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At least 271 records · Page 15Linked to original sources
PubMed1999

Cardiovascular disease risk factors in young children in the STRIP baby project. Special Turku coronary Risk factor Intervention Project for children.

Introducing nutritional principles of preventive cardiology to the care of young children may improve permanently adherence to a low-saturated-fat, low-cholesterol diet later in life. This approach has not been readily adapted because of worries of the possible effects of such a diet on the growth and development of children. In the STRIP baby project, 1062 infants were randomized at 7 months of age into an intervention group (n = 540) or a control group (n = 522). The counselling of the intervention children aimed at a fat intake of 30% of energy after the age of 1 year and to a 1:1:1 ratio in saturated:monounsaturated:polyunsaturated fat intake. Dietary intake, growth and serum lipid concentrations were monitored in the children regularly through the first years of life. The intake of total fat, saturated fat and cholesterol were lower and the intake of polyunsaturated fat and the ratio of polyunsaturated to saturated fat (P/S) in the diet were higher in the intervention children than in the controls. During the first 3 years of the trial, the serum cholesterol concentration was 3-6% lower in the intervention children than in the controls (95% CI for the mean difference between groups from -0.27 to -0.12 mmol/L). No differences in the growth of the children were observed between the groups. We conclude that repeated individualized counselling aiming at reduced consumption of saturated fat combined with regular follow-up is effective and does not restrict the growth of children.

Cardiovascular Diseases↗
PubMed2002

The Beacon Project--a community-based health improvement project.

Inequality and socioeconomic deprivation remain powerful determinants of the nation's health. The Beacon Project, led by two primary health care visitors, was initiated to tackle the rapidly declining health and social needs of a community in Cornwall, southwest England. Significant improvements in conditions and a general sense of wellbeing on the estate, together with the improvements in social outcomes was observed over a period of four years.

Community Health Planning↗
PubMed1992

Nigrostriatal projections in the rat as demonstrated by retrograde transport of horseradish peroxidase. II. Projection to the caudal striatum.

The distribution of nigral neurons projecting to the caudal and basal parts of the striatum was studied in 9 rats by means of the horseradish peroxidase labelling technique. Labelled neurons localized in the substantia nigra pars compacta were demonstrated throughout the antero-posterior extent of the nucleus. Most of them were found in the lateral half of the SNc. Labelled neurons localized in the substantia nigra part reticulata predominated in the caudolateral part of the SNr. Characteristic features included major perikaryal polymorphism and size range of the nigrostriatal neurons.

Animals↗
PubMed1992

[Cardiologic emergencies: mortality and treatment. An analysis of 500 consecutive coronary events within the framework of the WHO-MONICA Project--Brianza Area. The Research Group of the WHO-MONICA Project--Brianza Area].

Recently, a decreasing trend in cardiovascular mortality, starting from 1976-78, has been observed in Italy, particularly in northern regions. In order to explore one possible cause of the phenomenon, a survey of acute coronary care has been performed in a sample area, with about one tenth of the population of Lombardy, the largest and most developed northern Italian region. The survey has been carried out within the framework of the WHO-MONICA project: the treatment of 500 consecutive suspected coronary events in the age group 25-64 years, has been examined according to the international protocol. The following items have been investigated: time between onset of symptoms and medical intervention; characteristics of initial care; cardiac arrest and cardiopulmonary resuscitation in or outside the hospital; intensive care unit admission and length of stay; type of treatment before, during and after the event. Marked improvements have been accomplished in managing cardiac emergency. They have reduced in-hospital coronary mortality by more than 50%. However, several problems were still present at the time of the study, 1986-87: a) only 52% of patients obtained assistance within 4 hours (Tab III); b) cardiac arrest was practically always fatal outside the hospital and in 75% of the cases inside (Tab V); c) essential drugs, e.g. beta-blockers, were not so widespread and substantially absent were angioplasty and coronary bypass surgery (Tab IX). It has been estimated that improving adherence to optimal therapeutic standards might save more than 700 lives a year in Lombardy in the age group 25-65 years.

Adult↗
PubMed2005

Individuals' cardiovascular risk profile projected by family doctors and individuals' knowledge of cardiovascular risk factors: a challenge for primary prevention. The cardiovascular risk prevention project "Help Your Heart Stay Young".

BACKGROUND: Whether the practice of family doctors of assessing individuals' cardiovascular risk profile improves individuals' knowledge of risk factors in primary prevention has not been established. Accordingly, we evaluated patients' knowledge of cardiovascular risk factors and lifestyle in healthy subjects whose family doctors provided individual cardiovascular risk score. METHODS: Subjects who visited their family doctor in a time frame of 3 months, who accepted to fill-in a simple questionnaire measuring their knowledge of cardiovascular risk factors and of non-pharmacological interventions able to reduce cardiovascular risk were evaluated. RESULTS: Fifty-one family doctors were involved. The study sample comprised 4239 subjects (mean age 56 +/- 9 years, 62% women) in primary prevention. They were classified by their family doctors, based on the Framingham algorithm, as being at low (< 10%; 45.7% of subjects), medium (10-20%; 38.7% of subjects) or moderate-to-high (> 20%; 15.6% of subjects) cardiovascular risk. The prevalence of obese subjects (40, 48, and 49%, respectively) and of heavy smokers (> or = 20 cigarettes/day; 26, 30, and 34%) increased from the low to the moderate-to-high risk group (both p < 0.05). The proportion of subjects unaware of personal history of arterial hypertension (5, 6, and 9%) and that of subjects who were unaware of history of elevated cholesterol levels (10, 11, and 12%, both p < 0.01) increased with higher cardiovascular risk score. The proportion of subjects self-reporting blood pressure > 135/85 mmHg, but self-reporting being normotensive (30, 50, and 52%), and the proportion of subjects who referred cholesterol levels > 200 mg/dl among those who self-referred not to have elevated cholesterol levels (13, 25, and 31%) increased both with cardiovascular risk category (p < 0.001). The proportion of subjects who were unaware of their personal history of diabetes was similar in the cardiovascular risk groups. The prevalence of low educational level was higher (56, 58, and 62%, p < 0.01) and the level of knowledge of non-pharmacological remedies to cardiovascular risk factors (63, 61, and 59%, p < 0.01) was lower in higher cardiovascular risk score group. Subjects aged < 55 years showed similar lack of knowledge about cardiovascular risk factors and the proportion of heavy smoking was as high as in the group of older participants. CONCLUSIONS: In cardiovascular primary prevention, the projection of higher individuals' risk profile by family doctors was not paralleled by an increase in individual's knowledge of major cardiovascular risk factors and of lifestyle interventions able to reduce the cardiovascular risk.

Cardiovascular Diseases↗
PubMedDate not supplied

[From research to users: the Worksafe European Project and the IST-Gaslini Prevention and Safety Project].

OBJECTIVE: The Worksafe Project aims at increasing access to and use of the large amount of data related to the broad sector of health protection of workers and workplace safety recognising the key role of the communication and dissemination of the research results with particular reference to cancer. PARTICIPANTS: Four scientific institutes: National Institute for Research on Cancer, Genoa (IST); Finnish Institute of Occupational Health (FIOH), Helsinki; Karolinska Institutet (KI), Stockholm; International Agency for Research on Cancer (IARC), Lyon, and two technological partners (Softeco Sismat, Genoa; Fundacion Robotiker, Bilbao). RESULTS: The creation of the Worksafe portal, a web based infrastructure that allows knowledge sharing on top of a distributed digital data collection and provides web accessed services addressing a broad interested audience including biomedicine companies universities, research institutions, local and national public organisations and private users.

Environmental Illness↗
PubMed1991

Coronary drug project: experience with niacin. Coronary Drug Project Research Group.

Niacin was one of the treatments compared in the Coronary Drug Project, a placebo-controlled, multicenter trial of lipid-lowering drugs in the secondary prevention of coronary heart disease. A total of 1119 men, aged 30-64 at entry, were randomized to niacin and 2789 to placebo by the end of recruitment in March 1969. Although side-effects interfered with adherence to the niacin regimen, it was the most effective agent in achieving cholesterol-lowering (10% overall); other agents in the trial were clofibrate, dextrothyroxine, and conjugated equine estrogens. At the scheduled conclusion of the trial in February 1975, the niacin-treated group exhibited a statistically significantly lower incidence of definite, non-fatal myocardial infarction (MI) than the placebo group. There was a trend toward improvement in the life-table mortality curve, but this was not statistically significant. In 1981 an extended follow-up was carried out concerning vital status for the 6008 men who were still alive at the end of treatment and active follow-up in the trial in 1975 (827 in the niacin group and 2008 in placebo groups). Vital status was determined for 99.1% of these men after a mean of 9 years from conclusion of the trial. In the group previously randomized to niacin, there were 69 (11%) fewer deaths than were expected on the basis of mortality in the placebo group. This difference was significant (z = -3.52; P = 0.0004). The data also suggested that patients with a higher baseline cholesterol experienced greater benefit from niacin therapy, as did those with the best response to the drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

[Responses of the vibrissal projection zone of the cat somatosensory projection zone to afferent activation].

Responses of 375 neurons of SI cortex region in the vibrissae projection zone were recorded in unanesthetized cats: responses to electrical stimulation of infraorbital nerve and mechanical stimulation of vibrissae were studied. Nerve and vibrissae stimulation evoked complex synaptic potentials (short EPSPs followed by IPSPs) in most neurons primary IPSPs were found in other units. The corresponding changes of impulse activity could be recorded in many neurons extracellularly. Initial inhibition was evoked by vibrissae stimulation more frequently (in 45% units comparing to 16% when the nerve was stimulated). Difference of minimal EPSP and IPSP latencies during intraorbital nerve stimulation was 0.8 ms, difference of mean values--1.4 ms. Directional sensitivity of cortical neurons (to the changes in direction of vibrissae deflection) is demonstrated. Neurons located in the close proximity may possess different pattern of directional sensitivity. It is supposed that short latency neuronal inhibition in SI cortical zone is mainly afferent (not recurrent). Probable mechanisms of directional sensitivity of the studied neurons are discussed.

Afferent Pathways↗
PubMed1989

The noradrenergic neurotoxin DSP-4 eliminates the coeruleospinal projection but spares projections of the A5 and A7 groups to the ventral horn of the rat spinal cord.

Systemic administration of the noradrenergic neurotoxin DSP-4 results in a complete loss of staining of noradrenergic (NA) axons in the dorsal horn and intermediate zone of the rat spinal cord. NA axon staining in the ventral horn and in the intermediolateral cell column is only slightly decreased by the drug treatment. We have taken advantage of this differential effect of DSP-4 on NA axons to determine the location and number of cells that give rise to NA axons in the ventral horn and the intermediolateral cell column. Retrograde transport of the fluorescent tracer True blue was combined with dopamine-beta-hydroxylase immunohistochemistry 2 weeks after treatment of rats with 50 mg/kg of DSP-4. Compared with controls, the drug treatment resulted in a more than 90% decrease in the number of retrogradely labeled NA neurons in the locus coeruleus and an only 30-50% reduction in the number of retrogradely labeled NA cells in the A5 and A7 groups. The results reveal different sites of termination in the spinal cord of NA axons originating in the LC and in NA cells of the A5 and A7 groups: the LC distributes fibers mainly to the dorsal horn and the intermediate zone, while NA cells of the A5 and A7 groups project to motoneurons of the ventral horn and the intermediolateral cell column.

Animals↗
PubMed1989

Nigrostriatal projections in the rat as demonstrated by retrograde transport of horseradish peroxidase. I. Projections to the rostral striatum.

The distribution of nigral neurons projecting to the rostral part of the striatum was studied in 12 rats using the horseradish peroxidase or the wheatgerm lectin bound horseradish peroxidase labelling techniques. Labelled neurons localized in the substantia nigra pars compacta (SNc) were demonstrated throughout the anteroposterior extent of the nucleus. Most of the labelled neurons were localized in the medial half of the SNc, predominantly in its basal part. Labelled neurons localized in the substantia nigra pars reticulata (SNr) predominated in the caudal half of the nucleus where they were found in its medial, central and lateral parts. A quantitative evaluation of the shape and size of the labelled neurons showed no statistically significant differences between the SNc and SNr as to the shape of the labelled perikarya. In contrast, nigrostriatal neurons in the SNc were found to have larger perikarya than their counterparts in the SNr.

Animals↗
PubMed1988

Impact of the National Control of Diarrhoeal Diseases Project on infant and child mortality in Dakahlia, Egypt. National Control of Diarrheal Diseases Project.

The Egyptian National Control of Diarrheal Diseases Project (NCDDP) started in 1983. A field trial done in Dakahlia Governorate in 1980 to promote oral rehydration therapy showed that the mortality rate for the under-fives during the diarrhoea season was 18.1/1000 in control villages and 10.5/1000 in "outreach" villages (p less than 0.001). In 1986 mortality rates had become similar in the two areas and lower than in 1980 (6.5/1000 and 6.0/1000, respectively), even though there were no significant changes in diarrhoea incidence. Virtually all the reduction in mortality was due to a decline in diarrhoea-associated deaths. The principal differences between 1986 and 1980 were better case-management by mothers and doctors, in both outreach and control villages, and far greater television ownership. Village civil registers showed only slight changes in under-five mortality from all causes after 1980, but an accelerating decline from 1983. Governorate-wide civil registration data showed slowly falling infant death rates from 1970 onward, accelerating after 1982, with most of the decline corresponding to the seasonal pattern of diarrhoea-associated mortality throughout the year. Thus NCDDP promotion of better treatment seems to have been responsible for the decline in mortality.

Child, Preschool↗
PubMed1980

Treatable risk factors--hypercholesterolemia, smoking, and hypertension--after myocardial infarction: implications of the coronary drug project data for clinical management. Coronary Drug Project Research Group.

Data from the five-year follow-up of the 2789 men in the placebo group of the Coronary Drug Project indicate that serum cholesterol level elevation and cigarette smoking, both remediable factors, adversely affect morbidity and mortality following recovery from myocardial infarction. Although the most powerful predictive factors of mortality from coronary heart disease were those related to the status of the myocardium (selected electrocardiographic changes, cardiomegaly, New York Heart Association functional classification), these features are basically irremediable. These observations suggest that benefit may ensue from measures that can safely reduce elevated serum cholesterol levels or lead to cessation of smoking or both and that use of these two interventions appears prudent in patients recovered from myocardial infarction. Data regarding hypertension are less clear; at present the evidence would suggest that management of mild hypertension following myocardial infarction should give emphasis to sodium restriction and reduction of weight, when appropriate.

Adult↗
PubMedDate not supplied

Making the most of nursing student projects: a collaborative pain management project.

A simple quality assurance project involving one facility and two nursing students provided an opportunity to meet the needs of the students, institution, nursing staff, and patients. Patients received more information on pain and pain management. Students met the objectives of their programs and also gained invaluable experience in research methods, education of staff members, and development of new policies. The facility capitalized on the findings of the original quality assurance study and used that information to make changes in the way pain was managed at the institution. This collaborative effort is just one example of the benefits that accrue when educational and clinical facilities work together. The challenge to education and practice is to work together to identify mutual goals and achieve objectives that meet educational and clinical needs. Not only can collaboration facilitate exceptional learning experiences for the student, it also can stimulate staff nurses' interest in research and lay the groundwork for education of staff to make changes in the way care is delivered.

Education, Nursing, Baccalaureate↗
PubMedDate not supplied

[A collaborative project of epidemiological research on the quality of care for the woman with a tumor. The Collaborative Research Group, the Barin Project].

The Barin Project aimed at evaluating the quality of health care for women affected by breast, ovarian and uterine cancer, using as a measure the satisfaction expressed by women. For 2 years women of the Associazione Coltivatori Diretti (a rural women association) accepted to report and describe a sample of contacts with health services, for any reason (symptoms, controls, exams) related, according to the women's perception, to cancer. 3,620 women participated in the survey: 2,313 (64%) completed questionnaires only 1,142 (50%) of them were of sufficient quality to be analysed. Data were compared with figures obtained in a previous survey on the same population and the following relevant changes were observed: the number of contacts with the general practitioner increased (27% vs 12%) and the number of women who underwent a screening almost doubled, with a sensible reduction of the delay due to the woman (2 vs 4 weeks of the previous survey). The number of episodes reporting an unfavourable evaluation of services and/or health personnel decreased from 41 to 3.8%.

Adult↗
PubMedDate not supplied

Clinical presentation of (subclinical) jaundice--the Euricterus project in The Netherlands. United Dutch Hospitals and Euricterus Project Management Group.

BACKGROUND: From a primary clinical database, we wanted to obtain insight in disease distribution and clinical presentation of adult jaundiced patients in a Western country. MATERIALS AND METHODS: As part of the Euricterus project, 24 Dutch general and academic hospitals in a period of 2 years gathered prospectively 702 patients on a standard proforma. Patient aged 16 years or more (median 61) and with a serum bilirubin of 20 mmol/l or more (median 83) were included. The final diagnosis was established within 3 months. RESULTS: Pancreatic or biliary carcinoma (20%), gallstone disease (13%) and alcoholic liver cirrhosis (10%) were the 3 most frequent diagnoses. Imaging (79%), clinical course (63%) and chemistry/serology (57%) were the most used ascertaining methods. Pancreatic or biliary carcinoma and gallstone disease were more common and age higher in general hospitals (p = 0.0001), and 'immunological' liver disease, non-alcoholic cirrhosis and hepatocellular carcinoma (HCC) more common in academic hospitals (p = 0.001). Patients aged 90 years or older (13%) had pancreatic or biliary carcinoma, liver metastases or heart failure and patients with age less than 20 (0.9%) had acute viral hepatitis, nonalcoholic active liver disease or HCC. Risk factors were more apparent (p < 0.02) in those aged less than 61 years. Feeling unwell (78%), dark urine (67%) and anorexia (57%) were the 3 most frequent symptoms; the 3 most frequent signs were liver enlarged (39%), looking ill (29%) and appearing wasted (23%). CONCLUSIONS: Through Euricterus, fresh clinical knowledge has emerged of symptomatology, age stratification and hospital preponderance of (sub)clinical jaundice in this country. This is important both for teaching and in preparing clinical studies.

Adolescent↗
PubMed1997

Project MATCH secondary a priori hypotheses. Project MATCH Research Group.

AIMS: (1) To assess the benefits of matching alcohol dependent clients to three treatments, based upon a priori hypotheses involving 11 client attributes; (2) to discuss the implications of these findings and of matching hypotheses previously reported from Project MATCH. SETTING AND PARTICIPANTS: (1) Clients receiving outpatient therapy (N = 952; 72% male); (2) clients receiving aftercare therapy following inpatient or day hospital treatment (N = 774; 80% male). INTERVENTION: Clients were randomly assigned to one of three 12-week, manual-guided, individual treatments: Cognitive Behavioral Coping Skills Therapy (CBT), Motivational Enhancement Therapy (MET) or Twelve-Step Facilitation Therapy (TSF). DESIGN: Two parallel but independent randomized clinical trials were conducted, one with outpatients, one with aftercare clients. Participants were monitored over 15 months including a 1-year post-treatment period. Individual differences in response to treatment were modeled as a latent growth process and evaluated for 17 contrasts specified a priori. Outcome measures were percentage of days abstinent and drinks per drinking day. FINDINGS: Two a priori contrasts demonstrated significant post-treatment attribute by treatment interactions: (1) outpatients high in anger and treated in MET had better post-treatment drinking than in CBT; (2) aftercare clients high in alcohol dependence had better post-treatment outcomes in TSF; low dependence clients did better in CBT. Other matching effects varied over time, while still other interactions were opposite that predicted. CONCLUSIONS: (1) Anger and dependence should be considered when assigning clients to these three treatments; (2) considered together with the results of the primary hypotheses, matching effects contrasting these psychotherapies are not robust. Possible explanations include: (a) among the client variables and treatments tested, matching may not be an important factor in determining client outcomes; (b) design issues limited the robustness of effects; and (c) a more fully specified theory of matching is necessary to account for the complexity of the results.

Adult↗