The use of anxiolytics is higher (25.4 vs 16–22.4 DDD's) and ratio with antidepressants is also unfavourable. The use of hypnotics and sedatives is favourably low (10.7 vs 31.8–44.6 DDD's).ConclusionsLow use of hypnotics and sedatives is favourable. The share of new neuroleptics and antidepressants is comparable. The use of antidepressants is probably too low. However, prescribing guidelines for anxiolytics, anticholinergics (too high use of both group) and lithium (too low use) should be introduced in Slovenia. Copyright © 2003 John Wiley & Sons, Ltd.
Increased suicide attempt rate among patients interrupting use of atypical antipsychotics
Authors: Herings Ron M. C. , Erkens Joëlle A. 
Published: July 2003

AbstractPurposeThe aim of the study is to investigate whether patients at risk to commit suicide could be identified based on their drug refill patterns.MethodsData for this study were obtained from the PHARMO system comprising drug‐dispensing data linked to hospital discharge records. All patients aged 15–45 years, suspected to suffer from schizophrenia and exclusive users of olanzapine or risperidone were selected. The use of antipsychotics was converted into treatment episodes of uninterrupted use. Therapy non‐compliance was defined as a drug holiday of at least 30 days. The follow‐up started with a treatment episode of at least 90 days. Relative risks for suicide attempts and 95% confidence limits due to drug holidays were estimated using Poisson regression analyses.ResultsOf 603 patients, 33% interrupted treatment for at least 30 days. An increased suicide attempt rate was observed when comparing uninterrupted and interrupted drug use (20.0/1000 person years vs 72.1/1000 person years, respectively). A four‐fold increased risk for attempting suicide among patients with drug holidays was found (RRadjusted for age and gender 4.2, 95%CI: 1.7–10.1) compared to patients without drug holidays.ConclusionsPatients who do not refill atypical antipsychotics in time can be identified in the pharmacy and are most likely those with an increased risk to commit suicide. Copyright © 2003 John Wiley & Sons, Ltd.
The adjunctive use of a centralised database in the monitoring of clozapine‐related neutropenia
Authors: Pascoe Steven J. 
Published: July 2003

AbstractObjectiveTo assess the effectiveness of centralised routine monitoring of blood counts in subjects receiving clozapine.DesignA cohort study based on a prospective drug exposure database.Setting and ParticipantsPatients with schizophrenia in 38 specialised centres across Australia.Outcome MeasuresThe time from detection of neutropenia to the interruption of therapy, the time to recovery of the absolute neutrophil count, the eventual outcome of subjects developing neutropenia.ResultsA total of 1500 subjects were registered on the database. Seven subjects developed severe neutropenia (a neutrophil count < 1.5 × 109/L) whilst on therapy. Mean time to cessation of therapy was 1.6 days (range < 1–6 days). Neutrophil counts recovered to normal levels in all subjects after 6.4 days (range< 1–13).ConclusionsIn the population investigated, the addition of a centralised database to clinical monitoring resulted in very rapid detection of severe neutropenia and an equally rapid cessation of therapy. In the sample investigated, this led to very low morbidity and zero mortality. Copyright © 2003 John Wiley & Sons, Ltd.
Factors influencing prescription of CNS medications in different elderly populations
Authors: Craig David , Passmore A. Peter , Fullerton Ken J. , Beringer Timothy R.O. , Gilmore David H. , Crawford Vivienne L.S. , McCaffrey Patricia M. , Montgomery Anne 
Published: July 2003

AbstractFactors influencing the use of neuroleptic and other CNS‐acting medications (‘antidepressants’ and ‘hypnotics/anxiolytics’) were examined in different elderly populations (>65 years): long‐stay care hospital subjects (n = 381), nursing home subjects (n = 1247), private residential home subjects (n = 321), statutory residential home subjects (n = 525), old age psychiatry facility subjects (n = 48), community dwellers (n = 97), in different geographical areas (urban n = 1223 and rural n = 1396). Neuroleptics were prescribed in 28% of the individuals, hypnotics/anxiolytics in 33% and antidepressants in 12%. Prescription of neuroleptics was significantly predicted by institutional placement (other than long‐stay care hospital facility), lower cognitive function and rural geographical area. Age greater than 75 years and lower functional score (lower dependency) significantly decreased the likelihood of receipt of neuroleptics. Antidepressant use was significantly less likely in male subjects, patients with cognitive impairment and patients greater than 85 years. Institutional placement (other than long‐stay care hospital facility and old age psychiatry facility) and rural locality predicted increased likelihood of antidepressant prescription. Institutional placement (other than long‐stay care hospital facility) and geographical (rural) location were significant independent predictors of hypnotic/anxiolytic use. Prescription of hypnotic/anxiolytic drug class was significantly less likely in those individuals with lower cognitive status. In this representative elderly cohort, patient characteristics: age, sex, cognitive score, functional score, place of residence and geographical location markedly influenced drug utilisation. Copyright © 2003 John Wiley & Sons, Ltd.
Assessment of diagnostic markers by goodness‐of‐fit tests
Authors: Nakas Christos , Yiannoutsos Constantin T. , Bosch Ronald J. , Moyssiadis Chronis 
Published: July 2003

AbstractReceiver operating characteristic (ROC) curves are useful statistical tools used to assess the precision of diagnostic markers or to compare new diagnostic markers with old ones. The most common index employed for these purposes is the area under the ROC curve (θ) and several statistical tests exist that test the null hypotheses H0: θ= 0.5 or H0: θ1=θ2, in the case of two‐marker comparisons, against alternatives of interest. In this paper we show that goodness‐of‐fit of uniformity of the distribution of the false positive (true positive) rates can be used instead of tests based on the area index. A semi‐parametric approach is based on a completely specified distribution of marker measurements for either the healthy (F) or diseased (G) subjects, and this is extended to the two‐marker case. We then extend to the one‐ and two‐marker case when neither distribution is specified (the non‐parametric case). In general, ROC‐based tests are more powerful than goodness‐of‐fit tests for location differences between the distributions of healthy and diseased subjects. However ROC‐based tests are less powerful when location‐scale differences exist (producing ROC curves that cross the diagonal) and are incapable of discriminating between healthy and diseased samples when θ=0.5 but F ≠ G. In these cases, goodness‐of‐fit tests have a distinct advantage over ROC‐based tests. In conclusion, ROC methodology should be used with recognition of its potential limitations and should be replaced by goodness‐of‐fit tests when appropriate. The latter are a viable alternative and can be used as a ‘black box’ or as an exploratory first step in the evaluation of novel diagnostic markers. Copyright © 2003 John Wiley & Sons, Ltd.
Implementation and applications of bootstrap methods for the National Immunization Survey
Authors: Smith Philip J. , Hoaglin David C. , Battaglia Michael P. , Barker Lawrence 
Published: July 2003

AbstractIn complex probability sample surveys, numerous adjustments are customarily made to the survey weights to reduce potential bias in survey estimates. These adjustments include sampling design (SD) weight adjustments, which account for features of the sampling plan, and non‐sampling design (NSD) weight adjustments, which account for non‐sampling errors and other effects. Variance estimates prepared from complex survey data customarily account for SD weight adjustments, but rarely account for all NSD weight adjustments. As a result, variance estimates may be biased and standard confidence intervals may not achieve their nominal coverage levels. We describe the implementation of the bootstrap method to account for the SD and NSD weight adjustments for complex survey data. Using data from the National Immunization Survey (NIS), we illustrate the use of the bootstrap (i) for evaluating the use of standard confidence intervals that use Taylor series approximations to variance estimators that do not account for NSD weight adjustments, (ii) for obtaining confidence intervals for ranks estimated from weighted survey data, and (iii) for evaluating the predictive power of logistic regressions using receiver operating characteristic curve analyses that account for the SD and NSD adjustments made to the survey weights. Copyright © 2003 John Wiley & Sons, Ltd.
Gatekeeping strategies for clinical trials that do not require all primary effects to be significant
Authors: Dmitrienko Alexei , Offen Walter W. , Westfall Peter H. 
Published: July 2003

AbstractIn this paper we describe methods for addressing multiplicity issues arising in the analysis of clinical trials with multiple endpoints and/or multiple dose levels. Efficient ‘gatekeeping strategies’ for multiplicity problems of this kind are developed. One family of hypotheses (comprising the primary objectives) is treated as a ‘gatekeeper’, and the other family or families (comprising secondary and tertiary objectives) are tested only if one or more gatekeeper hypotheses have been rejected. We discuss methods for constructing gatekeeping testing procedures using weighted Bonferroni tests, weighted Simes tests, and weighted resampling‐based tests, all within the closed testing framework. The new strategies are illustrated using an example from a clinical trial with co‐primary endpoints, and using an example from a dose‐finding study with multiple endpoints. Power comparisons with competing methods show the gatekeeping methods are more powerful when the primary objective of the trial must be met. Copyright © 2003 John Wiley & Sons, Ltd.
Interval estimation of the attributable risk for multiple exposure levels in case‐control studies with confounders
Authors: Lui Kung‐Jong 
Published: July 2003

AbstractThe attributable risk (AR) is one of the most important and commonly‐used epidemiological indices to assess the public health importance of an association between a risk factor and a disease. When the underlying risk factor has multiple exposure levels in the presence of confounders, we consider the case‐control studies using random sampling to collect the cases and controls here. We develop four asymptotic interval estimators for AR, including the interval estimator using Wald's statistic, the interval estimator using the logarithmic transformation, the interval estimator using the logit transformation, and the interval estimator derived from a quadratic equation. We apply Monte Carlo simulation to evaluate the finite‐sample performance of these interval estimators in a variety of situations. We demonstrate that given an adequately large sample size, all the estimators developed here can actually perform reasonably well. We note that the interval estimator using the logit transformation may be of limited use when the number of studied subjects is not large. We also note that the interval estimator using the logarithmic transformation can lose efficiency compared to the interval estimator using Wald's statistic or the interval estimator derived from a quadratic equation developed in this paper. Finally, we use the data taken from a case‐ontrol tudy of the oral contraceptive use in myocardial nfarction patients with various smoking levels to illustrate he practical usefulness of these estimators. Copyright © 2003 John Wiley & Sons, Ltd.
Oxytocin in prefilled Uniject™ injection devices for managing third‐stage labor in Indonesia
Authors: Tsu V.D. , Sutanto A. , Vaidya K. , Coffey P. , Widjaya A. 
Published: July 2003

AbstractWe assessed the use and acceptability of an injection device (Uniject™) prefilled with oxytocin, as part of active management of third‐stage labor (AMTL) by Indonesian midwives attending home births. We interviewed 140 village midwives (bidan di desa) and 2220 mothers whose deliveries they attended during the intervention period. We completed baseline and post‐intervention assessments to determine their experiences and views of oxytocin Uniject™ use. Delivery logs and supervisory reports were reviewed. The assessment was done in three rural districts and one municipality in Lombok. Injection practices and oxytocin availability did not change dramatically, although dose accuracy, use of sterile injection equipment, and proper disposal improved when the Uniject™ device was used. Midwives had little difficulty using the Uniject™ device properly; they overwhelmingly preferred it to standard needles and syringes. Postpartum hemorrhage rates did not change substantially. Oxytocin via Uniject™ holds promise for safer, more convenient use of oxytocin by trained midwives attending home deliveries, thereby potentially reducing the incidence of postpartum hemorrhage.
Individual and familial characteristics of youths involved in street corner gangs in Singapore
Authors: Kee C , Sim K , Teoh J , Tian C.S , Ng K.H 
Published: July 2003

AbstractThirty‐six youths involved in street corner gangs in Singapore were compared with 91 age‐matched controls on measures of self‐esteem, aggression, dysfunctional parenting and parent–adolescent communication. Results revealed that gang youths had lower self‐esteem and higher levels of aggression than controls. Of note were the findings that gang youths reported a relative absence of parental abuse and indifference, and experienced less open communication and higher levels of over‐control with their mothers, but not fathers. These findings diverge from anticipated familial correlates of antisocial activity in youths and were discussed with reference to cultural factors and their implications on prevention and intervention.
Gender differences in changes in and stability of conduct problems from early adolescence to early adulthood
Authors: Storvoll Elisabet E. , Wichstrøm Lars 
Published: July 2003

AbstractThe present paper examines whether there are gender differences in changes in the aggregate level and individual stability of conduct problems from early adolescence to early adulthood. We analysed self‐reported data collected as part of a longitudinal general population study of Norwegian adolescents (n=1234). The analyses showed that involvement in conduct problems for both genders peaked in mid‐adolescence. The extent to which this peak reflected changes in the number of participants or differences in the frequency of problems among the participants varied according to gender. In most cases, the individual stability of involvement in conduct problems was similar for girls and boys. However, in the long term, relative involvement was more stable for boys than for girls. Moreover, the proportion of boys who showed a high level of involvement both during adolescence and early adulthood was greater than for girls.
Communication about contraception and knowledge of oral contraceptives amongst Norwegian high school students
Authors: Hansen Thomas , Skjeldestad Finn Egil 
Published: July 2003

AbstractCommunication about contraception and specific knowledge of oral contraceptives (OCs) were examined in a sample (n=4650) of Norwegian high school students. Data were collected through a 44‐item questionnaire especially developed for the study. The response rate was 73% and data from a total of 1714 girls and 1389 boys were eligible for analyses. More females (83%) than males (54%) discussed contraception at least monthly. Discussions were predominantly held with peers and not adults. Females were far more knowledgeable about OCs than males. Respondents knew more about side effects and the pill's relative efficacy than about risks of cancer and tromboembolism. The most significant predictors of high knowledge scores were gender and OC use (females). Also predictive of high knowledge scores were frequent discussions about contraception with peers. Talks about contraception with health workers were unrelated to knowledge scores.
Parental practices in late adolescence, a comparison of three countries: Canada, France and Italy
Authors: Claes Michel , Lacourse Eric , Bouchard Céline , Perucchini Paula 
Published: July 2003

AbstractThe objective of this study was to examine parental practices, such as affection, control and conflict, in three countries: Canada, France and Italy. The sample was composed of more than 900 late adolescents with an average age of 17 years, from three large cities: Montreal, Paris and Rome. Participants answered a self‐report questionnaire that assessed five measures: emotional bonds with the father and mother, parental supervision, tolerance towards friends, punitiveness for violation of rules, and conflict frequency. Analyses of the results indicated that the country of origin discriminated for most of the parental practice dimensions. Canadian adolescents considered their parents to be more tolerant and rated them as using less punitive measures when rules were broken. Canadian parents also seemed to adopt comparable norms for boys and girls, which could be interpreted as a form of sexual egalitarianism, whereas Italian and French parents appeared less tolerant towards girls. Italian adolescents reported strong emotional bonds with each parent, and also identified more conflicts in their relationships with parents. French adolescents reported weaker emotional bonds with each parent and less parental supervision. Results were interpreted in the light of studies that have reported an influence of cultural background on both parental practices and parental decisions in each of these countries.
Differing susceptibility of anadromous brown trout (Salmo trutta L.) populations to salmon louse (Lepeophtheirus salmonis (Krøyer, 1837)) infection
Authors: Glover K.A , Skaala Ø , Nilsen F , Olsen R , Teale A.J , Taggart J.B 
Published: July 2003

AbstractThree Norwegian sea trout (Salmo trutta L.) stocks and a farmed Atlantic salmon (Salmo salar L.) stock were challenged with salmon lice (Lepeophtheirus salmonis (Krøyer, 1837)), in a “common garden” experiment. Sea trout from the River Guddal exhibited a significantly lower level of infection, as measured by louse abundance and louse density, than other stocks. In addition, salmon lice developed significantly more slowly on the Guddal stock than on the other stocks. Salmon louse abundance and density were similar for the Rivers Fortun and Sima stocks of sea trout, and abundance of lice, though not density, was highest for farmed Atlantic salmon. Within stocks, there were no differences in infection levels of salmon louse between mature and immature fish, between sexes, or between anal-fin-clipped and non-clipped salmon. Differences in infection level among the sea trout stocks may, it is suggested, reflect genetic differences.
An ecosystem model of food web and fisheries interactions in the Baltic Sea
Authors: Harvey Chris J , Cox Sean P , Essington Timothy E , Hansson Sture , Kitchell James F 
Published: July 2003

AbstractBecause fisheries operate within a complex array of species interactions, scientists increasingly recommend multispecies approaches to fisheries management. We created a food web model for the Baltic Sea proper, using the Ecopath with Ecosim software, to evaluate interactions between fisheries and the food web from 1974 to 2000. The model was based largely on values generated by multispecies virtual population analysis (MSVPA). Ecosim outputs closely reproduced MSVPA biomass estimates and catch data for sprat (Sprattus sprattus), herring (Clupea harengus), and cod (Gadus morhua), but only after making adjustments to cod recruitment, to vulnerability to predation of specific species, and to foraging times. Among the necessary adjustments were divergent trophic relationships between cod and clupeids: cod exhibited top-down control on sprat biomass, but had little influence on herring. Fishing, the chief source of mortality for cod and herring, and cod reproduction, as driven by oceanographic conditions as well as unexplained variability, were also key structuring forces. The model generated many hypotheses about relationships between key biota in the Baltic Sea food web and may ultimately provide a basis for estimating community responses to management actions.
GLIA: A reassessment based on novel data on the developing and mature central nervous system
Authors: Villegas Santiago Nahuel , Poletta Fernando Adrián , Carri Néstor Gabriel 
Published: July 2003

AbstractSeveral studies on neurobiology have contributed to our understanding of the genesis, survival and death of neurons, unquestionably the stars of the Central Nervous System (CNS). However, they would not be so famous without their close associates: the glial cells. Since novel studies have demonstrated new and important functions for glial cells, they are beginning to gain significant importance in brain research to allow us to reinterpret long known functions on the basis of new concepts. Here, we review recent progress in our understanding of the role of glial cells in the biology of tissue development and maturation.
Only few workers exposed to wood dust are detected with specific IgE against pine wood
Authors: Skovsted T. A. , Schlünssen V. , Schaumburg I. , Wang P. , Staun‐olsen P. , Skov P. S. 
Published: July 2003

Background: Our aim was to investigate the frequency of pine allergy in woodworkers with respiratory symptoms and to identify high molecular weight allergens in pine wood extracts.Methods: In a cross‐sectional study we examined work‐related respiratory symptoms in 2033 furniture workers and 474 controls by questionnaires. Clinical examination was performed in 365 wood dust exposed and 116 nonexposed subjects. Blood samples were collected for measuring pine‐specific immunoglobulin (Ig)E by an immunoassay and Western blots.Results: Eleven exposed and three nonexposed subjects had pine‐specific IgE. In the group with clinically defined asthma eight persons (5.4%) had pine‐specific IgE compared with six persons (1.8%) in the group without asthma (P < 0.05). In the groups with and without respiratory symptoms, 13 (3.8%) and one (0.7%) subject, respectively, had pine‐specific IgE (P = 0.06). Western blots demonstrated pine‐specific IgE to components in the molecular range of 14 – 100 kD in eight samples (all wood dust exposed). Five samples had pine‐specific IgE against components in a 43 – 59 kD zone and against two bands at 27 and 29 kD that are candidates for major allergens.Conclusion: Some workers in the Danish furniture industry are specific IgE sensitized against pine wood dust. Pine‐specific IgE probably explains a minor part of the respiratory symptoms in workers exposed to pine wood dust.