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PubMed2000

Use of practitioner-based complementary therapies by persons reporting mental conditions in the United States.

BACKGROUND: To our knowledge, this study provides the first national estimates for use of practitioner-based complementary treatments by US residents reporting mental conditions. METHODS: A total of 16038 respondents to the 1996 Medical Expenditure Panel Survey were asked about visits for 12 complementary medical services (eg, chiropractic services and herbal remedies). Bivariate and multiple regression models examined use of these therapies in individuals reporting a mental condition (n= 1803), fair or poor mental health status (n=992), and 1 of 4 chronic medical conditions (n = 3262) and in the remainder of the sample (n= 10 793). RESULTS: A total of 9.8% of those reporting a mental condition made a complementary visit, and about half of these (4.5%) made a visit to treat the mental condition. Persons reporting transient stress or adjustment disorders were most likely (odds ratio, 9.1%; 95% confidence interval, 5.5%-12.7%), and those with psychotic (odds ratio, 1.5%; 95% confidence interval, 0.0%-4.2%) and affective (odds ratio, 2.6%; 95% confidence interval, 1.5%-3.8%) conditions least likely, to use complementary therapies to treat their mental condition. In multivariate models controlling for medical comorbidity, fair or poor mental health status, and demographic factors, report of a mental condition predicted a 1.27-fold increase in the odds of a complementary visit (95% confidence interval, 1.04-1.54). CONCLUSIONS: Self-reported mental conditions were associated with increased use of complementary treatments, although use of these treatments was concentrated in respondents with transient distress rather than chronic and serious conditions. More research using structured diagnostic interviews is needed to examine the prevalence, patterns, and clinical implications of use of these treatments by individuals with mental conditions in "real world" community settings.

Adult↗
PubMed1997

Protein synthesis under conditions of anoxia and changing workload in ventricle strips from turtle heart.

An earlier study determined that protein synthesis in isolated perfused turtle (Trachemys [= Pseudemys] scripta elegans) hearts was three-fold lower under conditions of anoxia than under conditions of normoxia. However, the earlier study did not attempt to define the role of work in the isolated perfused preparation. In this study, the effects of varying workload, as defined by changing frequency of contraction, and anoxia on protein synthesis were examined. The ventricle strip preparation allows for comparison of multiple strips from a single heart, which aids in eliminating the variability found between individuals chosen from wild populations. Ventricle strips forced to contract at 24 contractions.min-1 under anoxic conditions failed more rapidly than strips forced to contract at 24 contractions.min-1 under normoxic conditions. Protein synthesis decreased by 32% when compared to normoxic controls. When stimulation was terminated after 2 hr of contraction, the rate of protein synthesis in strips under anoxic conditions was similar to that in strips under normoxic conditions. Also, returning strips to normoxic conditions after 2 hr of anoxia restored protein synthesis to the level of the normoxic controls. A significant correlation between pacing rate and protein synthesis was found under normoxic conditions but not under anoxic conditions when strips were paced at 12, 18 and 24 contractions.min-1. Protein synthesis increased by 30% at the 18 contractions.min-1 frequency and 45% at the 24 contractions.min-1 frequency over the rate at 12 contractions.min-1 frequency. Force-frequency studies revealed that under normoxic conditions force generation did not change until above 24 contractions.min-1, but under anoxic conditions there was a significant negative inotropic effect (20% decrease in force) at 24 contractions.min-1 and fell to 50% of initial at 36 contractions.min-1. These studies indicate that, in the turtle heart, anoxia per se is not the only determinant of protein synthesis but rather that work plays an important role in protein synthesis, as in the mammalian heart.

Animals↗
PubMed1999

Pattern learning by honeybees: conditioning procedure and recognition strategy.

In recognizing a pattern, honeybees Apis mellifera, may focus either on its ventral frontal part, or on the whole frontal image. We asked whether the conditioning procedure used to train the bees to a pattern determines the recognition strategy employed. Bees were trained with the same patterns presented vertically on the back walls of a Y maze. Conditioning was either absolute, that is, bees should learn to choose a rewarded pattern when there is no alternative, or differential, that is, bees should learn to choose a rewarded pattern that is paired with a different, nonrewarded one. Bees used different pattern recognition strategies depending on the conditioning procedure: absolute conditioning restricted recognition to the lower half whilst differential conditioning extended it to the whole pattern. Bees trained with absolute conditioning saw and learned the features of the upper part of the trained patterns, but assigned more weight to the lower part. Bees trained with differential conditioning learned not only the features of the reinforced stimulus in an excitatory way, but also those of the nonreinforced one in an inhibitory way. Thus, conditioning tasks that involve not only excitatory acquisition of the conditioned stimulus per se, but also discrimination of nonreinforced stimuli, result in an increase in the visual field assigned to the recognition task. Conditioning tasks that involve only excitatory acquisition of the rewarded stimulus result in a higher weighting of the lower pattern half and thus in a more reduced field assigned to the recognition task. This difference may reflect that existing between a conditioned and an incidental behavioural modification. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed1994

Encoding of behavioral significance of visual stimuli by primate prefrontal neurons: relation to relevant task conditions.

Single-unit activity was recorded from the inferior dorsolateral prefrontal cortex of two monkeys while they performed a symmetrically rewarded go/no-go discrimination task. Three different task conditions were used in which the monkeys had to base their response on (1) the color, or (2) the shape, or (3) the position of a cue that was presented during fixation of a light spot. The colors of the fixation spot informed the monkeys which condition was relevant. The monkeys had to make an immediate release (go) or a delayed release (no-go) at the time of the fixation color change (imperative stimulus) depending on the currently relevant condition and the discriminative cue previously presented. The effect of changing the relevant condition on neuronal responses to the discriminative cue was analyzed. Out of 328 neurons tested in two or three conditions, 249 responded differentially at the cue period depending on the particular behavioral meaning of the stimulus (go or no-go) in at least one of the task conditions. This differential cue-period activity was examined across the different task conditions: the majority of neurons (111/154, 72%) showed such activity in all three conditions. In the remaining 43 neurons (28%) the differential activity was observed in two conditions (27/154, 18%) or in one condition (16/154, 10%). A few neurons (n = 7) showed feature-specific cue-period activity. In addition, 27 neurons displayed condition-dependent anticipatory activity prior to the cue onset. It is suggested that neurons in the inferior dorsolateral prefrontal cortex may participate in the conversion of sensory information from different visual channels into behavioral information (information on the upcoming response).

Animals↗
PubMed2004

Influence of recruit condition on food competition and predation risk in a coral reef fish.

Settlement rate is considered to be a major determinant of the population structure of coral reef fishes. In this study, the effects of larval physiological condition on survival, predation risk and competitive ability are assessed for a small damselfish, Pomacentrus moluccensis. New settlers were collected and fed for 5 days to produce high and low condition (measured as lipid) treatment fish. In a field experiment, pairs (one high and one low condition fish) were transplanted to corals. Persistence over 2 weeks was much higher (100% vs. 25%) in high condition fish. In mixed groups in the laboratory, high condition fish were both aggressively dominant and consumed more of a limiting prey source than low condition fish. In addition, low condition fish were shown to be at much higher risk of predation. All of the low condition fish but only 33% of high condition fish in mixed groups were consumed by fish predators, and in a separate experiment, 73% of feeding strikes by predators were directed at low condition fish. Quality of new settlers can have an important influence on subsequent juvenile survival. The mechanisms for this effect are likely to include a combination of effects of condition on food competition and predation risk.

Animals↗
PubMed1990

Effects of repetitive conditioning crush lesions on regeneration of the rat sciatic nerve.

The effect of repetitive conditioning lesions was tested on regeneration of the rat sciatic nerve. The nerve was conditioned by crush lesions one, two or three times with an interval of 2 or 4 days between each successive lesion. Axonal elongation was measured 3 days after a final test crush lesion. Two conditioning lesions stimulated axonal elongation more than one, while a third conditioning lesion had no further effect on axonal outgrowth. However, if the number of conditioning lesions were varied within a constant conditioning interval, outgrowth after the test lesion was the same. This suggests that the conditioning interval and not the number of conditioning lesions determined the outgrowth after a test lesion. When the conditioning lesion(s) and the test lesion were made at the same place, outgrowth was longer than if the lesions were spatially separated. Incorporation of [3H]thymidine in the regenerated nerve segment showed that proliferation of non-neuronal cells was initiated by each lesion. By counting the number of cell nuclei this proliferation was shown to correspond to an increase of cells in the regenerating nerve. It is therefore possible that the greater number of non-neuronal cells in the distal nerve segment accounts for the enhanced conditioning lesion effect in nerves where the conditioning and test lesions are made at the same place.

Animals↗
PubMed1992

Activity rhythms in mice. III: Stability and plasticity of rhythm characteristics in experimental and environmental conditions.

The expression of a biological rhythm as measured by a given descriptor results from a set of components: the subject, the measuring device, and the experimental conditions. Rhythm of activity under four experimental conditions was observed in two strains of mice: BALB/c and C57BL/6. Condition 1, the optimal normal situation, was used as a reference; condition 2 was a retest of the animals used in condition 1 twelve days later; condition 3 tested animals for a period of 3 days in a food-deprivation situation; in condition 4, animals were isolated for 2 weeks prior to testing. Data analysis of rhythm of activity in the synchronic mode is based on a series of tests in the frequency and temporal domains. Analysis of condition-linked variation in the findings indicates that these parameters are only slightly affected by the four experimental conditions. The results, however, can be hierarchized according to condition and according to the kind of parameter. The temporal parameters are more sensitive than the frequency parameters, the least sensitive being the temporo-frequential measures. Isolation produces the greatest variation in parameter magnitude. The results show that rhythm of activity is fairly stable across a number of experimental conditions, a finding that could considerably simplify experimental protocols.

Animals↗
PubMed1994

In vitro development of bovine embryos in Buffalo rat liver- or bovine oviduct-conditioned medium.

A culture system for bovine embryos was developed using Buffalo rat liver cell (BRL) line-conditioned medium without serum. Zygotes, obtained by in vitro maturation and fertilization of oocytes, were cultured either in unconditioned medium (TCM 199 or DMEM/F12) or in the same medium conditioned by bovine oviduct or BRL cells. No serum was added during conditioning or during embryo culture. The DMEM/F12 medium was superior to TCM 199 for development of bovine embryos to the 5 to 8-cell stage: on average between 50 and 57% of the embryos reached this stage after 2 d of culture in DMEM/F12 or in conditioned medium, while 36% reached this stage in TCM 199. Further development to the blastocyst stage was enhanced by conditioning. The highest percentage of blastocysts was achieved in DMEM/F12 medium conditioned with BRL cells (30%). The yield of blastocysts was similar in TCM 199 and in DMEM/F12 media conditioned with bovine oviduct cells (22 versus 20%), but after conditioning with BRL cells, DMEM/F12 medium yielded a higher percentage of blastocysts than TCM 199 (30 versus 18%). This might be explained by the fact that viability of BRL cells was better in DMEM/F12 medium than in TCM 199 when serum was omitted. Blastocysts produced in BRL-conditioned medium had a higher number of cells than blastocysts obtained in bovine oviduct-conditioned medium, and their transfer to recipients led to pregnancies and birth of calves. In conclusion, culture of bovine embryos in DMEM/F12 medium conditioned with BRL cells without serum led to the development of good-quality blastocysts and is thus a promising method for producing embryos for the study of potential embryotrophic factors. The use of rat liver cell lines guarantees against bovine viruses and allows for better production of embryos.

Journal Article↗
PubMed2005

Design and validation of a methodology using the International Classification of Diseases, 9th Revision, to identify secondary conditions in people with disabilities.

OBJECTIVE: To design and validate a methodology that identifies secondary conditions using International Classification of Disease, 9th Revision (ICD-9) codes. DESIGN: Secondary conditions were identified through a literature search and a survey of Washington State physiatrists. These conditions were translated into ICD-9 codes and this list was then validated against a national sample of Medicare survey respondents with differing levels of mobility and activities of daily living (ADL) disability. SETTING: National survey. PARTICIPANTS: Participants (N=9731) in the 1999 Medicare Current Beneficiary Survey with no, mild, moderate, and severe mobility and ADL disability. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Percentage of survey respondents with a secondary condition. The secondary conditions were grouped into 4 categories: medical, psychosocial, musculoskeletal, and dysphagia related (problems associated with difficulty in swallowing). RESULTS: Our literature search and survey of 26 physiatrists identified 64 secondary conditions, including depression, decubitus ulcers, and deconditioning. Overall, 70.4% of all survey respondents were treated for a secondary condition. We found a significant relation between increasing mobility as well as ADL disability and increasing numbers of secondary conditions (chi 2 test for trend, P <.001). This relation existed for all categories of secondary conditions: medical (chi 2 test for trend, P <.001), psychosocial (chi 2 test for trend, P <.001), musculoskeletal (chi 2 test for trend, P <.001), and dysphagia related (chi 2 test for trend, P <.001). CONCLUSIONS: We created a valid ICD-9-based methodology that identified secondary conditions in Medicare survey respondents and discriminated between people with different degrees of disability. This methodology will be useful for health services researchers who study the frequency and impact of secondary conditions.

Disability Evaluation↗
PubMed1997

Palladium(II)-Catalyzed Intramolecular Aminocarbonylation of endo-Carbamates under Wacker-Type Conditions.

Pd(II)-catalyzed intramolecular aminocarbonylation of olefins bearing many types of nitrogen nucleophiles has been examined under two typical conditions: acidic conditions [conditions A, typically PdCl(2) (0.1 equiv) and CuCl(2) (3.0 equiv) under 1 atm of CO at room temperature in methanol] and buffered conditions [conditions B, typically PdCl(2) (0.1 equiv) and CuCl(2) (2.3 equiv) under 1 atm of CO at 30 degrees C in trimethyl orthoacetate]. Among nitrogen nucleophiles, endo-carbamates 7 display distinctive reactivity: endo-carbamates 7a-k smoothly undergo intramolecular aminocarbonylation under conditions B to furnish 4-[(methoxycarbonyl)methyl]-2-oxazolidinones 8a-k in good yields, while they would not undergo the expected reaction under conditions A. Other nitrogen nucleophiles (exo-ureas 1, endo-ureas 3, exo-carbamates 5, and exo-tosylamides 9), on the other hand, satisfactorily undergo aminocarbonylation only under conditions A to give rise to 2, 4, 6, and 10, respectively, in good yields. Under conditions B, they are unreactive and provide either the expected products in poor yields or intractable mixtures of products. On the basis of this contrasting reactivity between endo-carbamates and other nitrogen nucleophiles, the chemoselective aminocarbonylation of 7l-o has been achieved; aminocarbonylation takes place at the endo-carbamate moieties to furnish 8l-o exclusively under conditions B, and aminocarbonylation occurs at the exo-carbamate, exo-urea, and exo-tosylamide moieties to yield 13a-d exclusively under conditions A.

Journal Article↗
PubMed2004

Relationship of demographic variables on perception of fatigue and discomfort following prolonged standing under various flooring conditions.

It has been suggested that prolonged standing is associated with pain and discomfort experienced by assembly line workers and other occupations. In an attempt to alleviate these problems, companies have implemented ergonomic interventions which include alterations to the flooring conditions upon which workers stand. The purpose of this study was to investigate assembly line workers' perceptions of fatigue and discomfort associated with various body regions after standing for an 8-h shift on three different flooring conditions: (1) standing on a wood-block floor, (2) standing on a floor mat, and (3) wearing insoles. Eleven assembly line workers employed at a large Midwest manufacturing company participated in the study. They were exposed to one of three flooring conditions each Monday for 3 weeks during their 8-h work shift. A Latin Square research design was used to schedule participant rotation. Following their shift, participants answered a questionnaire inquiring about perceived firmness of the flooring condition, and perceived fatigue discomfort. Overall, this study found that the insoles and mat conditions appeared to decrease general fatigue, leg fatigue, and discomfort ratings. Moderately strong correlations were found for the variables of age, height, weight, and job tenure. Older participants and participants with more seniority experienced less discomfort while wearing insoles. Shorter subjects indicated higher scores of perceived firmness while standing on the wood-block floor and mat. No statistically significant differences were found between flooring condition and subjective ratings of fatigue or discomfort in various body regions. However, the insoles and mat conditions were perceived significantly softer than the wood-block floor condition. Insoles and mat conditions were also chosen significantly more often as conditions participants would use after the study when compared to the wood-block floor condition.

Age Factors↗
PubMed2002

Outcome of endovascular abdominal aortic aneurysm repair in patients with conditions considered unfit for an open procedure: a report on the EUROSTAR experience.

OBJECTIVE: Endovascular abdominal aortic aneurysm repair (EAR) can be performed in patients whose conditions were previously considered unfit for conventional treatment of the aneurysm. However, because the life span in this category of patients often is limited because of serious comorbidity, the efficacy of EAR in prolonging life expectancy remains uncertain. This study involves the evaluation of preoperative risk classification and an assessment of the outcome of interventions. METHODS: The data of 3075 patients, who underwent operation in 101 European institutions that collaborated in the EUROSTAR Registry, were assessed. Only the patients who had been prospectively enrolled in the registry were used for this analysis. Patient characteristics, operative risk factors, procedural details, and types of devices were correlated with preoperative estimates of operative risk, early and late mortality, complications, and primary and secondary outcome success rates. In addition, the intermediate-term survival rates in patients with unfit conditions with EAR (observed series) and with conservative approaches of the aneurysms (rupture rates as derived from the literature) were compared in a mathematical model. RESULTS: Of the overall study group, 2525 patients were at "normal" risk for a surgical procedure (group A), 399 patients had conditions that were considered unfit for open surgery (group B), and 151 patients had conditions that were unfit for general anesthesia (group C). Both unfit categories had significantly more comorbid factors and larger aneurysms than did the patients in good medical condition. Differences were observed in comorbidities between the two high-risk categories, groups B and C. Factors that influenced the abdominal approach (previous laparotomies, hostile abdomen, and obesity) and local anatomic factors (eg, retroperitoneal fibrosis, inflammatory aneurysm, dissections, and enterostomy) were present in 19% of the patients with conditions that were unfit for open surgery and in only 1% of the category unfit for anesthesia. In contrast, severe pulmonary disease was present in 33% of the patients with conditions that were unfit for anesthesia as opposed to 11% of the patients with conditions that were unfit for open surgery. The early and late mortality rates were significantly higher in the unfit categories (groups B and C). Life table results showed a 3-year survival rate of 83% in patients at normal operative risk and of 68% in patients with unfit conditions (P =.0001). An independent correlation with late death was shown for the clinical classification into high-risk groups B and C, pulmonary disease, team experience of less than 60 procedures, and the diameter of the aneurysm. In groups B and C, aneurysms smaller than 6.0 cm were associated with a 2-year survival rate of 80% and larger aneurysms with a rate of 68% (P =.02). This difference was caused by an increased non-aneurysm-related mortality rate in the group with aneurysms of more than 6 cm. The mathematical model showed an advantage of EAR with regard to the reduction of the death rate in patients with unfit conditions as compared with no intervention after 1 year. The advantage of EAR was observed in patients with AAAs between 5 and 6 cm and with larger aneurysms. CONCLUSION: Early and late mortality rates were increased in patients with the preoperative clinical diagnosis "unfit for open surgery and general anesthesia" as compared with patients at "normal" operative risk. EAR appeared of potential benefit in patients with unfit conditions, regardless of the aneurysm diameter. The life expectancy of patients at high risk who are considered for EAR should be longer than 1 year before any realistic gain in life span can be anticipated.

Age Factors↗
PubMed2005

Genetic parameters of ascites-related traits in broilers: effect of cold and normal temperature conditions.

(1) Ascites syndrome is a growth-related disorder of broilers that occurs more often in fast-growing birds and at low temperatures. The objective of this study was to estimate genetic and phenotypic correlations among ascites-related traits measured either under cold or under normal temperature conditions, and to estimate genetic correlations between ascites-related traits measured under cold and normal conditions. (2) Several traits related to ascites were measured on more than 4000 chickens under cold conditions and on more than 700 chickens under normal conditions. (3) The heritability estimates for body weight (BW) measured under cold and normal conditions were 0.42 and 0.50, respectively, for haematocrit value 0.46 and 0.17, respectively, and for ratio of right to total ventricular weight 0.45 and 0.12, respectively. (4) The genetic correlation between BW and haematocrit value under cold conditions was -0.23 and between BW and ratio of right to total ventricular weight -0.27. Under normal conditions, however, these genetic correlations were 0.55 and 0.50, respectively. (5) These results demonstrate that the heritability estimates of ascites-related traits as well as genetic correlations between ascites-related traits and BW depend on the temperature conditions under which animals are kept. (6) Strong positive genetic correlations (around 0.8) were observed between total mortality, fluid in the abdomen and ratio of right to total ventricular weight under cold conditions. The genetic correlation between ratio of right to total ventricular weight under cold and normal conditions was 0.91. (7) These results suggest that the ratio of right to total ventricular weight measured under normal temperature conditions might serve as a good indicator trait for ascites.

Animals↗
PubMed2004

Effect of liveweight and condition score of ewes at mating, and shearing mid-pregnancy, on birthweights and growth rates of twin lambs to weaning.

AIMS: To determine the effects of liveweight and condition score of ewes at mating, and shearing mid-pregnancy, on birthweights and growth rates of twin lambs from birth to the time of weaning, and; to determine whether any effect of condition score is independent of liveweight. METHODS: Romney ewes (n=435) which conceived within a 17-day mating period and successfully gave birth to and reared twin lambs to weaning were used. Ewes were managed during pregnancy so that their total liveweight increased at a level equivalent to the expected growth of the conceptuses. Approximately half of the ewes were shorn 70 days after the mid-point of mating, and the remainder were left unshorn, at which time they had 6-months' wool growth. All lambs were weighed within 12 h of birth and again at weaning. RESULTS: There was a significant linear relationship (R2=0.99) between mean group liveweight and condition score of ewes at mating (difference of 7.3 kg per 1.0 unit condition score). Liveweight of ewes at mating had small but significant (p<0.05) positive effects on both birthweights and growth rates of twin lambs to weaning. Ewes that had condition scores of 3.5-4.0 (scale 0-5) at mating gave birth to significantly (p<0.05) lighter lambs than ewes that had condition scores <3.5. The condition score of ewes at mating was positively associated with growth rates of lambs, although this effect was largely explained by variation in the liveweight of ewes at mating. Twin lambs born to ewes shorn mid-pregnancy were significantly (p<0.05) heavier at birth (by 0.4 kg) and at weaning (p<0.05) than those born to unshorn ewes. The heavier weaning weights of lambs born to ewes shorn mid-pregnancy were due to a heavier birthweights rather than increased growth rate. CONCLUSIONS: Liveweight and condition score of ewes at mating had small positive effects on growth rates to weaning of twin lambs. Shearing mid-pregnancy increased birthweights and weaning weights of twin lambs. To achieve high weaning weights of twin lambs, farmers should ensure ewes attain high liveweights and condition scores at mating and shear mid-pregnancy. It is speculated that the effects of liveweight and condition score of ewes at mating on weaning weights of twin lambs would be greater than those observed in the present study under conditions in which nutrition of the dam is below optimum.

Journal Article↗
PubMed2006

The evolution of condition-dependent sexual dimorphism.

Theory suggests that the net benefit of allocating resources to a sexual trait depends both on the strength of sexual selection on that trait and on individual condition. This predicts a tight coevolution between sexual dimorphism and condition dependence and suggests that these patterns of within-sex and between-sex variation may share a common genetic and developmental basis. Although condition-dependent expression of sexual traits is widely documented, the extent of covariation between condition dependence and sexual dimorphism remains poorly known. I investigated the effects of condition (larval diet quality) on multivariate sexual dimorphism in the fly Telostylinus angusticollis (Neriidae). Condition determined the direction of sexual size dimorphism and modulated sexual shape dimorphism by affecting allometric slopes and/or intercepts of sexually homologous traits in both sexes. Although the greatest responses to condition manipulation were observed in male sexual traits, both sexual and nonsexual traits exhibited substantial variation in the nature and magnitude of condition effects. Nonetheless, condition dependence and sexual dimorphism were remarkably congruent: variation in the strength of condition effects on male traits explained more than 90% of the variation in the magnitude of sexual dimorphism, whether quantified in terms of trait size or allometric slope. The genetic mechanisms that give rise to multivariate sexual dimorphism in body shape thus function in a strongly condition-dependent manner in this species, suggesting a common genetic basis for body shape variation within and between sexes.

Animals↗
PubMed2004

Defining chronic conditions for primary care with ICPC-2.

BACKGROUND: With the increasing prevalence of chronic conditions, there is need for a standardized definition of chronicity for use in research, to evaluate the population prevalence and general practice management of chronic conditions. OBJECTIVES: Our aims were to determine the characteristics required to define chronicity, apply them to a primary care classification and provide a defined codeset of chronic conditions. METHODS: A literature review evaluated characteristics used to define chronic conditions. The final set of characteristics was applied to the International Classification of Primary Care-Version 2 (ICPC-2) through more specific terms available in ICPC-2 PLUS, an extended terminology classified to ICPC-2. A set of ICPC-2 rubrics was delineated as representing chronic conditions. RESULTS: Factors found to be relevant to a definition of chronic conditions for research were: duration; prognosis; pattern; and sequelae. Within ICPC-2, 129 rubrics were described as 'chronic', and another 20 rubrics had elements of chronicity. Duration was the criterion most frequently satisfied (98.4% of chronic rubrics), while 88.2% of rubrics met at least three of the four criteria. CONCLUSION: Monitoring the prevalence and management of chronic conditions is of increasing importance. This study provided evidence for multifaceted definitions of chronicity. While all characteristics examined could be used by those interested in chronicity, the list has been designed to identify chronic conditions managed in Australian general practice, and is therefore not a nomenclature of all chronic conditions. Subsequent analysis of chronic conditions using pre-existing data sets will provide a baseline measure of chronic condition prevalence and management in general practice.

Australia↗
PubMed1995

Mechanisms of drought response in Thuja occidentalis L. II. Post-conditioning water stress and stress relief.

We examined the extent of osmotic adjustment and the changes in relative water content (RWC) and transpiration rate (i.e., relative stomatal function) that occur in water-deficit-conditioned 6-year-old Thuja occidentalis L. (eastern white cedar) trees in response to a severe drought. Trees conditioned by successive cycles of mild or moderate nonlethal water stress (conditioning) and nonconditioned trees were exposed to drought (i.e., -2.0 MPa predawn water potential) to determine if water deficit conditioning enhanced tolerance to further drought stress. Following drought, all trees were well watered for 11 days to evaluate how quickly osmotic potential, RWC and transpiration rate returned to preconditioning values. Both nonconditioned trees and mildly conditioned trees exhibited similar responses to drought, whereas moderately conditioned trees maintained higher water potentials and transpiration rates were 38% lower. Both conditioned and nonconditioned trees exhibited a similar degree of osmotic adjustment (-0.39 MPa) in response to drought relative to the well-watered control trees. The well-watered control trees, nonconditioned trees and mildly conditioned trees had similar leaf RWCs that were about 3% lower than those of the moderately conditioned trees. Following the 11-day stress relief, there were no significant differences in osmotic potential between the well-watered control trees and any of the drought-treated trees. Daily transpiration rates and water potential integrals (WPI) of all drought-treated trees approached those of the well-watered control trees during the stress relief period. However, the relationship between cumulative transpiration and WPI showed that previous exposure to drought stress reduced transpiration rates. Leaf RWC of the moderately conditioned trees remained slightly higher than that of the nonconditioned and mildly conditioned trees.

Journal Article↗
PubMed1998

Autoimmune conditions associated with primary biliary cirrhosis: response to ursodeoxycholic acid therapy.

OBJECTIVES: A variety of autoimmune conditions occur in association with primary biliary cirrhosis. Among these conditions are sicca syndrome, Raynaud's phenomenon, arthritis, and Hashimoto's thyroiditis. Information is sparse regarding the prevalence and natural history of these conditions when associated with primary biliary cirrhosis and their response to ursodeoxycholic acid treatment. We evaluated the prevalence, natural history, and response to ursodeoxycholic acid therapy of these conditions coassociated with primary biliary cirrhosis. METHODS: One hundred-eighty patients with primary biliary cirrhosis, enrolled in a prospective randomized controlled trial of ursodeoxycholic acid (13-15 mg/ kg/day), were included. Patients were assessed at study entry and annually. RESULTS: At entry, 77/180 patients (43%) had one of the four conditions, and 18/180 patients (10%) had two or more conditions. Sicca syndrome was the most common, occurring in 58/180 patients (32%). After 2 yr, there was no difference between the treatment groups with regard to resolution or spontaneous onset of these autoimmune features. Sicca syndrome was the most common spontaneously developing condition (9% per yr). Sicca syndrome was the most common associated autoimmune condition, present in one-third of our patients. The associated conditions tended to improve over time, with a low rate of spontaneously developing these conditions. Although ursodeoxycholic acid therapy leads to improvement in the underlying liver disease, it did not appear to influence either the development or resolution of these autoimmune features. CONCLUSIONS: Although ursodeoxycholic acid is beneficial in the treatment of primary biliary cirrhosis, it had no measurable effect on the autoimmune conditions coassociated with the disease.

Arthritis↗