bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role and contribution of nurses for learning disabilities: a local study in a county of the Oxford–Anglia region
Authors: Stewart David , Todd Margaret 
Published: March 2003

SummaryThirty‐two professionals (i.e. nurses, teachers and managers) working in the field of learning disabilities were interviewed regarding the current and future role of registered nurses for learning disabilities (RNLDs). The present exploratory study used semi‐structured interviews based on four main research questions examining the contribution of RNLDs in terms of knowledge, practical skills, future skills and the development of services. The results show that RNLDs are held in high regard, being characterized by a breadth of knowledge, qualities and skills. The findings also make clear that differences exist in the perceptions of the different professional groups, and that the way forward for RNLDs remains unclear in both the minds of nurses and colleagues. Suggestions are made to help clarify the future position of RNLDs.
Vulnerability of witnesses with learning disabilities: preparing to give evidence against a perpetrator of sexual abuse
Authors: Green Gill 
Published: March 2003

SummaryTestifying in court to sexual abuse is always stressful and can be particularly problematic for a witness with learning disabilities (LDs). The present case report illustrates the assessment of capacity in relation to issues such as consent, competence and ability to withstand court procedures of a witness with LDs who alleged abuse by her paid carer. It describes the support offered to her by a number of agencies, including the police, and the health and social services. Finally, new legislation is described that might enable vulnerable witnesses, including some people with LDs, to give their best evidence in criminal proceedings.
Advocacy and the learning disability nurse
Authors: Jenkins Robert , Northway Ruth 
Published: March 2003

SummaryAdvocacy is often seen as an ideal role for nurses to undertake, especially when working with people who have a learning disability. However, advocacy is not without its risks and dilemmas for learning disability nurses. The present paper attempts to examine why people with learning disabilities may be viewed as vulnerable and why advocacy may be an appropriate activity to undertake. It explores some of the different types of advocacy and the dilemmas which learning disability nurses may face. Finally, guidance is offered on the type of role that learning disability nurses may take when acting as advocates on behalf of people with a learning disability.
Psychological intervention for people with learning disabilities who have experienced bereavement: a case study illustration
Authors: Summers S. J. , Witts P. 
Published: March 2003

SummaryThe evidence base for interventions for people with learning disabilities who have experienced a bereavement is sparse. This article reviews current theoretical understandings of bereavement and loss and describes the assessment, formulation and psychological treatment of a woman with learning disabilities with close reference to these understandings. A psychological intervention is described, which utilizes both psycho‐educational and psychodynamic approaches.
Inactivation of refrigerator biofilm bacteria for application in the food service environment
Authors: Michaels, Barry , Ayers, Troy , Celis Marlene , Gangar Vidhya 
Published: March 2003

AbstractRefrigerator biofilm formation in food environments can result in spoilage and food safety problems. Biofouling of food contact surfaces are difficult to combat, and while there are significant risks involved with tolerating their presence, methods for their removal are not commonly available. In this study, biofilms were grown on plastic refrigerator trays. Cultures of mixed wild strains were started using kitchen scraps suspended in nutrient broth. Biofilms were allowed to mature with approximately 109 CFU per tray test area. Spoilage species identified included Pseudomonas putida, Sphingobacterium multivorum, Citrobacter freundii and Proteus vulgaris. A series of 39 different treatment interventions were trialed during three different biofilm test runs. Results obtained from treatments ranged from a less than 1 log10 reduction for light duty cleaning operations to over a 5 log10 reduction involving more complex treatment methods. The latter included combinations of hot soapy water (75 °C), scrubbing, treatment with high pH (12.0) cleaners followed by acetic acid (vinegar) exposure and included pre‐ and post‐treatment wiping with paper towels.
Learning from the competition II: a case history dissecting in‐market Quick‐Serve‐Restaurants communications through conjoint analysis
Authors: Moskowitz Howard , Itty Barbara , Manchaiah Madhu , Ma Zhenyu 
Published: March 2003

AbstractThis paper assesses the impact of current QSR (quick service restaurant) messages on the Internet by conjoint analysis. The stimuli comprised 89 short phrases taken from the web communications of different QSR’s, along with 14 different visuals depicting generic situations (e.g. people) or actual products (e.g. burgers). A total of 1 942 respondents participated, with each respondent generating an additive model showing the utility value of each of the 103 concept elements. The results suggest the existence of at least four and possibly five segments of respondents. Two segments comprise individuals who like the basic idea of QSR’s but are either indifferent to, or actually hostile to many of the communications. A third segment comprises individuals interested in ambiance and entertainment; a fourth segment comprises individuals interested in health; and a fifth segment comprises individuals interested in the food, and authentic good taste. No single QSR appeals to all of the segments. The study suggests the need for different communications in order to appeal to the segmented populations, and shows the specific communication elements appealing most strongly to each segment.
Perceived flavour changes in white wine after tasting blue mould cheese
Authors: Nygren I. T. , Gustafsson I.‐B. , Johansson L. 
Published: March 2003

AbstractThe object of this study was to evaluate by descriptive sensory analysis how the sensory perception of dry white wines was affected by prior tasting of blue mould cheese. Trained assessors profiled five commercial white wines before and after tasting each of two blue mould cheeses. The study showed that descriptive sensory analysis could be used to quantify changes in the perception of white wines after the consumption of cheese. For all five wines the main findings were that most of the intensities of perceived flavours and acidity decreased after tasting blue mould cheese.
Genetically modified crops: consumer attitudes and trends in plant research in Japan
Authors: Nishiura Hiroshi , Imai Hirohisa , Nakao Hiroyuki , Tsukino Hiromasa , Kuroda Yoshiki , Katoh Takahiko 
Published: March 2003

AbstractAlthough Japanese consumers had relatively relaxed attitudes about genetically modified (GM) food five years ago, we now find that Japanese consumer acceptance has changed dramatically. Our survey utilized a postal questionnaire to a random sample of 200 Japanese consumers living in Miyazaki Prefecture and 150 Japanese plant breeding researchers. Results showed that Japanese consumers had become uneasy about the potential health risks of genetically modified foods. This issue is likely to be ethically motivated rather than scientific. Of the 106 responding Japanese plant breeding researchers, 77 (72.6%) said it was necessary to develop GM crops. The major reason being to overcome future food security problems. Most researchers thought the way to improve consumer acceptance was ‘To broadcast correct information through the mass media’ (73.6%).
Comparison of two methods to obtain a desired first isepamicin peak in intensive care patients
Authors: Fauvelle Francis , Coulaud Jean‐Michel , Lecointre Karine , Tardy Dominique , Poussel Jean‐François , Trape Gérard 
Published: March 2003

A randomized multicenter study in intensive care unit (ICU) patients, evaluated the capacity of a Bayesian method to obtain an optimal first isepamicin (ISP) peak of 80 mg/L in comparison to a fixed loading dose (LD). Patients (n=236) over 18 years of age were enrolled from 6 September 1997 to 17 July 1999 and randomly assigned to received ISP in a calculated dose (CD) or a loading dose (LD) of 25 mg/kg body weight. The CD was estimated using a specific population model with Bayesian methodology implemented in the PKS program (Abbott PKS, Abbott Diagnostics, Rungis, France). The data required included age, body weight, height, gender and serum creatinine. ISP disposition is described by a one‐compartment model. Blood samples were drawn 1 and 24 h after the start of infusion for fluorescence polarization immunoassay measurement of serum ISP concentrations. The predictive performance was assessed by computing bias and precision. Peak concentrations were significantly higher in CD group than the LD group (84.2 ± 28.6 vs. 74.7 ± 24.1 mg/L, respectively; P=0.008), but trough levels were comparable. The optimal ISP peak was attained by a significantly higher percentage of CD patients (P=0.018), and by significantly more CD patients on mechanical ventilation (P=0.025), and with simplified acute physiological scores (SAPS) > 35 (P=0.002). Pharmacokinetic parameters were similar for the two groups with large interindividual variations. Mean (± SD) volume of distribution of ventilated patients (72%) was significantly higher than of nonventilated patients (23.31 ± 7.35 vs. 20.60 ± 6.30 L, respectively; P=0.001). No relationship was found between the volume of distribution and SAPS. Total clearance was significantly correlated with estimated CLCR (creatinine clearance) (P=0.0001). Precision (RMSE) is better for CD than for LD strategy, respectively 27.96 and 28.66 mg/L.The Bayesian method was significantly more accurate and performed particularly well in ventilated patients and patients with high SAPS, compare to an LD of 25 mg/kg to obtain a first ISP peak of 80 mg/L in ICU patients. Therefore, a fixed dose of 28.5 mg/kg would be also adequate to reach a peak of 80 mg/L.
Pharmacokinetic‐pharmacodynamic modeling of the inhibitory effect of erythromycin on tumour necrosis factor‐α and interleukin‐6 production
Authors: Guchelaar Henk‐Jan , Schultz Marc J. , Van Der Poll Tom , Koopmans Richard P. 
Published: March 2003

Erythromycin inhibits the production of tumour necrosis factor‐alpha (TNF‐α) and interleukin‐6 (IL6) induced by heat‐killed Streptococcus pneumoniae in human whole blood ex‐vivo. The objective of the present study was to determine and characterize the concentration–effect relationship of this phenomenon in order to predict its possible clinical relevance.Six healthy volunteers received a single intravenous dose of 1000 mg erythromycin. Blood samples were obtained up to 4 h after drug administration. Samples were assayed for erythromycin concentrations and (after heat‐killed Streptococcus pneumoniae stimulation) for TNF‐α and IL6 concentrations. Effect vs. time data from individual subjects were fitted to the indirect response model with an Emax concentration–effect relationship. Simulations of these effects were performed for therapeutic intravenous and oral erythromycin dosage regimens. The geometric means of the values of Kin, Kout and EC50 were 15.4 μg/h, 0.82/h, 9.4 mg/L for TNF‐α and 321 μg/h, 2.02/h, 18.3 mg/L for IL6. Simulations revealed a maximal inhibition of TNF‐α concentrations of 35%, 50%, 16% and 27% at erythromycin dosages of 500 mg iv, 1000 mg iv, 500 mg p.o and 1000 mg p.o. q 6 h, respectively, whereas a maximal inhibition of IL6 of 29%, 44%, 13% and 22% are predicted for the respective regimens. The inhibitory effect of erythromycin on TNF‐α and IL6 production can be adequately described by the indirect response model with an Emax concentration–effect relationship. Simulations predicted a substantial decrease of production of these cytokines at intravenous and to a much lesser extent at oral erythromycin dosage regimens.
MEGX disposition in critically‐ill trauma patients: subsequent assessments during the first week following trauma
Authors: Pea Federico , Licari Maurizia , Baldassarre Marco , Furlanut Mario 
Published: March 2003

ABSTRACTThe objective of this study was to evaluate MEGX disposition as a surrogate marker in assessing the influence that injury may exert on liver function during the first week after the traumatic event in young vs. elderly patients. The MEGX exposure over time was assessed at 0.25, 0.5, 1, 2, 4 and 6 h after the intravenous administration of a 1 mg/kg lidocaine test dose in 12 young and 7 elderly trauma patients on days1, 4 and 7 after a severe injury (Apache II score > 10). MEGX plasma concentration–time profiles were consistently different on day 1 in the elderly vs. young, consistent with a statistically significant lower rate of both lidocaine clearance and MEGX formation, and with a considerably longer MEGX elimination in the elderly than in the young. This suggests an impairment of liver blood flow as a result of splanchnic vasoconstriction occurring mainly in elderly trauma patients. A significant improvement in MEGX disposition occurred on days 4 and 7 vs. the day of trauma in most elderly, whereas minor changes were observed in the young. Multiple factors may account for these major changes in the elderly: the more severe status, the major sensitivity to the pathophysiologic changes induced by trauma, and also at least partially the ageing processes. Although referring to a limited number of observations, our findings on MEGX disposition suggest that liver function may be affected by the severity of injury, even if the influence of age should not be underestimated in these patients.
Regulation of cerebral blood flow in patients with autonomic dysfunction and severe postural hypotension
Authors: Hesse Birger , Mehlsen Jesper , Boesen Finn , Schmidt Jes F. , Andersen Erling B. , Waldemar Gunhild , Andersen Allan R. , Paulson Olaf B. , Vorstrup Sissel 
Published: March 2003

Background: Whether cerebral blood flow (CBF) autoregulation is maintained in autonomic dysfunction has been debated for a long time, and the rather sparse data available are equivocal. The relationship between CBF and mean arterial blood pressure (MABP) was therefore tested in eight patients with symptoms and signs of severe cardiovascular autonomic dysfunction. Patients and methods: Eight patients were included, three of whom had Parkinson's disease, three diabetes, one pure autonomic failure and the last one had multiple system atrophy. By the use of two techniques, the arteriovenous oxygen [(a‐v)O2] method and xenon‐inhalation with single photon emission tomography, 15 measurements (range 10–20) and three to four CBF measurements, respectively, were obtained in each patient. Following CBF measurements during baseline, MABP was raised gradually using intravenous noradrenaline infusion, and then lowered by application of lower body negative pressure. From the (a‐v)O2 samples the CBF response to changes in MABP was evaluated using a computer program fitting one or two regression lines through the plot. Results and conclusion: Preserved autoregulation was observed in three patients, while the remaining five patients showed a linear relationship between CBF and MABP. Comparison of the results of the tomographic CBF measurements to the (a‐v)O2 data demonstrated that it is not possible to assess whether CBF is autoregulated or not with only three to four pairs of data.
RFLP and RAPD Analysis of In Vivo Genetic Interactions Between Strains of Helicobacter pylori
Authors: Danon Stephen J. , Luria Brian J. , Mankoski Raymond E. , Eaton Kathryn A. 
Published: March 2003

Background.The nature of the in vivo interactions between co‐colonizing strains of Helicobacter pylori has not been well studied. This study was designed to investigate the in vivo interaction between strains of H. pylori using restriction fragment length polymorphism analysis (RFLP) and random amplified polymorphic DNA fingerprinting (RAPD) analysis.Materials and Methods.Mice were orally inoculated with either a single strain or a mixture of strains, and killed at various time intervals up to 12 months after inoculation.Results.Inoculum and recovered bacteria were identified by RAPD and RFLP. After 12 months of colonization, bacteria recovered from mice given a single strain were identical to the inoculum. In contrast, bacteria recovered from mice given a mixture of strains developed minor but consistent differences in their RAPD patterns. This variation occurred in spite of the fact that only single strains were recovered from mice given a mixture of strains.Conclusion.These findings support the development of genetic heterogeneity of H. pylori during long‐term colonization either by genetic drift or by in vivo recombination. Such genomic modification in vivo could explain the naturally occurring heterogeneity of H. pylori.
Helicobacter pylori (H. pylori) in Gastric Mucosa of Children with Abdominal Complaints: Immunohistochemistry Detects Antigen‐Reactive Corpus Mucosa Cells
Authors: Vorobjova Tamara , Maaroos Heidi‐Ingrid , Rägo Tiina , Zimmermann Arthur , Uibo Raivo 
Published: March 2003

Background.Previous morphological and serological studies of gastric Helicobacter pylori (H. pylori) colonization among Estonian children with abdominal complaints, as well as among populations of schoolchildren, have shown a high prevalence of H. pylori (49–60%). Based on published data concerning the high specificity and sensitivity of immunohistochemical detection of H. pylori, we examined the prevalence of H. pylori in gastric biopsy specimens of Estonian children by different localization and morphological type of gastritis comparing Giemsa staining with immunohistochemistry.Material and Methods.Formalin‐fixed biopsies (107 antral, 108 corpus mucosa) of 112 children (41 boys, 71 girls, age range 1–16~years, median age 12~years) with abdominal complaints were stained with hematoxylin & eosin and Giemsa stains, as well as examined using the peroxidase antiperoxidase (PAP) method with polyclonal antibodies to H. pylori.Results.Gastritis of any degree and localization was found in 84/112 (75%) children. Using Giemsa staining H. pylori were detected in 83/112 (74%) of all children, and by use of the PAP method in 55/112 (49%) (p~=~.001). Concordance of the results of immunohistochemical and Giemsa methods in antrum biopsies was 70%, in corpus biopsies 73%. In 12 out of 108 (11%) corpus mucosa specimens a positive staining with anti‐H. pylori IgG was localized in the cytoplasma of corpus mucosal cells in the neck part of the glands.Conclusions.The prevalence of H. pylori was higher when employing the Giemsa stain in comparison with immunohistochemistry. Antibody reactivity of cells in the neck part of the corpus glands may either be due to cross‐reactivity of anti‐H. pylori IgG with epithelial cell epitopes, or to internalization of H. pylori by these cells, suggesting a pathogenic role of neck cells in an anti‐H. pylori immune response.
Cure of H. pylori Infection Using a 7‐Day Triple Therapy Combining Pantoprazole with Two Antibiotics
Authors: Adamek Romuald J. , Pfaffenbach Boris , Szymanski Christian 
Published: March 2003

Background.Acid pump inhibitors combined with antimicrobials cure gastritis and peptic ulcer disease but a standard therapy has not yet been established. We therefore investigated a triple therapy with pantoprazole.Methods.The aim of this open‐label monocenter trial, involving 30 intention‐to‐treat patients with peptic ulcer disease or functional dyspepsia, was to assess the H. pylori cure rate after a 7‐day triple therapy with pantoprazole (40 mg bid) plus metronidazole (500 mg bid) and amoxicillin (1 g bid). The H. pylori status was assessed by rapid urease test, histological examination and culture at the initial examination and by histological examination and culture at the study end 4 weeks after ending all therapy.Results.At the end of the trial H. pylori was eradicated in 21 of 27 per protocol patients (78%; 95% CI 58–91%) and in 21 of 30 patients included in the trial (70%; 95% CI 51–85%). In 15 of 16 per protocol patients with metronidazole‐sensitive strain (94%; 95% CI 70–100%) the infection was cured, but in contrast eradication was accomplished in only one of 3 patients with a metronidazole‐resistant H. pylori strain. Post‐treatment resistance to metronidazole was observed in 6 cases, although 4 of them had had H. pylori strains sensitive to metronidazole at the initial visit. The gastritis had clearly been improved, and the activity of gastritis had completely disappeared 4 weeks after treatment. Seven adverse events were observed in 7 patients, the intensity of which was moderate in 6 cases.Conclusions.This short‐term triple therapy with pantoprazole, amoxicillin and metronidazole provides an effective regimen especially in patients with metronidazole‐sensitive strain.
Lansoprazole Quadruple Therapy Is Effective in Curing Helicobacter pylori Infection
Authors: Korman Melvyn G. , Bolin Terry D. , Nicholson Fiona B. , Engelman Jeffrey L. 
Published: March 2003

Background.Quadruple therapy using omeprazole combined with classic bismuth triple therapy has been advocated as optimal therapy for the cure of Helicobacter pylori (H. pylori) infection. We investigated the efficacy of substituting lansoprazole for omeprazole in proton pump quadruple therapy.Materials and Methods.In a prospective open study, 219 consecutive patients, with either peptic ulcer disease or biopsy‐proven H. pylori‐associated gastritis, received seven days of lansoprazole, bismuth, tetracycline and metronidazole after three days of lansoprazole pretreatment. Cure of infection was judged by 14C urea breath test at six weeks after completion of therapy.Results.On an intention to treat basis, 198 of the 219 patients (90%) were confirmed to be cured of H. pylori infection. Compliance was excellent and minimal side effects reported.Conclusion.Lansoprazole‐based quadruple therapy achieves a very high cure rate in an unselected population of either peptic ulcer patients or those with H. pylori‐associated gastritis. Recommended regimens should achieve at least 90% cure of infection. Lansoprazole quadruple therapy is effective and compares favorably with other H. pylori treatment regimens.