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PubMed2002

Clinical, provider and sociodemographic predictors of late initiation of antenatal care in England and Wales.

OBJECTIVE: To identify factors that are predictive of late initiation of antenatal care in England and Wales. DESIGN: A multivariate binomial regression model was constructed to examine the association between clinical, provider and sociodemographic characteristics and late initiation of antenatal care. SETTING: Nine maternity units in Northern England and North Wales. POPULATION: A total of 20,771 women with a singleton pregnancy who delivered a liveborn or stillborn baby between 1 August 1994 and 31 July 1995. All analyses were based on the 17,765 (85.5%) women for whom information on gestational age at initial presentation for antenatal care and other variables incorporated into the regression model was retrievable from the case records. RESULTS: Primiparous women of high obstetric risk were 13.4% more likely to initiate antenatal care after 10 weeks of gestation than a low risk reference group (adjusted OR 1.134, 95% CI 1.011, 1.272; P = 0.0312), and 34.3% more likely to initiate antenatal care after 18 weeks of gestation (adjusted OR 1.343, 95% CI 1.046, 1.724; P = 0.0208). This association between high obstetric risk status and late initiation of antenatal care was not replicated among multiparous women. When the effects of other independent variables on gestational age at booking were examined, the following characteristics were associated with failure to initiate antenatal care by 10 weeks of gestation (P < or = 0.05): maternal age at booking, smoking status, ethnicity, type of hospital at booking, the planned pattern of antenatal care and the planned place of delivery. Adopting a criterion of 18 weeks of gestation exacerbated the association between clinical and sociodemographic characteristics and late initiation of antenatal care, but appeared to dilute the association between provider characteristics and late initiation of antenatal care. CONCLUSIONS: There is a pressing need for further research to identify the specific concerns of late bookers, to identify areas where new interventions might encourage the uptake of services and to gauge the likely impact of increased dissemination of information about the availability of antenatal care services.

Adolescent↗

PubMed2004

Low concentrations of maternal thyroxin during early gestation: a risk factor of breech presentation?

OBJECTIVE: To evaluate the relation between breech position at term (>37 weeks of gestation) and low maternal fT4 levels during gestation in women not suffering from overt thyroid dysfunction. DESIGN: A prospective cohort study of pregnant women. SETTING: Community-based study. POPULATION/SAMPLE: At random selected pregnant women of the general population. METHODS: At antenatal booking, based on thyroid function assessed at 12 weeks of gestation in a large cohort of pregnant women, two groups of participants were defined: women with low fT4 levels-below the 10th centile (n= 135) and women with fT4-between the 50th and 90th centiles at 12 weeks of gestation (n= 135). Women with clinical thyroid dysfunction (fT4 and TSH outside reference range) at 12 weeks of gestation were excluded. Maternal thyroid function (fT4 and TSH) was subsequently assessed at 24 and 32 weeks of gestation. Analysis refers to 204 women who met the inclusion and exclusion criteria and in whom all thyroid parameters were assessed. MAIN OUTCOME MEASURES: Fetal presentation (cephalic-breech) at delivery in women with term gestation (>37 weeks of gestation) in relation to maternal thyroid function at 12, 24 and 34 weeks of gestation. RESULTS: Breech presentation at term delivery was independently related to fT4 levels <10th centile at 12 weeks of gestation (OR = 4.7, 95% CI 1.1-19 [but not to an fT4 level below the 10th centile at 24 and 32 weeks of gestation]) as well as primiparity (OR = 4.7, 95% CI 1.3-15). CONCLUSIONS: Women with hypothyroxinaemia (fT4 level at the lowest 10th centile) during early gestation but without overt thyroid function are at risk for fetal breech presentation at term (>37 weeks of gestation).

Biomarkers↗

PubMed2005

Characterization of dried whey protein concentrate and isolate flavor.

The flavor of whey protein concentrates (WPC 80) and whey protein isolates (WPI) was studied using instrumental and sensory techniques. Four WPC 80 and 4 WPI, less than 3 mo old, were collected in duplicate from 6 manufacturers in the United States. Samples were rehydrated and evaluated in duplicate by descriptive sensory analysis. Duplicate samples with internal standards were extracted with diethyl ether. Extracts were then distilled to remove nonvolatile material using high vacuum distillation. Volatile extracts were analyzed using gas chromatography/olfactometry with post peak intensity analysis and aroma extract dilution analysis. Compounds were identified by comparison of retention indices, odor properties, and gas chromatography/mass spectrometry against reference standards. Whey proteins exhibited sweet aromatic, cardboard/wet paper, animal/wet dog, soapy, brothy, cucumber, and cooked/milky flavors, along with the basic taste bitter, and the feeling factor astringency. Key volatile flavor compounds in WPC 80 and WPI were butanoic acid (cheesy), 2-acetyl-1-pyrroline (popcorn), 2-methyl-3-furanthiol (brothy/burnt), 2,5-dimethyl-4-hydroxy-3-(2H)-furanone (maple/spicy), 2-nonenal (fatty/old books), (E,Z)-2,6-nonadienal (cucumber), and (E,Z)-2,4-decadienal (fatty/oxidized). This baseline data on flavor and flavor sources in whey proteins will aid ongoing and future research and will help to identify the most appropriate whey ingredients to use to control or minimize flavor variability in whey enhanced products.

Alcohols↗

PubMed1993

Some salient features of 'Kitabul-Hashaish' with special reference to the manuscript preserved in Khuda Baksh O.P. Library, Patna.

The contributions of Dioscorides in the field of materia medica and pharmacology are unparalleled in the history of medicine. This great botanist of the 1st century A.D. made personal observations of the specific properties of drugs and presented them through illustrations for the first time. Almost all the physician authors of Unani system of medicine from Galen to Azam Khan have quoted Dioscorides. Kitabul-Hashaish was rendered into English and arabic and published repeatedly in the West. The book has great value and is quoted widely due to its authenticity. This unique work needs to be edited critically and afterwards translated into Urdu and other languages for the benefit of the present day students and scholars.

Arab World↗

PubMed1992

[The original of the "Tratado de Urología" by Francisco Díaz. Lost during the fire of the Monastery of El Escorial in 1671?].

The publication of the Treaty of Urology of Francisco Díaz towards the end of the sixteenth Century, was a milestone in the History of medicine. The originality and precociousness of his doctrine entailed a true revolution in the genesis of medicosurgical literature, considering that the text constitutes an inspired anticipation to the specialization age. Ever since the last century, all historians and annotators of this work have asked themselves whether there was an earlier edition to that of 1588 since the title "Newly printed treaty ..." invites such a inference. So far, every investigation searching for the original or a copy of the first edition have been in vain. This paper, based on documents and old works from the Archive of Protocols in Madrid, Library of the Royal Palace and Library of El Escorial Monastery, reveals certain data until now unpublished on the destiny of most of the copies belonging to the second edition presented and brings into light old references on which account is given that the original "Treaty of Urology" by Francisco Díaz, considered to be a Sixteenth Century Codex was lost in the fire of the El Escorial Monastery in 1671.

Fires↗

PubMed2006

[Wooden models of human skeleton made in Edo era, Japan, with special reference to Hoshino wooden skeleton].

The wooden model of the human skeleton, called wooden skeleton, is a distinguished original craft object in Edo era (1600-1867), Japan, when medical doctors were unable to keep the human skeleton for their study and teaching purpose. There are three kinds of wooden skeletons, i. e. Hoshino, Kagami and Okuda wooden skeletons made in 1792, 1810 and 1820, respectively. The former two are of adult male and the latter of female. They were made in surprising accuracy as compared with figures appeared in medical books available in Japan at that time, which suggests scientific readiness of the doctors and skills of the craftsmen. A complete set of the skeleton, except for the hyoid bone, has been preserved for Hoshino and Okuda wooden skeletons, while several bones have been missing in Kagami wooden skeleton. Each bone of Hoshino and Kagami wooden skeletons was made separately and connected by a tenon and a corresponding mortise at the articular surface. So it is hardly considered that all wooden bones were assembled into the whole body skeleton on use. Okuda wooden skeleton, on the other hand, was made for being shown in sitting position. The skull of Hoshino wooden skeleton is of special interest: the skull cap is not open, yet the internal structures of the skull, such as the sella turcica, foramina for nerves and vessels, and sulci for venous sinuses were made in considerable accuracy. Moreover, the proper connection of most foramina was proved between the inside and outside of the skull. The skull caps of Kagami and Okuda wooden skeletons are open as those used in the modern medical education.

Anatomy↗

PubMed1988

A comprehensive indexed bibliography data base using a micro computer.

A comprehensive index has been developed for coding and cataloguing alcohol literature. A system has been implemented using a commercial data base management program and a micro computer for computerising the references. In addition to the index code and citation the user can also enter an abstract and a description of the article. References can be added to the computer, edited, searched for, displayed on screen, typed on paper, or sent to a text file using a selection of criteria entered by the user. When a search is performed the printout can include the abstract of each paper similar to that obtained from larger bibliographic services. Such a system is beneficial for personal study, for writing books, articles and theses and for use by departments and small libraries.

Abstracting and Indexing↗

PubMed2002

A brief history of illusion: Milner, Winnicott and Rycroft.

Illusion is a word that Raymond Williams might have included among his list of keywords of British culture, since it is a word that discloses 'both continuity and discontinuity, and also deep conflicts of value and belief' within its intellectual and political history (1983, p. 23). It is a banner under which the meaning of that culture has frequently been contested. The author indicates some of the more significant of these contests, with occasional glances at the wider European context and with special reference to the history of psychoanalysis, where the conflicts that characterise the larger history of the word have been interestingly re-enacted. In particular, the author explores its significance for the English psychoanalysts Marion Milner and Charles Rycroft and, more centrally, for Donald Winnicott, not least because in Winnicott's case it is a word that has been treated only peripherally in the two books that are organised around the study of his language, Alexander Newman's Non-Compliance in Winnicott's Words (1995) and Jan Abram's The Language of Winnicott (1996).

Female↗

PubMed1973

THIS is where it's at.

The Medical Center Library contracted to provide bibliographic information services for the Tobacco and Health Research Institute of the University of Kentucky. This new department is now an integral part of the Medical Center Library providing reference and literature services in the tobacco and health area. Operating as a quasi-independent unit of the Medical Center Library, THIS (Tobacco and Health Information Services) functions separately in all areas of library operations, or more specifically, as a special library within a library. Its collection differs from that of most libraries in that it consists almost solely of periodical reprints instead of books and journals. The diversity of disciplines which tobacco and health literature encompasses has created the need for the development of a current awareness service for researchers. It is the belief of the author that there is a definite trend toward library collections such as THIS within larger medical libraries, as more institutes with special areas of interest are being formed.

Bibliographies as Topic↗

PubMed2000

Applying for grant funds: there's help around the corner.

Scientists should know where to get help when they write grant proposals. Books, videos, consultants and colleagues can all be useful. The World Wide Web is an excellent resource for finding competitors, collaborators and a wealth of other useful information such as funding agencies, available grant money, pertinent articles and form pages for grant applications. Software is available to help you make an outline of your proposal, prepare the required figures and tables and build a database of references from which to create a bibliography. This article will point you in the right direction for a plethora of information and resources.

Information Services↗

PubMed1977

The systemic use of procaine in the treatment of the elderly: a review.

This article is a review and evaluation of the world literature on the systemic use of procaine in the treatment of the aging process and the common chronic diseases of later life. Included are data from 285 articles and books, describing treatment in more than 100,000 patients in the past 25 years. Except for a possible antidepressant effect, there is no convincing evidence that procaine (or Gerovital, of which procaine is the major component) has any value in the treatment of disease in older patients. If procaine has an antidepressant effect, there is some likelihood that this accounts for the reports of decreased complaints referable to the musculoskeletal, cardiovascular, endocrine sexual, gastrointestinal and respiratory systems.

4-Aminobenzoic Acid↗

PubMed2002

Cryptic designs on the peppered moth.

In a provocative recent book, Jonathan Wells (2000) decries what he discerns as a systematic pattern in how introductory biology textbooks "blatantly misrepresent" ten routinely cited examples offered as evidence for evolution. Each of these examples, according to Wells, is fraught with interpretive problems and, as such, textbooks that continue to use them should at the very least be accompanied by warning labels. The following essay critiques his reasoning with reference to one of these examples, the phenomenon of industrial melanism. After criticizing Wells's specific argument, the essay draws several conclusions about the nature of science lost in his account.

Adaptation, Physiological↗

PubMed2000

Roundway, Wiltshire County Asylum attendants and nurses, 1881-1905: a window onto Victorian sobriety.

The only detailed surving Male and Female Registers of Roundway provide a rich documentary glimpse of nineteenth century mental health care staff. An analysis is made of what constituted desirable behavior and problems occurring in the workplace. More primary source material has been gathered from visitors books, medical superintendents' reports, patient case records, admission/discharge registers and account books. An attempt will be made to show how the dominant characteristics of Victorianism shaped the lives of the staff. Religion, morality and personal qualities appear more influential than scientific inquiry in determining the pattern of events. The 'Asylum for the Pauper Insane of the County of Wiltshire' later came to be called 'Roundway Hospital'. It is commonly remembered as 'Roundway' and that is how it is referred to here. The nursing staff changed their titles in minor ways during the period considered, but for convenience the dominant titles - 'attendants' for men and 'nurses' for women - are used. The period chosen, 1881-1905, begins from when Dr John Bowes was appointed Medical Superintendent and started to write in the new Staff Registers. The period finishes when he ceased to make entries. There are no detailed registers for any other nineteenth century period.

England↗

PubMed1993

[Effective vision screening can decrease the rate of amblyopia].

The quality of screening for testing visual disorders is unsatisfactory. Diagnosis and therapy are generally too late to exploit the advantage therapy can give during the sensitive period of visual acuity. About 10% of the adult population show decreased visual acuity (below 0.8). These persons have a more or less distinct amblyopia. Commonly used visual acuity tests do not allow the crowding phenomenon to be measured, although it is an easily measurable amblyopia characteristic. The most frequently used visual acuity test by German health authorities (R 5/R 11 test with plate No. 120) shows 48% false-negative results. We introduced the H test for preschool children. For school children and adults we developed the C test. To detect amblyopia precisely we designed both tests so that the crowding phenomenon could be measured. Both tests were validated in more than 700 subjects. All persons received an extensive ophthalmological checkup, which was used as the reference for normality. The H test is based on the matching principle and works with musical feedback. The test can be used from the age of 3 years onward. Therefore, the advantage of early therapy can be fully exploited. The H test has a 3% percentage false-negative rate. The C test is based on the Landolt ring. The visual acuity charts are presented as a book (40 cm distance) for measuring near visual acuity and (5 m) for measuring distance visual acuity. The C test has less than 5% false-negative results. Both tests can help in different age groups to diagnose amblyopic cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

[Galen's oncology].

"Claudius Galenus" is the Author of "De tumoribus praeter naturam". The book was studied on the original Greek text with Latin version edited by K.G. Kühn ("Opera omnia Claudii Galeni": VII, 705-732). This Galen's clinical and pathological oncology was examined as far as categorization, classification, morphology, etiology, pathogenesis, morphogenesis, topography, behaviour (with related therapeutic and prognostic implications) and terminology are concerned. Problems, aspects and concepts, more or less clarified by Galen, were extensively discussed with special reference to the Galen's scientific knowledge and compared with the modern oncology.

History, Ancient↗

PubMed2004

Cross sectional study of automated blood pressure measurements throughout pregnancy.

OBJECTIVE: To generate reliable new reference ranges for pregnancy blood pressure from a large population. DESIGN: A prospective cross sectional study. SETTING: Obstetric outpatient clinic, Zurich University Hospital. SAMPLE: Accurately dateable singleton pregnancies (Caucasian: n= 3234; Asian [predominantly from Sri Lanka, Thailand and the Philippines]: n= 577; Black n= 212). METHODS: Between January 1996 and February 2000 blood pressure was determined in 4023 pregnant women using an oscillometric automated device (Dinamap) according to British Hypertension Society recommendations. Women receiving antihypertensive medication were excluded. MAIN OUTCOME MEASURE: Blood pressure. RESULTS: Only the means of duplicate measures at the booking visit (5-42 weeks) were used in the analysis. Mean blood pressure decreased from early to mid pregnancy before increasing to levels 4 mmHg higher at term than in early pregnancy. Values >130/80 and <90/50 mmHg were above the 95th and below the 5th centiles, respectively. Parity, age and body mass index were significant determinants in Caucasians. Blood pressure was slightly lower in Asians and Blacks. CONCLUSIONS: The current World Health Organisation definition of high diastolic blood pressure (>or=90 mmHg on two occasions) reflects values >2 standard deviations from the mean. This may be too conservative as threshold for detecting women at risk of pre-eclampsia. Further studies are required to determine the prognostic implications of gestational values >or=95th centile (>or=130/80 mmHg) and <or=5th centile (<or=90/50 mmHg).

Adult↗

PubMed2003

Narrating survival and change in Guatemala and South Africa: the politics of representation and a liberatory community psychology.

Peace accords and international interventions have contributed to the suspension of armed conflict and the censuring of repressive regimes in many parts of the world. Some governments and their opposition parties have agreed to the establishment of commissions or other bodies designed to create historical records of the violations of human rights and foster conditions that facilitate reparatory and reconciliatory processes. This paper explores selected roles that community psychologists have played in this process of remembering the past and constructing new identities towards creating a more just future. With reference to two community groups (in Guatemala and South Africa) we show how efforts to "speak out" about one's own experiences of political and military repression involve complex representational politics that go beyond the simple binary opposition of silencing versus giving voice. The Guatemalan group consisted of Mayan Ixil women who, together with the first author, used participatory action research and the PhotoVoice technique to produce a book about their past and present struggles. The South African group, working within the ambit of the Truth and Reconciliation Commission and in collaboration with the third author and others, explored ways of speaking about their roles in apartheid and post-apartheid society. Although both these initiatives can be seen as moments in on-going struggles to overcome externally-imposed repressive practices that censor the voices of marginalized communities, they also serve to dispel overly romanticized notions of "univocal" communities now liberated to express themselves in an unmediated and unequivocal fashion. The paper discusses how each group of women instead entered into subtly nuanced relationships with community psychologists involving a continual interplay between the authenticity of their self-representational accounts and the requirements of the discursive technologies into which they were being inducted and the material conditions within their sites of struggle. In both cases the group's agenda also evolved over time, so that what emerged was not so much a particular account of themselves, or even the development of a particular "voice" for speaking about themselves, but an unfolding process--for the groups and for the community psychologists who accompanied them--of becoming active players in the postmodern, mediated world of self-representational politics and social struggle.

Culture↗

PubMed2001

The effects of physical therapy in Parkinson's disease: a research synthesis.

OBJECTIVE: To present a critical review and meta-analysis of studies evaluating the effects of physical therapy in patients suffering from Parkinson's disease (PD), in terms of neurologic signs, activities of daily living (ADLs), and walking ability. DATA SOURCES: Articles published from 1966 to May 1999 were compiled by means of MEDLINE, Cochrane register of controlled trials, and CINAHL using combinations of the key words Parkinson's disease, exercise, exercise therapy, physical therapy, and group training. References presented in relevant publications were also examined. Articles written in English, German, or Dutch were included. STUDY SELECTION: Studies had to meet the following selection criteria: (1) patients with PD were included in the intervention study, (2) the effects of physical therapy (PT) were evaluated, (3) the study could be classified as true or quasi-experiment, and (4) the study was published in a journal or book. DATA EXTRACTION: Two reviewers assessed independently the methodologic quality of the data of each included study. One reviewer extracted relevant meta-analysis data. DATA SYNTHESIS: For each outcome measure the estimated effect size and the summary effect size (SES) were calculated, using fixed (ie, Hedges's g) and random effects models. The meta-analysis resulted in a significant homogeneous SES with regard to ADLs (.40; confidence interval [CI] = .17-.64) and stride length (.46; CI = .12-.82). The SES with regard to walking speed showed a significant heterogeneous SES, which remained significant after applying a random effects model (.49; CI = .21-.77). The SES with regard to neurologic signs was not significant (.22; CI = -.08 to .52). The small number of studies included and the shortcomings of the methodologic quality of these studies, however, bias the results of the present study. CONCLUSIONS: The results of the present research synthesis support the hypothesis that Parkinson patients benefit from PT added to their standard medication.

Activities of Daily Living↗