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PubMed1997

Poststroke depression: an examination of the literature.

OBJECTIVE: To examine literature on poststroke depression (PSD). DATA SOURCES: More than 200 articles related to stroke and depression were selected from a computer-based search spanning 1985 to 1995. STUDY SELECTION: All relevant articles on PSD. Articles in foreign languages, case studies, anecdotal reports, book chapters, and reviews were excluded. DATA EXTRACTION: Summary findings were independently reviewed by the authors. DATA SYNTHESIS: PSD remains a frequent sequela of stroke; its prevalence remains uncertain because of continued methodologic problems in defining subject groupings and in utilizing psychiatrically normed assessment tools with neurologically impaired individuals, and because of the poor specificity/sensitivity of neuroendocrine markers in determining a diagnosis. The etiology of PSD appears to be complex and not fully understood. Although there has been much research on PSD, this review highlights the sparsity of available literature on its treatment. CONCLUSION: The review points out the further need for more carefully designed studies of PSD that examine both assessment and treatment.

Antidepressive Agents↗

PubMed1998

Metastases that interfere with circulation.

OBJECTIVES: To review the nursing implications of select circulatory problems caused by metastatic cancer. DATA SOURCES: Journal articles, research studies, and book chapters relating to circulatory problems associated with metastatic disease. CONCLUSIONS: During the metastatic process, tumor cells can interfere with circulation. As a result, circulatory impairments can range from life threatening to manifestations that may alter a person's quality of life. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have a responsibility to seek current knowledge about therapeutic and supportive care for persons experiencing circulatory alterations. Collaboration with colleagues can facilitate patient care in these clinical situations. Patient education can be supportive and may enhance optimal outcomes.

Ascites↗

PubMed1996

Clinical evaluation of asthma.

OBJECTIVE: The purpose of this article is to review the medical history and physical examination of the asthmatic patient. DATA SOURCES: English references identified from relevant articles and book chapters, experts, and MEDLINE search, using "asthma," "physical diagnosis," and "medical history." STUDY SELECTION: Clinical studies of the medical history or physical examination in subjects with respiratory disease were selected for review. RESULTS: Symptoms such as wheezing, chest tightness and difficulty in taking a deep breath suggest asthma, while symptoms such as gasping, smothering or air hunger suggest alternative diagnoses. Symptoms of asthma correlate poorly with airway obstruction in one-third to one-half of asthmatic patients. Respiratory signs such as wheezing, breath sound intensity, forced expiratory time, accessory muscle use, respiratory rate and pulsus paradoxus correlate roughly with airway obstruction. However, clinicians disagree on the presence or absence of respiratory signs 55% to 89% of the time. Furthermore, physicians correctly predict pulmonary function based on history and physical examination only about half the time, and correctly diagnose asthma based on the clinical examination 63% to 74% of the time. CONCLUSIONS: The medical history and physical examination are moderately effective in diagnosing asthma and estimating its severity. Objective measures of lung function are necessary for the accurate diagnosis of asthma.

Asthma↗

PubMed1981

Treating adolescent obesity: a pilot project in a school.

A weight control program for junior high school students was developed to change eating, exercise and habit patterns. The course included dietary management, physical activity and behavior modification techniques. Classes were structured to emphasize peer group involvement and daily practical application. The curriculum was compiled in a book for educational personnel. The program was tested as a pilot project with a selected group of eighth grade obese adolescent girls and a comparison group. Immediately after the course, the subjects' percent of overweight had decreased; at a subsequent eight-month follow-up, additional losses were noted. The percent of overweight of the girls in the comparison group remained relatively unchanged. While the program was successful with this particular group of students, several key questions, requiring further study, were defined.

Adolescent↗

PubMed1986

Searching health education literature. Bibliographic and indexing tools.

The first two articles in this series looked in different ways at relationships between libraries and health education units. We now look at a selection of bibliographic and indexing tools that can be used to identify journal articles, books and other materials of interest to health educators. Audio-visual items are not covered.

Information Services↗

PubMed2006

[A review of screening tools to assess domestic violence against the elderly].

Data on elder abuse in Brazil are scarce. Systematic and thorough documentation can facilitate studies on magnitude, risk factors, and care of victims. This article reviews the existing screening tools on violence against elders in order to examine recent progress in the field, both in Brazil and abroad. A systematic review through MEDLINE, PsycINFO, LILACS, CANE, and OVID and reference books was performed using specific inclusion criteria. Studies on psychometric background and utilization of selected instruments were systematically examined, applying a set of quality assessment criteria. The Conflicts Tactics Scale was the only one of 17 identified scales that had been adapted to the Brazilian culture, although focusing on a younger age group. Some instruments with good psychometric characteristics were also found, namely the Caregiver Abuse Screen, Elder Abuse Assessment Tool, Hwalek Sengstok Abuse Screening Test, Indicators of Abuse Screen, QUALCARE scale, and Vulnerability to Abuse Screening Scale. However, there are still gaps in the process of design, validation, and adaptation, both in Brazil and abroad.

Aged↗

PubMed1992

The epidemiology of murder-suicide.

OBJECTIVE: To review the epidemiology, patterns, and major determinants of murder-suicide and to discuss the clinical and research strategies for identifying the individuals at greatest risk for this type of violence. DATA SOURCES: Data were obtained from English-language articles based on searches using MEDLINE (from 1966), PsychINFO (from 1967), and EMBASE (from 1974) programs. In addition, relevant articles, books, and monographs identified from the reference list of retrieved articles were reviewed. STUDY SELECTION: Case-control studies, descriptive epidemiologic surveys, and case series were chosen for review. DATA EXTRACTION: Because of the limited scope of the pertinent research literature, all data relevant to the incidence, demographics, circumstances, and precipitants of murder-suicide were summarized by the authors. DATA SYNTHESIS: Murder-suicide occurs with an annual incidence of 0.2 to 0.3 per 100,000 person-years and accounts for approximately 1000 to 1500 deaths yearly in the United States. The annual incidence of these events is relatively constant across industrialized nations and has not significantly changed over several decades. The principal perpetrators are young males with intense sexual jealousy, depressed mothers, or despairing elderly men with ailing spouses. The principal victims are female sexual partners or consanguineous relatives, usually young children. Clinical depression, specific motivations such as male sexual proprietariness or maternal salvation fantasies, and a history of previous suicide attempts are important in explaining underlying psychopathological mechanisms. CONCLUSIONS: Murder-suicide occupies a distinct epidemiological domain that overlaps with suicide, domestic homicide, and mass murder. These events may be categorized into one of only several phenomenologic typologies that share similar demographics, motivations, and circumstances. Despite the disruption of families and communities caused by murder-suicide, there are no standardized operational definitions, validated taxonomic systems, or national surveillance networks for these events, all of which are needed to develop prevention strategies.

Case-Control Studies↗

PubMed1986

[Classification of hearing loss in industrial workers for the purpose of expert testimony].

Periodical examinations of 472 industrial workers exposed to noise promoted classification of those workers' hearing into four categories: A. Normal hearing, B. Non-noise-induced impairments, C. Multi-causal impairments, not excluding noise, D. Chronic acoustic trauma. To the particular categories, appropriate qualifying, preventive or therapeutic procedure have been ascribed. Appropriate hearing category (A, B, C or D) entered into the worker's health record book would spare repeating the medical examinations at a new workplace, simplify administrative, certificatory (selection of the workplace, prevention or treatment) and claiming procedures.

Disability Evaluation↗

PubMed1971

A survey of information sources used by psychiatrists.

To study the information sources of psychiatrists, we sent a questionnaire to 400 randomly selected members of the American Psychiatric Association. Seventy-four percent responded. Journals and books (in that order) were the most important information sources. The average number of journals regularly read was 4.3. An average of 9.1 books had been read during the preceding twelve months. Twenty-eight percent of books were obtained through a library. Sixty-nine percent of the respondents use a medical library at least monthly. Important differences were found by type of practice. For example, academicians reported reading almost 19 books the preceding year; private practitioners, 6.4. We conclude that a major aim in the postgraduate education of psychiatrists should be instruction in the use of all information services. In addition, abstracts and an authoritative annual review should help psychiatrists keep up in areas outside their special interest.

Books↗

PubMed1994

[Participant observation as data collection method in nursing research].

Participant observation as data collection method in nursing research is explored in this article. The scientific basis of observation method comes from symbolic interactionism. Nature and epistemological starting points of the knowledge produced by observational method can vary depending on the purpose of the study. Participant observation is a process, which aims at scientific research through observer's presence in social situations. Fieldwork should be carefully prepared because the main problem in participant observation is observer's influence on phenomenon which is being studied. In the beginning of the field-work researcher tries to get a general view what happens in the situation. After the analysis the researcher can focus his observations according to his research problems and finally observe selectively. The data consists of record-keeping, descriptions and field-work note book. Participant observation is the most subjective observation method of data collection. By using triangulation a researcher can avoid his personal influence on results and make the validity of his study better. The researcher must take ethical issues into consideration when collecting data by participant observation.

Data Collection↗

PubMed1996

Prevention of hepatitis A infections: guidelines for use of hepatitis A vaccine and immune globulin. American Academy of Pediatrics Committee on Infectious Diseases.

The licensing of two inactivated hepatitis A vaccines for persons 2 years or older necessitates development of recommendations for pediatric use, as well as a review of the current indications for immune globulin (IG) in hepatitis A prophylaxis. Both vaccines are immunogenic and protective in children and adults. A single dose of vaccine induced antibody in 88% to 96% of subjects by 2 weeks and 97% to 100% by 1 month, and protected against subsequent hepatitis A virus (HAV) disease occurring 21 days after receipt of the dose in a community with endemic hepatitis A infection. However, completion of the full vaccine schedule is recommended to assure high antibody titers and likely long-term protection. The major pediatric indications for vaccine are: (1) travelers to areas with intermediate to high rates of endemic hepatitis A, (2) children living in defined and circumscribed communities with high endemic rates or periodic outbreaks of HAV infection, and (3) patients with chronic liver disease. Immune globulin is recommended for postexposure prophylaxis, as vaccine has not yet been demonstrated to be protective for this purpose. Except for travelers, recommendations for IG use are not changed from those in the current edition of the Red Book, and include contacts of cases in the home, child care centers, and other selected sites.

Animals↗

PubMed2006

Mapping the literature of medical-surgical nursing.

BACKGROUND: Medical-surgical or adult health nursing is a complex specialty that requires a wide-ranging literature to inform its research and practice. Several excellent qualitative aids exist for collection development for this field, but quantitative studies are few. While one bibliometric study of journals exists, no recent work had been done in this area. METHOD: The Mapping the Literature of Nursing Project protocol was used. Four source journals were selected, and a citation analysis of articles from 1996 to 1998 was conducted. RESULTS: A list of the most frequently cited journals was created, using Bradford's Law of Scattering. The list demonstrates that 1.2% of the cited medical-surgical nursing journals produced just over 33% of the citations. PubMed/MEDLINE, CINAHL, and Science Citation Index provided the most complete indexing coverage of all of the journals, with CINAHL providing the most complete coverage of nursing journals. Books were the second-most cited format. CONCLUSIONS: Citation analysis of journal articles is a useful aid for selecting journals for medical-surgical nursing collections, but it did not prove to be as useful for selecting materials in other formats. Indexes in addition to PubMed/MEDLINE are necessary to provide access to the journal literature serving this specialty.

Abstracting and Indexing↗

PubMed2003

'Natural selection merely modified while redundancy created'--Susumu Ohno's idea of the evolutionary importance of gene and genome duplications.

Susumo Ohno's influential book Evolution by gene duplication dealt with the idea that gene and genome duplication events are the principal forces by which the genetic raw material is provided for increasing complexity during evolution. In 1970, the evidence for this hypothesis consisted mostly of karyotypic information, crude information by today's standard genetic data, DNA sequences. Nonetheless, although the type of data are outdated, the idea remained current and is still debated today in the age of complete genome sequences. Even more than thirty years after the initial publication more research than ever is being carried out on the evolutionary significance of gene and genome duplications and the contribution of these mechanisms to the advances in genomic and organismal evolution.

Evolution, Molecular↗

PubMed2004

Insecticide-treated bed nets and curtains for preventing malaria.

BACKGROUND: Malaria is an important cause of illness and death in many parts of the world, especially in sub-Saharan Africa. There has been a renewed emphasis on preventive measures at community and individual levels. Insecticide-treated nets (ITNs) are the most prominent malaria preventive measure for large-scale deployment in highly endemic areas. OBJECTIVES: To assess the impact of insecticide-treated bed nets or curtains on mortality, malarial illness (life-threatening and mild), malaria parasitaemia, anaemia, and spleen rates. SEARCH STRATEGY: I searched the Cochrane Infectious Diseases Group trials register (January 2003), CENTRAL (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 to October 2003), EMBASE (1974 to November 2002), LILACS (1982 to January 2003), and reference lists of reviews, books, and trials. I handsearched journals, contacted researchers, funding agencies, and net and insecticide manufacturers. SELECTION CRITERIA: Individual and cluster randomized controlled trials of insecticide-treated bed nets or curtains compared to nets without insecticide or no nets. Trials including only pregnant women were excluded. DATA COLLECTION AND ANALYSIS: The reviewer and two independent assessors reviewed trials for inclusion. The reviewer assessed trial methodological quality and extracted and analysed data. MAIN RESULTS: Fourteen cluster randomized and eight individually randomized controlled trials met the inclusion criteria. Five trials measured child mortality: ITNs provided 17% protective efficacy (PE) compared to no nets (relative rate 0.83, 95% confidence interval (CI) 0.76 to 0.90), and 23% PE compared to untreated nets (relative rate 0.77, 95% CI 0.63 to 0.95). About 5.5 lives (95% CI 3.39 to 7.67) can be saved each year for every 1000 children protected with ITNs. In areas with stable malaria, ITNs reduced the incidence of uncomplicated malarial episodes in areas of stable malaria by 50% compared to no nets, and 39% compared to untreated nets; and in areas of unstable malaria: by 62% for compared to no nets and 43% compared to untreated nets for Plasmodium falciparum episodes, and by 52% compared to no nets and 11% compared to untreated nets for P. vivax episodes. When compared to no nets and in areas of stable malaria, ITNs also had an impact on severe malaria (45% PE, 95% CI 20 to 63), parasite prevalence (13% PE), high parasitaemia (29% PE), splenomegaly (30% PE), and their use improved the average haemoglobin level in children by 1.7% packed cell volume. REVIEWERS' CONCLUSIONS: ITNs are highly effective in reducing childhood mortality and morbidity from malaria. Widespread access to ITNs is currently being advocated by Roll Back Malaria, but universal deployment will require major financial, technical, and operational inputs.

Bedding and Linens↗

PubMed2000

Oral protein calorie supplementation for children with chronic disease.

BACKGROUND: Growth failure and poor nutritional status are common features in children with chronic diseases due to reduced appetite, malabsorption and increased nutritional requirements associated with some diseases. The provision of oral protein calorie supplements is one of a number of interventions used to improve nutritional status in these children. The use of these products, which are expensive, may be associated with a number of adverse effects, for example, they may effect development of normal eating behaviour patterns or lead to unpleasant symptoms such as vomiting and diarrhoea. OBJECTIVES: To examine the evidence that in children with chronic disease, oral protein calorie supplements alter daily nutrient intake, nutritional indices, survival and quality of life and are associated with adverse effects, for example diarrhoea, vomiting, reduced appetite, glucose intolerance, bloating and eating behaviour problems. SEARCH STRATEGY: All publications describing RCTs of the use of oral protein calorie supplements in children with chronic diseases were identified through comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. The companies which market oral protein calorie supplements were also contacted. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials comparing use of oral protein calorie supplements for at least one month to increase calorie intake with existing conventional therapy, which may include nutritional advice on how to improve nutritional intake from food or no specific intervention, in children with chronic disease. DATA COLLECTION AND ANALYSIS: The following outcomes were assessed: indices of nutrition and growth, anthropometric measures of body composition, calorie and nutrient intake (total, from oral protein calorie supplements and from food), eating behaviour, compliance, quality of life, specific adverse effects and disease severity scores, and mortality. MAIN RESULTS: Three trials have been identified as being suitable for inclusion in the review and we are awaiting further data from one of these trials. All of these trials were carried out in children with cystic fibrosis. Few statistical differences could be found between the treatment and control groups apart from change in total fat intake at three months (weighted mean difference 69.20 [95% CI 11.05, 127.35]). However, this was based on the results of only one, small study. No trials have been identified which assess the effectiveness of oral protein calorie supplements in children with other chronic diseases. REVIEWER'S CONCLUSIONS: Oral protein calorie supplements are widely used to improve the nutritional status of children with a number of chronic diseases. We have only been able to identify a small number of trials assessing these products in children with cystic fibrosis and have been unable to draw any conclusions based on the limited data extracted from these. We therefore recommend that a series of large, randomised controlled trials are undertaken investigating the use of these products in children with different chronic diseases. Until further data are available, we would suggest that these products are only used with caution.

Adolescent↗

PubMed2006

Meditation therapy for anxiety disorders.

BACKGROUND: Anxiety disorders are characterised by long term worry, tension, nervousness, fidgeting and symptoms of autonomic system hyperactivity. Meditation is an age-old self regulatory strategy which is gaining more interest in mental health and psychiatry. Meditation can reduce arousal state and may ameliorate anxiety symptoms in various anxiety conditions. OBJECTIVES: To investigate the effectiveness of meditation therapy in treating anxiety disorders SEARCH STRATEGY: Electronic databases searched include CCDANCTR-Studies and CCDANCTR-References, complementary and alternative medicine specific databases, Science Citation Index, Health Services/Technology Assessment Text database, and grey literature databases. Conference proceedings, book chapters and references were checked. Study authors and experts from religious/spiritual organisations were contacted. SELECTION CRITERIA: Types of studies: Randomised controlled trials. TYPES OF PARTICIPANTS: patients with a diagnosis of anxiety disorders, with or without another comorbid psychiatric condition. Types of interventions: concentrative meditation or mindfulness meditation. Comparison conditions: one or combination of 1) pharmacological therapy 2) other psychological treatment 3) other methods of meditation 4) no intervention or waiting list. Types of outcome: 1) improvement in clinical anxiety scale 2) improvement in anxiety level specified by triallists, or global improvement 3) acceptability of treatment, adverse effects 4) dropout. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two reviewers using a pre-designed data collection form. Any disagreements were discussed with a third reviewer, and the authors of the studies were contacted for further information. MAIN RESULTS: Two randomised controlled studies were eligible for inclusion in the review. Both studies were of moderate quality and used active control comparisons (another type of meditation, relaxation, biofeedback). Anti-anxiety drugs were used as standard treatment. The duration of trials ranged from 3 months (12 weeks) to 18 weeks. In one study transcendental meditation showed a reduction in anxiety symptoms and electromyography score comparable with electromyography-biofeedback and relaxation therapy. Another study compared Kundalini Yoga (KY), with Relaxation/Mindfulness Meditation. The Yale-Brown Obsessive Compulsive Scale showed no statistically significant difference between groups. The overall dropout rate in both studies was high (33-44%). Neither study reported on adverse effects of meditation. AUTHORS' CONCLUSIONS: The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety, and Kundalini Yoga did not show significant effectiveness in treating obsessive-compulsive disorders compared with Relaxation/Meditation. Drop out rates appear to be high, and adverse effects of meditation have not been reported. More trials are needed.

Anxiety Disorders↗

PubMed1994

192 IgG-saporin: I. Specific lethality for cholinergic neurons in the basal forebrain of the rat.

An immunotoxin (IT) composed of a monoclonal antibody to the nerve growth factor (NGF) receptor, 192 IgG, chemically linked to saporin, 192 IgG-saporin, was shown to selectively reduce forebrain choline acetyltransferase (ChAT) activity in the rat brain following intraventricular administration. In order to determine if the IT was killing NGF receptor-positive neurons in the CBF (rather than simply suppressing the cholinergic phenotype in these cells), a population of neurons in the nucleus basalis magnocellularis (NBM) was prelabeled by an intracortical injection of the neurotracer Fluoro-Gold (FG) 1 week before intraventricular injections of IT or control substances (reduced IT or phosphate-buffered saline). We found that there were very few double-labeled (i.e. FG-labeled and ChAT-positive) neurons remaining in the NBM of IT-treated animals. The absolute number of FG-labeled neurons in the NBM of IT-treated animals was reduced by a number similar to the counts of double-labeled neurons in the NBM of control animals. Our conclusion is that the IT is preferentially lethal to cholinergic neurons in the NBM. Due to its ability to selectively kill cholinergic neurons in the CBF and concomitantly spare noncholinergic neurons with similar morphology and projections, 192 IgG-saporin can be used to produce a selective model of CBF deficit in the rat.

Animals↗

PubMed1982

General-practitioner obstetrics: two styles of care.

Two systems of general-practitioner obstetric care currently in use in England are compared. In one (Oxford) a large number of doctors, working with community midwives, have autonomous responsibility for the management of patients whose condition conforms with defined booking criteria. In the other (Dulwich) two practitioners, working with hospital midwives, operate a minimal selection policy, but all their patients are reviewed at 36 weeks' gestation by a specialist obstetrician. Despite the differing selection policies which created incongruities in the groups in respect of age, social class, and birthweight distribution, the outcomes in terms of mode of delivery showed no significant differences. The perinatal mortality rates were also similar and appeared to be better than those achieved nationally.

Adolescent↗