0042213,Dean-Baar S,How do patients describe rehabilitation nurses?,Rehabil Nurs 2002 Sep-Oct;27(5):168,,"NURSES ROLE, PATIENT SATISFACTION, QUALITY OF HEALTH CARE","REHABILITATION, NURSING CARE",(Editorial),,,0278-6807,,
0042214,Folden SL,Practice guidelines for the management of constipation in adults,Rehabil Nurs 2002 Sep-Oct;27(5):169-75,,"CONSTIPATION, GUIDELINES, EPIDEMIOLOGY","ADULT, AMERICA, LONG TERM CARE, REHABILITATION",,,,0278-4807,AB,"Constipation is the most common gastrointestinal complaint of persons in primary, acute, or long-term care settings in the United States. However, defining constipation and documenting its incidence and prevalence is difficult because individuals define regularity of bowel patterns differently. Recognizing this, the Board of Trustees of the Rehabilitation Nursing Foundation (RNF) appointed a panel of experts to develop practice guidelines for the management of constipation in adults. Panel members included experts in rehabilitation nursing, nutrition, rehabilitation medicine, and consumer issues. Evidence-based practice guidelines outline treatment recommendations that reflect the best available scientific knowledge for use in making medical decisions. Developments of such guidelines requires a systematic, integrated review of the literature about the subject, a strategy for implementing the guidelines in professional practice, and an evaluative component (Ledbetter 2000). The use of scientifically based guidelines to manage clinical situations improve efficiency in the delivery and quality of healthcare and helps to control healthcare costs. Guidelines also provide a tool with which to evaluate provider performance (Friedland, 1998; Ledbetter 2000). The guidelines panel appointed by the RNF first drafted a working definition of constipation and adopted a 6-step process for the development and adoption of assessment and treatment recommendations. CINAHL and Medline databases were searched for all applicable medical and health-related articles published from 1968 through 1998. The following key words were used in the search: constipation research, constipation assessment, constipation prevention, constipation management, constipation intervention, constipation rehabilitation, constipation clinical trials, and laxative clinical trials. (ABSTRACT TRUNCATED)."
0042215,Secrest JE,How stroke survivors and primary support persons experience nurses in rehabilitation,Rehabil Nurs 2002 Sep-Oct;27(5):176-81,,"CEREBROVASCULAR DISORDERS, NURSES ROLE, QUALITY OF HEALTH CARE","REHABILITATION, NURSING CARE",,,,0278-4807,AB,"The role of nursing in rehabilitation has been studied from various perspectives. This study explored experiences with nursing care in rehabilitation from the perspective of stroke survivors and their primary support persons (PSP). The sample consisted of six stroke survivors and seven primary support persons. Through in-depth phenomenological interviews, participants related the experiences with nursing care that stood out for them. The experience was conceptualized as a two-dimensional continuum from helpful to adversarial, with none of the participants articulating a therapeutic presence from nurses. Implications for nursing are explored."
0042216,"Edwards NE, Ruettiger KM",The influence of caregiver burden on patients' management of Parkinson's disease: implications for rehabilitation nursing,Rehabil Nurs 2002 Sep-Oct;27(5):182-6,,"PARKINSON DIS, ADAPTATION PSYCHOLOGICAL, NURSES ROLE","CAREGIVERS, REHABILITATION, NURSING CARE",,,,0278-4807,AB,"In this study, we examined how the perceived burdens of caregivers influence how people with Parkinson's disease (PD) manage their condition. Burden has previously been defined as the extent to which caregivers perceive that their health, social life, and financial status are being adversely affected because of their care giving. We hypothesized that when caregivers perceive that their burden is increasing, the level of management by PD patients of their disease decreases. A purposive sample of 41 couples in which one spouse or partner had PD was obtained through physician referrals, PD educational programs, and support groups in six Midwestern states. Twenty-eight of the PD patients were men and 13 were women; their spouses or partners included 28 women and 13 men. How patients managed the disease was measured with the Management of Parkinson's Disease Instrument, developed by the first author. The Zarit Perceived Burden Inventory was used to measure the caregivers' perceived burdens. A significant path (p less than .02) was noted between the spouse or partner's perceived burden of care and the patient's management of the disease (beta = -.067). A path coefficient of beta = .365 was obtained. The role of the rehabilitation nurse in the relationship of caregiver and care recipient is that of counselor, educator, and supporter."
0042217,Zucker DM,Chronic heart disease: an approach for intervention,"Rehabil Nurs 2002 Sep-Oct;27(5):187-91, 198",,"HEART DIS, LENGTH OF STAY, LIFE STYLE","TREATMENT OUTCOME, REHABILITATION",,,,0278-4807,AB,"Before 1985, the goal of care for patients with coronary heart disease (CHD) was to support them through their infarction. Today, the treatment goal is to minimize ischemia and eliminate avoidable risk factors. High-tech interventions and long-acting pharmacotherapies have become the gold standard of treatment. Lengths of hospital stay are 50% less than what they were before 1985 and, as a result, teaching opportunities directed at lifestyle change have been curtailed. Unless patients are consistently referred to cardiac rehabilitation or are followed closely after discharge they have little support as they attempt to incorporate and maintain new, healthier behaviors. The two case studies reported here of men with CHD reveals the importance of the patient's early life experiences when developing meaningful recommendations for changing their lifestyle. The small sample limits the generalizability of the findings."
0042218,"Wipa SS, Wipke-Tevis D",Pressure ulcer prevention and treatment practices in inpatient rehabilitation facilities,Rehabil Nurs 2002 Sep-Oct;27(5):192-8,,"DECUBITUS ULCER, NURSING CARE, EDUCATION","PREVENTION, TREATMENT OUTCOME, REHABILITATION, NURSES",,,,0278-4807,AB,"Although many strategies have been developed to prevent pressure ulcers, they remain a significant healthcare problem, particularly for chronically ill patients in rehabilitation facilities. This study describes self-reported pressure ulcer prevention and treatment practices in rehabilitation facilities. Surveys were sent to all 52 licensed inpatient rehabilitation facilities in Missouri; the response rate was 76.9%. Less than 30% of the facilities used inexpensive nursing interventions such as keeping the head of a patient's bed at or below a level of 30 degrees. Informally established protocols were used more frequently than the evidence-based pressure ulcer prevention and treatment guidelines issued by the Agency for Health Care Policy and Research. Furthermore, only 50% of the respondent facilities used established, valid, and reliable risk assessment tools. There was little difference in the interventions used when a client either developed a pressure ulcer or was assessed as being at risk for an ulcer. These findings reveal a significant gap between research and practice and suggest a need to educate rehabilitation nurses about the most appropriate, evidence-based nursing interventions for preventing and treating pressure ulcers."
0042219,"Konin JG, Amato HK, Brader H",Incorporating the Renne test into the learning-over-time model,Athletic Ther Today 2002 Sep;7(5):12-7,,"PROFESSIONAL COMPETENCE, EDUCATION","ATHLETES, CURRICULUM",,,,1078-7895,,
0042220,Moss B,Balance,Athletic Ther Today 2002 Sep;7(5):44-5,,"BALANCE, INJURIES",PREVENTION,,,,1078-7895,,
0042221,"Silvestri PG, Uhl TL, Madaleno JA, Johnson DL, Blackport RM",Management of syndesmotic ankle sprains,Athletic Ther Today 2002 Sep;7(5):48-9,,"ANKLE, SPRAINS AND STRAINS, INJURIES","ATHLETES, REHABILITATION, TREATMENT OUTCOME",,,,1078-7895,,
0042222,Willuhn G,Arnica montana - medicinal plant of the year 2000,Z Arznei Gewurzpflanzen 2001 Jun;6(2):51,,"ARNICA MONTANA, PLANT EXTRACTS",PHARMACOLOGY,(Editorial),German,,1431-9292,,
0042223,Seidemann J,"Tetrapleure, an unknown African medicinal and spice plant",Z Arznei Gewurzpflanzen 2001 Jun;6(2):59-63,Tetrapleura tetraptera,"SAPONINS, TANNINS, BIOFLAVONOIDS, MOLLUSCACIDES","PHARMACOLOGY, TRADITIONAL MEDICINE AFRICAN, PLANTS MEDICINAL, ADVERSE EFFECTS",,German,English Summary,1431-9292,AB,"A detailed description of the morphological attributes and the compounds is given of the Tetrapleura tetraptera (Schum et Thonn.) Taub; Fabaceae family. Its habit are the tropical parts of West Africa. Furthermore the compounds of the plant are treated. Various saponins (e.g. aridinin), glycosides, tannins, and, flavonoids are contained in all parts of the plant (leaves, bark, fruits and seeds). Alkaloids are found only in the leaves and in the fruit oil. Thorough description of the pharmacological effects and toxicity of the various parts of the plants and its use in the traditional West African medicine as well as spice and occasional as hunting poison is given. The molluskicid effect of the tetrapleure fruits and its aqueous extracts are emphasized."
0042224,"Schneider E, Brunner P, Stekly G, Messmer M, Buter B",Breeding of the SALUSCHOCKE(R) - a project for the quality improvement of pharmaceutically used artichoke,Z Arznei Gewurzpflanzen 2001 Jun;6(2):64-8,,"HERBAL DRUGS, CYNARA","REPRODUCTION, PLANTS MEDICINAL, STANDARDS",,German,English Summary,1431-9292,AB,"In recent years the demand of artichoke leaves as a medicinal plant increased steadily. On the base of an international collection of artichoke and cardy lines a breeding procedure and subsequent selection of lines with high content of active ingredients, high yield of leaves and suitability for mechanized harvest was carried out. To verify the relationship of the inbreed with the parent material - especially in view of the recent taxonomic revision - RAPD analysis was applied."
0042225,"Kuria KA, De Proft M, Masengo W, Kibwage I, Quirynen L, Maes L, Janssen L, Hoogmartens J, Laekman GM",Cultivating the African plant Ajuga remota in Belgium and confirming its biological activity against Plasmodium falciparum,Z Arznei Gewurzpflanzen 2001 Jun;6(2):69-72,Ajuga remota,"ANTIMALARIALS, PLANT EXTRACTS","PLANTS MEDICINAL, PHARMACOLOGY",,,,1431-9292,AB,"Ethnobotanical and ethnopharmacological investigations led to identification of Ajuga remota Benth (Lamiiaceae) as being frequently used in herbal medicine treatment of malaria in Kenya. The antimalarial activity of the plant has confirmed by in vitro testing against Plasmodium falciparum in order to ensure a continuous production of plant material we started local cultures in Leuven, Belgium. Micropropagation of Ajuge remota starting from seeds on a general culture medium was not successful. Sowing the seeds in full soil in the greenhouse resulted in a germination rate of more than 75%. Intensive watering was necessary to initiate germination. Within 4 months the plant could be harvested and decoctions were prepared from the dried material. The antimalarial activity of Belgian Ajuga remota decoctions in vitro expressed as AC-50 (mean +/- SD) was 998 +/- 168 m/grams/ml. Greenhouse cultivation seems to provide satisfying conditions to grow enough plants and enabling further research into validating Kenyan medicine practice."
0042226,"Bottcher H, Gunther I",Physiological postharvest response of Hyssop (Hyssopus officinalis L.),Z Arznei Gewurzpflanzen 2001 Jun;6(2):73-8,Hyssopus officinalis,"RESPIRATION, FOOD PRESERVATION, HERBS","PLANTS EDIBLE, PHYSIOLOGY",,German,English Summary,1431-9292,AB,"Freshly harvested hyssop herbs (Hyssopus officinalis L.) have a substantial respiration rate: 484 +/- 82 W.t(-1) (Watt.ton(-1)) at 10 degrees C, 1080 +/- 215 W.t(-1) at 20 degrees C and 2041 +/- 409 W.t(-1) (Watt.ton(-1)) at 30 degrees C, on average of 3 trials. The temperature-caused rise of respiration (Q10) run to x = 2.23 for the range of 10 to 20 degrees C and thus is in full agreement with van't Hoff's rule. A further increase in temperature from 20 to 30 degrees C caused a clearly heat-related depression (Q10. = 1.89). The high respiration rate turned out to be persistent also in the postharvest period and so the senescence-related decrease took place in dependence on the postharvest period (x) according to the formula y = alpha + beta . e(c(x-z))(c greater than 0) and reached levels of 66.9% at 10 degrees C, 62.1% at 20 degrees C and 65.2% at 30 degrees C, each measurement taken 80 hours after harvest. The considerable respiration rate and the involved transpiration rate entailed fresh matter losses of 1.7% in 24 hours (10 degrees C). Colour and exterior quality of the harvested herbs can be best maintained in cold conditions at 10 degrees C."
0042227,"Schulz H, Steuer B, Kruger H, Schutze W, Junghanns W, Weinreich B",Rapid determination of quality parameters in Rosemary leaves (Rosmarinus officinalis L.) by near infrared spectroscopy,Z Arznei Gewurzpflanzen 2001 Jun;6(2):79-83,Rosmarinus officinalis,"TERPENES, PLANT LEAVES, ANTIOXIDANTS, SPECTRUM ANALYSIS","DRUG ISOLATION, METHODS, ROSMARINUS",,German,English Summary,1431-9292,AB,"The presented results confirm, that NIR spectroscopy as a non-destructive and fast analytical method can be principally used for the simultaneous prediction of several valuable minor components such as terpenoids or antioxidative substances in air-dried rosemary leaves. Furthermore it has been proven that also fresh cut rosemary leaves can be analysed in a similar way using a mobile NIT-spectrometer. Based on the obtained calibration statistics the developed NIRS methods can be applied as a very useful tool for the selection of rosemary genotypes with added-values as well as the optimisation of harvest time with respect to the related valuable plant components."
0042228,Master FJ,Common use of rare nosodes,Homoeopath Heritage 2002 Sep;27(9):3-5,,"NOSODES, HOMEOPATHY",DRUG PICTURE,,,,0970-6038,,
0042229,Case EE,Clinical cases,Homoeopath Heritage 2002 Sep;27(9):7-9,,"HOMEOPATHY, HEMOPHILIA, HOMEOPATHIC DRUGS, VERTIGO","DRUG THERAPY, TREATMENT OUTCOME",,,,0970-6038,,
0042230,Singh K,A case of hematuria and enlarged prostate,Homoeopath Heritage 2002 Sep;27(9):10-5,Hamamelis virginica,"PROSTATIC DIS, LYCOPODIUM","DRUG THERAPY, TREATMENT OUTCOME, HOMEOPATHY",,,,0970-6038,,
0042231,Strutte L,Bereavement and trauma,Homoeopath Heritage 2002 Sep;27(9):16-20,,BEREAVEMENT,"GRIEF, PSYCHOLOGY",,,,0970-6038,,
0042232,Chappell P,An acute case,Homoeopath Heritage 2002 Sep;27(9):21,,"PHARYNGITIS, LAC CANINUM","DRUG THERAPY, TREATMENT OUTCOME, HOMEOPATHY",,,,0970-6038,,
0042233,Oji C,Taming the human immunodeficiency virus (HIV),Homoeopath Heritage 2002 Sep;27(9):23-9,,"HIV, MAGNETICS, ARSENICUM ALBUM, HYPERICUM, ECHINACEA, IMMUNE SYSTEM","HOMEOPATHY, DRUG THERAPY, TREATMENT OUTCOME, WATER, DRUG EFFECTS",,,,0970-6038,AB,"Efficacy and safety of a therapy, for the Human Immune Deficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS) were evaluated in 25 Nigerian patients. Twenty patients (8 males and 12 females) had the HIV infection, while 5 patients (3 males and 2 females) had AIDS. The result of an analysis after 5 years (January 1996-December 2000) of therapy is presented herein. Each patient received autoserotherapy of 5mL IM twice weekly and was exposed to 20 minutes of high-powered north and south pole therapy on the soles and palms during each sitting. In addition, each patient drank a minimum of 2.5 liters of magnetized water daily. Homeopathic preparations of Arsenicum album, Hypericum and Echinacea were given to the patients. Efficacy was evaluated by improvement of CD4 cell count and/or disappearance or resolution of clinical signs and symptoms from the patient's baseline condition. Tolerability and safety were assessed by the occurrence of adverse events. The clinical signs and symptoms disappeared in all the HIV patients and the CD4 cell count increased considerably in each HIV patient. None of the AIDS patients survived for more than 6 months. No adverse effects of the treatment were observed. We therefore conclude that the above-mentioned treatment regimen is a cheap and easy-to apply method for effective management of patients with HIV infection."
0042234,Wills DD,One year later: remembrance and a call to action,J Am Chiropractic Assoc 2002 Sep;39(9):6-7,,CHIROPRACTIC,"TRENDS, UNITED STATES, SOCIETIES MEDICAL",,,,1081-7166,,
0042235,Anonymous,Marketing the most sensible form of health care,J Am Chiropractic Assoc 2002 Sep;39(9):8-18,,"CHIROPRACTIC, MARKETING OF HEALTH SERVICES",METHODS,,,,1081-7166,,
0042236,Owens EF,Chiropractic subluxation assessment: what the research tells us,J Am Chiropractic Assoc 2002 Sep;39(9):20-4,,CHIROPRACTIC,"SUBLUXATION, RESEARCH, METHODS",,,,1081-7166,,
0042237,Spresser K,Manual therapy found superior to continued medical care,J Am Chiropractic Assoc 2002 Sep;39(9):25,,MANIPULATION CHIROPRACTIC,"TREATMENT OUTCOME, RESEARCH",,,,1081-7166,,
0042238,Anonymous,Persistence pays off: DC joins the UW-Madison team,J Am Chiropractic Assoc 2002 Sep;39(9):26-7,,"CHIROPRACTIC, UNIVERSITIES, HEALTH SERVICES ACCESSIBILITY, INTERPROFESSIONAL RELATIONS, PATIENT CARE TEAM","STUDENTS, UNITED STATES, PROGRAM DEVELOPMENT",,,,1081-7166,,
0042239,"Cerf JL, Puglisi G",Creating a hospital emergency chiropractic program,J Am Chiropractic Assoc 2002 Sep;39(9):28-31,,"EMERGENCY MEDICAL SERVICES, CHIROPRACTIC, PAIN, MANIPULATION CHIROPRACTIC","COMBINED MODALITY THERAPY, PROGRAM DEVELOPMENT, HOSPITALS",,,,1081-7166,,
0042240,Cooperstein R,Dual probe thermography: constructive test par excellence,J Am Chiropractic Assoc 2002 Sep;39(9):32-4,,"THERMOGRAPHY, DIAGNOSIS, INFLAMMATION","ADVERSE EFFECTS, METHODS, ETIOLOGY, CONSISTENCY AND RELIABILITY",,,,1081-7166,,
0042241,Maurer EL,The bone and joint decade: 2002-2011,J Am Chiropractic Assoc 2002 Sep;39(9):36-7,,"MUSCULOSKELETAL DIS, PATIENT EDUCATION, PATIENT PARTICIPATION","HEALTH RESOURCES, PROGRAM DEVELOPMENT, FINANCING ORGANIZED",,,,1081-7166,,
0042242,Anonymous,DCs on the move: can you take your license with you when you go?,J Am Chiropractic Assoc 2002 Sep;39(9):40-3,,"CHIROPRACTIC, LICENSURE","UNITED STATES, LEGISLATION",,,,1081-7166,,
0042243,"Cupon LN, Jahn WT",The testifying expert: jurors' perceptions,J Am Chiropractic Assoc 2002 Sep;39(9):46-8,,"FORENSIC MEDICINE, JURISPRUDENCE","CHIROPRACTIC, PSYCHOLOGY",,,,1081-7166,,
0042244,Barnard D,Advance carepPlanning is not about "getting it right",J Pall Med 2002 Aug;5(4):475-81,,"ADVANCE DIRECTIVES, PATIENT ADVOCACY",TRENDS,(Editorial),,,1096-6218,,
0042245,Kinzbrunner BM,For profit vs. not-for-profit hospice: it is the quality that counts,J Pall Med 2002 Aug;5(4):483-5,,"HOSPICES, HOSPICE CARE","UNITED STATES, STANDARDS, ECONOMICS",(Editorial),,,1096-6218,,
0042246,"Mullan PB, Weissman DE, Ambuel B, Von Gunten C",End-of-life care education in internal medicine residency programs: an interinstitutional study,J Pall Med 2002 Aug;5(4):487-96,,"TERMINAL CARE, INTERNAL MEDICINE, EDUCATION MEDICAL","CURRICULUM, KNOWLEDGE",,,,1096-6218,AB,"Background: Integrating end-of-life care (EOL) education into medical residency programs requires knowledge of what programs currently teach and what residents learn. Objective: Evaluate EOL teaching content and practices in internal medicine residency programs and the EOL knowledge of their faculty and residents. Design: An interinstitutional pilot study. We examined patterns of EOL education, discerned from program directors' responses to structured surveys of institutional teaching and evaluation practices, and EOL knowledge, derived from the performance of faculty and residents on a 36-item knowledge examination. Subjects: Program directors, faculty, and residents at 32 accredited U.S. internal medicine residency programs. Results: Although all programs cited inclusion of some EOL education, expected EOL domains were not systematically taught or assessed. Pain assessment and treatment training was required in only 60% of programs. Even fewer programs required instruction on nonpain symptoms (less than 30%) or hospice and nonhospital care settings (22%). EOL assessment depends primarily on faculty's general ratings of residents' global competency; few programs use knowledge examinations or structured skill assessments. Directors identified barriers and support for improving education. On the knowledge examination, the mean score of residents increased across training levels (F = 21.7, p less than .001), and the mean score of faculty was higher than residents' (57.6%: 48.9%, t = 51.6, p less than .001). Conclusions: Existing internal medicine residency education lacks training in critical EOL care domains. Residency programs need additional training for residents and teaching faculty in EOL content and skills, with assessment practices that demonstrate competencies have been acquired."
0042247,"Weissman DE, Mullan PB, Ambuel B, Von Gunten C",End-of-life curriculum reform: outcomes and impact in a follow-up study of internal medicine residency programs,J Pall Med 2002 Aug;5(4):497-506,,"TERMINAL CARE, EDUCATION MEDICAL, HEALTH CARE REFORM, INTERNAL MEDICINE","CURRICULUM, FOLLOW UP STUDIES, OUTCOME AND PROCESS ASSESSMENT",,,,1096-6218,AB,"Background: In 1998 we initiated a pilot project to evaluate the feasibility of recruiting and training internal medicine residency programs in methods designed to enhance and integrate end-of-life (EOL) instruction and assessment into their curriculum. Objective: To evaluate participants' assessment of the training program and the 12-month impact of the training on the 32 residency programs' EOL teaching. Design: Prospective multi-institutional study. Measurement and Results: After participating in training, all participants agreed/strongly agreed that the skills-related objectives of the training were met. Mean ratings of intention to continue with the program were consistent across trainees representing different academic ranks (F. = 2.8, p = 0.07), levels of experience in EOL education (F = 1.3, p = 0.28), and involvement in other national EOL training programs (F = 1.5, p = 0.23). Twelve months after training, most programs (78%) continued with the project and had initiated EOL curriculum reform in seven key EOL domains.). Conclusions: The study suggests that focused training in EOL teaching methods and institutional change strategies can facilitate EOL curriculum reform."
0042248,"Lorenz KA, Ettner SL, Rosenfeld KE, Carlisle DM, Leake B, Asch SM",Cash and compassion: profit status and the delivery of hospice services,J Pall Med 2002 Aug;5(4):507-14,,"DELIVERY OF HEALTH CARE, HOSPICE CARE, HOSPICES, TERMINAL ILLNESS","LONG TERM CARE, INSURANCE, COMPARATIVE STUDY, NURSING CARE, ECONOMICS",,,"To evaluate the relationship of hospice profit status to patient selection and service delivery. DESIGN: We analyzed responses to the 1997 California Office of Statewide Health Planning and Development (OSHPD) annual home care and hospice survey. Outcomes included the percentages of patients with noncancer diagnoses, referred from long-term care, and with government payers; average length of stay (LOS); the intensity and skill mix of nursing services; and potential availability of chemotherapy and radiotherapy. Reduced models controlled for facility type, profit status, urbanicity, and patient-days. Complete models additionally controlled for patient gender, age, race/ethnicity, diagnosis, referral source, and primary reimbursement source. PARTICIPANTS: All 176 licensed California hospices in 1997. RESULTS: We report comparisons of for-profit and not-for-profit hospices as the absolute difference in percentage points between outcomes (e.g., a difference of 40% vs. 50% is reported as a 10 percentage point difference). In reduced models, for-profit hospices reported 17 percentage points more discharges with noncancer diagnoses, 15 percentage points more long-term care referrals, and 8 percentage points more patients with government payers. Average LOS did not differ by profit status. In reduced models, for-profit hospices delivered 0.20 more daily nursing visits on average; this difference was attributable to patient characteristics. The ratio of skilled to total nursing visits was 11 percentage points lower for for-profit hospices compared to not-for-profit hospices in reduced models (7 in complete models). Profit status was unrelated to the potential availability of chemotherapy and radiotherapy.",1096-6218,AB,OBJECTIV
0042249,"Christakis NA, Iwashyna TJ, Zhang JX",Care after the onset of serious illness: a novel claims-based dataset exploiting substantial cross-set linkages to study end-of-life care,J Pall Med 2002 Aug;5(4):515-29,,"TERMINAL CARE, TERMINAL ILLNESS, MEDICARE","DATA COLLECTION, UNITED STATES, MORTALITY, FOLLOW UP STUDIES",,,,1096-6218,AB,"To date, there has not been a study using a large, nationally representative group of patients with serious illness who are at risk for hospice use and who are followed forward in time to understand the determinants of hospice use. In this paper, we outline the development of a large new cohort of 1,221,153 Medicare beneficiaries newly diagnosed with 1 of 13 serious conditions in 1993, a cohort that can be used to study end-of-life care in the United States. In describing our methods, we illustrate the possible utility of Medicare claims for end-of-life research. The members of our cohort are followed forward for hospice and other health care use through December 1997, and for mortality through June 1999. Medicare claims data on their inpatient and outpatient hospital use is also collected. Based on the ZIP Codes and counties in which cohort members lived, we were also able to characterize the health care markets of cohort members, as well as obtain other socioeconomic information about them. Information about cohort member's health care providers is also available. Detailed health information about cohort members' spouses was also collected. We conclude by highlighting the types of analyses that can be conducted in this data set."
0042250,"Iwashyna TJ, Zhang JX, Christakis NA",Disease-specific patterns of hospice and related healthcare use in an incidence cohort of seriously ill elderly patients,J Pall Med 2002 Aug;5(4):531-8,,"TERMINAL ILLNESS, HOSPICE CARE, NEOPLASMS, LEUKEMIA, CARDIOVASCULAR DIS, CEREBROVASCULAR DISORDERS","HEALTH SERVICES RESEARCH, AGED, LENGTH OF STAY, PATIENT TRANSFER",,,,1096-6218,AB,"There appears to be significant heterogeneity across diseases in their patterns of health care use at the end of life. We use a new, nationally representative sample of patients diagnosed in 1993 with 13 serious diseases to demonstrate this variation in rates of inpatient, outpatient, and hospice utilization. The diseases are: cancer of the lung, colon, pancreas, urinary tract, liver or biliary tract, head or neck, or central nervous system, as well as leukemia or lymphoma, stroke, congestive heart failure, hip fracture, or myocardial infarction. We present disease-specific rates of: length of stay, interhospital transfer, outpatient visits in the year before and 3 years after diagnosis, death within 4 years, and gender-specific hospice use rates among decedents. Among decedents with noncancer diagnoses, rates of hospice use vary from 5.9% to 8.7%. Among decedents with cancer diagnoses, rates vary from 15.2% to 35.2%. For the cohort overall, 14.2% of male decedents and 12.4% of female decedents used hospice. Patterns of end-of-life care vary substantially according to diagnosis."
0042251,"Ury WA, Arnold RM, Tulsky JA",Palliative care curriculum development: a model for a content and process-based approach,J Pall Med 2002 Aug;5(4):539-48,,"TERMINAL CARE, EDUCATION MEDICAL, CURRICULUM",PROGRAM DEVELOPMENT,,,,1096-6218,AB,"To ensure its success, a new curriculum has to meet the needs of learners, patients, and the institution. A review of the literature indicates that despite a tremendous need for palliative care services and a lack of appropriate knowledge and attitudes among physicians, few palliative care curricula for medical residents have been developed. Most are developed by national organizations, and as a result can not meet the individual needs of different institutions. This paper outlines the process of developing a palliative care curriculum in the context of available institutional resources that meets the learners' needs. The development of a curriculum can be divided into four phases: needs assessment, curricular design, implementation, and evaluation. Content (curricular content, instructional strategies and available resources for the curriculum and the developmental process) and process (methods through which the curriculum is developed and institutional issues are addressed) issues that are pertinent to the successful completion of each phase are discussed. Two hypothetical institutions are used to illustrate relevant issues. Methods that have been successfully used to develop residency curricula are discussed."
0042252,"Linder JF, Enders SR, Craig E, Richardson J, Meyers FJ",Hospice care for the incarcerated in the United States: an introduction,J Pall Med 2002 Aug;5(4):549-52,,"HEALTH SERVICES ACCESSIBILITY, HOSPICE CARE, PRISONERS, TERMINAL ILLNESS, PRISONS","UNITED STATES, PROGRAM EVALUATION, HEALTH STATUS",,,,1096-6218,AB,"Prison populations throughout the Unites States are growing; the 1990s saw an average 6.5% per year increase. Average inmate age is increasing, as are both the number and rate of inmate deaths. Aging inmates experience health concerns typical of the general, free, aging population. Inmates have higher incidence of health complications associated with various circumstances, risk behaviors, and associated medical conditions. These circumstances include prison violence, incarceration-related constraints on exercise, and diet. Inmates are more likely to have a history of alcohol abuse, substance abuse or addiction and sex industry work. Risk-behavior conditions include human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), hepatitis B and C, liver disease, tuberculosis, endocarditis, and cardiomyopathy. Hospice is increasingly the preferred response to the health and care needs of terminally ill inmates. Implementing hospice behind bars has some unique challenges in addition to those inherent in hospice work. This series will provide an in-depth look at four hospice programs for inmates in the United States."
0042253,"Evans C, Herzog R, Tillman T",The Louisiana State Penitentiary: Angola prison hospice.,J Pall Med 2002 Aug;5(4):553-8,,"TERMINAL ILLNESS, PRISONS, HOSPICE CARE, DELIVERY OF HEALTH CARE","UNITED STATES, PROGRAM EVALUATION, COMMUNITY HEALTH SERVICES",,,,1096-6218,AB,"Louisiana State Penitentiary (Angola) has a large population of aging men serving long sentences with little hope of reprieve. Eighty-five percent of the 5108 inmates currently incarcerated at Angola are expected to die there. The prison, in partnership with University Hospital Community Hospice in New Orleans, has created a program that meets criteria set by the National Hospice and Palliative Care Organization for community hospice programs. The hospice was developed and services are delivered without additional cost to the prison. Consultation, training and support have been provided by the community hospice. Care is provided within the prison infirmary, by prison staff and inmate volunteers."
0042254,Weissman DE,Fast facts and concepts No.14a palliative chemotherapy,J Pall Med 2002 Aug;5(4):559-60,,"PALLIATIVE TREATMENT, TERMINAL CARE, TERMINAL ILLNESS, NEOPLASMS","DRUG THERAPY, METHODS",,,,1096-6218,,
0042255,Hasley PB,Doctoring your family,J Pall Med 2002 Aug;5(4):561-2,,"ATTITUDE OF HEALTH PERSONNEL, FAMILY RELATIONS, PHYSICIAN PATIENT RELATIONS","EMOTIONS, DECISION MAKING, CASE REPORT",,,,1096-6218,,
0042256,Harcrow K,Angels among us,J Pall Med 2002 Aug;5(4):563-4,,"DEATH, PHYSICIAN PATIENT RELATIONS, PROFESSIONAL FAMILY RELATIONS, ATTITUDE OF HEALTH PERSONNEL","PSYCHOLOGY, TERMINAL CARE",,,,1096-6218,,
0042257,Simpson DE,"If you don't know where you're going": a framework for educational program planning,J Pall Med 2002 Aug;5(4):565,,"EDUCATION PROFESSIONAL, TERMINAL CARE","MODELS THEORETICAL, PROGRAM DEVELOPMENT",,,,1096-6218,,
0042258,"Morzinski JA, Montagnini ML",Logic modeling: a tool for improving educational programs,J Pall Med 2002 Aug;5(4):566-70,,"EDUCATION PROFESSIONAL, TERMINAL CARE","MODELS THEORETICAL, PROGRAM DEVELOPMENT",,,,1096-6218,AB,"Purpose: Palliative care education programs must be systematically designed and accurately evaluated in order to account for their impact on learners and learning communities. Logic modeling is a framework for designing educational programs and monitoring their influence. Methods: We applied a logic modeling process to a Palliative Care Educational Program (PCEP), embedded within a required month-long geriatrics rotation for third-year general internal medicine residents at the V A Medical Center in Milwaukee, Wisconsin. Each of four main categories of a logic model and the process for applying the steps to the PCEP are described. The four logic model categories that form the basis of the analysis are: (1) inputs, the raw resources consumed by the program (human resources, money, and space); (2) outputs, program activities and the number and types of actual participants; (3) outcomes, what the program will achieve in the short term (knowledge, attitudes and behavior change); and (4) impact, the results that are of ultimate interest to program stakeholders, such as placement in medically underserved areas, improved health or more efficient care. Results: The application of logic modeling to the PCEP exposed achievements (e.g., resident knowledge gains) and gaps (no evidence of long-term impact) in each of the model categories and has resulted in the design team's reassessment of each program component."
0042259,"Fins JJ, Von Gunten C",When the prognosis leads to indifference,J Pall Med 2002 Aug;5(4):571-3,,"TERMINAL CARE, TERMINAL ILLNESS, PATIENT CARE MANAGEMENT","PROGNOSIS, CASE REPORT, METHODS, TRENDS",,,,1096-6218,,
0042260,Barnard D,World Health Organization guidelines for national narcotics control policies,J Pall Med 2002 Aug;5(4):575-7,,"WORLD HEALTH ORGANIZATION, NARCOTICS, TERMINAL ILLNESS, PAIN, HEALTH POLICY","GUIDELINES, DRUG THERAPY, PROFESSIONAL PRACTICE",,,,1096-6218,,
0042261,"Weissman DE, Mullan P, Ambuel B, Von Gunten CF, Block S",End-of-life graduate education curriculum project: project abstracts/progress report - year 3,J Pall Med 2002 Aug;5(4):579-606,,"TERMINAL CARE, EDUCATION MEDICAL GRADUATE","CURRICULUM, UNITED STATES, INTERNAL MEDICINE",,,,1096-6218,,
0042262,Ellershaw J,Clinical pathways for care of the dying: an innovation to disseminate clinical excellence,J Pall Med 2002 Aug;5(4):617-21,,"TERMINAL CARE, DELIVERY OF HEALTH CARE, QUALITY ASSURANCE HEALTH CARE","STANDARDS, METHODS, PROGRAM DEVELOPMENT",(Editorial),,,1096-6218,,
0042263,"Portenoy R, Heller KS",Developing an integrated department of pain and palliative medicine,J Pall Med 2002 Aug;5(4):623-33,,"PAIN, TERMINAL CARE, PATIENT CARE TEAM","HOSPITAL DEPARTMENTS, DELIVERY OF HEALTH CARE, PROGRAM DEVELOPMENT, UNITED STATES",,,,1096-6218,,
0042264,"Bookbinder M, Romer AL",Raising the standard of care for imminently dying patients using quality improvement,J Pall Med 2002 Aug;5(4):635-44,,"TERMINAL CARE, QUALITY ASSURANCE HEALTH CARE","STANDARDS, METHODS, PROGRAM DEVELOPMENT",,,,1096-6218,,
0042265,Davis MP,In response to development and implementation of an inpatient acute palliative care service,J Pall Med 2002 Aug;5(4):645-7,,"TERMINAL CARE, TERMINAL ILLNESS, QUALITY ASSURANCE HEALTH CARE","INPATIENTS, ACUTE DIS, SYMPTOMS, STANDARDS, ECONOMICS",(Letter),,,1096-6218,,
0042266,"Knikou M, Conway BA",Reflex effects of induced muscle contraction in normal and spinal cord injured subjects,Muscle Nerve 2002 Sep;26(3):374-82,,"SPINAL CORD INJURIES, MUSCLE CONTRACTION, H REFLEX","FUNCTIONAL ELECTRIC STIMULATION, COMPARATIVE STUDY, PHYSIOLOGY, PHYSIOPATHOLOGY, MUSCLE SKELETAL",,,,0148-639X,AB,"The modulation of the soleus H reflex in response to functional electrical stimulation (FES) of the rectus femoris (RF) muscle and its overlying skin was examined in 11 normal adults and 6 patients with a clinically defined complete spinal cord injury (SCI). Stimulation of RF at twice motor threshold (MT) resulted in a long-lasting (greater than 1,000 ms) and significant reduction (50-70% of control) in the size of the soleus H reflex in all normal subjects tested. For five of the SCI subjects, 2MT stimulation of RF induced a 55-60% reduction in the soleus H reflex that was also long-lasting (greater than 160 ms). In the remaining SCI subject, 2MT stimulation resulted in an initial period of significant H-reflex facilitation (0-14 ms) that was followed by a longer-lasting inhibition commencing 60 ms after the cessation of the conditioning stimulation. Decreasing the strength of stimulation to below that required to generate a clear contraction in RF resulted in mixed facilitatory and inhibitory actions that were subject dependent. The changes in H-reflex excitability resulting from FES highlight the potential use of FES in the management of hypertonicity in SCI but also suggest that the central actions of FES need to be considered when FES gait restoration programs are designed."
0042267,"Trombetti A, Herrmann F, Hoffmeyer P, Schurch MA, Bonjour JP, Rizzoli R",Survival and potential years of life lost after hip fracture in men and age-matched women,Osteoporos Int 2002 Sep;13(9):731-7,,"HIP FRACTURES, BONE DENSITY, LIFE EXPECTANCY","OSTEOPOROSIS, MALE, FEMALE, MORTALITY, COMPARATIVE STUDY, RISK",,,,0937-941X,AB,"Hip fracture is associated with a higher mortality rate in men than in women. However, mean age of men and women with hip fracture differs markedly. Thus, some of the differences in the clinical pattern and outcome between genders could be related to different ages. To avoid the influence of age on gender-specific outcome, we analyzed prefracture conditions and hip fracture outcome in a cohort of men and of age-matched women. Risk factors for low bone mass were recorded in 106 men (mean age +/- SD, 80.3 +/- 9.3 years) and 264 age-matched women (mean age 81.4 +/- 8.0) with hip fracture. We compared mortality rate, survival, years of potential life lost and modification of housing conditions. These outcomes were prospectively assessed during an average 3.6 years follow-up (up to 7 years). Men with hip fracture differed from age-matched hip-fractured women by a higher alcohol and tobacco consumption, a greater frequency of living in couple, and by less prevalent fractures. Mortality rate after hip fracture was significantly higher in men (RR = 1.74, 95% CI 1.34-2.24). Since mortality is higher in the general male population, we compared reduction in life expectancy taking into account the gender-specific mortality rate. The excess mortality in each age-group of hip-fractured patients, which was measured during the whole follow-up period, and is an estimate of death attributable to fracture, did not differ between genders. Reduction in life expectancy due to hip fracture was similar in both genders (5.9 +/- 4.5 and 5.8 +/- 4.8 years, in men and women, respectively; NS), but the proportion of the years of life lost was higher in men (70 +/- 33%) than in women (59 +/- 42%, p less than 0.01). It was concluded that for the same age, mortality rate after hip fracture was higher in men than in women. (ABSTRACT TRUNCATED)."
0042268,"Press J, Neumann L, Uziel Y, Bolotin A, Buskila D",Assessment of quality of life of parents of children with juvenile chronic arthritis,Clin Rheumatol 2002 Aug;21(4):280-3,,"QUALITY OF LIFE, ARTHRITIS JUVENILE RHEUMATOID, PARENTS, PARENTING, ANXIETY, DEPRESSION, ATTITUDE TO HEALTH","ADAPTATION PSYCHOLOGICAL, PSYCHOLOGY, PSYCHOLOGICAL TESTS, CHILD",,,,0770-3198,AB,"The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low."
0042269,"Faucher M, Poiraudeau S, Lefevre-Colau MM, Rannou F, Fermanian J, Revel M",Algo-functional assessment of knee osteoarthritis: comparison of the test-retest reliability and construct validity of the Womac and Lequesne indexes,Osteoarthritis Cartilage 2002 Aug;10(8):602-10,,"OSTEOARTHRITIS, KNEE JOINT, CLINICAL ASSESSMENT SCALES, DISABILITY EVALUATION","PAIN, PHYSIOPATHOLOGY, CONSISTENCY AND RELIABILITY, COMPARATIVE STUDY, REPRODUCIBILITY OF RESULTS",,,,1063-4584,AB,"Objective: To assess and compare the test-retest reliability and the construct validity of the Lequesne and the French-Canadian version of the WOMAC indexes. Design: Patients with symptomatic knee osteoarthritis (OA) fulfilling the revised criteria of the American College of Rheumatology completed both the Lequesne and the French-Canadian version of the WOMAC indexes twice at a 3-h interval. Impairment outcome measures, patients' perceived discomfort in walking and handicap were recorded. For both questionnaires, an analysis was performed item by item. Repeatability was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated using the Spearman rank correlation coefficient and a factor analysis was performed. Results: 88 patients were included. Eight questions of the WOMAC section C and one question of the Lequesne index had insufficient psychometric properties. Although repeatability of questionnaires was fair to excellent (0.82, 0.68, 0.74, 0.95 for the WOMAC sections A, B, C and Lequesne index respectively), construct validity could not be demonstrated. Factor analysis of the WOMAC extracted five factors which differed from the a priori triple stratification. Factor analysis of the WOMAC section C extracted two factors explaining 71% of the variance which could not be clinically characterized. For the Lequesne index, expected convergent correlations were not always achieved. Three factors were extracted by factor analysis explaining 58% of the variance. Conclusion: Despite their good test-retest reliability, the two composite indexes evaluated are not valid to assess the concept of functional disability induced by knee OA in a French population."
0042270,"Rogers LQ, Macera CA, Hootman JM, Ainsworth BE, Blair SN",The association between joint stress from physical activity and self-reported osteoarthritis: an analysis of the Cooper Clinic data,Osteoarthritis Cartilage 2002 Aug;10(8):617-22,,"STRESS MECHANICAL, OSTEOARTHRITIS, EXERCISE, HIP JOINT, KNEE JOINT","EPIDEMIOLOGY, RISK",,,,1063-4584,AB,"Objective: The purpose was to evaluate the association between estimated joint stress from physical activity (PA) and hip/knee osteoarthritis (OA). Design: A nested case-control study was performed using data from the Aerobics Center Longitudinal Study. Participants without self-reported OA at baseline who attended the clinic between 1974 and 1993 and returned a follow-up questionnaire in 1990 or 1995 were eligible. Cases were those who reported a physician diagnosis of OA of the knee and/or hip at follow-up (N = 415). A random sample of persons in the remaining cohort were classified as controls (N = 1995). PA was measured at baseline by self-report and subjects were classified as 'moderate/high' or 'low' joint stress by PA type. Those reporting no PA were classified as sedentary with 'no' joint stress (the reference group). Men and women were analyzed separately. Stratified analysis and multiple logistic regression were used to assess the relationship between hip/knee OA and joint stress as predicted by PA. Results: After adjustment for age, body mass index, years of follow-up, and history of hip/knee joint injury, among men, there was no association between hip/knee OA and low joint stress while moderate/high joint stress was associated with reduced risk of hip/knee OA (adjusted odds ratio (OR) = 0.62, 95% confidence interval (CI) = 0.43-0.89). Among women, both levels of joint stress were associated with reduced risk of hip/knee OA (OR = 0.58, 95% CI = 0.34-0.99 for low and OR = 0.24, 95% CI = 0.11-0.52 for moderate/high). Conclusions: PA may reduce the risk of hip/knee OA, especially among women. Further research should assess the combined effects of frequency, intensity, duration and joint stress level of PA on incidence of hip/knee OA."
0042271,"Miranda H, Vikari-Juntura E, Martikainen R, Rihimaki H",A prospective study on knee pain and its risk factors,Osteoarthritis Cartilage 2002 Aug;10(8):623-30,,"KNEE, PAIN, WEIGHT BEARING, OBESITY","FOLLOW UP STUDIES, RISK, EPIDEMIOLOGY",,,,1063-4584,AB,"Objectives: To evaluate the effects of work-related and individual factors as well as physical activity and sports on the incidence and persistence of knee pain among a working population. Design: Employees of a large Finnish forestry company replied to a questionnaire (a modified version of the Nordic Questionnaire) on musculoskeletal pain and its possible risk factors at the baseline of this study. A cohort of 2122 workers free of knee pain and another cohort of 333 workers with severe knee pain were followed up for one year. The effects of the risk factors on the incidence and persistence of knee pain were studied using multivariable logistic regression models. Results: A total of 214 (10%) workers developed knee pain during the follow-up. Significant predictors of incident knee pain in the multivariable model were higher age, overweight, smoking, and previous knee injuries. Also, working with the trunk forward flexed in kneeling or standing position and physically strenuous work were non-significant predictors of incident knee pain. Of those 333 workers with severe knee pain at baseline, 220 (66%) still reported severe knee pain after one year. Higher age and job dissatisfaction increased the risk of persistent symptoms. General physical exercise and different sports activities did not predict the incidence or persistence of knee pain. Conclusions: In this large prospective study, the risk factors for self-reported knee pain seemed to be highly similar to the risk factors for knee osteoarthritis (OA) reported in other papers. Age, previous knee injuries, overweight, and knee-straining work were those risk factors, which contributed to the incidence of knee pain. Psychosocial elements of work were more involved in the persistence of the symptoms in the knee."
0042272,"Love T, Swinney D, Wong E, Buxton R",Perfusion imaging and stroke: a more sensitive measure of the brain bases of cognitive deficits,Aphasiology 2002 Sep;16(9):873-84,perfusion,"CEREBROVASCULAR DISORDERS, COGNITIVE SYMPTOMS, BRAIN, APHASIA, MAGNETIC RESONANCE IMAGING","READING, PHYSIOPATHOLOGY, COMPLICATIONS, CASE REPORT, DIAGNOSIS, ANATOMY, METHODS",,,,0268-7038,AB,"Aims: We provide evidence that the use of perfusion imaging reveals the neuroanatomical basis for a behaviourally demonstrated cognitive deficit that is not revealed via standard neuroradiological imaging techniques. Methods & Procedures: We present a case study of a 52-year-old female stroke survivor (16 years post onset) whose speech was fluent and grammatical with some word-finding difficulties that were typically overcome with common circumlocution strategies. Based on standardised measures, the patient's clinical diagnosis was anomic aphasia. In addition to word-finding deficits, it was discovered that this patient also demonstrated difficulties in reading; while able to eventually read and understand text, there was extreme difficulty in completing such tasks. A series of experimental findings exploring this reading deficit are presented. This patient's lesion, as revealed via structural brain imaging, did not involve a brain region typically implicated in reading dysfunction. This behaviour-lesion inconsistency was explored via perfusion MRI technology as a means of assessing whether other neural regions not directly implicated in the structural scans (such as the angular gyrus) could in fact show some level of dysfunction. Outcomes & Results: Behavioural. Analysis of the patient's overall reading time demonstrated that as compared to a matched control, this patient took significantly more time in reading paragraphs both silently and aloud. In addition, the patient produced more errors (fillers, pauses, elongations) than the matched control during the reading paragraphs aloud and story-retelling conditions. There were no differences exhibited between the patient and control with respect to content accuracy produced during these conditions. Outcomes & Results: Neuroradiological. (ABSTRACT TRUNCATED)."
0042273,"Hillis AE, Heidler J",Mechanisms of early aphasia recovery,Aphasiology 2002 Sep;16(9):885-96,perfusion,"APHASIA, CEREBRAL ISCHEMIA, MAGNETIC RESONANCE IMAGING, SPEECH DISORDERS","REGIONAL BLOOD FLOW, ETIOLOGY, COMPLICATIONS, REHABILITATION, PROGNOSIS, METHODS",,,,0268-7038,AB,"Background: The course of recovery of aphasia after stroke is highly variable. Some patients, even with severe aphasia, recover rapidly over the first days after onset. The mechanism of this early recovery (and later recovery) is unclear. Plausible accounts include reperfusion of ischaemic tissue surrounding the stroke, and rapid reorganisation of structure/function relationships. Aims: Based on a recent study showing that the severity of word comprehension impairment in acute stroke patients is strongly correlated with the severity of hypoperfusion (low blood flow) in Wernicke's area, we hypothesised that early recovery of spoken word comprehension is due to reperfusion (restored blood flow) to Wernicke's area. Our objective was to evaluate this hypothesis using advanced magnetic resonance imaging techniques of perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI). Methods and Procedures: A series of 100 patients with acute, left hemisphere ischaemic stroke were evaluated within 24 hours of onset or worsening of symptoms, and 3 days later, using PWI, DWI, and a battery of lexical tasks, including spoken word/picture verification. A subset of 18 patients with impaired spoken word comprehension at Day 1 were included in the study. Chi square analysis was used to identify the association between early recovery of spoken word comprehension and reperfusion of each of 10 Brodmann's areas (BA). Outcomes & Results: Early recovery of spoken word comprehension was significantly associated with reperfusion of BA 22 (Wernicke's area), but not with reperfusion of other BAs. All patients who showed early recovery of word comprehension also showed reperfusion of Wernicke's area, due to carotid endarterectomy, carotid stenting, induced blood pressure elevation, or spontaneous reperfusion. (ABSTRACT TRUNCATED)."
0042274,"Stoddart H, Whiteley E, Harvey I, Sharp D",What determines the use of home care services by elderly people?,Health Soc Care Community 2002 Sep;10(5):348-60,,"HOME CARE SERVICES, INDEPENDENT LIVING, HEALTH STATUS, HEALTH SERVICES NEEDS AND DEMAND","AGED, QUESTIONNAIRES, AGE FACTORS, GREAT BRITAIN",,,,0966-0410,AB,"The objective of the present study was to investigate the determinants of use of statutory and private home care services by older people living in the community. A questionnaire was distributed to a stratified random sample of 2000 elderly people living in the community registered with 11 general practices in a British city (equal numbers of men and women, aged 65-74 years, and 75 years or over). The outcome measures were the use of statutory or private home care services in the previous 3 months. Logistic regression was used to explore potential determinants of the use of these services. The response rate was 79%. Increasing age, not owning a car and being a widow(er) were associated with greater use of both statutory and private home care services, as was worse self-reported overall health. Worse physical functioning, worse emotional health, problems with cognition, foot problems and a greater number of falls were determinants of use of statutory and private services. Older age on leaving full-time education was associated with increased use of private home care services. Problems with eyesight were determinants for both types of home care services for women, but only private services for men. For women, leakage of urine was associated with greater use of private services. Social networks and social support were not generally associated with use of these services after controlling for demographic factors. Understanding the determinants for the use of both statutory and private home care services is important because of the increasing numbers of elderly people in the population and the policy to maintain older people in their own homes. Purchasers and providers should be able to address at least some of the modifiable predictors."
0042275,"Jianping Z, Rose K",Chinese medicine and complexity,Clin Acupunct Oriental Med 2002;3(2):77-91,,"TRADITIONAL MEDICINE CHINESE, EVIDENCE BASED MEDICINE","COMPARATIVE STUDY, KNOWLEDGE, RESEARCH, METHODS",,,,1461-1449,AB,"Chinese medical theory and complexity theory are two distinct bodies of knowledge concerned with the nature and behavior of natural systems. The former is an artifact from mankind's ancient past; the latter is a vanguard of contemporary science. Yet the basic principles and modes of thinking in these two subjects can be productively compared and employed to make connections between ideas and individuals from apparently disparate backgrounds. These connections may provide insights to all involved. This paper presents some basic comparisons and explores potential ways to begin to construct links between a millennia-old method of traditional medicine and methodologies that lie at the frontiers of modern scientific knowledge. Topics addressed include: the dilemma facing modern Western medicine, the methodology of Chinese medicine, relationships between Chinese medicine and complexity theory, keys to further research, including: language and terminology, analysis of medicinal formulas, analysis of diagnostic and therapeutic principles and procedures, and the application of the metaphoric mode of thinking of Chinese medicine to the investigation of complex adaptive systems. Finally, there is a statement of principles that should be borne in mind by researchers in development of detailed guidelines and criteria for the design of studies and the evaluation of results."
0042276,Schroen JH,"Non-linear dynamics and Chinese medicine: an essay on research models, TCM, and recent changes in modern scientific philosophy",Clin Acupunct Oriental Med 2002;3(2):92-8,,TRADITIONAL MEDICINE CHINESE,"RESEARCH, PHILOSOPHY",,,,1461-1449,,
0042277,Pritzker S,"From the simple to the complex: what is complexity theory, and how does it relate to Chinese medicine?",Clin Acupunct Oriental Med 2002;3(2):99-104,chaos therapy,"TRADITIONAL MEDICINE CHINESE, MODELS THEORETICAL","MATHEMATICS, PHILOSOPHY",,,,1461-1449,,
0042278,"Tsukayama H, Yamashita H",Systematic review of clinical trials on acupuncture in the Japanese literature,Clin Acupunct Oriental Med 2002;3(2):105-113,,"ACUPUNCTURE, LITERATURE, DATABASES BIBLIOGRAPHIC","CLINICAL TRIALS, JAPAN, PUBLICATIONS",,,,1461-1449,AB,"Objective: To evaluate and introduce the current status of acupuncture clinical trials in Japan. Methods: We performed a database search of controlled clinical trials (CCTs) published in Japan, using 'Igaku Chuo Zasshi (Japana Centra Revuo Medicina) CD-ROM version (between 1987-2000)' and an independent search. Parallel or crossover designed trials which assessed the efficacy of needle acupuncture were included. Results: We located 32 published papers (24 full papers and eight abstracts), which reported 34 trials. Only two of these were listed in Medline or the Cochrane Library. Conditions examined were musculoskeletal pain (20 trials including 10 for low back pain and three for sciatica), neck and shoulder stiffness (four trials) and miscellaneous conditions (10 trials). Thirty-three trials were described as randomized, although seven trials employed a quasi-random method. Applying the 5-point Jadad quality assessment scoring system, the mean score was 1.85 +/- 1.16 (SD). Eighteen (53%) of the reports were conducted to determine a more effective procedure of acupuncture, these compared a certain type of acupuncture with another type of acupuncture or specific additional points. Conclusions: Japanese acupuncture CCTs, which are rarely listed in the Western databases, differ in several respects from Western reports. Systematic reviews including non-English papers with collaboration among authors representing different languages would promote more thorough scientific evaluation of complementary and alternative medicine."
0042279,Rosenberg Z,Rebuttal to the Leon Hammer article 'tradition and revision',Clin Acupunct Oriental Med 2002;3(2):114-6,,"TRADITIONAL MEDICINE CHINESE, PULSE","METHODS, DIAGNOSIS",,,,1461-1449,,
0042280,"Bachmann RM, May W",Schmerz und Saure-Basen-Haushalt: Ubersauerungszustande und daraus resultierende Erkrankungen,Schweiz Z Ganzheits Medizin 2002 Sep;14(5):247-9,,"ACID BASE IMBALANCE, FOOD, PAIN","PHYSIOPATHOLOGY, COMPLICATIONS, ETIOLOGY",,German,,1015-0684,,
0042281,"Feldges A, Kovacsovics T",Das Tumorlysesyndrom,Schweiz Z Ganzheits Medizin 2002 Sep;14(5):250-1,tumor lysis syndrome,"NEOPLASMS, ANTINEOPLASTIC AGENTS","INTERVIEWS, ETIOLOGY, ADVERSE EFFECTS, DRUG THERAPY",,German,,1015-0684,,
0042282,Schnorrenberger CC,Syndrome acupuncture (Bian-Zheng Zhen-Jui) and herbal prescription: a new medical paradigm for the West,Schweiz Z Ganzheits Medizin 2002 Sep;14(5):252-9,,"TRADITIONAL MEDICINE CHINESE, EVIDENCE BASED MEDICINE, ACUPUNCTURE, DRUGS CHINESE HERBAL","PHILOSOPHY, METHODS, HISTORY, TRENDS, RESEARCH",,,,1015-0684,AB,"The majority of diseases are not clear-cut, mechanical disturbances as Western orthodox medicine presumes, but holistic and individual syndromes as understood by Eastern medicine and as depicted in complex ideographs. Western therapy is not concerned with an integrated analysis of the who1e system of the human being but tries instead to combine heterogeneous views of different specialist areas by perceiving human individuals just as bodily objects, as an a posteriori in philosophical terms. Thus, orthodox medicine increases parameters and data without understanding the human being from the inside, something which becomes possible by applying a Differentiating Syndrome Diagnosis (Chinese: Bian-Zheng). Immanuel Kant's statement that \"all knowledge is transcendental\" should be effectuated in Western medicine. Transcendental information is contained in ancient Chinese medical characters as an a priori. Chinese medicine is the \"Medicine of Time\", the powerful \"New Paradigm of Natural Healing\", which is instrumental in extending human life expectancy (WHO). This is in line with Aristotle's definition of Nature and consistent with the work of famous medical authorities of the past like Hippokrates, Paracelsus, Hufeland, Hahnemann and others. Here, the Occidental roots of Eastern medicine can be found, namely in our own Western tradition."
0042283,"Hensel A, Frank B, Hose S","Psyllium, part 1. A traditional drug against diseases of the modern civilisation",Schweiz Z Ganzheits Medizin 2002 Sep;14(5):260-6,"Psyllium, Plantago ovata","HYPERCHOLESTEROLEMIA, CATHARTICS","PLANTS MEDICINAL, DRUG THERAPY, PHARMACOLOGY, PLANT EXTRACTS",,German,English Summary,1015-0684,AB,"A traditional drug against diseases of the modern civilisation Review of the pharmacological, clinical and toxicological data for Psyllium husk. The clinical use as a laxative and for the reduction of moderate hypercholesterinemia is assessed to be proven. New aspects of the remedy in terms of use and safety are discussed."
0042284,"Kalin P, Sulger Buel E","The common butterbur - Petasites hybridus. Portrait of a medicinal herb: history, pharmacology, clinical applications",Schweiz Z Ganzheits Medizin 2002 Sep;14(5):267-74,,"HERBS, PARASYMPATHOLYTICS, ANTIINFLAMMATORY AGENTS, MIGRAINE, SESQUITERPENES, PETASITES","PLANTS MEDICINAL, HISTORY, PHARMACOLOGY, DRUG THERAPY, ADVERSE EFFECTS",,German,English Summary,1015-0684,AB,"Dioscurides used the finely pounded leaves of butterbur as a poultice for skin ulcers and Tabernaemontanus recommended taking it for stomach colic, asthma and as a mucolytic. Today the results of recent research open up entirely new indications for butterbur. The spasmolytic and anti-inflammatory effects of the Petasins (sesquiterpene esters) have been well documented - the latter of which depends on an inhibition of leucotrienes. Thanks to special extraction techniques the concentration of potentially hepatotoxic pyrrolizidine alkaloids (PA) are below the detection limits in modern butterbur extracts. Modern indications for butterbur extracts include migraine prophylaxis, tension headache, spasms of the urogenital tract, gastro-intestinal tract and bile duct, dysmenorrhoea, asthma and hay fever. Future research will reveal whether the inhibition of leucotrienes observed also permits application for inflammatory bowel disorders. Three cases of a reversible cholestatic hepatitis have until now been probably associated with long-term administration of butterbur extracts. Alcohol abuse and additional long-term medication with potentially hepatotoxic medicaments constitute risk factors. It is unknown which components of butterbur are responsible for the long-term hepatoxicity. Further side effects involve the gastro-intestinal tract and are usually mild."
0042285,"Exl-Preysch BM, Fritsche R","Allergen-reduced infant nutrition, part 1. An overview about immune development and the role of hydrolysated formulae pHF",Schweiz Z Ganzheits Medizin 2002 Sep;14(5):275-80,protein hydrolysates,"INFANT NUTRITION, IMMUNE SYSTEM, ALLERGENS, HYPERSENSITIVITY","EPIDEMIOLOGY, ETIOLOGY, INFANT, PROTEINS, TREATMENT OUTCOME",,German,English Summary,1015-0684,AB,"The human gastrointestinal tract is confronted from birth onwards with a constant inflow of (food) allergens, other antigens, bacteria, viruses and parasites. The gut immune system has the complicated task of accepting 'harmless' food allergens and, at the same time, attacking other potentially harmful proteins. The development of this Hu so-called oral tolerance is one of the basic phenomena of survival. A constant increase in allergic diseases has been reported for some decades now. Over this period, up to 35% of the infant population in the developed world has become affected and allergies are on the increase in the industrialised urban areas of the developing countries also. The reasons for the possible causes of this dramatic increase that places so great a burden on the health care system are manifold. The main goal of all preventive efforts should be the induction of oral tolerance to food allergens and as such a reduction of rates of sensibilisations as well as a reduction in the incidence of early atopic skin manifestations, because an early sensitisation or allergisation to food allergens is, besides early and lasting atopic dermatitis (about 50% el of which are associated with food allergy), the best predictive factor for other subsequent (respiratory) allergies. Until now, more than 30 studies have shown in corresponding results that in newborns with an elevated risk of allergies (single or double familial risk), allergen-reduced infant nutrition during the first 4-6 months on the basis of breastfeeding and/or an allergen-reduced infant formula can significantly reduce the onset of first allergic manifestations especially of the skin (atopic dermatitis) by about 50% during the first 3-5 years of life. Within those studies one pHF (Beba HA, NAN HA, Nestle) and 2 different eHFs were successfully tested. (ABSTRACT TRUNCATED)."
0042286,Ernst E,"Complementary/alternative medicine in rheumatology - between negligence, ignorance and arrogance",Osteoarthritis Cartilage 2002 Sep;10(9):671-2,,"COMPLEMENTARY MEDICINE, RHEUMATIC DIS","COMPLEMENTARY THERAPIES, RESEARCH, ATTITUDE OF HEALTH PERSONNEL, THERAPY",(Editorial),,,1063-4584,,
0042287,Vernon T,Nutrition for healing: everyone's responsibility,Wound Care 2002 Sep;2002(3):4,,"NUTRITION, DIET THERAPY, WOUND HEALING, WOUNDS","THERAPY, METHODS",(Editorial),,,,,
0042288,Young J,The secrets of the East,Heres Health 2002 Oct;2002(10):51-4,,"TRADITIONAL MEDICINE CHINESE, BUDDHISM","METHODS, PHILOSOPHY",,,,0018-0696,AB,"A therapy that believes spirits influence your wellbeing, and your pulse can explain your health? Find out how a 200 year old Tibetan medicine could help you cope with modern life."
0042289,Lim H,Just the tonic,Heres Health 2002 Oct;2002(10):56-7,,"HERBS, PLANT EXTRACTS, ROSMARINUS, PANAX GINSENG, ASTRAGALUS, RHODIOLA, LYCIUM","FRUIT, ROOTS, BEVERAGES",,,,0018-0696,AB,Herbal preparations are a great way to maintain a healthy balance when your body needs a little extra help to cope with the changing season.
0042290,Slyfield M,"Simple steps to better health, part nine: learn to meditate",Heres Health 2002 Oct;2002(10):66-7,,"MEDITATION, STRESS PSYCHOLOGICAL, PAIN","PATIENT EDUCATION, METHODS, THERAPY",,,,0018-0696,,
0042291,Haigh C,"The lowdown supplements explained: honey, pollen and propolis - health from the beehive",Heres Health 2002 Oct;2002(10):70-1,,"PROPOLIS, HONEY, POLLEN, DIETARY SUPPLEMENTS, WOUND HEALING, ANTIINFECTIVE AGENTS, GASTROINTESTINAL DIS","PHARMACOLOGY, THERAPY, DIET THERAPY, NUTRITIONAL STATUS",,,,0018-0696,,
0042292,Howells L,Build up your bones!,Heres Health 2002 Oct;2002(10):74-6,,"BONES, BONE DENSITY, OSTEOPOROSIS, FRACTURES, PREVENTION","ETIOLOGY, RISK, DIET THERAPY, EXERCISE THERAPY, PHYTOESTROGENS",,,,0018-0696,AB,"One slip could mean a fractured hip, one fall a broken wrist that won't heal - osteoporosis is serious and this disease can start to take hold in your 20s. But there's so much you can do to stop it - take preventative measures now."
0042293,"Spinks T, Stewart S",Ease arthritis naturally,Heres Health 2002 Oct;2002(10):78-9,,"ARTHRITIS, COMPLEMENTARY THERAPIES","HOMEOPATHY, ACUPRESSURE, AROMA THERAPY, HERBAL DRUGS, DIET THERAPY, DIETARY SUPPLEMENTS",,,,0018-0696,AB,"If you have stiff, painful joints, help yourself the holistic way with our round-up of natural remedies and therapies..."
0042294,"Haigh C, Hudson L, Lim H",Home remedies for healthy eyes,Heres Health 2002 Oct;2002(10):81,,"EYE DIS, FOLK REMEDIES","THERAPY, PLANT EXTRACTS",,,,0018-0696,AB,Eyes are the windows of the soul so take good care of yours with these natural remedies.
0042295,Davies S,'We heal the mind as well as the body',Heres Health 2002 Oct;2002(10):82-3,,"MIND BODY RELATIONS, NEOPLASMS, SPIRITUALITY, TERMINAL ILLNESS","DIET THERAPY, COMPLEMENTARY THERAPIES, PROGRAM EVALUATION",,,,0018-0696,AB,"Cancer causes fear and uncertainty, but there is a place where you can get invaluable advice and support - The Bristol Cancer Help Centre."
0042296,Anonymous,Testing times for holistic therapies,Int Ther 2002 Sep-Oct;48:16,,"COMPLEMENTARY THERAPIES, EVIDENCE BASED MEDICINE","TREATMENT OUTCOME, ECONOMICS, RESEARCH",,,,,,
0042297,Davies D,A day in the life of... a hospital therapist,Int Ther 2002 Sep-Oct;48:20-1,,"DEMENTIA, DEPRESSION, AROMA THERAPY, DELIVERY OF HEALTH CARE","AGED, GERIATRICS, THERAPY, INPATIENTS, MASSAGE",,,,,,
0042298,Anonymous,Supplementary knowledge,Int Ther 2002 Sep-Oct;48:34,,"CHAMOMILE, VACCINIUM, PLANT EXTRACTS, ANTIINFLAMMATORY AGENTS, URINARY TRACT INFECTIONS, AVITAMINOSIS","DIET THERAPY, BEVERAGES, PHARMACOLOGY",,,,,,
0042299,Anonymous,Carrier oils: coconut,Int Ther 2002 Sep-Oct;48:36,,"PLANTS, SKIN, HAIR, COSMETICS, MASSAGE, COCOS","PLANT OILS, FOOD, DOSAGE FORMS",,,,,,
0042300,Pearce J,Must do better,Community Care 2002 Sep 12;1439:34-5,,"MENTAL HEALTH, TEACHERS, MENTAL DISORDERS","SCHOOLS, DIAGNOSIS, EDUCATION CONTINUING, CHILD",,,,0307-5508,AB,"The author examines the role that schools can play in detecting and treating mental health problems in pupils, and finds that teachers need more training and support to confront the issue."
0042301,Roberts K,Disabled and dispersed,Community Care 2002 Sep 12;1439:38-9,refugees,"DISABLED, DISABILITY, PREJUDICE, SOCIAL SUPPORT, SOCIAL ISOLATION","GREAT BRITAIN, SOCIOECONOMIC FACTORS, RESEARCH",,,,0307-5508,AB,"Refugees and asylum seekers who are disabled might reasonably expect to have left threats to their health and safety behind them. But once here, they can find access to even necessities of life impeded, writes the author, a researcher."
0042302,Kusch M,Psychoonkologische Nachsorge - Einfuhrung in das Themenheft,Pravent Rehabil 2002;14(3):89-90,,"NEOPLASMS, DELIVERY OF HEALTH CARE, REHABILITATION PSYCHOSOCIAL, ADAPTATION PSYCHOLOGICAL","MODELS THEORETICAL, THERAPY, PSYCHOEDUCATION, PSYCHOTHERAPY",,German,,0937-552X,,
0042303,Kusch M,Quality development and quality assurance in psychooncology aftercare: the care-service-science-concept,Pravent Rehabil 2002;14(3):91-8,,"QUALITY ASSURANCE HEALTH CARE, NEOPLASMS, DISEASE MANAGEMENT","REHABILITATION PSYCHOSOCIAL, PROGRAM DEVELOPMENT, GERMANY, DELIVERY OF HEALTH CARE",,German,English Summary,0937-552X,AB,"Psychooncology has to adapt to the new developments in the German healthcare sector. Disease management and integrated healthcare will be followed by a shorter length of stay and changing in healthcare pathways. The development, implementation and testing of psychooncological aftercare must be sufficient for the legal specifications to the healthcare quality and for the health-carereality of the clinician. The Care-Service-Science-Concept serves for quality development and quality assurance of complex healthcare structures on base of established structures of clinical practice and creates the prerequisites for their evaluation."
0042304,"Kusch M, Ebmeier A, Mucke K, Nelle I, Stecker R",Integrated psychooncology health care: the Herford model,Pravent Rehabil 2002;14(3):99-111,,"NEOPLASMS, DISEASE MANAGEMENT, DELIVERY OF HEALTH CARE, QUALITY ASSURANCE HEALTH CARE","MODELS THEORETICAL, PSYCHOEDUCATION, PROGRAM DEVELOPMENT, GERMANY, REHABILITATION PSYCHOSOCIAL",,German,English Summary,0937-552X,AB,"Psychooncology is an important constituent of comprehensive cancer therapy. Though in many hospitals a psychooncological service is missing, its requirement is recognized. The implementation and extension of the department of psychooncology at the Community Clinic Herford by the SULO foundation are one result of these requirement. The \"Herforder Model\" of psychooncological health care is the other result. One target of further optimization of the \"Herforder Model\" is the development of a quality-assurance system, that guarantees an economic and above all effective psychooncological health care. In this article we describe the conversion of these targets into clinical practice with consideration to the legal request for quality assurance and integrated health care."
0042305,"Labouvie H, Hasan C, Bode U",Psychosocial aftercare in pediatric oncology - the Bonn model,Pravent Rehabil 2002;14(3):112-9,,"REHABILITATION PSYCHOSOCIAL, NEOPLASMS, QUALITY ASSURANCE HEALTH CARE","CHILD, PEDIATRICS, MODELS THEORETICAL, PROGRAM DEVELOPMENT",,German,English Summary,0937-552X,AB,"Psychosocial aftercare did become more important within the pediatric oncology during the last years. A comprehensive conception of aftercare is essential regarding to the intensity of therapy, delayed recovery and a considerable risk of long-term sequelae. A program of psychosocial aftercare was developed in our department and integrated into the existing medical outpatient setting. Following the care-service-science-concept necessary requirements with regard to the content, to formal and scientifical aspects of the psychosocial care were integrated. Thus important conditions of a continuous quality development of psychosocial aftercare were established."
0042306,"Thorenz A, Kanth E, Erhardt H",Case management in psycho-oncology aftercare - the Augsburg model,Pravent Rehabil 2002;14(3):120-8,,"NEOPLASMS, PATIENT CARE TEAM, DISEASE MANAGEMENT, QUALITY ASSURANCE HEALTH CARE","PILOT PROJECTS, PSYCHOEDUCATION, REHABILITATION, INTERINSTITUTIONAL RELATIONS, GERMANY",,German,English Summary,0937-552X,AB,"With the objective of an improved connection of inpatient and outpatient treatment according to SGB V an interdisciplinary oriented aftercare-concept has been developed and implemented for children and young persons suffering from cancer or other chronical and serious diseases as well as for their families. The Augsburg model of aftercare \"Bunter Kreis\" is a pilot study representing a holistic, family-oriented case-management. It has been drawn from practice as a social-integrative approach in cooperation with staff of the hospital for children (member of the Krankenhauszweckverband in Augsburg), self-help groups and scientists. Case-management is understood as \"help for self-help\" that is adapted to the individual case by means of goal-directed support and the interaction of appropriate cooperating partners for the out-patient continuing treatment at home. Thus, a network is established including potential partners, such as physicians, outpatient care services, hospitals, health insurance companies, self-help groups, advisory boards and other institutions. At present the well-tried case-management-concept of the institution \"Bunter Kreis\" for the aftercare of chronically ill children is transferred to the field of adult treatment. It is projected by the beta Institute to outpatient networks of physicians treating patients with mammacarcinoma. In this article we describe the Augsburg aftercare model as well as the standard usage and the fundamentals of the \"Bunter Kreis\" case-management."
0042307,"Winkler von Mohrenfels U, Ittner E, Beck JD, Langer T","Behavior problems, emotional changes and physical complaints in children suffering from acute lymphoblastic leukemia (ALL) - indications for a psychooncological follow-up in pediatric oncology",Pravent Rehabil 2002;14(3):129-37,leukemia lymphocytic acute L1,"BEHAVIORAL DISORDERS, EMOTIONS","CHILD, FOLLOW UP STUDIES, PEDIATRICS, PHYSIOPATHOLOGY, PSYCHOLOGICAL TESTS, EPIDEMIOLOGY, COMPLICATIONS",,German,English Summary,0937-552X,AB,"In a multicenter cross sectional study we examined 103 former patients suffering from acute lymphoblastic leukemia (ALL) on average 7 years after end of therapy. These 103 former ALL patients were examined with the Child Behavior Checklist (CBCL) (German version designed by Achenbach and Edelbrock), in order to evaluate remarkable behaviors, emotional changes and physical complaints as late sequelae. In the analysis a special meaning comes to the so-called \"critical items\" and the total value of the CBCL scores. If one takes the cut off score from 30, then there are 31/103 patients (30%) documented as pathological. According to the criterion of \"more than 2 critical items\" 19/104 (18%) patients exhibited psychologically pathological results. Analyzing the results of our study, 20-30% of the former patients represent impairments in \"attention disturbances\", \"social retreat\", \"fear/depression\" and \"aggressive behavior\". Intermediate evaluations and/or interventions were not accomplished by routine. We conclude that regular psycho-oncological re-examinations are indicated, in order to be able to intervene promptly if necessary."
0042308,Higgs K,Creating a strong message that positions us as a prime force in health care is a key step in creating the future of our profession,Physiother Can 2002 Summer;54(3):149-53,,"PHYSIOTHERAPY, DELIVERY OF HEALTH CARE","TRENDS, FORECASTING, CANADA",,,,0300-0508,,
0042309,Sawatzky D,Work hardening approach,Physiother Can 2002 Summer;54(3):154-5,,"PHYSIOTHERAPY, ATTITUDE OF HEALTH PERSONNEL, REHABILITATION","PROGRAM EVALUATION, REHABILITATION VOCATIONAL",(Letter),,,0300-0508,,
0042310,"Chau N, Harris SR",Practices and opinions of physiotherapists treating patients with breast cancer-related lymphedema,Physiother Can 2002 Summer;54(3):156-63,,"LYMPHEDEMA, PHYSIOTHERAPY, ATTITUDE OF HEALTH PERSONNEL, BREAST NEOPLASMS","COMPLICATIONS, PROFESSIONAL PRACTICE, PNEUMATIC COMPRESSION, HEAT THERAPY, COLD THERAPY, INTERFERENTIAL THERAPY",,,,0300-0508,AB,"The purpose of this study was to identify British Columbia physiotherapists' treatment practices, effectiveness and rationale in management of breast cancer-related lymphedema. Questionnaires were mailed to 249 physiotherapists from the Physiotherapy Association of British Columbia with 125 returned (response rate = 50.2%); 35% of respondents reported that they had treated breast cancer-related lymphedema. The most common modalities were heat/ice, interferential current, laser and pneumatic compression pumps. Despite being contraindicated for patients with cancer, therapeutic ultrasound was used by 7% of physiotherapists. The majority of physiotherapists employed compression garments and circumferential tape measurements. Less than half of the physiotherapists treating lymphedema believe that their treatment is \"always or usually effective.\" The most frequently-cited rationales for treatment were clinical experience (28%) and the use of clinical practice guidelines (21%). The majority of physiotherapists feel that more knowledge would most improve their treatment of persons with lymphedema. These findings suggest that, in addition to further research, physiotherapists need to access current knowledge about lymphedema."
0042311,Ploughman M,A review of brain neuroplasticity and implications for the physiotherapeutic management of stroke,"Physiother Can 2002 Summer;54(3):164-76, 185",neuronal plasticity,"CEREBROVASCULAR DISORDERS, BRAIN, HEMIPLEGIA","PATHOLOGY, PHYSIOPATHOLOGY, PROGNOSIS, PHYSIOTHERAPY, NERVOUS SYSTEM PHYSIOLOGY",,,,0300-0508,AB,"The brain continually organizes itself from birth, during learning and development and during skill acquisition in adulthood. The brain can recruit adjacent undamaged areas, supplementary and association areas and ipsilateral pathways to varying degrees in response to brain injury. This occurs throughout life but is more evident when injury occurs at an earlier age and is highly variable among patients. Enriched or impoverished environments, sensory inputs and motor skill practice can influence brain plasticity. There appears to be evidence for rehabilitative strategies to be employed for patients with varying degrees of hemiparesis and at different stages of recovery. Recent findings indicate that the stroke patient benefits from physiotherapy however more research is required to identify the ability of specific therapies to influence neuroplasticity and the critical time lines."
0042312,"Sordoni C, Hall C, Forwell L",The use of imagery in athletic injury rehabilitation and its relationship to self-efficacy,Physiother Can 2002 Summer;54(3):177-85,,"IMAGERY, ATHLETIC INJURIES, SELF EFFICACY, MOTIVATION, COGNITION","REHABILITATION, PHYSIOTHERAPY, TREATMENT OUTCOME, COMPARATIVE STUDY, PSYCHOLOGY",,,,0300-0508,AB,"PURPOSE: Paivio 1 identified two types of imagery utilized by athletes in training and competition: motivational and cognitive. Researchers have found that athletes also use motivational and cognitive imagery in injury rehabilitation.2 The present study extended previous findings by examining healing imagery, in addition to motivational and cognitive imagery, and also investigated the relationship between imagery use during rehabilitation and self-efficacy (i.e., self-confidence). METHOD: Injured athletes (N = 217) attending physiotherapy completed the Athletic Injury Imagery Questionnaire-2 (AIIQ-2) and the Injury Self-Efficacy Questionnaire (ISEQ). RESULTS: Exploratory factor analyses showed the AIIQ-2 consisted of three factors that were labeled motivational imagery, cognitive imagery, and healing imagery. The ISEQ consisted of one factor that was labeled athletic injury rehabilitation self-efficacy. Significant findings were as follows: a) each function of imagery (i.e., motivational, cognitive, and healing) was employed to about the same extent, b) competitive athletes used more cognitive imagery than their recreational counterparts, c) use of healing imagery was positively related to self-efficacy, and d) recreational female athletes were significantly lower in self-efficacy than competitive female athletes."
0042313,"Anderson CM, Overend TJ, Lucy SD",Changing practice through a systematic review: reflections from experience,"Physiother Can 2002 Summer;54(3):186-98, 205",,"PHYSIOTHERAPY, EVIDENCE BASED MEDICINE, LITERATURE","DATA COLLECTION, PROFESSIONAL PRACTICE",,,,0300-0508,AB,"Purpose: To encourage physiotherapists to resolve practice issues by conducting and implementing results of a systematic review. Summary of Key Points: Systematic reviews employ scientific methods to minimize error and bias in the review of a body of literature. The stages of a systematic review include identifying and refining a tightly focused research question, searching and screening the literature, critically appraising and extracting data from the identified papers, synthesizing the extracted data, and making a recommendation. The recommendation must then be disseminated and implemented, and evaluation of the change in practice must be carried out. Recommendation: Physiotherapists should consider a systematic review for generating the evidence to inform and evaluate practice."
0042314,"Hendry L, Yardley K, Hurley L, Gross AR",Agreement of physiotherapists with advanced training in manual therapy on magnitude of adverse events following the application of cervical spine manual therapy,Physiother Can 2002 Summer;54(3):199-205,,"SPINAL MANIPULATION, ATTITUDE OF HEALTH PERSONNEL, PHYSIOTHERAPY, SPINAL MOBILISATION","ADVERSE EFFECTS, CERVICAL VERTEBRAE, RISK, SAFETY",,,,0300-0508,AB,"Purpose: To determine perceived severity of 94 potential adverse events following the application of cervical spine manipulation or mobilization (CSM). Methods: In 1999, eighty physiotherapists with advanced training in manual therapy (respondents) completed a mail survey, rating 94 1isted adverse events following CSM. A seven point rating scale was used. Results: Respondents demonstrated significant agreement on perceived severity of most major events. Respondents were cautious in rating some serious but reversible events as major events. The median responses categorized 79/94 listed events as major, 12/94 as moderate and 3/94 symptoms as minor events following application of CSM. Respondents demonstrated significant disagreement on moderate and minor events. Conclusions: The disagreement on perceived severity of moderate and minor events indicates the need for directives such as protocols and databases to standardize, monitor and evaluate the occurrence and risk associated with even minor events following the application of CSM."
0042315,"Leerar PJ, Miller EW",Concurrent validity of distance-walks and timed-walks in the well-elderly,J Geriatr Phys Ther 2002;25(2):3-7,,"WALKING, TASK PERFORMANCE AND ANALYSIS, GAIT ANALYSIS","AGED, PATIENT ASSESSMENT, PHYSIOTHERAPY",,,,,AB,"Purpose: The purposes were to investigate the concurrent validity of the 10- and 20-meter short distance walking tests and of the 3-, 6-, and 12-minute timed walking tests in the well-elderly. Methods: Sixty-four participants without notable medical history, living independently in the community and ranging in age from 60 to 92 years randomly completed all of the 5 walking tests. Results: Mean speeds (meters/second) for the short distance walks were: 10-meter = 1.65 and 20-meter = 1.73; and for the timed walks were: 3-minute-1.39, 6-minute = 1.38, and 12-minute = 1.33. Pearson correlations with coefficients of determination were as follows: 10/20-meter = 0.922 (0.85), 3-/6-minute = 0.847 (0.72), 3-/12-minute = 0.854 (0.73), 6-/12-minute = 0.903 (0.82). Conclusion: These results indicate that for the well elderly, the shorter distance walk (10-meter) provides similar information to the longer 20-meter walk and that the shorter timed walk (3-minute) provides clinically similar information to the longer 6-minute and 12-minute walks."
0042316,"Chesbro SB, Davis LA",Applying Knowles' model of andragogy to individualized osteoporosis education,J Geriatr Phys Ther 2002;25(2):8-11,,"OSTEOPOROSIS, EDUCATION","PHYSIOTHERAPISTS, ADULT, PATIENT CARE",,,,,AB,"Osteoporosis is one of many health-related conditions about which physical therapists routinely educate consumers. However, the process by which therapists provide education is variable. Malcolm Knowles introduced a model of adult education in the 1960s, called andragogy, which identified characteristics of how adults learn. While this framework for adult education has been widely used in the general education of adults, it has realized limited application in patient/client-related instruction. The purpose of this manuscript is to demonstrate how Knowles' model of andragogy can be applied to the process of education-based intervention with older adults. An example applied to individualized osteoporosis education is given."
0042317,"Deneen EK, Banerjee S, Heermans AG, Dean RC",Bedside exercise for mobility-limited nursing home residents: a case study,J Geriatr Phys Ther 2002;25(2):12-9,,"EXERCISE, NURSING HOMES, DISABILITY EVALUATION, BALANCE","FRAIL ELDERLY, BEDS, LEG",,,,,AB,"Background and purpose: Illness or injury in elderly patients may lead to physical inactivity and result in functional decline. Application of specific resistive exercises for elderly patients during, or following, a course of illness may reduce the rate of physical decline. The purpose of this case study of mobility limited subjects were to: (1) demonstrate that frequent, daily, resistive exercise of medium intensity performed in bed, using a special exercise device, is feasible and safe; and (2) describe subjects' response to the exercise regimen with respect to their lower extremity strength, balance, and functional mobility. Subjects: Three nondemented nursing home residents (71, 78, and 82 years old), who required assistance foe ambulation, participated in the study. Materials and Methods: The In-Bed Exercise (IBEX tm) device, which attaches to the frame of hospital beds, was used to provide resistance to lower limb extension. Lower limb strength was measured with the IBEXtm device using the one repetition maximum (1RM) method. Mobility and balance were measured with the Physical Disability Index (PDI). The intervention consisted of 3 short duration exercise sessions per day, 5 days per week, for 6 weeks, beginning at 50% of 1 RM and progressing to a maximum of 80% of 1RM. Results: All subjects completed the study. Strength outcome varied between subjects. The PDI scores increased during the exercise intervention in all subjects. Most of the functional improvement occurred in bed mobility while the least improvement occurred in balance. Discussion and Conclusion: Exercising with IBEXtm several times per day offers a possible method of reducing the risk of functional decline in the frail elderly following illness or injury. Further studies are needed to establish the efficacy of using the device."
0042318,Newton RA,Neurologic physiotherapy in the new millennium,Physiother Singapore 2001 Dec;4(4):2-7,,"TRENDS, COMPUTERS, DATABASES","PHYSIOTHERAPY, ELECTRONICS",,,,0219-1091,AB,Pioneer physiotherapists and early adopters will meet the challenges of health care in the new millenium. Relatively new approaches are available to analyze and synthesize the literature to provide clinicians with access to applicable research and clinical treatment. Tele-physical therapy is introduced in this manuscript as a mechanism for electronic globalization of physiotherapy. The agenda for pioneer physiotherapists and early adopters emphasizes paradigm shifts including: a shift to provide primary preventative measures and to promote health and wellness; a lifespan approach and the modification of current practice strategies to reflect current population growth areas.
0042319,Shaw T,Is there a relationship between knee circumference or range of motion measured immediately postoperatively and at six months after ACL reconstruction?,Physiother Singapore 2001 Dec;4(4):8-14,,"ANTERIOR CRUCIATE LIGAMENT, RECONSTRUCTIVE SURGICAL PROCEDURES, RANGE OF MOTION","POSTOPERATIVE CARE, KNEE, QUESTIONNAIRES",,,,0219-1091,AB,"Objective: To determine if a relationship exists between day one and postoperative range of motion (ROM) or swelling and outcome at six-months postoperatively, in subjects with anterior cruciate ligament (ACL) reconstruction. Subjects: Thirty-four subjects underwent ACL reconstruction receiving either the bone patella tendon (n = 17) or hamstring graft (n=17). Background: Little scientific literature exists which investigates whether early postoperative outcome can be predicted from impairment deficits immediately following ACL reconstruction. Methods: Knee ROM and circumference were measured on day one following reconstruction. Six-months postoperatively, parameters were re-measured and a modified Cincinnati subjective knee questionnaire was completed. Results: Significant improvement was found between day one and six-months postoperatively for all ROM measurements and a significant reduction was observed for knee circumference measurements (p less than 0.001). Linear regression analyses did not demonstrate that day one measurements of knee ROM or circumference were able to predict six month re-measurement (R2=0.012, p=0.15-0.77) except at 10cm proximally to the tibial tuberosity where 30% of six month postoperative circumference variance was significantly predicted by day one postoperative measures (R2=0.30, p less than 0.01). Range of motion and circumference measurements were not shown to be significant predictors of modified Cincinnati scores or analogue satisfaction scores at six months postoperatively (R2=0.06, p=0.29-0.94). Conclusion: Although significant improvement of ROM and knee swelling may be expected after six-months following ACL reconstruction, the current findings appear to suggest that neither ROM or circumference of the reconstructed knee on the first postoperative day offer significant predictive value for outcome at six-months postoperatively."
0042320,"Huxham F, Bate P, Morris M",Disorders of upper limb speed and accuracy following stroke,Physiother Singapore 2001 Dec;4(4):15-22,,"CEREBROVASCULAR DISORDERS, MOVEMENT DISORDERS, AGING","MEASUREMENT, CLINICAL ASSESSMENT SCALES",,,,0219-1091,AB,"Objectives: The primary aim of this investigation was to quantify disorders of movement speed, accuracy and motor function in the upper limb following stroke. A further aim was to examine variability in upper limb performance in elderly stroke subjects over a 24-hour period. Subjects: Eighteen subjects with a mean age of 76.4 (S.D. 8.7) years and a history of a unilateral stroke (post stroke 8-52 days) were tested. Methods: Upper limb movement speed and movement accuracy were measured using discrete Fitts' aiming tasks (1,2). Ten discrete aiming movements consisting of moving a metal stylus from the starting point to a target were performed at three indices of difficulty (IDs) according to Fitts' protocol: 4.32, 5.32 and 6.32 (2). Upper limb function was quantified using the Action Research Arm Test (ARA) (3) and the advanced hand component of the Motor Assessment Scale (MAS) (4). Results: Sixteen subjects repeated the speed and accuracy tasks on the second day. Movement times increased as a function of ID although the subjects with strokes were considerably slower than previously reported for both unimpaired adults and younger stroke patients. The mean score for the ARA was 47.3 (S.D. 8.5) whilst the median score for the MAS was 2(IQR 2), indicating moderate upper limb disability. Although individuals showed moderate within-session variability in performance of the Fitts' tasks, there were high correlations between repeat measures of movement speed over the 24-hour period (ICCs (2,1) were 0.88 at ID 4.32, 0.95 at ID 5.42; and 0.74 at ID 6.32). Conclusion: The subjects with strokes had disorders of upper limb movement speed and accuracy that were moderately disabling yet remained consistent from one day to the next."
0042321,Dossey L,Nothing,"Alternat Ther Health Med 2002 Sep-Oct;8(5):12-6, 118-23",Spontaneous remission,COMPLEMENTARY MEDICINE,,,,,1078-6791,,
0042322,Dossey L,The uncertainties of medicine: a cause for celebration,Alternat Ther Health Med 2002 Sep-Oct;8(5):32-4,,"RESEARCH, EVIDENCE BASED MEDICINE",,,,,1078-6791,,
0042323,"Moher D, Riley D",When to disbelieve the believable,Alternat Ther Health Med 2002 Sep-Oct;8(5):36-7,,"DELIVERY OF HEALTH CARE, EVIDENCE BASED MEDICINE, RESEARCH",,,,,1078-6791,,
0042324,Pollan M,The precautionary principle,Alternat Ther Health Med 2002 Sep-Oct;8(5):38,,"PUBLIC HEALTH, ENVIRONMENTAL POLLUTANTS",,,,,1078-6791,,
0042325,"Herron RE, Fagan JB",Lipophil-mediated reduction of toxicants in humans: an evaluation of an Ayurvedic detoxification procedure,Alternat Ther Health Med 2002 Sep-Oct;8(5):40-51,,"AYURVEDIC MEDICINE, DETOXIFICATION, ENVIRONMENTAL POLLUTANTS",CHROMATOGRAPHY,,,,1078-6791,AB,"CONTEXT: Lipophilic toxicants have been associated with hormone disruption, immune system suppression, reproductive disorders, several types of cancer, and other diseases. Due to environmental persistence and bioaccumulation, body burdens of certain toxicants, such as dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyls (PCBs), appear to be a health risk despite the toxicants' having been banned for decades. OBJECTIVE: To determine whether a safe, standardized, Ayurvedic detoxification procedure can mobilize lipid-soluble toxicants and stimulate their excretion. DESIGN: Cross-sectional and longitudinal evaluations. SETTING: Southeastern Iowa. PARTICIPANTS: In the cross-sectional study, 48 participants who had undertaken lipophil-mediated detoxification were compared with 40 control subjects. In the prospective, longitudinal evaluation, serum levels were measured in 15 subjects before and after they underwent the detoxification procedure. These 15 subjects served as their own controls. INTERVENTION(S): Ayurvedic lipophil-mediated detoxification procedure. MAIN OUTCOME MEASURE: Gas chromatographic analysis of 17 serum toxicant levels (9 PCB congeners and 8 pesticides or metabolites) on a lipid-adjusted and wet-weight basis (ng/g) as parts per billion. RESULTS: In the cross-sectional study, gas chromatographic analysis of 9 PCB congeners and 8 pesticides revealed that serum PCB levels were significantly lower in the detoxification subjects than in controls. Trans-nonachlor (TNC), p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), oxychlordane, and hexachlorobenzene (HCB) levels were also markedly lower in the detoxification group. All subjects had undetectable levels of p,p'-DDT, lindane, and a-hexachlorocyclohexane (a-HCH). (ABSTRACT TRUNCATED)."
0042326,"Aragon D, Farris C, Byers JF",The effects of harp music in vascular and thoracic surgical patients,Alternat Ther Health Med 2002 Sep-Oct;8(5):52-60,Harp,"PAIN, ANXIETY, MUSIC THERAPY, PATIENT SATISFACTION","CLINICAL ASSESSMENT SCALES, TREATMENT OUTCOME, PILOT PROJECTS, POSTOPERATIVE PERIOD",,,"Visual analog scales (VAS) were used to measure patient anxiety and pain. Patient satisfaction was measured with a 4-item questionnaire. Physiological measures (heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation) were recorded from the bedside monitor. METHODS: Visual analog scales (VAS) were completed just before harp playing, 20 minutes after harp playing was started, and 10 minutes after completion. Patient satisfaction with the experience was measured with a 4-item questionnaire. (ABSTRACT TRUNCATED).",1078-6791,AB,"CONTEXT: Music has been used in the acute clinical care setting as an adjunct to current treatment modalities. Previous studies have indicated that some types of music may benefit patients by reducing pain and anxiety, and may have an effect on physiological measures. OBJECTIVE: To evaluate the scientific foundation for the implementation of a complementary therapy, harp playing. The research questions for this pilot study were: Does live harp playing have an effect on patient perception of anxiety, pain, and satisfaction? Does live harp playing produce statistically and clinically significant differences in physiological measures of heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation? DESIGN: A prospective, quasiexperimental, repeated measures design was used with a convenience sampling. SETTING: Orlando Regional Medical Center, Orlando Fla. PATIENTS: Subjects were eligible for the study if they were postoperative and admitted to a hard-wired-bedside-monitored room of the Vascular Thoracic Unit within the 3 days of the study period. INTERVENTION: A single 20-minute live harp playing session. MAIN OUTCOME MEASUR"
0042327,"Blackmore SJ, Rose N",Testing the bioelectric shield,Alternat Ther Health Med 2002 Sep-Oct;8(5):62-7,Bioelectric shield,"HAND STRENGTH, RADIATION, EMOTIONS","PLACEBOS, DATA COLLECTION, TREATMENT OUTCOME",,,,1078-6791,AB,"A pendant was claimed to provide numerous health benefits, including reduced stress, increased strength, and protection from electromagnetic radiation from computers and mobile phones. Three experiments tested the effectiveness of this pendant's effect as a bioelectric shield. In the first experiment, 12 subjects who work with computers wore shields (6 real, 6 sham) for several weeks and were regularly tested for hand strength and mood changes. Both types of shield increased calmness, but the real shields did not have any greater effect. In 2 further studies (in each N = 40) hand strength was measured at baseline, with mobile phone, and with mobile phone and bioelectric or sham shield. The shields did not differ in their effects. Both studies showed a significant correlation between the change in strength with and without the shield and subjects' scores on a questionnaire concerning their belief in and use of alternative therapies. The shields appear to produce a measurable placebo effect but are otherwise ineffective."
0042328,"Standish LJ, Greene K, Greenlee H, Kim JG, Grosshans C",Complementary and alternative medical treatment of breast cancer: a survey of licensed North American naturopathic physicians,Alternat Ther Health Med 2002 Sep-Oct;8(5):68-75,,"BREAST NEOPLASMS, COMPLEMENTARY MEDICINE","NATUROPATHY, TREATMENT OUTCOME",,,"Demographics of naturopathic physicians, development of treatment plans, CAM therapies used, perceived efficacy of therapeutic interventions. RESULTS: Of those respondents screened, 497 (77%) had provided naturopathic care to women with breast cancer, and 402 (63%) had treated women with breast cancer in the previous 12 months. Naturopaths who were women were more likely than men to treat breast cancer (P less than or = .004). Of the survey respondents, 104 (65%) practiced in the United States, and 57 (35%) practiced in Canada; 107 (66.5%) were women, and 54 (33.5%) were men. To develop naturopathic treatment plans, naturopathic physicians most often considered the stage of cancer, the patient's emotional constitution, and the conventional therapies used. To monitor patients clinically, 64% of the naturopathic physicians used diagnostic imaging, 57% considered the patient's quality of life, and 51% used physical examinations. The most common general CAM therapies used were dietary counseling (94%), botanical medicines (88%), antioxidants (84%), and supplemental nutrition (84%). (ABSTRACT TRUNCATED).",1078-6791,AB,"CONTEXT: Complementary and alternative medicine (CAM) use is on the rise in the United States, especially for breast cancer patients. Many CAM therapies are delivered by licensed naturopathic physicians using individualized treatment plans. OBJECTIVE: To describe naturopathic treatment for women with breast cancer. DESIGN: Cross-sectional mail survey in 2 parts: screening form and 13-page survey. SETTING: Bastyr University Cancer Research Center, Kenmore, Wash. PARTICIPANTS: All licensed naturopathic physicians in the United States and Canada (N = 1,356) received screening forms; 642 (47%) completed the form. Of the respondents, 333 (52%) were eligible, and 161 completed the survey (48%). MAIN OUTCOME MEASUR"
0042329,"Irvine KN, Warber SL",Greening healthcare: practicing as if the natural environment really mattered,Alternat Ther Health Med 2002 Sep-Oct;8(5):76-83,,"COMPLEMENTARY MEDICINE, DELIVERY OF HEALTH CARE",EVIDENCE BASED MEDICINE,,,"Computerized searches were conducted using MEDLINE, PsycINFO, the Social and Scientific Science Indices, Dissertation Abstracts, Lexus-Nexus, the University of Michigan library, and the Internet. Searches were conducted from June 2001 through March 2002. STUDY SELECTION: Keywords used included health, well-being stress, attention, nature, garden, landscape, restorative, and healing. The literature, published between 1960 and 2001, came from various disciplines, including medicine, public health, nursing psychology, natural resources, history, and landscape architecture. Four components of well-being were used as a framework for literature selection: physical psychological-emotional social, and spiritual. DATA EXTRACTION: Articles were qualitatively reviewed to extract theories, hypotheses, and experimental evidence. DATA SYNTHES",1078-6791\r\nInteraction with nature positively affects multiple dimensions of human health. Physiological effects of stress on the autonomic nervous system are lessened. (ABSTRACT TRUNCATED).,AB,"OBJECTIVE: The natural world's role in human well-being is an essential, yet often forgotten, aspect of healthcare. Of particular importance are the benefits one can derive through interaction with natural environments. While health is an obvious goal of allopathic medicine, many healthcare settings are neither nurturing nor healing. Reincorporating the natural world into the design of settings in which medicine is practiced is one way to complement conventional healing modalities and move healthcare toward being more \"green.\" This article discusses the breadth of existing knowledge available on the positive aspects of interaction with nature and provides a comprehensive theoretical perspective for future research. DATA SOURC"
0042330,"Michalsen A, Moebus S, Spahn G, Esch T, Langhorst J, Dobos GJ",Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study,Alternat Ther Health Med 2002 Sep-Oct;8(5):84-8,,"OSTEOARTHRITIS, KNEE, LEECHING, PAIN, ANALGESIA, PATIENT ACCEPTANCE OF HEALTH CARE","ADVERSE EFFECTS, PILOT PROJECTS",,,"To determine the effect of leech therapy as an adjunctive treatment in painful knee osteoarthritis, to investigate the onset of action, to evaluate patients' acceptance of this treatment, and to investigate the side effects of the procedure. DESIGN: Observational, controlled, nonrandomized pilot-study. SETTING: Subjects were inpatients of an academic teaching hospital of the University of Essen, Department of Internal and Integrative Medicine, Essen, Germany. PATIENTS: 16 inpatients (mean age 69 +/- 9 years) with a confirmed diagnosis of osteoarthritis of the knee joint; 10 patients were treated with leeches and 6 served as controls. INTERVENTION: A single trial of 4 leeches (Hirudo medicinalis) applied topically at painful periarticular sites of the knee joint in the experimental group (n = 10). Both groups received conventional treatment for pain with the exclusion of nonsteroidal anti-inflammatory drugs. MAIN OUTCOME MEASUR\r\nSelf-reported general knee pain, assessed by visual analog scale for 10 days daily and in a follow-up after 28 days. Frequency of adverse effects also was recorded. RESULTS: Periarticular application of 4 leeches led to rapid relief of pain with sustained improvement after 4 weeks in the absence of major complications. CONCLUSION: Leech therapy may be an effective treatment for rapid reduction of pain associated with osteoarthritis of the knee. (ABSTRACT TRUNCATED).",1078-6791,AB,"CONTEXT: Leech therapy was a mainstay in conventional treatment for pain from antiquity until the mid-19th century. Its use is still widespread in traditional healing procedures in Asia, Africa, and Arabic countries. There is renewed interest in leech therapy in the field of complementary medicine and empirical evidence for specific benefit in knee osteoarthritis. OBJECTIV"
0042331,"Keating A, Chez RA",Ginger syrup as an antiemetic in early pregnancy,Alternat Ther Health Med 2002 Sep-Oct;8(5):89-91,,"NAUSEA, VOMITING, PREGNANCY, ZINGIBER OFFICINALE","RANDOMIZED CONTROLLED TRIALS, DOUBLE BLIND METHOD, DOSAGE FORMS",,,"Duration and severity of nausea and vomiting over a 2-week period measured on a 10-point scale. RESULTS: After 9 days, 10 of the 13 (77%) subjects receiving ginger had at least a 4-point improvement on the nausea scale. Only 2 of the 10 (20%) remaining subjects in the placebo group had the same improvement. Conversely, no woman in the ginger group, but 7 (70%) of the women in the placebo group, had a 2-point or less improvement on the nausea scale. Eight of the 12 (67%) women in the ginger group who were vomiting daily at the beginning of the treatment stopped vomiting by day 6. Only 2 of the 10 (20%) women in the placebo group who were vomiting stopped by day 6. CONCLUSION: The ingestion of 1 g of ginger in syrup in a divided dose daily may be useful in some patients experiencing nausea and vomiting in the first trimester of pregnancy.",1078-6791,AB,"CONTEXT: Ginger (Zingiber officinale) has been used to ameliorate symptoms of nausea. A beverage containing ginger in a syrup may be easier to consume than a capsule or solid food. OBJECTIVE: To determine if ginger syrup mixed in water is an effective remedy for the relief of nausea and vomiting in the first trimester of pregnancy. DESIGN: Double-blind, placebo-controlled, randomized clinical trial. SETTING: Subjects were enrolled from the University of South Florida department of obstetrics and gynecology private practice office. PATIENTS: 26 subjects in the first trimester of pregnancy. INTERVENTION: Subjects ingested 1 tablespoon of commercially prepared study syrup (or placebo) in 4 to 8 ounces of hot or cold water 4 times daily. MAIN OUTCOME MEASUR"
0042332,Ausubel K,Kenny Ausubel: ecological medicine: interview by Bonnie Horrigan,Alternat Ther Health Med 2002 Sep-Oct;8(5):92-100,Ausubel K,"NEOPLASMS, HERBALISM",FAMOUS PERSONS,,,,1078-6791,,
0042333,Sierpina VS,Progress notes: Tufts University School of Medicine,Alternat Ther Health Med 2002 Sep-Oct;8(5):104-5,,COMPLEMENTARY MEDICINE,"EDUCATION, NORTH AMERICA",,,,1078-6791,,
0042334,"Lee R, Balick MJ",Micronesian massage and massage oils: ancient practice and contemporary medical therapy,Alternat Ther Health Med 2002 Sep-Oct;8(5):107-10,Micronesia,"MASSAGE, OILS VOLATILE",,,,,1078-6791,,
0042335,Raffensperger C,The precautionary principle: bearing witness to and alleviating suffering,Alternat Ther Health Med 2002 Sep-Oct;8(5):111-5,,"CHILD DEVELOPMENT DISORDERS, ENVIRONMENTAL POLLUTANTS, PUBLIC HEALTH",,,,,1078-6791,,
0042336,Chilton K,Broadening the base: treating people together,Alternat Ther Health Med 2002 Sep-Oct;8(5):116-7,,"COMPLEMENTARY MEDICINE, CHRONIC DIS, HOLISTIC HEALTH",NORTH AMERICA,,,,1078-6791,,
0042337,"Mela P, Veltink PH, Huijing PA, Salmons S, Jarvis JC",The optimal stimulation pattern for skeletal muscle is dependent on muscle length,IEEE Trans Neural Syst Rehabil Eng 2002 Jun;10(2):85-93,,"MUSCLE SKELETAL, ELECTRIC STIMULATION, MUSCLE FATIGUE","MUSCLE CONTRACTION, RABBITS",,,,1534-4320,AB,"Stimulation patterns can be optimized by maximizing the force-time integral (FTI) per stimulation pulse of the elicited muscle contraction. Such patterns, providing the desired force output with the minimum number of pulses, may reduce muscle fatigue, which has been shown to correlate to the number of pulses delivered. Applications of electrical stimulation to use muscle as a controllable biological actuator may, therefore, be improved. Although muscle operates over a range of lengths, optimized patterns have been determined only at optimal muscle length. In this study, the patterns with up to four pulses that produced the highest isometric FTI were determined at 10 muscle lengths for 11 rabbit tibialis anterior muscles. The interpulse intervals (IPIs) used ranged from 4 to 54 ms. At high muscle length, the optimal stimulation pattern consisted of an initial short IPI (doublet) followed by longer IPIs, in agreement with previous studies. However, at low length, the third pulse still elicited more than linear summation (triplet); furthermore, the relative enhancement of the FTI per pulse was considerably larger at low length than at high length, suggesting that optimal stimulation patterns are length dependent."
0042338,"Reinkensmeyer DJ, Pang CT, Nessler JA, Painter CC",Web-based telerehabilitation for the upper extremity after stroke,IEEE Trans Neural Syst Rehabil Eng 2002 Jun;10(2):102-8,,"INTERNET, CEREBROVASCULAR DISORDERS, ARM","REHABILITATION, BIOMECHANICS, THERAPY, TREATMENT OUTCOME",,,,1534-4320,AB,"Stroke is a leading cause of disability in the United States and yet little technology is currently available for individuals with stroke to practice and monitor rehabilitation therapy on their own. This paper provides a detailed design description of a telerehabilitation system for arm and hand therapy following stroke. The system consists of a Web-based library of status tests, therapy games, and progress charts, and can be used with a variety of input devices, including a low-cost force-feedback joystick capable of assisting or resisting in movement. Data from home-based usage by a chronic stroke subject are presented that demonstrate the feasibility of using the system to direct a therapy program, mechanically assist in movement, and track improvements in movement ability."
0042339,"Hintzy F, Tordi N, Perrey S",Muscular efficiency during arm cranking and wheelchair exercise: a comparison,Int J Sports Med 2002 Aug;23(6):408-14,,"EXERCISE, ENERGY METABOLISM, OXYGEN CONSUMPTION","WHEELCHAIRS, ARM, MOVEMENT",,,,0172-4622,AB,"The present study was performed to compare various individual muscular efficiency indices, i. e., gross (GE), net (NE), work (WE), and delta (DE), during arm cranking ergometer (ACE) and wheelchair ergometer (WERG) exercise at the same relative exercise intensities. Following a maximal test on both the ACE and WERG, 15 able-bodied subjects completed 4 submaximal bouts at 0, 40, 55 and 70% of the mode-specific VO2peak. The peak power output and VO2 values were significantly higher with ACE than WERG maximal exercise. As a consequence, the power output imposed during WERG submaximal bouts was significantly lower compared to ACE submaximal bouts. ACE exercise was found to elicit a significantly higher (p less than 0.001) VO2 (16 to 28 vs 14 to 23 ml x min (-1) x kg (-1)), GE (9 to 11 vs 6 to 9%) and NE (14 to 13 vs 10 to 11%) compared to WERG exercise at power output from 40 to 70% VO2peak, respectively. However, WE (17 to 15 vs 17 to 14% at 40 to 55% VO2peak) and DE (12 to 13 vs 12 to 12% at Delta40-55% to Delta55-70% VO2peak) values were similar between ACE and WERG exercise. The lower GE and NE observed during WERG compared to ACE exercise could be explained by the biomechanical disadvantages of the hand-rim WERG pattern movement. These findings also supported that the different indices of efficiency influenced the interpretation of the comparison between ACE and WERG propulsion."
0042340,"Fabre C, Chamari K, Mucci P, Masse-Biron J, Prefaut C",Improvement of cognitive function by mental and/or individualized aerobic training in healthy elderly subjects,Int J Sports Med 2002 Aug;23(6):415-21,,"AGING, COGNITION, MEMORY, EXERCISE","HEART RATE, VITAL CAPACITY",,,,0172-4622,AB,"The aim of this study was to compare the effects of aerobic and mental training on cognitive function and to determine if the association of the two techniques shows better results. Thirty-two healthy elderly subjects (60-76 years) were assigned to one of four groups: aerobic training, mental training, combined aerobic and mental training and a control group. All subjects took two cognitive tests and an incremental exercise test before and after the training period. The intensity of exercise was individualized at the heart rate corresponding to the ventilatory threshold of each subject. After two months, the control group showed no alteration in physiological and cognitive variables. After the training period, the results showed a significant improvement in VO2max (F = 4.45, DF = 1, p less than 0.05) of 12% and 11% in aerobic training and combined aerobic and mental training groups, respectively. Logical memory (F = 4.31, DF = 1, p less than 0.05), as well as paired associates learning scores (F = 5.47, DF = 1, p less than 0.05) and memory quotient (F = 6.52, DF = 1, p less than 0.01) were significantly improved in the three trained groups. The mean difference in memory quotient between pre and post training was significantly higher in the combined aerobic and mental training group compared to aerobic training or mental training groups (F = 11.60, DF = 3, p less than 0.001). We conclude that the specific aerobic training and mental training used in this study could induce the same degree of improvement in cognitive function and that combined training seemed to lead to greater effects than either technique alone."
0042341,"Rittweger J, Ehrig J, Just K, Mutschelknauss M, Kirsch KA, Felsenberg D","Oxygen uptake in whole-body vibration exercise: influence of vibration frequency, amplitude, and external load",Int J Sports Med 2002 Aug;23(6):428-32,,"EXERCISE, MUSCLE PHYSIOLOGY, OXYGEN CONSUMPTION","REHABILITATION, THERAPY, MUSCLE CONTRACTION",,,,0172-4622,AB,"Vibration exercise (VbX) is a new type of physical training to increase muscle power. The present study was designed to assess the influence of whole-body VbX on metabolic power. Specific oxygen uptake (sVO2) was assessed, testing the hypotheses that sVO2 increases with the frequency of vibration (tested in 10 males) and with the amplitude (tested in 8 males), and that the VbX-related increase in sVO2 is enhanced by increased muscle force (tested in 8 males). With a vibration amplitude of 5 mm, a linear increase in sVO2 was found from frequencies 18 to 34 Hz (p less than 0.01). Each vibration cycle evoked an oxygen consumption of approximately 2.5 micro l x kg (-1). At a vibration frequency of 26 Hz, sVO2 increased more than proportionally with amplitudes from 2.5 to 7.5 mm. With an additional load of 40% of the lean body mass attached to the waist, sVO2 likewise increased significantly. A further increase was observed when the load was applied to the shoulders. The present findings indicate that metabolic power in whole-body VbX can be parametrically controlled by frequency and amplitude, and by application of additional loads. These results further substantiate the view that VbX enhances muscular metabolic power, and thus muscle activity."
0042342,Fulder S,Extinction and diversity in alternative medicine,J Alternat Complement Med 2002 Aug;8(4):395-7,,COMPLEMENTARY MEDICINE,,(Editorial),,,1075-5535,,
0042343,"Cho ZH, Oleson TD, Alimi D, Niemtzow RC",Acupuncture: the search for biologic evidence with functional magnetic resonance imaging and positron emission tomography techniques,J Alternat Complement Med 2002 Aug;8(4):399-401,,ACUPUNCTURE,MAGNETIC RESONANCE IMAGING,(Editorial),,,1075-5535,,
0042344,Hockaday TD,"Two herbal preparations, cordyceps Cs4 and cogent db: do they act on blood glucose, insulin sensitivity, and diabetes as \"viscous dietary fibers?\"",J Alternat Complement Med 2002 Aug;8(4):403-5,"Cogent db, Cordyceps Cs4","FUNGI, BLOOD GLUCOSE, INSULIN, DIABETES MELLITUS",PLANT EXTRACTS,(Editorial),,,1075-5535,,
0042345,"Burns SB, Fulder S",Arabic medicine: preservation and promotion. A millennium of achievement,J Alternat Complement Med 2002 Aug;8(4):407-10,Arabic medicine,DELIVERY OF HEALTH CARE,"TRADITIONAL MEDICINE, HISTORY",,,,1075-5535,,
0042346,"Kong J, Ma L, Gollub RL, Wei J, Yang X, Li D, Weng X, Jia F, Wang C, Li F, Li R, Zhuang D",A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods,J Alternat Complement Med 2002 Aug;8(4):411-9,,"ELECTROACUPUNCTURE, ACUPOINTS, ACUPUNCTURE THERAPY, BRAIN MAPPING","PILOT PROJECTS, MAGNETIC RESONANCE IMAGING",,,"To characterize the brain activation patterns evoked by manual and electroacupuncture on normal human subjects. DESIGN: We used functional magnetic resonance imaging (fMRI) to investigate the brain regions involved in electroacupuncture and manual acupuncture needle stimulation. A block design was adopted for the study. Each functional run consists of 5 minutes, starting with 1-minute baseline and two 1-minute stimulation, the interval between the two stimuli was 1 minute. Four functional runs were performed on each subject, two runs for electroacupuncture and two runs for manual acupuncture. The order of the two modalities was randomized among subjects. During the experiment, acupuncture needle manipulation was performed at Large Intestine 4 (LI4, Hegu) on the left hand. For each subject, before scanning started, the needle was inserted perpendicular to the skin surface to a depth of approximately 1.0 cm. Electroacupuncture stimulation was delivered using a continuous rectangular wave form (pulse width 30 ms) at a frequency of 3 Hz. For manual acupuncture, the needle was rotated manually clockwise and counterclockwise at a rate of about 180 times per minute (3 Hz). SUBJECTS: Eleven right-handed, normal, healthy volunteer adults, 6 male and 5 female, ages 21-64 participated in the experiment. RESULTS: Results showed that electroacupuncture mainly produced fMRI signal increases in precentral gyrus, postcentral gyrus/inferior parietal lobule, and putamen/insula; in contrast, manual needle manipulation produced prominent decreases of fMRI signals in posterior cingulate, superior temporal gyrus, putamen/insula. CONCLUSION: These results indicate that different brain networks are involved during manual and electroacupuncture stimulation. It suggests that different brain mechanisms may be recruited during manual and electroacupuncture.",1075-5535,AB,OBJECTIV
0042347,"Dennehy EB, Webb A, Suppes T",Assessment of beliefs in the effectiveness of acupuncture for treatment of psychiatric symptoms,J Alternat Complement Med 2002 Aug;8(4):421-5,,"ACUPUNCTURE THERAPY, PATIENT SATISFACTION, MENTAL DISORDERS","CLINICAL ASSESSMENT SCALES, ATTITUDE, TREATMENT OUTCOME",,,"Research has demonstrated that beliefs or expectancies can exert a powerful influence on treatment and/or drug effects. As patients participate in more complementary and/or alternative treatments for psychiatric conditions, it is important to assess the role of belief or expectancy on response to nontraditional treatment approaches. The Acupuncture Beliefs Scale was developed to assess belief in the efficacy of acupuncture for both physical and psychiatric symptoms and conditions. Development and psychometric properties of the scale are described. Design and subjects: Research personnel solicited statements regarding the potential experience and effects of acupuncture. These items were collapsed into a set of 36 items, with some rotated to avoid response bias. Outpatients diagnosed with bipolar disorder and undergraduates completed the scale (n = 118). RESULTS: The scale yielded excellent internal consistency (coefficient alpha = 0.97), and item-total score correlations between 0.37 and 0.83. Principal component analysis with a varimax rotation revealed three significant and meaningful factors that were consistent across both subject groups. Factors appeared to capture general endorsement of acupuncture treatment, beliefs in the scientific value and credibility of acupuncture treatment, and beliefs about the procedures and physical experience of acupuncture. CONCLUSIONS: The Acupuncture Beliefs Scale is a 36-item self-report scale that may be useful for measurement of beliefs in the effectiveness of acupuncture treatment.",1075-5535,AB,OBJECTIV
0042348,"Croft RJ, Chandler JS, Burgess AP, Barry RJ, Williams JD, Clarke AR","Can the Q Link Ally,(R) a form of sympathetic resonance technology (SRT trade mark), attenuate acute mobile phone-related changes to neural function?",J Alternat Complement Med 2002 Aug;8(4):427-35,"Mobile phones, auditory stimulation",NEURAL CONDUCTION,"PHYSICAL STIMULATION, PILOT PROJECTS, ELECTROENCEPHALOGRAPHY",,,"Exposure to active mobile phones (MP) has been shown to affect human neural function as shown by the electroencephalogram (EEG). Although it has not been determined whether such effects are harmful, a number of devices have been developed that attempt to minimize these MP-related effects. One such device, the Q Link Ally((R)) (QL; Clarus Products, International, L.L.C., San Rafael, CA), is argued to affect the human organism in such a way as to attenuate the effect of MPs. The present pilot study was designed to determine whether there is any indication that QL does alter MP-related effects on the human EEG. DESIGN: Twenty-four (24) subjects participated in a single-blind, fully counterbalanced crossover design in which subjects' resting EEG and phase-locked neural responses to auditory stimuli were assessed under conditions of either active MP or active MP plus QL. RESULTS: The addition of QL to the MP condition increased resting EEG in the gamma range and did so as a function of exposure duration, and it attenuated MP-related effects in the delta and alpha range (at trend-level). The addition of the QL also affected phase-locked neural responses, with a laterality reversal in the alpha range and an alteration to changes over time in the delta range, a reduction of the MP-related beta decrease over time at fronto-posterior sites, and a global reduction in the gamma range that increased as a function of exposure duration. No unambiguous relations were found between these changes and either performance or psychologic state. CONCLUSIONS: This pilot study suggests that the addition of the QL to active MP-exposure does affect neural function in humans, altering both resting EEG patterns and the evoked neural response to auditory stimuli, and that there is a tendency for some MP-related changes to the EEG to be attenuated by the QL.",1075-5535,AB,OBJECTIV
0042349,"Grinstein O, Elhayany A, Goldberg A, Shvarts S",Complementary medicine in Israel,J Alternat Complement Med 2002 Aug;8(4):437-43,,COMPLEMENTARY MEDICINE,"ISRAEL, ATTITUDE",,,,1075-5535,AB,"In recent years, the status of complementary medicine in Israel has appeared frequently on the public agenda. The debates and the newspaper headlines concerned with this subject usually deal with legal aspects of the subject, including the relation between complementary medicine and the medical establishment. With the enactment in 1995 of the Compulsory Health Insurance Law, debate over the issue intensified, with the public divided over any proposal to make complementary medicine part of the services guaranteed by law. This paper addresses the current status of complementary medicine in Israel, describes the introduction of complementary medicine to Israel, attitudes toward it of both consumers and medical professionals, and the question of its legal status. While no comprehensive survey describing all aspects of this subject in Israel has yet been undertaken, this paper is based on a survey of the professional literature in Israel, especially that of the Israeli scientific-medical community, a survey of the general press, and an analysis of the health insurance law and its position with respect to the complementary medicine."
0042350,"Shekhar KC, Achike FI, Kaur G, Kumar P, Hashim R",A preliminary evaluation of the efficacy and safety of cogent db (an ayurvedic drug) in the glycemic control of patients with type 2-diabetes,J Alternat Complement Med 2002 Aug;8(4):445-57,Cogent db,DIABETES MELLITUS,"PLANTS MEDICINAL, EPIDEMIOLOGIC METHODS, TREATMENT OUTCOME, SAFETY",,,"Thirty-two (32) clinical variables were investigated, including liver enzymes, kidney function tests, hematologic parameters, blood glucose, insulin, and C-peptide assays. RESULTS: At the end of 3 months it was found that there was a significant decrease in the levels of fasting and postprandial blood glucose, cholesterol, triglycerides, glycated hemoglobin (Hb A(1C)) and fasting insulin in the treatment group compared to the controls. Cogent db did not alter the liver function tests, hematologic parameters, or the kidney function tests.",1075-5535,AB,"Objectives and study design: A nonrandomized, non-placebo-controlled clinical trial to evaluate the efficacy of Cogent db (an herbal preparation; Cybele Herbal Laboratories (PVT) Ltd. Kochi, Kerala State, India) as an adjuvant in the treatment of patients with type 2 diabetes was carried out during a 3-month period. Settings/location: This study was conducted in two major peripheral clinics of Kuala Lumpur in the Klang Valley, Malaysia. SUBJECTS: A total of 39 Cogent db-treated cases and 40 age-matched controls were recruited for this preliminary study. Nineteen (19) subjects (10 and 9 from control and treatment groups, respectively) dropped out of the study leaving a total of 60 subjects (30 each for control and treatment groups) who completed the study. INTERVENTIONS: All subjects in the treatment group were given Cogent db (2 tablets three times daily after each meal) in addition to the regular allopathic drugs (Daonil, (Aventis Farma, SA Petaling Jaya, Selangor State, Malaysia) and Diamicron((R)) (Sevier, Bangkok, Thailand), with or without Metformin (Upha Corporation, Bangi, Selangor State, India)) that they took in common with the control group. OUTCOME MEASUR"
0042351,"Song Z, Wu H, Mathee K, Hoiby N, Kharazmi A",Gerimax ginseng regulates both humoral and cellular immunity during chronic pseudomonas aeruginosa lung infection,J Alternat Complement Med 2002 Aug;8(4):459-66,Pseudomonas aeruginosa,"CYSTIC FIBROSIS, PANAX GINSENG, RESPIRATORY TRACT INFECTIONS","EPIDEMIOLOGIC METHODS, BACTERIA",,,,1075-5535,AB,"BACKGROUND: Chronic lung infection among patients with cystic fibrosis (CF), diffused panbronchiolitis, and chronic obstructive bronchiecteisis is often because of Pseudomonas aeruginosa. High morbidity and mortality in patients with CF are because of P. aeuruginosa that undergoes genotypic and phenotypic changes during prolonged stay in the lung resulting in increased antibiotic resistance, necessitating a search for alternative or supplement drugs. OBJECTIVE: In this study we compared the therapeutical effect of Gerimax (Dansk Droge A/S, Ishoj, Denmark) ginseng with placebo control by using a rat model of chronic P. aeruginosa lung infection mimicking that in patients with CF. Methods and interventions: The animals were challenged intratracheally with the prototypic P. aeruginosa PAO1 in alginate beads (1 x 10(9) colony-forming units per milliliter (CFU/mL)) followed by subcutaneous injection of ginseng extract (150 mg/kg body weight once per day) and examined on days 7 and 21. RESULTS: The day 7 analyses show that ginseng treatment resulted in lowering serum immunoglobulin M (IgM) and lung interleukin-4 (IL-4) levels compared to the control group. On day 21, higher lung IgA, upregulated serum IgG2a, stronger lung responses of interferon-gamma, IL-4, and tumor necrosis factor-alpha with milder lung pathology and enhanced lung bacteriology were detected in the ginseng-treated group when compared to those of the control group. CONCLUSION: These results suggest that the Gerimax ginseng treatment can modulate the immune system in favor of clearing the infection with P. aeruginosa in the lungs of rats. Thus, ginseng might be a promising alternative supplement for the treatment of chronic P. aeruginosa lung infection in patients with CF."
0042352,"Wilasrusmee C, Kittur S, Siddiqui J, Bruch D, Wilasrusmee S, Kittur DS",In vitro immunomodulatory effects of ten commonly used herbs on murine lymphocytes,J Alternat Complement Med 2002 Aug;8(4):467-75,,"ADJUVANTS IMMUNOLOGIC, LYMPHOCYTES, HERBAL DRUGS",RESEARCH,,,"Physicians are increasingly encountering patients who use herbal products. Some of these products are known to modulate the immune system but their scientific basic is not well established. Because these products can affect the host immune system, they could be beneficial in the treatment of immune-related diseases, or alternatively, they could cause inadvertent side-effects. The purpose of this study was to determine which of these common herbal products modulate lymphocyte proliferation in vitro. METHODS: Lymphocyte proliferation assays using concanavalin A (mitogen stimulation) and mixed lymphocyte culture (alloantigen stimulation) were used as in vitro tests to investigate the immunomodulatory effects of 10 commonly used herbal products. RESULTS: Ginger and tea were consistently immunosuppressive while dong quai, milk thistle, and St. John's wort were consistently immunostimulatory in vitro. Ginseng enhanced lymphocyte proliferation only in the mitogen-stimulation assay. The magnitude of the enhancement or suppression of the individual herbal products was different in the two assays. CONCLUSION: Our study provides a uniform survey of the immunomodulatory properties of 10 commonly used herbal products and paves the way for testing these effects in vivo and in clinical setting.",1075-5535,AB,OBJECTIV
0042353,"Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ, Marshall LM","Types of alternative medicine used by patients with breast, colon, or prostate cancer: predictors, motives, and costs",J Alternat Complement Med 2002 Aug;8(4):477-85,,"NEOPLASMS, COMPLEMENTARY MEDICINE, COST OF ILLNESS, CHOICE BEHAVIOR","ADULT, NORTH AMERICA, ATTITUDE",,,,1075-5535,AB,"OBJECTIVE: Assess predictors and costs of various types of alternative medicine used by adult patients with cancer. Design, location, subjects: Telephone survey of 356 patients with colon, breast, or prostate cancer identified from the population-based Cancer Surveillance System of western Washington. RESULTS: Overall, 70.2% of patients used at least one type of alternative medicine, with 16.6% seeing alternative providers, 19.1% using mental/other therapy, and 64.6% taking dietary supplements. Compared to males, females were five times more likely to see an alternative provider and about twice as likely to use mental therapies or supplements (p less than 0.05 for all). Older patients were less likely to use mental/other therapy. Higher education (but not income) was associated with use of all types of alternative medicine. Patients with multiple medical treatments were two times more likely to take dietary supplements compared to patients having only surgery (p less than 0.01). Varying by the type of alternative therapy, 83%-97% of patients reported that they used alternative medicine for general health and well-being while 8% to 56% reported use for treatment of cancer. Almost all patients reported that the alternative therapy improved their well-being. Expenditures for alternative medicine averaged 68 dollars per user per year, but ranged from 4 dollars to 14,659 dollars. CONCLUSIONS: Given the high prevalence of use and that patients believed that alternative medicine improved their well-being, clinicians should show an open mind toward these treatment choices and encourage frank discussion. Familiarity and some knowledge regarding use of alternative medicine is important in cases where interactions between conventional and alternative medicine may occur. (ABSTRACT TRUNCATED)."
0042354,"Kumar R, Divekar HM, Gupta V, Srivastava KK",Antistress and adaptogenic activity of lecithin supplementation,J Alternat Complement Med 2002 Aug;8(4):487-92,Lecithin,DIETARY SUPPLEMENTS,"TREATMENT OUTCOME, STRESS PSYCHOLOGICAL, PHOSPHATIDYLCHOLINES",,,,1075-5535,AB,"OBJECTIVE: Investigation of lecithin administration in rats for its antistress and adaptogenic activity. DESIGN: Lecithin was administered orally (1 mg/g body weight) to rats 0.5 hour, 1.5 hours, 3.0 hours, and 6.0 hours prior to cold (5 degrees C)-hypoxia (428 mm Hg)-restraint (C-H-R) exposure and serum choline estimation. The rectal temperature (T(rec)) of the rats was monitored during the exposure and the recovery periods. The time for decrease of T(rec) to 23 degrees C and its recovery to 37 degrees C were used as indices of antistress and adaptogenic activity. RESULTS: Lecithin administration 3-6 hours prior to C-H-R exposure was found to have significant adaptogenic activity that correlated with increased serum choline levels. Lecithin administration prior to C-H-R exposure increased the stress tolerance of the rats by delaying the time for decrease of T(rec) to 23 degrees C during C-H-R exposure. It also helped shorten poststress recovery as observed by decreased time to attain T(rec) of 37 degrees C from C-H-R-induced hypothermia (T(rec), 23 degrees C). CONCLUSIONS: The results suggested that lecithin supplementation acted as an antistress and adaptogenic functional food. It improved resistance during C-H-R exposure and enhanced recovery from hypothermia."
0042355,"Ghafar MA, Golliday E, Bingham J, Mansukhani MM, Anastasiadis AG, Katz AE","Regression of prostate cancer following administration of Genistein Combined Polysaccharide (GCP trade mark), a nutritional supplement: a case report",J Alternat Complement Med 2002 Aug;8(4):493-7,Genistein,"PROSTATIC NEOPLASMS, ANTINEOPLASTIC AGENTS PHYTOGENIC, ISOFLAVONES, POLYSACCHARIDES, DIETARY SUPPLEMENTS",CASE REPORT,,,,1075-5535,AB,"PURPOSE: It has been reported that genistein, an isoflavone used in soybeans, has antiprostate cancer effects. Genistein Combined Polysaccharide (GCP trade mark; AMino Up, Sapporo, Japan), a nutritional supplement manufactured in Japan, is composed of genistein and a polysaccharide obtained from basidiomycetes (mycelia) that grows in a variety of mushrooms. METHODS: We report a case of a patient with a biopsy proven prostate cancer showing clinical and pathologic evidence of regression following administration of GCP. The patient was enrolled in an Institutional Review Board (IRB)-approved protocol and received GCP for 6 weeks prior to radical prostatectomy. RESULTS: The patient's prostate-specific antigen (PSA) decreased from an initial value of 19.7 to 4.2 ng/mL after 44 days of low-dose GCP. No cancer was identified in the radical prostatectomy specimen and no side effects were observed in this patient. CONCLUSION: This case suggests that GCP, which has shown potent inhibitory effects against prostate cancer in vitro, may have some potential activity in the treatment and prevention of prostate cancer."
0042356,"Wilson K, McGowan J, Guyatt G, Mills EJ",Teaching evidence-based complementary and alternative medicine: 3. Asking the questions and identifying the information,J Alternat Complement Med 2002 Aug;8(4):499-506,,"COMPLEMENTARY MEDICINE, INFORMATION SCIENCE",EVIDENCE BASED MEDICINE,,,,1075-5535,AB,"Practicing evidence-based complementary and alternative medicine (EBCAM) requires skills in accessing current valid literature on clinical queries. This requires searching a variety of sources within a broad scope of scientific disciplines. This daunting task requires effective skills for accessing information from both print and electronic sources. This paper identifies the progression from question formulation through to searching and acquiring the valid information. In the evolving information age, complementary and alternative medicine (CAM) practitioners require informational databases and knowledge of search terminology. This paper suggests practical strategies for successful database searches in support of EBCAM."
0042357,"Hui KK, Zylowska L, Hui EK, Yu JL, Li JJ",Introducing integrative East-West medicine to medical students and residents,J Alternat Complement Med 2002 Aug;8(4):507-15,,"COMPLEMENTARY MEDICINE, DELIVERY OF HEALTH CARE, EDUCATION",CURRICULUM,,,,1075-5535,AB,"Over the last several years, many medical schools and residencies have introduced complementary and alternative medicine (CAM) into their curricula, prompting a discussion as to how CAM should be taught. In this paper, we share our experiences teaching medical trainees integrative East-West medicine, an approach to health and disease that brings together modern Western and Chinese medicine. A 2-week clinical rotation that is intimately tied to our busy clinical program is described in detail as we explore some of the challenges and opportunities involved in teaching a CAM-related field to medical trainees. We also demonstrate how such a clinical experience offers an opportunity to impart on our students a broad view of medicine and to discuss novel approaches to clinical problem-solving."
0042358,"Jardat MS, Noonan DJ, Wu B, Avery MA, Feller DR",Pseudolaric acid analogs as a new class of peroxisome proliferator-activated receptor agonists,Planta Med 2002 Aug;68(8):667-71,"pseudolaric acid B, Pseudolarix kaempferi, peroxisome proliferator activated receptor","DITERPENES, PLANT EXTRACTS, ANTIFUNGAL AGENTS","PHARMACOLOGY, PLANTS MEDICINAL, PROTEINS",,,,0032-0943,AB,"Extracts of the root and trunk barks of the Chinese tree Pseudolarix kaempferi, which contain pseudolaric acids, are used in Chinese medicine for treatment of fungal infections. Pseudolaric acid B (PLAB) is the major constituent that exhibits anti-fungal activity. The nuclear peroxisome proliferator-activator receptors (PPAR) were proposed as a cellular target for the action of PLAB and its analogs. PLAB and two derivatives were tested for the activation of PPAR isoforms in two mammalian cell lines. CV-1 and H4IIEC3 cells were transfected with phorbol ester response element or PPAR response element reporter constructs, and CV-1 cells were co-transfected with the individual PPAR isoform expression plasmids. PLAB showed similar concentration-dependent effects for the activation of PPAR alpha, gamma and delta isoforms in CV-1 and H4IIEC3 cells. O-Deacetylation of PLAB (PLAC) or esterification of the free carboxy group of PLAB with beta- D- O-glucopyranoside (PLAG) markedly reduced or abolished the activation of these PPAR isoforms. In H4IIEC3 cells, PLAB increased the activation of endogenous PPARalpha and the phospholipase C signaling pathway; and stimulated peroxisomal fatty acyl-CoA oxidase activity. These effects of PLAB on the activation of endogenous PPARalpha and phospholipase C-dependent pathway were blocked by staurosporine. These results suggest that the action of PLAB on PPARalpha in H4IIEC3 cells is mediated by a protein kinase C dependent phosphorylation. Based upon these findings, the chemical class of biologically active diterpene acids related to PLAB may have promise for the treatment of metabolic and pathophysiological disorders that are regulated by these nuclear receptor isoforms."
0042359,"Barthomeuf C, Debiton E, Mshvildadze V, Kemertelidze E, Balansard G",In vitro activity of hederacolchisid A1 compared with other saponins from Hedera colchica against proliferation of human carcinoma and melanoma cells,Planta Med 2002 Aug;68(8):672-5,,"SAPONINS, TUMOR CELLS CULTURED, CISPLATIN, ANTINEOPLASTIC AGENTS PHYTOGENIC, HEDERA","PLANTS MEDICINAL, PHARMACOLOGY, COMPARATIVE STUDY",,,,0032-0943,AB,"Hederacolchisid A1, a new oleanolic acid monodesmoside, isolated from Hedera colchica K. Koch, an ivy species endemic in Georgia, was evaluated in vitro for antiproliferative activity on cancer cells versus normal cells in comparison to cisplatin. Investigations were made on six human cell lines (colon adenocarcinoma DLD-1, ovarian teratocarcinoma PA 1, lung carcinoma A 549, breast adenocarcinoma MCF7, prostatic adenocarcinoma PC 3 and malignant melanoma M4 Beu) versus normal human fibroblasts, by assaying both cellular metabolic activity (RTT test) and DNA content in living cells (test with Hoechst 33 342) after 48 h continuous contact. Results demonstrated the strong cytotoxicity of hederacolchisid A 1 on all cancer cells (IC 50 from 4.5 to 12 &mgr;M). The antiproliferative effects on malignant melanoma M4 Beu (IC 50 ca 4.5 mgr M) versus normal cells (IC 50 ca 7.5 mgr M) suggests that, despite a lack of specificity for cancer cells, hederacolchisid A1 has potential anti-tumor applications. Comparison of the cytotoxicity of hederacolchisid A1 with that of five other saponins from H. colchica, offers some new information about structure-activity relationships. It was observed that i) for a same sugar sequence, monodesmosides with oleanolic acid as aglycone exhibit higher cytotoxicity than those containing hederagenin, ii) the sugar sequence O-alpha-L-rhamnopyranosyl(1-2)-alpha-L-arabinopyranoside at C3 induces strong cytotoxicity and might be identified as a basic sequence for anti-tumor activity of oleanolic acid monodesmosides. iii) a complementary glucopyranosyl moiety branched at C1 of arabinose increases the cytotoxicity against malignant melanoma M4 Beu, prostatic adenocarcinoma PC 3 and normal fibroblasts in a different manner for each type of monodesmoside. (ABSTRACT TRUNCATED)."
0042360,"He Q, Osuchowski MF, Johnson VJ, Sharma RP","Physiological responses to a natural antioxidant flavonoid mixture, silymarin, in BALB/c mice: I induction of transforming growth factor beta1 and c-myc in liver with marginal effects on other genes",Planta Med 2002 Aug;68(8):676-9,"silymarin, Silybum marianum","ANTIOXIDANTS, LIGNANS, LIVER DIS, LIVER","FLAVONES, PLANTS MEDICINAL, PREVENTION, MICE, PHARMACOLOGY, DRUG EFFECTS",,,,0032-0943,AB,"Silymarin, a mixture of flavonolignans isolated from Silybum marianum, is known for its hepatoprotective properties. We investigated the expression of cytokines in mouse liver following treatment with 0, 10, 50, and 250 mg/kg of silymarin once daily for 5 days. A dose-related but insignificant decrease of circulating alanine aminotransferase and aspartate aminotransferase after silymarin treatment was observed, suggesting that silymarin treatment did not induce hepatic damage. Silymarin treatment caused significant increases in the expressions of transforming growth factor (TGF) beta1 and c-myc in liver. No significant difference was detected among these treatments in the expression of hepatocyte growth factor, interferon gamma, tumor necrosis factor alpha, and class II major histocompatibility complex. These results suggest that alterations of TGFbeta1 and c-myc expression in the liver may be involved in the hepatoprotective effects of silymarin observed in other studies."
0042361,"Gigante B, Silva AM, Marcelo-Curto MJ, Feio SS, Roseiro J, Reis LV",Structural effects on the bioactivity of dehydroabietic acid derivatives,Planta Med 2002 Aug;68(8):680-4,dehydroabietic acid,"DITERPENES, ANTIINFECTIVE AGENTS, ANTIFUNGAL AGENTS","PHARMACOLOGY, MOLECULAR STRUCTURE",,,,0032-0943,AB,"The synthesis and the evaluation of the antimicrobial activity against a filamentous fungus, yeasts and bacteria of 15 hydrophenanthrene compounds derived from dehydroabietic acid, bearing different functional groups and different stereochemistry of the A/B ring junction are disclosed. The results obtained showed how their activity is dependent of the functionality at C-18, which can be increased by deisopropylation or introduction of other groups into the molecule. While the filamentous fungus tested is sensitive to almost all of the compounds under study, the aldehyde function showed to be of major importance to the inhibition of yeast. Alcohols and aldehyde C-18 derivatives also inhibit the growth of a Gram-positive bacteria, whereas Gram-negative are not sensitive."
0042362,"Oh H, Pae HO, Oh GS, Lee SY, Chai KY, Song CE, Kwon TO, Chung HT, Lee HS",Inhibition of inducible nitric oxide synthesis by catalposide from Catalpa ovata,Planta Med 2002 Aug;68(8):685-9,"Catalpa ovata, catalposide","NITRIC OXIDE, GLUCOSIDES","PLANTS MEDICINAL, METABOLISM, DRUG ISOLATION, PHARMACOLOGY",,,,0032-0943,AB,"Catalposide (1) and two related iridoids were isolated from the stem of Catalpa ovata (Bignoniaceae) by bioassay guided fractionation. Catalposide (1) significantly inhibited the production of nitric oxide (NO) in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages in a dose-dependent manner. RT-PCR and Western blot analyses demonstrated that catalposide (1) suppressed the expression of inducible nitric oxide synthase (iNOS) gene and iNOS protein. Catalposide (1) also inhibited the activation of LPS-induced NF-kappaB as analyzed by electrophoretic mobility shift assay (EMSA). In addition to the inhibitory effect on NO production in LPS-stimulated RAW 264.7 cells, catalposide (1) significantly inhibited the NO production in cytokine-stimulated human DLD-1 and rat vascular smooth muscle (VSM) cells in a dose-dependent manner."
0042363,"Sanae F, Miyaichi Y, Hayashi H",Potentiation of vasoconstrictor response and inhibition of endothelium-dependent vasorelaxation by gallic Acid in rat aorta,Planta Med 2002 Aug;68(8):690-3,gallic acid,"BLOOD VESSELS, AORTA, VASODILATION, VASOCONSTRICTOR AGENTS","RATS, AORTA, CARBOXYLIC ACIDS, RATS, DRUG EFFECTS, CARDIOVASCULAR AGENTS, PREVENTION",,,,0032-0943,AB,"In the isolated rat thoracic aorta, gallic acid potentiated the vasoconstrictor response to phenylephrine. The potentiation produced by gallic acid was absent in endothelium-denuded arteries. The potentiation was abolished by N(G)-nitro- L-arginine methyl ester, an inhibitor of nitric oxide synthesis, and slightly attenuated by an addition of L-arginine, while indomethacin or BQ610 had no effect. The potentiation of response to phenylephrine was not found for structural modifications of gallic acid, except for caffeic acid. Gallic acid also inhibited vasorelaxation induced by acetylcholine, sodium nitroprusside or prostacyclin, especially that by acetylcholine. The effect on vasorelaxation induced by acetylcholine was decreased by esterification of the carboxy group of gallic acid, and in the absence or by the methylation of the o-dihydroxy group. Caffeic acid inhibited the vasorelaxation, though the effect was smaller than that of gallic acid. These findings indicate that gallic acid produces a potentiation of contractile response and inhibition of vasorelaxant responses, probably through inactivation of nitric oxide (NO), in which endothelially produced NO is principally involved, and that the modification of functional groups of the gallic acid molecule abolishes the potentiation of contractile response and attenuates the inhibition of vasorelaxant responses."
0042364,"Lahlou S, Magalhaes PJ, Carneiro-Leao RF, Leal-Cardoso JH",Involvement of nitric oxide in the mediation of the hypotensive action of the essential oil of Mentha x villosa in normotensive conscious rats,Planta Med 2002 Aug;68(8):694-9,,"NITRIC OXIDE, MENTHA, OILS VOLATILE, MUSCLE SMOOTH, ANTIHYPERTENSIVE AGENTS, BLOOD PRESSURE, VASODILATION","DRUG EFFECTS, METABOLISM, PHARMACOLOGY, RATS, AORTA",,,,0032-0943,AB,"Recently, we showed that intravenous (i.v.) treatment with the essential oil of Mentha x villosa (EOMV) in pentobarbitone-anaesthetised rats decreased blood pressure; the effect occurred independently of the presence of an operational central autonomic drive to the cardiovascular system. This finding suggested that the hypotensive activity of EOMV may result from its vasodilatory effects directly upon vascular smooth muscle. The present study examines this possibility and whether EOMV-induced hypotension is mediated, at least in part, by an endothelial L-arginine/nitric oxide pathway. In conscious rats, i.v. injections of bolus doses (1 to 20 mg/kg) of EOMV elicited immediate and dose-dependent decreases in mean aortic pressure (MAP) and heart rate (HR). Pretreatment with i.v. hexamethonium (30 mg/kg) reduced the EOMV-induced bradycardia without affecting the hypotension. However, i.v. pretreatment with the nitric oxide synthase inhibitor, N(G)-nitro-L-arginine methyl (L-NAME, 20 mg/kg), reduced partially, but significantly, the maximal percent decreases in MAP elicited by EOMV without affecting the bradycardia. In rat isolated thoracic aorta preparations, EOMV (1-130 microg/ml) induced a concentration-dependent reduction of potassium (60 mM)-induced contraction. This smooth muscle-relaxant activity of EOMV was significantly reduced by the incubation of endothelium-intact rings with L-NAME (20 microM), as evidenced by the significant enhancement in the IC 50 for EOMV-induced reduction of potassium-induced contraction (133.8 +/- 26.5 vs. 65.2 +/- 8.2 microg/ml in the absence of L-NAME). Furthermore, the vasorelaxant effects of EOMV in endothelium-denuded aortic rings were also significantly reduced (IC 50 = 109 +/- 10 microg/ml), compared to those observed in segments with intact endothelium (IC 50 = 61 +/- 13 microg/ml). (ABSTRACT TRUNCATED)."
0042365,"Guedes DN, Silva DF, Barbosa-Filho JM, Medeiros IA",Muscarinic agonist properties involved in the hypotensive and vasorelaxant responses of rotundifolone in rats,Planta Med 2002 Aug;68(8):700-4,,"OILS VOLATILE, MENTHA, AORTA, BLOOD PRESSURE, ANTIHYPERTENSIVE AGENTS","RATS, DRUG EFFECTS, PHARMACOLOGY, MUSCLE SMOOTH, HEART RATE",,,,0032-0943,AB,"The acute cardiovascular effects of rotundifolone (ROT), the major constituent (63.5 %) of the essential oil of Mentha x villosa (OEMV), were tested in rats by using a combined (in vivo and in vitro) approach. ROT (1, 5, 10, 20 and 30 mg kg (-1)i. v.) induced a significant and dose-dependent hypotension and bradycardia in non-anaesthetized normotensive rats. The hypotensive effect was significantly attenuated by pre-treatment of the rats with atropine (2 mg kg (-1)i. v.) or L-NAME (20 mg kg (-1)i. v.). Furthermore, the bradycardic effect was abolished by atropine. In isolated rat atrial preparations, ROT (10, 100, 300 and 500 microg ml (-1)) produced concentration-related negative inotropic and chronotropic effects. In isolated intact aortic rings, increasing concentrations of ROT (0.3, 1, 10, 100, 300 and 500 microg ml (-1)) were able to antagonize the contractile effect of phenylephrine (1 microM) (IC 50 = 184 +/- 6 microg ml (-1)). The smooth muscle-relaxant activity of ROT was inhibited by either removal of vascular endothelium, atropine (1 microM), L-NAME (100 and 300 microM) or indomethacin (10 microM) (IC 50 values = 235 +/- 7, 247 +/- 8, 387 +/- 21, 723 +/- 75 and 573 +/- 38 microg ml (-1), respectively). These results suggest that rotundifolone markedly lowers arterial pressure and heart rate in non-anaesthetized animals. The hypotensive action of rotundifolone can be a consequence of a decrease in heart rate and peripheral vascular resistance, probably due to a non-selective muscarinic receptor stimulation."
0042366,"Hu CP, Xiao L, Deng HW, Li YJ",The cardioprotection of rutaecarpine is mediated by endogenous calcitonin related-gene peptide through activation of vanilloid receptors in guinea-pig hearts,Planta Med 2002 Aug;68(8):705-9,"rutaecarpine, guinea pigs, Evodia rutaecarpa","CARDIOTONIC AGENTS, HEART, CORONARY VESSELS, PLANT EXTRACTS, HEART DIS","ALKALOIDS, DRUG EFFECTS, PHARMACOLOGY, RODENTS, PLANTS MEDICINAL, PREVENTION",,,,0032-0943,AB,"Previous investigations have shown that calcitonin gene-related peptide (CGRP) protects against myocardial ischemia-reperfusion injury and that rutaecarpine activates vanilloid receptors to evoke CGRP release. In the present study, we examined whether rutaecarpine enhances preservation with cardioplegia in guinea-pig hearts, and whether the protective effects of rutaecarpine are related to stimulation of endogenous CGRP release via activating vanilloid receptors. The isolated guinea-pig heart was arrested using St. Thomas Hospital solution, and then reperfused with normothermic Krebs-Henseleit solution for 30 min after a 4-h hypothermic ischemic period. Hypothermic ischemia caused a decline in cardiac function (left ventricular pressure, +/-dp/dt max, heart rate and coronary flow) and an increased release of creatine kinase during reperfusion. Rutaecarpine at the concentration of 1.0 microM significantly improved the recovery of cardiac function and reduced the release of creatine kinase during reperfusion after hypothermic ischemia. Rutaecarpine at the concentration of 3.0 microM significantly reduced the release of creatine kinase and increased the coronary flow, but only caused a slight improvement of left ventricular pressure, +/-dp/dt max, heart rate during reperfusion. The cardioprotective effects of rutaecarpine were abolished by capsazepine, a competitive vanilloid receptor antagonist, or by CGRP (8-37), a selective CGRP receptor antagonist. Rutaecarpine at the concentration of 1.0 or 3.0 microM significantly increased the release of CGRP, which was also abolished by capsazepine. These results suggest that rutaecarpine enhances preservation with cardioplegia in guinea-pig hearts and that the protective effects of rutaecarpine are due to stimulation of endogenous CGRP release via activating vanilloid receptors."
0042367,"Jiang DJ, Tan GS, Zhou ZH, Xu KP, Ye F, Li YJ",Protective effects of demethylbellidifolin on myocardial ischemia-reperfusion injury in rats,Planta Med 2002 Aug;68(8):710-3,Swertia davidi,"PLANT EXTRACTS, MYOCARDIAL DIS, CREATINE KINASE, ISCHEMIA, REGIONAL BLOOD FLOW","PLANTS MEDICINAL, RATS, PREVENTION, METABOLISM, PHARMACOLOGY",,,,0032-0943,AB,"The effect of demethylbellidifolin (DMB), a major compound of Swertia davidi Franch, on ischemia-reperfusion injury was studied in rats. Ischemia-reperfusion injury in vivo and in vitro was induced by 20 min of global ischemia followed 40 min of reperfusion and 60 min of coronary artery occlusion followed 180 min of reperfusion, respectively. DMB (100 or 300 microg/L) significantly improved the recovery of cardiac function during reperfusion in isolated rat hearts, as shown by enhancement of coronary flow, left ventricular pressure and its first derivatives (+/-dp/dt max). DMB decreased the release of creatine kinase in coronary effluent as well as the level of malondialdehyde in myocardial tissues. In vivo, DMB (0.5 or 1.0 mg/kg) markedly decreased infarct size and the release of creatine kinase. These results suggest that DMB protects the myocardium against damage due to ischemia-reperfusion in rats. The present study also suggests that the effect of DMB may be related to inhibition of lipid peroxidation."
0042368,"Akao T, Yoshino T, Kobashi K, Hattori M",Evaluation of salicin as an antipyretic prodrug that does not cause gastric injury,Planta Med 2002 Aug;68(8):714-8,"salicin, salicylic acid, saligenin","ANALGESICS, FEVER, PLANT EXTRACTS","HYDROCARBONS, ALCOHOLS, COMPARATIVE STUDY, CARBOXYLIC ACIDS, PHENOLS, RATS, DRUG EFFECTS, PHARMACOLOGY",,,,0032-0943,AB,"Pharmacokinetic and pharmacological studies were performed to compare the antipyretic effects of salicin (SL), saligenin (SG, an aglycone of SL) and salicylic acid (SA, an active metabolite of SL) in rats. When SL was administered orally to rats, SA appeared slowly in the plasma and levels increased gradually, in contrast to the rapid appearance observed after oral administration of sodium salicylate (SANa) or SG. Orally administered SL did not affect the rectal temperatures of afebrile rats at a dose of 5 mmol/kg; at this dose, SANa and SG lowered body temperature significantly. However, it significantly reduced yeast-induced fever, producing a normal body temperature, and completely prevented fever when administered simultaneously with yeast. SL did not induce gastric lesions even at a dose of 5 mmol/kg; conversely, SANa and SG induced severe gastric lesions in a dose-dependent manner at 1, 2.5 and 5 mmol/kg. Poor absorption of SL and rapid absorption of SA and SG were confirmed in an in vivo system, as well as in an in vitro system using everted rat jejunal sacs. Only small amounts of SA and SG were detected in the intestinal tracts of rats 1 h after oral administration, whereas more than 50% of an SL dose was recovered as SL and SG from the intestinal tracts 1 h after treatment and 15.8% of the dose was still present as SG 4 h after administration. When given to germ-free rats, 19.8% of the SL dose was recovered intact, mainly from the cecum, and no SG was detected even at 4 h after treatment. These results indicate that SL is a prodrug which is gradually transported to the lower part of the intestine, hydrolyzed to SG by intestinal bacteria, and converted to SA after absorption. It thus produces an antipyretic action without causing gastric injury."
0042369,"Wang ML, Du J, Zhang PC, Chen RY, Xie FZ, Zhao B, Yu DQ","Saccopetrins A and B, two novel gamma-Lactones from Saccopetalum prolificum",Planta Med 2002 Aug;68(8):719-22,Saccopetalum prolificum,"PLANT EXTRACTS, LACTONES, TUMOR CELLS CULTURED, ANTINEOPLASTIC AGENTS PHYTOGENIC","PLANTS MEDICINAL, DRUG ISOLATION, SPECTRUM ANALYSIS, MOLECULAR STRUCTURE, DRUG EFFECTS",,,,0032-0943,AB,"Two new gamma-lactones, saccopetrin A (1) and saccopetrin B (2), together with 10 known compounds have been isolated from the roots of Saccopetalum prolificum. Their structures were established by spectroscopic and chemical methods. The absolute configuration of 1 was determined by chemical transformation and the Mosher method. Cytotoxic activities were evaluated against several different cell lines. Compound 2 exhibited stronger cytotoxic activities than 1 against KB and HCT-8 cell lines at a concentration of 10 (-5) mol/L."
0042370,"Ye Q, Zhao W","New alloaromadendrane, cadinene and cyclocopacamphane type sesquiterpene derivatives and bibenzyls from Dendrobium nobile",Planta Med 2002 Aug;68(8):723-9,Dendrobium nobile,"SESQUITERPENES, PLANT EXTRACTS, GLYCOSIDES","PLANTS MEDICINAL, SPECTRUM ANALYSIS, MOLECULAR STRUCTURE",,,,0032-0943,AB,"Five new sesquiterpene glycosides with alloaromadendrane, cadinene and cyclocopacamphane type aglycones, one new cyclocopacamphane type sesquiterpene, two new bibenzyls and eight known compounds have been obtained from stems of Dendrobium nobile Lindl. Their structures were determined on the basis of 1D, 2D NMR and HR-MS analyses and chemical methods."
0042371,"Su BN, Chang LC, Park EJ, Cuendet M, Santarsiero BD, Mesecar AD, Mehta RG, Fong HH, Pezzuto JM, Kinghorn AD",Bioactive constituents of the seeds of Brucea javanica,Planta Med 2002 Aug;68(8):730-3,Brucea javanica,"PLANT EXTRACTS, DRUGS CHINESE HERBAL, BREAST NEOPLASMS, TUMOR CELLS CULTURED, LEUKEMIA","PLANTS MEDICINAL, SPECTRUM ANALYSIS, MOLECULAR STRUCTURE, MICE, DRUG EFFECTS, PHARMACOLOGY",,,,0032-0943,AB,"A new quassinoid, yadanziolide S (1), was isolated from the seeds of the traditional Chinese medicinal herb, Brucea javanica, along with ten known compounds, flazin, bruceine D, yadanziolide B, bruceoside A, yadanziolide S, yadanzigan, glycerol 1,3-bisoleate, azelaic acid, (+/-)-8-hydroxyhexadecanoic acid, and vanillin. Compound 1 is the first quassinoid to have been isolated from B. javanica without a methyleneoxy bridge between C-8 and C-13, and its structure was determined using spectroscopic methods, and confirmed by single-crystal X-ray diffraction. All isolates were evaluated for their potential to induce human promyelocytic leukemia (HL-60) cell differentiation, and to inhibit cyclooxygenase-1 (COX-1), -2 (COX-2), and 7,12-dimethylbenz(a)anthracene (DMBA)-induced lesions in a mouse mammary organ culture model."
0042372,"Bailey NJ, Sampson J, Hylands PJ, Nicholson JK, Holmes E",Multi-component metabolic classification of commercial feverfew preparations via high-field 1H-NMR spectroscopy and chemometrics,Planta Med 2002 Aug;68(8):734-8,,"TANACETUM PARTHENIUM, HERBAL DRUGS","NUCLEAR MAGNETIC RESONANCE, QUALITY CONTROL, STANDARDS, CLASSIFICATION",,,,0032-0943,AB,"There is increasing interest in evaluating the clinical efficacy of herbal medicines. However, there are significant analytical problems associated with quality control and the measurement of the overall composition of such complex, multi-component mixtures as normally required in the pharmaceutical industry. Here we describe a novel NMR spectroscopic and pattern recognition analytical approach to investigate composition and variability of a commonly used herbal medicine. 600 MHz (1)H-NMR spectroscopy and principal components analysis (PCA) was used to discriminate between batches of 14 commercially available feverfew samples based on multi-component metabolite profiles. Two of the batches were significantly different from the other twelve. The twelve remaining classes could be classified into discrete groups by PCA on the basis of minor differences in overall chemical composition. NMR based pattern recognition (PR) analysis of extracts proved to be superior to PR analysis of HPLC traces of the same mixtures. This work indicates the potential value of NMR combined with PCA for the characterisation of complex natural product mixtures, and the discrimination of samples containing allegedly identical ingredients."
0042373,"Castelli MV, Cortes JC, Escalante AM, Bah M, Pereda-Miranda R, Ribas JC, Zacchino SA","In vitro inhibition of 1,3-beta-glucan synthase by glycolipids from Convolvulaceous species",Planta Med 2002 Aug;68(8):739-42,Convolvulaceae,"PLANT EXTRACTS, ENZYME INHIBITORS, LACTONES, ANTIFUNGAL AGENTS, CELL MEMBRANE","PLANTS, PHARMACOLOGY, DRUG EFFECTS",(Letter),,,0032-0943,AB,"Sixteen convolvulaceous glycolipids selected from the tricolorin (1-7) and orizabin (8-16) series, proved to be strong in vitro inhibitors of the enzyme that catalyzes the synthesis of 1,3-beta-D-glucan, a major polymer of fungal cell-walls. Results provide an insight into function of the specific structures of these complex macrocyclic lactones as inhibitors of the 1,3-beta-D-glucan synthase and open the possibility of using these compounds as starting points for the development of antifungal agents that act by inhibiting fungal cell-wall synthesis."
0042374,"Minami T, Iwamoto M, Ohtsu H, Ohishi H, Tanaka R, Yoshitake A",Aromatase inhibitory activities of standishinal and the diterpenoids from the bark of Thuja standishii,Planta Med 2002 Aug;68(8):742-5,Thuja standishii,"PLANT EXTRACTS, ENZYME INHIBITORS, DITERPENES","PLANTS MEDICINAL, MOLECULAR STRUCTURE, CHEMISTRY ANALYTICAL, PHARMACOLOGY",(Letter),,,0032-0943,AB,"The absolute stereostructure of a novel skeletal diterpene, standishinal (1), from the bark of Thuja standishii was confirmed by X-ray crystallographic analyses of 1 and its p-bromobenzoate derivative. Aromatase inhibitory activities of standishinal, eight known diterpenes, totarol,12-methoxyabieta-8,11,13-trien-11-ol,12-hydroxy-6,7-seco-abieta-8,11,13-triene-6,7-dial, trans-communic acid, labda-8(17),13-dien-12R,15-olid-19-oicacid,12S-hydroxylabda-8(17),13(16),14-trien-19-oic acid, 13-oxo-15,16-dinorlabda-8(17),11 E-dien-19-oic acid and 14-oxo-15-norlabda-8(17),12 E-dien-19-oic acid from the plant, and four synthetic analogs were evaluated using a recombinant human aromatase. Among them, standishinal and its diacetate derivative had significant inhibitory activities."
0042375,"Lee J, Min B, Lee S, Na M, Kwon B, Lee C, Kim Y, Bae K",Cytotoxic sesquiterpene lactones from Carpesium abrotanoides,Planta Med 2002 Aug;68(8):745-7,Carpesium abrotanoides,"SESQUITERPENES, LACTONES, PLANT EXTRACTS, TUMOR CELLS CULTURED","PLANTS MEDICINAL, DRUG ISOLATION, PHARMACOLOGY, DRUG EFFECTS",(Letter),,,0032-0943,AB,"Eight sesquiterpene lactones, 4alpha,5 alpha-epoxy-10alpha,14-dihydro-inuviscolide (1), 2,3-dihydroaromomaticin (2), carpesiolin (3), carabrone (4), carabrol (5), telekin (6), ivalin (7) and 11,13-didehydroivaxillin (8), were isolated from the aerial parts of Carpesium abrotanoides Linne (Compositae). In vitro cytotoxicity testing was carried out against L1210, A549, SK-OV-3, SK-MEL-2, XF-498 and HCT-15 tumor cell lines. Sesquiterpene lactone compounds 1-8 showed significant cytotoxic activity (ED 50 values, less than 20 mgr M) against all tumor call lines tested. Among these compounds, 4alpha,5 alpha-epoxy-10alpha,14-dihydro-inuviscolide (1), 2,3-dihydroaromomaticin (2), telekin (6) and ivalin (7) showed cytotoxic activity (ED 50, less than 10 microM) comparable to that of cisplatin."
0042376,"Oh H, Kim JS, Song EK, Cho H, Kim DH, Park SE, Lee HS, Kim YC",Sesquiterpenes with hepatoprotective activity from Cnidium monnieri on tacrine-induced cytotoxicity in Hep G2 cells,Planta Med 2002 Aug;68(8):748-9,Cnidium monnieri,"SESQUITERPENES, LIVER DIS, TUMOR CELLS CULTURED","PREVENTION, PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, MOLECULAR STRUCTURE, DRUG ISOLATION",(Letter),,,0032-0943,AB,"Bioassay-guided fractionation of the EtOH extract of Cnidium monnieri (Apiaceae) furnished two hepatoprotective sesquiterpenes, torilin (1) and torilolone (2), together with a new derivative, 1-hydroxytorilin (3). Compounds 1 and 2 showed hepatoprotective effects on tacrine-induced cytotoxicity in human liver-derived Hep G2 cells. The EC 50 values of compounds 1 and 2 were 20.6 +/- 1.86 (P less than 0.01) and 3.6 +/- 0.1 (P less than 0.01) microM, respectively. Silybin as a positive control showed an EC 50 value of 69.0 +/- 3.4 microM."
0042377,"Schmidt TJ, Brun R, Willuhn G, Khalid SA",Anti-trypanosomal activity of Helenalin and some structurally related sesquiterpene lactones,Planta Med 2002 Aug;68(8):750-1,Helenalin,"SESQUITERPENES, LACTONES, ANTIPARASITIC AGENTS, PLANT EXTRACTS","PLANTS MEDICINAL, PHARMACOLOGY, MOLECULAR STRUCTURE",(Letter),,,0032-0943,AB,"The anti-trypanosomal activity of six sesquiterpene lactones (helenalin, mexicanin I, 11alpha,13-dihydrohelenalin acetate, chamissonolide, ivalin and isoalantolactone) against the African Trypanosoma brucei rhodesiense and American T. cruzi was investigated. All tested compounds were found active towards both parasites, the former being generally more sensitive. Helenalin was the most active compound in the series with IC 50 values of 0.051 and 0.695 microM against T. brucei rhodesiense and T. cruzi, respectively. The low IC 50 value for T. b. rhodesiense indicates that helenalin type compounds may be interesting candidates for further evaluation."
0042378,"Lin X, Guolin W, Jun-Tian Z",Intracellular calcium involved in the long-term potentiation induced by securinine in dentate gyrus of anesthetized rats,Planta Med 2002 Aug;68(8):752-3,"securinine, Securinega suffruticosa, nimodipine","CALCIUM, PLANT EXTRACTS, BRAIN, MEMORY","RATS, ALKALOIDS, PLANTS MEDICINAL, PHYSIOLOGY, DRUG EFFECTS, HETEROCYCLIC COMPOUNDS, METABOLISM",(Letter),,,0032-0943,AB,"The effect of nimodipine on securinine-induced long-term potentiation in rat hippocampus was studied. The rise of intracellular calcium during the induction of long-term potentiation was measured using Fura-2/AM - a Ca (2+) fluorescent chelator. Results showed that intracerebroventricular injection of nimodipine (4 nmol) blocked the induction of long-term potentiation elicited by securinine (0.4 pmol) and high-frequency stimulation (p less than 0.05), but 2-amino-5-phosphonovaleric acid (5 nmol) had no inhibitory effect on securinine-induced long-term potentiation. In addition, securinine-induced intracellular calcium increment was inhibited by nimodipine (10 (-6) mol. L (-1), p less than 0.01), but not by 2-amino-5-phosphonovaleric acid (10 (-6) mol. L (-1), p greater than 0.05)."
0042379,"Hsieh MT, Tsai FH, Lin YC, Wang WH, Wu CR",Effects of ferulic acid on the impairment of inhibitory avoidance performance in rats,Planta Med 2002 Aug;68(8):754-6,"ferulic acid, piracetam, tacrine","BEHAVIOR ANIMAL, MEMORY, MOTOR ACTIVITY","DRUG EFFECTS, COUMARINS, CEREBROVASCULAR CIRCULATION, RATS, COMPARATIVE STUDY, AMIDES, CARBOXYLIC ACIDS, HETEROCYCLIC COMPOUNDS",(Letter),,,0032-0943,AB,"Ferulic acid (50 and 100 mg/kg) reversed the step-through latency shortened by scopolamine and cycloheximide but not by p-chloroamphetamine in an inhibitory avoidance performance. Piracetam and tacrine might reverse the step-through latency shortened by the above drugs. However, ferulic acid, piracetam or tacrine alone at any used dose did not influence motor activity produced by non-shock rats. Furthermore, the cerebral blood flow of rats treated with ferulic acid, piracetam or tacrine was enhanced. From these results, we suggest that the potency of ferulic acid was better than that of piracetam, but its action mechanism was somewhat different from that of piracetam and tacrine. Thus, the attenuating effects of ferulic acid on the avoidance performance impairment were related to memory processes, and might be enhancing the cholinergic activities and cerebral blood circle."
0042380,"Mukherjee S, Ghosh B, Jha TB, Jha S",Variation in content of taxol and related taxanes in eastern Himalayan populations of Taxus wallichiana,Planta Med 2002 Aug;68(8):757-9,"Taxus wallichiana, paclitaxel","PLANTS MEDICINAL, PLANT EXTRACTS","TAXUS, ENVIRONMENT, ALKALOIDS",(Letter),,,0032-0943,AB,"Extraction and analysis of paclitaxel and other taxanes in bark, needle leaves and stem segments of male and female plants of Taxus wallichiana, representing several populations, indicate that significant variation in taxane content exists within the population. Bark accumulated maximum amount of paclitaxel in almost all plants. Populations located at higher altitude tended to accumulate more paclitaxel than lower altitude plants. Seasons in which samples were collected and plant age have also been shown to affect paclitaxel accumulation. No effects of plant sex on paclitaxel content of the plants analyzed were observed. Significant differences in baccatin-III and 10-deacetylbaccatin III content were found to exist in the trees analyzed in this study."
0042381,"Bondarev N, Reshetnyak O, Nosov A",Features of development of Stevia rebaudiana shoots cultivated in the roller bioreactor and their production of steviol glycosides,Planta Med 2002 Aug;68(8):759-62,,"GLYCOSIDES, CELL DIFFERENTIATION, GROWTH, STEVIA","PLANTS, PHYSIOLOGY",(Letter),,,0032-0943,AB,"Growth and development of Stevia rebaudiana shoots cultivated in the roller bioreactor and their production of steviol glycosides (SGs) were investigated. It was found that, owing to the highly favorable conditions of shoot cultivation created in such an apparatus, the intensity of shoot growth and SG production appeared to be 1.5-2.0 times higher than those of the shoots grown in tubes. These results indicate the existence of a positive correlation between these two processes. The data obtained suggest that the enhanced SG production is due to the differentiation of chlorenchyma cells and formation of specific subcellular structures for the glycoside to be accumulated."
0042382,"Juliani HR, Biurrun F, Koroch AR, Oliva MM, Demo MS, Trippi VS, Zygadlo JA",Chemical constituents and antimicrobial activity of the essential oil of Lantana xenica,Planta Med 2002 Aug;68(8):762-4,Lantana xenica,"OILS VOLATILE, ANTIINFECTIVE AGENTS, PLANT EXTRACTS, BACTERIA","PLANTS MEDICINAL, SPECTRUM ANALYSIS, DRUG EFFECTS",(Letter),,,0032-0943,AB,"The aim of this work was to evaluate the chemical composition of Lantana xenica essential oil and its antimicrobial activity. The oil from the aerial parts of Lantana xenica Mold. (Verbenacea) was obtained by steam distillation and analyzed by gas chromatography/mass spectrometry. The major constituent of the oil was (E)-caryophyllene (35.2 %), with minor amounts of gamma-cadinene (13.3%), alpha-pinene (9.3%), ocimene (9.2%) and germacrene D (6.6%). The antimicrobial assays showed that the essential oil of L. xenica inhibited the growth of Bacillus cereus and Proteus mirabilis and both bacteria were inhibited by (E)-caryophyllene, the major component of the oil. Enterococcus faecalis, Staphylococcus epidermidis and S. aureus showed a lower inhibition. The bacteria Micrococcus luteus, Klebsiella sp., Escherichia coli and the yeast Candida albicans were insensitive to both the oil and (E)-caryophyllene."
0042383,"Monacelli B, Pasqua G, Botta B, Vinciguerra V, Gacs-Baitz E, Monache GD",Abietane diterpenoids from callus cultures of Taxus baccata,Planta Med 2002 Aug;68(8):764-6,Taxus baccata,"DITERPENES, PLANTS MEDICINAL, PLANT EXTRACTS","TAXUS, DRUG ISOLATION, MOLECULAR STRUCTURE, SPECTRUM ANALYSIS",(Letter),,,0032-0943,AB,"A new compound was isolated from calli of Taxus baccata L. and assigned the structure 3beta,11-dihydroxy-12-methoxyabieta-8,11,13-triene-7-one. Two other metabolites were identified as 3-oxocryptojaponol and taxamairein C, both previously isolated from Taxus mairei."
0042384,Moskowitz MA,Advances in understanding chronic pain: mechanisms of pain modulation and relationship to treatment,Neurology 2002 Sep 10;59(5)Supp 2:S1,,PAIN INTRACTABLE,"PUBLICATIONS, TREATMENT OUTCOME",,,,0028-3878,,
0042385,"Bolay H, Moskowitz MA",Mechanisms of pain modulation in chronic syndromes,Neurology 2002 Sep 10;59(5)Supp 2:S2-7,,"PAIN, CENTRAL NERVOUS SYSTEM, CHRONIC DIS","PERIPHERAL NERVES, SENSORY THRESHOLDS",,,,0028-3878,AB,"Transmission of pain from the periphery to the cortex depends on integration and signal processing within the spinal cord, brainstem, and forebrain. Sensitization, a component of persistent or chronic pain, may develop either through peripheral mechanisms or as a consequence of altered physiology in the spinal cord or forebrain. Several molecular and biophysical mechanisms contribute to the phenomenon of sensitization and persistent pain, including upregulation of sensory neuron-specific sodium channels and vanilloid receptors, phenotypic switching of large myelinated axons, sprouting within the dorsal horn, and loss of inhibitory neurons due to apoptotic cell death. Recently, forebrain structures have been implicated in the pathophysiology of persistent pain. Although a number of treatment options are used, unfortunately pharmacotherapy for neuropathic pain is often ineffective. Unraveling the mysteries of chronic pain may lead to better treatment options, such as drugs that act specifically on sensory neuron-specific sodium channels or as NR2B-subunit-selective N-methyl-D-aspartate receptor antagonists."
0042386,Backonja MM,Use of anticonvulsants for treatment of neuropathic pain,Neurology 2002 Sep 10;59(5)Supp 2:S14-7,,"ANTICONVULSANTS, PAIN, PERIPHERAL NERVOUS SYSTEM DIS","CENTRAL NERVOUS SYSTEM, TREATMENT OUTCOME",,,,0028-3878,AB,"Emerging evidence from animal models of neuropathic pain suggests that many pathophysiologic and biochemical changes occur in the peripheral and central nervous system. Similarities between the pathophysiologic phenomena observed in some epilepsy models and in neuropathic pain models justify the use of anticonvulsants in the symptomatic management of neuropathic pain. Positive results from laboratory and clinical trials further support such use. Carbamazepine was the first of this class of drugs to be studied in clinical trials and has been longest in use for treatment of neuropathic pain. Clinical trial data support its use in treating trigeminal neuralgia, but data for treatment of painful diabetic neuropathy are less convincing. Use of newer anticonvulsants has marked a new era in the treatment of neuropathic pain. Gabapentin has demonstrated efficacy, specifically in painful diabetic neuropathy and postherpetic neuralgia. Lamotrigine has been reported to be effective in relieving pain from trigeminal neuralgia refractory to other treatments, HIV neuropathy, and central post-stroke pain. Results from clinical trials of phenytoin are equivocal. Zonisamide's mechanisms of action suggest that it would be effective in controlling neuropathic pain symptoms. Other anticonvulsants, including lorazepam, valproate, topiramate, and tiagabine, have also been under investigation. Anecdotal experience provides support for studies with oxcarbazepine and levetiracetam for treating neuropathic pain. Evidence supporting the efficacy of anticonvulsants in treatment of such pain is evolving. Additional clinical trials should provide information that will better define their role in neuropathic pain."
0042387,Wallace MS,Treatment options for refractory pain: the role of intrathecal therapy,Neurology 2002 Sep 10;59(5)Supp 2:S18-24,,"PAIN INTRACTABLE, INJECTIONS, SPINE","DRUG THERAPY, TREATMENT OUTCOME",,,,0028-3878,AB,"Intraspinal drug delivery represents an important treatment option for the management of chronic pain. Selection of candidates for this type of therapy requires careful evaluation of the patient, possibly including psychological screening. Although determining the efficacy of long-term intraspinal drug therapy has been challenging, several classes of agents have been identified to provide benefits in patients with a variety of pain types. Such agents include opioids, alpha(2)-agonists, sodium channel antagonists, and gamma-aminobutyric acid agonists. In addition, combinations of agents with distinct mechanisms of action may be therapeutically advantageous because many clinical pain states result from more than one mechanism."
0042388,"Bussing R, Zima BT, Gary FA, Garvan CW",Use of complementary and alternative medicine for symptoms of attention-deficit hyperactivity disorder,Psychiatr Serv 2002 Sep;53(9):1096-102,,"ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY, EPIDEMIOLOGY","COMPLEMENTARY THERAPIES, INTERNET, CHILD",,,,1075-2730,AB,"OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD) is a common childhood psychiatric condition for which evidence-based treatments have been established. This study describes use of complementary and alternative medicine among children with ADHD or at risk of having ADHD and explores possible predictors of use of such treatments. METHODS: A sample of 1,615 parents of elementary school students in a public school district were interviewed in a telephone screening survey of ADHD symptoms and use of traditional and nontraditional ADHD treatment. A total of 822 parents had a child with a diagnosis of ADHD, had a child in whom ADHD was suspected, or had a child about whose emotions or behavior the parents or school staff had general concerns. RESULTS: Use of complementary and alternative medicine was significantly higher among children who had received a diagnosis of ADHD (12%) or in whom ADHD was suspected (7%) than among those about whom parents or school staff had general concerns (3%). Faith healing had been used for 4 percent of the 822 children. Nontraditional treatments were more likely to have been used among children with a diagnosis or a suspected diagnosis of ADHD and those whose parents used the Internet as a source of information than among other children. CONCLUSIONS: Providers should inquire about nontraditional interventions and educate families about evidence-based approaches when treating children with ADHD."
0042389,"Dixon L, Hoch JS, Clark R, Bebout R, Drake R, McHugo G, Becker D",Cost-effectiveness of two vocational rehabilitation programs for persons with severe mental illness,Psychiatr Serv 2002 Sep;53(9):1118-24,,"MENTAL HEALTH, ECONOMICS, PROGRAM EVALUATION",REHABILITATION VOCATIONAL,,,,1075-2730,AB,"OBJECTIVE: This study sought to determine differences in the cost-effectiveness of two vocational programs: individual placement and support (IPS), in which employment specialists within a mental health center help patients obtain competitive jobs and provide them with ongoing support, and enhanced vocational rehabilitation (EVR), in which stepwise services that involve prevocational experiences are delivered by rehabilitation agencies. METHODS: A total of 150 unemployed inner-city patients with severe mental disorders who expressed an interest in competitive employment were randomly assigned to IPS or EVR programs and were followed for 18 months. Wages from all forms of employment and the number of weeks and hours of competitive employment were tracked monthly. Estimates were made of direct mental health costs and vocational costs. Incremental cost-effectiveness ratios (ICERs) were calculated for competitive employment outcomes and total wages. RESULTS: No statistically significant differences were found in the overall costs of IPS and EVR. Participation in the IPS program was associated with significantly more hours and weeks of competitive employment. However, the average combined earnings-earnings from competitive and noncompetitive employment-were virtually the same both programs. The ICER estimates indicated that participants in the IPS program worked in competitive employment settings for an additional week over the 18-month period at a cost of 283 dollars (13 dollars an hour). CONCLUSIONS: The analyses suggest that IPS participants engaged in competitive employment at a higher cost. When combined earnings were used as the outcome, data from the statistical analyses were insufficient to enable any firm conclusions to be drawn. The findings illustrate the importance of choice of outcomes in evaluations of employment programs."
0042390,"Edwards J, Maude D, Herrmann-Doig T, Wong L, Cocks J, Burnett P, Bennett C, Wade D, McGorry P",Rehab rounds: a service response to prolonged recovery in early psychosis,Psychiatr Serv 2002 Sep;53(9):1067-9,,"PSYCHOTIC DISORDERS, COUNSELING, PROFESSIONAL COMPETENCE","REHABILITATION, EDUCATION",42399,,,1075-2730,AB,"Introduction by the column editor: The period around the onset of the first psychotic episode and the first years after the start of treatment provide pivotal opportunities to affect the course of schizophrenia. Early intervention in schizophrenia is receiving increasing interest, and a number of specialized centers are focusing on treating young people to secure better outcomes and prevent the accrual of disabilities. For example, the Early Psychosis Prevention and Intervention Centre (EPPIC) is a comprehensive treatment service for individuals experiencing their first psychotic episode who live in the western metropolitan region of Melbourne. Readers can learn more at EPPIC's Web site, www.eppic.org.au. About a fifth of persons with recent-onset schizophrenia have persistent psychotic symptoms that translate into disability, suffering, and family burden. Since 1994, a subprogram of EPPIC, the Treatment Resistance Early Assessment Team (TREAT), has been developing a framework for the management of patients experiencing prolonged recovery in early psychosis. Below, Edwards and her colleagues outline the rationale and operation of the consultation service provided by TREAT to the clinicians working at EPPIC."
0042391,"Ramamohan N, Kelly IG",Joint replacement in the rheumatoid shoulder,Curr Orthop 2002 Feb;16(1):1-14,,"ARTHRITIS RHEUMATOID, SHOULDER, ARTHROPLASTY","ROTATOR CUFF, TREATMENT OUTCOME",,,,0268-0890,AB,"Rheumatoid arthritis is a polyarticular disease of unknown aetiology and joints of the shoulder joint complex are frequently involved. Four radiological patterns of the rheumatoid shoulder have been identified with the wet pattern being associated with early rupture of the rotator cuff. Since local tenderness is a poor guide to the site of the problem and imaging only poorly correlates with the clinical presentation, we frequently employ the injection test for locating the site of pain. The indication for arthroplasty in the rheumatoid shoulder is uncontrolled pain localized to the glenohumeral joint, with loss of function. Humeral head replacement and unconstrained Neer II total arthroplasty are the most frequently reported procedures, with long-term studies showing good or excellent results in over 90% of cases. When there is painful glenohumeral incongruity with adequate glenoid bone stock, an intact rotator cuff and sufficient capsular freeing, a total shoulder arthroplasty is performed. Otherwise, only a humeral head replacement is used. Loosening of the cemented humeral component in rheumatoid shoulders is uncommon and even though radiological loosening of the glenoid component is frequently encountered, it is rarely symptomatic. Glenohumeral arthroplasty can achieve excellent pain relief and functional improvement in the management of rheumatoid shoulders even in the presence of inadequate bone stock and rotator cuff deficiency."
0042392,Limb D,Shoulder replacement - current problems,Curr Orthop 2002 Feb;16(1):15-20,,"ARTHROPLASTY, SHOULDER, PROSTHESIS DESIGN","SURGERY OPERATIVE, COMPLICATIONS, TREATMENT OUTCOME",,,,0268-0890,AB,"Shoulder replacement is a successful procedure with results comparable to hip and knee replacement surgery. As surgical technique and implant design evolve, the management of uncomplicated osteoarthritis and rheumatoid disease gives increasingly satisfying results. It has become apparent, however, that the best shoulder replacements are those that most accurately reproduce the normal anatomy and mechanics of the shoulder. Implants are quickly evolving to address the findings of basic science research, sometimes to the detriment of the requirement for long-term results. Arguments have been made to alter the design of both humeral and glenoid components to allow more adaptability for the variable anatomy encountered. For fracture surgery, these changes also attempt to facilitate secure reattachment of the rotator cuff, whilst more radical changes have been tried to substitute the absent rotator cuff in cuff arthropathy."
0042393,"Copeland S, Funk L, Levy O",Surface-replacement arthroplasty of the shoulder,Curr Orthop 2002 Feb;16(1):21-31,,"PROSTHESIS, SHOULDER, SURGERY OPERATIVE","TREATMENT OUTCOME, ARTHROPLASTY",,,,0268-0890,AB,"Over the past 20 years the design of the surface replacement prostheses has evolved, but the basic concept and design of surface replacement, minimal removal of bone and cementless fixation, has remained constant. The indications and surgical technique have been refined during this period. The surface replacement prosthesis has demonstrated results at least equal to those of conventional stemmed prostheses suggesting that the humeral component does not need a stem or cement for fixation. In this paper, we discuss the evolution and development of surface replacement of the shoulder, describe the indications and surgical technique and present the results of the Copeland surface-replacement arthroplasty."
0042394,"Bohnsack M, Wulker N",Shoulder instability,Curr Orthop 2002 Feb;16(1):32-40,,"SHOULDER DISLOCATION, RECONSTRUCTIVE SURGICAL PROCEDURES, HISTORY","DIAGNOSIS, ANATOMY",,,,0268-0890,,
0042395,"Jones LT, Hansen U, Wallace AL",Capsular shrinkage of the shoulder,Curr Orthop 2002 Feb;16(1):41-8,,"HEAT, SHOULDER, COLLAGEN","TREATMENT OUTCOME, ANATOMY",,,,0268-0890,,
0042396,McNally EG,Musculoskeletal ultrasound,Curr Orthop 2002 Feb;16(1):49-56,,"ULTRASONOGRAPHY, MUSCULOSKELETAL DIS, TENDON INJURIES","DIAGNOSIS, DIAGNOSTIC IMAGING",,,,0268-0890,AB,"Ultrasound is one of the most rapidly growing imaging techniques in orthopaedics. Much of this can be attributed to improvements in technology. These developments have included improvements in probe technology, digital imaging and faster and cheaper processing power to post process images. The net effect is greatly improved resolution, particularly for superficial structures. The particular impact for orthopaedic imaging is self-evident. The principal applications of musculoskeletal ultrasound have been the detection of injury to tendons, ligaments and muscle."
0042397,Conybeare M,The early diagnosis of developmental dysplasia of the hip,Curr Orthop 2002 Feb;16(1):57-64,,"HIP DISLOCATION, EPIDEMIOLOGY","DIAGNOSIS, ULTRASONOGRAPHY",,,,0268-0890,AB,"The meaning of the term developmental dysplasia of the hip is discussed and a brief description of the fetal development of the hip is given. The potential methods for making the diagnosis of hip dysplasia are described with an emphasis on diagnostic indicators and upon clinical and ultrasonic methods. The application of these methods in the context of screening whole populations, it is suggested, is currently problematic and further research is required before a solution is found which meets the ideals, which are described, of screening programmes in general."
0042398,"Fopma E, Macnicol MF",Tarsal coalition,Curr Orthop 2002 Feb;16(1):65-73,,"TARSAL BONES, FLATFOOT","EPIDEMIOLOGY, ETIOLOGY",,,,0268-0890,,
0042399,Ahlqvist J,Hydrotherapy has had and has a rationale,Rheumatol 2002 Sep;41(9):1070-1,,"HYDROTHERAPY, SWIMMING",TREATMENT OUTCOME,(Letter),,,1462-0324,,
0042400,Heinrich M,Ginkgo among the best available phytomedicine,Pharm J 2002 Sep 14;269(7215):359,,"PHYTOTHERAPY, GINKGO BILOBA, MEMORY","TREATMENT OUTCOME, AGED",(Letter),,,0031-6873,,
0042401,"Davis JA, Polatajko HJ, Ruud CA",Childrens' occupations in context: the influence of history,J Occup Sci 2002 Aug;9(2):54-64,,"CHILD DEVELOPMENT, HISTORY, ACTIVITIES OF DAILY LIVING","CHILD, CULTURE",,,,1320-0038,AB,"Typically, the concepts occupation and children are not put together; however, children are always busy doing, in other words, occupationally engaged. While it is generally accepted that adult occupations are the result of the interaction between person and environment, it is held that children's developmental levels, in interaction with their immediate environments, determine their occupations. The impact of broad conceptual factors, including social views, trends and situations, on children's occupations are rarely discussed. On the assumption that the historical context affords a natural vehicle for examining the role of the broad environment, and an historical analysis of literary works between 1650 and 1990 was carried out. This paper demonstrates that the social views, trends and situations that shaped different periods history have indeed had an impact on children's occupations, in particular on determining the predominant occupations of children."
0042402,"Ratcliff E, Farnworth L, Lentin P",Journey to wholeness: the experience of engaging in physical occupation for women survivors of childhood abuse,J Occup Sci 2002 Aug;9(2):65-71,,"SEXUAL ABUSE, HOLISTIC NURSING, EMPLOYMENT","FEMALE, OCCUPATIONAL THERAPY, TREATMENT OUTCOME",,,,1320-0038,AB,"This qualitative study was undertaken to add to the conceptual understanding of occupation through exploring the subjective experience of engaging in physical occupation for women survivors of Childhood Sexual Abuse (CSA). In-depth interviews were used to gather rich contextual narrative of two women's long-term experiences of engaging in physical occupation, martial arts and circus performance, as survivors of childhood abuse. The women identified engagement in physical occupation as having supported them to reconnect to their bodies and experience their lives more fully. The findings suggest that further research exploring the role of physical occupation in initiating the experience of embodiment and supporting a holistic mind-body integration of the abuse experience would add to the knowledge base of occupational science and inform clinical practice with survivors of childhood abuse."
0042403,"Nagle S, Cook JV, Polatajko HJ",I'm doing as much as I can: occupational choices of persons with severe and persistent mental illness,J Occup Sci 2002 Aug;9(2):72-81,,"MENTAL HEALTH, EMPLOYMENT, CAREER CHOICE","REHABILITATION VOCATIONAL, OCCUPATIONAL THERAPY",,,,1320-0038,AB,"Competitive employment is important for meeting many needs that contribute to health. For persons with a mental illness, entering or re-entering the workforce is often an unattainable goal. Despite rehabilitation efforts, unemployment rates remain very high. This study used in-depth, long interviews and member checking to explore what persons with a severe and persistent mental illness do in the absence of competitive employment. The study was designed to discover what supported or hindered their evolving occupational life paths. The major findings of this study were that persons with a mental illness make choices constrained by fear of relapse and socio-economic realities, to engage in occupations that will maintain or enhance their social connections, and most importantly, their health."
0042404,"Schisler AM, Polatajko HJ",The individual as mediator of the person-occupation-environment interaction: learning from the experience of refugees,J Occup Sci 2002 Aug;9(2):82-92,refugees,"SELF CONCEPT, ETHNIC GROUPS, EMPLOYMENT","CULTURE, OCCUPATIONAL THERAPY, CANADA",,,,1320-0038,AB,"This ethnographic research explored the changes that occur in daily occupations when an individual's environment is drastically altered. In particular, the experiences of eight adult refugees who relocated from Burundi, central Africa, to Canada were examined. Both informal and formal participant observer methods over a period of 16 months and in-depth interviews were used to explore the experiences of Burundian refugees. The findings indicate that the physical, socio-cultural, political and economic environmental changes that these refugees experienced impacted on all aspects of their daily occupations and on their perceptions of themselves. Although occasionally occupations continued as before, for the most part, they were altered or abandoned and new occupations were added. With few exceptions, the person mediated the occupational change stimulated by the environmental change. This study reinforces the interplay between the person, environment and occupation and points to the role of the person as mediator of that interplay."
0042405,"Persson D, Erlandsson LK",Time to reevaluate the machine society: post-industrial ethics from an occupational perspective,J Occup Sci 2002 Aug;9(2):93-9,,"ETHICS, LIFE STYLE, EMPLOYMENT",OCCUPATIONAL THERAPY,,,,1320-0038,AB,"This paper discusses the ethics underlying the occupational repertoire of the post-industrial citizen, giving attention to lifestyle phenomena such as increased tempo and quantity of occupations; manipulation of time, organisms and environments; decreases in sleep, rest and play etc. In trying to understand human behavior in the 21st century, an ethical perspective is delineated and some starting points for a discussion of ethics from everyday occupational perspective are investigated. Using examples from contemporary Western society, human occupational behavior is described as imprinted by machine-ethical values. It is argued that since behavior arising from such values has been little formulated or observed, it constitutes a substantial risk factor for ill health and stress. An alternative eco-ethical perspective of occupation, inspired by Skolimowski, the Polish professor of eco-philosophy, is proposed. The concept of \"ecopation\" is introduced as an optimal choice, denoting occupations that are performed with concern for the ecological context, at a pace that gives room for reflection and experience of meaning. The question raised in this paper may be important for occupational scientists to more fully understand the implicit guidelines of contemporary and future occupation and for occupational therapists taking an active part in future healthcare."
0042406,"Konishi Y, Fukubayashi T, Takeshita D",Possible mechanism of quadriceps femoris weakness in patients with ruptured anterior cruciate ligament,Med Sci Sports Exerc 2002 Sep;34(9):1414-8,,"ANTERIOR CRUCIATE LIGAMENT, RUPTURE, MUSCLE CONTRACTION","ELECTROMYOGRAPHY, KNEE JOINT",,,,0195-9131,AB,"PURPOSE: The purpose of this study was to test the hypothesis that loss of afferent feedback due to rupture of anterior cruciate ligament (ACL) is the cause of quadriceps femoris (QF) weakness through gamma loop. Two experiments were designed to prove our hypothesis. METHODS: In experiment 1, the maximal voluntary contraction (MVC) of knee extension and integrated electromyogram (I-EMG) of vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) were measured in 13 patients with ruptured ACL and 7 healthy volunteers before and after injection of anesthetic agent into the knee. In experiment 2, MVC of knee extension and I-EMG of the VM, VL, and RF were measured in 13 patients with ruptured ACL, 7 knee-anesthetized healthy subjects, and 12 normal subjects, before and after 20-min vibration stimulation applied to the infrapatellar tendon. RESULTS: The results of experiment 1 revealed that injection of anesthetic agent into the knee capsule resulted in significant decrease of MVC and I-EMGs. In experiment 2, the mean percentage change of MVC in the control group was significantly lower than that in the other two groups. There was no significant difference between knee-anesthetized group and patients with ruptured ACL. The mean percentage change of I-EMG showed a pattern similar to that of MVC. CONCLUSION: Our results suggest that loss of feedback from mechanoreceptors in ACL is the underlying mechanism of weakness of QF in patients with ACL lesion. This conclusion is based on chronic suppression of recruitment of high-threshold motor units during voluntary contraction because ACL lesion leads to chronic reduction in Ia-feedback to muscles around the knee due to a lack of feedback from ACL to gamma motor neurons."
0042407,"Schneider SM, Watenpaugh DE, Lee SM, Ertl AC, Williams WJ, Ballard RE, Hargens AR",Lower-body negative-pressure exercise and bed-rest-mediated orthostatic intolerance,Med Sci Sports Exerc 2002 Sep;34(9):1446-53,weightlessness,"EXERCISE, BED REST, BLOOD PRESSURE",GRAVITATION,,,,0195-9131,AB,"PURPOSE: Supine, moderate exercise is ineffective in maintaining orthostatic tolerance after bed rest (BR). Our purpose was to test the hypothesis that adding an orthostatic stress during exercise would maintain orthostatic function after BR. METHODS: Seven healthy men completed duplicate 15-d 6 degrees head-down tilt BR using a crossover design. During one BR, subjects did not exercise (CON). During another BR, subjects exercised for 40 min.d(-1) on a supine treadmill against 50-60 mm Hg LBNP (EX). Exercise training consisted of an interval exercise protocol of 2- to 3-min intervals alternating between 41 and 65% (.)VO(2max). Before and after BR, an LBNP tolerance test was performed in which the LBNP chamber was decompressed in 10-mm Hg stages every 3 min until presyncope. RESULTS: LBNP tolerance, as assessed by the cumulative stress index (CSI) decreased after BR in both the CON (830 +/- 144, pre-BR vs 524 +/- 56 mm Hg.min, post-BR) and the EX (949 +/- 118 pre-BR vs 560 +/- 44 mm Hg.min, post-BR) conditions. However, subtolerance (0 to -50 mm Hg LBNP) heart rates were lower and systolic blood pressures were better maintained after BR in the EX condition compared with CON. CONCLUSION: Moderate exercise performed against LBNP simulating an upright 1-g environment failed to protect orthostatic tolerance after 15 d of BR."
0042408,"Craig CL, Russell SJ, Cameron C",Reliability and validity of Canada's physical activity monitor for assessing trends,Med Sci Sports Exerc 2002 Sep;34(9):1462-7,,"CLINICAL ASSESSMENT SCALES, PHYSICAL FITNESS, HEALTH PROMOTION","CONSISTENCY AND RELIABILITY, CANADA",,,,0195-9131,AB,"PURPOSE: This investigation assessed the reliability and criterion validity of the Physical Activity Monitor, a telephone-interview adaptation of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ), which is currently used to assess trends in the Canadian population. METHODS: A sample of 512 people aged 18 yr and older was selected by random-digit dialing for telephone interviewing in the reliability study. The Monitor questions were administered twice, 3 wk apart. For the criterion validity study, a sample of 148 people aged 18-69 yr was selected at random from households. Participants completed the Monitor questions by telephone and an in-home step test to estimate maximum oxygen uptake. Another random sample of individuals aged 18-69 yr participated in a comparison study of the Monitor against the 1988 Campbell's Survey of Well-Being (CSWB) instrument. All studies were conducted in the vicinity of Toronto, Ontario. Spearman correlations controlling for age and sex were calculated as a measure of association for the reliability, validity, and comparison studies. Validity estimates were further adjusted for body mass index and physical activity demands of work and chores. RESULTS: The Monitor instrument produced reliable estimates of total energy expenditure (P = 0.90, P less than 0.0001) with criterion validity of 0.36 (P less than 0.0001). The association between estimates of total energy expenditure derived from the Monitor and CSWB instruments was 0.77 (P less than 0.0001). CONCLUSION: The Physical Activity Monitor has acceptable test-retest reliability and criterion validity. The research also demonstrated that for the purpose of population monitoring a change in data collection mode-telephone interview versus self-administration in households-can yield reasonably comparable estimates from two adaptations of the MLTPAQ."
0042409,"Auslander LA, Jeste DV",Perceptions of problems and needs for service among middle-aged and elderly outpatients with schizophrenia and related psychotic disorders,Community Ment Health J 2002 Oct;38(5):391-402,,"SCHIZOPHRENIA, PSYCHOTIC DISORDERS, HEALTH SERVICES NEEDS AND DEMAND","QUESTIONNAIRES, AGING, PATIENT SATISFACTION",,,,0010-3853,AB,"We examined the perceived problems and needs for services among 72 middle-aged and elderly outpatients with schizophrenia and related psychotic disorders. The survey questionnaire included 50 Likert scaled items involving everyday functioning skills, health, clinical symptoms, and social skills. Subjects assigned the highest priority to physical health and memory. Other areas of high priority were: social functioning, education about their own mental illness, and improvements in sleep and mood. Reducing frequency of psychiatric hospitalization, and drug or alcohol rehabilitation received low priority. Focused interventions targeting health-related and social issues are needed in older patients with schizophrenia."
0042410,"Davalos DB, Green M, Rial D",Enhancement of executive functioning skills: an additional tier in the treatment of schizophrenia,Community Ment Health J 2002 Oct;38(5):403-12,,"SCHIZOPHRENIA, COGNITION, ACTIVITIES OF DAILY LIVING","REHABILITATION, TREATMENT OUTCOME",,,,0010-3853,AB,"Schizophrenia is viewed by most as having a neuropsychological component, with deficits primarily occurring in the areas of attention/concentration, memory, and executive functioning. These deficits often contribute to difficulties in everyday living and social functioning. The purpose of this study is to examine the efficacy of cognitive rehabilitation methods, typically utilized by brain-injured patients, to improve the executive functioning skills of patients with schizophrenia spectrum disorders. While this pilot study is limited in terms of sample size, results suggest that the addition of cognitive rehabilitation to the comprehensive treatment of schizophrenia could be beneficial in enhancing daily living skills."
0042411,"Damen L, Spoor C, Snijders C, Stam H",Does a pelvic belt influence sacroiliac joint laxity?,Clin Biomech 2002 Aug;17(7):495-8,,"SACROILIAC JOINT, PELVIS, PAIN",BIOMECHANICS,,,,0268-0033,AB,"Objective: To evaluate the influence of different positions and tensions of a pelvic belt on sacroiliac joint laxity in healthy young women. Background: Clinical experience has shown that positive effects can be obtained with different positions and tensions of a pelvic belt. A functional approach to the treatment of the unstable pelvic girdle requires an understanding of the effect of a pelvic belt on a normal pelvic girdle. Methods: Sacroiliac joint laxity was assessed with Doppler imaging of vibrations. The influence of two different positions (low: at the level of the symphysis and high: just below the anterior superior iliac spines) and tensions (50 and 100 N) of a pelvic belt was measured in ten healthy subjects, in the prone position. Data were analysed using repeated measures analysis of variance. Results: Tension does not have a significant influence on the amount by which sacroiliac joint laxity with belt differs from sacroiliac joint laxity without belt. A significant effect was found for the position of the pelvic belt. Mean sacroiliac joint laxity value was 2.2 (SD, 0.2) threshold units nearer to the without-belt values when the belt was applied in low position as compared to the case with the belt in high position. Conclusions: A pelvic belt is most effective in a high position, while a tension of 100 N does not reduce laxity more than 50 N."
0042412,"De Wilde L, Audenaert E, Barbaix E, Audenaert A, Soudan K",Consequences of deltoid muscle elongation on deltoid muscle performance: a computerised study,Clin Biomech 2002 Aug;17(7):499-505,,"SHOULDER, MUSCLES, PROSTHESIS DESIGN","BIOMECHANICS, COMPUTERS",,,,0268-0033,AB,"Background: The deltoid muscle plays an important role in normal shoulder function. Knowledge of the position of the glenohumeral rotational centre and of the deltoid muscle length is essential to understand optimal placement of a total shoulder prosthesis. Objective: This study is designed to analyse the effect of deltoid muscle elongation on shoulder joint function. Design: A three-dimensional model of the glenohumeral joint with deltoid muscle analysis in the scapular plane. Methods: A geometrical three-dimensional ball-and-socket model of the shoulder joint was developed. From dry bones, the position of the origins and insertions of the three parts of the deltoid muscle relative to the calculated centre of rotation of the humeral head was defined. The position and the direction of the muscle force working lines relative to this humeral centre were calculated using former measurements and CT-data of the deltoid. Muscle length-tension data were applied to obtain angle-force relationships. The model was used to calculate the angle-force relationships, the moment arm and the moment of the deltoid muscle components for successive arm elevation angles in the scapular plane. These data were compared to those of a theoretical situation assuming a 10% elongation of the muscle. Results: Muscle angle-force curves show a more favourable slope after moderate (10%) deltoid muscle elongation. Elongating the muscle by changing the distance between the humeral rotation point and the deltoid insertion along the humeral axis does not affect moment arms. The moments of the deltoid muscle forces themselves, however, seem more adapted to elevation in the scapular plane. The deltoid maximal moment exceeds the arm-weight moment by about 40% instead of being approximately equal, and that the maximum is situated around 100 degrees of elevation. (ABSTRACT TRUNCATED)."
0042413,"Moojen T, Snel J, Ritt M, Kauer J, Venema H, Bos K",Three-dimensional carpal kinematics in vivo,Clin Biomech 2002 Aug;17(7):506-14,,"CARPAL BONES, WRIST, SURGERY OPERATIVE","TOMOGRAPHY X RAY COMPUTED, KINEMATICS",,,,0268-0033,AB,"Objective: The purpose of this study was to accurately quantify three-dimensional in vivo kinematics of all carpal bones in flexion and extension and radial and ulnar deviation. Design and methods: The right wrists of 11 healthy volunteers were imaged by spiral CT with rotational increments of 5 degrees during ulnar-radial deviation and of five of them also during flexion-extension motion. One regular-dose scan was used and the subsequent scans during wrist motion were performed with one-tenth of the regular dose. A three-dimensional matching technique using the internal structure of the bones was developed to trace the relative translations and rotations of the carpal bones very accurately. Results: Most of our results are in concordance with previously published in vitro data. We could, among others, substantiate proof to the statement that there is more than one kinematic pattern of the scaphoid. Furthermore, we could accurately describe small adaptive intercarpal motions in vivo of the distal carpal row. Conclusions: To our knowledge, this is the first time the three-dimensional in vivo kinematics of all eight carpal bones is quantified accurately and non-invasively."
0042414,"Freund J, Toivonen R, Takala E",Grip forces of the fingertips,Clin Biomech 2002 Aug;17(7):515-20,,"HAND STRENGTH, FINGERS","BIOMECHANICS, EQUIPMENT DESIGN",,,,0268-0033,AB,"Objective: A model has been developed for the power grip on a cylindrical handle. The model gives estimates of the forces acting on the fingertips as functions of total grip force, diameter of the handle, and hand size. Design: The data in the literature were used to estimate the parameters of the model. An experiment was conducted to verify that the distribution of the forces is independent of the force level. Background: In the authors' opinion, the outcomes of the various experiments described in the literature can be represented in a compact model without too much information loss. Methods: The forces acting on the fingertips of 10 subjects were measured with three different handle diameters and five grip force levels. Results: The force sharing turned out to be independent of the grip force and the diameter of the handle. Conclusions: It is advantageous to shape the handle so that the local diameters at the fingers are proportional to the finger lengths."
0042415,"Miyoshi S, Takahashi T, Ohtani M, Yamamoto H, Kameyama K",Analysis of the shape of the tibial tray in total knee arthroplasty using a three dimension finite element model,Clin Biomech 2002 Aug;17(7):521-5,,"ARTHROPLASTY, KNEE, STRESS MECHANICAL","BIOMECHANICS, IMPLANTS ARTIFICIAL",,,,0268-0033,AB,"Objective and design: The purpose of this study was to evaluate whether the stress and displacement change with differing shapes of the tibial component in total knee arthroplasty. Background: There are few reports on tibial tray mechanics with and without a posterior concave slot, using three-dimensional finite element analysis. Methods: By considering two different shapes for the tibial component, we analyzed the von Mises stresses and displacements at the component/bone interface and surrounding bone using a three-dimensional finite element model. Results: There was no difference between the two designs in regards to the von Mises stress fields or displacements. The displacement of the tibial tray with a posterior concave slot was less than that of the tray without one in some of the loading configurations. The posterior concave slot appears to reduce the micromotion of the tibial component. Discussion and conclusion: Overall, this finite element analysis showed little difference between the two different types of tibial base plates used with both posterior cruciate ligament retention and substitution. The results of this finite element model analysis do not support the use of tibial base plates without a posterior cut-out slot."
0042416,"Eils E, Demming C, Kollmeier G, Thorwesten L, Volker K, Rosenbaum D",Comprehensive testing of 10 different ankle braces. Evaluation of passive and rapidly induced stability in subjects with chronic ankle instability,Clin Biomech 2002 Aug;17(7):526-35,,"BRACING, ANKLE INJURIES, RANGE OF MOTION","PREVENTION, TREATMENT OUTCOME",,,,0268-0033,AB,"Objective: The aim of the present investigation was to test the stability of 10 different ankle braces under passive and rapidly induced loading conditions in a population suffering from chronic ankle instability in order to provide objective information to choose or recommend an appropriate model for specific needs. In addition, the relationship between passive and rapidly induced testing of the stabilizing effect against inversion was evaluated to identify if passive support characteristics of braces are reflected under rapidly induced conditions. Design: An experimental in vivo study with a repeated-measures design was used. Background: Ankle braces are commonly used for treatment, rehabilitation, and prevention of ankle injuries. A variety of products exists but there is few information available to assist clinicians, physiotherapists and coaches as well as consumers in choosing a brace on a basis of objective information. Furthermore, there is a lack of studies that provide data for both passively and rapidly induced movement of the ankle joint when using different ankle braces. Methods: Twenty-four subjects with chronic ankle instability participated in the project. Passive ankle range of motion measurements were performed in a custom-built fixture and simulated inversion sprains were elicited on a tilting platform. Results: The tested braces restrict range of motion significantly compared to the no-brace condition for both the passively and rapidly induced inversion and marked differences between braces were revealed. A close relationship between passive and rapidly induced test results for inversion was found. Conclusions: Passive as well as rapidly induced stability tests provide a basis of objective information to describe the characteristics of different ankle braces. (ABSTRACT TRUNCATED)."
0042417,"McNair P, Hewson D, Dombroski E, Stanley S",Stiffness and passive peak force changes at the ankle joint: the effect of different joint angular velocities,Clin Biomech 2002 Aug;17(7):536-40,,"ANKLE JOINT, EXERCISE",BIOMECHANICS,,,,0268-0033,AB,"Objective: To compare peak force and stiffness at the ankle joint in response to repetitive dorsiflexion at two joint angular velocities (5 and 25 degs(-1)). Design: Pre- post-repeated measures design. Background: Stretching affects the biomechanical properties of tissues. In many instances, stretching is performed in a cyclic manner. An important factor that might influence the effects of stretching is the speed at which the tissues are lengthened. Methods: Eighteen healthy subjects participated. A dynamometer repeatedly moved the ankle joint from 0 deg of dorsiflexion to 80% of maximum dorsiflexion over a 2 min period. Two joint angular velocities were examined: 5 and 25 degs(-1). Force and angle data were recorded simultaneously. Electromyographic activity from plantar and dorsiflexor muscles was monitored. The variables of interest were peak passive force and average stiffness at the first and last repetition of motion. Results: Peak force was significantly higher (P less than 0.05) at 25 degs(-1) for the first repetition. At both joint angular velocities, peak passive force decreased significantly over the 2 min of motion. The decreases were 13% and 21% at 5 and 25 degs(-1) respectively. Peak passive force was not significantly different (P greater than 0.05) across velocities at 2 min. Stiffness was greater at 25 degs(-1) initially (P less than 0.05), however, it decreased significantly across time. The magnitude of the decrease was 20% and 31% at 5 and 25 degs(-1) respectively. After 2 min of motion, there was no significant difference (P greater than 0.05) in stiffness across the joint angular velocities examined. Conclusion(s): The findings showed that while significant differences existed in stiffness and peak force across angular velocities at the start of the stretching motion (ABSTRACT TRUNCATED)."
0042418,"Suter E, McMorland G",Decrease in elbow flexor inhibition after cervical spine manipulation in patients with chronic neck pain,Clin Biomech 2002 Aug;17(7):541-4,,"NECK PAIN, RANGE OF MOTION, PAIN MEASUREMENT","MANIPULATION, CERVICAL VERTEBRAE",,,,0268-0033,AB,"Objectives: This study measured functional capacity and subjective pain in patients with chronic neck pain before and after manipulation of the cervical spine. Design: Outcomes study on 16 patients with chronic neck pain. Background: Muscle inhibition, i.e., the inability to fully activate a muscle, has been observed following joint pathologies and in low back pain conditions. Although chronic neck pain has been associated with changes in muscle recruitment and coordination in the shoulder and arms, the possibility of muscle inhibition has not been explored. Methods: Biceps activation during a maximal voluntary elbow flexor contraction was assessed using the interpolated twitch technique and electromyography. Cervical range of motion and pressure pain thresholds were measured using a goniometer and an algometer. Manipulation of the cervical spine was applied at the level of C5/6/7, and functional assessments were repeated. Results: Patients showed significant inhibition in their biceps muscles. Cervical range of motion was restricted laterally, and increased pressure pain sensitivity was evident. After cervical spine manipulation, a significant reduction in biceps inhibition and an increase in biceps force occurred. Cervical range of motion and pressure pain thresholds increased significantly. Conclusions: Significant dysfunction in biceps activation was evident in patients with chronic neck pain, indicating that this muscle group cannot be used to the full extent. Spinal manipulation decreased muscle inhibition and increased elbow flexor strength at least in the short term."
0042419,"Seng K, Lee Peter V, Lam P",Neck muscle strength across the sagittal and coronal planes: an isometric study,Clin Biomech 2002 Aug;17(7):545-7,,"NECK, MUSCLE STRENGTH, ISOMETRIC CONTRACTION","ELECTROMYOGRAPHY, REPRODUCIBILITY OF RESULTS",,,,0268-0033,AB,"Objective: To determine the maximal isometric strength of neck muscles across different anatomical positions in the body sagittal and coronal planes. Design: A descriptive study involving maximal isometric strength measurements of the cervical musculature in extension, flexion, and left and right lateral bending. Before measurements, the new device was tested for reliability. Background: The literature contains only a few studies on cervical musculature strength assessment. Of these, measurement methods have displayed weak reliability. No studies existed reporting neck strength at various positions in the body coronal plane. Methods: A new device incorporating local population anthropometry was developed for neck strength assessment on an isokinetic dynamometer. The device's repeatability attributes at measuring the strength of functionally different groups of neck muscles were first evaluated. The isometric apparatus was next used to determine the maximal strength of the cervical musculature of 17 healthy volunteers at different anatomical positions across the body sagittal and coronal motion planes. Results: The results showed good intratester repeatability for intraday and day-to-day studies for all measured parameters. Strength values demonstrated that extensor muscles yielded the greatest torque and that flexor muscles provided the least torque. Linear regression analyses showed strong association of isometric strength with anatomical positions in the two body planes. Conclusions: Maximal isometric strength of neck muscles in four directions was quantified. Cervical musculature strength levels vary in discernible patterns with head-neck positions and contraction directions."
0042420,"Hamaoui A, Do M, Poupard L, Bouisset S",Does respiration perturb body balance more in chronic low back pain subjects than in healthy subjects?,Clin Biomech 2002 Aug;17(7):548-50,,"LOW BACK PAIN, BALANCE, RESPIRATION","TREATMENT OUTCOME, REHABILITATION",,,,0268-0033,AB,"Objective: To determine whether body balance is perturbed more in low back pain patients than in healthy subjects, under the concept of posturo-kinetic capacity. Design: Comparison of posturographic and respiratory parameters between low back pain and healthy subjects. Background: It has been demonstrated that respiratory movements constitute a perturbation to posture, compensated by movements of the spine and of the hips, and that low back pain is frequently associated with a loss of back mobility. Method: Ten low back pain patients and ten healthy subjects performed five posturographic tests under three different respiratory rate conditions: quiet breathing (spontaneous), slow breathing (0.1 Hz) and fast breathing (0.5 Hz). Results: Intergroup comparison showed that the mean displacements of the center of pressure were greater for the low back pain group, especially along the antero-posterior axis, where respiratory perturbation is primarily exerted. Inter-condition comparison showed that in slow and fast breathing relatively to quiet breathing, the mean displacement of the center of pressure along the antero-posterior axis was significantly increased only for the low back pain group. Conclusion: According to the results, respiration presented a greater disturbing effect on body balance in low back pain subjects."
0042421,"Neitzel J, Kernozek T, Davies G",Loading response following anterior cruciate ligament reconstruction during the parallel squat exercise,Clin Biomech 2002 Aug;17(7):551-4,,"ANTERIOR CRUCIATE LIGAMENT, EXERCISE, WEIGHT BEARING","RECONSTRUCTIVE SURGICAL PROCEDURES, RANGE OF MOTION",,,,0268-0033,AB,"Objective: To determine if individuals 1.5-15 months post-anterior cruciate ligament reconstruction demonstrated an equal loading response on their involved and uninvolved lower extremity during a parallel squat exercise versus a control group. Design: Four-group repeated measures design with one between-subject factor (time post-anterior cruciate ligament reconstruction) and two within-subject factors (knee angle and added weight). Background: It has been a clinical observation that post-anterior cruciate ligament reconstruction, individuals do not place equal amounts of weight upon each lower extremity during double-leg exercises. Methods: Twenty-four subjects were in each of the experimental groups, 1.5-4 months, 6-7 months, and 12-15 months post-anterior cruciate ligament reconstruction, while 24 subjects without history of lower extremity pathology/injury served as the control group. Pedar(TM) in-shoe sensors were placed inside the subjects' shoes to record loading response patterns during the exercises. All performed 3 sets of 9 randomized squats to each of the three knee flexion angles (30 degrees, 60 degrees, and 90 degrees) with the three different weights (20.45 kg bar only, 35%, and 50% body mass) using a Smith squat rack (TM). A three-way repeated measures ANOVA (P less than 0.050) was used to compare the differences between groups in loading response statically between the uninvolved and involved lower extremity for each of the different weights at each knee flexion angle during the squat exercise. Results: The three-way repeated measures ANOVA revealed that there was a significant group effect (P less than 0.001). Thus, the amount of time post-anterior cruciate ligament reconstruction affected the difference in the subjects' loading response for the uninvolved and involved lower extremities. (ABSTRACT TRUNCATED)."
0042422,"Kerr H, Eng J",Multidirectional measures of seated postural stability,Clin Biomech 2002 Aug;17(7):555-7,,"SEATING, POSTURE, REPRODUCIBILITY OF RESULTS","AGED, TASK PERFORMANCE AND ANALYSIS",,,,0268-0033,AB,"Objective: To quantify the limits of stability during a leaning/reaching task and determine (1) test-retest reliability and (2) effect of movement direction and foot support. Design: Test-retest reliability design. Background: Seated reaching and leaning are used in rehabilitation programs to assess and train sitting balance and motor function. Continuous (as opposed to ordinal), multidirectional measures of seated postural stability have not been previously presented. Methods: Twelve older adults performed a seated reaching/leaning task while net body centre of pressure displacement and velocity were measured with three forceplates (under buttocks and each foot) over two separate days. Conditions of movement direction (forward, backward, lateral) and foot support (with and without) were randomized. Results: Except for the backward movement in the supported foot condition, all measures had moderate to very high reliability. Measurements were sensitive to both foot support and movement direction."
0042423,"Sim J, Adams N",Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia,Clin J Pain 2002 Sep-Oct;18(5):324-36,,"FIBROMYALGIA, EXERCISE THERAPY, BEHAVIOR THERAPY, EDUCATION, ACUPUNCTURE","DATABASES, PUBLICATIONS, THERAPY",,,,0749-8047,AB,"OBJECTIVE: Little is known of the effectiveness of nonpharmacological interventions for fibromyalgia syndrome (FMS). The authors therefore carried out a systematic review from 1980 to May 2000 of randomized controlled trials (RCTs) of nonpharmacological interventions for FMS. METHOD: A search of computerized databases was supplemented by hand searching of bibliographies of key publications. The methodological quality of studies included in the review was evaluated independently by two researchers according to a set of formal criteria. Discrepancies in scoring were resolved through discussion. RESULTS: The review yielded 25 RCTs, and the main categories of interventions tested in the studies were exercise therapy, educational intervention, relaxation therapy, cognitive-behavioral therapy, acupuncture, and forms of hydrotherapy. Methodological quality of studies was fairly low (mean score = 49.5/100). Most studies had small samples (median for individual treatment groups after randomization = 20), and the mean power of the studies to detect a medium effect (greater than or = to 0.5) was 0.36. Sixteen studies had blinded outcome assessment, but patients were blinded in only 6 studies. The median longest follow-up was 16 weeks. Statistically significant between-group differences on at least one outcome variable were reported in 17 of the 24 studies. CONCLUSIONS. The varying combinations of interventions studied in the RCTs and the wide range of outcome measures used make it hard to form conclusions across studies. Strong evidence did not emerge in respect to any single intervention, though preliminary support of moderate strength existed for aerobic exercise. There is a need for larger, more methodologically rigorous RCTs in this area."
0042424,"Garrod R, Paul EA, Wedzicha JA",An evaluation of the reliability and sensitivity of the London Chest Activity of Daily Living Scale (LCADL),Respir Med 2002 Sep;96(9):725-30,,"ACTIVITIES OF DAILY LIVING, CLINICAL ASSESSMENT SCALES, LUNG DISEASES OBSTRUCTIVE","CONSISTENCY AND RELIABILITY, REHABILITATION",,,,0954-6111,AB,"We have previously reported the validity of a new assessment tool; the London Chest Activity of Daily Living Scale (LCADL). This work investigates the reliability and responsiveness of that measure. Reliability was assessed in 19 patients with stable severe chronic obstructive pulmonary disease (COPD); median age (range) 66 (55-79) years, FEV1 mean (SD) 0.91 (0.29) l, by test-retest 4 weeks apart. Responsiveness was assessed in 59 patients; median age (range) 66 (38-84) years, FEV1 mean (SD) 0.87 (0.30) l, who had undergone at least 6 weeks of pulmonary rehabilitation. Test-retest scores of the LCADL showed a strong relationship with one another, Intraclass correlation coefficient Icc=0.93 95%CI (0.82-0.97) demonstrating evidence of good reliability. With the exception of the Domestic component, all domains of the LCADL showed a statistically significant reduction in dyspnoea during ADLs after pulmonary rehabilitation. There was a statistically significant improvement in the total LCADL score (mean difference (95% CI) -5.91 (from -9.23 to -2.60) after rehabilitation. These data support the use of the LCADL as an outcome measure in COPD which is valid, reliable and responsive to change."
0042425,"Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, Schramm P, Juttler E, Oehler J, Hartmann M, Hahnel S, Knauth M, Hacke W, Sartor K",CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke,Stroke 2002 Sep;33(9):2206-10,,"ISCHEMIA, MAGNETIC RESONANCE IMAGING","TOMOGRAPHY X RAY COMPUTED, REPRODUCIBILITY OF RESULTS",,,,0039-2499,AB,"BACKGROUND AND PURPOSE: Diffusion-weighted MRI (DWI) has become a commonly used imaging modality in stroke centers. The value of this method as a routine procedure is still being discussed. In previous studies, CT was always performed before DWI. Therefore, infarct progression could be a reason for the better result in DWI. METHODS: All hyperacute (less than 6 hours) stroke patients admitted to our emergency department with a National Institutes of Health Stroke Scale (NIHSS) score greater than 3 were prospectively randomized for the order in which CT and MRI were performed. Five stroke experts and 4 residents blinded to clinical data judged stroke signs and lesion size on the images. To determine the interrater variability, we calculated kappa values for both rating groups. RESULTS: A total of 50 patients with ischemic stroke and 4 patients with transient symptoms of acute stroke (median NIHSS score, 11; range, 3 to 27) were analyzed. Of the 50 patients, 55% were examined with DWI first. The mean delay from symptom onset until CT was 180 minutes; that from symptom onset until DWI was 189 minutes. The mean delay between DWI and CT was 30 minutes. The sensitivity of infarct detection by the experts was significantly better when based on DWI (CT/DWI, 61/91%). Accuracy was 91% when based on DWI (CT, 61%). Interrater variability of lesion detection was also significantly better for DWI (CT/DWI, kappa = 0.51/0.84). The assessment of lesion extent was less homogeneous on CT (CT/DWI, kappa = 0.38/0.62). The differences between the 2 modalities were stronger in the residents' ratings (CT/DWI: sensitivity, 46/81%; kappa = 0.38/0.76). CONCLUSIONS: CT and DWI performed with the same delay after onset of ischemic stroke resulted in significant differences in diagnostic accuracy. (ABSTRACT TRUNCATED)."
0042426,"Baquet G, Berthoin S, Van Praagh E",Are intensified physical education sessions able to elicit heart rate at a sufficient level to promote aerobic fitness in adolescents?,Res Q Exerc Sport 2002 Sep;73(3):282-8,,"PHYSICAL EDUCATION, HEART RATE, HEALTH PROMOTION","ADOLESCENT, SCHOOLS",,,,0270-1367,AB,"The purpose of this study was to determine the effects of intensified physical education sessions on adolescents ages 11-16years. They were divided into two experimental groups-high-intensity running group (HIRG) and high-intensity jumping group (HlJG) - and a control group (C). During the sessions, heart rate (HR) was monitored. There was no significant difference between mean HR for HIRG and HIJG, while the mean HR was significantly lower for C (p less than .001). For both HIRG and HIJG, the mean HR was significantly higher for girls than for boys (p less than .001). Our results suggested that these intensified physical education lessons require a high percentage of maximal HR in adolescents and can be used to improve aerobic fitness."
0042427,"Evans L, Hardy L",Injury rehabilitation: a goal-setting intervention study,Res Q Exerc Sport 2002 Sep;73(3):310-9,,"GOALS, SELF EFFICACY, INJURIES, MENTAL PROCESSES","ATHLETES, REHABILITATION",,,,0270-1367,AB,"The study examined the effects of a 5-week goal-setting intervention on athletes' rehabilitation adherence, self-efficacy, treatment efficacy, and the psychological response variables: dispirited and reorganization. Participants were matched across six variables and randomly assigned to one of three groups: goal-setting intervention, social support control, and control. The results confirmed some of the hypothesized effects of the goal-setting intervention: (a) athlete self-report of adherence showed the goal-setting group adhered significantly more to the rehabilitation program than the other two groups; (b) the goal-setting intervention resulted in significant group differences for self-efficacy (the goal-setting group having the highest level of self-efficacy); and (c) there was a significant increase across time for reorganization and decrease across time for dispirited (between specific timephases)."
0042428,"Evans L, Hardy L",Injury rehabilitation: a qualitative follow-up study,Res Q Exerc Sport 2002 Sep;73(3):320-9,,"ATHLETIC INJURIES, GOALS, SELF EFFICACY","REHABILITATION, TREATMENT OUTCOME",,,,0270-1367,AB,"The current qualitative follow-up study was conducted to enhance the interpretability and meaningfulness of the findings emerging from a 5-week goal-setting intervention study with injured athletes. Semistructured interviews were conducted with a sample of 9 injured athletes, 3 from each of the three intervention study groups (goal-setting, social support control, and control), and cross-case summaries were inductively derived. The study highlighted the importance of individual difference variables, and the interaction of person and situational variables, including support from coaches and club, inability to train, weight gain, slowness of progress, physiotherapist support, and the importance of long-term outcome goals. Possible mechanisms for the observed effects of the goal-setting intervention included the effects of goal-setting on self-efficacy, attributions, perceptions of control, and attention."
0042429,"Tudor-Locke C, Jones R, Myers AM, Paterson DH, Ecclestone NA",Contribution of structured exercise class participation and informal walking for exercise to daily physical activity in community-dwelling older adults,Res Q Exerc Sport 2002 Sep;73(3):350-6,,"WALKING, EXERCISE, PATIENT PARTICIPATION","AGED, PHYSICAL FITNESS",,,,0270-1367,,
0042430,Pearce D,Consultation with children with autistic spectrum disorders about their experience of short-term residential care,Br J Learn Disabil 2002 Sep;30(3):97-104,,"CHILD DEVELOPMENT DISORDERS, DELIVERY OF HEALTH CARE, RESIDENTIAL FACILITIES","CHILD, PATIENT SATISFACTION",,,,1354-4187,AB,"Consultation with children receiving services from social services departments is required by international and national legislation. Research has been undertaken examining the experience of children with disabilities receiving short-term care. However, none of these studies has focused on autistic spectrum disorders (ASDs). The present paper suggests that this condition's characteristics affect the ability of children with ASDs to participate in consultation. Case studies were undertaken investigating the impact of the characteristics of autism upon researchers' abilities to elicit children's opinions about their experience of short-term residential care. Factors which maximized the children's input and the accuracy of results are identified."
0042431,"Cameron L, Murphy J",Enabling young people with a learning disability to make choices at a time of transition,Br J Learn Disabil 2002 Sep;30(3):105-12,,"LEARNING DISABILITY, COMMUNICATION, SOCIAL ISOLATION","PATIENT PARTICIPATION, COMPUTERS",,,,1354-4187,AB,"Transition times, such as leaving school and moving to and from college or day centre, are highly significant for young people with a learning disability, but it can be particularly difficult to ensure that their voice is heard when making choices. The pilot study described in the present paper examined whether Talking Mats, a light-technology augmentative framework, could be used successfully with young adults with a learning and communication disability. The participants were able to indicate their likes and dislikes, and to express views about the choices available to them. Some expressed opinions not previously known to their carers, and some raised sensitive topics, such as where they wanted to live and who they wished to spend time with. The 'mats' allowed differences of opinion to be explored and were used as a vehicle for further, deeper discussion. Talking Mats has proved to be a powerful tool in allowing young people with a learning disability to communicate their views."
0042432,"MacHale R, Carey S",An investigation of the effects of bereavement on mental health and challenging behaviour in adults with learning disability,Br J Learn Disabil 2002 Sep;30(3):113-7,,"LEARNING DISABILITY, BEREAVEMENT, BEHAVIORAL DISORDERS","ADULT, CAREGIVERS, ADAPTATION PSYCHOLOGICAL",,,,1354-4187,AB,"The purpose of the present study was to investigate the impact of bereavement on people with learning disability. Twenty adults with learning disabilities who had experienced the death of a primary caregiver in the previous 2 years were compared with a matched control group on measures of psychiatric disturbance and challenging behaviour. With regard to psychiatric disturbance, significant differences were found for 'neurotic disorder' and for 'organic condition' among the bereaved group on the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD). No difference was found for 'psychotic disorder' on the PAS-ADD. As regards challenging behaviour, significant differences were found for 'irritability', 'lethargy' and 'hyperactivity' among the bereaved group on the Aberrant Behavior Checklist (ABC). No differences were found for 'stereotypy' or 'inappropriate speech' on the ABC. The clinical implications of these findings are outlined, and recommendations for supporting people with learning disabilities who experience bereavement are presented."
0042433,"Brown JF, Spencer K, Swift S",A parent training programme for chronic food refusal: a case study,Br J Learn Disabil 2002 Sep;30(3):118-21,,"EATING DISORDERS, EDUCATION, LEARNING DISABILITY","PARENTS, CASE REPORT, MOTIVATION",,,,1354-4187,AB,The present paper describes the successful implementation of a training programme for the parents of a child with moderate learning difficulties presenting with chronic food refusal and provides an example of how professionals can work with families to manage clinical problems in the home. The parents were taught to use the Premack principle to motivate their child in the consumption of previously refused foods. A multiple baseline design across three foods demonstrated the efficacy of the programme and the dietary changes were maintained at the 3-month follow-up.
0042434,"Rouse L, Herrington P, Assey J, Baker R, Golden S","Feeding problems, gastrostomy and families: a qualitative pilot study",Br J Learn Disabil 2002 Sep;30(3):122-8,,"LEARNING DISABILITY, EATING DISORDERS, NUTRITION","PARENTS, INTERVIEWS, COMMUNICATION",,,,1354-4187,AB,"Feeding problems are often found in children with severe and profound learning disabilities. It is increasingly common for these children to receive a gastrostomy button so that they can maintain an adequate nutritional intake. The psychological implications of this operation for families and carers have received little attention, with most studies focusing on medical and nutritional outcomes. The present paper describes the qualitative findings of interviews carried out with professionals and parents as part of a pilot study. The themes which emerged included the need for early multidisciplinary support and information for parents, improved communication between professionals, and problems relating to funding. Suggestions for improved service delivery are proposed."
0042435,"Kaye N, Allen D",Over the top? Reducing staff training in physical interventions,Br J Learn Disabil 2002 Sep;30(3):129-32,,"LEARNING DISABILITY, BEHAVIORAL DISORDERS, HEALTH PERSONNEL",EDUCATION,,,,1354-4187,AB,"The use of emergency physical interventions on an acute admission unit for persons with learning disability and challenging behaviour was monitored over a 9-month period. Only a minority of the physical interventions that were taught to staff were actually used in practice. Possible reasons for this discrepancy are discussed, and a number of potential sources of bias in estimating the original training requirements for the service identified. Implications for changing the training programme are described."
0042436,"Whitaker S, Porter J",Valuing people: a new strategy for learning disability for the 21st century,Br J Learn Disabil 2002 Sep;30(3):133,,"LEARNING DISABILITY, HEALTH SERVICES","EPIDEMIOLOGY, ENGLAND",(Letter),,,1354-4187,,
0042437,Noble M,Accessing the Tower: a case study of accessibility in a historic monument,Access Des 2002 Autumn;92:8-12,,"ARCHITECTURAL ACCESSIBILITY, HISTORY",ENGLAND,,,,0959-1591,AB,"The tower of London is a historic monument of international importance. Historic Royal Palaces, which manages the site, has recently embarked on a process of improving accessibility at the Tower. The author coordinates this case study of that process."
0042438,Petherick D,Revision of the Part M Building Regulation,Access Des 2002 Autumn;92:13-9,,"LEGISLATION, ARCHITECTURAL ACCESSIBILITY",ENGLAND,,,,0959-1591,AB,"The draft Approved Document Part M has now been published. The author, Principal Architect in Building Regulations Division at the Office of the Deputy Prime Minister, discusses the background to the document, the reasoning behind the proposed amendments and highlights the main changes that the new draft contains."
0042439,Chisnall V,Accessible hospitals: championing better design in the NHS,Access Des 2002 Autumn;92:20-3,,"DISABILITY, ARCHITECTURAL ACCESSIBILITY, HOSPITALS",ENGLAND,,,,0959-1591,AB,"Many disabled people face difficulties due to poorly designed and ill-equipped hospitals. In this article, the author, who has worked as an occupational therapist in several NHS Trusts, describes some of the access and design issues raised during her three years as Disability Advisor at Aintree Hospital NHS Trust, Liverpool and through her contact with staff in other hospitals."
0042440,Irving J,Judith Irving,Access Des 2002 Autumn;92:25-6,,"DISABILITY, ARCHITECTURAL ACCESSIBILITY, PATIENT SATISFACTION","ENGLAND, AMERICA, COMPARATIVE STUDY",,,,0959-1591,AB,"The author, a trustee of CAE and Access Officer for the City of Salford, discusses her experiences as a disabled student in the USA and her subsequent life in the UK."
0042441,"King V, Williams PJ",The effect of the DDA on existing leases,Access Des 2002 Autumn;92:27-9,,"LEGISLATION, DISABILITY, ARCHITECTURAL ACCESSIBILITY",HOUSING,,,,0959-1591,AB,What effect is the Disability Discrimination Act going to have on relationships between landlords and tenants? The authors offer some thoughts.
0042442,Highman P,Hull healthy living centre,Access Des 2002 Autumn;92:30-1,,"HEALTH SERVICES, QUALITY OF LIFE, ARCHITECTURAL ACCESSIBILITY","AGED, ENGLAND",,,,0959-1591,AB,"The opening of the Hull Healthy Living Centre in January 2002 by Age Concern Hull, has provided the local community with a rich and varied resource, which offers an exciting model of service provision for older people in the 21st century. In this article, the author explores this innovative new venture."
0042443,Hyland ME,Recommendations from quality of life scales are not simple,BMJ 2002 Sep 14;325(7364):599-600,,"QUALITY OF LIFE, CLINICAL ASSESSMENT SCALES",CONSISTENCY AND RELIABILITY,(Letter),,,0959-8138,,
0042444,Master FJ,From the Editor's desk,Homoeopath Heritage 2002 Jan;27(1):3-4,,HOMEOPATHY,,(Editorial),,,0970-6038,,
0042445,"Gupta G, Srivastava AK",In vitro activity of Thuja occidentalis Linn. against human pathogenic apergilli,Homoeopath Heritage 2002 Jan;27(1):5-12,,"ANTIFUNGAL AGENTS, LUNG DIS, MYCOSES, THUJA OCCIDENTALIS","PLANTS MEDICINAL, PLANT EXTRACTS",,,,0970-6038,AB,"In-vitro antifungal potential of homeopathic drug Thuja occidentalis Q, 30, 200, IM, 10M, 50M against Aspergillus flavus causing cutaneous aspergillosis and Aspergillus niger causing otomycosis in Human are evaluated by following food poisoning method. Thuja Q, 30, 200 are found highly potent against Aspergillus flavus and 50M against Aspergillus niger. Percent growth inhibition, sporulation and exudation are taken as parameters for assessment. Results are reported for the first time and are discussed in relation to homeopathic concept \"Higher dilution and high energy\"."
0042446,Gibson DM,Basic principles of homeopathy,Homoeopath Heritage 2002 Jan;27(1):13-7,,HOMEOPATHY,,,,,0970-6038,,
0042447,Anonymous,Eat your food the way God made it,Homoeopath Heritage 2002 Jan;27(1):18-9,,"HOMEOPATHY, DIET THERAPY",,,,,0970-6038,,
0042448,Moussier F,Around the world: a thyroidinum case,Homoeopath Heritage 2002 Jan;27(1):20-1,,HOMEOPATHY,CASE REPORT,,,,0970-6038,,
0042449,Master FJ,Computers in homoeopathy,Homoeopath Heritage 2002 Jan;27(1):22-3,,"HOMEOPATHY, COMPUTERS",,,,,0970-6038,,
0042450,Prabhakaran K,A case of acute septic axillary lymphadenitis,Homoeopath Heritage 2002 Jan;27(1):24-7,,"LYMPHATIC DIS, HOMEOPATHY",CASE REPORT,,,,0970-6038,,
0042451,Prabhakaran K,A case of chronic axillary hydradenitis,Homoeopath Heritage 2002 Jan;27(1):26-7,,"SKIN DIS, HOMEOPATHY",CASE REPORT,,,,0970-6038,,
0042452,Master FJ,An attitude of a homoeopath,Homoeopath Heritage 2002 Feb;27(2):3-6,,HOMEOPATHY,ATTITUDE,,,,0970-6038,,
0042453,Kumar Nath R,Homoeopathy for curing asthma,Homoeopath Heritage 2002 Feb;27(2):7-13,,"ASTHMA, HOMEOPATHY",TREATMENT OUTCOME,,,,0970-6038,,
0042454,Williamson AP,The treatment of sciatica,Homoeopath Heritage 2002 Feb;27(2):14-8,,"SCIATICA, PAIN, HOMEOPATHY",TREATMENT OUTCOME,,,,0970-6038,,
0042455,Anonymous,Diet in diabetes mellitus,Homoeopath Heritage 2002 Feb;27(2):19-22,,"DIABETES MELLITUS, DIET THERAPY, EXERCISE",HOMEOPATHY,,,,0970-6038,,
0042456,Laloy JL,Three clinical cases of juvenile rheumatoid arthritis,Homoeopath Heritage 2002 Feb;27(2):23-6,,"ARTHRITIS JUVENILE RHEUMATOID, HOMEOPATHY",TREATMENT OUTCOME,,,,0970-6038,,
0042457,Master FJ,Synthesis repertory world's most authentic repertory,Homoeopath Heritage 2002 Feb;27(2):27-9,,HOMEOPATHY,REPERTORY,,,,0970-6038,,
0042458,"Pareek RS, Pareek A",Contributions of homoeopathy to modern management of renal failure,Homoeopath Heritage 2002 Feb;27(2):31-41,,"KIDNEY FAILURE CHRONIC, HOMEOPATHY",DISEASE MANAGEMENT,,,,0970-6038,,
0042459,Master FJ,How reliable is doctrine of signature?,Homoeopath Heritage 2002 Mar;27(3):3-7,,"PROVING, MATERIA MEDICA",HOMEOPATHY,,,,0970-6038,,
0042460,Shore J,Birds,Homoeopath Heritage 2002 Mar;27(3):8-14,,"BIRDS, HOMEOPATHY",,,,,0970-6038,,
0042461,Banerjee SN,Etiology of constipation and its management from homoeopathic point of view,Homoeopath Heritage 2002 Mar;27(3):16-20,,"HOMEOPATHY, CONSTIPATION, DISEASE MANAGEMENT",ETIOLOGY,,,,0970-6038,,
0042462,Anonymous,Diet and regimen: grapes,Homoeopath Heritage 2002 Mar;27(3):21-4,Grapes,DIET THERAPY,"PLANTS, HOMEOPATHY",,,,0970-6038,,
0042463,"Simon L, Scheietzel T, Artner CG, Kummel HC, Schulte M",Anthroposophical treatment of rheumatic conditions,Homoeopath Heritage 2002 Mar;27(3):25-7,,"RHEUMATIC DIS, ANTHROPOSOPHICAL MEDICINE","TREATMENT OUTCOME, HOMEOPATHY",,,,0970-6038,,
0042464,Islam HH,Accuracy and efficiency,Homoeopath Heritage 2002 Mar;27(3):29-31,,"HOMEOPATHY, COMPUTER SYSTEMS",SOFTWARE,,,,0970-6038,,
0042465,Anonymous,Digitalis patients in verse,Homoeopath Heritage 2002 Mar;27(3):32,Digitalis,"POETRY, HOMEOPATHY","PLANTS, PLANT EXTRACTS, SYMPTOMS",,,,0970-6038,,
0042466,Bilimoria PA,Case of gallstones,Homoeopath Heritage 2002 Mar;27(3):33-7,,"CHOLELITHIASIS, HOMEOPATHY","CASE REPORT, DRUG THERAPY",,,,0970-6038,,
0042467,Master FJ,From the Editor's desk,Homoeopath Heritage 2002 Apr;27(4):3,Hahnemann S,HOMEOPATHY,FAMOUS PERSONS,(Editorial),,,0970-6038,,
0042468,Dua S,Spleen: is it the source of vital force?,Homoeopath Heritage 2002 Apr;27(4):4-8,,"HOMEOPATHY, SPLEEN",SIMILIMUM,,,,0970-6038,,
0042469,Kumar AS,Mental hygiene,Homoeopath Heritage 2002 Apr;27(4):9-14,,"HOMEOPATHY, MENTAL HEALTH",HEALTH PROMOTION,,,,0970-6038,,
0042470,Morrell P,Some notes about Hahnemann's horoscope,Homoeopath Heritage 2002 Apr;27(4):15-9,Hahnemann S,HOMEOPATHY,FAMOUS PERSONS,,,,0970-6038,,
0042471,Anonymous,Diet and diabetes,Homoeopath Heritage 2002 Apr;27(4):20-2,,"DIABETES MELLITUS, DIET THERAPY",HOMEOPATHY,,,,0970-6038,,
0042472,Ernst E,ITMA: it's that man again!,Homoeopath Heritage 2002 Apr;27(4):23-7,Ernst E,HOMEOPATHY,"RESEARCH, GREAT BRITAIN",,,,0970-6038,,
0042473,Das E,Precise result oriented case analysis techniques,Homoeopath Heritage 2002 Apr;27(4):28-31,,"HOMEOPATHY, COMPUTER SYSTEMS",SOFTWARE,,,,0970-6038,,
0042474,Dhingreja J,a case of post herpetic neuralgia with osteoarthritis,Homoeopath Heritage 2002 Apr;27(4):32-5,,"NEURALGIA, OSTEOARTHRITIS, HERPES ZOSTER, HOMEOPATHY","CASE REPORT, DRUG THERAPY",,,,0970-6038,,
0042475,Master FJ,Clinical observations on childhood pneumonia,Homoeopath Heritage 2002 May;27(5):3-7,,"PNEUMONIA, HOMEOPATHY","DRUG THERAPY, CHILD, SYMPTOMS",,,,0970-6038,,
0042476,"Gupta G, Gupta N, Singh V",Efficacy of homoeopathic drugs in cases of leucoderma: a clinical study,Homoeopath Heritage 2002 May;27(5):8-19,,"SKIN DIS, HOMEOPATHIC DRUGS","DRUG THERAPY, TREATMENT OUTCOME",,,,0970-6038,AB,"Six hundred and ninety five (695) patients suffering from leucoderma were registered for treatment at Gaurang Clinic & Centre for Homoeopathic Research, Lucknow from April 1996 to March 2001; out of which a total of five hundred and sixty (560) patients were available for proper follow up of treatment and analysis to assess the percent response by treatment with homoeopathic drugs. The treatment of leucoderma with homoeopathic drugs, based on totality of symptoms, showed significant improvement in three hundred and twenty eight (328) patients (58.57%), out of which four (4) patients (0.71%) were cured, seventeen (17) patients (3.04%) showed more than 90% improvement, three hundred and seven (307) patients (54.82%) are improving; while two hundred (200) patients (35.71%) maintained status quo and thirty two (32) patients (5.71%) did not improve at all."
0042477,Gibson Miller R,The repetition of the remedy,Homoeopath Heritage 2002 May;27(5):20-6,,"HOMEOPATHY, HOMEOPATHIC DRUGS",METHODS,,,,0970-6038,,
0042478,Anonymous,Healthy eating in high blood pressure,Homoeopath Heritage 2002 May;27(5):27-31,,"HYPERTENSION, HEART DIS","DIET THERAPY, PREVENTION",,,,0970-6038,,
0042479,Campbell A,When does classical mean classical?,Homoeopath Heritage 2002 May;27(5):32-5,,HOMEOPATHY,"HISTORY, METHODS",,,,0970-6038,,
0042480,Vithoulkas G,Vithoulkas Expert System (VES) - a helping tool to reach the simillimum,Homoeopath Heritage 2002 May;27(5):36-40,,"EXPERT SYSTEMS, SIMILIMUM, THERAPY COMPUTER ASSISTED, HEPATITIS","METHODS, CASE REPORT",,,,0970-6038,,
0042481,Clark D,Beacons in eastern Europe,Eur J Palliat Care 2002 Sep-Oct;9(5):180,,"PALLIATIVE TREATMENT, DELIVERY OF HEALTH CARE","EUROPE, HOSPICE CARE",,,,1352-2779,,
0042482,Marcadante S,Dry mouth and palliative care,Eur J Palliat Care 2002 Sep-Oct;9(5):182-5,xerostomia,"SALIVARY GLAND DIS, NEOPLASMS, QUALITY OF LIFE","PALLIATIVE TREATMENT, DRUG THERAPY",,,,1352-2779,,
0042483,Lloyd-Williams M,Diagnosis and treatment of depression in palliative care,Eur J Palliat Care 2002 Sep-Oct;9(5):186-8,,"DEPRESSION, TERMINAL ILLNESS, QUALITY OF LIFE","DIAGNOSIS, PALLIATIVE TREATMENT",,,,1352-2779,,
0042484,"Davis C, Syed M",The case study masterclass,Eur J Palliat Care 2002 Sep-Oct;9(5):190-1,,"BREAST NEOPLASMS, PATIENT ASSESSMENT","CASE REPORT, DIAGNOSIS, FEMALE",,,,1352-2779,,
0042485,"Finlay I, Williams J",Patient-held records: 'patient-led' or 'professionally led'?,Eur J Palliat Care 2002 Sep-Oct;9(5):192-6,,"MEDICAL HISTORY TAKING, PATIENT PARTICIPATION, HEALTH STATUS","PALLIATIVE TREATMENT, PHYSICIANS ROLE",,,,1352-2779,,
0042486,Magnan M,The dilemma of therapy,Eur J Palliat Care 2002 Sep-Oct;9(5):197-201,,"QUALITY OF LIFE, PATIENT ASSESSMENT, DECISION MAKING","PALLIATIVE TREATMENT, THERAPY",,,,1352-2779,,
0042487,"Wright M, Clark D","The development of palliative care in Brasov, Romania",Eur J Palliat Care 2002 Sep-Oct;9(5):202-5,Romania,"DELIVERY OF HEALTH CARE, HOSPICE CARE","PALLIATIVE TREATMENT, EUROPE",,,,1352-2779,,
0042488,Salamagne M,An overview of the Lyon Congres,Eur J Palliat Care 2002 Sep-Oct;9(5):206-7,,"CONGRESSES, RESEARCH",PALLIATIVE TREATMENT,,,,1352-2779,,
0042489,"Dein S, Thomas K",To tell or not to tell,Eur J Palliat Care 2002 Sep-Oct;9(5):209-12,,"ATTITUDE TO DEATH, ETHICS, COMMUNICATION","PALLIATIVE TREATMENT, PROGNOSIS, FAMILY",,,,1352-2779,,
0042490,Manojlovich M,Message from the CAOT president,Occup Ther Now 2002 Sep-Oct;4(5):3,,"PROFESSIONAL COMPETENCE, DELIVERY OF HEALTH CARE","OCCUPATIONAL THERAPY, CANADA",,,,1401-5532,,
0042491,Missiuna C,Poor handwriting is only a symptom: children with developmental coordination disorder,Occup Ther Now 2002 Sep-Oct;4(5):4-6,,"DEVELOPMENTAL DISABILITIES, WRITING","OCCUPATIONAL THERAPY, SCHOOLS, DIAGNOSIS",,,,1401-5532,AB,"Occupational therapists are often asked to consult with a teacher about a child's handwriting. However, when they arrive at the school, they also hear that the child is the last to go out at recess, never seems able to get his homework organized, is a behaviour problem during arts and crafts, won't participate in gym class, is teased a lot and has no friends."
0042492,Cameron D,Occupational therapy in action: using the CO-OP program,Occup Ther Now 2002 Sep-Oct;4(5):6-7,,"LEARNING DISABILITY, PATIENT ASSESSMENT, PSYCHOMOTOR PERFORMANCE","CASE REPORT, FEMALE, CHILD, OCCUPATIONAL THERAPY",,,,1401-5532,,
0042493,Johal H,Primary care: early identification of DCD,Occup Ther Now 2002 Sep-Oct;4(5):7-8,,"DEVELOPMENTAL DISABILITIES, DELIVERY OF HEALTH CARE","CANADA, OCCUPATIONAL THERAPY, FAMILY",,,,1401-5532,,
0042494,"Gowan N, Strong S",The expanding world of occupational therapy,Occup Ther Now 2002 Sep-Oct;4(5):9-13,,WORKPLACE,OCCUPATIONAL THERAPISTS,,,,1401-5532,AB,"Historically, occupational therapists were found within the clinic providing treatment somewhat removed from the workplaces and homes of the client. This approach has quickly changed. It's now common to see an occupational therapist with hard hat and work boots in the workplace, facilitating healthy work environments and effective return-to-work programs. This result was due to the pioneering of many therapists who dared to step into the workplace and realize the true connection between disability and productivity."
0042495,Anonymous,Back to work at the bank,Occup Ther Now 2002 Sep-Oct;4(5):14,,"WORKPLACE, DELIVERY OF HEALTH CARE","OCCUPATIONAL THERAPY, CANADA",,,,1401-5532,,
0042496,"Miyazaki M, Liu L",Tele-occupational therapy: making occupational therapy services accessible,Occup Ther Now 2002 Sep-Oct;4(5):16-9,,"HEALTH SERVICES ACCESSIBILITY, COMMUNICATION",OCCUPATIONAL THERAPY,,,,1401-5532,,
0042497,Green MC,Skills for the job of living at home and in the community: occupational therapy in Manitoba,Occup Ther Now 2002 Sep-Oct;4(5):20-2,,"HOME NURSING, COMMUNITY HEALTH SERVICES, EMPLOYMENT","OCCUPATIONAL THERAPY, CANADA",,,,1401-5532,AB,"No sick person is cured until enabled to fill the same, or equally as good a place in the community as before sickness...often where the work of the surgeon, the trained nurse, the physiotherapist ends, our hardest work begins..."
0042498,Miller Polgar J,Using technology to enable occupation,Occup Ther Now 2002 Sep-Oct;4(5):23-5,,"TECHNOLOGY, DISABILITY AIDS, ACTIVITIES OF DAILY LIVING",OCCUPATIONAL THERAPY,,,,1401-5532,AB,"Canadians who find they can't do what they used to as easily will find there is help through technology and occupational therapy. The authors define assistive technology as any device or product, either custom made or commercially available, which augment people's function or reduces and environmental barrier."
0042499,Ong V,007 Technology,Occup Ther Now 2002 Sep-Oct;4(5):25-6,,"TECHNOLOGY, DISABILITY AIDS, PATIENT ASSESSMENT","OCCUPATIONAL THERAPY, REHABILITATION",,,,1401-5532,,
0042500,Anonymous,Tools for living well,Occup Ther Now 2002 Sep-Oct;4(5):26,,"DISABILITY AIDS, ACCIDENTAL FALLS","AGED, PREVENTION, CANADA",,,,1401-5532,,
0042501,Anonymous,Using music to help children with disabilities play,Occup Ther Now 2002 Sep-Oct;4(5):27,,"MUSIC, DISABILITY, PLAY AND PLAYTHINGS, COMPUTERS","CHILD, TREATMENT OUTCOME, OCCUPATIONAL THERAPY",,,,1401-5532,,
0042502,Ringaert L,Universal design and occupational therapy,"Occup Ther Now 2002 Sep-Oct;4(5):28, 30",,"ARCHITECTURAL ACCESSIBILITY, DISABILITY",OCCUPATIONAL THERAPISTS,,,,1401-5532,,
0042503,Green MC,Zonta accessible playground (ZAP): a river of the senses,Occup Ther Now 2002 Sep-Oct;4(5):29,,"PLAY AND PLAYTHINGS, ARCHITECTURAL ACCESSIBILITY","CHILD, OCCUPATIONAL THERAPY, LEISURE ACTIVITIES",,,,1401-5532,,
0042504,Ong V,Improving access at Vancouver's largest hospital,Occup Ther Now 2002 Sep-Oct;4(5):31,,"ARCHITECTURAL ACCESSIBILITY, DISABILITY, HOSPITALS","OCCUPATIONAL THERAPY, CANADA",,,,1401-5532,,
0042505,Ong V,The importance of play for children,Occup Ther Now 2002 Sep-Oct;4(5):32-3,,"CHILD DEVELOPMENT, PLAY AND PLAYTHINGS","OCCUPATIONAL THERAPY, CHILD",,,,1401-5532,,
0042506,Ong V,Play and be healthy!,Occup Ther Now 2002 Sep-Oct;4(5):32,,"HEALTH PROMOTION, LEISURE ACTIVITIES, PLAY AND PLAYTHINGS","OCCUPATIONAL THERAPISTS, MOTIVATION",,,,1401-5532,,
0042507,Anonymous,Singing as therapy,Occup Ther Now 2002 Sep-Oct;4(5):33,,"MUSIC, CEREBROVASCULAR DISORDERS, BREATHING EXERCISES, SPEECH","OCCUPATIONAL THERAPY, CANADA",,,,1401-5532,,
0042508,Hawkett S,NHS cancer plan - a supportive and palliative care strategy,Palliat Care Today 2002;10(3):36-7,,"QUALITY OF HEALTH CARE, SOCIAL SUPPORT, NEOPLASMS, PATIENT PARTICIPATION","PALLIATIVE TREATMENT, ENGLAND",,,,0969-7853,AB,"When a diagnosis of cancer is first made, it can have a devastating impact on the patient's quality of life. Patients and their families need access to information and supportive care from the point of diagnosis, throughout the disease process and into bereavement. But how well is this done? For too long lip service has been paid to its importance but no systematic approach has been adopted by the NHS."
0042509,Ellershaw J,Liverpool integrated care pathway for the dying patient,Palliat Care Today 2002;10(3):38,,"DELIVERY OF HEALTH CARE, ECONOMICS","PALLIATIVE TREATMENT, ENGLAND, HOSPITALS, HOSPICES",,,,0969-7853,AB,"There is an increasing movement in healthcare towards continuous quality improvement and guideline based practice. The focus is to promote high-quality, efficient and cost-effective care. Current systems of monitoring and evaluating outcomes in palliative care are poorly developed."
0042510,Keeley V,An integrated service model: Southern Derbyshire Specialist Palliative Care Service's Beacon,Palliat Care Today 2002;10(3):39,,"HEALTH SERVICES, QUALITY OF HEALTH CARE","PALLIATIVE TREATMENT, ENGLAND",,,,0969-7853,AB,The Southern Derbyshire Specialist Palliative Care Services was awarded Beacon status for its integrated service model. It is an NHS service and part of an acute district general hospital.
0042511,Wee B,"Education and training in palliative care: Countess Mountbatten House, Southampton",Palliat Care Today 2002;10(3):40,,"EDUCATION, QUALITY OF HEALTH CARE",PALLIATIVE TREATMENT,,,,0969-7853,AB,"Being awarded a Palliative Care Beacon is a fantastic feeling. It does wonders for staff morale and certainly results in a boost of energy and enthusiasm. Education and training is all about dissemination of good practice so we are already used to doing it all, but on a shoe-string!"
0042512,Hillier R,"Community care and support for carers: Countess Mountbatten House, Southampton",Palliat Care Today 2002;10(3):41,,"SOCIAL SUPPORT, COMMUNITY HEALTH SERVICES","CAREGIVERS, PALLIATIVE TREATMENT, ENGLAND",,,,0969-7853,AB,"One of the hallmarks of those services to be awarded an NHS Beacon is effective interprofessional working. After winning a Beacon for Palliative Care Community Services and Caring for the Carer, we attended a meeting convened by the NHS Executive for all Beacon holders in the area."
0042513,Meystre CJ,Warwickshire Integrated Service Directorate for Palliative Care: North Warwickshire NHS Trust,Palliat Care Today 2002;10(3):42,,DELIVERY OF HEALTH CARE,"PALLIATIVE TREATMENT, ENGLAND",,,,0969-7853,AB,"The Government's modernisation programme for the NHS is ambitious, with aims so broad that the only way to achieve them is to employ the system itself. This works on the basis that changes tried and tested from within brings longer-lasting reform."
0042514,George R,The place of specialist palliative care as a core service: Camden and Islington Community NHS Trust,Palliat Care Today 2002;10(3):43,,"QUALITY OF HEALTH CARE, HEALTH SERVICES","PALLIATIVE TREATMENT, ENGLAND",,,,0969-7853,AB,What are the main challenges/difficulties/problems in being awarded a Beacon? Are there benefits in being a Beacon? And what Beacon events/programmes can people access and how?
0042515,"Palliative Care Team, Northgate and Prudhoe NHS Trust",People with learning and physical disabilities,Palliat Care Today 2002;10(3):44,,"DISABILITY, LEARNING DISABILITY, QUALITY OF HEALTH CARE",HEALTH SERVICES NEEDS AND DEMAND,,,,0969-7853,AB,"Northgate and Prudhoe NHS Trust is the largest specialist provider of health and social care for people with learning and physical disabilities in the UK. Services are provided in people's homes, residential community settings, outpatient clinics, schools, day centres and on three hospital sites in the North East of England. However, more people with a learning disability live in local communities, in the family home, independently or in a supported living environment."
0042516,Jeffrey D,The Palliative Care Education Group for Gloucestershire (PEGG): Cheltenham General Hospital,Palliat Care Today 2002;10(3):45,,"EDUCATION, HEALTH PERSONNEL, PATIENT CARE TEAM","PALLIATIVE TREATMENT, ENGLAND",,,,0969-7853,AB,"Effective palliative care demands multi-disciplinary team working by healthcare professionals who are both competent and compassionate. Traditionally, the education of healthcare professionals has been carried out within single professional disciplines."
0042517,"Cavanagh HM, Wilkinson JM",Biological activities of lavender essential oil,Phytother Res 2002 Jun;16(4):301-8,"lavender oil, Lavandula","OILS VOLATILE, AROMA THERAPY, ANTIINFECTIVE AGENTS","PLANTS, PHARMACOLOGY",,,,0951-418X,AB,"Essential oils distilled from members of the genus Lavandula have been used both cosmetically and therapeutically for centuries with the most commonly used species being L. angustifolia, L. latifolia, L. stoechas and L. x intermedia. Although there is considerable anecdotal information about the biological activity of these oils much of this has not been substantiated by scientific or clinical evidence. Among the claims made for lavender oil are that is it antibacterial, antifungal, carminative (smooth muscle relaxing), sedative, antidepressive and effective for burns and insect bites. In this review we detail the current state of knowledge about the effect of lavender oils on psychological and physiological parameters and its use as an antimicrobial agent. Although the data are still inconclusive and often controversial, there does seem to be both scientific and clinical data that support the traditional uses of lavender. However, methodological and oil identification problems have severely hampered the evaluation of the therapeutic significance of much of the research on Lavandula spp. These issues need to be resolved before we have a true picture of the biological activities of lavender essential oil."
0042518,"Toda S, Shirataki Y",Inhibitory effects of echinoisoflavanone and sophoraisoflavanone D in Sophora chrysophylla SEEM on copper ion-induced protein oxidative modification of mouse brain homogenate in vitro,Phytother Res 2002 Jun;16(4):309-11,"echinoisoflavanone, sophoraisoflavanone D, Sophora chrysophylla","ISOFLAVONES, PLANT EXTRACTS, BRAIN, OXIDATIVE STRESS","MICE, PHARMACOLOGY, DRUG EFFECTS",,,,0951-418X,AB,We present the results of an in vitro investigation of the inhibitory effects of echinoisoflavanone and sophoraisoflavanone D isolated from Sophora chrysophylla SEEM on copper-induced protein oxidative modification of mouse brain homogenate in vitro. They inhibited copper-induced protein oxidative modification. The order of inhibitory effects of these isoflavanones and mannitol as a hydroxyl radical scavenger was sophoraisoflavanone D greater than mannitol greater than echinoisoflavanone. The results suggest that these natural products may be of use in cases where oxidative stress is present.
0042519,"Topic B, Hasenohrl RU, Hacker R, Huston JP",Enhanced conditioned inhibitory avoidance by a combined extract of Zingiber officinale and Ginkgo biloba,Phytother Res 2002 Jun;16(4):312-5,,"ZINGIBER OFFICINALE, GINKGO BILOBA, PLANT EXTRACTS, BEHAVIOR ANIMAL, DEFENSE MECHANISMS, LEARNING","DRUG EFFECTS, RATS, TASK PERFORMANCE AND ANALYSIS, PHARMACOLOGY",,,,0951-418X,AB,"Previous work has shown that intragastric administration of Zingicomb, a preparation consisting of Zingiber officinale and Ginkgo biloba extracts, has anxiolytic-like properties. The aim of the present study was to assess the effects of acute treatment with this preparation on inhibitory avoidance learning. The influence of pre-trial administered Zingicomb (ZC) on inhibitory avoidance conditioning was investigated in adult male Wistar rats, with a one-trial step-through avoidance task. The animals were treated intragastrically with either vehicle, 0.5, 1, 10 or 100 mg/kg ZC 60 min prior to the acquisition trial. When tested 24 h after training, rats which had received 10 mg/kg ZC exhibited significantly longer step-through latencies than vehicle treated animals. This result, thus, demonstrates the beneficial effects of Zingicomb on conditioned inhibitory avoidance. Unlike conventional anxiolytic drugs, such as the benzodiazepines, which tend to have amnesic properties, this phytopharmacon is a potent anxiolytic agent which, additionally, can facilitate performance on a learning task, indicating promising clinical applications."
0042520,"Plesca-Manea L, Parvu AE, Parvu M, Taamas M, Buia R, Puia M",Effects of Melilotus officinalis on acute inflammation,Phytother Res 2002 Jun;16(4):316-9,"Melilotus officinalis, citrulline","INFLAMMATION, PLANT EXTRACTS, COUMARINS, PHAGOCYTES, ANTIINFLAMMATORY AGENTS","PLANTS MEDICINAL, ACUTE DIS, COMPARATIVE STUDY, AMINO ACIDS, DRUG EFFECTS, PHARMACOLOGY",,,,0951-418X,AB,"Our study investigated the effects of Melilotus officinalis L. extract, containing 0.25% coumarin, on acute inflammation induced with oil of turpentine in male rabbits. The results were compared with those from a group treated with hydrocortisone sodium hemisuccinate and one injected with coumarin before inflammation was induced. The effects were evaluated by measuring serum citrulline, a test of in vitro phagocytosis, total leukocyte count and differential leukocyte count expressed as a percentage. M. officinalis had antiinflammatory effects because it reduced the activation of circulating phagocytes and lowered citrulline production. These properties were similar to those of hydrocortisone sodium hemisuccinate and coumarin. In the bone marrow acute phase response, M. officinalis had an inhibitory action that was lower than that of hydrocortisone sodium hemisuccinate and similar to coumarin."
0042521,"Blatt CT, Chavez D, Chai H, Graham JG, Cabieses F, Farnsworth NR, Cordell GA, Pezzuto JM, Kinghorn AD",Cytotoxic flavonoids from the stem bark of Lonchocarpus aff. fluvialis,Phytother Res 2002 Jun;16(4):320-5,Lonchocarpus aff fluvialis,"BIOFLAVONOIDS, PLANT EXTRACTS, TUMOR CELLS CULTURED, TRITERPENES, FLAVONES, ANTINEOPLASTIC AGENTS PHYTOGENIC","PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, DRUG ISOLATION",,,,0951-418X,AB,"Activity-guided fractionation of a chloroform-soluble extract of Lonchocarpus aff. fluvialis stem bark using a human epidermoid (KB) tumour cell line as a monitor afforded five rotenoids, one pterocarpan, one chalcone, three flavanones, one flavone and one triterpenoid. All of the compounds isolated proved to be of previously known structure. Among them, the rotenoids (-)-sumatrol and (+/-)-villosinol, the dibenzoylmethane derivative (+)-3,4-methylenedioxy-2'-methoxy-(2\",3\":4',3')-furanodibenzoylme thane, and the flavanones (-)-isoglabrachromene and (-)-candidone have been shown to exhibit significant cytotoxic activity against human cancer cells for the first time. This is the first report of the chemical constituents of this species, and the profile of compounds obtained was in accordance with the established chemosystematic patterns of species in the tribe Tephrosieae (Leguminosae, Papilionoideae)."
0042522,"Dhara AK, Pal S, Nag Chaudhuri AK",Psychopharmacological studies on Tragia involucrata root extract,Phytother Res 2002 Jun;16(4):326-30,Tragia involucrata,"PLANT EXTRACTS, BEHAVIOR ANIMAL, MOTOR ACTIVITY, CENTRAL NERVOUS SYSTEM DEPRESSANTS","PLANTS MEDICINAL, ROOTS, PHARMACOLOGY, DRUG EFFECTS",,,,0951-418X,AB,"The methanol fraction of the root extract of Tragia involucrata was investigated for psychopharmacological activity in rodents. It produced an alteration of behavioural pattern and a reduction in spontaneous motility. A significant potentiation of pentobarbitone-induced sleep, a decrease of body temperature, suppression of the aggressive behaviour pattern and of the conditioned avoidance response (CAR) were observed with the fraction. These suggest that the methanol fraction of the T. involucrata root extract possesses significant central nervous system depressant action."
0042523,"Sen T, Dhara AK, Bhattacharjee S, Pal S, Nag Chaudhuri AK",Antioxidant activity of the methanol fraction of Pluchea indica root extract,Phytother Res 2002 Jun;16(4):331-5,Pluchea indica,"ANTIOXIDANTS, PLANT EXTRACTS, FREE RADICALS, ANTIINFLAMMATORY AGENTS, LIPID PEROXIDATION","PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, MICE",,,,0951-418X,AB,"Studies were carried out to evaluate the influence of the methanol fraction of Pluchea indica Less root extract (PIRE), the dual inhibitors (BW 755C and phenidone) and vitamin on both in vivo and in vitro free radical-scavenging activities, CCl(4)-induced lipid peroxidation and the metabolism of arachidonic acid by lipoxygenase. PIRE produced significant antiinflammatory activity against glucose oxidase-induced paw oedema (in vivo), inhibited hydroxyl radical and superoxide generation, lysis of erythrocytes induced by hydrogen peroxide, CCl(4)-induced lipid peroxidation and also dioxygenase activity of lipoxygenase (both in the presence and absence of hydrogen peroxide). Significantly higher free radical-scavenging activity was observed with BW 755C and phenidone compared with PIRE. However, both BW 755C and phenidone stimulated hydroxyl radical generation compared with the observed inhibitory effects of PIRE and vitamin E."
0042524,"Marinkovic B, Marin PD, Knezevic-Vukcevic J, Sokovic MD, Brkic D",Activity of essential oils of three Micromeria species (Lamiaceae) against micromycetes and bacteria,Phytother Res 2002 Jun;16(4):336-9,"Micromeria dalmatica, Micromeria albanica, Micromeria thymifolia","OILS VOLATILE, BACTERIA, FUNGI, ANTIINFECTIVE AGENTS, ANTIFUNGAL AGENTS","PLANTS MEDICINAL, PHARMACOLOGY, PLANT EXTRACTS, DRUG EFFECTS",,,,0951-418X,AB,"The chemical composition of essential oils from three Micromeria species: M dalmatica Benth., M. albanica (Griceb. ex K. Mal) Silic and M. thymifolia (Scop.) Fritsch were investigated by GC and GC-MS and their antibacterial and antifungal activities against seven fungal and six bacterial species were evaluated. Biological assays showed strong fungitoxicity of oils from all three Micromeria spp., particularly M. albanica, against all fungi tested. Essential oils of these species also exerted antibacterial effect against Streptococcus aureus, Escherichia coli, Bacillus subtilis and Micrococcus luteus at low concentrations. Higher concentrations of essential oil of M. albanica and M. dalmatica were active against Gram-negative Pseudomonas aeruginosa, which could be due to the high content of piperitenone oxide."
0042525,"Shinohara R, Ohta Y, Hayashi T, Ikeno T",Evaluation of antilipid peroxidative action of propolis ethanol extract,Phytother Res 2002 Jun;16(4):340-7,microsomes liver,"PROPOLIS, LIPID PEROXIDATION, ANTIOXIDANTS","DRUG EFFECTS, PHARMACOLOGY, CELLS, PHARMACOLOGY",,,,0951-418X,AB,"The antilipid peroxidative action of the ethanol extract of Brazilian propolis at a concentration of 47% (w/v) was evaluated by examining the inhibitory effect of the extract on the formation of hydroperoxide- and endoperoxide-type lipid peroxides during heating of authentic polyunsaturated fatty acids and on Fe(3+)-ADP/ascorbic acid- and Fe(3+)-ADP/NADPH-dependent lipid peroxidation reactions in rat liver microsomes. Hydroperoxide-type lipid peroxides were measured by the haemoglobin-methylene blue method and endoperoxide-type lipid peroxides by the thiobarbituric acid (TBA), Fe(3+)-TBA and LPO-586 methods. Propolis ethanol extract inhibited dose-dependently the formation of hydroperoxide- and endoperoxide-type lipid peroxides during heating of linoleic acid, linolenic acid or arachidonic acid and the amount of the extract causing a half inhibition of these lipid peroxide formations ranged between 20 and 75 microg. Propolis ethanol extract inhibited dose-dependently both Fe(3+)-ADP/ascorbic acid- and Fe(3+)-ADP/NADPH-dependent lipid peroxidation reactions in rat liver microsomes when lipid peroxides produced in both reactions were measured by the TBA method. The amount of propolis extract causing a half inhibition of the Fe(3+)-ADP/ascorbic acid-dependent lipid peroxidation was about 5 microg, while that of the extract causing a half inhibition of the Fe(3+)-ADP/NADPH-dependent lipid peroxidation was about 0.15 microg. These results indicate that the propolis ethanol extract exerts an antilipid peroxidative action at very low doses."
0042526,"Alche LE, Barquero AA, Sanjuan NA, Coto CE",An antiviral principle present in a purified fraction from Melia azedarach L leaf aqueous extract restrains herpes simplex virus type 1 propagation,Phytother Res 2002 Jun;16(4):348-52,,"ANTIVIRAL AGENTS, HERPES SIMPLEX, PLANT EXTRACTS, MELIA AZEDARACH","PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, GENETICS",,,,0951-418X,AB,"Meliacine (MA), an antiviral principle isolated from leaves of Melia azedarach L., exhibits potent antiviral activity against herpes simplex virus type 1 (HSV-1) by inhibiting specific infected-cell polypeptides (ICPs) produced late in infection. Some of these are involved in DNA synthesis and in the assembly of nucleocapsids. The present report provides additional evidence to elucidate the mode of action of MA against HSV-1. Time-of-addition experiments confirmed that MA affects a late event in the multiplication cycle of HSV-1. We showed that MA diminished the synthesis of viral DNA and inhibited the spread of infectious viral particles when HSV-1 that expresses beta-galactosidase activity was used. In addition, the lack of a protein with an apparent MW of 55 KD was detected in MA-treated cell extracts. Ultrastructural analysis of infected cells showed that, in the case of MA treatment, a large number of unenveloped nucleocapsids accumulated in the cytoplasm and a minor proportion of mature virus was found in cytoplasmic vesicles. These findings suggest that MA exerts an antiviral action on both the synthesis of viral DNA and the maturation and egress of HSV-1 during the infection of Vero cells."
0042527,"Masuda T, Oyama Y, Yonemori S, Takeda Y, Yamazaki Y, Mizuguchi S, Nakata M, Tanaka T, Chikahisa L, Inaba Y, Okada Y","Flow cytometric estimation on cytotoxic activity of leaf extracts from seashore plants in subtropical Japan: isolation, quantification and cytotoxic action of (-)-deoxypodophyllotoxin",Phytother Res 2002 Jun;16(4):353-8,,"PLANTS MEDICINAL, PLANT EXTRACTS, TUMOR CELLS CULTURED, ANTINEOPLASTIC AGENTS PHYTOGENIC, CELL DIVISION","JAPAN, PHARMACOLOGY, DRUG EFFECTS",,,,0951-418X,AB,"The cytotoxic activity of methanol extracts of leaves collected from 39 seashore plants in Iriomote Island, subtropical Japan was examined on human leukaemia cells (K562 cells) using a flow cytometer with two fluorescent probes, ethidium bromide and annexin V-FITC. Five extracts (10 microg/mL) from Hernandia nymphaeaefolia, Cerbera manghas, Pongamia pinnata, Morus australis var. glabra and Thespesia populnea greatly inhibited the growth of K562 cells. When the concentration was decreased to 1 microg/mL, only one extract from H. nymphaeaefolia still inhibited the cell growth. A cytotoxic compound was isolated from the leaves by bioassay-guided fractionation and was identified as (-)-deoxypodophyllotoxin (DPT). The fresh leaves of H. nymphaeaefolia contained a remarkably high amount of DPT (0.21 +/- 0.07% of fresh leaf weight), being clarified by a quantitative HPLC analysis. DPT at 70-80 pM started to inhibit the growth of K562 cells in an all-or-none fashion and at 100 pM or more it produced complete inhibition in all cases. Therefore, the slope of the dose-response curve was very steep. DPT at 100 pM or more decreased the cell viability to 50%-60% and increased the number of cells undergoing apoptosis (annexin V-positive cells). The results indicate that DPT contributes to the cytotoxic action of the extract from the leaves of H. nymphaeaefolia on K562 cells."
0042528,"Park KH, Park J, Koh D, Lim Y","Effect of Saikosaponin-A, a triterpenoid glycoside, isolated from Bupleurum falcatum on experimental allergic asthma",Phytother Res 2002 Jun;16(4):359-63,"Bupleurum falcatum, saikosaponin A","PLANT EXTRACTS, TRITERPENES, MAST CELLS, HISTAMINE, ANTIALLERGIC AGENTS","PLANTS MEDICINAL, DRUG ISOLATION, STEROIDS, RATS, DRUG EFFECTS, PHARMACOLOGY",,,,0951-418X,AB,"The separation and isolation of an extract of Bupleurum falcatum were performed based on antiallergic activities in preliminary studies with higher plants. The final active compound was identified as saikosaponin-A (SSA), a triterpenoid glycoside. SSA at more than 1 mg/kg (i.v.) significantly inhibited the passive cutaneous anaphylaxis reaction in rats in a dose-dependent manner, attaining a maximum inhibition of approximately 60% with 10 mg/kg. SSA at 3 and 10 mg/kg also suppressed asthmatic bronchoconstriction in sensitized guinea-pigs. SSA possesses a weak inhibitory activity on histamine-induced tracheal contraction in guinea-pigs and on histamine release induced by A-23187 in rat mast cells. These results indicate that SSA has an inhibitory activity against allergic asthma. This activity seems to derive from both antagonism of the histamine action and inhibition of allergic mediators. Additional mechanisms may also be involved."
0042529,"Choi HR, Choi JS, Han YN, Bae SJ, Chung HY",Peroxynitrite scavenging activity of herb extracts,Phytother Res 2002 Jun;16(4):364-7,peroxynitrite,"HERBS, PLANT EXTRACTS, ANTIOXIDANTS","NITROGEN COMPOUNDS, METABOLISM, PHARMACOLOGY",,,,0951-418X,AB,"Peroxynitrite (ONOO(-)) is a cytotoxicant with strong oxidizing properties toward various cellular constituents, including sulphydryls, lipids, amino acids and nucleotides and can cause cell death, lipid peroxidation, carcinogenesis and aging. The aim of this study was to characterize ONOO(-) scavenging constituents from herbs. Twenty-eight herbs were screened for their ONOO(-) scavenging activities with the use of a fluorometric method. The potency of scavenging activity following the addition of authentic ONOO(-) was in the following order: witch hazel bark greater than rosemary greater than jasmine tea greater than sage greater than slippery elm greater than black walnut leaf greater than Queen Anne's lace greater than Linden flower. The extracts exhibited dose-dependent ONOO(-) scavenging activities. We found that witch hazel (Hamamelis virginiana L.) bark showed the strongest effect for scavenging ONOO(-) of the 28 herbs. Hamamelitannin, the major active component of witch hazel bark, was shown to have a strong ability to scavenge ONOO(-). It is suggested that hamamelitannin might be developed as an effective peroxynitrite scavenger for the prevention of ONOO(-) involved diseases."
0042530,Gebhardt R,Inhibition of cholesterol biosynthesis in HepG2 cells by artichoke extracts is reinforced by glucosidase pretreatment,Phytother Res 2002 Jun;16(4):368-72,,"CHOLESTEROL, PLANT EXTRACTS, LIVER, TUMOR CELLS CULTURED, GLUCOSIDES, CYNARA SCOLYMUS","PLANTS, METABOLISM, PHARMACOLOGY, DRUG EFFECTS",,,,0951-418X,AB,"High-dose aqueous extracts from artichoke leaves were found to inhibit cholesterol biosynthesis from (14)C-acetate rather moderately in HepG2 cells in contrast to primary cultured rat hepatocytes in which the inhibition was stronger. Preincubation of the extracts with several glycohydrolases revealed that pretreatment with beta-glucosidase considerably reinforced the inhibition. A significant reduction of acetate incorporation was found above extract concentrations of 0.01 mg/mL and at 0.2 mg/mL almost 60% inhibition was observed. Cytotoxic effects detected by the MTT-assay were restricted to higher concentrations of the extracts with and without beta-glucosidase pretreatment. Since cynaroside represents a major glucoside in artichoke extracts, both cynaroside and its aglycone luteolin were tested. It could be demonstrated that cynaroside is indeed one of the targets of beta-glucosidase and that the liberated luteolin is responsible for the inhibitory effect. Direct measurements of beta-glucosidase activity in rat hepatocytes and HepG2 cells revealed that endogenous enzyme activity in hepatocytes may be sufficient to convert cynaroside to its aglycone, while in HepG2 cells this may not be the case. These findings emphasize the importance of beta-glucosidase-dependent liberation of luteolin for the ability of artichoke extracts to inhibit hepatic cholesterol biosynthesis."
0042531,"Sekiya N, Goto H, Shimada Y, Terasawa K",Inhibitory effects of Keishi-bukuryo-gan on free radical induced lysis of rat red blood cells,Phytother Res 2002 Jun;16(4):373-6,hemolysis,"ANTIOXIDANTS, ERYTHROCYTES, CELL MEMBRANE, DRUGS CHINESE HERBAL","PHARMACOLOGY, DRUG EFFECTS, FREE RADICALS, METABOLISM",,,,0951-418X,AB,"Keishi-bukuryo-gan (KBG) prevents the progression of atherosclerosis in cholesterol-fed rabbits by its antioxidative effect. The present study was to test our hypothesis that ingestion of KBG would protect red blood cell (RBC) membranes from free radical induced oxidation if polyphenolic antioxidants in KBG could be absorbed and circulated in the blood. When incubated with a RBC suspension, KBG and four of five herb medicines constituting KBG provided strong protection for RBC membranes against haemolysis induced by 2,2-azo-bis (2-amidinopropane) dihydrochloride (AAPH), an azo free radical initiator. The inhibitory effect was dose dependent at concentrations of 100-1000 microg/mL. Furthermore, the ingestion of 200 mg of KBG was associated with a significant decrease in susceptibility of RBC to haemolysis in rats."
0042532,"Kobayashi T, Song QH, Hong T, Kitamura H, Cyong JC",Preventative effects of the flowers of Inula britannica on autoimmune diabetes in C57BL/KsJ mice induced by multiple low doses of streptozotocin,Phytother Res 2002 Jun;16(4):377-82,Inula britannica,"DIABETES MELLITUS, PLANT EXTRACTS, HYPOGLYCEMIC AGENTS","MICE, FLOWERS, PHARMACOLOGY, DISEASE MODELS ANIMAL, PREVENTION, AUTOIMMUNE DIS, PLANTS MEDICINAL",,,,0951-418X,AB,"We have reported that an aqueous extract from the flowers of Inula britannica L. subsp. japonica Kitam. (IB) prevented immunologically induced experimental hepatitis in mice and suggested that the antihepatitic effect of IB is due to inhibition of IFN-gamma production. We then investigated the effects of IB on diabetes in mice induced by multiple low doses of streptozotocin (MLDSTZ), which is a mouse model for IFN-gamma-dependent autoimmune diabetes. C57BL/KsJ mice (male, 7 weeks) were provided with IB extract (500 mg/kg/ day) in drinking water ad libitum, starting 7 days before the first STZ injection. Autoimmune diabetes was induced by MLDSTZ (40 mg/kg/day for 5 daily doses, i.p.). The IB treatment significantly suppressed the increase of blood glucose levels. Histological analysis of the pancreas showed that the degree of insulitis and destruction of beta-cells were reduced by IB treatment. The IFN-gamma production from stimulated splenic T lymphocytes was inhibited by the IB treatment. Moreover, the proportion of IFN-gamma-producing cells in the CD4(+) population, which was increased by MLDSTZ, was significantly decreased by the IB treatment. These results suggest that IB has a preventative effect on autoimmune diabetes by regulating cytokine production."
0042533,"Alarcon-Aguilar FJ, Roman-Ramos R, Flores-Saenz JL, Aguirre-Garcia F",Investigation on the hypoglycaemic effects of extracts of four Mexican medicinal plants in normal and alloxan-diabetic mice,Phytother Res 2002 Jun;16(4):383-6,"Bidens pilosa, Salvia officinalis, Psacalium peltatum, Turnera diffusa","DIABETES MELLITUS, HYPOGLYCEMIC AGENTS, PLANT EXTRACTS, BLOOD GLUCOSE","PLANTS MEDICINAL, MEXICO, MICE, PHARMACOLOGY, DRUG EFFECTS",,,,0951-418X,AB,"The hypoglycaemic activities of four water ethanol extracts (WEE) prepared from Bidens pilosa L., Salvia officinalis L., Psacalium peltatum H.B.K. (Cass) and Turnera diffusa Willd. were investigated in healthy and alloxan-diabetic mice. The WEE of S. officinalis significantly reduced the blood glucose of fasting normal mice 120 (15.7%) and 240 min (30.2%) after intraperitoneal administration (p less than 0.05). The WEE of P. peltatum and B. pilosa also significantly diminished glycaemia in healthy mice at 240 min (19.6% and 13.8%, respectively). In mildly diabetic mice, the WEE of P. peltatum lowered the basal blood glucose level 120 (16%) and 240 min (54%) after intraperitoneal administration (p less than 0.05 and p less than 0.01, respectively). The WEE of B. pilosa and S. officinalis also significantly diminished the hyperglycaemia in mildly diabetic mice at 240 mins (32.6% and 22.7%, respectively). The administration of these three extracts to animals with severe hyperglycaemia did not cause a significant decrease. The WEE of T. diffusa did not show any hypoglycaemic activity. Thus, three of the WEE studied conserved the hypoglycaemic activity originally detected in the traditional preparations of the studied antidiabetic plants. It appears that these extracts require the presence of insulin to show hypoglycaemic activity."
0042534,"Mongelli E, Pomilio AB, Sanchez JB, Guerra FM, Massanet GM","ent-Kaur-16-en-19-oic acid, a KB cells cytotoxic diterpenoid from Elaeoselinum foetidum",Phytother Res 2002 Jun;16(4):387-8,Elaeoselinum foetidum,"DITERPENES, ANTINEOPLASTIC AGENTS PHYTOGENIC, PLANT EXTRACTS","PLANTS TOXIC, PHARMACOLOGY, DRUG ISOLATION",,,,0951-418X,AB,"Toxic and cytotoxic activities of the toxic plant Elaeoselinum foetidum (Apiaceae) were evaluated using the brine shrimp toxicity (BST) and KB cell cytotoxicity assays. The active chloroform extract was subjected to a bioactivity-directed fractionation, monitored by the BST assay, that led to the isolation of the diterpenoid ent-kaur-16-en-19-oic acid. This compound was potent against the brine shrimp (LC(50) = 4.8 microg/mL) and KB cells (IC(50) = 1.6 microg/mL)."
0042535,"Bello R, Moreno L, Primo-Yufera E, Esplugues J",Globularia alypum L. extracts reduced histamine and serotonin contraction in vitro,Phytother Res 2002 Jun;16(4):389-92,Globularia alypum,"PLANT EXTRACTS, MUSCLE CONTRACTION, UTERUS, ILEUM, DUODENUM, MUSCLE SMOOTH","PLANTS MEDICINAL, PHARMACOLOGY, HISTAMINE, SEROTONIN, RATS, DRUG EFFECTS",,,,0951-418X,AB,"The present study analyses in in vitro models the pharmacological activity of methanol and dichloromethane extracts (1, 10 and 100 microg/mL) obtained from the leaves and stems of Globularia alypum L. Preincubation of the guinea-pig ileum and rat uterus with both extracts produced a dose dependent abolition of the contractile effects of histamine and serotonin, respectively. At the same doses, neither methanol nor dichloromethane extract reduced the contractile effects of acetylcholine on rat duodenum or noradrenaline on rat vas deferens."
0042536,"Tiwari TN, Pandey VB, Dubey NK",Plumieride from Allamanda cathartica as an antidermatophytic agent,Phytother Res 2002 Jun;16(4):393-4,"Allamanda cathartica, plumieride","PLANT EXTRACTS, ANTIFUNGAL AGENTS, SKIN DISEASES INFECTIOUS, MYCOSES","PLANTS MEDICINAL, HETEROCYCLIC COMPOUNDS, DRUG ISOLATION, PHARMACOLOGY, DRUG THERAPY",,,,0951-418X,AB,Plumieride has been isolated as an active principle of the leaves of Allamanda cathartica. It showed strong fungitoxicity against some dermatophytes causing dermatomycosis to animals and human beings. It exhibited a noncytotoxic nature against a P(388) mouse leukaemia cell line.
0042537,"Monforte MT, Trovato A, Rossitto A, Forestieri AM, D'Aquino A, Miceli N, Galati EM",Anticonvulsant and sedative effects of Salvadora persica L. stem extracts,Phytother Res 2002 Jun;16(4):395-7,Salvadora persica,"ANTICONVULSANTS, PLANT EXTRACTS, HYPNOTICS AND SEDATIVES, SEIZURES, SLEEP","PLANTS MEDICINAL, PHARMACOLOGY, RATS, MORTALITY, DRUG EFFECTS, DRUG THERAPY",,,,0951-418X,AB,The effect of Salvadora persica L. stem extracts on the potentiation of sodium pentobarbital activity and on generalized tonic-clonic seizure produced by pentylenetetrazol (PTZ) on the rat is reported. The extracts of Salvadora persica L. extended sleeping-time and decreased induction-time induced by sodium pentobarbital; in addition it showed protection against pentylenetetrazol-induced convulsion by increasing the latency period and diminishing the death rate.
0042538,"Okazaki K, Kawazoe K, Takaishi Y",Human platelet aggregation inhibitors from thyme (Thymus vulgaris L.),Phytother Res 2002 Jun;16(4):398-9,Thymus vulgaris,"PLANT EXTRACTS, PLATELET AGGREGATION","PLANTS MEDICINAL, PHARMACOLOGY, DRUG ISOLATION, SPECTRUM ANALYSIS, MOLECULAR STRUCTURE, DRUG EFFECTS",,,,0951-418X,AB,"Two antiaggregant compounds, thymol (compound 1) and 3,4,3',4'-tetrahydroxy-5,5'-diisopropyl-2,2'-dimethylbiphenyl (compound 2) were isolated from the leaves of thyme (Thymus vulgaris L.). The structures were determined by (1)H-, (13)C-NMR and mass spectra (MS) studies. These compounds inhibited platelet aggregation induced by collagen, ADP, arachidonic acid (AA) and thrombin except that compound 2 did not inhibit platelet aggregation induced by thrombin."
0042539,"Chen JC, Johnstone SA",Quality of life after lung cancer surgery: a forgotten outcome measure,Chest 2002 Jul;122(1):4-5,,"LUNG NEOPLASMS, QUALITY OF LIFE, SURGERY OPERATIVE","POSTOPERATIVE CARE, COUNSELING, DECISION MAKING",(Editorial),,,0012-3692,,
0042540,"Handy JR, Asaph JW, Skokan L, Reed CE, Koh S, Brooks G, Douville EC, Tsen AC, Ott GY, Silvestri GA",What happens to patients undergoing lung cancer surgery? Outcomes and quality of life before and after surgery,Chest 2002 Jul;122(1):4-5,,"QUALITY OF LIFE, LUNG NEOPLASMS, SURGERY OPERATIVE","POSTOPERATIVE CARE, HEALTH STATUS",,,,0012-3692,AB,"OBJECTIVE: To compare baseline preoperative and 6-month postoperative functional health status and quality of life in patients undergoing lung cancer resection. METHODS: Lung cancer surgery patients from three hospitals were administered the Short-Form 36 Health Survey (SF-36) and the Ferrans and Powers' quality-of-life index (QLI) before surgery and 6 months after surgery. Preoperative, intraoperative, hospital stay, and 6-month postoperative clinical data were collected. All p values less than or = to 0.05 were considered significant. RESULTS: One hundred thirty-nine patients were studied; 131 patients were discharged and 8 patients (5.8%) died. One hundred three patients (78.6%) who survived underwent an evaluation at 6 months, 16 patients (12.2%) died during follow-up, 2 patients refused follow-up, 4 patients were unavailable for follow-up, and 6 patients are awaiting an evaluation at 6 months. Compared with matched healthy subjects, preoperative lung cancer patients had worse results on the SF-36 physical functioning, role-emotional, mental health, and energy subscales. At 6 months, SF-36 subscales for physical functioning, role-physical, bodily pain, and mental health were significantly worse than preoperative values. The visual analog pain scale was significantly worse at follow-up. The QLI with all subscales and SF-36 for role-emotional, energy, and general health subscales were unaffected by lung cancer resection. Whereas preoperative FEV(1) and 6-min walk results did not predict postoperative functional health status or QLI, a low preoperative diffusion capacity of the lung for carbon monoxide (DLCO) predicted poor postoperative QLI. Preoperative chemoradiation, extent of resection, postoperative complications, or adjuvant therapy did not negatively affect the results of the 6-month QLI or SF-36. (ABSTRACT TRUNCATED)."
0042541,"Solway S, Brooks D, Lau L, Goldstein R",The short-term effect of a rollator on functional exercise capacity among individuals with severe COPD,Chest 2002 Jul;122(1):56-65,,"LUNG DISEASES OBSTRUCTIVE, EXERCISE, WALKING","REHABILITATION, DISABILITY EVALUATION",,,"This study was conducted to examine the short-term effects of using a rollator on functional exercise capacity among individuals with COPD and to characterize which individuals benefit most from its use. DESIGN: Repeated-measures randomized crossover design using the 6-min walk test (6MWT) as the primary outcome measure. SETTING: Respiratory rehabilitation center. PATIENTS: Forty stable subjects who had received a diagnosis of COPD. INTERVENTIONS: Two 6MWTs were performed on each study day. One 6MWT was performed unaided, and the other was performed with a rollator. The order was randomized on the first day and reversed on the second day. RESULTS: Use of the rollator was associated with a significant reduction in dyspnea (p less than 0.001) and duration of rest (reduction for the total group, 19 s; and reduction for those who walked less than 300 m unaided, 40 s; p = 0.001) during the 6MWT. For subjects who walked less than 300 m unaided, there was also a significant improvement in distance walked (p = 0.02). No changes were found for the measures of cardiorespiratory function or gait (p greater than 0.05). The requirement to rest during an unaided 6MWT was a significant predictor of improved functional exercise capacity with the use of the rollator (p less than 0.005). The majority of subjects whose unaided 6MWT distance was less than 300 m preferred using the rollator to walking unaided. CONCLUSIONS: Use of a rollator was effective in improving functional exercise capacity by reducing dyspnea and rest duration among stable individuals with severe COPD. Individuals who walked less than 300 m and individuals who required a rest during an unaided 6MWT benefited the most from using a rollator in terms of reduced dyspnea, reduced rest time, and improved distance walked.",0012-3692,AB,STUDY OBJECTIV
0042542,"Franklin B, Bonzheim K, Warren J, Haapaniemi S, Byl N, Gordon N","Effects of a contemporary, exercise-based rehabilitation and cardiovascular risk-reduction program on coronary patients with abnormal baseline risk factors",Chest 2002 Jul;122(1):338-43,,"EXERCISE, CORONARY DIS, CHOLESTEROL, CARDIOVASCULAR SYSTEM","REHABILITATION, RISK",,,,0012-3692,AB,"Phase II cardiac rehabilitation programs are associated with improvements in exercise tolerance, coronary risk factors, and psychosocial well-being. Nevertheless, previous reports have generally evaluated the global effectiveness of these programs (ie, on all subjects, collectively), which may serve to camouflage or attenuate the impact of these interventions on specific patient subsets. In this study, we investigated the effectiveness of a contemporary, exercise-based cardiac rehabilitation program that included a cardiovascular risk-reduction intervention, using a computerized database on 117 patients (average age, 66.5 years; 68% men; 96% white) who completed pre-phase II and post-phase II evaluations. Exercise training involved three 45- to 60-min sessions per week at minimum of 40 to 50% to a maximum of 75% oxygen uptake for 6 to 8 weeks. The effectiveness of the exercise training program was substantiated by significant (p less than or = to 0.05) reductions in heart rate (- 8 beats/min), systolic BP (- 11 mm Hg), and rating of perceived exertion (- 2, 6 to 20 scale) at a standard submaximal workload. Initial and follow-up ratings of overall health were improved: excellent (2.6 to 4.3%) and very good (20.7 to 35.7%). Average changes (p less than or = to 0.05 unless otherwise indicated) for all participants and those with abnormal baseline risk factors were as follows: systolic BP (- 4 mm Hg and - 16 mm Hg); diastolic BP (- 5 mm Hg and - 18 mm Hg); total cholesterol (- 19 mg/dL and - 75 mg/dL); low-density lipoprotein cholesterol (- 17 mg/dL and - 61 mg/dL); high-density lipoprotein cholesterol (- 1 mg/dL (not significant) and + 11 mg/dL); and triglycerides (- 5 mg/dL (not significant) and - 82 mg/dL), respectively. (ABSTRACT TRUNCATED)."
0042543,"Curtis JR, Wenrich MD, Carline JD, Shannon SE, Ambrozy DM, Ramsey PG","Patients' perspectives on physician skill in end-of-life care: differences between patients with COPD, cancer, and AIDS",Chest 2002 Jul;122(1):356-62,,"QUALITY OF HEALTH CARE, TERMINAL ILLNESS, PHYSICIANS ROLE, PATIENT SATISFACTION","COMMUNICATION, PATIENT EDUCATION, PALLIATIVE TREATMENT",,,"Patients' views of physician skill in providing end-of-life care may vary across different diseases, and understanding these differences will help physicians improve the quality of care they provide for patients at the end of life. The objective of this study was to examine the perspectives of patients with COPD, cancer, or AIDS regarding important aspects of physician skill in providing end-of-life care. DESIGN: Qualitative study using focus groups and content analysis based on grounded theory. SETTING: Outpatients from multiple medical settings in Seattle, WA. PATIENTS: Eleven focus groups of 79 patients with three diseases: COPD (n = 24), AIDS (n = 36), or cancer (n = 19). RESULTS: We identified, from the perspectives of patients, the important physician skills for high-quality end-of-life care. Remarkable similarities were found in the perspectives of patients with COPD, AIDS, and cancer, including the importance of emotional support, communication, and accessibility and continuity. However, each disease group identified a unique theme that was qualitatively more important to that group. For patients with COPD, the domain concerning physicians' ability to provide patient education stood out as qualitatively and quantitatively more important. Patients with COPD desired patient education in five content areas: diagnosis and disease process, treatment, prognosis, what dying might be like, and advance care planning. For patients with AIDS, the unique theme was pain control; for patients with cancer, the unique theme was maintaining hope despite a terminal diagnosis. CONCLUSIONS: Patients with COPD, AIDS, and cancer demonstrated many similarities in their perspectives on important areas of physician skill in providing end-of-life care, but patients with each disease identified a specific area of end-of-life care (ABSTRACT TRUNCATED).",0012-3692,AB,OBJECTIV
0042544,"Flynn E, O'Driscoll R",Exercise testing in the consulting room,Chest 2002 Jul;122(1):383,,"EXERCISE TESTING, LUNG DIS, PATIENT ASSESSMENT","OXYGEN CONSUMPTION, CLINICAL PROTOCOLS",(Letter),,,0012-3692,,
0042545,Van Der Weyden MB,Editorial independence is built on trust and communication,Aust J Physiother 2002;48(3):167-8,,"JOURNALS, COMMUNICATION",,(Editorial),,,0004-9514,,
0042546,"Refshauge KM, Parry S, Shirley D, Larsen D, Rivett DA, Boland R",Professional responsibility in relation to cervical spine manipulation,Aust J Physiother 2002;48(3):171-9,,"SPINAL MANIPULATION, CERVICAL VERTEBRAE, ETHICS","PHYSIOTHERAPISTS, TREATMENT OUTCOME, COMPLICATIONS",,,,0004-9514,AB,"Manipulation of the cervical spine is one of the few potentially life-threatening procedures performed by physiotherapists. Is it worth the risk? A comparison of risks versus benefits indicates that at present, the risks of cervical manipulation outweigh the benefits: manipulation has yet to be shown to be more effective for neck pain and headache than other interventions such as mobilisation, whereas the risks, although infrequent, are serious. This analysis is of particular concern because the conditions for which manipulation is indicated are benign and usually self-limiting. Because physiotherapists have legal and ethical obligations to the community to avoid foreseeable harm and provide optimum care, it may be prudent to determine who in our profession should perform cervical manipulation. That is, the profession could restrict the practice of cervical spine manipulation. Although all registered physiotherapists in Australia are entitled to perform cervical manipulation, few choose to use this intervention. Therefore, it might be feasible to encourage those practitioners who wish to use cervical manipulation to undertake formal education programs. Such a requirement could be embodied in a code of practice that discourages those without formal training from performing cervical manipulation. By taking such measures, we could ensure that our profession exercises wisdom in its monitoring and use of cervical manipulation."
0042547,"Jull G, Magarey M, Niere K, Elvey R","Physiotherapy, a responsible profession to use cervical manipulation. (Response to Refshauge et al)",Aust J Physiother 2002;48(3):180-3,,"SPINAL MANIPULATION, CERVICAL VERTEBRAE, SAFETY","PHYSIOTHERAPY, TREATMENT OUTCOME",,,,0004-9514,,
0042548,"Refshauge KM, Parry S, Shirley D, Larsen D, Rivett DA, Boland R",Professional responsibility means responding professionally. (Response to comment by Jull et al),Aust J Physiother 2002;48(3):183-5,,"SPINAL MANIPULATION, CERVICAL VERTEBRAE","COMPLICATIONS, PHYSIOTHERAPY",,,,0004-9514,,
0042549,Jull G,Use of high and low velocity cervical manipulative therapy procedures by Australian manipulative physiotherapists,Aust J Physiother 2002;48(3):189-93,,"SPINAL MANIPULATION, CERVICAL VERTEBRAE, NECK PAIN, BACKACHE","PHYSIOTHERAPY, COMPLICATIONS, TREATMENT OUTCOME",,,,0004-9514,AB,"The use of cervical manipulation presents concerns because of a risk of devastating side effects of trauma to the vertebral artery. Little is known about the frequency of use of cervical manipulation versus passive mobilisation by physiotherapists. A recent national, multi-centre randomised clinical trial of the physiotherapy management of cervicogenic headache provided an opportunity to gain an insight into practices of a sample of manipulative physiotherapists across Australia. The treatment records for the 100 subjects who received only manipulative therapy, or manipulative therapy with exercise as per the trial protocol, were audited. The results revealed that cervical manipulation was used in 20.2% of the 1090 treatments provided to these subjects but cervical joint mobilisation only was used in the vast majority of treatments (77.6%). Nevertheless, 42% of subjects were treated with cervical manipulation at some time. In most instances, manipulation was accompanied by passive mobilisation in the same treatment session. Patients were manipulated on one to six occasions and this occurred predominantly in the latter half of the 12-treatment program. Cervical manipulation was used less frequently in the group who also received exercise. The data suggest that the physiotherapists participating in this study used cervical manipulation selectively and relatively conservatively considering the high use of cervical mobilisation techniques. This may reflect their due regard to safety in the treatment of the cervical region."
0042550,"Ackermann B, Adams R, Marshall E",The effect of scapula taping on electromyographic activity and musical performance in professional violinists,Aust J Physiother 2002;48(3):197-204,,"MUSIC, SCAPULA, ELECTROMYOGRAPHY",TASK PERFORMANCE AND ANALYSIS,,,,0004-9514,AB,"Taping the scapula has been suggested as a method of improving both scapula position and muscular efficiency of the shoulder girdle. These factors have been linked to neck and arm problems in violinists. The purpose of this study was to evaluate the effects of taping the scapulae of violinists into a position that prevented excessive elevation and protraction whilst playing. Eight professional violinists played three different musical excerpts with and without scapula taping applied in random order. Electromyographic activity was recorded from the upper trapezii, the scapula retractors and the right sternocleidomastoid muscles. Performances were recorded onto videotape and audiocassette, and self-report data collected for later analysis. Compared with the control condition, scapula taping increased electromyographic activity in the left upper trapezius muscle during playing by 49% as an overall effect, with a 60% increase in the most physically demanding piece played. Lower music quality was detected in the same piece by raters blinded to performance conditions. Taping also had significant negative effects on subjects' reports of concentration and comfort. Short-term application of scapula taping did not enhance selected scapula stabilising muscles during playing and was not well tolerated by professional violinists."
0042551,"Pontifex E, Williams MT, Lunn R, Parsons D",The effect of huffing and directed coughing on energy expenditure in young asymptomatic subjects,Aust J Physiother 2002;48(3):209-13,,"RESPIRATION DISORDERS, COUGH, ENERGY METABOLISM",LUNG VOLUME MEASUREMENTS,,,,0004-9514,AB,"Coughing and huffing have been shown to be effective airway clearance techniques and some authors have anecdotally reported that a huff requires less energy than a series of coughs commencing and finishing at the same lung volume. The aim of this study was to determine whether there is a difference in the energy expenditure between periods of huffing and directed voluntary coughing commencing from the same initial lung volume in young asymptomatic subjects. Energy expenditure was measured using open-circuit indirect calorimetry equipment. Twenty-four non-smoking asymptomatic subjects (12 male, 12 female, aged 18-24 years), without any form of disease and within 10% of their predicted pulmonary function, completed the study. Energy expenditure was measured over three 10min, randomly ordered sessions of huffing, directed coughing and rest. The forced expiratory sessions comprised a single huff or double-barrel cough (both starting at total lung capacity) at the end of every two minutes. Each session was separated by a 5min washout period. No significant difference in energy expenditure was found between the huffing and directed coughing periods (mean difference 0.003 mL/kg/min (95% CI -0.160 to 0.114) and both produced significantly greater energy expenditure than rest (rest and huff mean difference 0.309 mL/kg/min (95% CI 0.080 to 0.549) and rest and cough mean difference 0.306 mL/kg/min (95% CI 0.074 to 0.508)). The suggested benefits of huffing versus coughing in terms of energy conservation are yet to be shown."
0042552,"Barrett CJ, Smerdely P",A comparison of community-based resistance exercise and flexibility exercise for seniors,Aust J Physiother 2002;48(3):215-9,,"RESISTANCE TRAINING, QUALITY OF LIFE, HEALTH STATUS","AGED, BALANCE, PHYSICAL FITNESS",,,,0004-9514,AB,"Progressive resistance training has positive effects on the health of elderly people, however exercise programs for seniors frequently focus on other forms of exercise. This study is a randomised trial with a blinded assessor comparing a community based progressive resistance training program (n = 20) with a flexibility program (n = 20), both one hour twice weekly for 10 weeks. Outcomes were strength, gait, balance and quality of life. Progressive resistance training had a greater effect than flexibility training on right sided quadriceps strength (mean difference between groups = 7.7%; 95% CI 3.6-11.8%, p less than 0.003 MANOVA), left sided quadriceps strength (mean difference = 9.9%; 95% CI 5.6-14.2%, p less than 0.003 MANOVA), left sided biceps strength (mean difference = 15.2%; 95% CI 11.7-19.2%, p less than 0.003 MANOVA), functional reach (mean difference = 11.7%; 95% CI 7.1-16.3%, p less than 0.003 MANOVA) and step test (mean difference = 8.6%; 95% CI 3.8-13.4%, p less than 0.003 MANOVA). Neither group had improvements in SF36 quality of life measures. Results suggest progressive resistance training produces greater strength, gait and balance improvements in elderly people than a flexibility exercise program."
0042553,"Schonstein E, Kenny DT, Maher CG",WorkCover's physiotherapy forms: purpose beyond paperwork?,Aust J Physiother 2002;48(3):221-5,,"WORKMENS COMPENSATION, LOW BACK PAIN","PHYSIOTHERAPISTS, COMMUNICATION, INSURANCE",,,,0004-9514,AB,"We retrospectively analysed 219 consecutive treatment plans submitted to a large New South Wales workers' compensation insurer for workers coded by the insurer as suffering from back pain. The purpose was to (i) describe the quality of goals of treatment provided to insurers by physiotherapists for workers with back pain using guidelines provided by the WorkCover Authority of New South Wales (WorkCover); (ii) compare the physiotherapists' prognoses against prognoses indicated in clinical practice guidelines; and (iii) make recommendations about the communication system between physiotherapists and insurers. The back pain of most treated workers was classified as acute and the majority of physiotherapists estimated that treatment would be of short duration, which is concordant with current treatment guidelines. However, most physiotherapists did not provide precise, measurable or time-specific treatment goals, despite this being emphasised by WorkCover. We propose ways of improving communication practices between physiotherapists and insurers."
0042554,Davidson M,The interpretation of diagnostic test: a primer for physiotherapists,Aust J Physiother 2002;48(3):227-33,,"PATIENT ASSESSMENT, PREDICTIVE VALUE OF TESTS","DIAGNOSIS, PHYSIOTHERAPY",,,,0004-9514,AB,"This paper outlines a practical approach to assist physiotherapists to interpret the results of diagnostic or screening tests. Diagnostic tests are used during clinical assessment to increase or decrease the clinician's estimate of the likelihood that a client has a particular condition. A negative result for a test that is 100% sensitive can rule a condition out (SnOUT), and a positive result for a test that is 100% specific can rule a condition in (SpIN). However, tests are rarely 100% accurate, and false-positive and false-negative results can occur. The examining therapist needs to estimate the probability that a client has a particular condition (the pre-test probability), then estimate the extent to which they are more or less certain given a positive or negative test result (the post-test probability). The likelihood ratio, which combines the information provided by a test's sensitivity and specificity, is the most useful tool for the clinical interpretation of test results."
0042555,McEllister C,Bed exercises result in decreased pain with functional activities following hip arthroplasty,Aust J Physiother 2002;48(3):234-5,,"ARTHROPLASTY, HIP, EXERCISE, DISABILITY EVALUATION, PAIN","PHYSIOTHERAPY, TREATMENT OUTCOME",(Letter),,,0004-9514,,
0042556,"Carotti M, Salaffi F, Manganelli P, Salera D, Simonetti B, Grassi W",Power Doppler sonography in the assessment of synovial tissue of the knee joint in rheumatoid arthritis: a preliminary experience,Ann Rheum Dis 2002 Oct;61(10):877-82,,"ARTHRITIS RHEUMATOID, KNEE, SYNOVITIS","ULTRASONOGRAPHY, CLINICAL ASSESSMENT SCALES",,,,0003-4967,AB,"OBJECTIVE: To investigate the intra-articular vascularisation of the synovial pannus in the knee of patients with rheumatoid arthritis (RA) with power Doppler ultrasonography (PDS) and an echo contrast agent and correlate the area under the time-intensity curves with the clinical findings and laboratory measures of disease activity. METHOD: Forty two patients with RA (31 women, 11 men) with history and signs of knee arthritis, classified according to a modified index of synovitis activity (active, moderately active, and inactive), were studied. Clinical and functional assessment (number of swollen joints, intensity of pain, general health-visual analogue scale, disability index-Health Assessment Questionnaire, Ritchie articular index) and a laboratory evaluation were made on all patients. Disease activity was evaluated using the disease activity score (DAS) and the chronic arthritis systemic index (CASI) for each patient. All patients were examined with conventional ultrasonography and PDS before injection of intravenous ultrasound contrast agent (Levovist). The quantitative estimation of the vascularisation of the synovial membrane was performed with time-intensity curves and calculation of the area under the curves. RESULTS: The mean (SD) value of the area underlying time-intensity curves was 216.2 (33.4) in patients with active synovitis, 186.8 (25.8) in patients with moderately active synovitis, and 169.6 (20.6) in those with inactive synovitis. The mean value of the areas differed significantly between the patients with active and those with inactive synovitis (p less than 0.01). The mean value of the area under the curve of the entire group was weakly correlated with the number of swollen joints (p = 0.038), but a strong correlation was found with composite indexes of disease activity such as the DAS (p = 0.006) (ABSTRACT TRUNCATED)."
0042557,"Bender T, Balint PV, Balint GP",A brief history of spa therapy,Ann Rheum Dis 2002 Oct;61(10):949-50,,"RHEUMATIC DIS, HYDROTHERAPY",REHABILITATION,(Letter),,,0003-4967,,
0042558,"Steineck G, Helgesen F, Adolfsson J, Dickman PW, Johansson JE, Norlen BJ, Holmberg L",Quality of life after radical prostatectomy or watchful waiting,N Engl J Med 2002 Sep 12;347(11):790-6,,"PROSTATIC NEOPLASMS, SELF ASSESSMENT","QUALITY OF LIFE, COMPARATIVE STUDY, SYMPTOMS, RANDOMIZED CONTROLLED TRIALS, SURGERY OPERATIVE",,,,0028-4793,AB,"BACKGROUND: We evaluated symptoms and self-assessments of quality of life in men with localized prostate cancer who participated in a randomized comparison between radical prostatectomy and watchful waiting. METHODS: Between 1989 and 1999, a group of Swedish urologists randomly assigned men with localized prostate cancer to radical prostatectomy or watchful waiting. In this follow-up study, we obtained information from 326 of 376 eligible men (87%) concerning certain symptoms, symptom-induced distress, well-being, and the subjective assessment of quality of life by means of a mailed questionnaire. RESULTS: Erectile dysfunction (80% vs. 45%) and urinary leakage (49% vs. 21%) were more common after radical prostatectomy, whereas urinary obstruction (e.g., 28% vs. 44% for weak urinary stream) was less common. Bowel function, the prevalence of anxiety, the prevalence of depression, well-being, and the subjective quality of life were similar in the two groups. CONCLUSIONS: The assignment of patients to watchful waiting or radical prostatectomy entails different risks of erectile dysfunction, urinary leakage, and urinary obstruction, but on average, the choice has little if any influence on well-being or the subjective quality of life after a mean follow-up of four years."
0042559,Chaitow L,Individuality,J Bodywork Mov Ther 2002 Jul;6(3):141-2,,"PERSONALITY, PATIENT ASSESSMENT",BIOCHEMISTRY,(Editorial),,,1360-8592,,
0042560,"Lovas JM, Craig AR, Segal YD, Raison RL, Weston KM, Markus MR",The effects of massage therapy on the human immune response in healthy adults,J Bodywork Mov Ther 2002 Jul;6(3):143-50,,"IMMUNE SYSTEM, MASSAGE","ADULT, TREATMENT OUTCOME",,,,1360-8592,AB,"Little scientific investigation has been conducted to examine objectively the belief that massage therapy can effect the immune system of healthy people. If there are any links between massage therapy and improved immune function, the mechanisms by which they operate are not known. This study evaluated the effects of massage therapy on immune functions of two healthy females. Using a single-case experimental ABAB design, two subjects received a relaxing massage during the experimental phases (B) and no massage during baseline phases (A). Assays were conducted for T and B lymphocyte mitogen-induced proliferation, enumeration of T and B lymphocyte subsets, quantification of immunoglobulins A, G and M (IgA, IgG, IgM) and cortisol levels. Trait and state anxiety levels were also examined. The results indicated a consistent and significant trend of increased activity of both T and B lymphocytes and levels of serum IgG for both subjects during the B phases compared to the A phases. There were no other significant differences between experimental and control conditions for the remaining measures, although serum IgM levels approached significance (P = 0.06). Both subjects demonstrated a reduction in trait anxiety over the period of massage therapy. Further studies with larger sample sizes in control and experimental groups, over a longer experimental period are necessary. The study of the effects of massage therapy poses an exciting challenge in psychoneuroimmunology."
0042561,Liebenson C,Are prolonged sitting postures bad for the back?,J Bodywork Mov Ther 2002 Jul;6(3):151-3,,"POSTURE, SITTING, SELF EFFICACY",METHODS,,,,1360-8592,,
0042562,Liebenson C,Micro-breaks,J Bodywork Mov Ther 2002 Jul;6(3):154-5,,"SITTING, EXERCISE, TIME",,,,,1360-8592,,
0042563,Korkia P,"Osteoporosis: process, prevention, and treatment",J Bodywork Mov Ther 2002 Jul;6(3):156-69,,"OSTEOPOROSIS, BONE DENSITY, CALCIUM, EXERCISE THERAPY, STEROIDS","PREVENTION, PHYSIOPATHOLOGY, TREATMENT OUTCOME",,,,1360-8592,,
0042564,"Zakas A, Galazoulas C, Grammatikopoulou MG, Vergou A","Effects of stretching exercise during strength training in prepubertal, pubertal and adolescent boys",J Bodywork Mov Ther 2002 Jul;6(3):170-6,,"REFLEX, MUSCLES, RESISTANCE TRAINING","LEG, RANGE OF MOTION, ADOLESCENT, MALE, EPIDEMIOLOGIC METHODS, TREATMENT OUTCOME",,,,1360-8592,AB,"The purpose of the study was to investigate the effect of stretching exercises on lower extremity range of motion (ROM) in prepubertal, pubertal and adolescent boys. We also aimed to examine the initial ROM among the three age groups for both sides of the body. A total of 110 boys aged 10, 13 and 16 years old were divided into two equal groups (training group A and control group B), each group including three age subgroups. Group A participated in school physical activities and an interval strength training programme (12 weeks, 50 min/day, 3 days/week) at high intensity (80-85% of max) and at light intensity (30-40% of max). High-intensity workload was performed on a cycle ergometer for 4 min, alternating with light intensity workload for 8 min including stretching exercises. Group B participated only in the school physical activities, 2-3 times/week. ROM was determined during hip flexion, extension and abduction and knee flexion for right and left sides, using a flexometer and a goniometer. A mixed within- and between-subjects analysis of variance (ANOVA) with repeated measures revealed that initial ROM in hip joint flexion and extension for the left side were similar at all three ages. ROM in hip joint abduction and knee joint flexion was significantly greater in 10-year-old boys than 16-year-olds boys (P less than 0.05). For all age groups, the initial ROM between the right and left sides was similar. No significant differences were revealed in ROM before and after the training programme for the control group. However, significant improvements in ROM were shown in all three age groups of the training subjects (P less than 0.01). These findings suggest that ROM is similar between the right and the left sides of boys during prepuberty, puberty and adolescence. (ABSTRACT TRUNCATED)."
0042565,"Hernandez-Reif M, Field T, Largie S, Cullen C, Beutler J, Sanders C, Weiner W, Rodriguez-Bateman D, Zelaya L, Schanberg S, Kuhn C",Parkinson's disease symptoms are differentially affected by massage therapy vs. progressive muscle relaxation: a pilot study,J Bodywork Mov Ther 2002 Jul;6(3):177-82,,"PARKINSON DIS, MASSAGE, MUSCLE RELAXATION, EXERCISE THERAPY","SYMPTOMS, PILOT PROJECTS, COMPARATIVE STUDY",,,,1360-8592,AB,"Sixteen adults diagnosed with idiopathic Parkinson's disease (M age = 58) received 30-min massage therapy or progressive muscle relaxation exercise sessions twice a week for 5 weeks (10 sessions total). Physicians rated participants in the massage therapy group as improved in daily living activities by the end of the study. The massaged group also rated themselves as improved in daily functioning, and having more effective and less disturbed sleep. Urine samples revealed that at the end of the 10 sessions, the massage therapy group had lower norepinephrine and epinephrine (stress hormone) levels, suggesting they were less stressed. The progressive muscle relaxation group had higher dopamine levels, which is interesting in that Parkinson's is associated with a decrease in dopamine. The relaxation group also showed higher epinephrine levels, suggesting that although the relaxation exercises might have been beneficial, some Parkinson's participants might have found the relaxation technique stressful."
0042566,Grieve GP,The masqueraders,J Bodywork Mov Ther 2002 Jul;6(3):183-98,,"MUSCULOSKELETAL SYSTEM, PATIENT ASSESSMENT",DIAGNOSTIC ERRORS,,,,1360-8592,,
0042567,"Baruch G, Fearon P",The evaluation of mental health outcome at a community-based psychodynamic psychotherapy service for young people: a 12-month follow-up based on self-report data,Psychol Psychother 2002 Sep;75(3):261-78,,"COMMUNITY MENTAL HEALTH SERVICES, PSYCHOTHERAPY, SELF ASSESSMENT","PROGRAM EVALUATION, ADOLESCENT, FOLLOW UP STUDIES",,,,1476-0835,AB,"The present study focuses on the evaluation of mental health outcome of 151 young people who received psychodynamic psychotherapy at the Brandon Centre, a community-based psychodynamic psychotherapy centre for young people. This paper reports the results from a 1-year follow-up based on self-report data. Participants aged 12-18 years completed either the Youth Self Report form or, if they were aged over 18, the Young Adult Self Report form at intake, 3 months, 6 months, and 1 year. The domains evaluated included young people's externalizing problems, internalizing problems, and total problems. Outcome was measured in three different ways: the change in mean scores; the change in numbers from the clinical to the non-clinical range; and categorizing cases according to the presence of statistically reliable change in the level of adaptation. These approaches showed improvement among participants in all three domains. Although there was a high general tendency to improve, the rate of improvement dropped significantly over time. Several tentative predictors of improvement were identified. The paper discusses how the results from systematic monitoring of effectiveness at the Brandon Centre have formed an empirical basis that has led to changes in service delivery with the aim of optimizing provision for troubled young people."
0042568,"Spruytte N, Van Audenhove C, Lammertyn F, Storms G",The quality of the caregiving relationship in informal care for older adults with dementia and chronic psychiatric patients,Psychol Psychother 2002 Sep;75(3):295-312,,"CAREGIVERS, MENTAL DISORDERS, QUALITY OF HEALTH CARE","DEMENTIA, AGED",,,,1476-0835,AB,"The present study focuses on the dyadic relationship between a family carer and a patient. Besides clarifying the quality of the caregiving relationship in two populations of chronically ill patients, this investigation examines whether patient characteristics, carer characteristics and network characteristics are predictive of relationship quality in dementia caregiving. Partners, children or children-in-law caring for a relative suffering from dementia (N = 144) and partners or parents of persons suffering from chronic mental illness (N = 77) were interviewed with a semi-structured questionnaire. The measurement of relationship quality is based on the literature of Expressed Emotion and covers two dimensions: the level of criticism and the level of warmth. In general, the relationship between a carer and his or her chronically ill relative was marked by a low level of conflict or criticism and a high degree of warmth. The main predictors of a poorer relationship quality were disturbances in the patient's behaviour and the carer's perception of these disturbances. Our results suggest that, rather than limiting investigations to the burden experienced by the family carer, future research and interventions on chronically ill patients should focus on the quality of the carer-patient relationship and its determinants."
0042569,"Troosters T, Vilaro J, Rabinovich R, Casas A, Barbera JA, Rodriguez-Roisin R, Roca J",Physiological responses to the 6-min walk test in patients with chronic obstructive pulmonary disease,Eur Respir J 2002 Sep;20(3):564-9,,"LUNG DISEASES OBSTRUCTIVE, EXERCISE TESTING, EXERCISE TOLERANCE",PHYSIOLOGY,,,,0903-1936,AB,"The 6-min walking test (6MWT) is frequently used to assess functional capacity in chronic cardiopulmonary disorders because of its simplicity. The study examines the physiological responses during encouraged 6MWT in patients with chronic obstructive pulmonary disease. Pulmonary oxygen (O2) uptake (V'O2) was measured in 20 male patients (age 66 +/- 6 yrs, forced expiratory volume in one second 45 +/- 14% predicted) during 6MWT and incremental cycling, in random order. VO2 tension in arterial blood, carbon dioxide tension in arterial blood and arterial lactate concentration ((La)art) were obtained in the last 10 patients. During the 6MWT, V'O2 showed a plateau after the 3rd min (1.39 +/- 0.28, 1.42 +/- 0.31, and 1.40 +/- 0.30 L x min(-1), 4th, 5th and 6th min, respectively), and minute ventilation (V'E) (42 +/- 8 L x min(-1)) was 91% maximal voluntary ventilation. No differences were shown between 6MWT (6th min) and peak cycling exercise in V'O2 (1.40 +/- 0.30 versus 1.41 +/- 0.28 L x min(-1), respectively), cardiac frequency (126 +/- 13 versus 130 +/- 12 beats x min(-1)), or arterial respiratory blood gases. The two tests were significantly different in V'E (42 +/- 8 versus 47 +/- 8 L x min(-1), 6MWT versus cycling, respectively), carbon dioxide production (1.30 +/- 0.31 versus 1.45 +/- 0.18 L x min(-1)) and (La)art (2.9 +/- 1.99 versus 5.9 +/- 1.51 M). The study demonstrates that an encouraged 6-min walking test generates a high but sustainable oxygen uptake. Since the oxygen uptake plateau reflects the integrated response of the system, it may explain the high prognostic value of the 6-min walking test."
0042570,"Lotters F, van Tol B, Kwakkel G, Gosselink R",Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis,Eur Respir J 2002 Sep;20(3):570-6,,"LUNG DISEASES OBSTRUCTIVE, MUSCLE STRENGTH, DYSPNEA","META ANALYSIS, EVIDENCE BASED MEDICINE, REHABILITATION",,,,0903-1936,AB,"The purpose of this meta-analysis is to review studies investigating the efficacy of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients and to find out whether patient characteristics influence the efficacy of IMT. A systematic literature search was performed using the Medline and Embase databases. On the basis of a methodological framework, a critical review was performed and summary effect-sizes were calculated by applying fixed and random effects models. Both IMT alone and IMT as adjunct to general exercise reconditioning significantly increased inspiratory muscle strength and endurance. A significant effect was found for dyspnoea at rest and during exercise. Improved functional exercise capacity tended to be an additional effect of IMT alone and as an adjunct to general exercise reconditioning, but this trend did not reach statistical significance. No significant correlations were found for training effects with patient characteristics. However, subgroup analysis in IMT plus exercise training revealed that patients with inspiratory muscle weakness improved significantly more compared to patients without inspiratory muscle weakness. From this review it is concluded that inspiratory muscle training is an important addition to a pulmonary rehabilitation programme directed at chronic obstructive pulmonary disease patients with inspiratory muscle weakness. The effect on exercise performance is still to be determined."
0042571,"Emelyanov A, Fedoseev G, Krasnoschekova O, Abulimity A, Trendeleva T, Barnes PJ",Treatment of asthma with lipid extract of New Zealand green-lipped mussel: a randomised clinical trial,Eur Respir J 2002 Sep;20(3):596-600,New Zealand green-lipped mussels,"ASTHMA, RESPIRATORY AIRFLOW, HYDROGEN PEROXIDE","INVERTEBRATES, RANDOMIZED CONTROLLED TRIALS, TREATMENT OUTCOME, BIOLOGICAL PRODUCTS",,,,0903-1936,AB,"Asthma is a chronic inflammatory disease of the airways mediated, at least in part, by leukotrienes and other lipid mediators. Experimental studies have shown that lipid extract of New Zealand green-lipped mussel, Perna canaliculus, is effective in inhibiting 5'-lipoxygenase and cyclo-oxygenase pathways responsible for production of eicosanoids, including leukotrienes and prostaglandins. The aim of this study was to assess its effect on symptoms, peak expiratory flow (PEF) and hydrogen peroxide (H2O2) in expired breath condensate as a marker of airway inflammation in patients with steroid-naive atopic asthma in a double-blind randomised, placebo-controlled clinical trial. Forty six patients with atopic asthma received two capsules of lipid extract (Lyprinol) or placebo b.i.d for 8 weeks. Each capsule of lipid extract contained 50 mg omega-3 polyunsaturated fatty acids and 100 mg olive oil, whereas placebo capsules contained only 150 mg olive oil. There was a significant decrease in daytime wheeze, the concentration of exhaled H2O2 and an increase in morning PEF in the lipid extract group compared to the placebo group. There were no significant side-effects. The authors conclude that lipid extract of New Zealand green-lipped mussel may have some beneficial effect in patients with atopic asthma."
0042572,"Chenuel B, Haouzi P, Olivier P, Marie PY, Chalon B, Borrelly J",Effect of exercise on lung-perfusion scanning in patients with bronchogenic carcinoma,Eur Respir J 2002 Sep;20(3):710-6,,"LUNG NEOPLASMS, EXERCISE THERAPY, RESPIRATORY FUNCTION TESTS, PREOPERATIVE CARE",RADIONUCLIDE IMAGING,,,,0903-1936,AB,"The aim of this study was to determine whether perfusion-scintillation scanning, used as a predictive pre-operative index of lung functionality in patients with lung cancer, is affected by the level of pulmonary blood flow (PBF). Twenty patients with primary lung cancer underwent spirometry and a radionuclide-perfusion scan (macroaggregated albumin particles labelled with 99mTechnetium) both at rest and during the last minute of a ramp-like increase in work rate until exhaustion. On average, the perfusion of the lung with the tumour was significantly reduced by the same magnitude at rest and during exercise (mean +/- SD: -9 +/- 6% versus -10 +/- 4% of the cardiac output), regardless of the extent of the tumour. However, subject-by-subject analysis revealed that in two patients, a larger decrease in the perfusion of the lung with the tumour was observed during exercise than at rest (-11% and -17%, respectively). This leads to an underestimation of predictive postoperative functional parameters if resting values are used in these patients. The use of perfusion scintigraphy at rest therefore gives a clear picture of the functionality of the lung before resection in most patients requiring surgery."
0042573,"Fagan MJ, Julian S, Mohsen AM",Finite element analysis in spine research,Proc Inst Mech Eng (J Eng Med) 2002;216(5):281-98,,SPINE,"FINITE ELEMENT ANALYSIS, BIOMECHANICS, RESEARCH",,,,0954-4119,AB,"Finite element analysis is a widely accepted tool used in many industries and research activities. It allows new designs to be thoroughly 'tested' before a prototype is even manufactured, components and systems which cannot readily be experimented upon to be examined, and 'diagnostic' investigations to be undertaken. Finite element models are already making an important contribution to our understanding of the spine and its components. Models are being used to reveal the biomechanical function of the spine and its behaviour when healthy, diseased or damaged. They are also providing support in the design and application of spinal instrumentation. The spine is a very complex structure, and many of the models are simplified and idealized because of the complexity and uncertainty in the geometry, material properties and boundary conditions of these problems. This type of modelling simplification is not peculiar to spinal modelling problems. Indeed, the idealization is often a strength when there is such uncertainty and variation between one individual and another, allowing cause-effect relationships to be isolated and fully explored, and the inherent variability of experimental tests to be eliminated. This paper reviews the development of finite element analysis in spinal modelling. It shows how modelling provides a wealth of information on our physiological performance, reduces our dependence on animal and cadaveric experiments and is an invaluable complement to clinical studies. It also leads to the conclusion that, as computing power and software capabilities increase, it is quite conceivable that in the future it will be possible to generate patient-specific models that could be used for patient assessment and even pre- and inter-operative planning."
0042574,"Fagan MJ, Julian S, Siddall DJ, Mohsen AM",Patient-specific spine models. Part 1: finite element analysis of the lumbar intervertebral disc - a material sensitivity study,Proc Inst Mech Eng (J Eng Med) 2002;216(5):299-314,,"LUMBAR VERTEBRAE, INTERVERTEBRAL DISK","FINITE ELEMENT ANALYSIS, BIOMECHANICS, MODELS BIOLOGICAL",,,,0954-4119,AB,"If patient-specific finite element models of the spine could be developed, they would offer enormous opportunities in the diagnosis and management of back problems. Several generic models have been developed in the past, but there has been very little detailed examination of the sensitivity of these models' characteristics to the input parameters. This relationship must be thoroughly understood if representative patient-specific models are to be realized and used with confidence. In particular, the performance of the intervertebral discs are central to any spine model and need detailed investigation first. A generic non-linear model of an intervertebral disc was developed and subjected to compressive, flexion and torsional loading regimes. The effects of both material and geometric non-linearities were investigated for the three loading schemes and the results compared with experimental data. The basic material properties of the fibres, annulus and nucleus were then varied and the effects on the stiffness, annulus bulge and annulus stresses analysed. The results showed that the non-linear geometry assumption had a significant effect on the compression characteristics, whereas the non-linear material option did not. In contrast, the material non-linearity was more important for the flexural and torsional loading schemes. Thus, the inclusion of non-linear material and geometry analysis options in finite element models of intervertebral discs is necessary to predict in vivo load-deflection characteristics accurately. When the influence of the material properties was examined in detail, it was found that the fibre properties did not have a significant effect on the compressive stiffness of the disc but did affect the flexural and torsional stiffnesses by up to +/- 20%. All loading modes were sensitive to the annulus properties (ABSTRACT TRUNCATED)."
0042575,Hardy D,Creating through loss: an examination of how art therapists sustain their practice in palliative care,Inscape 2001;6(1):23-31,,ART THERAPY,PALLIATIVE TREATMENT,,,,0264-7141,AB,"In this article it is argued that therapists working in the field of palliative care should be more open to acknowledging their own needs and feelings of loss when clients die. A review of the art therapy literature demonstrates that there has been a reticence about looking at this feature of our work and the reasons for this are examined. The second part of the article considers the arguments for and against working with transference and countertransference relationship with this client group. By drawing upon personal experience as an art therapist working in palliative care, the author discusses the positive advantages that can be accrued by working in this way. He suggests that a more active engagement with transference and countertransference issues would enhance practitioners' efforts in this field, by enabling art therapists to retain their own creativity and versatility. The article concludes that an awareness of transference issues is necessary not only for sustained good practice, but for long-term 'survival' of the therapist as well."
0042576,Wright S,Open your mind,Nurs Stand 2002 Aug 14;16(48):20-1,,"COMPLEMENTARY MEDICINE, PSYCHOTROPIC DRUGS, PSYCHOTIC DISORDERS","COMPLEMENTARY THERAPIES, PSYCHOLOGY, DRUG THERAPY",,,,0029-6570,,
0042577,Portman F,How I lost my fear of cancer,Nurs Stand 2002 Aug 14;16(48):22,,"NEOPLASMS, ATTITUDE TO HEALTH, PALLIATIVE TREATMENT","FEAR, PSYCHOLOGY, ATTITUDE OF HEALTH PERSONNEL",,,,0029-6570,,
0042578,Scullion P,Neurological patients: the need for alliances,Br J Ther Rehabil 2002 Aug;9(8):293,,"NEUROLOGIC MANIFESTATIONS, INTERPROFESSIONAL RELATIONS","GREAT BRITAIN, SOCIETIES MEDICAL",(Editorial),,,1354-8581,,
0042579,Boniface G,Understanding reflective practice in occupational therapy,Br J Ther Rehabil 2002 Aug;9(8):294-8,,"OCCUPATIONAL THERAPY, MENTAL HEALTH, CEREBROVASCULAR DISORDERS","REHABILITATION, KNOWLEDGE, MENTAL PROCESSES",,,,1354-8581,AB,"This study aims to identify occupational therapists' understanding of reflective practice in three separate settings: mental health, stroke rehabilitation and general medicine. The factors that encourage or hinder reflection are investigated and analysed to inform future practice."
0042580,"Bannigan K, Hooper L",How journal clubs can overcome barriers to research utilization,Br J Ther Rehabil 2002 Aug;9(8):299-303,,"JOURNALS, INTERPROFESSIONAL RELATIONS","RESEARCH, GROUP PROCESSES",,,,1354-8581,AB,"The second of this two-part article will focus on journal clubs - an intervention used to increase the use of research findings and provide a forum for critical appraisal. This article introduces the concept of a journal club, explores the roles that they can play in overcoming barriers to research utilization, and provides an insight into how to establish a journal club."
0042581,Maylor ME,The rationale behind pressure-reducing equipment: 1,Br J Ther Rehabil 2002 Aug;9(8):304-8,,"DECUBITUS ULCER, PRESSURE, SUPPORT MATERIALS","PREVENTION, BEDS, EQUIPMENT DESIGN",,,,1354-8581,AB,This is the first of two articles surveying the different types and operational characteristics of pressure-reducing equipment used for protecting patients from pressure ulceration.
0042582,Gibbs V,Hospital induction and its effects on staff turnover,Br J Ther Rehabil 2002 Aug;9(8):309-13,,"PERSONNEL TURNOVER, STAFF DEVELOPMENT, HOSPITALS, ATTITUDE OF HEALTH PERSONNEL","METHODS, PSYCHOLOGY, LONDON, ORGANIZATIONAL INNOVATION",,,,1354-8581,AB,"This article examines the current induction process within a central London hospital and its effects, if any, on staff retention. It aims to compare the effectiveness of this hospital's induction process with those used in other organizations, in order to obtain ideas for possible improvement."
0042583,Wright CC,The use of graphs and statistics in health-care research,Br J Ther Rehabil 2002 Aug;9(8):314-21,bias epidemiology,"HEALTH SERVICES RESEARCH, STATISTICS","PUBLIC HEALTH, QUALITY OF HEALTH CARE, DATA COLLECTION",,,,1354-8581,AB,"This article will discuss key features of simple graphical and numerical summaries that are routinely used to describe numerical data. It considers the different types of data and how these influence the choice of appropriate summaries, and helps the consumer to identify information that has been presented in an inappropriate or misleading manner."
0042584,Master FJ,Nature as a tool for materia medica,Homoeopath Heritage 2002 Jul;27(7):3-7,,"MATERIA MEDICA, HOMEOPATHY","PLANTS MEDICINAL, PHYTOTHERAPY, SYMPTOMS",(Editorial),,,0970-6038,,
0042585,Riley DS,Proving of Geranium robertianum,Homoeopath Heritage 2002 Jul;27(7):8-18,,"HOMEOPATHIC DRUGS, PROVING, GERANIUM",PLANTS MEDICINAL,,,,0970-6038,,
0042586,Kamalapurkar PM,Homoeopathy cures tubal blockage,Homoeopath Heritage 2002 Jul;27(7):20-2,fallopian tube diseases,"HOMEOPATHY, HOMEOPATHIC DRUGS","GENITAL DISEASES FEMALE, DRUG THERAPY, CASE REPORT, TREATMENT OUTCOME",,,,0970-6038,,
0042587,Treuherz F,Memorium - 50 years since liberation: a case,Homoeopath Heritage 2002 Jul;27(7):23-4,,"VERTIGO, HOMEOPATHIC DRUGS","DRUG THERAPY, CASE REPORT, AGED, FEMALE, WAR",,,,0970-6038,,
0042588,Kokelengerg G,The treatment of headaches,Homoeopath Heritage 2002 Jul;27(7):25-9,,"HEADACHE, HOMEOPATHIC DRUGS","ETIOLOGY, DRUG THERAPY",,,,0970-6038,,
0042589,Rothenberg A,It is nice to wait,Homoeopath Heritage 2002 Jul;27(7):31-3,,"HEADACHE, VAGINITIS, CANDIDIASIS","CASE REPORT, DRUG THERAPY, HOMEOPATHY, FEMALE",,,,0970-6038,,
0042590,Kokelenberg G,A farmer's daughter,Homoeopath Heritage 2002 Jul;27(7):34-7,,"AGRICULTURE, HEADACHE, HYPERSENSITIVITY","DRUG THERAPY, HOMEOPATHY, CASE REPORT, TREATMENT OUTCOME, FEMALE",,,,0970-6038,,
0042591,Master FJ,Accept what is acceptable to you but do not reject what is not acceptable to you,Homoeopath Heritage 2002 Jun;27(6):3-6,,"HOMEOPATHY, ATTITUDE OF HEALTH PERSONNEL","KNOWLEDGE, PSYCHOLOGY",,,,0970-6038,,
0042592,Fonrobert H,Homoeopathic treatment of eczema,Homoeopath Heritage 2002 Jun;27(6):7-8,,"ECZEMA, SULFUR COMPOUNDS, HOMEOPATHIC DRUGS","DRUG THERAPY, HOMEOPATHY",,,,0970-6038,,
0042593,Triebel H,About prostatic enlargements,Homoeopath Heritage 2002 Jun;27(6):9-11,,"PROSTATIC HYPERTROPHY, HOMEOPATHIC DRUGS","DRUG THERAPY, HOMEOPATHY, SYMPTOMS, PATHOLOGY",,,,0970-6038,,
0042594,Kumta PS,Homoeopathy in acute cases: some simple hints,Homoeopath Heritage 2002 Jun;27(6):12-5,,"HOMEOPATHY, TEACHING","METHODS, PROFESSIONAL PRACTICE, ACUTE DIS",,,,0970-6038,,
0042595,Shepherd D,Chronic hoarseness,Homoeopath Heritage 2002 Jun;27(6):16-8,,"VOICE DISORDERS, HOMEOPATHIC DRUGS","HOMEOPATHY, DRUG THERAPY, TREATMENT OUTCOME, CHRONIC DIS",,,,0970-6038,,
0042596,Anonymous,Food and drink in asthma patients,Homoeopath Heritage 2002 Jun;27(6):19-21,,"ASTHMA, ALCOHOL DRINKING","ETIOLOGY, DIET THERAPY, ALLERGENS",,,,0970-6038,,
0042597,Khalsa OS,Pulsatilla patients in verse,Homoeopath Heritage 2002 Jun;27(6):22,,"POETRY, HOMEOPATHIC DRUGS, PULSATILLA","HOMEOPATHY, SYMPTOMS, PLANTS MEDICINAL",,,,0970-6038,,
0042598,Bowie RC,Hypertension,Homoeopath Heritage 2002 Jun;27(6):23-5,,"HYPERTENSION, HOMEOPATHIC DRUGS","ETIOLOGY, DRUG THERAPY, COMORBIDITY",,,,0970-6038,,
0042599,Calcot RD,Eye cases treated homoeopathically,Homoeopath Heritage 2002 Jun;27(6):26-8,,"EYE DIS, HOMEOPATHIC DRUGS","HOMEOPATHY, DRUG THERAPY",,,,0970-6038,,
0042600,Banerjee TN,A chronic case of trauma,Homoeopath Heritage 2002 Jun;27(6):28-9,,"HEADACHE, VOMITING, DIARRHEA, HOMEOPATHIC DRUGS","CHRONIC DIS, HOMEOPATHY, CASE REPORT, MALE, ADOLESCENT, TREATMENT OUTCOME",,,,0970-6038,,
0042601,Peretz DI,Moxibustion,Can Med Assoc J 2002 Sep 3;167(5):448,,MOXIBUSTION,,(Letter),,,0820-3946,,
0042602,Maddocks I,Spaces and silences,Prog Palliat Care 2002;10(4):159-60,,PALLIATIVE TREATMENT,PROFESSIONAL PATIENT RELATIONS,(Editorial),,,0969-9260,,
0042603,"Strasser F, Bruera E",Mechanism of cancer cachexia: progress on disentangling a complex problem,Prog Palliat Care 2002;10(4):161-7,Cachexia,"NEOPLASMS, CHRONIC DIS, ANOREXIA","MODELS BIOLOGICAL, EVIDENCE BASED MEDICINE",(Review),,,0969-9260,,
0042604,"Kraus P, Andrews S, Tanchel I",HIV infection and its implications for palliative care in South Africa,Prog Palliat Care 2002;10(4):168-71,,"PALLIATIVE TREATMENT, HIV INFECTIONS",SOUTH AFRICA,(Review),,,0969-9260,,
0042605,"Janssen CG, Schuengel C, Stolk J",Understanding challenging behaviour in people with severe and profound intellectual disability: a stress-attachment model,J Intellect Disabil Res 2002 Sep;46(6):445-53,,"BEHAVIORAL DISORDERS, LEARNING DISORDERS","MODELS PSYCHOLOGICAL, PSYCHOPHYSIOLOGY",,,,0964-2633,AB,"BACKGROUND: Advances in our knowledge of attachment, stress and coping may foster new explanations for the development of challenging behaviour in people with intellectual disability (ID). Method Research on stress and coping among people with ID was reviewed initially, and then studies on the security of the attachment relationships of people with ID with their caregivers were analysed. RESULTS: There is evidence that people with ID are more vulnerable to stress and use less effective coping strategies. Furthermore, the body of studies on attachment indicates that people with ID are at risk for developing insecure, especially disorganized attachment. There is evidence from other populations that the combination of stress, and insecure or disorganized attachment may put people at risk for developing behaviour problems. CONCLUSION: A stress-attachment model of the development of challenging behaviour among people with ID shows promise as an explanatory framework. The uncovering of these developmental mechanisms may be particularly useful for the prevention of behavioural problems."
0042606,"Barron P, Hassiotis A, Banes J",Offenders with intellectual disability: the size of the problem and therapeutic outcomes,J Intellect Disabil Res 2002 Sep;46(6):454-63,,"LEARNING DISORDERS, SOCIAL PROBLEMS","SEX OFFENSES, EVIDENCE BASED MEDICINE, TREATMENT OUTCOME",,,,0964-2633,AB,"BACKGROUND: People with intellectual disability (ID) who offend may be subject to a variety of disposals within the criminal justice system, or via diversion to health and social services in inpatient units or in community ID teams. Offenders with ID are a group with complex needs who may pose a recurrent risk to the public. Despite the significant number of offenders with ID, there is limited evidence on treatment effectiveness and outcomes. METHODS: A literature search of all electronic databases was undertaken, and journals were hand-searched for clinical trials or case studies of interventions for offenders with ID. The main outcome was recidivism rates. Results: There were no published clinical trials of offenders with ID. A series of small-scale group cognitive-behavioural treatments for sex offenders offers the most persuasive evidence of success in reducing recidivism. CONCLUSION: Offenders with ID often receive inadequate services as a result of poor identification through the criminal justice system and research into effective treatments is rudimentary. Further studies are necessary in order to improve treatment efficacy and service provision for a complex group of individuals."
0042607,"Smith C, Felce D, Ahmed Z, Fraser WI, Kerr M, Kiernan C, Emerson E, Robertson J, Allen D, Baxter H, Thomas J",Sedation effects on responsiveness: evaluating the reduction of antipsychotic medication in people with intellectual disability using a conditional probability approach,J Intellect Disabil Res 2002 Sep;46(6):464-71,,"PSYCHOTROPIC DRUGS, SUBSTANCE WITHDRAWAL SYNDROME, LEARNING DISORDERS","HYPNOTICS AND SEDATIVES, CLINICAL ASSESSMENT SCALES, ADULT",,,,0964-2633,AB,"BACKGROUND: The impact of the withdrawal of long-term antipsychotic medication prescribed to adults with intellectual disabilities on behavioural functioning has been investigated using a real-time direct observation methodology. Previous authors have reported a significant post-reduction difference in engagement in activity between the successful drug reduction and control groups. METHOD: In the present study, sequential analysis of the relationship between staff:resident interaction and behavioural engagement was used to give a more precise measure of the extent to which user responsiveness is affected by drug withdrawal. Responsiveness was measured by calculating the likelihood of engagement occurring given the occurrence of staff interaction. This likelihood was represented by the statistic Yule's Q-value. RESULTS: High Yule's Q-value results pre- and post-baseline were found, indicating that clients were highly responsive to staff interaction. However, Yule's Q-value did not significantly increase following drug withdrawal. CONCLUSION: The present study provides no evidence of greater responsiveness following the withdrawal of psychotropic medication."
0042608,"Devenny DA, Zimmerli EJ, Kittler P, Krinsky-McHale SJ",Cued recall in early-stage dementia in adults with Down's syndrome,J Intellect Disabil Res 2002 Sep;46(6):472-83,,"DOWNS SYNDROME, DEMENTIA, MEMORY",MENTAL RECALL,,,,0964-2633,AB,"BACKGROUND: Memory declines were evaluated with an adaptation of the Cued Recall Test (CRT) in 19 adults with Down's syndrome (DS) with mild or moderate intellectual disability (ID) who were at an early-stage of dementia of the Alzheimer type (DAT), and their performance was compared to peer groups of 75 adults with DS and 66 adults with ID without DS who were not suspected of functional declines. METHOD: The CRT consisted of a training period in which 12 items were presented, four at a time, with each item accompanied by a unique category cue. The testing phase consisted of three trials which generated two measures, a free recall score (FRS; spontaneous recall of the list of 12 items) and a total score (TS; FRS plus items recalled when the category cue was provided). RESULTS: It was found that a cut-off value of less than or = to 23 on the TS resulted in a sensitivity of 94.7% and a specificity of 93.9% with a positive predictive value of 81.9% when those individuals with DAT were compared to the participants with ID without DS. Eight of these individuals with DAT had relatively poor performance on the CRT compared to their healthy peers at a baseline when they were not suspected of functional declines, suggesting that memory declines can occur several years prior to the identification of DAT. In addition, 17 participants with DS without a diagnosis of DAT met the criterion for the cut-off score. Longitudinal data and converging measures indicated that there was the possibility that 15 of these individuals are in a 'pre-clinical' stage of decline. CONCLUSION: The usefulness of the CRT as a screening test for early memory deficits for this population needs to be confirmed by following these participants for an extended period of time and by studying an independent sample."
0042609,"Dykens EM, Shah B, Sagun J, Beck T, King BH",Maladaptive behaviour in children and adolescents with Down's syndrome,J Intellect Disabil Res 2002 Sep;46(6):484-92,,"DOWNS SYNDROME, BEHAVIORAL DISORDERS","CHILD, ADOLESCENT",,,,0964-2633,AB,"BACKGROUND: Although children with Down's syndrome (DS) are at lower risk for psychopathology than others with intellectual disability, they do show more problems than typically developing children. However, age-related trends in these problems remain unclear. METHODS: The present authors examined age-related changes in the maladaptive behaviours of 211 children and adolescents with DS aged between 4 and 19 years (mean = 9.74 years). Most participants (n = 180) were recruited from families residing in the greater Los Angeles area, California, USA, while a minority (n = 31) were patients from a clinic specializing in the psychiatric management of people with DS. The participants were divided into four age groups: (1) 4-6 years, (2) 7-9 years, (3) 10-13 years and (4) 14-19 years. RESULTS: Externalizing behaviours were lower across both the community and clinic samples, while internalizing behaviours were significantly higher in older adolescents aged between 14 and 19 years. Increases were found in withdrawal, seen in 63% of community-based adolescents, and 75% of clinic adolescents. CONCLUSIONS: Older adolescents with DS may show decreased externalizing symptoms and subtle increases in withdrawal. Possible relationships are discussed between these shifts and increased risks of later-onset depression and Alzheimer's disease in adults with DS."
0042610,"Nottestad JA, Linaker OM",Predictors for attacks on people after deinstitutionalization,J Intellect Disabil Res 2002 Sep;46(6):493-502,,"DEINSTITUTIONALIZATION, LEARNING DISORDERS, SOCIAL BEHAVIOR","AGGRESSION, FORECASTING",,,,0964-2633,AB,"BACKGROUND: The deinstitutionalization movement is presently spreading in Europe, but studies evaluating the effects of deinstitutionalization on behaviour disturbances among people with intellectual disability (ID) are inconclusive. The prevalence of aggressive behaviour among people with ID is high in both institutions and in community. Aggression and attacks on people are a significant problem for people with ID in both institutions and society. In the present paper, the authors focus on individuals who started attacking people after deinstitutionalization. METHOD: The authors studied individual and environmental characteristics before and after deinstitutionalization to look for individual and environmental predictors for the development of aggression with the hope that some could be possible intervention points for preventive action. In an institution for people with ID, all who did not attack people before deinstitutionalization were included. The individuals who started attacking others after deinstitutionalization (n = 22) were the study group (group A) and those who did not (n = 42) comprised the control group (group B). The population was examined before and after deinstitutionalization. As far as possible the same methods were used at both occasions. The covariates included individual ones, such as mental health, behaviour disturbances and behaviour deficits, and environmental ones, such as caretaker education, caretaker:patient ratio, housing and leisure activities. Psychiatric disorders were identified in 1987 and 1995 with the Psychopathology Instrument for Mentally Retarded Adults (PIMRA), which was filled in by the caretakers. RESULTS: Group A showed significantly more self-injurious behaviour (SIB) than group B in 1987. (ABSTRACT TRUNCATED)."
0042611,"Clegg J, Sheard C",Challenging behaviour and insecure attachment,J Intellect Disabil Res 2002 Sep;46(6):503-6,,"LEARNING DISORDERS, BEHAVIORAL DISORDERS, AGGRESSION","DATA COLLECTION, ADOLESCENT",,,,0964-2633,AB,"BACKGROUND: The present authors investigated a database about people with severe intellectual disability (ID) to explore whether secure/insecure attachment plays a role in challenging behaviour. METHODS: The study took the form of a survey of staff and carers involved with a cohort of 54 school-leavers with severe ID. RESULTS: Thirty-four per cent of students were rated by placement staff as 'over-investing in one or a few relationships which become a source of jealousy'. Students without such problems were significantly less likely to show challenging behaviours, while those with them were significantly more likely to be living outside the family home. CONCLUSIONS: These preliminary results justify more detailed and longitudinal research into the relationship between attachment status and challenging behaviour."
0042612,"Wanless LK, Jahoda A",Responses of staff towards people with mild to moderate intellectual disability who behave aggressively: a cognitive emotional analysis,J Intellect Disabil Res 2002 Sep;46(6):507-16,,"LEARNING DISORDERS, ALLIED HEALTH PERSONNEL, AGGRESSION",ATTITUDE TO DISABILITY,,,,0964-2633,AB,"Background: Traditionally, research into interactions between staff and adults with an intellectual disability who engage in challenging behaviour has been carried out within a behavioural paradigm. Recent work has begun to examine cognitive factors. The majority of this research has drawn upon Weiner's attributional model of helping behaviour. Moreover, staff responses have usually been investigated in relation to client vignettes of challenging behaviour. Method: The present study involved 38 staff who worked with frequently aggressive clients and its aims were twofold: (1) to compare different methods of examining the cognitive and emotional responses of staff to aggression; namely, descriptive vignettes and real incidents of aggression which staff could recall; and (2) to attempt to replicate previous findings supportive of Weiner's model with a new carer group (day centre staff). Results: When staff responses were compared across the hypothetical and real scenarios, using a series of one-way analyses of variance, it was revealed that staff experienced more negative emotions in response to the real incidents of aggression. The present study produced little evidence in support of Weiner's model. However, it was found that staff perceptions of the aggressive clients were linked to their cognitive and emotional responses to the aggression. Conclusion: The theoretical and clinical implications of these findings are considered, and the possible role played by interpersonal attributions in mediating staff responses to aggression is discussed."
0042613,"Charlot L, Fox S, Friedlander R",Obsessional slowness in Down's syndrome,J Intellect Disabil Res 2002 Sep;46(6):517-24,Slowness,"DOWNS SYNDROME, OBSESSIVE BEHAVIOR",DIAGNOSIS,,,,0964-2633,AB,"BACKGROUND: Obsessional slowness was originally described by S. Rachman in 1974. His patients had obsessive-compulsive disorder (OCD) and spent hours performing daily routines such as bathing, dressing and eating. Although some ritualistic behaviours were seen, slowness was the most prominent problem for these patients. Subsequently, a number of similar case reports emerged. In 1994, R. J. Pary described a small number of patients who had both obsessional slowness and Down's syndrome (DS). Apart from this, only one other report of slowness symptoms in people with developmental disabilities has been found in the literature, and this individual also had DS. METHODS: In the present exploratory case series report, 11 individuals with DS and slowness are described based on a retrospective chart review. Descriptive data and four case vignettes are presented. RESULTS: The 11 individuals with DS were described as spending hours engaged in usual daily routines. Several individuals had tics, hypothyroidism and periods of freezing. Although some ritualistic behaviours were described, slowness was seen to occur in the absence of these, and often without manifest anxiety. DISCUSSION: Obsessional slowness may be a severe variant of OCD. Although it appears to occur infrequently, there may be an elevated rate in people with DS. The current report is severely limited in scope since the case descriptions were based on a retrospective review. However, because of the paucity of published information about this clinical phenomena, it was felt that the case series might serve to establish the need for further, more systematic, prospective evaluation of individuals with DS and clinically significant slowness."
0042614,"Bauldoff GS, Hoffman LA, Zullo TG, Sciurba FC",Exercise maintenance following pulmonary rehabilitation: effect of distractive stimuli,Chest 2002 Sep;122(3):948-54,,"LUNG DISEASES OBSTRUCTIVE, EXERCISE THERAPY, MUSIC THERAPY, WALKING","RANDOMIZED CONTROLLED TRIALS, EPIDEMIOLOGIC METHODS",,,,0012-3692,AB,"STUDY OBJECTIVE: To determine if distractive auditory stimuli (DAS) in the form of music would promote adherence to a walking regimen following completion of a pulmonary rehabilitation program (PRP) and, thereby, maintenance of gains achieved during the program. DESIGN: Experimental, randomized, two-group design with testing at baseline, 4 weeks, and 8 weeks. SETTING: Outpatient. PATIENTS: Twenty-four patients (4 men and 20 women) with moderate-to-severe COPD (FEV(1) 41.3 +/- 13% predicted (mean +/- SD)). INTERVENTION: Experimental group subjects (n = 12) were instructed to walk at their own pace for 20 to 45 min, two to five times a week, using DAS with a portable audiocassette player. The control group (n = 12) received the same instructions, but no DAS. MEASUREMENTS AND RESULTS: Primary outcome measures were perceived dyspnea during activities of daily living (ADL) and 6-min walk (6MW) distance. Secondary outcome measures were anxiety, depressive symptoms, health-related quality of life (QoL), global QoL, and breathlessness and fatigue at completion of the 6MW. In addition, all subjects recorded the distance and time walked using self-report (pedometers and daily logs). There was a significant decrease in perceived dyspnea during ADL (p = 0.0004) and a significant increase in 6MW distance (p = 0.0004) over time in the DAS group compared to the control group. DAS subjects increased 6MW distance 445 +/- 264 feet (mean +/- SD) from baseline to 8 weeks, whereas control subjects decreased 6MW distance to 169 +/- 154 feet. No significant differences were noted for the remaining variables. The cumulative distance walked by the DAS group was 19.1 +/- 16.7 miles compared to 15.4 +/- 8.0 miles for the control group, a 24% difference (p = 0.49). Despite this difference, self-report exercise log data were similar for the two groups."
0042615,"Silvestri GA, Sherman C, Williams T, Leong SS, Flume P, Turrisi A",Caring for the dying patient with lung cancer,Chest 2002 Sep;122(3):1028-36,,"LUNG NEOPLASMS, TERMINAL ILLNESS, PALLIATIVE TREATMENT, PAIN, ANALGESIA","PREVENTION, THERAPY",(Review),,,0012-3692,,
0042616,Thomas S,The use of sterile maggots in wound management,Nurs Times 2002 Sep 3;98(36):45-6,Maggot therapy,WOUND HEALING,,,,,0954-7762,AB,"Maggots have long been known to prevent wound infections, but larval therapy fell into disuse in the 20th century. The author describes its revival and its many applications."
0042617,Robertson IH,Cognitive neuroscience and brain rehabilitation: a promise kept,J Neurol Neurosurg Psychiatry 2002 Oct;73(4):357,,"SPATIAL NEGLECT, BRAIN DIS",REHABILITATION,,,,0022-3050,,
0042618,"Foltynie T, Sawcer S, Brayne C, Barker RA",The genetic basis of Parkinson's disease,J Neurol Neurosurg Psychiatry 2002 Oct;73(4):363-70,,"PARKINSON DIS, GENES, HEREDITARY DIS",EVIDENCE BASED MEDICINE,(Review),,,0022-3050,AB,"Although the mechanisms underlying neurodegeneration in Parkinson's disease are not fully understood, considerable evidence suggests that genetic factors can influence susceptibility to the disease. In this article, we critically review this evidence and examine studies estimating patterns of inheritance. In a few families, Parkinson's disease is clearly inherited in a Mendelian fashion, and in some of these the disease causing genes have already been identified. Possible pathogenic mechanisms by which these genes cause Parkinson's disease are discussed. Further candidate genes and systematic efforts to identify genes influencing susceptibility to the disease in general are also summarised. The identification of such susceptibility genes will eventually enable us to more accurately classify this complex disease."
0042619,"Ikeda M, Brown J, Holland AJ, Fukuhara R, Hodges JR","Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer's disease",J Neurol Neurosurg Psychiatry 2002 Oct;73(4):371-6,,"DEMENTIA, BEHAVIORAL DISORDERS, EATING",ALZHEIMERS DIS,,,"To investigate the frequency of changes in eating behaviours and the sequence of development of eating behaviours in frontotemporal dementia and Alzheimer's disease, using a caregiver questionnaire. METHODS: Three groups of patients were studied: frontal variant frontotemporal dementia (fv-FTD) (n = 23), semantic dementia (n = 25), and Alzheimer's disease (n = 43). Level of education and dementia severity was similar in the three groups. The questionnaire consisted of 36 questions investigating five domains: swallowing problems, appetite change, food preference, eating habits, and other oral behaviours. RESULTS: The frequencies of symptoms in all five domains, except swallowing problems, were higher in fv-FTD than in Alzheimer's disease, and changes in food preference and eating habits were greater in semantic dementia than in Alzheimer's disease. In semantic dementia, the developmental pattern was very clear: a change in food preference developed initially, followed by appetite increase and altered eating habits, other oral behaviours, and finally swallowing problems. In fv-FTD, the first symptom was altered eating habits or appetite increase. In Alzheimer's disease, the pattern was not clear although swallowing problems developed in relatively early stages. CONCLUSIONS: Change in eating behaviour was significantly more common in both of the frontotemporal dementia groups than in Alzheimer's disease. It is likely that the changing in eating behaviours reflects the involvement of a common network in both variants of frontotemporal dementia-namely, the ventral (orbitobasal) frontal lobe, temporal pole, and amygdala.",0022-3050,AB,"BACKGROUND: Despite numerous reports of changes in satiety, food preference, and eating habits in patients with frontotemporal dementia, there have been few systematic studies. OBJECTIV"
0042620,"Olichney JM, Morris SK, Ochoa C, Salmon DP, Thal LJ, Kutas M, Iragui VJ",Abnormal verbal event related potentials in mild cognitive impairment and incipient Alzheimer's disease,J Neurol Neurosurg Psychiatry 2002 Oct;73(4):377-84,,"MENTAL DISORDERS, ALZHEIMERS DIS, EVOKED POTENTIALS","PSYCHOLOGICAL TESTS, EPIDEMIOLOGIC METHODS",,,,0022-3050,AB,"BACKGROUND: It has been reported that patients with amnesia have a reduced effect of word repetition upon the late positive component of the event related potential (ERP), which peaks at around 600 ms after word onset. OBJECTIVE: To study a word repetition ERP paradigm in subjects with mild cognitive impairment. SUBJECTS: 14 patients with mild cognitive impairment (mean mini-mental state examination score = 27); 14 normal elderly controls. METHODS: Auditory category statements were each followed by a single visual target word (50% \"congruous\" category exemplars, 50% \"incongruous\") while ERPs were recorded. N400 (an ERP component elicited by semantically \"incongruous\" words) and LPC amplitude data were submitted to analysis of variance. RESULTS: The latency of the N400 was slower in mild cognitive impairment. In normal controls, the ERPs to \"congruous\" targets showed a late positive component to new words, which was greatly diminished with repetition. This repetition effect in normal subjects started before 300 ms at right frontal sites, and peaked at approximately 600 ms post-stimulus over posterior sites. In contrast, the group with mild cognitive impairment had a reduced repetition effect (p less than 0.02), which started around 500 ms, with a more central distribution. Further comparisons within the cognitive impairment group showed no appreciable congruous word repetition effect among seven individuals who subsequently converted to probable Alzheimer's disease. The congruous word repetition effect in the group with mild cognitive impairment was almost entirely accounted for by the non-converters. The amplitude of the congruous late positive component word repetition effect was significantly correlated (0.38 less than or = to r less than or = to 0.73) with several verbal memory measures. (ABSTRACT TRUNCATED)."
0042621,"Loher TJ, Burgunder JM, Weber S, Sommerhalder R, Krauss JK",Effect of chronic pallidal deep brain stimulation on off period dystonia and sensory symptoms in advanced Parkinson's disease,J Neurol Neurosurg Psychiatry 2002 Oct;73(4):395-9,,"PARKINSON DIS, DYSTONIA, CENTRAL NERVOUS SYSTEM AGENTS",TREATMENT OUTCOME,,,,0022-3050,AB,"OBJECTIVE: To investigate the efficacy of chronic pallidal deep brain stimulation (DBS) on off period dystonia, cramps, and sensory symptoms in advanced Parkinson's disease (PD). METHODS: 16 patients (6 women, 10 men; mean age at surgery 65 years) suffering from advanced PD were followed up prospectively for one year after implantation of a monopolar electrode in the posteroventral lateral globus pallidus internus. Unilateral DBS was performed in 9 patients. 10 patients had bilateral procedures (contemporaneous bilateral surgery in 7 and staged bilateral surgery in 3 instances). The decision whether to perform unilateral or bilateral surgery depended on the clinical presentation of the patient. Patients were formally assessed preoperatively, at 3-5 days, 3 months, and 12 months after surgery. RESULTS: In patients who underwent unilateral surgery, pain was present in 7 (78%), off dystonia in 5 (56%), cramps in 6 (67%), and dysaesthesia in 4 (44%). In patients who underwent bilateral surgery, pain was present in 7 (70%), off dystonia in 6 (60%), cramps in 7 (70%), and dysaesthesia in 4 (40%). With unilateral DBS, contralateral off period dystonia was improved by 100% at 1 year postoperatively, pain by 74%, cramps by 88%, and dysaesthesia by 100%. There was less pronounced amelioration of ipsilateral off period dystonia and sensory symptoms. With bilateral DBS, total scores for dystonia were improved by 86%, for pain by 90%, for cramps by 90%, and for dysaesthesia by 88%. The benefit appeared early at the first evaluation 3-5 days after surgery and was stable throughout the follow up period. CONCLUSIONS: Pallidal DBS yields major improvement of off period dystonia, cramps, and sensory symptoms in patients with advanced PD."
0042622,"Braun-Fahrlander C, Riedler J, Herz U, Eder W, Waser M, Grize L, Maisch S, Carr D, Gerlach F, Bufe A, Lauener RP, Schierl R, Renz H, Nowak D",Environmental exposure to endotoxin and its relation to asthma in school-age children,N Engl J Med 2002 Sep 19;347(12):869-77,endotoxins,"ENVIRONMENTAL EXPOSURE, ASTHMA, HAY FEVER, BEDS, ALLERGENS","CHILD, TOXINS, EPIDEMIOLOGY, LEUKOCYTES, RISK",,,,0028-4793,AB,"BACKGROUND: In early life, the innate immune system can recognize both viable and nonviable parts of microorganisms. Immune activation may direct the immune response, thus conferring tolerance to allergens such as animal dander or tree and grass pollen. METHODS: Parents of children who were 6 to 13 years of age and were living in rural areas of Germany, Austria, or Switzerland where there were both farming and nonfarming households completed a standardized questionnaire on asthma and hay fever. Blood samples were obtained from the children and tested for atopic sensitization; peripheral-blood leukocytes were also harvested from the samples for testing. The levels of endotoxin in the bedding used by these children were examined in relation to clinical findings and to the cytokine-production profiles of peripheral-blood leukocytes that had been stimulated with lipopolysaccharide and staphylococcal enterotoxin B. Complete data were available for 812 children. RESULTS: Endotoxin levels in samples of dust from the child's mattress were inversely related to the occurrence of hay fever, atopic asthma, and atopic sensitization. Nonatopic wheeze was not significantly associated with the endotoxin level. Cytokine production by leukocytes (production of tumor necrosis factor alpha, interferon-gamma, interleukin-10, and interleukin-12) was inversely related to the endotoxin level in the bedding, indicating a marked down-regulation of immune responses in exposed children. CONCLUSIONS: A subject's environmental exposure to endotoxin may have a crucial role in the development of tolerance to ubiquitous allergens found in natural environments."
0042623,"Lockwood AH, Salvi RJ, Burkard RF",Tinnitus,N Engl J Med 2002 Sep 19;347(12):904-10,,TINNITUS,"ETIOLOGY, EPIDEMIOLOGY, THERAPY, DIAGNOSIS",(Review),,,0028-4793,,
0042624,Letizia JM,The supreme court helps employers by narrowing the definition of disability,Home Health Care Manage Pract 2002 Oct;14(6):484-5,,"DISABILITY, JURISPRUDENCE, EMPLOYERS","LEGISLATION, UNITED STATES, CLASSIFICATION",,,,1084-8223,,
0042625,Loose AC,Rhythm - structuring our lives (part 1),Kranken Gymnastik 2002;54(9):1438-44,,"PERIODICITY, TIME","CHILD DEVELOPMENT, THERAPY",,German,English Summary,0023-4494,AB,"Rhythm - a term often used in therapy and many other remedial methods. This article intends to clarify how important rhythm actually is in human development, and how necessary it is to bring rhythmical elements into therapy. The structure of time, the structure of the space we inhabit, putting events into perspective, sizing up spatial dimensions - a child has to learn to master all these things, and he learns most effectively through play, or \"the rhythm of life\". A theoretical introduction in this first part of our publication, plus a number of practical examples in a second part should help therapists to use rhythmical elements with various remedial methods."
0042626,Loose AC,"Rhythm - structuring our lives (part 2: promoting play through rhythm, and vice versa)",Kranken Gymnastik 2002;54(9):1446-54,,"PLAY AND PLAYTHINGS, SENSATION","CHILD DEVELOPMENT, METHODS",,German,English Summary,0023-4494,AB,"In the initial part of this work, we delved into the may aspects of sensory experience which lay the foundation for structure, such as that of space/time which plays an essential role in child development. The intimate relationship between vestibular/kinaesthetic and body awareness, and the development of space/time structuring was made clear. We concluded part one of this work with an overview of the roots of rhythm in movement and music education. In this second part, we present a number of practical examples to show how rhythmical elements can be applied to individual methods for promoting development."
0042627,Kempe C,Klara Wolf's integral respiratory and movement method,Kranken Gymnastik 2002;54(9):1456-62,,"BREATHING EXERCISES, EXERCISE THERAPY, MOVEMENT","METHODS, PSYCHOLOGY",,German,English Summary,0023-4494,AB,"Klara Wolf, the well known pioneer of respiratory therapy from Brugg, Switzerland, has practised and continually developed her \"Integral respiratory and movement method\" for over sixty years. Her holistic method combines scientific observations and practical experience in body work. The respiratory therapy aspect is enhanced by a pedagogic approach in order to emphasise not only a healthy attitude to one's body but also to encourage personal and cultural individual development. Essential to this method is the variety of rhythmical and dynamic arrangements in the exercises, which serve as an inspiration for psychological development."
0042628,"Frund A, Richter A",Effects of physiotherapy in an out-patient group of patients with cardiac insufficiency of clinical grade NYHA II,Kranken Gymnastik 2002;54(9):1464-7,,"PHYSIOTHERAPY, HEART DIS, QUALITY OF LIFE","OUTPATIENTS, AMBULATORY CARE, PROGRAM EVALUATION, METHODS, TREATMENT OUTCOME",,German,English Summary,0023-4494,AB,"We present here the results of physiotherapy in a group of patients with cardiac insufficiency, who were seen as out-patients in the \"Cardiac Group\". With respect to the common assumption that these severely ill patients are normally regarded as barely treatable, the group treatment was a risk, which however turned out to be well worth taking. It became apparent that even patients with severe cardiac insufficiency were able to improve the quality of their lives with appropriate training methods. The structure and set-up of the group is described in detail."
0042629,Gospodarek C,Resource-oriented physiotherapy with a group of senile dementia patients,Kranken Gymnastik 2002;54(9):1468-75,,"PHYSIOTHERAPY, DEMENTIA, QUALITY OF LIFE, SELF EFFICACY","AGED, METHODS, PSYCHOLOGY, ALZHEIMERS DIS, GERIATRICS, PHYSIOPATHOLOGY, PERSONALITY",,German,English Summary,0023-4494,AB,"With the increasing elderly population, there will continue to be an increase of patients with Alzheimer's disease and other forms of senile dementia. Unfortunately, physiotherapy still plays only a minor role in the care of patients in gerontopsychiatry. This paper presents a closer look at the pathology of these diseases, explores the consequences for both patients and their relatives, and suggests possibilities for group physiotherapy. The major emphasis of therapy is to stabilise feelings of self respect through respecting their personality traits and encouraging their remaining capabilities and possibilities, in order to retain a good quality of life."
0042630,Furll-Riede C,Interessantes im Web,Kranken Gymnastik 2002;54(9):1476-7,,"INTERNET, CIRCADIAN RHYTHM",INFORMATION SERVICES,,German,,0023-4494,,
0042631,Prakash G,Physiotherapie aus der Sicht des Yoga (Atemubungen = Pranyama),Kranken Gymnastik 2002;54(9):1478-82,,"PHYSIOTHERAPY, YOGA, BREATHING THERAPIES",METHODS,,German,,0023-4494,,
0042632,Wolf SK,Eine alt Behandlungsmethode - neu entdeckt,Kranken Gymnastik 2002;54(9):1482,milk human,PHYSIOTHERAPY,"METHODS, SECRETIONS, MILK",,German,,0023-4494,,
0042633,Bahrle RJ,Zeugnisse und Geheimcodes,Kranken Gymnastik 2002;54(9):1484,,"PHYSIOTHERAPY, NOMENCLATURE",,,German,,0023-4494,,
0042634,Bahrle RJ,Betriebsubergang/Unterrichtung der Arbeit-nehmer - der neue 613a Absatz 5 BGB,Kranken Gymnastik 2002;54(9):1485-8,employees,PHYSIOTHERAPY,"LEGISLATION, GERMANY",,German,,0023-4494,,
0042635,Dornbusch HL,Steuern auf das Erbe in Euro,Kranken Gymnastik 2002;54(9):1490-2,,TAXES,"GERMANY, LEGISLATION",,German,,0023-4494,,
0042636,Riedle H,Der unter Betreuung stehende Patient 1,Kranken Gymnastik 2002;54(9):1494-6,,DELIVERY OF HEALTH CARE,"STANDARDS, PATIENT ADVOCACY",,German,,0023-4494,,
0042637,Schell W,Das Haftungsrecht im Spiegel einiger interessanter Gerichtsentscheidungen,Kranken Gymnastik 2002;54(9):1496-7,,"PHYSIOTHERAPY, JURISPRUDENCE","GERMANY, LEGISLATION",,German,,0023-4494,,
0042638,Reischmann P,Es geht nicht oder kleine Wunder werden gross,Kranken Gymnastik 2002;54(9):1498,,"PHYSIOTHERAPY, LONG TERM CARE, DISABILITY","METHODS, THERAPY",,German,,0023-4494,,
0042639,Ketels G,Jahrestagung des Vereins fur Reflektorische Atemtherapie,Kranken Gymnastik 2002;54(9):1499,,BREATHING THERAPIES,"CONGRESSES, GERMANY",,German,,0023-4494,,
0042640,Furll-Riede C,Jubilaumstagung der Vereingung der Bobath-Therapeuten Deutschlands e.V.,Kranken Gymnastik 2002;54(9):1500-3,,NEURODEVELOPMENTAL THERAPY,"SOCIETIES MEDICAL, GERMANY, CONGRESSES",,German,,0023-4494,,
0042641,"Chard DJ, Vaughn S, Tyler BJ",A synthesis of research on effective interventions for building reading fluency with elementary students with learning disabilities,J Learn Disabil 2002 Sep-Oct;35(5):386-406,,"READING, LEARNING DISABILITY, LEARNING","RESEARCH, MODELS THEORETICAL",,,,0022-2194,AB,"Fluent reading, often defined as speed and accuracy, is an important skill for all readers to develop. Students with learning disabilities (LD) often struggle to read fluently, leading to difficulties in reading comprehension. Despite recent attention to reading fluency and ways to improve fluency, it is not clear which features of interventions that are designed to enhance fluency are beneficial for the most struggling readers. The purpose of this study is to synthesize research on interventions that are designed primarily to build reading fluency for students with LD. The search yielded 24 published and unpublished studies that reported findings on intervention features, including repeated reading with and without a model, sustained reading, number of repetitions, text difficulty, and specific improvement criteria. Our findings suggest that effective interventions for building fluency include an explicit model of fluent reading, multiple opportunities to repeatedly read familiar text independently and with corrective feedback, and established performance criteria for increasing text difficulty."
0042642,Tractenberg RE,"Exploring hypotheses about phonological awareness, memory, and reading achievement",J Learn Disabil 2002 Sep-Oct;35(5):407-24,,"READING, PHONETICS, HEARING DISORDERS, MEMORY","COMPARATIVE STUDY, TASK PERFORMANCE AND ANALYSIS, AWARENESS",,,,0022-2194,AB,"Reading-related skills were tested in adults with and without reading disabilities (RD) and adults with profound hearing impairment (PHI) who did not differ on average Performance IQ. The RD group and the PHI group both demonstrated levels of phonological awareness lower than the control group's, but only the RD group also exhibited deficits in other skills, including verbal short-term memory, morphological awareness, speeded written naming, and reading comprehension. The average reading level of the PHI group was significantly higher than that of the RD group. Three control group members also demonstrated limited phonological awareness without other deficits in a pilot study, performing similarly to the PHI group. The results support other studies suggesting that processes dependent on memory, not solely phonological awareness, may contribute to determining reading achievement."
0042643,"Aaron PG, Joshi RM, Plamer H, Smith N, Kirby E",Separating genuine cases of reading disability from reading deficits caused by predominantly inattentive ADHD behavior,"J Learn Disabil 2002 Sep-Oct;35(5):425-35, 447",,"READING, ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY, DYSLEXIA","TASK PERFORMANCE AND ANALYSIS, DIAGNOSIS DIFFERENTIAL, CHILD, MODELS THEORETICAL, ATTENTION",,,,0022-2194,AB,"Conventional methods of differentiating reading disability (RD) caused by deficits in decoding skills or comprehension from poor reading performance caused by inconsistent attention associated with attention-deficit/hyperactivity disorder (ADHD) have produced equivocal results. This study presents a model of differential diagnosis of attentional problems and RD that differs from these conventional approaches. The new diagnostic procedure uses intraindividual differences seen in the performance of at-risk learners on tasks related to reading that vary in their sensitivity to the sustained attention required for successful performance. The hypothesis is that children with inconsistent attention would perform more poorly on tests that require sustained attention, such as listening comprehension, than on tests that are more tolerant of inattention, such as reading comprehension. Such differences would not be seen in the test scores of children who have only RD, because their performance is determined more by the difficulty level of the reading tests than by the degree of sensitivity of the task to attention. The validity of this new model was evaluated by determining the capability of the differences seen in the scores of tests that differ in their sensitivity to sustained attention to predict the degree of inconsistency in sustained attention as measured by a continuous performance test. The data obtained from 39 children who are at risk for RD suggest that this is a viable model."
0042644,"Laing SP, Kambi AG",The use of think-aloud protocols to compare inferencing abilities in average and below-average readers,J Learn Disabil 2002 Sep-Oct;35(5):436-47,,"READING, VERBAL BEHAVIOR, THINKING, MEMORY","CHILD, TASK PERFORMANCE AND ANALYSIS, COMPARATIVE STUDY",,,,0022-2194,AB,"In this study, we examined whether think-aloud procedures would uncover differences in the kinds of inferences generated by average and below-average readers. Participants were 40 third-grade children who were divided into groups of average and below-average readers. All participants completed measures of nonverbal IQ, reading, language, and working memory, and a story comprehension task that consisted of two conditions: listen through and think aloud. The major findings in this study were that (a) average readers generated significantly more explanatory inferences than below-average readers, and (b) comprehension performance as measured by story recall was significantly better for both groups in the think-aloud condition than in the listen-through condition. The discussion addresses the implications of these findings."
0042645,"Weiler MD, Bernstein JH, Bellinger D, Waber DP","Information processing deficits in children with attention-deficit/hyperactivity disorder, inattentive type, and children with reading disability",J Learn Disabil 2002 Sep-Oct;35(5):448-61,,"READING, DYSLEXIA, ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY, MENTAL PROCESSES","CHILD, PHYSIOPATHOLOGY, ATTENTION, TASK PERFORMANCE AND ANALYSIS, COGNITION",,,,0022-2194,AB,"We examined the information processing capabilities of children diagnosed with the inattentive subtype of attention-deficit/hyperactivity disorder (ADHD) who had been characterized as having a sluggish cognitive tempo. Children referred for school-related problems (n = 81) and nonreferred community controls (n = 149) participated. Of the referred children, 24 met criteria for ADHD, 42 met criteria for reading disability (RD), and 9 of these were comorbid for RD and ADHD. Children with ADHD differed from those without ADHD on a visual search task but not on an auditory processing task; the reverse was true for children with RD. Decomposition of the visual search task into component operations demonstrated that children in the ADHD group had a slow processing rate that was not attributable to inattention. The children with ADHD were not globally poor at information processing or inattentive, but they demonstrated diminished speed of visual processing."
0042646,"Janiga SJ, Costenbader V",The transition from high school to postsecondary education for students with learning disabilities: a survey of college service coordinators,J Learn Disabil 2002 Sep-Oct;35(5):462-8,,"SCHOOLS, UNIVERSITIES, LEARNING DISABILITY, TRANSITION PROGRAMS","PROGRAM EVALUATION, UNITED STATES, STUDENTS, PERSONAL SATISFACTION",,,,0022-2194,AB,"Federal legislation requires that students with disabilities receive services to assist them in the transition from high school to post-secondary life. Transition services must address students' understanding of their disability, learning strengths and weaknesses, career decision-making skills, and preparation for the increased demands of postsecondary education. This study surveyed coordinators of special services for students with disabilities at 74 colleges and universities in New York state. Respondents provided their perceptions of how well the students they served had been prepared by the transition services they had received in high school. Overall, little satisfaction with transition services was expressed. Respondents were most satisfied with high schools' provision of updated evaluations for students prior to enrollment in college, and they rated students' preparation for self-advocacy as the greatest weakness of current transition services."
0042647,"Weatherly Valle J, Aponte E",IDEA and collaboration: a Bakhtinian perspective on parent and professional discourse,J Learn Disabil 2002 Sep-Oct;35(5):469-79,,"PROFESSIONAL FAMILY RELATIONS, EDUCATION SPECIAL, LANGUAGE DEVELOPMENT DISORDERS","DECISION MAKING, CHILD, LEARNING DISABILITY, PSYCHOLOGY",,,,0022-2194,AB,"In accordance with the Bakhtinian framework of this article, the text represents a dialogue between practices documented in the literature; the first author's perspective as a teacher, evaluator, and consultant; Bakhtin's theories of language; and the lived experiences of the second author, a parent whose child has been labeled as having a language learning disability. Although the Individuals with Disabilities Education Act (IDEA) grants parents the right to be involved in educational decisions about their children, we argue that the routine disqualification of parents' voices by school professionals is a major obstacle to authentic collaboration. Bakhtin's theories of language serve to illuminate the discourse between parents and professionals in special education committee meetings. We conclude with our vision for a mutual dialogic exchange between parents and professionals."
0042648,"Alexander JG, McDaniel GS, Baldwin MS, Money BJ","Promoting, applying, and evaluating problem-based learning in the undergraduate nursing curriculum",Nurs Educ Perspect 2002 Sep-Oct;23(5):248-53,problem based learning,"NURSING, EDUCATION NURSING","LEARNING, CURRICULUM, TEACHING, METHODS, PROGRAM EVALUATION",,,,1536-5026,AB,"Since its development in the 1960s, problem-based learning (PBL) has become increasingly prominent in nursing education. In 1998, Samford University received a grant from the PEW Charitable Trusts to promote, apply, and evaluate PBL in its undergraduate curriculum over three years. Nursing faculty approached this project with tenacity and enthusiasm. PBL has become integrated into the nursing curriculum in clinical and nonclinical courses. Descriptions of its implementation in specific courses are provided, and its usefulness in nursing education is discussed. Evaluations and test scores indicate that PBL has had a positive effect on the students and exceeded the educational outcomes anticipated by the faculty."
0042649,"Hughes MD, Bartlett RM",The use of performance indicators in performance analysis,J Sports Sci 2002 Oct;20(10):739-54,,"SPORTS, TASK PERFORMANCE AND ANALYSIS",BIOMECHANICS,,,,0264-0414,AB,"The aims of this paper are to examine the application of performance indicators in different sports and, using the different structural definitions of games, to make general recommendations about the use and application of these indicators. Formal games are classified into three categories: net and wall games, invasion games, and striking and fielding games. The different types of sports are also sub-categorized by the rules of scoring and ending the respective matches. These classes are analysed further, to enable definition of useful performance indicators and to examine similarities and differences in the analysis of the different categories of game. The indices of performance are sub-categorized into general match indicators, tactical indicators, technical indicators and biomechanical indicators. Different research examples and the accuracy of their presentation are discussed. We conclude that, to enable a full and objective interpretation of the data from the analysis of a performance, comparisons of data are vital. In addition, any analysis of the distribution of actions across the playing surface should also be presented normalized, or non-dimensionalized, to the total distribution of actions across the area. Other normalizations of performance indicators should also be used more widely in conjunction with the accepted forms of data analysis. Finally, we recommend that biomechanists should pay more attention to games to enrich the analysis of performance in these sports."
0042650,"Paul S, Peterson CQ",Interprofessional collaboration: issues for practice and research,Occup Ther Health Care 2001;15(3-4):1-12,,"DELIVERY OF HEALTH CARE, COST BENEFIT ANALYSIS, INTERPROFESSIONAL RELATIONS",,,,,0738-0577,AB,"The current health care system is based on accountability, cost containment, and quality of care. Collaborative practice models may be a viable means for improving health care delivery. The purpose of this paper is to outline how interprofessional education, practice, and research can establish economic benefits and effective clinical outcomes outside of discipline specific investigation."
0042651,"Miller BK, Ishler KJ",The Rural Elderly Assessment Project: a model for interdisciplinary team training,Occup Ther Health Care 2001;15(3-4):13-34,,"PATIENT ASSESSMENT, INTERPROFESSIONAL RELATIONS, ALLIED HEALTH PERSONNEL","AGED, RURAL POPULATION, EDUCATION PROFESSIONAL",,,,0738-0577,AB,"The Rural Elderly Assessment Project (REAP) was designed to train occupational therapy, physical therapy, physician assistant, and public health faculty and students to conduct interdisciplinary team health assessments with rural, community-dwelling older adults. This article highlights key features of the project's design and implementation and presents preliminary evaluation data from the 25 students who participated in the project. Students completed several pre- and post-test measures. Statistically significant improvements were observed in all but one of the knowledge, skill, and attitude domains that were specifically targeted by the project. Students identified a variety of benefits they received from participating in the project, and all students indicated that they would recommend the project to another student. Implications for project replication and interdisciplinary team training of allied health students are discussed."
0042652,"Nelson DL, Cipriani DJ, Thomas JJ",Physical therapy and occupational therapy: partners in rehabilitation for persons with movement impairments,Occup Ther Health Care 2001;15(3-4):35-57,,"MOVEMENT DISORDERS, PATIENT CARE TEAM","PHYSIOTHERAPY, OCCUPATIONAL THERAPY, REHABILITATION",,,,0738-0577,AB,"The professions of physical therapy and occupational therapy have legitimate roles in the restoration of human movement in the rehabilitation process. This paper first presents a physical therapy perspective on changing trends in therapeutic exercise. Recent trends in physical therapy reflect a shift away from isolating patterns of movement and open kinetic chain exercises toward a new emphasis on functional patterns of movement and closed kinetic chain exercises. Rehabilitation of persons with hip fracture is used as an example of these shifting trends. Next, the paper presents an occupational therapy perspective. Occupational therapy's historical emphasis on the use of naturalistic occupations as the context for therapeutic exercise is described. Theoretical advantages of occupationally embedded movement are listed, and recent research in support of naturalistic occupations is summarized. Physical therapy and occupational therapy are distinct professions with autonomous outlooks and terminologies, but the responsibilities of physical therapists and occupational therapists potentially overlap in the restoration of movement. Suggestions are made for interdisciplinary teamwork whereby the holistically considered welfare of the patient is always the primary concern of all therapists."
0042653,"Dolhi CD, Rogers JC","Dementia, nutrition, and self-feeding: a systematic review of the literature",Occup Ther Health Care 2001;15(3-4):59-87,,"DEMENTIA, NUTRITIONAL STATUS, FEEDING BEHAVIOR",EVIDENCE BASED MEDICINE,,,,0738-0577,AB,"The outcomes of feeding training are typically evaluated in terms of feeding skills and swallowing abilities rather than the ultimate goal of feeding, namely, adequate nutritional status. To increase occupational therapy practitioners' awareness of nutritional status as an outcome of feeding training, a systematic review of the research literature was conducted to examine the relationship between nutritional status and self-feeding skills in people with dementia. Studies were evaluated by the strength of their evidence and analyzed to determine the relationships among dementia, nutritional status, and the ability to feed one's self. Results revealed that although nutritional status in people with dementia is variable, there is a tendency for lower body weight, lower measures of body composition, and lower body mass indexes in persons with dementia compared to those with no cognitive impairment. Individuals who feed themselves tend to weigh more compared to those who need assistance for feeding. There is also evidence to support that as feeding status improves or declines, body weight similarly increases or decreases."
0042654,"Mu K, Royeen C, Paschal KA, Zardetto-Smith AM",Promoting awareness and understanding of occupational therapy and physical therapy in young school aged children: an interdisciplinary approach,Occup Ther Health Care 2001;15(3-4):89-99,,"OCCUPATIONAL THERAPY, PHYSIOTHERAPY, AWARENESS, PUBLIC OPINION, INTERPROFESSIONAL RELATIONS","CHILD, EDUCATION",,,,0738-0577,AB,"Public awareness and understanding of the professions of occupational therapy and physical therapy are limited. In this study, we examined perceptions of young school-aged children about occupational therapy and physical therapy as part of a larger grant project funded by the National Institute on Drug Abuse (R25 DAl2168 and R25 DAI3522). One hundred three elementary school children (55 boys and 48 girls), grades 3 to 7, from local schools attended a one-day neuroscience and allied health profession exposition held at a local Boys & Girls Club. Children's understanding of occupational therapy and physical therapy was assessed through a pre/post questionnaire prior to and immediately after attending the exposition. At five of the 18 exhibition booths, faculty members and students from occupational therapy and physical therapy introduced and explained what occupational and physical therapists do at their work through interactive demonstrations. The results of the current study revealed that prior to attending the exposition, children's understanding of occupational therapy and physical therapy was limited. On pre-test, children reported they have some understanding of occupational therapy (18.6%) and physical therapy (34.9%). Children's understanding of occupational therapy and physical therapy, however, dramatically increased after the exposition (75.6% vs. 18.6%,98.9% vs. 34.9%, respectively). Furthermore, the scope and depth of children's understanding also improved considerably. This finding suggests that an interactive neuroscience exposition including occupational therapy and physical therapy is an effective way to promote children's awareness and understanding of the professions. Implications for practice and future research directions are discussed in the study."
0042655,Nochajski SM,Collaboration between team members in inclusive educational settings,Occup Ther Health Care 2001;15(3-4):101-12,,"INTERPROFESSIONAL RELATIONS, DISABLED","EDUCATION SPECIAL, STUDENTS",,,,0738-0577,AB,"The inclusion of students with disabilities into general education settings and programs has necessitated the development of integrated, collaborative service delivery models that are compatible with the goals and purpose of inclusive education. Although there is considerable theoretical literature on collaboration, there is minimal empirical data available on the process or its outcomes. The purpose of this exploratory study was to gain insight on the perspectives of regular and special educators, and occupational, physical, and speech-language therapists towards collaboration. Using a semi-structured interview, participants (n = 51) responded to questions concerning the definition, nature, and extent of collaboration in their school setting. Participants also responded to questions related to the advantages of, barriers towards, and strategies to promote collaboration. Participants typically defined collaboration as not a problem-solving process, but in terms of activities associated with it. Results indicate that participants believed collaboration was mutually beneficial for both students and team members. However, implementing a collaborative approach was problematic. Lack of administrative approval for time for planning meetings was the most frequently cited barrier to collaboration. Although 51.6% of the participants reported time available for collaborative planning by regular and special educators, only 21.5% of the participants reported this time being available for therapists to meet with educators. Education about collaboration, either in professiona1/preservice education programs or as continuing education, was recommended as a strategy to facilitate a collaborative approach. Although a collaborative approach is being used by therapists and educators more and more frequently, there is a need for research to validate its efficacy."
0042656,"Hyter YD, Atchison B, Henry J, Sloane M, Black-Pond C",A response to traumatized children: developing a best practices model,Occup Ther Health Care 2001;15(3-4):113-40,,"DELIVERY OF HEALTH CARE, INJURIES, PROGRAM DEVELOPMENT",CHILD,,,,0738-0577,AB,"This manuscript describes the key components for establishing collaborative partnerships in the delivery of services to children who have been traumatized by abuse, neglect, and prenatal exposure to alcohol. Specifically, the manuscript addresses: the national need for such collaborative partnerships; the effects of abuse, neglect, and prenatal exposure to alcohol on developmental and educational outcomes; the process used to develop the children's trauma assessment center (CTAC) including discussion on the family centered and transdisciplinary nature of the center; and the accomplishment and future goals of CTAC. The members of the CTAC team currently include the disciplines of counseling, occupational therapy, pediatric medicine, social work, and speech-language pathology. Future goals include expanding the core team to include the nursing and educational psychology disciplines."
0042657,Frederick C,Liberating Sisyphus: hypnotically facilitated therapy for obsessive-compulsive disorder,Hypnos 2002 Sep;29(3):99-105,,"OBSESSIVE COMPULSIVE DISORDER, HYPNOSIS, GENETICS",ROLE,,,,0282-5090,AB,"The biological aspects of Obsessive Compulsive Disorder (OCD) as well as the use of medication for its treatment are emphasized the current literature. Yet, many clinical syndromes are best understood when a stress-diathesis model is utilized. Such models recognize that genomic expression resulting in clinical syndromes can be precipitated by various stressors. Additionally, for certain patients, OCD symptoms may also be more specific mind-body communications such as defenses against and expressions of psychodynamic messages of profound meaning. In this paper the author will review the roles of genetics, character defense, and dissociation in some OCD manifestations, as well as the usefulness and the limitations of hypnotic ego-strengthening and Ego State Therapy for understanding and working with patients whose OCD is dissociatively driven."
0042658,Liossi C,The place of clinical hypnosis in the paediatric oncology setting,Hypnos 2002 Sep;29(3):106-11,,"HYPNOSIS, NEOPLASMS, DISEASE MANAGEMENT","ADVERSE EFFECTS, CHILD, EVIDENCE BASED MEDICINE",,,,0282-5090,AB,Despite the fact that research on clinical hypnosis with children is still in an early stage of development and the child hypnosis literature is predominantly composed of anecdotal case histories and uncontrolled research studies one of the best-documented uses of hypnosis is in the treatment of children with cancer. Hypnosis has established a successful record in the paediatric oncology setting mainly in the management of chemotherapy-related nausea and vomiting and procedure-related pain where it has achieved status as an empirically supported intervention. This paper summarises the current literature and the author's clinical experience of the efficacy and usefulness of hypnosis in the paediatric oncology setting.
0042659,Barilan YM,Microhypnosis: a preliminary name for introducing elements from hypnosis into doctor-patient interaction,Hypnos 2002 Sep;29(3):112-23,,"HYPNOSIS, PHYSICIAN PATIENT RELATIONS",,,,,0282-5090,AB,"Microhypnosis is a method for expediting the daily interaction between patients and their physicians, applying motifs and techniques from the art of clinical hypnosis. Microhypnosis aims at enhancing the contemporary clinical encounter while accommodating its constraints. It does not require additional time or exceptional resources. Segments of conversation and bodily gestures serve as hypnotic-like micro sessions. Microhypnosis takes advantage of the spontaneous trance, which usually develops during the clinical encounter. Doctor patient conversation is shifted to and fro routine interaction to segments of microhypnotic suggestions. Microhypnosis is a semantic oriented approach. Emphasis is placed on the meaning layered within the interaction according to knowledge derived from cognitive psychology, cognitive anthropology, hermeneutics and phenomenology of the self in health and disease. The article provides a few examples of 'microhypnosis' in clinical practice."
0042660,Johnson BG,Mental training for chronic benign pain: patients with catastrophizing,Hypnos 2002 Sep;29(3):124-31,,"PAIN INTRACTABLE, PAIN, SELF ASSESSMENT, RELAXATION, EXERCISE","PREVENTION, THERAPY, CLINICAL ASSESSMENT SCALES",,,,0282-5090,AB,"Patients with chronic benign pain who participated in a training with relaxation and exercises in strategies for pain management, were tested pre- and post- the training program with Coping Strategies Questionnaire, Visual Analogous Scale for self rating of pain and Circle Integration Test, a projective drawing test for personality assessment. Persons with high and low catastrophizing were selected accordingly the outcome in CSQ. Results: Besides an unspecific favourable but limited effect in both groups it was shown that there was no success in influencing the high catastrophizing group in regards to their special stance to pain. It was considered that a pain phobia had developed. From a therapeutic point of view the pain phobia should then be the target of the primary intervention."
0042661,"Brown DC, Bobart V",Medical obstetrical hypnosis and Apgar scores and the use of anaesthesia and analgesia during labor and delivery,Hypnos 2002 Sep;29(3):132-9,,"HYPNOSIS, LABOR, ANALGESIA, ANESTHESIA",CLINICAL ASSESSMENT SCALES,,,,0282-5090,AB,"Objective: To determine if there was a significant difference in Apgar scores of babies born to mothers who had hypnosis training for childbirth compared with matched controls who delivered the same day without hypnosis training. The authors present original research on hypnosis and obstetrics from Nova Scotia in a case control study with 36 cases and 36 controls. Each group contained 36 maternal infant pairs. The hypnosis infants demonstrated significantly better Apgar scores than the non-hypnosis infants. Thirty-five of the control patients (97%) received regional anaesthesia for delivery compared to (38%), fourteen out of thirty-six, of the hypnosis group. The hypnosis group had a significantly shorter hospital stay. Discussion: Hypnosis was successful as the sole anaesthetic in 61% (22/36) of deliveries, whereas in the control group 2.7% (1/36) did not require any anesthetic or premedication. A larger prospective study is recommended with carefully matched controls."
0042662,Walker WL,Improvised self-hypnosis for childbirth,Hypnos 2002 Sep;29(3):140-1,,"LABOR, HYPNOSIS, SELF EFFICACY",,,,,0282-5090,,
0042663,Uebaba K,Present status and prospect of Ayurveda in Japan,Ancient Sci Life 2002 Apr;21(4):218-29,,AYURVEDIC MEDICINE,"JAPAN, HISTORY",,,,0257-7941,,
0042664,"Udayakumar R, Begum VH",Antimicrobial studies of some selected medicinal plants,Ancient Sci Life 2002 Apr;21(4):230-4,,"ANTIINFECTIVE AGENTS, PLANTS MEDICINAL",PLANT EXTRACTS,,,,0257-7941,AB,"Antimicrobial activities were detected in the 80% ethanolic extract of Achyranthes aspera, Ficus glomerata, Leucas aspera, Thespesia populnea and Zizyphus jujuba against Escherichia coli, Klebsiella pneumoniae and Salmonella typhi. The treatments resulted in the formation of various inhibitory zones, in contrast to the control where no inhibitory zone was observed."
0042665,"Verma SM, Suresh KB",Phytochemical investigations of Indigofera tinctoria Linn leaves,Ancient Sci Life 2002 Apr;21(4):235-9,Indigofera tinctoria,"GLYCOSIDES, ALKALOIDS, TERPENES","PLANTS MEDICINAL, PLANT LEAVES, NUCLEAR MAGNETIC RESONANCE, BIOFLAVONOIDS",,,,0257-7941,AB,"Studies of Indigofera tinctoria Linn has shows that it possesses low toxicity. Phytochemical evaluation of leaf extract of Indigofera tinctoria Linn has been carried out to characterize some constituents present therein. Qualitative analysis of the extracts showed the presence of flavonoids, alkaloids, glycosides, terpenoids. Five compounds have been isolated from petroleum ether extract and methanolic extract and have been characterized by U.V. IR and H1 NMR data. Petroleum ether extract were also characterized by HPTLC."
0042666,"Mundhada S, Tatke P, Rehman MK",Antimicrobial activity of Ayurvedic tablet "Hadrabi",Ancient Sci Life 2002 Apr;21(4):240-3,Hadrabi,ANTIINFECTIVE AGENTS,"PLANTS MEDICINAL, PLANT EXTRACTS, AYURVEDIC MEDICINE",,,,0257-7941,AB,"The Ethanolic extract of \"Hadrabi\" powder was tested for anitmicrobial activities against gram positive organisms. Staphylococus aureus, Bacillus subtilis, Clostridium perfringens and gram negative organisms - Pseudomonas aeruginosa, Salmonella paratyphi - B. Escherichia coli and Klebsiella pneumoniae. Significant antimicrobial activity of the extract was found in this study at the dose of 1250 mg."
0042667,"Madhukiran BL, Vijaya Lakshmi K, Uma Maheswari DP",Antibacterial properties of Leucas cephalotes (Roth.) spreng. leaf,Ancient Sci Life 2002 Apr;21(4):244-7,Leucas cephalotes,ANTIGENS BACTERIAL,"PLANTS MEDICINAL, PLANT EXTRACTS",,,,0257-7941,AB,"Leucas cephalotes a common ethanomedicinal plant, is used by folklore of Tirupati in Andhra Pradesh for fevers and urinary tract infections. In the present study leaves of L. cephalotes were shade dried, powdered and extracts were made by Soxhlet Extractor using different organic solvents like hexane, dichloromethane, methanol and ethylacetate. The antimicrobial activity of these organic extracts was evaluated against pathogenic organisms of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris and Klebsiella pneumoniae. These isolates were obtained from clinical specimens like urine, blood and pus of Sri Venkateshwara Institute of Medical Sciences, Tirupati. The zone of inhibition was determined for these pathogenic microorganism by using specific standards and respective controls for determining Minimum Inhibitory Concentration (MlC). Among these tested organic extracts, hexane and methanolic extracts showed prominent antibacterial activity in comparison with dichloromethane and ethylacetate. Activity index for each tested extract has been calculated."
0042668,"Chitra M, Thoppil JE",Pharmacognostical and phytochemical investigations on the tuberous roots of Hemidesmus indicus (Linn.) R.BR. (Asclepiadaceae),Ancient Sci Life 2002 Apr;21(4):248-55,Hemidesmus indicus,PHARMACOLOGY,"PLANTS MEDICINAL, PLANT EXTRACTS, ROOTS",,,,0257-7941,AB,"The macroscopic and microscopic characters, physical constant values, extractive values, ash values the behaviour of the powdered drug on treatment with different chemical reagents, microchemical and histochemical analyses were conducted to characterise some pharmacognostical parameters of Hemidesmus indicus (Linn.) R.Br. (Asclepiadaceae)."
0042669,"Ilavarasan R, Mohideen S, Vijayalakshmi M",Antiulcer activity of Aegle marmelos Linn,Ancient Sci Life 2002 Apr;21(4):256-9,Aegle marmelos,ANTIULCER AGENTS,"PLANTS MEDICINAL, PLANT EXTRACTS, TREATMENT OUTCOME",,,,0257-7941,AB,"Aegle marmelos Linn is a common plant used to treat many disease conditions in Indian traditional systems of medicine. The present study was undertaken to find out a scientific validation for the efficacy of Aegle marmelos against gastric ulcer. Aqueous extract of Aegle marmelos leaves was prepared and used for investigation. A daily dose of 1 gm/kg body weight of the extract administered orally for 21 days. The volume of the gastric secretion, ulcer lesion count, pepsin content, pH, total acidity, hexose and hexosamine content were estimated. The result indicated a significant reduction in the ulcer lesion count, volume of gastric juice and acidity and increase in pH and hexosamine after treatment with extract. However the Pepsin and hexose content not significantly altered. Histopathological studies were conducted to support the antiulcer study."
0042670,"Joy PP, Thomas J, Skaria S, Skaria M, Skaria BP",Agrotechniques for the cultivation of Curcuma zedoaria (Berg.) Rosc.,Ancient Sci Life 2002 Apr;21(4):260-7,Curcuma zedoaria,AGRICULTURE,"PLANTS MEDICINAL, PLANT EXTRACTS",,,,0257-7941,AB,"Curcuma zedoaria (Berg) Rose. (wild turmeric or kastoorimanjal of commerce) rhizome is used as appetizer, tonic, blood purifier and cosmetic. It is useful in flatulence and dyspepsia and also for worms and skin diseases. A study on the agrotechniques for its cultivation at the Aromatic and Medicinal plants Research Station, Odakkali during 1996-1999 revealed that it is highly adaptable to a wide range of spacings, producing similar yields by adjusting the number of plants/hill. It produces maximum yield of rhizome (34 t/ha), essential oil (0.33%) and oeoresin (5.5%) when 1.5 t/ha of seed rhizomes are planted at 60 x 40 cm spacing with the receipt of premonsoon showers in May and harvested in January. Application of 20t/ha of FYM, lOO: 50: 50 kg N:P:K/ha, biofertilisers, green manuring and mulching maXimize the yields. Combination and interaction effects of the various manurial treatments are to be studied further in detail. The nutrient removal by the crop for the production of rhizomes was 115.96: 9.46: 111.23 kg NPK/ha."
0042671,Punjani BL,Ethnobotanical aspects of some plants of Aravalli Hills in North Gujarat,Ancient Sci Life 2002 Apr;21(4):268-80,,"TRADITIONAL MEDICINE, CULTURE","PLANTS MEDICINAL, PLANT EXTRACTS, INDIA, RURAL POPULATION",,,,0257-7941,AB,"The Aravalli ranges run along the Sabarkantha district is the ancient region of India, inhibited by tribals living in close vicinity of enriched forest. The present paper contains various ethnobotanical aspects of some plant species used by the tribals for their day-to-day requirement. The paper includes the first hand information collected through tribal informants, medicine men and tribal people of several villages during the field trips in the region for last three years in different seasons."
0042672,Dasture AV,Global market potentials of Ayurveda drugs - some facts,Ancient Sci Life 2002 Apr;21(4):281-6,,"PLANTS MEDICINAL, TRADITIONAL MEDICINE, AYURVEDIC MEDICINE",,,,,0257-7941,,
0042673,Bulankova Ollo NV,Acute leukemia,Homeopath Int 2002 Summer;15(2):4-7,,"LEUKEMIA, HOMEOPATHY","DRUG THERAPY, CASE REPORT, TREATMENT OUTCOME",,,,0953-1203,,
0042674,Evans J,The sea and cancer,Homeopath Int 2002 Summer;15(2):8-9,Oceans and seas,"NEOPLASMS, HOMEOPATHY",DRUG THERAPY,,,,0953-1203,,
0042675,Anonymous,In memory of a revolutionary homeopath Dr Madan Lal Sehgal,Homeopath Int 2002 Summer;15(2):10-11,Sehgal ML,HOMEOPATHY,FAMOUS PERSONS,,,,0953-1203,,
0042676,Saleem Baig M,Cure hepatitis with homeopathy,Homeopath Int 2002 Summer;15(2):14-7,,"HEPATITIS, HOMEOPATHY",DRUG THERAPY,,,,0953-1203,,
0042677,Shine M,Recipe for homeopath par excellence,Homeopath Int 2002 Summer;15(2):18-9,,HOMEOPATHY,PHILOSOPHY,,,,0953-1203,,
0042678,"Ameet, Panchal N",Case of bronchial asthma,Homeopath Int 2002 Summer;15(2):20-1,,"ASTHMA, HOMEOPATHY","DRUG THERAPY, CASE REPORT",,,,0953-1203,,
0042679,Anonymous,Case of post-menopausal affections,Homeopath Int 2002 Summer;15(2):21-3,,"MENOPAUSE, HOMEOPATHY","ADVERSE EFFECTS, DRUG THERAPY, CASE REPORT",,,,0953-1203,,
0042680,Kishori,Case of bronchial asthma,Homeopath Int 2002 Summer;15(2):23-4,,"ASTHMA, HOMEOPATHY","CASE REPORT, DRUG THERAPY",,,,0953-1203,,
0042681,Anonymous,Case of osteomyelitis,Homeopath Int 2002 Summer;15(2):24-5,,"OSTEOMYELITIS, HOMEOPATHY","DRUG THERAPY, CASE REPORT",,,,0953-1203,,
0042682,Adajania FJ,Ugly and forsaken,Homeopath Int 2002 Summer;15(2):25-8,,"PARESTHESIA, HOMEOPATHY","DRUG THERAPY, CASE REPORT",,,,0953-1203,,
0042683,Shah J,Fanaticism - lecture by Dr. Farokh Master,Homeopath Int 2002 Summer;15(2):30-1,,"EMOTIONS, HOMEOPATHY",DRUG THERAPY,,,,0953-1203,,
0042684,Ferguson A,"Setting up a new practice, or building on an existing one?",Homeopath Int 2002 Summer;15(2):32-4,,"HOMEOPATHY, PRIVATE PRACTICE",,,,,0953-1203,,
0042685,Beyer D,Ausgewogene Ernahrung halt Herz-Kreislauf-Erkrankungen in Schach,Gesund Leben 2002 Aug;79(4):10-6,,"CARDIOVASCULAR DIS, DIETARY SUPPLEMENTS","PREVENTION, DIET THERAPY, FOOD, VITAMINS, METALS, TRACE ELEMENTS",,German,,0016-9250,,
0042686,Middeke M,Stellenweert der Aquaretika in der Behandlung von Odemen,Gesund Leben 2002 Aug;79(4):17-21,,"EDEMA, PLANTS, WATER, DIURETICS","PHYTOTHERAPY, DRUG THERAPY",,German,,0016-9250,,
0042687,Anonymous,Erklarung zu dem Widerruf fur Kava-Kava-haltige Arzneimittel durch das BfArM,Gesund Leben 2002 Aug;79(4):26,,KAVA,"GERMANY, ADVERSE EFFECTS",,German,,0016-9250,,
0042688,Peters U,Losliche Ballaststoffe - Grundlage einer gesunden Darmflora,Gesund Leben 2002 Aug;79(4):31-3,,"DIETARY FIBER, INTESTINES, PROBIOTICS","IMMUNE SYSTEM, HEALTH STATUS",,German,,0016-9250,,
0042689,"Krautheimer B, Strittmatter B",Ohr-Akupunktur in der Urologie,Gesund Leben 2002 Aug;79(4):48-53,,"EAR ACUPUNCTURE, UROLOGIC DIS","METHODS, ACUPUNCTURE THERAPY",,German,,0016-9250,,
0042690,Dlugos B,Kalium bichromicum,Gesund Leben 2002 Aug;79(4):63,Kalium bichromicum,"HOMEOPATHIC DRUGS, RESPIRATORY TRACT DIS, GASTROINTESTINAL DIS","DRUG PICTURE, DRUG THERAPY",,German,,0016-9250,,
0042691,Beyer D,Frauenmantel (Alchemilla vulgaris L.),Gesund Leben 2002 Aug;79(4):65,,"PLANT EXTRACTS, DIARRHEA, BIOFLAVONOIDS, ALCHEMILLA","PLANTS MEDICINAL, DRUG THERAPY",,German,,0016-9250,,
0042692,Duggan RM,New beginnings and gratitude to many,Meridians 2002 Spring;9(2):3,,"ACUPUNCTURE, MERIDIANS",UNITED STATES,(Editorial),,,,AB,"With a new campus and new opportunities for service, a new cycle begins at Tai Sophia. The Institute's president reflects on what has made such creation possible."
0042693,Gurland S,"Acupuncture for weight loss, smoking...",Meridians 2002 Spring;9(2):4-7,,"WEIGHT LOSS, SMOKING CESSATION, OBESITY","ACUPUNCTURE THERAPY, ATTITUDE TO HEALTH",,,,,AB,"Acupuncture is a strong support for behavioral change - for stopping smoking, weight loss and more - and it helps create balance and harmony in the whole person."
0042694,Grissmer J,When anger rises: ways to claim anger's gift to ourselves and to the world,Meridians 2002 Spring;9(2):9-14,,"ANGER, MIND BODY RELATIONS, ATTITUDE",PSYCHOLOGY,,,,,AB,"Alerted to the nuances of our anger, we can transform it into creative, benevolent action."
0042695,Hill R,"Father Larre: a life lived from the heart, 1919-2001",Meridians 2002 Spring;9(2):15-20,,"TRADITIONAL MEDICINE CHINESE, TEACHING",RELIGION,,,,,,
0042696,"Connelly D, Ellrich B","Deep roots, new growth, wider service",Meridians 2002 Spring;9(2):24-30,,"ACUPUNCTURE, EDUCATION PROFESSIONAL","TEACHING, UNITED STATES, PROGRAM EVALUATION",,,,,AB,Tai Sophia's work in 2001 served the wider world of health care as well as the Institute's immediate community. Here the authors report of the growth and service.
0042697,Hancock E,Short treatments: at Penn North,Meridians 2002 Spring;9(2):37-8,,"SUBSTANCE ABUSE, HERBALISM","UNITED STATES, ACUPUNCTURE THERAPY, TEACHING",,,,,,
0042698,Hantman B,Practicing the "amazing" art of five-element acupuncture in Israel,Meridians 2002 Spring;9(2):39-42,,"ACUPUNCTURE, JUDAISM","PHILOSOPHY, ISRAEL, METHODS, ACUPUNCTURE THERAPY",,,,,AB,A research scientist who discovered acupuncture discusses his practice of this healing art.
0042699,"Cappelletti M, Kopelman M, Butterworth B",Why semantic dementia drives you to the dogs (but not to the horses): a theoretical account,Cognit Neuropsychol 2002 Sep;19(6):483-503,,"DEMENTIA, READING, WRITING, SEMANTICS","PHYSIOPATHOLOGY, MEMORY, MODELS THEORETICAL",,,,0264-3294,AB,"This paper describes a patient (IH) with semantic dementia and severe impairment in all semantic categories except for numerical knowledge, which was preserved. IH showed a severe deficit in reading and writing non-number words (e.g., candle, juice) and nonwords, and preservation of reading and writing number words (e.g., one, forty) and numerals (e.g., 1, 40). IH's pattern of performance can be explained by the combination of a selective sparing of one semantic category - i.e., numbers - with a total deficit of nonsemantic processes for mapping letters and sounds. As number was the only spared semantic category in the presence of these other nonsemantic deficits, it follows that the semantic route is sufficient for accurate reading and spelling. Our data clarify the nature of reading and writing processes and support the functional and neuroanatomical independence of the number domain."
0042700,Gilmour JA,Dis/integrated care: family caregivers and in-hospital respite care,J Adv Nurs 2002 Sep;39(6):546-53,,"CONTINUITY OF PATIENT CARE, RESPITE CARE, DEMENTIA, QUALITY OF HEALTH CARE, PROFESSIONAL FAMILY RELATIONS","FAMILY, CAREGIVERS, INPATIENTS, PATIENT SATISFACTION, NURSES, NURSING STAFF",,,,0309-2402,AB,"Aim: The aim of this study was to explore family caregivers' experiences of in-hospital respite care for people with dementia and the factors that influenced their perceptions of the service. Background: The provision of respite care is based on the assumption that temporary relief from caregiving will relieve caregiver stress and may possibly extend the duration of home care. Research evidence suggests that this is a simplistic perspective which fails to account for families' concerns about the quality of institutional care and the impact of relocation on the person being cared for. Design: Nine family caregivers, using four different hospitals sites were interviewed during a period of 3 years from 1994 to 1997. The research texts were analysed using a critical discourse analysis approach drawing on the work of Foucault. Findings: Family caregiver texts were distinguished by difference rather than by homogeneity. Caregivers occupied a range of positions in terms of their ability to take advantage of the respite time intermittent care offered. My reading of these texts has highlighted the aspects of nurse-family relationships that ameliorated, or alternately exacerbated, the tensions felt by caregivers, as they were torn between the necessity to have a break and their anxieties about the impact of in-hospital respite care on the person with dementia. Conclusion: Nurses' practices in this study were a critical element in facilitating, or alternately constraining, family caregivers' ability to relinquish care and to take full advantage of the respite time. The research findings highlight the need for nurses and other formal caregivers to locate themselves in a secondary and supporting caregiving role, to acknowledge the family caregivers as the primary caregiver, and use family caregivers in-depth and intimate knowledge. (ABSTRACT TRUNCATED)."
0042701,"Clark AM, Barbour RS, McIntyre PD",Preparing for change in the secondary prevention of coronary heart disease: a qualitative evaluation of cardiac rehabilitation within a region of Scotland,J Adv Nurs 2002 Sep;39(6):589-98,,"CORONARY DIS, PATIENT COMPLIANCE, CONTINUITY OF PATIENT CARE, HEALTH PROMOTION","SCOTLAND, REHABILITATION, PROGRAM EVALUATION, PREVENTION, HEALTH SERVICES ACCESSIBILITY, SOCIOECONOMIC FACTORS",,,,0309-2402,AB,"Background: Secondary prevention of Coronary Heart Disease (CHD) is often poorly managed and its benefits attained in only a minority of those with CHD. Guidelines developed in the United Kingdom and North America suggest that in future cardiac rehabilitation programmes should provide services through individualized programmes that cater for a wide range of conditions associated with CHD. This will involve substantial and costly changes to current programmes that are mostly standardized and for postmyocardial infarction patients. Based on change theory, this study examined the dynamics, strengths and weaknesses of an existing programme in a Scottish region which was due to undergo the changes suggested by guidelines. Aim: To examine the perceived provision of secondary prevention services for CHD from the perspectives of health professionals within one region in the West of Scotland. Methods: A purposive sample of 14 health professionals (eight primary and six secondary care health professionals) was selected to cover a range of professional roles including both specialists and generalists. Separate focus group discussions (2) were held with primary care and secondary care professionals. Findings: Whilst the health professionals were enthusiastic about CHD prevention and their involvement, they perceived barriers to the success of the existing service as being complex and multifactorial, including patient, social and service-related factors. Although both groups identified motivation as the most influential personal factor, secondary care staff tended to focus on the importance of patient factors in influencing motivation to change, whereas the primary care staff referred more to the cumulative effects of social and cultural factors. (ABSTRACT TRUNCATED)."
0042702,"Ferguson RJ, Robinson AB, Splaine M",Use of the reliable change index to evaluate clinical significance in SF-36 outcomes,Qual Life Res 2002 Sep;11(6):509-16,health care surveys,"CLINICAL ASSESSMENT SCALES, HEALTH STATUS","CONSISTENCY AND RELIABILITY, STATISTICS, STANDARDS, OUTCOME AND PROCESS ASSESSMENT, HEALTH SERVICES RESEARCH",,,,0962-9343,AB,"The SF-36 Health Survey is the most widely used self-report measure of functional health. It is commonly used in both randomized controlled trials (RCT) and non-controlled evaluation of medical or other health services. However, determining a clinically significant change in SF-36 outcomes from pre-to-post-intervention, in contrast to statistically significant differences, is often not a focus of medical outcomes research. We propose use of the Reliable Change Index (RCI) in combination with SF-36 norms as one method for researchers, provider groups, and health care policy makers to determine clinically significant healthcare outcomes when the SF-36 is used as a primary measure. The RCI is a statistic that determines the magnitude of change score necessary of a given self-report measure to be considered statistically reliable. The RCI has been used to determine clinically significant change in mental health and behavioral medicine outcomes research, but is not widely applied to medical outcomes research. A usable table of RCIs for the SF-36 has been calculated and is presented. Instruction and a case illustration of how to use the RCI table is also provided. Finally, limitations and cautionary guidelines on using SF-36 norms and the RCI to determine clinically significant outcome are discussed."
0042703,"Incalzi RA, Bellia V, Maggi S, Imperiale C, Capparella O, Pistelli R, Grassi V",Reversible bronchial obstruction and disease-related health status in COPD,Qual Life Res 2002 Sep;11(6):517-25,,"LUNG DISEASES OBSTRUCTIVE, HEALTH STATUS, AIRWAY OBSTRUCTION","AGED, PHYSIOPATHOLOGY, ETIOLOGY, BRONCHI, CLINICAL ASSESSMENT SCALES",,,,0962-9343,AB,"We aimed to assess whether partially reversible and fixed airway obstructions are associated with different health status profiles of chronic obstructive pulmonary disease (COPD) patients. We characterized health status profiles of outpatients over 64 years suffering from COPD with fixed (n = 181) or partially reversible obstruction (n = 95) and from chronic bronchitis with forced expiratory volume in the first second (FEV1) greater than 69% of that predicted (n = 109) on the basis of the Saint George Respiratory Questionnaire (SGRQ) and indexes assessing cognitive (Mini Mental State), affective (15-item Geriatric Depression Scale) and physical status (Index of Barthel, six-minute walking test) and quality of sleep (Index of disturbed sleep). The degree of group-specificity of health status profiles was assessed by discriminant analysis. The 54.1% of COPD patients with partially reversible obstruction were recognized to have a distinctive health status profile characterized by a moderate to severe impairment of all components ('Symptoms', 'Activity', 'Impacts') of the SGRQ and of select indexes of performance. According to logistic regression analysis, this health status profile was associated with FEV less than 46% of that predicted (odds ratio (OR): 1.6, 95% confidence interval (CI): 1.07-2.38), the use of at least three respiratory drugs (OR: 2.28, CI: 1.46-3.57) and living alone (OR: 2.01, 95% CI: 1.3-2.29). COPD patients with fixed obstruction had a very heterogeneous health status. Research is needed to verify whether the unfavorable health status profile typical of a subset of COPD patients is associated with a distinctive prognosis and can be improved by dedicated therapeutic interventions."
0042704,"Stave K, Jodalen H",Reliability and validity of the COOP/WONCA health status measure in patients with chronic obstructive pulmonary disease,Qual Life Res 2002 Sep;11(6):527-33,,"LUNG DISEASES OBSTRUCTIVE, HEALTH STATUS, CLINICAL ASSESSMENT SCALES, QUALITY OF LIFE","CONSISTENCY AND RELIABILITY, REPRODUCIBILITY OF RESULTS, QUESTIONNAIRES, COMPARATIVE STUDY, STANDARDS",,,,0962-9343,AB,"The objective of the study was to assess the reliability and validity of the Dartmouth Primary Care Cooperative Information Project/World Organization of National Colleges, Academies, and Academic Associations of General Practice/Family Physicians (COOP/WONCA) questionnaire in outpatients with chronic obstructive pulmonary disease (COPD). The test-retest reliability of individual items of the COOP/WONCA questionnaire was assessed using a weighted kappa-statistic, and construct validity was assessed by correlating items of the COOP/WONCA with the EQ-5D health status measure. Discriminant validity was assessed by comparing scores for known groups, at the same time comparing the results with those of a lung-specific health status questionnaire. The individual items of the COOP/WONCA had test-retest reliabilities of 0.67-0.78 (weighted kappa). Spearman's rank correlations between COOP/WONCA single-item scores and corresponding EQ-5D ranged 0.45-0.72, which were generally higher than associations between non-corresponding items. Four of the five COOP/WONCA items did not discriminate between patient groups divided according to forced expiratory flow in 1 sec (FEV1) in percent of predicted and 6-min walking distance, while four of five items of the lung-specific questionnaire discriminated well between these groups. The COOP/WONCA chart system was reliable and showed properties supporting the construct validity of the measure. The items, however, did not discriminate well between known groups, indicating that this questionnaire is not very sensitive in patients with COPD. The reliability of the COOP/WONCA items was acceptable for use at group level, but lower than current recommendations for use in individual patients."
0042705,"Thompson DR, Jenkinson C, Roebuck A, Lewin RJ, Boyle RM, Chandola T",Development and validation of a short measure of health status for individuals with acute myocardial infarction: the myocardial infarction dimensional assessment scale (MIDAS),Qual Life Res 2002 Sep;11(6):535-43,,"MYOCARDIAL INFARCTION, HEALTH STATUS, CLINICAL ASSESSMENT SCALES, QUALITY OF LIFE","ACUTE DIS, PROGRAM DEVELOPMENT, CONSISTENCY AND RELIABILITY, STANDARDS, REHABILITATION, PSYCHOLOGY",,,,0962-9343,AB,"The purpose of this study was to develop and validate a disease-specific health status measure for individuals with myocardial infarction (MI). The development of the myocardial infarction dimensional assessment scale (MIDAS) followed three main stages. Stage 1 consisted of in-depth, semi-structured, exploratory interviews conducted on a sample of 31 patients to identify areas of salience and concern to patients with MI. These interviews generated 48 candidate questions. In stage 2 the 48-item questionnaire was used in a postal survey to identify appropriate rephrasing/shortening, to determine acceptability and to help identify sub-scales of the instrument addressing different dimensions of MI. Finally, in stage 3 the construct validity of MIDAS subscales was examined in relation to clinical and other health outcomes. A single centre (district general hospital) in England was used for stages 1 and 3 and a national postal survey was conducted for stage 2. A total of 410 patients were recruited for the national survey (stage 2). Full data were available on 348 (85%) patients. One hundred and fifty-five patients were recruited to test construct validity (stage 3). The MIDAS contains 35 questions measuring seven areas of health status: physical activity, insecurity, emotional reaction, dependency, diet, concerns over medication and side effects. The measure has high face, internal and construct validity and is likely to prove useful in the evaluation of treatment regimes for MI."
0042706,"Padierna A, Quintana JM, Arostegui I, Gonzalez N, Horcajo MJ",Changes in health related quality of life among patients treated for eating disorders,Qual Life Res 2002 Sep;11(6):545-52,,"QUALITY OF LIFE, EATING DISORDERS, HEALTH STATUS","FOLLOW UP STUDIES, MENTAL HEALTH, COMPARATIVE STUDY, SELF CONCEPT, PSYCHIATRIC STATUS RATING SCALES, PSYCHOLOGY",,,,0962-9343,AB,"OBJECTIVE: To prospectively investigate changes in the perception of health-related quality of life (HRQoL) among eating disorder patients after 2 years of treatment and follow-up and clinical predictors of change. METHOD: One hundred and thirty-one consecutive subjects were recruited from an eating disorder outpatient clinic. Subjects completed a generic HRQoL questionnaire, the Short Form-36 (SF-36), as well as the Eating Attitudes Test (EAT-40) to measure symptom severity and the Hospital Anxiety and Depression scale (HAD), at the first visit and after 24 months. RESULTS: Perception of HRQoL, measured by the SF-36, showed significant improvement in all but the role emotional domain after 2 years. The greatest improvements were observed in the physical function and social function domains, followed by mental health and vitality. Despite significant improvement in the summary mental health scale, scores after 2 years of treatment and follow-up were still below normative population values of women aged 18-34. Severity of eating disorder symptoms and presence of anxiety or depression at baseline significantly affected improvement in various SF-36 domains. CONCLUSIONS: Despite improvements in perception of HRQoL, eating disorder patients were more dysfunctional in all domains of the SF-36 even after 2 years of treatment and follow-up compared with women in the general population, and the severity of eating disorder symptoms was correlated with degree of dysfunction."
0042707,"Ritsner M, Kurs R, Kostizky H, Ponizovsky A, Modai I",Subjective quality of life in severely mentally ill patients: a comparison of two instruments,Qual Life Res 2002 Sep;11(6):553-61,,"QUALITY OF LIFE, MENTAL DISORDERS, PSYCHIATRIC STATUS RATING SCALES","COMPARATIVE STUDY, STANDARDS, CONSISTENCY AND RELIABILITY, PSYCHOMETRICS",,,,0962-9343,AB,"Although many quality of life (QOL) scales have been developed, comparison of specific QOL instruments is lacking. We compared the psychometric properties of two QOL measures in parallel samples of mentally disturbed and non-patient subjects. We simultaneously administered the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and self-report items of the Lancashire Quality of Life Profile (LQOLP) to 199 patients with severe mental disorders and 175 non-patients. The patients were evaluated with psychiatric rating scales. We identified five concordant domains, and five instrument-specific domains for the LQOLP and four for the Q-LES-Q. The Q-LES-Q provides better psychometric properties than the LQOLP in both samples. Both instruments show a good capacity to evaluate QOL and discriminate between the patients and non-patient controls. Within the patient sample, both QOL measures showed similarly negative correlations with severity of depression, but not mania, positive, negative, and general symptomatology. Both instruments proved to be mental health related, but neither was mental-disorder specific. Despite the acceptable psychometric properties and correlation of general QOL indices, similar QOL domains proved to be instrument specific and not sufficiently compatible. These discrepancies should be considered when comparing evaluations from similar domains in these QOL scales."
0042708,"Coyne K, Revicki D, Hunt T, Corey R, Stewart W, Bentkover J, Kurth H, Abrams P",Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q,Qual Life Res 2002 Sep;11(6):563-74,,"BLADDER DIS, QUALITY OF LIFE, CLINICAL ASSESSMENT SCALES, URINARY INCONTINENCE","PSYCHOMETRICS, CONSISTENCY AND RELIABILITY, SYMPTOMS, QUESTIONNAIRES, PSYCHOLOGY, COMPARATIVE STUDY",,,,0962-9343,AB,"OBJECTIVE: Overactive bladder (OAB) is characterized by symptoms of urinary frequency and urgency, with and without incontinence, and has been shown to have significant impact on health-related quality of life (HRQL). Currently, no OAB-specific questionnaires exist to evaluate all symptoms of OAB; thus we sought to evaluate the psychometric properties of a newly developed OAB HRQL questionnaire. METHODS: The 33-item, self-administered OAB-q contains a symptom bother and HRQL scale. Both the OAB-q and SF-36 were completed by participants from two sources: (1) a community sample who screened positive for OAB in a random-digit dial telephone survey and participated in a clinical validation study (n = 254); and (2) a clinical study of patients' seeking treatment for OAB symptoms (baseline assessment) (n = 736). Item and exploratory factor analysis were performed to assess the subscale structure of the questionnaire. Psychometric evaluation was conducted to assess reliability and validity. RESULTS: Seventy-four percent of the sample were women with mean age of 58.5. Participants with continent and incontinent symptoms reported significantly greater symptom bother and HRQL impact than normal participants. Significant differences were present among all patient groups in all OAB-q subscales (p less than 0.0001) except sleep where the impact of continent and incontinent OAB was similar, but significantly worse than normal participants (p less than 0.0001). Internal consistency was high with the subscale Cronbach alpha-values ranging from 0.86 to 0.94. CONCLUSION: The OAB-q is a reliable and valid instrument that discriminates between normal and clinically diagnosed continent and incontinent OAB participants. The OAB-q demonstrates that both continent and incontinent OAB symptoms cause significant symptom bother and have a negative impact on HRQL."
0042709,"Raat H, Landgraf JM, Bonsel GJ, Gemke RJ, Essink-Bot ML",Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population,Qual Life Res 2002 Sep;11(6):575-81,,"HEALTH STATUS, QUALITY OF LIFE, CLINICAL ASSESSMENT SCALES","CHILD, CONSISTENCY AND RELIABILITY, NETHERLANDS, QUESTIONNAIRES, ADOLESCENT, REPRODUCIBILITY OF RESULTS",,,,0962-9343,AB,"Feasibility, reliability, and discriminative validity of the cross-culturally adapted Dutch version of the originally US child health questionnaire-child form (CHQ-CF87), an 87-item generic pediatric health-related quality of life instrument, were assessed. The success criterion in this first evaluation was the equivalence of psychometric properties of the adapted and the original CHQ. A total of 466 schoolchildren (9-17 years) were invited to complete the questionnaire in the classroom. Test-retest reliability was measured after 14 days in a subgroup (n = 71). Response was 96%. Four scales had ceiling effects (greater than 50%), as was reported in an Australian study. Cronbach alpha-values were adequate (greater than 0.70), except for 'physical functioning' (0.56). Test-retest correlations, not previously reported, were not statistically significant for two CHQ-scales, whereas average retest scores indicated better health for five scales (p less than 0.01). The CHQ scales discriminated significantly (p less than 0.01) between children without (n = 281) and children with two or more self-reported chronic diseases (n = 59). This is in correspondence with US and Australian reports. Conclusions: The current data support application of the Dutch CHQ-CF in predominantly healthy populations, e.g. in school settings. Given the limitations of this study and some less favorable results (score distributions, internal consistency, test-retest reliability), further evaluation of the CHQ-CF is recommended, preferably by analyses of item performance and scale validity in international data sets that include varied clinical subgroups."
0042710,"Demers L, Monette M, Descent M, Jutai J, Wolfson C",The Psychosocial Impact of Assistive Devices Scale (PIADS): translation and preliminary psychometric evaluation of a Canadian-French version,Qual Life Res 2002 Sep;11(6):583-92,,"DISABILITY, DISABILITY AIDS, REHABILITATION PSYCHOSOCIAL, CLINICAL ASSESSMENT SCALES, QUALITY OF LIFE","QUESTIONNAIRES, PSYCHOMETRICS, CONSISTENCY AND RELIABILITY, LANGUAGE",,,,0962-0343,AB,"This article reports on the Canadian-French translation of the Psychosocial Impact of Assistive Devices Scale (PIADS), a 26-item questionnaire that measures the quality of life (QoL) impacts of using assistive technologies from the person with disability's point of view. Following standard procedures, the study included forward and backward translations, committee reviewing, pre-testing with bilingual lay people, and psychometric evaluation of the translated questionnaire with subjects with mobility impairment (n = 83) and visual impairment (n = 37). The use of translators translating in their mother tongue and the participation of one author of the questionnaire contributed to the quality of the translation. We found that words that had equivalence in English and French did not necessarily cover the same areas of meaning. The subscales (n = 3) and total scale of the French PIADS achieved good test-retest stability (ICC of 0.77-0.90) and internal consistency (0.75-0.94). Concurrent validity with the source PIADS also produced acceptable coefficients (0.77-0.83). At the item level, non-significant t test (p greater than 0.10) results supported the premise that the scores were not different across languages, except for two items. The results are robust enough to recommend the use of the Canadian-French questionnaire for the investigation of the QoL impacts of assistive technologies for persons with disability."
0042711,"Min SK, Kim KI, Lee CI, Jung YC, Suh SY, Kim DK",Development of the Korean versions of WHO Quality of Life scale and WHOQOL-BREF,Qual Life Res 2002 Sep;11(6):593-600,,"QUALITY OF LIFE, CLINICAL ASSESSMENT SCALES, WORLD HEALTH ORGANIZATION, HEALTH STATUS","PROGRAM DEVELOPMENT, KOREA, CONSISTENCY AND RELIABILITY, QUESTIONNAIRES",,,,0962-9343,AB,"The purpose of this study was to develop the Korean version of World Health Organization Quality of Life study assessment instrument (WHOQOL) and WHOQOL-BREF, an abbreviated version of WHOQOL and to identify contributing factors in the quality of life of Koreans. The WHOQOL and WHOQOL-BREF were translated into colloquial Korean according to instructions of the WHOQOL study group. Then the Korean questionnaire was applied to 538 subjects, composed of 171 medical patients and 367 healthy subjects who volunteered to rate the scale. Finally, 486 subjects completed the rating. Collected data were analyzed statistically. The Korean version of WHOQOL and WHOQOL-BREF domain scores demonstrated good test-retest reliability, internal consistency, criterion validity, content validity and discriminant validity. The physical, psychological, social and environmental domains made a significant contribution to explaining the variance in the quality of life while the independence and spiritual domains made a lesser contribution. The domain scores produced by the WHOQOL-BREF correlated highly with the WHOQOL. The physical health domain contributed most in overall quality of life, while the social domain made the least contribution. These results suggest that the Korean version of WHOQOL and WHOQOL-BREF are valid and reliable in the assessment of quality of life and that physical domain is contributing most and social and spiritual factors are contributing least to the quality of life in Koreans."
0042712,"Chen NH, Li HY, Gliklich RE, Chu CC, Liang SC, Wang PC",Validation assessment of the Chinese version of the Snore Outcomes Survey,Qual Life Res 2002 Sep;11(6):601-7,snoring,"CLINICAL ASSESSMENT SCALES, SLEEP DISORDERS","CHINA, CONSISTENCY AND RELIABILITY, LANGUAGE, SYMPTOMS",,,,0962-9343,AB,"The aim of this study was to use a parallel model to translate the Snore Outcomes Survey (SOS) into Mandarin Chinese language by comparing performing characteristics and statistical properties of the original and Chinese versions SOS. The Chinese version SOS (CSOS) was validated in a prospective, non-randomized manner. A total of 359 patients with sleep-disordered breathing (SDB) aged 18 years and older diagnosed as having SDB participated in the study at entry. Reliability, validity, and longitudinal sensitivity data for CSOS were obtained. CSOS demonstrated good test-retest reliability (Intra-class correlation coefficient = 0.751). The Cronbach's alpha coefficient was 0.86. The item-total correlation coefficients varied from 0.30 to 0.99. The CSOS correlated well with polysomnogram (PSG) parameters including respiratory distress index (RDI), lowest arterial O2 saturation (LAST). CSOS also yielded significant correlations with vitality subscale of Chinese Taiwan version SF-36 (r = 0.4, p = 0.0011). The standard response mean (SRM) for CSOS was 1.33. The validation demonstrated only minor effects of language; the statistical properties of the CSOS were equivalent to the English version. The CSOS is a valid tool to evaluate adults with SDB among Chinese-speaking population."
0042713,Cammarata JF,"The anatomy professor that ate New York: some dinosaurs are teachers, and some teach about dinosaurs",J Am Osteopath Assoc 2002 Aug;102(8):415-6,,OSTEOPATHY,EDUCATION,(Editorial),,,0098-6151,,
0042714,"Rivera-Martinez S, Wells MR, Capobianco JD",A retrospective study of cranial strain patterns in patients with idiopathic Parkinson's disease,J Am Osteopath Assoc 2002 Aug;102(8):417-22,,"PARKINSON DIS, MANIPULATION OSTEOPATHIC","EPIDEMIOLOGIC METHODS, DATA COLLECTION",,,,0098-6151,AB,"While providing osteopathic manipulative treatment to patients with Parkinson's disease at the clinic of the New York College of Osteopathic Medicine of New York Institute of Technology, physicians noted that these patients may exhibit particular cranial findings as a result of the disease. The purpose of this study was to compare the recorded observations of cranial strain patterns of patients with Parkinson's disease for the detection of common cranial findings. Records of cranial strain patterns from physician-recorded observations of 30 patients with idiopathic Parkinson's disease and 20 age-matched normal controls were compiled. This information was used to determine whether different physicians observed particular strain patterns in greater frequency between Parkinson's patients and controls. Patients with Parkinson's disease had a significantly higher frequency of bilateral occipitoatlantal compression (87% vs. 50%; P less than .02) and bilateral occipitomastoid compression (40% vs. 10%; P less than .05) compared with normal controls. Over subsequent visits and treatments, the frequency of both strain patterns were reduced significantly (occipitoatlantal compression, P less than .01; occipitomastoid compression, P less than .05) to levels found in the control group."
0042715,"Ross GE, Bever FN, Uddin Z, Hockman EM, Herman BA",Decreased laboratory testing for lecithin-to-sphingomyelin ratio and phosphatidylglycerol after fetal lung maturity assessment from lamellar body count in amniotic fluid,J Am Osteopath Assoc 2002 Aug;102(8):423-8,Amniotic fluids,"RESPIRATORY DISTRESS SYNDROME, COST BENEFIT ANALYSIS","INFANT NEWBORN, PREVENTION, FLUIDS, CLINICAL ASSESSMENT SCALES",,,,0098-6151,AB,"The objectives of this study were to do inexpensive lamellar body count (LBC) in amniotic fluid, to do statistical analysis to evaluate cutoff values for fetal lung maturity (FLM) and fetal lung immaturity (FLI), to derive a threshold for obtaining a lecithin-to-sphingomyelin (L/S) ratio and phosphatidylglycerol percentage (%PG), and to determine the potential cost savings to the hospital if they use this new method. Testing (LBC, L/S ratio, and %PG) was done on 123 specimens of amniotic fluid. Receiver operating characteristic (ROC) curve, discriminant, linear regression, chi2, and cost analyses were used to evaluate the laboratory and financial parameters. Lamellar body counts of greater than 41,500 (Coulter MAXM: sensitivity, 90.5%; specificity, 87.7%; positive predictive value, 79.2%; negative predictive value, 94.7%) and greater than 32,000 (Coulter Gen.S: sensitivity, 90.5%; specificity, 85.2%; positive predictive value, 76.0%; negative predictive value, 94.5%) were the best threshold for biochemical FLM. Similarly, LBC of less than 24,000 (MAXM: sensitivity, 78.6%; specificity, 100%; positive predictive value, 100%; negative predictive value, 90.0%) and less than 21,000 (Gen.S: sensitivity, 71.4%; specificity, 100%; positive predictive value, 100%; negative predictive value, 87.1%) provided the best statistical cutoff for biochemical FLI from discriminant analysis. The authors concluded that FLM and FLI can be predicted with reasonable accuracy from LBC in amniotic fluid specimens. The expensive and not easily accessible L/S ratio and %PG can then be done only in cases in which LBC indicates transitional FLM. A cascade approach results in 86% savings to the hospital if the L/S ratio and %PG are not sent to a reference laboratory."
0042716,Jackson CR,Clinical experience with pneumococcal conjugate vaccines in infants and children,J Am Osteopath Assoc 2002 Aug;102(8):431-6,,"STREPTOCOCCAL INFECTIONS, VACCINES","CHILD, INFANT, TREATMENT OUTCOME",,,,0098-6151,AB,"Streptococcus pneumoniae is a leading cause of morbidity and mortality in pediatric patients, particularly in infants and children younger than 2 years. Each year, S pneumoniae is responsible for significant morbidity and mortality in the United States. During the past several decades, the emergence of penicillin-nonsusceptible and multi drug-resistant pneumococcal isolates has become a major cause for concern, with the overuse or inappropriate use of antibiotics playing a significant role in the increase of resistance. Because the resistance of S pneumoniae to antibiotics has complicated the treatment of pneumococcal infections, attention has focused on the need to prevent disease through vaccination. The objective of this article is to describe the rationale for the development of pneumococcal conjugate vaccines and to summarize the clinical experience to date with these vaccines in infants and children."
0042717,"Triano JJ, Rogers CM, Combs S, Potts D, Sorrels K",Developing skilled performance of lumbar spine manipulation,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):353-61,,"MANIPULATION CHIROPRACTIC, LUMBAR VERTEBRAE","RANDOMIZED CONTROLLED TRIALS, EDUCATION, BIOMECHANICS",,,,0161-4754,AB,"OBJECTIVE: To quantify elements of spinal manipulation therapy performance and to test the strategy of combined rehearsal and quantitative feedback as a means of enhancing student skill development. DESIGN: Randomized, controlled study. SETTING: Chiropractic college. SUBJECTS: Thirty-nine chiropractic student volunteers entering the manipulation technique training course participated after providing informed consent. METHODS: Student performance of lumbar spinal manipulation therapy was quantified at the beginning, middle, and end of a trimester with a manipulation table imbedded with an AMTI force plate. Loads acting passing through the L5/S1 functional spinal unit were estimated by inverse dynamics. Participating students rehearsed the mamillary push, diversified procedure following either the standard curriculum alone or a modified curriculum adding a training aid as assigned on a randomized basis. Student's t and chi(2) tests were used to explore and describe biomechanical parameter changes over time as the semester progressed. RESULTS: Significant changes in performance between the standard curriculum and modified curriculum were observed in several biomechanical parameters. CONCLUSION: The reported project used a rehearsal program defined empirically and was self-administered in practice by the student. Results demonstrated significant changes in performance of spinal manipulation by students using the training aid instrument versus those who did not. With quantitative training aids and biomechanical measurement systems, future training programs may be optimized and tested."
0042718,"Chiradejnant A, Latimer J, Maher CG",Forces applied during manual therapy to patients with low back pain,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):362-9,,"LOW BACK PAIN, MANIPULATION CHIROPRACTIC, SPINAL MOBILISATION","REPRODUCIBILITY OF RESULTS, PHYSIOTHERAPY",,,,0161-4754,AB,"BACKGROUND: To date, there is little information available regarding the forces used during mobilization treatment of patients with low back pain (LBP). OBJECTIVE: This study measured such forces and investigated whether the force characteristics could be predicted on the basis of physical therapist and patient characteristics. SUBJECTS: Ten physical therapists applied a central posteroanterior (PA) mobilization treatment to 80 patients with LBP, providing data on treatment of 123 lumbar levels. METHODS: Physical therapists were required to treat their patients while the patients lay on an instrumented couch. This couch has been shown to be highly accurate in its measurement of force in 3 directions (error less than 2%) and has demonstrated high test-retest reliability (ICC (2, 1), 99% CI = 0.99-1.00). The forces applied by the physical therapists were recorded over a 10-second period. Data on the characteristics of the physical therapists and patients were collected by means of questionnaires. RESULTS: The force used by physical therapists related not only to patient characteristics but also to physical therapist characteristics. Interestingly, current pain intensity and nature of symptoms did not affect the forces used. The overall patterns of the force characteristics were generally consistent with previous studies performed in asymptomatic subjects. However, the magnitude of the force applied and the frequency of each grade used in the present study are relatively higher than in earlier studies. CONCLUSION: These preliminary data provide some useful quantitative information about the forces used during mobilization treatment of patients with LBP. Also, the force characteristics described here may provide useful data for both teaching and research in manual therapy."
0042719,"Haynes MJ, Cala LA, Melsom A, Mastaglia FL, Milne N, McGeachie JK",Vertebral arteries and cervical rotation: modeling and magnetic resonance angiography studies,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):370-83,,"VERTEBRAL ARTERY, CERVICAL VERTEBRAE, ROTATION, MANIPULATION CHIROPRACTIC, SPINAL STENOSIS",ULTRASONOGRAPHY,,,,0161-4754,AB,"OBJECTIVE: To determine whether lumen narrowing in vertebral arteries during atlanto-axial rotation is due to stretch or localized compression. DESIGN AND SETTING: Experiments with models were made in a private chiropractic clinic, whereas studies of cadaveric specimens were performed in an anatomy laboratory. Doppler ultrasound and magnetic resonance angiography (MRA) studies were carried out in the radiology department of a public hospital. PATIENTS: Eight patients had their vertebral arteries examined by use of a Doppler velocimeter and MRA. Main Outcome Measure: Stenosis of the vertebral arteries caused by stretch, localized compression, or kinking. RESULTS: All 16 vertebral arteries from the 8 patients displayed no changes in their lumen dimensions with full cervical rotation, although curves in each of the arteries did change. The model and cadaveric vertebral arteries demonstrated localized compression or kinking of the vessel wall with atlanto-axial rotation contralaterally but revealed no evidence of major contribution of stretching to stenosis. CONCLUSION: The lumen of vertebral arteries is usually unaffected by atlanto-axial rotation. In cases where there is stenosis, this is mainly due to localized compression or kinking. These findings are relevant to premanipulative screening of vertebral arteries with Doppler ultrasound scanning."
0042720,"Fryer GA, Mudge JM, McLaughlin PA",The effect of talocrural joint manipulation on range of motion at the ankle,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):384-90,,"ANKLE JOINT, MANIPULATION CHIROPRACTIC","RANGE OF MOTION, TREATMENT OUTCOME, RANDOMIZED CONTROLLED TRIALS, EPIDEMIOLOGIC METHODS",,,,0161-4754,AB,"OBJECTIVE: To determine whether a single high-velocity, low-amplitude thrust manipulation to the talocrural joint altered ankle range of motion. DESIGN: A randomized, controlled and blinded study. SUBJECTS: Asymptomatic male and female volunteers (N = 41). METHODS: Subjects were randomly assigned into either an experimental group (n = 20) or a control group (n = 21). Both ankles of subjects in the experimental group were manipulated by using a single high-velocity, low-amplitude thrust to the talocruraljoint. Pretest and posttest measurements of passive dorsiflexion range of motion were taken. RESULTS: No significant changes in dorsiflexion range of motion were detected between manipulated ankles and those of control subjects. A significantly greater pretest dorsiflexion range of motion existed in those ankles in which manipulation produced an audible cavitation. CONCLUSION: Manipulation of the ankle does not increase dorsiflexion range of motion in asymptomatic subjects. Ankles that displayed a greater pretest range of dorsiflexion were more likely to cavitate, raising the possibility that ligament laxity may be associated with the tendency for ankles to cavitate."
0042721,"Harrison DE, Jones EW, Janik TJ, Harrison DD",Evaluation of axial and flexural stresses in the vertebral body cortex and trabecular bone in lordosis and two sagittal cervical translation configurations with an elliptical shell model,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):391-401,,"CERVICAL VERTEBRAE, LORDOSIS","MODELS BIOLOGICAL, STRESS MECHANICAL",,,,0161-4754,AB,"BACKGROUND: Osteoarthritis and spinal degeneration are factors in neck and back pain. Calculations of stress in clinically occurring configurations of the sagittal cervical spine are rare. OBJECTIVE: To calculate and compare combined axial and flexural stresses in lordosis versus cervical configurations in anterior and vertical sagittal head translated positions. DESIGN: Digitized measurements from lateral cervical radiographs of 3 different shapes were used to calculate axial loads and bending moments on the vertebral bodies of C2-C7. METHODS: An elliptical shell model was used to model horizontal cross-sections of the vertebral bodies of C2 through T1. Axial and flexural stresses were calculated with short compression block equations. Elliptical shell modeling permitted separation of stresses into cortical and inner medullary regions. Digitized radiographic points were used to create polynomials representing the shape of the sagittal cervical curvatures from C1 to T1. To calculate bending moments at each vertebral segment, moment arms from a vertical line through C1 were determined from digitizing. RESULTS: Compared with the normal lordosis, stresses on the anterior vertebral body cortical margins of C5-T1 in the sagittal translated postures are compression rather than tension. At the posterior vertebral bodies in the anteriorly translated position and vertically translated postures, the stresses change from compression to tension at C5 through T1. In absolute value (ABS) compared with values at the same segments in a normal lordosis, the magnitude of the combined anterior stresses in the sagittal postures are higher at C5-C7 (eg, ABS(sigma(straight)/sigma(normal)) approximately 1.25 to 4.25). CONCLUSIONS: Vertebral body stresses are reversed in direction at C5-T1 in sagittal translated postures compared to a normal lordosis. (ABSTRACT TRUNCATED)."
0042722,Diez F,Guidelines for the diagnosis of osteoporosis by densitometric methods,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):403-15,,"OSTEOPOROSIS, BONE DENSITY","EVIDENCE BASED MEDICINE, DIAGNOSIS, GUIDELINES, TOMOGRAPHY X RAY COMPUTED",,,"The objectives of this article were to review national and international guidelines to establish a congruent set of parameters that may aid the clinician in the decision-making process for the diagnosis of osteoporosis. Data Sources: An online search of several databases provided 18 guidelines for this review. Comparison among the guidelines was made on 10 different aspects: format, focus, significance of hip and vertebral body fractures, primary diagnostic considerations, BMD measurement technology, interpretation, reporting and follow-up, equipment reliability and quality control, risk factors considered, and methodologic quality of the guidelines. Tables were created for easier comparison on the aspects covered and supported by each guideline. RESULTS: None of the guidelines reviewed fulfills all the requirements of good clinical practice guidelines. CONCLUSIONS: Further works should finally provide all those interested with a more complete and thorough set of guidelines based on the best evidence available.",0161-4754,AB,"BACKGROUND: Osteoporosis is a major health hazard for postmenopausal women and elderly people. Local, national, and international organizations developed clinical practice guidelines for the diagnosis and management of osteoporosis and the prevention of osteoporotic fractures. Low bone mineral density (BMD) is the most important risk factor for fragility fractures. Bone densitometry is the best method to measure BMD in an individual. Many risk factors contribute to the development of osteoporosis and increase the fracture risk independently from BMD. Guidelines must be comprehensive, factual, simple to implement, and should provide the clinician, patients, governments, and payers with the best evidence available. OBJECTIV"
0042723,"Osterhouse MD, Kettner NW",Neuropathic osteoarthropathy in the diabetic foot,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):416-22,,DIABETIC NEUROPATHIES,"DIABETIC FOOT, CASE REPORT, PHYSIOPATHOLOGY, TREATMENT OUTCOME, RADIOGRAPHY",,,,0161-4754,AB,"OBJECTIVE: To discuss a case involving a 55-year-old diabetic woman with neuropathic osteoarthropathy initiated by a fall. Clinical Features: The patient fell into a hole, injuring her left foot. Because of the anesthesia associated with her diabetic peripheral neuropathy, she did not notice the ensuing plantar puncture wound. The patient assumed that her swelling was a result of a sprain. Mild dislocation and osseous fragmentation was noted within the midfoot on radiographs. The neuropathic osteoarthropathy progressed until the patient was later casted. Plain films taken at the time of cast removal demonstrated resorption and consolidation of fragmentation, but the dislocation was unaltered. Intervention and Outcome: The patient was scheduled for surgery and wound debridement. However, before surgery, complications of a burn sustained on the contralateral foot required fifth ray amputation. Surgery of the left foot has been postponed until adequate postsurgical healing has occurred at the right foot amputation site. CONCLUSION: This article provides tools for the timely diagnosis and treatment of neuropathic osteoarthropathy. An increased understanding of this entity will help lead to a reduction in the incidence of delayed treatment resulting from misdiagnosis."
0042724,Keating JC,Evaluating the quality of clinical practice guidelines,J Manipulative Physiol Ther 2002 Jul-Aug;25(6):423-5,,"SUBLUXATION, SPINE, QUALITY OF HEALTH CARE",,(Letter),,,0161-4754,,
0042725,"Petrella RJ, Overend T, Chesworth B",FIM(trade mark) after hip fracture: is telephone administration valid and sensitive to change?,Am J Phys Med Rehabil 2002 Sep;81(9):639-44,,"HIP FRACTURES, PATIENT ASSESSMENT, CEREBROVASCULAR DISORDERS","DATA COLLECTION, REHABILITATION",,,"It has been reported recently that follow-up FIM(trade mark) scores have been obtained from stroke patients via telephone interviews with either the former patient or proxy caregivers. We studied the validity and sensitivity of change of a \"phone FIM\" score in a sample of hip fracture patients after rehabilitation. DESIGN: We compared FIM scores among hip fracture patients in a specialized musculoskeletal rehabilitation program. Sample size estimate of 27 was determined before the study. Patients included those with hip fracture returning to independent living in their own home. RESULTS: Twenty-nine patients were identified as a convenience sample of admitted patients. The phone FIM score at 8 wk was a valid predictor of the discharge FIM score and the observed FIM and phone FIM scores at 8 wk were similar. The sensitivity to change over 8 wk was similar between observed and phone FIM scores compared with the discharge FIM score. CONCLUSIONS: The phone FIM instrument presents a useful clinical instrument to monitor patient functional status in the community, showing excellent psychometric properties. Ease of use and low cost should encourage greater use in clinical management of these patients.",0894-9115,AB,OBJECTIV
0042726,"Fast A, Sosner J, Begeman P, Thomas MA, Chiu T",Lumbar spinal strains associated with whiplash injury: a cadaveric study,Am J Phys Med Rehabil 2002 Sep;81(9):645-50,,"LUMBAR VERTEBRAE, WHIPLASH INJURIES, LOW BACK PAIN",CADAVER,,,"To study and quantify the effects of rear-end collision on the lumbar spine. DESIGN: The lumbar spine of a cadaver was instrumented with rosette strain gauges applied on the lateral and anterior surfaces of T12, L2, and L4. Biaxial accelerometers were mounted on L1, L3, and L5. The cadaver was seated, restrained, and subjected to rear impacts of 5g and 8g. RESULTS: The anterior shear strains had a biphasic shape. Spinal strains peaked at the T12 at approximately 120 and 370 msec, whereas in the L4 vertebra, it peaked at 200 and 380 msec. The anterior strain pattern of the L4 and T12 vertebrae were in diametrically opposite directions. In the second set of tests (8g experiment), the acceleration forces and strains pattern were similar to the 5g test but of higher magnitude. The principal anterior strain was 480 microm/m for 5g and 530 microm/m for 8g; the lateral shear strain was 680 microm/m and 1500 microm/m in the 5g and 8g experiments, respectively. CONCLUSIONS: Forces generated during simulated whiplash collision induce biphasic lumbar spinal motions (increased-decreased lordosis) of insufficient magnitude to cause bony injuries, but they may be sufficient to cause soft-tissue injuries.",0894-9115,AB,OBJECTIV
0042727,"Rodriguez LP, Lopez-Rego J, Calbet JA, Valero R, Varela E, Ponce J",Effects of training status on fibers of the musculus vastus lateralis in professional road cyclists,Am J Phys Med Rehabil 2002 Sep;81(9):651-60,,"MUSCLE FIBERS, PHYSICAL ENDURANCE","BICYCLING, TREATMENT OUTCOME",,,,0894-9115,AB,"OBJECTIVE: To evaluate possible changes occurring in muscle fibers related to the training status of professional road cyclists. DESIGN: A comparative study was performed on two groups of male road cyclists: ten 21-yr-old cyclists with a history of 3 yr of sport competition (RC21) and ten 25-yr-old cyclists with a history of 7 yr of competition (RC25). The control group was formed by two subgroups of five nontrained, sedentary volunteers who were matched for age with the study subjects (NT21 and NT25). Biopsies of the vastus lateralis muscle were obtained to determine the fiber variables: percentage, cross-sectional area, mitochondrial volume, and capillary density. RESULTS: Control group variables were within the normal range. According to their training status, cyclists showed an increased percentage of type I and IIC fibers (RC25 greater than RC21 greater than NT) and decreased percentage of type IIA (RC25 less than RC21 less than NT) and IIB fibers (RC25 = RC21 less than NT), an increased cross-sectional area of all fiber types after 3 yr of training (RC25 = RC21 greater than NT) except IIB fibers (RC25 greater than RC21), an increased mitochondrial volume in all fiber types (RC25 greater than RC21 greater than NT) except type IIA fibers (RC25 greater than RC21 = NT21), and an increased capillary density (RC25 greater than RC21 greater than NT). CONCLUSIONS: Findings indicate a progressive increase in the muscle fiber types that are mostly implicated in endurance sports, accompanied by phenotypic changes in the fiber population of lesser participation."
0042728,"Dumas HM, Haley SM, Ludlow LH, Rabin JP",Functional recovery in pediatric traumatic brain injury during inpatient rehabilitation,Am J Phys Med Rehabil 2002 Sep;81(9):661-9,,BRAIN INJURIES,"CLINICAL ASSESSMENT SCALES, REHABILITATION, INPATIENTS, CHILD, TREATMENT OUTCOME",,,,0894-9115,AB,"OBJECTIVE: To examine changes in functional status of children with traumatic brain injury by identifying the pattern and amount of change between and within the domains of self-care, mobility, and social function during inpatient rehabilitation and to examine the relationships of age and injury severity to functional recovery. DESIGN: Retrospective descriptive study. Seventy-nine children and adolescents with traumatic brain injury were assessed at inpatient rehabilitation hospital admission and discharge by using the Pediatric Evaluation of Disability Inventory's (PEDI) functional skills and caregiver assistance domains of self-care, mobility, and social function. RESULTS: Admission self-care functional levels were significantly greater than mobility and social function for both PEDI scales. At discharge, significant improvement was noted within all three domains and the amount of change between domains was significantly greater for the mobility domain on both scales. Age was not related to the amount of recovery. Admission functional status was moderately negatively correlated to the change in PEDI scores (ranging from r = -0.432 to -0.681). CONCLUSIONS: Variations exist in the recovery of self-care, mobility, and social function capability and independence during inpatient rehabilitation. Self-care was the least affected. Participants showed significant improvement in all domains, with the most recovery in mobility. Children with greater functional deficits demonstrated greater functional gains."
0042729,"Melamed E, Robinson D, Halperin N, Wallach N, Keren O, Groswasser Z",Brain injury-related heterotopic bone formation: treatment strategy and results,Am J Phys Med Rehabil 2002 Sep;81(9):670-4,,"BRAIN INJURIES, OSSIFICATION PATHOLOGIC, BONES","RECURRENCE, TREATMENT OUTCOME",,,"Heterotopic bone formation (HO) is a phenomenon occurring in some neurologically injured patients that can adversely affect their rehabilitation. The current study aimed at evaluating functional results and recurrence rates after recurrence of such lesions. DESIGN: The results of 12 excisions of HO in 9 patients were assessed. A single-dose of 750 cGy delivered 24 hr postoperatively was used in seven of nine patients. RESULTS: One year postintervention, the arc of motion averaged 92.5 degrees in the hips, 66.6 in the knees, and 60 degrees in the elbow. Despite increased uptake on bone scans in all patients, recurrence did not occur in any patient. Ambulation levels improved in four of eight hips. Ease of personal hygiene was improved in all patients, although some patients still require assistance. CONCLUSIONS: Excision of symptomatic HO is recommended if limitation of joint motion seems to hinder the patient's rehabilitation. Some motor control is desirable to achieve significant improvement in the patient's quality of life. Increased uptake on bone scans is not a contraindication to surgical excision of HO, provided the neurologic status is stabilized.",0894-9115,AB,OBJECTIV
0042730,"Sakai T, Tanaka K, Holland GJ",Functional and locomotive characteristics of stroke survivors in Japanese community-based rehabilitation,Am J Phys Med Rehabil 2002 Sep;81(9):675-83,,CEREBROVASCULAR DISORDERS,"REHABILITATION, JAPAN, TREATMENT OUTCOME, QUALITY OF LIFE",,,,0894-9115,AB,"OBJECTIVE: The purposes of this study were as follows: (1) to compare the characteristics of functional fitness of Japanese stroke survivors with those of control subjects of a similar age; and (2) to relate these characteristics to the extent of physical impairment and the period after stroke onset to better design community-based rehabilitation programs for stroke survivors. DESIGN: One hundred fifty-three stroke survivors who participated in community-based rehabilitation and 119 control subjects were measured. Twelve performance test items were designed to assess functional fitness. RESULTS: The average functional fitness score for the stroke survivors was significantly lower than that of the control group. However, some survivors had higher performance scores than the control group. Significant correlations were shown between some functional fitness items and Brunnstrom recovery stage in the stroke survivors. CONCLUSION: The large variability in functional fitness scores for stroke survivors indicates a need to design variable rehabilitation programs so that survivors can be grouped according to their specific levels of functional fitness."
0042731,"Hinman RS, Bennell KL, Metcalf BR, Crossley KM",Temporal activity of vastus medialis obliquus and vastus lateralis in symptomatic knee osteoarthritis,Am J Phys Med Rehabil 2002 Sep;81(9):684-90,,"OSTEOARTHRITIS, KNEE","EPIDEMIOLOGIC METHODS, ELECTROMYOGRAPHY",,,,0894-9115,AB,"OBJECTIVE: Knee osteoarthritis has a major impact on quadriceps function, yet its effect on the specific temporal recruitment of vastus medialis obliquus and vastus lateralis is unknown. The aim of this study was to determine the electromyographic onset of vastus medialis obliquus activity relative to that of vastus lateralis in individuals with symptomatic knee osteoarthritis and in an asymptomatic control group during the functional task of stair climbing. DESIGN: Cross-sectional, comprising 41 participants with symptomatic knee osteoarthritis and 33 controls matched for age, sex, and body mass. RESULTS: No significant differences were detected in the timing of onset of vastus medialis obliquus relative to that of vastus lateralis between the osteoarthritis and control groups. Radiographic osteoarthritis severity, presence of patellofemoral joint disease, and pain intensity did not seem to influence the temporal relationship of the vastii in the osteoarthritis group. CONCLUSION: The presence of symptomatic, radiographic knee osteoarthritis is not associated with deficits in the temporal recruitment of vastus medialis obliquus and vastus lateralis during stair climbing. This implies that selective retraining of the individual components of the quadriceps is not indicated in rehabilitation programs for patients with this disease."
0042732,"Kaul MP, Pagel KJ",Value of the lumbrical-interosseous technique in carpal tunnel syndrome,Am J Phys Med Rehabil 2002 Sep;81(9):691-5,,"CARPAL TUNNEL SYNDROME, PARESTHESIA, NEURAL CONDUCTION",ELECTRODIAGNOSIS,,,,0894-9115,AB,"OBJECTIVE: To determine whether the second lumbrical-interosseous technique has comparable sensitivity with the median-ulnar transcarpal mixed nerve technique (palmdiff). DESIGN: A prospective series of consecutive patients with median distribution paresthesias were evaluated with electrodiagnostic testing. Outpatient veterans referred by a heterogeneous group of specialists and generalists to the Portland Veterans Affairs Medical Center electrodiagnostic laboratory. A total of 129 consecutive veterans referred for evaluation of median distribution paresthesias were assessed with two electrodiagnostic tests. RESULTS: The second lumbrical-interosseous technique performed with equal sensitivity (60.5%) to the palmdiff technique, with the added unique feature of its being uniformly obtainable. CONCLUSIONS: The second lumbrical-interosseous technique is characterized by performance equal to the palmdiff in categorizing carpal tunnel syndrome. It is also characterized by being nearly uniformly obtainable, even n severe carpal tunnel syndrome. These features suggest a wider role for the second lumbrical-interosseous technique than currently accepted."
0042733,"Bean J, Kiely DK, Leveille SG, Morris J",Associating the onset of motor impairments with disability progression in nursing home residents,Am J Phys Med Rehabil 2002 Sep;81(9):696-704,,"MOVEMENT, DISABILITY EVALUATION","NURSING HOMES, RANGE OF MOTION, CLINICAL ASSESSMENT SCALES, ACTIVITIES OF DAILY LIVING",,,"To evaluate the association between the onset of movement impairments and disability progression in nursing home residents. DESIGN: Retrospective cohort analysis of data from the State of New York Minimal Data Set, version 2.0, between November 1998 and October 1999. Participants were nursing home residents (n = 84,346) in the State of New York. Items defined as \"functional limitation in range of motion\" and \"lack of voluntary movement\" served as measures of movement impairments. Scores on the activities of daily living summary scale served as a measure of disability. Age, sex, measures of cognition, depression, and measures of medical stability served as adjustment variables. RESULTS: After adjusting for age, sex, cognition, depression, and measures of medical stability, the onset of either singular or combined movement impairments in voluntary movement or range of motion was associated with a concurrent step-wise loss in activities of daily living (P less than 0.001). The progression in activities of daily living loss occurred regardless of location or limb type. CONCLUSION: This study directly links the onset of movement impairments with disability progression. These findings have important implications for physiatrists and other practitioners of geriatric rehabilitation.",0894-9115,AB,OBJECTIV
0042734,"Sliwa JA, McPeak L, Gittler M, Bodenheimer C, King J, Bowen J, AAP Medical Education Committee",Clinical ethics in rehabilitation medicine: core objectives and algorithm for resident education,Am J Phys Med Rehabil 2002 Sep;81(9):708-17,,ETHICS MEDICAL,"REHABILITATION, EDUCATION",,,,0894-9115,AB,"Described as the balance of values on either side of a moral dilemma, ethics and ethical issues are of increasing importance in the changing practice of rehabilitation medicine. Because the substance of ethics and true ethical issues can be difficult to identify, the education of rehabilitation residents in ethics can similarly be challenging. This article discusses topics pertinent to an understanding of clinical ethics in rehabilitation medicine and provides a method of teaching residents through an algorithm of ethical issues, learning objectives, and illustrative cases."
0042735,"Chen B, Stitik TP, Foye PM, Nadler SF, DeLisa JA",Central post-stroke pain syndrome: yet another use for gabapentin?,Am J Phys Med Rehabil 2002 Sep;81(9):718-20,Gabapentin,"CEREBROVASCULAR DISORDERS, CENTRAL NERVOUS SYSTEM DIS, PAIN","CASE REPORT, TREATMENT OUTCOME, ACETIC ACID",,,,0894-9115,AB,"Although gabapentin was originally developed for treating partial seizures, it has been used mainly to treat various peripheral neuro-pathic pain conditions; however, there is very limited experience with gabapentin for the treatment of pain conditions of the central nervous system like central post-stroke pain syndrome. We report the case of a 45-yr old man with central post-stroke pain syndrome who failed to respond to a variety of oral analgesics, but within 2 wk of the inception of gabapentin therapy, his average pain was significantly reduced and his level of function improved. We conclude that gabapentin may be an effective medication for the treatment of central post-stroke pain syndrome."
0042736,"Tsur A, Glass I, Solzi P","Exhausting fatigue influences F-wave and peripheral conduction velocity, following lumbar radiculopathy",Disabil Rehabil 2002 Sep 10;24(13):647-53,,"LUMBAR VERTEBRAE, MUSCLE FATIGUE, SPINAL NERVE ROOTS, NERVE COMPRESSION SYNDROMES","ELECTROPHYSIOLOGY, EPIDEMIOLOGIC METHODS",,,,0963-8288,AB,"PURPOSE: The purpose of the study was to determine whether mechanical nerve root compression could indirectly contribute to early muscle fatigue because of impaired activation. METHOD: The patients' two legs and the control group's dominant leg were subjected to exhausting foot dorsiflexion against 2 kg weight. Electrophysiological parameters were measured under three conditions: before, upon completion of, and five minutes after the exhausting effort (i.e. causing unbearable fatigue). The study was performed in a warm room (24 degrees C), in the EMG laboratory of a rehabilitation centre using standard equipment. Eighteen patients participated in the study (12 males and six females, mean age 47.8 +/- 12.0 years). They suffered from lumbar radiculopathy and unilateral complaints at the L4, L5 innervation territory. There were 22 matched controls (18 males and 4 females, mean age 44.4 +/- 9.9 years) that were healthy subjects. The patients' two legs and the dominant leg of the control participants were tested. The peroneal nerve was stimulated supra-maximally, behind the fibular head. Recording the activity of the anterior tibial muscle served to calculate F-wave latency, the conduction velocity of the nerve and muscle complex (NMCV), the compound muscle action potential (CMAP) amplitude and the exhaustion time. RESULTS: Following the exhausting fatigue, the symptomatic, asymptomatic, and control legs exhibited a significant decrease in NMCV and reduced CMAP amplitude (p less than 0.05). In each condition (rest, effort, recovery), the patients' two leg types exhibited similar NMCV (symptomatic vs asymptomatic), yet each of these two types was significantly slower than the controls' NMCV. A significant prolongation of F-wave latency after an exhausting effort was found in the symptomatic legs. (ABSTRACT TRUNCATED)."
0042737,"Das-Gupta R, Turner-Stokes L",Traumatic brain injury,Disabil Rehabil 2002 Sep 10;24(13):654-65,,BRAIN INJURIES,"REHABILITATION, TREATMENT OUTCOME",,,,0963-8288,AB,"PURPOSE: Traumatic brain injury (TBI) leading to severe disability is fortunately rare, but when it occurs, the effect on patients and their families can be devastating. ISSUE: In the UK at the current time, there are insufficient specialist rehabilitation services to cater for the case-load and many patients receive their care in general wards. CONCLUSION: This educational article outlines the principles of management of severe TBI from a practical clinical viewpoint, reviews briefly the evidence for effectiveness of rehabilitation and offers an approach to consistent outcome measurement."
0042738,"Zorowitz RD, Gross E, Polinski DM",The stroke survivor,Disabil Rehabil 2002 Sep 10;24(13):666-79,,CEREBROVASCULAR DISORDERS,"TREATMENT OUTCOME, REHABILITATION, PHYSIOLOGY, METHODS, GUIDELINES",,,"Stroke remains the third most common cause of death in the Western World, and is the leading cause of adult disability and placement into extended care facilities. Stroke is not a disease of the old, but affects many people under the age of 65. Comprehensive rehabilitation may improve the functional abilities of the stroke survivor, despite age and neurologic deficit, and decrease long-term patient care costs. Rehabilitation not only involves restoring independence in mobility and activities of daily living, but maximizing compensatory strategies in linguistic and cognitive function. Strategies to reintegrate the stroke survivor into the community are discussed. Secondary complications of stroke are described, and interventions are suggested to prevent and treat potential medical issues. CONCLUSION: Stroke rehabilitation may be a lifetime endeavour, and requires proper medical resources to successfully address physical, linguistic, cognitive and psychosocial issues. Good communication between the rehabilitation team, the patient and the family facilitates optimal care and provides the stroke survivor with the opportunity to reach his maximal functional potential.",0963-8288,AB,PURPOSE: This article reviews the physiological basis of stroke rehabilitation and describes the theories and interventions involved in the rehabilitation of the stroke survivor. ISSU
0042739,"Sadowsky C, Volshteyn O, Schultz L, McDonald JW",Spinal cord injury,Disabil Rehabil 2002 Sep 10;24(13):680-7,,SPINAL CORD INJURIES,"REHABILITATION, METHODS, TRENDS",,,,0963-8288,AB,"PURPOSE: This article is an overview of the newer therapeutic interventions employed in the care of the spinal cord injured individual and the theoretical rationale supporting them. ISSUE: Spinal Cord Injury (SCI) care was, until recently, a maintenance type treatment, addressing systems mostly affected by complications of the original injury (e.g. bladder, skin, spasiticity). CONCLUSION: With the recent advances in the neuroscience field, more aggressive interventions geared at secondary injury prevention, neuronal regeneration and functional restoration are emerging."
0042740,"Davidson JH, Jones LE, Cornet J, Cittarelli T",Management of the multiple limb amputee,Disabil Rehabil 2002 Sep 10;24(13):688-99,Multiple trauma,"AMPUTATION, LEG, ARM, PATIENT CARE, PROSTHESIS",SURGERY OPERATIVE,,,,0963-8288,AB,"ISSUE: Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. METHOD: A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. CONCLUSION: Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation."
0042741,"Graham LA, Fyfe NC",Prosthetic rehabilitation of amputees aged over 90 is usually successful,Disabil Rehabil 2002 Sep 10;24(13):700-1,,"AMPUTATION, ARTIFICIAL LIMBS","AGED, REHABILITATION",,,,0963-8288,AB,"Prosthetic rehabilitation and prosthetic limb use in patients over 90 years of age have not been studied in detail. This study reports two concurrent successful cases and a review of registered patients aged over 90. Satisfactory outcomes often occur in this population and such patients should be referred for prosthetic rehabilitation, regardless of advanced age."
0042742,"Jackel WH, Gerdes N, Herdt J, Ollenschlager G",Knowledge management in rehabilitation - proposal for a systematic development of clinical practice guidelines,Rehabilitation (Stuttgart) 2002 Aug;41(4):217-25,,"REHABILITATION, LEGISLATION","GERMANY, GUIDELINES",,German,English Summary,0034-3536,AB,"In the past ten years, the German pension scheme has launched several initiatives that can be regarded as milestones on the way to a scientifically founded rehabilitation system. These initiatives were: the Rehab Commission (1989 - 1991), the Quality Assurance Programme (since 1994), and the German Research Funding Programme \"Rehabilitation Sciences\" (in cooperation with the Federal Ministry for Education and Research, since 1996). As a next step on this way, we propose an initiative aiming at a systematic development and implementation of clinical practice guidelines for the main diagnostic groups in rehabilitation. Guidelines for diagnostic and therapeutic decisions are an instrument to sift through the abundance of fast changing knowledge in medicine, to assess the existing knowledge according to its scientific evidence, and to transform it into recommendations for clinical practice. In rehabilitation, guidelines seem to be particularly needed because specialized knowledge is mostly disseminated through an informal \"training on the job\". Our proposal intends to establish a reference centre for each of the main indications (cardiology, musculoskeletal diseases, etc.). These centres should cooperate with experts from clinical practice and research, as well as with representatives of the cost-carrying agencies and patient organisations, and should systematically analyse the processes of rehabilitation in the most important diagnostic groups. Guided by a \"process matrix of rehabilitation\", these analyses should identify the points at which far-reaching decisions are called for during the processes of rehabilitation. At these points, the knowledge base available for rational decisions should be examined. When there is no sufficient knowledge, consensus conferences should be organized in order to collect and assess the available (ABSTRACT TRUNCATED)."
0042743,"Bitzer EM, Aster-Schenck IU, Klosterhuis H, Dorning H, Rose S",Developing evidence based guidelines on cardiac rehabilitation - phase 1: a qualitative review,Rehabilitation (Stuttgart) 2002 Aug;41(4):226-36,,HEART DIS,"GUIDELINES, GERMANY, REHABILITATION, EVIDENCE BASED MEDICINE",,German,English Summary,0034-3536,AB,"BACKGROUND: Guidelines are a means to support effective clinical practice and can be used to implement evidence-based medicine in rehabilitative practice. In 1998 a study on cardiac rehabilitation, funded by Bundesversicherungsanstalt fur Angestellte, BfA, concluded that the AHCPR's Guideline on Cardiac Rehabilitation published in 1995 could be used as a reference guideline for the rehabilitation of coronary patients. The AHCPR Guideline and other systematic reviews showed cardiac rehabilitation to be an effective means in coronary care. However, no detailed information is given with regard to the structural and processual details that are required for a multidimensional and comprehensive cardiac rehabilitation scheme. To define those central characteristics, therapeutic interventions that had been proven to be effective for cardiac rehabilitation were analysed. The information derived from these analyses will then be used to develop a more detailed evidence-based guideline. METHODS: The analysis was based on the research cited in the AHCPR Guideline. Additionally, a systematic search of the literature identified (randomised) controlled studies published after 1995 for the analysis. Using criteria that had been developed prior to our review, one third (n = 53) of the 159 studies identified were considered suitable for further analysis. Characteristics of the study design, the interventions and the outcomes reported were extracted on a standardised data sheet. In order to facilitate comparisons, studies were arranged according to main intervention and target groups. As it is not possible to present the results in their entirety, this publication focuses on the main aspects which illustrate the method applied. RESULTS: 32 of the 53 studies included dealt with patients after myocardial infarction (MI). In these 32 studies a total (ABSTRACT TRUNCATED)."
0042744,"Dodt B, Peters A, Heon-Klin V, Matthis C, Raspe A, Raspe H",Rehabilitation score for patients with type 2 diabetes mellitus: an instrument to standardize assessment of the need for rehabilitation,Rehabilitation (Stuttgart) 2002 Aug;41(4):237-48,,"DIABETES MELLITUS, HOLISTIC HEALTH, PATIENT ASSESSMENT","REHABILITATION, GERMANY, CLINICAL ASSESSMENT SCALES, ALGORITHMS",,German,English Summary,0034-3536,AB,"Type 2 diabetes is considered a multidimensional health impairment which includes several components like risk factors, cofactors and complications. The early and consequent therapy of all of these components reduces secondary complications. Instead of simply applying drug treatment, a more holistic concept including behavioural medicine therapy and empowerment of patients has been found much more effective. The facilities required for such a multifactorial therapy by different health care professions could easily be provided by the medical rehabilitation services available under the German pension insurance scheme. However, this emphasizes the demand for standardized protocols to achieve an objective allocation of rehabilitation services to individuals in need. In an epidemiological study on 12,429 working insurants (age 41-60 years) of the pension insurance fund in the region of Luebeck, persons suffering from type 2 diabetes were identified and evaluated regarding a need for medical rehabilitation. Therefore, an algorithm was developed quantifying the multidimensional disturbances which accumulate in type 2 diabetes mellitus. The following indicators are taken into consideration: risk factors like eating behaviour, lack of physical activity, smoking and stress; metabolic parameters such as HbA1c and plasma lipids; cofactors like hypertension and depression and, additionally, the acute complication of hypoglycaemia. Based on this rehabilitation score, 19% of cases in a preliminary evaluation of 79 patients with type 2 diabetes showed a need for medical rehabilitation therapy."
0042745,"Ludwig FJ, Melzer Ch, Grimmig H, Daalmann HH",Cross cultural adaptation of the Lequesne Algofunctional Indices for German speaking patients with osteoarthritis of the hip and the knee,Rehabilitation (Stuttgart) 2002 Aug;41(4):249-57,,"OSTEOARTHRITIS, KNEE, HIP","GERMANY, RESEARCH DESIGN, CLINICAL ASSESSMENT SCALES, CROSS CULTURAL COMPARISON",,German,English Summary,0034-3536,AB,"The Lequesne Algofunctional Index is a widespread international instrument and recommended by the World Health Organization (WHO) for outcome measurement in hip and knee diseases. Up to now there has been no German version of the questionnaire fulfilling the guidelines for cross-cultural adaptation and providing satisfactory metric quality. Based on these guidelines, we developed the German version of the Lequesne Algofunctional Index regarding osteoarthritis of the hip and knee joints presented in this article. All of the questions it contains have been worded as whole sentences, questions concerning walking performance have been substantiated by examples. In testing of the metric outcome (hip: n = 112; knee: n = 83), both questionnaires showed an excellent reliability (IKK greater than 0,88). As a validity criterion, the correlation with the WOMAC score was tested. We received a Spearman coefficient between 0,63 and 0,81, indicating a high correlation. Time needed to fill in the Lequesne score was 2 min. in patients, physicians took 1,2 min. to evaluate the questionnaire. Regarding the questionnaires handed back, the Lequesne score showed better results than the WOMAC index. Sensitivity, measured by the \"standardized response mean\", was good in both regions for the total score. Comparing the data received on pain-related questions, the WOMAC score however showed a better sensitivity. The German version of the Lequesne Algofunctional Index is a suitable outcome instrument to measure the intensity of pain, walking capacity and activity of daily life in patients with osteoarthritis of hip and knee joints."
0042746,"Farin E, Meixner K, Follert P, Jackel WH, Jacob A",Job satisfaction in rehabilitation clinics - development of the "MiZu-Reha" Questionnaire and its use in quality assurance,Rehabilitation (Stuttgart) 2002 Aug;41(4):258-67,,JOB SATISFACTION,"REHABILITATION CENTERS, CONSISTENCY AND RELIABILITY, GERMANY",,German,English Summary,0034-3536,AB,"In this study, we report on the development and validation of a questionnaire measuring job satisfaction in rehabilitation centres. The questionnaire \"Fragebogen zur Mitarbeiterzufriedenheit in Rehabilitationskliniken\" (\"MiZu-Reha\") consists of 75 items. Three scales measure work climate, leadership and work organisation/communication. Further items assess weak points of work organisation and job satisfaction with several predefined aspects (e. g., career opportunities and salary). The scales have good internal consistency with Cronbach's alpha between 0.86 and 0.94. The dimensionality of the scales was established by confirmatory factor analyses. Correlations between the MiZu-Reha scales and independent satisfaction measures indicate the validity of the questionnaire. Correlations between the MiZu-Reha scales and indicators of patient satisfaction, process quality and outcome are in all cases positive (the higher the job satisfaction, the better the quality of rehabilitation), though weak and statistically not significant. Rehabilitation centres differ clearly from each other regarding job satisfaction of their employees. This shows the usefulness of clinic comparisons based on the MiZu-Reha. The questionnaire can be utilized in external quality assurance programmes, in the context of internal quality assurance measures (e. g. the Business Excellence Model of the European Foundation of Quality Management, EFQM) and in the use of management instruments such as the Balanced Scorecard."
0042747,Welti F,"The SGB IX, book 9 of the German social code, in the development of social security law",Rehabilitation (Stuttgart) 2002 Aug;41(4):268-73,,"LEGISLATION, REHABILITATION",GERMANY,,German,English Summary,0034-3536,AB,"The SGB IX is the legal basis of rehabilitation in Germany since 2001. It is embedded in the codification of the German social code, the Sozialgesetzbuch (SGB). There it has an intermediate function between the general social law and the special laws of the social insurance and social security institutions. Rehabilitation in Germany is working in a system of several different institutions with different legal roots. In special these are compensation of damages caused by employment accident and war and the avoidance of disability benefits by rehabilitation and activation. Inequality of treatment of disabled people according to the cause of their disability and to their employment status are accepted less; common principles of rehabilitation are being searched. Important reforms of rehabilitation law have taken place in 1974 and 1975. Since then problems have become visible in implementation and in the coordination of the complex system. SGB IX is a new effort for a general rehabilitation law. Open questions remain in handling the relations between rehabilitation and sickness treatment, long term care and prevention. Important are the newly defined terms for participation (Teilhabe) and disability (Behinderung), which build the linkage of SGB IX with constitutional law and with the health sciences. A weak point is still the relation of disability and age. Political attempts for unequal benefits in health insurance endanger the now reached level of rehabilitation law."
0042748,Vomel U,"The SGB IX, book 9 of the German social code - reformatory approach, innovations, initial implementations",Rehabilitation (Stuttgart) 2002 Aug;41(4):274-8,,"DISABLED, SOCIAL SUPPORT, SOCIAL WELFARE, LEGISLATION","GERMANY, REHABILITATION",,German,English Summary,0034-3536,AB,"Effective as of July 1, 2001, the new Book 9 of the German Social Code is designed to bring about fundamental improvements in the situation of people with disabilities or at risk of being disabled, to be realized by replacing welfare and provision by the notion of participation: By making available the social services and supports needed, people with disabilities are to be enabled to participate in the life of the community and, notably, in working life. Focussing on people with disabilities, the author outlines some of the reformatory approaches and innovations in Book 9 and describes the steps taken by the various rehabilitation carriers over the last few months in order to implement the legislator's intentions, hence to improve the situation of people with disabilities."
0042749,"Jackel WH, Muller-Fahrnow W, Schliehe F","Guidelines in medical rehabilitation - position paper of the German Society of Rehabilitation Science, DGRW",Rehabilitation (Stuttgart) 2002 Aug;41(4):279-85,,REHABILITATION,"GERMANY, GUIDELINES",,German,,0034-3536,,
0042750,"Miller WC, Speechley M, Deathe AB",Balance confidence among people with lower-limb amputations,Phys Ther 2002 Sep;82(9):856-65,,"BALANCE, AMPUTATION, SELF EFFICACY, DISABILITY EVALUATION, VASCULAR DIS","LEG, ETIOLOGY, ACCIDENTAL FALLS, PSYCHOLOGY",,,,0031-9023,AB,"BACKGROUND AND PURPOSE: Confidence in a person's balance has been shown to be an important predictor of social activity among people with lower-limb amputations. The purposes of this study were to describe confidence in balance among people with transtibial or transfemoral lower-limb amputations and to compare people whose amputations were due to vascular and nonvascular causes. SUBJECTS AND METHODS: A survey of a sample of 435 community-dwelling individuals from 2 regional clinics was conducted. The sample consisted of people with unilateral transfemoral (26.7%) and transtibial (73.3%) amputations who lost their limb for vascular (53%) and nonvascular (47%) reasons. The mean age of the primarily male (71%) sample was 62.0 years (SD = 15.7). RESULTS: Mean scores, using the Activities-specific Balance Confidence (ABC) Scale, were 63.8 for the total sample, 54.1 for the subjects with amputations due to vascular reasons, and 74.7 for the subjects with amputations due to nonvascular reasons. Given a maximum possible ABC Scale score of 100, the results suggest that confidence was low. A difference between the subjects with amputations due to vascular reasons and those with amputations due to nonvascular reasons was observed over each item of the ABC Scale. Variables that were statistically related to balance confidence included age, sex, etiology, mobility device use, the need to concentrate while walking, limitations in activities of daily living, depression, and fear of falling. DISCUSSION AND CONCLUSION: Balance confidence scores among the study sample were low when compared with values previously reported by other researchers. Confidence was particularly low among individuals who had their amputation for vascular reasons. Balance confidence might be an important area of clinical concern."
0042751,"Janssen WG, Bussmann HB, Stam HJ",Determinants of the sit-to-stand movement: a review,Phys Ther 2002 Sep;82(9):866-79,,"SITTING, MOVEMENT, POSTURE, HOUSEHOLD EQUIPMENT","TASK PERFORMANCE AND ANALYSIS, EQUIPMENT DESIGN, BIOMECHANICS",,,,0031-9023,AB,"BACKGROUND AND PURPOSE: The sit-to-stand (STS) movement is a skill that helps determine the functional level of a person. Assessment of the STS movement has been done using quantitative and semiquantitative techniques. The purposes of this study were to identify the determinants of the STS movement and to describe their influence on the performance of the STS movement. METHODS: A search was made using MEDLINE (1980-2001) and the Science Citation Index Expanded of the Institute for Scientific Information (1988-2001) using the key words \"chair,\" \"mobility,\" \"rising,\" \"sit-to-stand,\" and \"standing.\" Relevant references such as textbooks, presentations, and reports also were included. Of the 160 identified studies, only those in which the determinants of STS movement performance were examined using an experimental setup (n = 39) were included in this review. RESULTS: The literature indicates that chair seat height, use of armrests, and foot position have a major influence on the ability to do an STS movement. Using a higher chair seat resulted in lower moments at knee level (up to 60%) and hip level (up to 50%); lowering the chair seat increased the need for momentum generation or repositioning of the feet to lower the needed moments. Using the armrests lowered the moments needed at the hip by 50%, probably without influencing the range of motion of the joints. Repositioning of feet influenced the strategy of the STS movement, enabling lower maximum mean extension moments at the hip (148.8 N m versus 32.7 N m when the foot position changed from anterior to posterior). DISCUSSION AND CONCLUSION: The ability to do an STS movement, according to the research reviewed, is strongly influenced by the height of the chair seat, use of armrests, and foot position. More study of the interaction among the different determinants is needed. (ABSTRACT TRUNCATED)."
0042752,"Bressel E, McNair PJ","The effect of prolonged static and cyclic stretching on ankle joint stiffness, torque relaxation, and gait in people with stroke",Phys Ther 2002 Sep;82(9):880-7,,"GAIT, CEREBROVASCULAR DISORDERS, ANKLE JOINT, CONTINUOUS PASSIVE MOTION, MUSCLE HYPERTONIA","TREATMENT OUTCOME, DYNAMOMETRY, THERAPY, REHABILITATION, BIOMECHANICS",,,,0031-9023,AB,"BACKGROUND AND PURPOSE: Continuous passive motion (cyclic stretching applied to the subject's limb) has been used for the rehabilitation of some orthopedic impairments; however, few researchers have considered its application in the management of neurological disorders such as stroke. The purpose of this study was to examine the short-term effects of prolonged static and cyclic calf stretching on passive ankle joint stiffness, torque relaxation, and gait in people with ischemic stroke. SUBJECTS: Ten community-dwelling people (mean age = 64.6 years, SD = 8.76, range = 53-76) who were diagnosed with a cerebrovascular accident volunteered to be subjects. METHODS: Participants engaged in one 30-minute static stretch and one 30-minute cyclic stretch of the calf muscle, using an isokinetic dynamometer that also collected torque and angle measurements. Before and after treatments, 10-m walking times were collected. Ankle joint stiffness was calculated from the slope of the torque and angle curves before and immediately after treatments, and torque relaxation was calculated as the percentage of decrease in peak passive torque over the 30-minute stretch durations. RESULTS: Ankle joint stiffness decreased by 35% and 30% after the static and cyclic stretches, respectively. Stiffness values and 10-m walk times were not different between conditions. The amount of torque relaxation was 53% greater for static stretching than for cyclic stretching. DISCUSSION AND CONCLUSION: These preliminary data from a very small sample of people with stroke indicate that ankle joint stiffness decreases after both prolonged static and cyclic stretches; however, neither technique appears to be better at reducing stiffness in people with stroke. (ABSTRACT TRUNCATED)."
0042753,"O'Shea S, Morris ME, Iansek R",Dual task interference during gait in people with Parkinson disease: effects of motor versus cognitive secondary tasks,Phys Ther 2002 Sep;82(9):888-97,,"PARKINSON DIS, GAIT, COGNITION, LOCOMOTION","GAIT ANALYSIS, TASK PERFORMANCE AND ANALYSIS, COMPARATIVE STUDY",,,,0031-9023,AB,"BACKGROUND AND PURPOSE: Exacerbation of movement disorders while doing 2 tasks (dual task performance) is a characteristic feature of Parkinson disease (PD). The aim of this investigation was to identify whether the type of secondary task (motor or cognitive) determined the severity of dual task interference. SUBJECTS AND METHODS: Footstep patterns for 15 people with PD and 15 comparison subjects without PD were compared when they walked: (1) at a self-selected speed, (2) while simultaneously performing a motor task (coin transference), and (3) while simultaneously performing a cognitive task (digit subtraction). Gait speed, stride length, cadence, and the percentage of the gait cycle in double-limb stance (DS) were examined with a computerized stride analyzer. RESULTS: When there was no second task, the mean stride length was less in the group with PD (1.29 m) than in the comparison group (1.51 m), and the mean gait speed was less in the group with PD (71.47 m/min) than in the comparison group (87.29 m/min). The mean cadence was less in the group with PD (110.79 steps/min) than in the comparison group (115.81 steps/min). The percentage of the gait cycle in DS was greater in the group with PD (33.38%) than in the comparison group (31.21%). Both groups reduced their stride length and speed when they had to change from unitask performance to dual task performance and DS increased. For the group with PD, cadence also decreased. For both groups, the type of secondary task had a negligible effect on the performance decrement. DISCUSSION AND CONCLUSION: Although the performance of simultaneous motor or cognitive tasks compromised gait in people with PD, the type of secondary task was not a major determinant of the severity of dual task interference."
0042754,"Merians AS, Jack D, Boian R, Tremaine M, Burdea GC, Adamovich SV, Recce M, Poizner H",Virtual reality-augmented rehabilitation for patients following stroke,Phys Ther 2002 Sep;82(9):898-915,,"VIRTUAL REALITY, CEREBROVASCULAR DISORDERS, MOTOR SKILLS, MOTOR ACTIVITY","REHABILITATION, TASK PERFORMANCE AND ANALYSIS, RANGE OF MOTION, THUMB, FINGERS, TREATMENT OUTCOME",,,"ML's function was the most impaired at the beginning of the intervention, but showed improvement in the thumb and fingers in range of motion and speed of movement. LE improved in fractionation and range of motion of his thumb and fingers. DK made the greatest gains, showing improvement in range of motion and strength of the thumb, velocity of the thumb and fingers, and fractionation. Two of the 3 patients improved on the Jebsen Test of Hand Function. DISCUSSION: The outcomes suggest that VR may be useful to augment rehabilitation of the upper limb in patients in the chronic phase following stroke.",0031-9023,AB,"BACKGROUND AND PURPOSE: Recent evidence indicates that intensive massed practice may be necessary to modify neural organization and effect recovery of motor skills in patients following stroke. Virtual reality (VR) technology has the capability of creating an interactive, motivating environment in which practice intensity and feedback can be manipulated to create individualized treatments to retrain movement. CASE DESCRIPTION: Three patients (ML, LE, and DK), who were in the chronic phase following stroke, participated in a 2-week training program (3 1/2 hours a day) including dexterity tasks on real objects and VR exercises. The VR simulations were targeted for range of motion, movement speed, fractionation, and force production. OUTCOM"
0042755,Lyons KJ,"Diversity, burnout, and other timely topics",J Allied Health 2002 Fall;31(3):125-6,,ALLIED HEALTH,UNITED STATES,(Editorial),,,0090-7421,,
0042756,Elwood TE,Congressional earmarks and pork barrel politics,J Allied Health 2002 Fall;31(3):127-30,,"ALLIED HEALTH, FINANCING GOVERNMENT","POLITICS, UNITED STATES, RESEARCH",,,,0090-7421,,
0042757,"Balogun JA, Titiloye V, Balogun A, Oyeyemi A, Katz J",Prevalence and determinants of burnout among physical and occupational therapists,J Allied Health 2002 Fall;31(3):131-9,,"PHYSIOTHERAPISTS, OCCUPATIONAL THERAPISTS, BURNOUT PROFESSIONAL","ETIOLOGY, EPIDEMIOLOGY, STRESS PSYCHOLOGICAL, UNITED STATES",,,,0090-7421,AB,"It is generally speculated that the ongoing changes in the health care system may increase the incidence of burnout among health care providers. The purposes of this cross-sectional study were to determine (1) the prevalence of burnout among physical therapists (PTs) and occupational therapists (OTs), (2) sociodemographic and work-related factors associated with emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA) traits of PTs and OTs. In fall 1998, 169 PTs and 138 OTs employed in various clinical settings in New York City completed the survey. Part I of the research questionnaire solicited sociodemographic and work-related information such as age, marital status, number of children (NC), religious affiliation (RA), exercise habits, level of support from supervisor (LSS), and level of support from colleagues (LSC). Part II of the questionnaire contained the Maslach Burnout Inventory (MBI). From the MBI, each subject's EE, DP, and PA scores were obtained. The data were analyzed with oneway analysis of variance and linear, multiple, and stepwise regression models to determine the relative and combined contributions of the independent (sociodemographic and work-related) variables toward predicting EE, DP, and PA. Overall the MBI scores revealed high (28.9 +/- 6.8) EE, high (18.3 +/- 4.7) DP, and low (18.0 +/- 7.0) PA. The contribution of sociodemographic and work-related variables toward the prediction of EE (26.7%), DP (12.8%) and PA (19.8%) was minimal. Of the 20 independent variables examined in this study, only 3 (LSS, NC and RA) were viable predictors of EE. The only viable predictor of PA trait was LSC. None of the variables examined accurately predicted DP trait. The EE, DP, and PA scores of the PTs and OTs in this study were higher than the norms reported in previous studies for the general population. (ABSTRACT TRUNCATED)."
0042758,"Schulman E, Gairola G, Kuder L, McCulloch J",Depression and associated characteristics among community-based elderly people,J Allied Health 2002 Fall;31(3):140-6,,"DEPRESSIVE DISORDERS, DEPRESSION, URBAN HEALTH, RURAL HEALTH","AGED, EPIDEMIOLOGY, ETIOLOGY, SOCIAL ENVIRONMENT, INDEPENDENT LIVING",,,,0090-7421,AB,"Depression is a major health problem, particularly among the elderly. It is important that allied health professionals, especially those working with the elderly, understand this often serious condition. The data for this article were collected as part of an interdisciplinary geriatric health care team project, which included allied health professionals working in rural and urban clinics. The primary purpose of this study was to determine the association of depression with various demographic, medical, mental, physical functionality, and social factors among community-based elderly people. A logistic regression (backward selection) indicated that elderly people living alone were 3.3 times more likely to be depressed than elderly residing in a household with others. As assistance with instrumental activities of daily living increased, the likelihood of depression also increased. Most significantly, urban residents were 3.8 times more likely to be depressed than their rural counterparts. Additional research into the differences in the prevalence of depression between urban and rural elderly would provide a more in-depth understanding of this problem and help to identify more effective treatment plans for different elderly populations. Other independent variables, including demographic, medical, and social characteristics were not found to be significantly predictive of depression in this study."
0042759,"Velde BP, Greer AG, Lynch DC, Escott-Stump S",Chaos theory as a planning tool for community-based educational experiences for health students,J Allied Health 2002 Fall;31(3):147-52,,"RURAL HEALTH, EDUCATION CONTINUING","PROGRAM EVALUATION, MODELS THEORETICAL, HEALTH PERSONNEL",,,,0090-7421,AB,"Educational and community health systems are social systems composed of a group or collection of entities for which there is a unifying principle. The purpose of this paper is to briefly explain chaos theory and to apply it to the Interdisciplinary Rural Health Training Program (IRHTP) as a case study. The IRHTP is an existing rural, community based educational program for baccalaureate and graduate health care students. Chaos theory attempts to understand the underlying order in processes that appear to not have any guidelines or principles. These processes typically involve the interaction of several elements over time. Chaos theory provided the university with a method of anticipating the natural flux between order and chaos to allow the system to function at its highest level. To thrive in such a complex dynamic environment the authors recommend application of Ockerman's Five Factors."
0042760,Bukowski EL,Assessment outcomes: computerized instruction in a human gross anatomy course,J Allied Health 2002 Fall;31(3):153-8,,"ANATOMY, PHYSIOTHERAPY, EDUCATION MEDICAL, COMPUTER ASSISTED INSTRUCTION","METHODS, TEACHING, CURRICULUM, COMPARATIVE STUDY, CADAVER, LEARNING, OUTCOME AND PROCESS ASSESSMENT",,,,0090-7421,AB,"New and traditional educational media were used to study alternative methods of instruction in a human gross anatomy course. Three consecutive entry-level physical therapy (PT) classes (55 students total) participated in this study. No other anatomy course was available to these students during this time. During the first year, all entering PT students (n = 18) completed a traditional cadaver anatomy course. This traditional group attended weekly lectures and dissection laboratories for 15 weeks. During the second year, the next entering class of PT students (n = 17) completed a self-study, computerized noncadaver anatomy course. This self-study group attended an introductory session to receive course objectives and instruction in using the computer package chosen for the study. After the introductory session, this group worked independently for the remainder of their 15-week course. During the third year, the entering class of PT students (n = 20) attended weekly lectures and completed a self-study, computerized non-cadaver laboratory course. This lecture and self-study group attended an introductory session to review course objectives and receive instruction in using the computer package. For the remainder of their 15-week course, this group attended a weekly lecture and worked independently on the computer for the laboratory portion of their course. All groups kept time logs, recording class and study time for each day of the course. The time logs were collected on the last day of each course. Each group's performance in anatomy-based system courses was followed through the remainder of the PT curricula, including clinical rotations, and through the completion of the state board licensure examination. Data were analyzed using a multivariate analysis of variance and a Kruskal-Wallis analysis of variance. (ABSTRACT TRUNCATED)."
0042761,"Ludwig RL, Turner LW",Effective patient education in medical imaging: public perceptions of radiation exposure risk,J Allied Health 2002 Fall;31(3):159-64,,"PATIENT EDUCATION, RADIOGRAPHY, RADIOLOGIC HEALTH","ADVERSE EFFECTS, RISK, PSYCHOLOGY, PATIENT SATISFACTION, ATTITUDE TO HEALTH",,,,0090-7421,AB,"Patients perceptions of risk for harm influence their decisions concerning medical procedures and feelings of satisfaction with medical care choices. Radiologic technologists, dental hygienists, and other allied health professionals frequently are asked by patients to explain the radiation exposure dose and health risk associated with an imaging procedure. The purpose of this study was to evaluate the radiation risk perceptions within the community to develop an effective patient education strategy for health professionals based on the responses of 200 participants in a cross-sectional survey. Less than half of the adults responding to the survey agreed with experts regarding the risk of radiation exposure from various sources, and 75% to 90% of the responders thought that imaging providers should be highly educated and highly regulated. With efficacious patient education, appropriate risk comparisons can be made in simple terminology by addressing the public's knowledge, beliefs, and attitudes toward sources of radiation exposure."
0042762,"Shah MA, Robinson TC, al Enezi N",International allied health education and cross-cultural perspectives,J Allied Health 2002 Fall;31(3):165-70,,"HEALTH EDUCATION, ALLIED HEALTH","FORECASTING, MODELS THEORETICAL, CULTURE, UNITED STATES",,,,0090-7421,AB,International partnerships develop long-lasting friendships among colleagues. This is a dividend that is of immense value in this otherwise terribly divided globe with health care issues being a major concern. The framework and lessons learned proposed herein should be of value to individuals in colleges and universities to promote a true learning experience for both partners that are enduring and replicable models of international cooperation.
0042763,"Whitman B, Perrin KR, Knudson-Buresh A",Family mentoring: a life experience,J Allied Health 2002 Fall;31(3):171-6,,"MENTORS, FAMILY THERAPY, ATTITUDE OF HEALTH PERSONNEL","NURSING, PHYSIOTHERAPY, OCCUPATIONAL THERAPY, SOCIAL WORK, METHODS, FAMILY RELATIONS",,,,0090-7421,AB,"The purpose of this study was to determine the effectiveness of a preservice education family mentor experience on the development of family-centered attitudes expressed by 84 nursing, occupational therapy, physical therapy, and social work students from a private Midwestern university. The instrument, Issues in Early Intervention, was administered to students before and after participation in a field experience that included a minimum of 8 hours with assigned families. The instrument measured changes in attitude regarding family-centered care expressed by students in response to 24 statements reflective of family-centered concepts and approaches. A Wilcoxon signed rank test was used to analyze data from pretests and posttests using the Issues in Early Intervention instrument. Eight items reflected significant positive changes in family-centered attitudes. When total scores were examined using a paired t-test, students demonstrated a significant increase (p less than or = 0.001) in family centered attitudes after the family mentor experience according to the instrument. The family mentor experience evaluation of outcome objectives was administered to students at the conclusion of the project. Results from student feedback on the family mentor experience evaluation of experience outcomes also indicated a positive impact in family-centered attitudes as a result of the family mentor experience."
0042764,"Fitz PA, Mitchell BE",Building our future - increasing diversity in the dietetics profession: a summary of the ADA Diversity Mentoring Project,J Allied Health 2002 Fall;31(3):177-83,,"MENTORS, DIET, HEALTH PROMOTION, NUTRITION","UNITED STATES, FORECASTING, PROGRAM EVALUATION",,,,0090-7421,AB,"American Dietetic Association (ADA) members, the largest group of food and nutrition professionals in the world, have the capability of expanding access to nutrition services for diverse populations in a variety of traditional and nontraditional therapeutic and health prevention settings. Toward that end, ADA's 2000-2003 Strategic Plan includes goals, objectives, and tactics focused on underrepresented groups. The ADA has committed to increasing diversity in educational preparation from 20% in 1998 to 25% by 2004. To meet this goal, the ADA recognized the urgent need to try new methods for addressing diversity issues and began the Diversity Mentoring Project in February 2001 with funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Interdisciplinary Community-Based Programs, Allied Health Branch. The purpose of the project was to develop a model for mentoring minorities into nutrition science and dietetics programs. Other health professions would be able to apply this model, ultimately improving the quality of health care and accessibility of health services within culturally diverse populations."
0042765,"Xie JT, Aung HH, Wu JA, Attel AS, Yuan CS",Effects of American ginseng berry extract on blood glucose levels in ob/ob mice,Am J Chin Med 2002;30(2-3):187-94,,"PANAX GINSENG, PLANT EXTRACTS, BLOOD GLUCOSE, DIABETES MELLITUS, OBESITY, HYPOGLYCEMIC AGENTS","DRUG EFFECTS, MICE, PHARMACOLOGY, DRUG THERAPY, DISEASE MODELS ANIMAL",,,,0192-415X,AB,"In this study, we evaluated antihyperglycemic effects of American ginseng berry extract in diabetic ob/ob mice. Animals received daily intraperitoneal (IP) injections of the extract 150 mg/kg for 12 days. On days 5 and 12, the extract-treated ob/ob mice had significantly lower fasting blood glucose levels compared to day 0 (both p less than 0.05). Glucose tolerance improved significantly, which was shown by overall glucose excursion, calculated as area under the curve (AUC) during the two-hour IP glucose tolerance test. The AUC decreased by 31.8% on day 12 compared to day 0 (p less than 0.01). In addition, after 12 days of the berry extract treatment, a significant reduction in body weight (p less than 0.01 compared to day 0) and a significant increase in body temperature (p less than 0.01 compared to day 0) was noticeable. Our results support in vivo antihyperglycemic and antiobese activity of American ginseng berry extract that may prove to be of clinical importance in the prevention and treatment of Type 2 diabetes."
0042766,"Nagasawa H, Watanabe K, Inatomi H",Effects of bitter melon (Momordica charantia l.) or ginger rhizome (Zingiber offifinale rosc) on spontaneous mammary tumorigenesis in SHN mice,Am J Chin Med 2002;30(2-3):195-205,,"MOMORDICA CHARANTIA, ZINGIBER OFFICINALE, BREAST NEOPLASMS, PLANT EXTRACTS, ANTINEOPLASTIC AGENTS PHYTOGENIC","PHARMACOLOGY, DRUG THERAPY, MICE, RHIZOME",,,,0192-415X,AB,"The effects of chronic treatment with hot water extract of Bitter Melon (Momordica charantia L.) or Ginger Rhizome (Zingiber offifinale Rosc) on spontaneous mammary tumorigenesis were examined in SHN virgin mice. In mice given free access to extract of Bitter Melon (0.5%) or Ginger (0.125%) in drinking water, the development of mammary tumors was significantly inhibited. Furthermore, the former inhibited uterine adenomyosis with a common pathological background to mammary tumors and the latter inhibited mammary tumor growth. While the mechanism of the effects of these natural products remains to be clarified, there were no adverse effects of chronic treatment with these agents as estimated from body weight, food and water intake and various plasma component levels as well as external appearance. Thus, these natural products, popular in Japan as foodstuffs, also appear to have a health benefit."
0042767,"Chen D, Wu CF, Huang L, Ning Z",Effect of the aqueous extract of xuio-ban-xia-tang on gastric emptying in mice,Am J Chin Med 2002;30(2-3):207-14,Pinellia ternata,"DRUGS CHINESE HERBAL, GASTROINTESTINAL MOTILITY, ZINGIBER OFFICINALE, GASTROINTESTINAL AGENTS","DRUG EFFECTS, MICE, PLANTS MEDICINAL, PHARMACOLOGY",,,,0192-415X,AB,"Gastric emptying effect of the aqueous extract of xiao-ban-xia-tang (XBXT) was investigated in mice. Mice with food deprived for 18 hours were orally administered a certain amount of test meal (ca. 0.8 g) equaling 0.8 ml in volume. The percentage of 0.8 g test meal remaining in the stomach after 20 minutes was estimated. It was shown that XBXT significantly antagonized dopamine- (0.56 mg/kg, i.p.), not atropine- (0.3 mg/kg, i.p.), induced gastric emptying inhibition. It also significantly restored metoclopramide-induced (8 mg/kg, p.o.) propulsion and potentiated methylneostigmine-induced (2 mg/kg, p.o.) gastric emptying enhancement. The aqueous extract of Pinellia ternata, but not that of Zingiber officinale showed an inhibitory activity on gastric emptying. The present results suggest that XBXT possesses a regulative effect on gastric motility."
0042768,"Nakada T, Watanabe K, Jin GB, Triizuk K, Hanawa T",Effect of ninjin-youei-to on Th1/Th2 type cytokine production in different mouse strains,Am J Chin Med 2002;30(2-3):215-23,,"DRUGS CHINESE HERBAL, IMMUNE SYSTEM","DRUG EFFECTS, PHARMACOLOGY, MICE",,,,0192-415X,AB,"Ninjin-youei-to (NYT; ren-shen-yang-rong-tang in Chinese) is a traditional herbal formula, which is widely used in Japan, Korea and China to modulate physiological immunity. The effects of oral administration of NYT on cytokine production from splenocytes were investigated in both C57BL/6 and BALB/c mice in which Th1 and Th2 were dominant, respectively. Splenocytes from C57BL/6 and BALB/c mice, which took NYT orally for four weeks, were cultured with anti-mouse CD3 mAb, and the supernatant was examined for cytokine production using enzyme-linked immunosorbent assay (ELISA). Administration of NYT to C57BL/6 mice, increased the production of interleukin-4 (IL-4) significantly, and slightly decreased interferon-y (IFN-gamma) production from splenocytes. In contrast, the same treatment significantly increased IFN-gamma secretion from splenocytes of BALB/c mice. No remarkable changes of IL-12 production from splenocytes were observed in either strain of mice. These results suggest that oral administration of NYT ameliorates the excessive inclination of Th1 and Th2 type cytokine production, and NYT may provide a beneficial effects for the treatment of diseases caused by a skewed Th1-Th2 balance in the immune system."
0042769,"Lin CC, Ng LT, Yang JJ, Hsu YF",Anti-inflammatory and hepatoprotective activity of peh-hue-juwa-chi-cao in male rats,Am J Chin Med 2002;30(2-3):225-34,"Hedyotis diffusa, Hedyotis corymbosa, Mollugo pentaphylla","ANTIINFLAMMATORY AGENTS, LIVER DIS, DRUGS CHINESE HERBAL, EDEMA","PREVENTION, RATS, PHARMACOLOGY, PLANTS MEDICINAL, PLANT EXTRACTS, DRUG THERAPY",,,,0192-415X,AB,"Peh-hue-juwa-chi-cao (PHJCC) is a common commercial name for the herbal extract of either Hedyotis diffusa (HD), H. corymbosa (HC), or Mollugo pentaphylla (MP). The present study was carried out to investigate the anti-inflammatory and hepatoprotective effects of these three extracts in rats. The results indicated that extracts of HC, HD and MP possess anti-inflammatory activity, and that MP has the greatest inhibition against carrageenan-induced paw edema. In the hepatoprotective study, results indicated that the three plant extracts significantly reduced the acute elevation of serum glutamate oxalate transaminase (sGOT) and serum glutamate pyruvate transaminase (sGPT) concentration, and alleviated the degree of liver damage 24 hours after the intraperitoneal administration of hepatotoxins."
0042770,"Ko YJ, Hsieh WT, Wu YW, Lin WC",Ameliorative effect of Silene aprica on liver injuries induced by carbon tetrachloride and acetaminophen,Am J Chin Med 2002;30(2-3):235-43,Silene aprica,"ACETAMINOPHEN, LIVER DIS, PLANTS, LIPID PEROXIDATION, TRIGLYCERIDES","PLANTS MEDICINAL, DRUG THERAPY, ETIOLOGY, RATS, PHARMACOLOGY, DRUG EFFECTS",,,,0192-415X,AB,"The effect of oral administration of a 50% ethanol extract of Silene aprica (SA) on acute liver injury was examined in rats intoxicated with carbon tetrachloride (CCl4) and acetaminophen. The results indicated that SA protected the liver from CCl4- and acetaminophen-induced injury as judged by morphological and biochemical observations. An increase in both lipid peroxidation (LPO) and triglyceride concentrations occurred in the liver with CCl4 injection, SA administration significantly reduced these changes."
0042771,"Liu CF, Lin CC, Lin MH, Lin YS, Lin SC",Cytoprotection by propolis ethanol extract of acute absolute ethanol-induced gastric mucosal lesions,Am J Chin Med 2002;30(2-3):245-54,,"PROPOLIS, NECROSIS, STOMACH, STOMACH ULCER, LIPID PEROXIDATION","PREVENTION, DRUG EFFECTS, PHARMACOLOGY",,,,0192-415X,AB,"Acute p.o. administration of absolute ethanol (1.0 ml/kg) to fasted rats produced extensive necrosis of gastric mucosa. Pretreatment with p.o. administration of propolis ethanol extract (PEE) could effectively and dose-dependently prevent such necrosis. This protective effect is called \"cytoprotection.\" The maximal cytoprotective effect against absolute ethanol (AE)-induced gastric mucosal lesion was observed 1 hour after PEE administration. A gross examination of the gastric mucosa showed a marked improvement in groups receiving PEE. In order to further investigate the gastric protective mechanism of PEE, lipid peroxidation (LPO) levels in vivo and in vitro were estimated. PEE exhibited dose-dependent superoxide scavenging activity and antioxidant effects on AE-induced LPO in rat gastric mucosal homogenates. It was concluded that the gastric protective mechanism of PEE was due, at least in part, to its ability to inhibit LPO, and hence indirectly protect the gastric mucosa from oxidative stress."
0042772,"Adam SE, Al-Yahya MA, Al-Farhan AH",Toxicity of Nerium oleander and Rhazya stricta in Najdi sheep: hematologic and clinicopathologic alterations,Am J Chin Med 2002;30(2-3):255-62,"Nerium oleander, Rhazya stricta","PLANTS TOXIC, SHEEP DIS, PLANT POISONING","NERIUM, ETIOLOGY, ADVERSE EFFECTS, SHEEP",,,,0192-415X,AB,"The toxic effects of oral administration of 0.25 g/kg Nerium oleander leaves, 0.25 g/kg Rhazya stricta leaves or their mixture at 0.25 g/kg N. oleander leaves plus 0.25 g/kg R. stricta leaves on Najdi sheep were investigated. Daily oral dosing of R. stricta leaves for 42 days was not fatal to sheep while single oral doses of either N. oleander leaves or the mixture with R. stricta leaves proved fatal to animals within 24 hours with dyspnea, grunting, salivation, grinding of the teeth, ruminal bloat, frequent urination, ataxia and recumbency prior to death. The main lesions were widespread congestion or hemorrhage, pulmonary cyanosis, emphysema, bronchotracheal froths, and hepatonephropathy. The clinical and pathological changes were correlated with alterations in serum LDH and AST activities and concentrations of cholesterol, bilirubin, urea, total protein, albumin, and globulin and hematological values."
0042773,"Hu K, Wang Q, Hu PQ",The male silkworm moth (Antheraea pernyi) is a key ingredient in hu-bao and sheng-bao for specific prolongation of the life-span of the male fruit fly (Drosophila melanogaster),Am J Chin Med 2002;30(2-3):263-70,,"INSECTS, DRUGS CHINESE HERBAL, LONGEVITY","DRUG EFFECTS, MALE, FEMALE",,,,0192-415X,AB,"It is well established in Traditional Chinese Medicine that certain natural products, such as male silkworm moths, have different therapeutic effects on men than on women. These natural products have been used as dietary supplements specifically formulated for men or for women. However, this presumed sex-specific effect of certain natural products has not yet been confirmed experimentally with animal models or in human clinical trials. Here, using the fruit fly (Drosophila melanogaster) as a longevity model, we examined the effect of hu-bao (HB) and seng-bao (SB), two marketed health products made from a mixture of natural ingredients. Our results convincingly demonstrate that the effect of HB and SB are indeed specific for the male fly. The life-span of the male was significantly increased when HB or SB was added to the culture medium. In contrast, neither HB nor SB had much effect on the female fly. Upon removal of the male silkworm moth ingredient from HB or SB, the life-span prolongation effect of HB and SB was drastically diminished. Only with the addition of the male silkworm moth did the culture medium show a statistically significant life-span prolongation effect. This result suggests that the male silkworm moth is a key ingredient, in combination with other components, for specific prolongation of the life-span of male flies."
0042774,"Lin CY, Sun JS, Sheu SY, Lin FH, Wang YJ, Chen LT",The effect of Chinese medicine on bone cell activities,Am J Chin Med 2002;30(2-3):271-85,Drynaria fortunei,"BONES, TRADITIONAL MEDICINE CHINESE, CONNECTIVE TISSUE CELLS, CELL PHYSIOLOGY, APOPTOSIS","RATS, METABOLISM, DRUG EFFECTS, PHARMACOLOGY, PLANTS MEDICINAL",,,,0192-415X,AB,"In this experiment, we investigate the biochemical effects of traditional Chinese medicines via an in vitro bone cell culture. Ten different Chinese medicines were used in this study. The rat osteoblast-osteoclast co-culture system was used as the experimental model. After the cells grew to 80% confluence, various tested materials were added. The mitochondria activity of the bone cells after exposure to various preparations of Chinese medicines was determined by colorimetric assay. Biochemical markers such as protein content, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and acid phosphatase (ACP) titer were analyzed to evaluate the bone cell activity. When cultured with various Chinese medicines for 24 hours, only four of these ten Chinese medicines had potential beneficial effects on the bone cell culture; and only Drynaria fortunei (Kunze) J. Sm. had a universal beneficial effect on bone cell metabolism. The major beneficial effect of Drynaria fortunei (Kunze) J. Sm. on bone cells is probably mediated by the induction of apoptosis of the osteoclast cell population. Continued study of alterations in gene expression of bone cells caused by Chinese medicines will improve our understanding of bone cell responses to various pharmacological interventions."
0042775,"Kano Y, Takaguchi S, Nohno T, Hiragami F, Kawamura K, Iwama MK, Miyamoto K, Takehara M",Chinese medicine induces neurite outgrowth in PC12 mutant cells incapable of differentiation,Am J Chin Med 2002;30(2-3):287-95,,"DRUGS CHINESE HERBAL, NEURONS, CELL PHYSIOLOGY","DRUG EFFECTS, CELLS CULTURED",,,,0192-415X,AB,"During continuous culture of neural PC12 cells, we obtained a drug-hypersensitive PC12 mutant cell that showed high stimulation of neurite outgrowth by various drugs. When several Chinese medicines such as shu-jing-huo-xie-tang and Wu-Ling-San were provided to these PC12 mutant cells, the frequency of nerve growth factor (NGF)-induced neurite outgrowth increased approximately 30-fold compared to NGF alone. Neurite outgrowth induced by NGF in PC12 cells is accompanied by sustained activation of mitogen-activated protein kinase (MAPK); however, these Chinese medicines did not induce MAPK activity. The findings thus indicate that certain Chinese medicines may induce neurite outgrowth by a novel mechanism which is distinct from the NGF-activated pathway in PC12 mutant cells."
0042776,"Song QH, Kobayashi T, Hong T, Cyong JC",Effects of Inula Britannica on the production of antibodies and cytokines and on T cell differentiation in C57BL/6 mice immunized by ovalbumin,Am J Chin Med 2002;30(2-3):297-305,Inula britannica,"ANTIBODIES, LYMPHOCYTES, PLANT EXTRACTS","PLANTS MEDICINAL, MICE, DRUG EFFECTS, PHARMACOLOGY",,,,0192-415X,AB,"In this study, we investigated the effects of Inula Britannica on the production of antibodies against ovalbumin, and the differentiation of T cells, in C57BL/6 mice. The oral administration of Inula Britannica suppressed IL-4 and IL-6 production in lymphocytes collected from an inguinal lymph node in the immunized leg. On the other hand, the intraperitoneal administration of Inula Britannica suppressed IgG1 production, the ratio of IFN-gamma+IL-4-/IFN-gamma-IL-4+ cells and cytokine production of IL-6. It was presumed that the effects of Inula Britannica on the production of antibodies were induced by regulation of the balance of Th1 and Th2. Further, IL-4 and IL-6 production by lymphocytes collected from an inguinal lymph node in the immunized leg were suppressed, and therefore production of antibodies was suppressed."
0042777,"Chang HC, Hung WC, Huang MS, Hsu HK",Extract from the leaves of Toona sinensis roemor exerts potent antiproliferative effect on human lung cancer cells,Am J Chin Med 2002;30(2-3):307-14,Toona sinensis,"PLANT LEAVES, ANTINEOPLASTIC AGENTS PHYTOGENIC, NEOPLASMS, TUMOR CELLS CULTURED","DRUG THERAPY, DRUG EFFECTS, PHARMACOLOGY, APOPTOSIS, PLANTS MEDICINAL",,,,0192-415X,AB,"Recent study indicated that the components of Toona sinensis Roemor have potent anti-inflammatory and analgesic effects. These components have also been reported to inhibit the growth of boils in vivo. In this study, we investigated the effect of crude extract from the leaves of Toona sinensis Roemor on the proliferation of A549 lung cancer cells. We found that the extract effectively blocked cell cycle progression by inhibiting the expression of cyclin D1 and E in A549 cells. Additionally, incubation of the extract led to activation of caspase-3-like proteases and apoptotic cell death. Conversely, the extract did not show any significant cytotoxic effect on primarily cultured human foreskin fibroblasts or MRC-5 human lung fibroblasts. Therefore, antiproliferative action of the extract is specific for tumor cells. Our results suggest that the components of Toona sinensis Roemor have potent anticancer effects in vitro and identification of the useful components in the extract may lead to the development of a novel class of anticancer drugs."
0042778,"Lin JG, Chen GW, Su CC, Hung CF, Yang CC, Lee JH, Chung JG",Effects of garlic components diallyl sulfide and diallyl disulfide on arylamine N-acetyltransferase activity and 2-aminofluorene-DNA adducts in human promyelocytic leukemia cells,Am J Chin Med 2002;30(2-3):315-25,,"ALLIUM SATIVUM, LEUKEMIA, ENZYME INHIBITORS, ANTINEOPLASTIC AGENTS PHYTOGENIC","DRUG THERAPY, DRUG EFFECTS, PHARMACOLOGY",,,,0192-415X,AB,"Two components of garlic, diallyl sulfide (DAS) and diallyl disulfide (DADS), inhibited arylamine N-acetyltransferase (NAT) activity and 2-aminofluorene-DNA adduct in human promyelocytic leukemia cells (HL-60). The NAT activity was measured by high performance liquid chromatography assaying for amounts of N-acetyl-2-aminofluorene (2-AAF) and remaining 2-aminofluorene (2-AF). Cellular cytosols and intact cell suspensions were assayed. The inhibition of NAT activity and 2-AF-DNA adduct formation in human leukemia cells by DAS and DADS were dose-dependent and were directly proportional. The data also indicated that DAS and DADS decrease the apparent values of Km and Vmax from human leukemia cells in both assays. This is the first report of garlic components affecting human leukemia cell NAT activity and 2-AF-DNA adduct formation."
0042779,"Usuki S, Higa TN, Soreya K",The improvement of luteal insufficiency in fecund women by tokishakuyakusan treatment,Am J Chin Med 2002;30(2-3):327-38,,"DRUGS CHINESE HERBAL, MENSTRUATION DISORDERS, CORPUS LUTEUM, INFERTILITY FEMALE","DRUG THERAPY, PHARMACOLOGY, DRUG EFFECTS, FEMALE, ETIOLOGY",,,,0192-415X,AB,"The effect of tokishakuyakusan, a Chinese herbal medicine, was examined, in vivo, in women with luteal insufficiency and in women with normal menstrual cycles. Luteal insufficiency was determined by daily measurement of basal body temperature and plasma progesterone levels. Tokishakuyakusan improved luteal insufficiency. Furthermore, the effects of tokishakuyakusan on prolactin, gonadotropins, steroids, angiotensin II, ANP and renin levels in the blood of women with normal menstrual cycles were studied, as were the medicine's effects on estrogens, pregnenediol and LH in the urine of the same women. Tokishakuyakusan had no adverse effect on hormonal levels in either blood or urine. Furthermore, no clinical side effects were detected. These results suggest that tokishakuyakusan improves luteal insufficiency in women but does not affect the hormonal levels of women with normal menstrual cycles."
0042780,"Hung-Ming W, Liu CS, Tsai JJ, Ko LY, Wei YH",Antioxidant and anticonvulsant effect of a modified formula of chaihu-longu-muli-tang,Am J Chin Med 2002;30(2-3):339-46,,"ANTIOXIDANTS, ANTICONVULSANTS, DRUGS CHINESE HERBAL, EPILEPSY, SEIZURES, LIPID PEROXIDATION","DRUG THERAPY, TREATMENT OUTCOME, DRUG EFFECTS, PHARMACOLOGY, COMPARATIVE STUDY",,,,0192-415X,AB,"Antiepileptic drug therapy in individuals with epilepsy can induce free radical generation and profound lipid peroxidation. Some Chinese herbs with antiepileptic potential show antioxidant effects. We performed an open add-on study of TW970, a modified formula of the Chinese medicine \"chaihu-longu-muli-tang\", on 20 patients with refractory epilepsy and a seizure frequency of at least four fits per month, and another 20 patients with benign epilepsy and a seizure frequency of less than four fits per month. The control group consisted of 20 age-matched healthy adults. Seizure frequency, serum malondialdehyde (MDA), glutathione (GSH) and copper-zinc superoxide dismutase (Cu,Zn-SOD) were investigated in patients with refractory and benign epilepsy before and after four months add-on treatment of TW970. There was a decrease in seizure frequency in refractory epileptics from 13.4 +/- 3.4 to 10.7 +/- 2.5/per month, although the p value was 0.084. Before TW970 add-on treatment, a significant enhancement of lipid peroxidation with increased MDA and Cu,Zn-SOD activities together with decreased GSH were seen in refractory epileptics compared with normal controls. After TW970 add-on treatment of refractory epileptics for four months, normalization of MDA and Cu,Zn-SOD levels was achieved. Before and after TW970 add-on treatment, there were no statistically significant changes of the above-mentioned parameters in the patients with benign epilepsy. These results suggest that TW970 can reduce the seizure frequency in patients with refractory epilepsy and this may be due to the antioxidant effects of the modified formula of chaihu-longu-muli-tang."
0042781,"Ikeda N, Hayasaka S, Nagaki Y, Hayasaka Y, Kadoi C, Matsumoto M",Effects of kakkon-to and sairei-to on aqueous flare elevation after complicated cataract surgery,Am J Chin Med 2002;30(2-3):347-53,aqueous flare,"CATARACT, DRUGS CHINESE HERBAL, POSTOPERATIVE COMPLICATIONS, MEDICINE KAMPO","SURGERY OPERATIVE, DRUG THERAPY, TREATMENT OUTCOME, EYE, BODY FLUIDS",,,,0192-415X,AB,"We evaluate prospectively the effects of traditional herbal medicines on elevation of aqueous flare after complicated cataract surgery. Twenty-seven patients with bilateral complicated cataract undergoing phacoemulsification with intraocular lens implantation were studied. The patients received no herbal medicine when the right eyes underwent cataract surgery. Fifteen patients were given kakkon-to (ge-gen-yang in Chinese) granules (7.5 g daily) and 12 patients were given sairei-to (cai-ling-tang in Chinese) granules (9.0 g daily), for 3 days before surgery, the day of surgery, and for 7 days after surgery when the left eyes underwent cataract surgery. Diclofenac eyedrops were instilled in all patients. Aqueous flare was measured before and after surgery. The differences in preoperative flare intensities between groups treated with Kakkon-to and Sairei-to were not significant. In the untreated right eyes of the kakkon-to and Sairei-to groups, the flare was 99.1 and 89.6 photon counts/msec, respectively, on day 1, and then gradually decreased. The flare intensities on days 1, 3, and 5 in the kakkon-to treated left eyes were significantly lower than in those of the untreated right eyes (Fig. 1). The flare intensities in the Sairei-to treated left eyes were the same as those in the untreated right eyes. Kakkon-to contributed to a reduction of aqueous flare elevation after surgery for complicated cataract."
0042782,"Kainuma M, Hayashi J, Sakai S, Imai K, Mantani N, Kohta K, Mitsuma T, Shimada Y, Kashiwagi S, Terasawa K",The efficacy of herbal medicine (kampo) in reducing the adverse effects of IFN-beta in chronic hepatitis C,Am J Chin Med 2002;30(2-3):355-67,drug therapy combined,"MEDICINE KAMPO, HEPATITIS, INTERFERONS, DRUGS CHINESE HERBAL","CHRONIC DIS, ADVERSE EFFECTS, DRUG THERAPY, COMPARATIVE STUDY, PHARMACOLOGY, TREATMENT OUTCOME",,,,0192-415X,AB,"The purpose of this study was to determine if the adverse effects of interferon (IFN) in hepatitis C patients could be reduced by treatment with Japanese Oriental (Kampo) medicine. Twelve patients with chronic hepatitis C were treated with a combination of IFN-beta and either Mao-to or Dai-seiryu-to (groups A and B), and 16 patients were treated with IFN-beta alone (group C). Mao-to was administered to eight patients and Dai-seiryu-to was administered to four in groups A and B, respectively. Adverse effects were evaluated by clinical and laboratory examinations. The severity of symptoms was daily self-classified into four categories (1: none, 2: very slight, 3: moderate, and 4: serious), using a questionnaire consisting of 29 items. Scores of symptom such as discomfort and fever in group A, and discomfort, general malaise, paresthesia and arthralgia in group B were significantly lower than those in group C (p less than 0.05). In all patients, HCV-RNA was negative at the end of the treatment, and serum alanine aminotransferase (ALT) levels had normalized transiently in all group A and B patients with genotype 1b by 2 weeks after cessation of IFN treatment. This study indicates that Kampo medicines are useful for reducing the adverse effects accompanying IFN treatment in patients with chronic hepatitis C without reducing the antiviral effects."
0042783,Hsieh CL,The physiological mechanisms of 2 Hz electroacupuncture: a study using blink and H reflex,Am J Chin Med 2002;30(2-3):369-78,blinking,"ELECTROACUPUNCTURE, H REFLEX","PHYSIOLOGY, ELECTROMYOGRAPHY, NEURAL PATHWAYS, ACUPOINTS",,,,0192-415X,AB,"Our previous studies have shown that the cerebral cortex modulates the physiological mechanisms of acupuncture. However, the role of the brain stem and spinal cord in acupuncture remains unclear. The present study investigated the action of the brain stem and spinal cord in acupuncture. A total of eight healthy adult volunteers were studied. Electrical stimulation of the supraorbital nerve in the supraorbital foramen was used to evoke the blink reflex. Electrical stimulation of the posterior tibial nerve in the right popliteal fossa was used to evoke the H reflex. Electroacupuncture (EA) of 2 Hz was applied to the Zusanli acupoint in the right or left leg. The area of the R1 and R2 components of the blink reflex, and the greatest H/M ratio and H-M interval of the H reflex were measured before EA, during EA and at various post-EA periods. These data were analyzed quantitatively by a computerized electromyographic examination system. The results indicate that EA did not change the R1 and ipsilateral R2 components of the blink reflex. EA depressed the contralateral R2 component of the blink reflex 10 minutes and 40 minutes after the start of EA, but not after 5 minutes. EA applied to the Zusanli acupoint did not change the H/M ratio or the H-M interval of the H reflex. The results of this study indicate that 2 Hz EA of the Zusanli acupoint does not change the R1 component of the blink reflex, and the H/M ratio and the H-M interval of the H reflex, suggesting that 2 Hz EA does not change the monosynaptic reflex in the brain stem and spinal cord in humans. We also found that EA at 2 Hz depressed the contralateral but not the ipsilateral R2 component of the blink reflex, suggesting that longer pathways, perhaps including the cerebral cortex, may play a role in the physiological mechanisms responsible for the effectiveness of acupuncture."
0042784,"Lee H, Park HJ, Kim SA, Lee HJ, Kim MJ, Kim CJ, Chung JH, Lee H",Acupuncture stimulation of the vision-related acupoint (Bl-67) increases c-Fos expression in the visual cortex of binocularly deprived rat pups,Am J Chin Med 2002;30(2-3):379-85,,"ACUPUNCTURE, ACUPOINTS, VISION, SENSORY DEPRIVATION, BRAIN","RATS, PHYSIOLOGY, TREATMENT OUTCOME",,,,0192-415X,AB,"Our previous study with functional magnetic resonance imaging (MRI) demonstrated that acupuncture stimulation of the vision-related acupoint, B1-67, activates the visual cortex of the human brain. As a further study on the effect of B1-67 acupuncture stimulation on the visual cortex, we examined c-Fos expression in binocularly deprived rat pups. Binocular deprivation significantly reduced the number of c-Fos-positive cells in the primary visual cortex, compared with that of normal control rat pups. Interestingly, acupuncture stimulation of B1-67 resulted in a significant increase in the number of c-Fos-positive cells in the primary visual cortex, while acupuncture stimulation of other acupoints less important for visual function had no significant effect on c-Fos expression in the primary visual cortex. The results suggest the possibility of vision-related acupoint (B1-67) having an influence over the activity of the primary visual cortex."
0042785,"Kurono Y, Egawa M, Yano T, Shimoo K",The effect of acupuncture on the coronary arteries as evaluated by coronary angiography: a preliminary report,Am J Chin Med 2002;30(2-3):387-96,,"NEEDLING, CORONARY VESSELS, ACUPOINTS, VASODILATION, ANGINA PECTORIS","ACUPUNCTURE THERAPY, TREATMENT OUTCOME, ETIOLOGY, METHODS, PHYSIOLOGY",,,,0192-415X,AB,"The Neiguan acupuncture point (EH-6) of the heart meridian is often used for circulatory disorders. To clarify this effect, we measured coronary diameters in patients with angina pectoris following acupuncture stimulation using cardioangiography. Two kinds of acupuncture stimulation, the leaving needle (LN) and the sparrow pecking method (SPM), were employed for this study. No significant differences were found between LN and SPM. Concerning the pattern of coronary reaction, coronary constriction following acupuncture showed a relationship to patients with vasospastic angina. Coronary dilation following acupuncture showed a relationship to patients with Syndrome X. The mean dilatation with acupuncture was 68.8% of that caused by isosorbide dinitrate. These findings may help to clarify the mechanism of acupuncture treatment."
0042786,"Lin JH, Wu LS, Wu YL, Lin CS, Yang NY",Aquapuncture therapy of repeat breeding in dairy cattle,Am J Chin Med 2002;30(2-3):397-404,,"CATTLE, INFERTILITY FEMALE, GLUCOSE","ACUPUNCTURE THERAPY, ACUPOINTS, VETERINARY MEDICINE, TREATMENT OUTCOME, INJECTIONS",,,,0192-415X,AB,"Repeat breeders cause great economic loss in dairy herds. This study determined the efficacy of simple aquapuncture therapy (acupuncture combined with injection) to treat repeat breeders in two dairy herds (one in Hsinchu County and the other in Tainan County). Both herds had used gonadotropin-releasing hormone (GnRH) beforehand to treat the symptom but the success rate was poor - about 30%. Therefore, cows that failed to respond to GnRH were given the aquapuncture treatment. A total of 18 animals (two heifers and 16 cows) that had failed to conceive to 3-9 services were treated by aquapuncture, in which 10 ml and 5 ml of 50% glucose solution were injected at Baihui (Hundred Meetings, the depression in the center of the lumbosacral space) and Shenpeng (Kidney Shelf, the depression in the space between the lumbar vertebral transverse processes 5-6) acupoints, respectively with a 21G, 1.5-inch hypodermic needle. Both acupoints belong to the traditional acupuncture points of bovine and equine systems. Most animals showed heat within 14 days after aquapuncture and were inseminated artificially. Serum progesterone concentrations and rectal palpation were used for pregnancy diagnosis. The pregnancy rate after the treatment was 14/18 (77.7%) and 12/18 (66.6%) based on progesterone concentration and rectal palpation respectively, suggesting acupuncture as a simple and effective method to treat repeat breeders in dairy herds. However, the final result obtained from actual delivery of fetus in the experimental animals was only 8/18 (44.4%)."
0042787,"Kim YY, Choi JM, Kim SY, Park SK, Lee SH, Lee KH",Changes in EEG of children during brain respiration-training,Am J Chin Med 2002;30(2-3):405-17,,"ELECTROENCEPHALOGRAPHY, MEDITATION, MIND BODY RELATIONS, BRAIN, RESPIRATION, BREATHING EXERCISES","METHODS, PHYSIOLOGY, CHILD, EMOTIONS, TASK PERFORMANCE AND ANALYSIS",,,,0192-415X,AB,"Brain Respiration (BR)-training is a unique form of breathing exercise that develops potential ability by facilitating brain function. It is recognized as an effective method of improving the scholastic aptitude and emotional stability of children. The present study was designed to investigate the characteristics of the EEG during this training. Spectral analysis was used to examine the relative power in the EEG of 12 children while they practiced BR-training, and these were compared to those of 12 matched controls. BR-trainees showed a lower theta rhythm than the controls before the training session began and lower beta2 power before, during and after the session. In contrast, the BR subjects showed greater relative alpha1 power than the controls in the left frontal region during BR-training, which persisted throughout the BR-training schedule. There is evidence that decreased theta and beta waves may be correlated with emotional maturation, whilst increased alpha waves are associated with educational achievement. These findings enhance our understanding of the neurophysiological basis of the effects of BR-training upon emotion and maturation."
0042788,"Park J, Park HJ, Lee HJ, Emst E",What's in a name? A systematic review of the nomenclature of Chinese medical formulae,Am J Chin Med 2002;30(2-3):419-27,,"TRADITIONAL MEDICINE CHINESE, NOMENCLATURE, DATABASES BIBLIOGRAPHIC, DRUGS CHINESE HERBAL","KOREA, JAPAN, LANGUAGE, JOURNALS",,,,0192-415X,AB,"Traditional Chinese Medicine (TCM) has been modified to some extent in other Far Eastern countries such as Korea and Japan. Researchers of each of the three countries seem to use different English names for the same Chinese medicinal formulae. Lack of knowledge of the Chinese characters is destined to increase this confusion. In order to investigate this matter systematically, all investigations of Chinese medicine formulae published in the American Journal of Chinese Medicine (AJCM, 1997-March 2001) were evaluated. Moreover, PubMed (1966-June 2001) was searched using keywords differentiated by language, location and number of hyphens, and upper-or lower-case of the first letter of the English equivalent of each Chinese character. Fifty-four formulae of TCM were identified in 45 reports published in AJCM. Thirty-two were named in Chinese only (23 reports); six in Japanese (six reports); and five in Korean (five reports). Ten formulae were named in Japanese with the Chinese name in brackets (ten reports); and one in Chinese with the Japanese name in brackets (one report). By computerized literature search, different numbers of research papers were retrieved by using keywords differentiated by language, location and number of hyphens. Such confusion may prevent progress in the evaluation of TCM. To increase the efficiency of studies on Chinese medical formulae, standardization of terminology is required."
0042789,Simoneau GG,JOSPT - this editor's perspective,J Orthop Sports Phys Ther 2002 Sep;32(9):430-1,,PHYSIOTHERAPY,,(Editorial),,,0190-6011,,
0042790,"Zannotti CM, Bohannon RW, Tiberio D, Dewberry MJ, Murray R",Kinematics of the double-leg-lowering test for abdominal muscle strength,J Orthop Sports Phys Ther 2002 Sep;32(9):432-6,,"ABDOMINAL MUSCLES, MUSCLE STRENGTH, EXERCISE TESTING, PELVIS",KINEMATICS,,,"A convenience sample of 17 subjects (7 women, 10 men) was tested. Using reflective spheres to identify specific body segments, subjects were videotaped while performing DLL under 2 conditions: attempting (controlled) prevention of anterior pelvic tilting versus not attempting (uncontrolled) prevention of anterior pelvic tilting. Videotape was analyzed using the PEAK 5 2-dimensional system. RESULTS: The pelvis tilted anteriorly by the time the extremities were lowered a mean 3.6 degrees, regardless of condition. No significant difference in anterior pelvic tilting was associated with the 2 DLL conditions (F = 2.95, P = 0.105) but pelvic tilting did increase significantly as the lower extremities were lowered from vertical (F = 98.41, P less than 0.001). CONCLUSIONS: There appears to be a natural tendency for the pelvis to tilt anteriorly from very early in the DLL maneuver. As healthy young subjects do not appear able to prevent the tilting, the scoring system associated with the DLL test should be questioned.",0190-6011,AB,"STUDY DESIGN: Prospective descriptive study. OBJECTIVE: To investigate the kinematics of the double-leg-lowering (DLL) test of abdominal muscle strength. BACKGROUND: Adequate strength of the abdominal muscles is necessary for many household, occupational, and sports activities. Therapists, therefore, need valid measures of abdominal muscle strength. METHODS AND MEASUR"
0042791,"Robertson VJ, Ward AR",Vastus medialis electrical stimulation to improve lower extremity function following a lateral patellar retinacular release,J Orthop Sports Phys Ther 2002 Sep;32(9):437-46,,"ELECTRIC STIMULATION, KNEE JOINT, MUSCLE STIFFNESS",TREATMENT OUTCOME,,,"To examine the effect of electrical stimulation of the vastus medialis muscle on stiffness, pain and function for a patient with delayed functional progress following a lateral patellar retinacular release. BACKGROUND: Five months after an arthroscopic lateral patellar retinacular release, the patient, although highly motivated, had made little progress using routine exercises and taping. METHODS AND MEASUR\r\nAn electrical stimulation program producing approximately 300 contractions daily of the vastus medialis muscle was implemented. The electrical stimulation applied for 33 of the 36 days was a rectangular and balanced biphasic pulse of 625-micros duration, 70-Hz frequency, 8-second peak on-time, 3-second off-time, 1-second ramp-up, and 0.5-second ramp-down. Objective measures of stair climbing and hopping, together with the subjective measure of therapist-palpated superomedial patella displacement force, were recorded for each treatment visit. Other subjective measures were the patient's daily recordings of knee pain and stiffness. RESULTS: Patient-reported stiffness reduced rapidly as the actual and cumulative number of daily contractions of the vastus medialis muscle increased. After 8 days of electrical stimulation, the patient was able to ascend stairs unassisted and after another 21 days to hop unsupported. CONCLUSIONS: Stiffness rapidly reduced and function started to improve once the electrical stimulation program was implemented. Recovery during the 36 days of treatment with electrical stimulation was greater than during the previous 5 months using other methods. Compliance was not an issue, nor was muscle soreness.",0190-6011,AB,STUDY DESIGN: A single-case study design. OBJECTIV
0042792,"Nourbakhsh MR, Arab AM",Relationship between mechanical factors and incidence of low back pain,J Orthop Sports Phys Ther 2002 Sep;32(9):447-60,,"LOW BACK PAIN, MUSCLE STRENGTH",,,,"To collectively investigate the association among 17 mechanical factors and occurrence of low back pain (LBP). BACKGROUND: Several physical characteristics, based on assumptions, clinical findings, and scientific experiments, have been associated with the development of LBP Controversy exists regarding the degree of association between some of these physical characteristics and LBP. Information regarding the degree of association of each factor to LBP is needed for effective prevention and appropriate treatment strategies. METHODS AND MEASUR\r\nA total of 600 subjects participated in this study. Subjects were categorized into 4 groups: asymptomatic men (n = 150, age (mean +/- SD) = 43 +/- 15 years), asymptomatic women (n = 150, age (mean +/- SD) = 43 +/- 13 years), men with LBP (n = 150, age (mean +/- SD) = 43 +/- 14 years), and women with LBP (n = 150, age (mean +/- SD0 = 43 +/- 13 years). Seventeen physical characteristics were measured in each group and the relative association of each characteristic with LBP was assessed. RESULTS: Among all the factors tested, endurance of the back extensor muscles had the highest association with LBP. Other factors such as the length of the back extensor muscles, and the strength of the hip flexor, hip adductor, and abdominal muscles also had a significant association with LBP. CONCLUSION: It appears that muscle endurance and weakness are associated with LBP and that structural factors such as the size of the lumbar lordosis, pelvic tilt, leg length discrepancy, and the length of abdominal, hamstring, and iliopsoas muscles are not associated with the occurrence of LBP.",0190-6011,AB,STUDY DESIGN: A multifactorial cross-sectional nonexperimental design. OBJECTIV
0042793,"Smutok MA, Mayo MF, Gabaree CL, Ferslew KE, Panus PC",Failure to detect dexamethasone phosphate in the local venous blood postcathodic iontophoresis in humans,J Orthop Sports Phys Ther 2002 Sep;32(9):461-8,,"PREGNANES, ANTIINFLAMMATORY AGENTS","IONTOPHORESIS, REPRODUCIBILITY OF RESULTS",,,"Six volunteers received the following dexamethasone phosphate (2.5 ml, 4 mg/ml) treatments to their wrists on separate occasions: cathodic iontophoresis (4 mA, 10 minutes or 4 mA, 20 minutes), passive application (10 or 20 minutes). Plasma samples from the ipsilateral antecubital vein were obtained 10 minutes prior to and half way through the treatment (5 or 10 minutes), at the end of the treatment (10 or 20 minutes), and posttreatment (15, 30, 60, 90, and 120 minutes). The present investigation examined: (1) the sensitivity and linearity of extraction and analysis of dexamethasone and dexamethasone phosphate; (2) the necessity for determining both; and (3) the plasma levels from proximal effluent venous blood following cathodic iontophoresis. RESULTS: The aggregate (n = 18) of the 6-point standard curves were linear for dexamethasone (r greater than 0.974) and dexamethasone phosphate (r greater than 0.829). In vitro dephosphorylation of dexamethasone phosphate to dexamethasone occurred in plasma at 37 degrees C and during freeze-thaw. Measurable dexamethasone or dexamethasone phosphate concentrations were absent at all time points and under all conditions in the human subjects. CONCLUSIONS: These results demonstrate the sensitivity of the current assay and the need for evaluating both forms of the drug, as in vitro dephosphorylation results in the presence of dexamethasone and dexamethasone phosphate in samples. (ABSTRACT TRUNCATED).",0190-6011,AB,"STUDY DESIGN: A single-blind, 2-factor (4 treatments by 8 time points) repeated-measures study design. OBJECTIVE: To analytically determine dexamethasone and dexamethasone phosphate concentrations in plasma derived from proximal effluent venous blood, following cathodic iontophoresis. METHODS AND MEASUR"
0042794,Knox M,Outcomes of total hip arthroplasty: a study of patients one year postsurgery,J Orthop Sports Phys Ther 2002 Sep;32(9):469-70,,"ARTHROPLASTY, HIP","TREATMENT OUTCOME, FOLLOW UP STUDIES, PHYSIOTHERAPY",(Letter),,,0190-6011,,
0042795,"Topp R, Woolley S, Hornyak J, Khuder S, Kahaleh B",The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee,Arch Phys Med Rehabil 2002 Sep;83(9):1187-95,,"OSTEOARTHRITIS, KNEE, RESISTANCE TRAINING, ISOMETRIC CONTRACTION","ADULT, COMPARATIVE STUDY, RANDOMIZED CONTROLLED TRIALS",,,"The time to descend and ascend a flight of 27 stairs and to get down and up off of the floor. Knee pain was assessed immediately after each functional task. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess perceived pain, stiffness, and functional ability. RESULTS: In the isometric group, time to perform all 4 functional tasks decreased (P less than .05) by 16% to 23%. In the dynamic group, time to descend and ascend stairs decreased by 13% to 17%. Both groups decreased knee pain while performing the functional tasks by 28% to 58%. Other measures of pain and functioning were significantly and favorably affected in the training groups. The improvements in the 2 training groups as a result of their respective therapies were not significantly different. The control group did not change over the duration of the study. CONCLUSION: Dynamic or isometric resistance training improves functional ability and reduces knee joint pain of patients with knee OA.",0003-9993,AB,"OBJECTIVE: To compare 16 weeks of isometric versus dynamic resistance training versus a control on knee pain and functioning among patients with knee osteoarthritis (OA). DESIGN: Randomized clinical trial. SETTING: Outpatient setting. PARTICIPANTS: A total of 102 volunteer subjects with OA of the knee randomized to isometric (n = 32) and dynamic (n = 35) resistance training groups or a control (n = 35). INTERVENTIONS: Strength exercises for the legs, 3 times weekly for 16 weeks. Dynamic group: exercises across a functional range of motion; isometric: exercises at discrete joint angles. MAIN OUTCOME MEASUR"
0042796,"Chan L, Beaver S, Maclehose RF, Jha A, Maciejewski M, Doctor JN",Disability and health care costs in the Medicare population,Arch Phys Med Rehabil 2002 Sep;83(9):1196-201,,"MEDICARE, DELIVERY OF HEALTH CARE, COST BENEFIT ANALYSIS","ACTIVITIES OF DAILY LIVING, REHABILITATION, AGED",,,"The impact of patient disability on health care costs (inpatient, outpatient, skilled nursing facility, home health, medications). Activity limitations were determined by patient assessment of restrictions in activities of daily living (ADLs). RESULTS: Over 20% (n=6,500,000) of the entire Medicare population had at least 1 health-related activity limitation. Total median health care costs per year (interquartile range (IQR)) increased as the number of these limitation increased (0 ADLs: 1934 dollars (IQR, 801-4761 dollars); 1-2 ADLs: 4540 dollars (IQR, 1744-12,937 dollars); 3-4 ADLs: 7589 dollars (IQR, 2580-23,149 dollars); 5-6 ADLs: 14,399 dollars (IQR, 5425-33,014 dollars)). After adjusting for confounding characteristics including the impact of comorbid illnesses, Medicare enrollees incurred higher health care costs as their number of activity limitations increased (0 ADLs: cost ratio = 1.0; 1-2 ADLs: cost ratio = 1.4 (95% confidence interval (CI), 1.2-1.6); 3-4 ADLs: cost ratio = 1.6 (95% CI, 1.3-2.0); 5-6 ADLs: cost ratio = 2.3 (95% CI, 1.7-3.2)). The cost increases were because of an increase in the frequency of all events (eg, hospital admissions, outpatient visits) rather than an increase in the intensity or cost of those events. In addition, with increasing activity limitations, there was a significant increase in the proportional impact of home health costs such that, for those with 5 or 6 limitations (ABSTRACT TRUNCATED).",0003-9993,AB,"OBJECTIVE: To determine the effect of activity limitations on health care expenditures. DESIGN: Cross-sectional. SETTING: National survey. PARTICIPANTS: Data from the 1997 Medicare Current Beneficiary Survey (n = 9298), a nationally representative sample of community-dwelling Medicare beneficiaries who were older than 64 years of age. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR"
0042797,"Gabriel DA, Basford JR, An KN",Vibratory facilitation of strength in fatigued muscle,Arch Phys Med Rehabil 2002 Sep;83(9):1202-5,,"MUSCLE FATIGUE, ISOMETRIC CONTRACTION, VIBRATION","ELECTROMYOGRAPHY, BIOMECHANICS, TREATMENT OUTCOME",,,Elbow extension torque was measured with a load cell. Triceps and biceps brachii muscle activity was measured with surface electromyography electrodes. RESULTS: Elbow extension torque increased 10% (2 Nm) during the stimulation trials relative to the control trials (P less than .05). The associated increase in mean peak-to-peak electromyographic amplitude was 47% (103 microV) for the triceps brachii and 38% (33 microV) for the biceps brachii (all P less than .05). The electromyographic frequency measures failed to reach the .05 probability level of significance. CONCLUSIONS: Elbow extension torque and triceps electromyographic activity were facilitated by tendon vibration of fatigued triceps in healthy subjects. This finding supports the use of proprioceptive feedback to facilitate voluntary muscle contractions.,0003-9993,AB,"OBJECTIVE: To assess the effects of tendon vibration on isometric torque and electromyographic activity of fatigued muscles. DESIGN: Subjects performed a 30-trial isometric (2-s maximal effort contractions alternating with 6-s rest periods) elbow extensor fatigue series. Three additional trials with the same work-to-rest ratio were then performed in which the triceps extensor tendon was subjected to a 60-Hz, 1-mm vibration during the rest intervals. SETTING: A biomechanics research laboratory. PARTICIPANTS: Thirteen healthy women without history of upper-extremity injury or neurologic disorder. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR"
0042798,"Lariviere C, Arsenault AB, Gravel D, Gagnon D, Loisel P, Vadeboncoeur R",Electromyographic assessment of back muscle weakness and muscle composition: reliability and validity issues,Arch Phys Med Rehabil 2002 Sep;83(9):1206-14,,"MUSCLE WEAKNESS, MUSCLE FIBERS, LOW BACK PAIN","ELECTROMYOGRAPHY, CONSISTENCY AND RELIABILITY",,,"Surface electromyography was recorded for 4 pairs of homologous back muscles while the subjects performed, on a dynamometer, static trunk extension efforts. Electromyographic parameters were computed to assess muscle weakness and muscle fiber composition. The reliability of the data collected across the 3 sessions and comparisons between groups were determined. RESULTS: Electromyographic parameters generally showed good to excellent reliability, but were insensitive to differences in back muscle strength and did not appear to be related to muscle composition. Some trends were observed in the electromyographic parameters across the force levels, but the large interindividual variability impeded statistical comparisons. CONCLUSIONS: The assessment of muscle weakness and muscle fiber composition through electromyographic analysis does not appear feasible, at least on an individual basis, for the muscles of the back.",0003-9993,AB,"OBJECTIVE: To assess the reliability and construct validity of various electromyographic indices developed to assess back muscle weakness and muscle fiber composition. DESIGN: A prospective study with repeated measures performed on 3 days along with comparisons of groups presenting different back strength and/or back muscle fiber composition. SETTING: A biomechanics laboratory within a rehabilitation center. PARTICIPANTS: Forty male volunteers (20 healthy, 20 with chronic low back pain) were assessed on 3 different days to assess reliability and to make group comparisons. Thirteen healthy women were also assessed once to obtain a third group with known lower strength and different back muscle fiber composition. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR"
0042799,"Mondelli M, Romano C, Rossi S, Cioni R",Herpes zoster of the head and limbs: Electroneuromyographic and clinical findings in 158 consecutive cases,Arch Phys Med Rehabil 2002 Sep;83(9):1215-21,,"HERPES ZOSTER, NEURAL CONDUCTION","ELECTROPHYSIOLOGY, REHABILITATION",,,"To quantify electromyographic and neurographic changes and to correlate them with the clinical data of outpatients with herpes zoster. DESIGN: Prospective case series. SETTING: Outpatient department. PATIENTS: A consecutive, unselected series of 158 outpatient cases (88 women, 70 men; mean age, 64 y) of herpes zoster of the head and limbs. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR\r\nBlink reflex and electromyography and motor and sensory nerve conduction velocities of nerves and muscles corresponding to affected dermatomes. RESULTS: Postherpetic neuralgia (PHN), segmental zoster paresis, and polyneuropathy were found in 31%, 19%, and 2.5% of cases, respectively. Absence or reduction of sensory action potential amplitudes, blink reflex areas, and compound muscle action potential amplitudes were found in 60%, 31%, and 18% of cases, respectively. Sensory and motor conduction velocities and motor and blink reflex latencies were nearly always normal or only slightly slowed. Electromyographic signs of abnormal spontaneous activity were found in 36% of the cases. Electrophysiologic alterations were correlated among themselves, with age, with presence of segmental zoster paresis, and with absence of antiviral therapy. The extent of the skin rash (number of dermatomes affected by herpes zoster) was the only variable predictive of disappearance or improvement of PHN. CONCLUSIONS: Sensory axonal neuropathy, often associated with similar motor involvement, can be shown by classical electrophysiologic methods in herpes zoster. The severity of damage to motor fibers was related to damage to sensory fibers, but no relation was found between peripheral axon damage and PHN. The site of motor system damage may be the ventral roots, plexus, or peripheral nerve. (ABSTRACT TRUNCATED).",0003-9993,AB,OBJECTIV
0042800,"Meikle B, Devlin M, Garfinkel S",Interruptions to amputee rehabilitation,Arch Phys Med Rehabil 2002 Sep;83(9):1222-8,,AMPUTATION,"REHABILITATION, CLINICAL ASSESSMENT SCALES, TREATMENT OUTCOME, COMPARATIVE STUDY",,,"To determine the frequency of interruptions to inpatient amputee rehabilitation, and to identify the causes, risk factors, and consequences of these interruptions. DESIGN: Retrospective cohort study. SETTING: Inpatient amputee rehabilitation service. PATIENTS: A total of 254 consecutive patients admitted within 90 days of amputation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR\r\nPatient age, gender, comorbid medical conditions, amputation type(s), days from amputation to admission, admission Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) score, rehabilitation length of stay (LOS), whether a prosthesis was fabricated, discharge destination, discharge Houghton Scale score, discharge 2-minute walk test, and discharge SF-36 score. RESULTS: Interruptions occurred in 76 patients (30%). Impaired stump healing caused 46 (18%) interruptions and acute medical illness caused 26 (10%); 4 (2%) interruptions were because of other causes. Higher incidence of interruption was associated with female gender, peripheral vascular disease, and decreased days from amputation to rehabilitation. The majority of patients with interruptions (60/76, 79%) returned to complete rehabilitation. Patients with interruptions had significantly longer rehabilitation LOS (48.5 vs 37.0d, P less than .001), but functional outcome measures at rehabilitation discharge were similar between those patients who returned to complete rehabilitation after interruption and those patients without interruption. CONCLUSIONS: Interruptions to amputee rehabilitation are common and result in longer rehabilitation LOS but do not adversely affect rehabilitation outcomes in those who are able to return to complete rehabilitation. No subgroup of patients with exceptionally high incidence of interruption could be identified.",0003-9993,AB,OBJECTIV
0042801,"Awan R, Smith J, Boon AJ",Measuring shoulder internal rotation range of motion: a comparison of 3 techniques,Arch Phys Med Rehabil 2002 Sep;83(9):1229-34,,"SHOULDER, ROTATION","REHABILITATION, RANGE OF MOTION, COMPARATIVE STUDY, CONSISTENCY AND RELIABILITY",,,"Shoulder IR ROM was measured by using a digital inclinometer with each of the 3 techniques. All measurements were performed independently by 2 groups of examiners and repeated to determine intra- and interrater reliabilities. RESULTS: IR ROM measurements obtained with the scapula stabilized or by visual inspection were significantly less than when measured with the standard technique (P = .001). Intrarater reliability was good or excellent for all 3 methods (intraclass correlation coefficients = .63-.71), was similar for the scapular stabilization and visual inspection techniques, and was superior to that previously reported for similar measurements. In general, interrater reliability was lower than intrarater reliability for all measurements. CONCLUSION: Because the visual inspection and scapular stabilized techniques control for accessory scapulothoracic motion, these techniques may represent more valid measures of glenohumeral motion than the standard technique. Both the visual inspection and scapular stabilized techniques exhibited equally acceptable reliability for clinical use. However, because the visual inspection technique may be applied by a single examiner, we recommend its use to measure shoulder IR ROM in the clinical setting.",0003-9993,AB,"OBJECTIVE: To compare the reliability of shoulder internal rotation (IR) range of motion (ROM) measured using 3 different methods: standard technique, manual scapular stabilization technique, and visual inspection technique. DESIGN: Prospective study. SETTING: Clinic-based sports medicine center. PARTICIPANTS: Convenience sample of 56 unimpaired high-school athlete volunteers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR"
0042802,"Powell JM, Temkin NR, Machamer JE, Dikmen SS",Nonrandomized studies of rehabilitation for traumatic brain injury: can they determine effectiveness?,Arch Phys Med Rehabil 2002 Sep;83(9):1235-44,,BRAIN INJURIES,"REHABILITATION, RESEARCH DESIGN, PROGNOSIS, CLINICAL ASSESSMENT SCALES",,,"The Glasgow Outcome Scale (GOS), Sickness Impact Profile (SIP), Burden Inventory, and Perceived Quality of Life (PQOL). The predictors of interest: discharge to comprehensive inpatient rehabilitation or home and inpatient rehabilitation length of stay (LOS). RESULTS: Discharge to rehabilitation was associated with poorer functioning on the GOS (P = .03) and SIP (P = .57), an increase on the Burden Inventory (P = .14), and improved PQOL (P = .20). Similar results were found for longer lengths of inpatient rehabilitation. CONCLUSIONS: The results appear to be because of a confounding effect rather than rehabilitation. The study design could not control for confounding that resulted from unmeasured or difficult to measure aspects of the clinical decisions for discharge placement and rehabilitation LOS. Furthermore, typical severity indices were inadequate to control for injury severity and recovery. Matching designs that investigate TBI rehabilitation are also at risk for inadequate confounder control.",0003-9993,AB,OBJECTIVE: To examine the feasibility of investigating rehabilitation effectiveness for traumatic brain injury (TBI) with a nonrandomized design. DESIGN: Observational cohort with confounder control by regression methodology. SETTING: Level I trauma center. PARTICIPANTS: Consecutive series of 365 individuals with TBI discharged to inpatient rehabilitation or home (78% follow-up). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR
0042803,"Kumakura N, Takayanagi M, Hasegawa T, Ihara K, Yano H, Kimizuka M",Self-assessed secondary difficulties among paralytic poliomyelitis and spinal cord injury survivors in Japan,Arch Phys Med Rehabil 2002 Sep;83(9):1245-51,,"SPINAL CORD INJURIES, POSTPOLIOMYELITIS SYNDROME, SELF ASSESSMENT","JAPAN, ACTIVITIES OF DAILY LIVING",,,"Respondents completed a questionnaire about demographic factors, physical complaints, activities of daily living (ADLs), social participation, and a visual analog scale of time course for difficulties (VAST-D) devised for the present study in which the subjects drew a single curve to indicate the lifetime course of disability as they perceived it. RESULTS: Signs of SWD in all extremities of the polio patients and in the upper extremities of the SCI subjects were visually shown by the VAST-D. Additionally, the prevalence of postpolio syndrome and SWD in the SCI group was estimated to be 55.3% and 45.1%, respectively. CONCLUSIONS: SWD was visually shown by the VAST-D in polio and SCI subjects.",0003-9993,AB,OBJECTIVE: To determine the time course of secondary worsening of difficulties (SWD) experienced by postpolio and spinal cord injury (SCI) subjects in the general population. DESIGN: Self-report survey. SETTING: Multicenter study in general community in Japan. PARTICIPANTS: A total of 662 postpolio and 736 SCI subjects who had had contact with some rehabilitation facility. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR
0042804,"Dillingham TR, Pezzin LE, Mackenzie EJ",Racial differences in the incidence of limb loss secondary to peripheral vascular disease: a population-based study,Arch Phys Med Rehabil 2002 Sep;83(9):1252-7,,"AMPUTATION, PERIPHERAL VASCULAR DIS","REHABILITATION, NORTH AMERICA, ETHNIC GROUPS",,,"Incidence rates standardized for age, gender, and race; and time trends. RESULTS: There were 27,149 discharges with dysvascular amputations, yielding an average annual rate of 44.3 per 100,000 persons. Incidence rates for dysvascular amputations increased from 41.4 per 100,000 in 1986 to 47.2 per 100,000 in 1997. For all levels of amputation, annual incidence rates among African Americans were considerably higher than those of other persons. African Americans were 2 to 4 times more likely to lose a lower limb than white persons of similar age and gender. CONCLUSIONS: Rising rates of lower-limb amputations in the general population combined with disproportionately higher rates among African Americans are concerning and warrant further investigation into their underlying causes and consequences.",0003-9993,AB,"OBJECTIVE: To evaluate racial differences in limb loss caused by peripheral vascular disease in a diverse, statewide population. DESIGN: Retrospective analysis of a cohort of dysvascular amputees. SETTING: Maryland State Hospital Discharge Data from 1986 to 1997. PARTICIPANTS: Persons with a procedure code for lower-limb amputation (ICD9-CM code 84.11-.19) were identified. Patients with limb loss because of trauma, malignancy, or congenital anomalies were excluded. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR"
0042805,"da Cunha IT, Lim PA, Qureshy H, Henson H, Monga T, Protas EJ",Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: a randomized controlled pilot study,Arch Phys Med Rehabil 2002 Sep;83(9):1258-65,,"CEREBROVASCULAR DISORDERS, GAIT ANALYSIS","REHABILITATION, BIOMECHANICS EQUIPMENT, PILOT PROJECTS",,,"Functional Ambulation Category Scale, gait speed, walking distance, gait energy expenditure, and gait energy cost. RESULTS: The small sample size did not generate enough power to detect significant differences in any variable. However, medium to large effect sizes of 0.7 and 1.16 standard deviation units were observed for gait energy cost and walk distance, respectively. CONCLUSIONS: This pilot study indicated that STAT is a safe, feasible, and promising intervention for acute stroke survivors. A larger trial is warranted for statistical relevance.",0003-9993,AB,"OBJECTIVE: To investigate gait outcomes with supported treadmill ambulation training (STAT) associated with regular rehabilitation in acute stroke survivors. DESIGN: Randomized controlled trial, pilot study. SETTING: Rehabilitation medicine service at a Veterans Affairs medical center. PARTICIPANTS: Seven acute stroke survivors assigned to regular intervention group and 6 patients assigned to STAT intervention. INTERVENTIONS: Regular intervention consisted of 3 hours daily of physical therapy, kinesiotherapy, and occupational therapy. STAT group received regular rehabilitation with STAT substituted for usual gait training. Participants were tested at baseline, treated for an average of 3 weeks, and retested on discharge. The analysis of covariance procedure was used to test for differences between the 2 approaches. MAIN OUTCOME MEASUR"
0042806,"Hood VL, Granat MH, Maxwell DJ, Hasler JP",A new method of using heart rate to represent energy expenditure: The Total Heart Beat Index,Arch Phys Med Rehabil 2002 Sep;83(9):1266-73,,"HEART RATE, GAIT, ENERGY METABOLISM, OXYGEN CONSUMPTION",CLINICAL ASSESSMENT SCALES,,,"To develop a new method of representing energy expenditure using heart rate and to determine its reproducibility compared with the criterion standard of oxygen cost. DESIGN: Repeated-measures design. SETTING: University gait analysis laboratory and gymnasium at 2 spinal injury units. PARTICIPANTS: Twenty unimpaired adults and 17 subjects with spinal cord injury (SCI). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR\r\nHeart rate and oxygen consumption were measured on 20 unimpaired adults walking under controlled steady-state and nonsteady-state conditions. New methods of estimating energy expenditure by using heart rate were compared with oxygen consumption, oxygen cost, and Physiological Cost Index (PCI). Nine subjects with SCI, walking with and without functional electric stimulation, were assessed to determine use of these new measures with this group. Sensitivity to change of the new measurement techniques was investigated in 10 subjects with SCI, comparing wheelchair pushing to walking. RESULTS: The Total Heart Beat Index (THBI) was developed as a new index, calculated by dividing the total heartbeats during activity by distance traveled. High repeatability was found under steady-state and nonsteady-state conditions (intraclass correlation coefficients, .893-.995). Sensitivity to change in activity level was also shown. CONCLUSIONS: The THBI is a simple parameter to calculate from continuous heart rate data and provides a reproducible alternative to gas analysis and the PCI.",0003-9993,AB,OBJECTIV
0042807,"Videler AJ, Beelen A, Aufdemkampe G, de Groot IJ, Van Leemputte M",Hand strength and fatigue in patients with hereditary motor and sensory neuropathy (types I and II),Arch Phys Med Rehabil 2002 Sep;83(9):1274-8,,"NEUROPATHIES HEREDITARY SENSORY AND AUTONOMIC, HAND STRENGTH, MUSCLE FATIGUE, ISOMETRIC CONTRACTION",EPIDEMIOLOGIC METHODS,,,"To compare maximal isometric hand strength and fatigue between subjects with hereditary motor and sensory neuropathy (HMSN) and healthy controls and to test the reproducibility of handgrip strength (peak force of handgrip (PFgrip)) and fatigue. DESIGN: PFgrip and the decline in PFgrip during 3 sets of 15 contractions were compared. SETTING: University hospital in The Netherlands. PARTICIPANTS: Twenty subjects with HMSN and 20 age- and sex-matched healthy controls; 15 healthy subjects for the reproducibility part of the study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR\r\nPFgrip and the decline in PFgrip were compared by using a digital handgrip dynamometer. Two-point and lateral pinch measurements of subjects with HMSN were standardized against reference values. Reproducibility measurements were performed on 15 healthy subjects on 2 separate occasions within a 1-week interval. RESULTS: PFgrip was significantly lower in the HMSN subjects compared with controls (P less than .05). Pinch measurements also showed a large variance from average normal performance. No significant difference was found in the decline in percentage of PFgrip. Reproducibility was excellent for PFgrip (intraclass correlation coefficient (ICC) = .98; 95% confidence interval (CI), .95-.99) but poor for fatigue (ICC = .62; 95% CI, .20-.85). CONCLUSION: PFgrip and 2-point and lateral pinch in HMSN subjects were significantly reduced compared with healthy controls. Our findings indicated that the rate of decline of PFgrip during effort does not vary between groups.",0003-9993,AB,OBJECTIV
0042808,"Commissaris DA, Nilsson-Wikmar LB, Van Dieen JH, Hirschfeld H",Joint coordination during whole-body lifting in women with low back pain after pregnancy,Arch Phys Med Rehabil 2002 Sep;83(9):1279-89,,"LOW BACK PAIN, PREGNANCY, LIFTING, PELVIS","KINEMATICS, COMPARATIVE STUDY, EPIDEMIOLOGIC METHODS",,,"Duration of downward and upward phases, relative instant of box lift-off, joint angles, spatial angles of trunk and pelvis, pelvic angle relative to trunk, and phase angle relationships between joints. RESULTS: The duration of the upward phase +/- standard deviation was longer in the pain group (1731 +/- 290 ms vs 1489 +/- 187 ms, P = .031). At box lift-off, this group had less hip joint flexion (101.9 degrees +/- 20.8 degrees vs 78.7 degrees +/- 12.4 degrees, P = .015) but more backward pelvis tilt relative to the trunk, that is, more lumbar spine flexion (126.3 degrees +/- 16.8 degrees vs 109.0 degrees +/- 12.3 degrees, P = .031). The pain group showed an immediate transition from lumbar spine flexion to extension, whereas the controls maintained peak flexion for about 600 ms. The peak phase lag between knee and hip joint extension in the upward phase was larger for the pain group (-29.7 degrees +/- 8.3 degrees vs -17.2 degrees +/- 5.5 degrees, P = .003). CONCLUSION: Women with low back and/or pelvic pain after pregnancy showed different kinematics of lifting. Further research is needed to determine the exact relationship between the altered kinematics and the underlying disorder.",0003-9993,AB,"OBJECTIVE: To quantify differences in the kinematics of lifting between women with low back and/or pelvic pain after pregnancy and women without. DESIGN: Comparison study. SETTING: Research laboratory. PARTICIPANTS: Volunteer sample of 7 women with pain (positive pain drawing, no physical examination) and 9 female controls (not matched). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUR"
0042809,"Richards JS, Hicken BL, Putzke JD, Ness T, Kezar L",Reliability characteristics of the Donovan spinal cord injury pain classification system,Arch Phys Med Rehabil 2002 Sep;83(9):1290-4,,"SPINAL CORD INJURIES, PAIN MEASUREMENT","CONSISTENCY AND RELIABILITY, REHABILITATION",,,,0003-9993,AB,"OBJECTIVE: To determine the interrater reliability of the Donovan system for classification of pain in spinal cord injury (SCI) as well as the clinician-based usefulness of each of the classification criteria used in the Donovan system. DESIGN: Information pertinent to the Donovan system was provided incrementally by videotape for each pain site. After each additional piece of information, the 3 raters classified the pain site into 1 of 5 types and gave a confidence rating (5-point Likert scale) regarding the accuracy of their classifications. Thus, each pain site was classified 6 separate times, each with an associated confidence rating. SETTING: Academic rehabilitation hospital. PARTICIPANTS: Twenty-eight persons with traumatic onset SCI reported 60 pain sites. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The short-form McGill Pain Questionnaire. RESULTS: Interrater agreement ranged from 50% to 70%. Interrater agreement did not change as additional information was provided. In contrast, confidence ratings significantly increased as additional information was provided. CONCLUSIONS: There was considerable variability between raters using the Donovan system for classifying SCI pain. Additional clinical information increased the rater's confidence in the accuracy of their ratings but did not improve interrater agreement."
0042810,"Newton AM, Kirby RL, Macphee AH, Dupuis DJ, Macleod DA",Evaluation of manual wheelchair skills: is objective testing necessary or would subjective estimates suffice?,Arch Phys Med Rehabil 2002 Sep;83(9):1295-9,,"WHEELCHAIR DEPENDENCE, APTITUDE, PATIENT ASSESSMENT","OCCUPATIONAL THERAPY, REHABILITATION, PHYSIOTHERAPY",,,"Wheelchair Skills Test (WST, version 2.4), a set of 50 standardized skills. RESULTS: The Spearman correlation coefficients between the total objective and subjective scores were .95 for the wheelchair users and .75 for the therapists. The mean difference between the total objective and subjective scores was statistically significant (P = .0002) for the wheelchair users (who overestimated their abilities by an average of 17.9%). The percentage concordance between subjective and objective scores for individual skills ranged from 57.1% to 100% for the wheelchair users and 50% to 100% for the therapists, with 25% and 35% of skills, respectively, for which there were no statistically significant associations (at a Bonferroni-adjusted alpha level of.001) between the objective and subjective scores. The skills that were misestimated by both were moving the armrests away, reaching a high object, transferring out of and into the wheelchair, folding the wheelchair, incline ascent, negotiation of gravel and irregular surfaces, and small curb ascent.",0003-9993,AB,"OBJECTIVE: To test the hypothesis that subjective estimates of the ability to perform manual wheelchair skills, by wheelchair users and the therapists working with them, accurately reflect the results of objective testing. DESIGN: Within-subject comparisons. SETTING: Kinesiologic laboratory in a rehabilitation center. PARTICIPANTS: Twenty-one wheelchair users and their therapists. INTERVENTIONS: The wheelchair users and their therapists subjectively estimated how the wheelchair users would perform manual wheelchair skills, followed by an objective assessment. MAIN OUTCOME MEASUR"
0042811,"Weatherall M, Harwood M",The accuracy of clinical assessment of bladder volume,Arch Phys Med Rehabil 2002 Sep;83(9):1300-2,,"URINATION DISORDERS, PHYSICAL EXAMINATION","REHABILITATION, ULTRASONOGRAPHY, COMPARATIVE STUDY, DIAGNOSIS",,,,0003-9993,AB,"OBJECTIVE: To determine the usefulness of physical examination in detecting elevated bladder volume. DESIGN: A blinded study of clinical examination by physicians to detect elevated bladder volumes compared with a criterion standard (ultrasonic bladder volume measurement). SETTING: Outpatient department of a general hospital in New Zealand. PARTICIPANTS: Sixteen healthy adult volunteers (age range, 21-37y; body mass index range, 22.9-37.2kg/m(2)) and 8 qualified resident physicians with 2 to 6 years of clinical experience. INTERVENTION: Elevated bladder volumes were achieved by randomly allocating the volunteers to void or not to void before the clinical examination. MAIN OUTCOME MEASURE: Clinical examination of the abdomen by abdominal palpation and suprapubic percussion, compared with portable ultrasound findings, to determine whether a healthy adult has a full bladder. RESULTS: For bladder volumes of 400 to 600mL, physical examination to detect a full bladder was 81% sensitive (95% confidence interval (CI), 54-96), 50% specific (95% CI, 39-68), and 55% accurate (95% CI, 45-65). The likelihood ratio for a positive finding on physical examination was 1.62 (95% CI, 1.17-2.24). CONCLUSION: Physical examination of the abdomen by relatively junior physicians is unreliable in detecting bladder volumes between 400 and 600mL in healthy volunteers."
0042812,"Hendricks HT, Zwarts MJ, Plat EF, Van Limbeek J",Systematic review for the early prediction of motor and functional outcome after stroke by using motor-evoked potentials,Arch Phys Med Rehabil 2002 Sep;83(9):1303-8,,"CEREBROVASCULAR DISORDERS, EVOKED POTENTIALS, DISABILITY EVALUATION","EVIDENCE BASED MEDICINE, PROGNOSIS, REHABILITATION",,,A computer-aided search to identify original prognostic studies published from 1988 through 2000; relevant references cited in the retrieved articles were also included. STUDY SELECTION: A preliminary screening selected studies in which transcranial magnetic stimulation was assessed as a prognostic determinant for outcome at the level of impairments (motor recovery) and disabilities (functional recovery). The studies were then subjected to a critical review according to a priori methodologic criteria. DATA EXTRACTION: Data from the studies were used to construct contingency tables with MEPs as a prognostic determinant. The distribution of cells was statistically assessed with the Fisher exact test. The prognostic test properties were expressed as sensitivity and specificity. The clinical significance was determined by odds ratios. DATA SYNTHES,"0003-9993\r\nOf 85 potentially relevant studies, 20 met the criteria for the preliminary screening; after the critical review, 5 studies were included for analysis and discussion. CONCLUSIONS: Analysis of the data from the 5 studies indicated obvious evidence for the prognostic value of MEPs for both motor and functional recovery. The prognostic test properties for subgroups of patients could be established. In predicting motor recovery of the upper extremity, the specificity was consistently very high for subgroups of patients with paralysis or severe paresis; this test property might be used in clinical practice. We discuss the prognostic value of MEPs and offer suggestions for further research.",AB,OBJECTIVE: To clarify the prognostic value of motor-evoked potentials (MEPs) in predicting motor and functional outcomes after acute stroke. DATA SOURC
0042813,"Slipman CW, Chow DW, Lenrow DA, Blaugrund JE, Chou LH",Dysphonia associated with epidural steroid injection: a case report,Arch Phys Med Rehabil 2002 Sep;83(9):1309-10,,"VOICE DISORDERS, STEROIDS","CASE REPORT, INJECTIONS, REHABILITATION",,,,0003-9993,AB,"A 46-year-old patient with left-side low back pain developed symptoms of dysphonia and throat irritation 24 hours after receiving a fluoroscopically guided steroid injection into the epidural space. A direct laryngoscopy performed before a second injection detected no abnormalities. When dysphonia reappeared 48 hours after that injection, laryngoscopy revealed edema in the anterior vocal cord with thick surrounding mucous. Full clinical resolution of the dysphonia was apparent by laryngoscopy 15 days after the second injection. The mechanism of dysphonia after epidural steroid injection is unknown, but it may result from a systemic steroid effect."
0042814,Murphy NA,Deep venous thrombosis as a result of hypotonia secondary to intrathecal baclofen therapy: a case report,Arch Phys Med Rehabil 2002 Sep;83(9):1311-2,,"BACLOFEN, CEREBRAL PALSY, MUSCLE HYPERTONIA","CASE REPORT, THROMBOSIS, REHABILITATION, ADVERSE EFFECTS",,,,0003-9993,AB,"After repair of the catheter of an implanted intrathecal baclofen (ITB) delivery system, a 17-year-old man with cerebral palsy developed acute lower-extremity hypotonia. Subsequently, he complained of right lower-extremity pain followed by swelling in the popliteal fossa. Doppler studies showed a thrombus extending from the femoral vein to the popliteal vein with probable extension into the distal portion of the leg. Deep vein thrombosis, an uncommon event in children, has not been reported previously as a complication of acute hypotonicity and immobilization associated with ITB, regardless of age. Clinicians caring for children being treated with ITB should be alert to this potential complication so that early diagnostic and treatment measures can be provided. In certain circumstances, it may be appropriate to consider prophylaxis against thrombosis."
0042815,"Hyman GS, Cardenas DD",Upper-extremity deep vein thrombosis associated with peripherally inserted central catheters in acute spinal cord injury: a report of 2 cases,Arch Phys Med Rehabil 2002 Sep;83(9):1313-6,,"THROMBOSIS, SPINAL CORD INJURIES, ARM","CATHETERIZATION, REHABILITATION",,,,0003-9993,AB,"Catheter-associated upper-extremity deep vein thrombosis (DVT) carries a 12% to 36% risk of pulmonary embolism (PE). Acute spinal cord injury (SCI) is a thrombophilic state resulting from altered fibrinolytic and platelet function and abnormal concentrations of clotting factors. Patients with SCI are frequently burdened with the classic risk factors of Virchow's triad including stasis, hypercoagulability, and intimal trauma. We present 2 patients with acute cervical SCI, both with venous thrombosis of the upper extremity associated with peripherally inserted central catheters. Both thrombotic events were insidious, and 1 patient developed a large PE. A high index of suspicion is necessary to make the diagnosis, and prompt aggressive anticoagulation is warranted absent contraindications. Little is known about the prevalence of and the morbidity associated with upper-extremity DVT in the SCI population. Our experience suggests that catheter-related, upper-extremity venous thromboembolism in SCI deserves further study."
0042816,"American Geriatrics Society, John A Hartford Foundation",A statement of principles: toward improved care of older patients in surgical and medical specialties,Arch Phys Med Rehabil 2002 Sep;83(9):1317-9,,"GERIATRICS, PHYSICAL MEDICINE","REHABILITATION, GUIDELINES",,,,0003-9993,AB,"The statement and recommendations in this report resulted from detailed discussions between geriatricians and specialists of 10 medical and surgical disciplines, including representatives of the American Academy of Physical Medicine and Rehabilitation. These physicians and their parent organizations are participants in a major project supported by the John A. Hartford Foundation and the American Geriatrics Society. The goal of this project is to improve the care of older patients. This position statement reviews demographic forces shaping contemporary health care, states the objectives of project, and lists 10 specific recommendations. The recommendations encompass attitudes, knowledge, medical training, clinical service delivery, and advocacy."
0042817,Whyte J,Traumatic brain injury rehabilitation: are there alternatives to randomized clinical trials?,Arch Phys Med Rehabil 2002 Sep;83(9):1320-2,,BRAIN INJURIES,"RANDOMIZED CONTROLLED TRIALS, REHABILITATION, RESEARCH DESIGN",(Commentary),,,0003-9993,AB,"Randomized clinical trials (RCTs) are widely considered to be the gold standard of evidence for treatment efficacy, but they have not been widely applied to rehabilitation or, more specifically, traumatic brain injury rehabilitation. Ethical, scientific, and resource factors may limit the application of RCTs. Thus, rigorous observational alternatives to the RCT would be of great value. In the article by Powell et al, an attempt to rigorously apply an observational design to assess the relative effectiveness of inpatient rehabilitation versus home discharge failed to control for important confounding factors. It appears nearly impossible to successfully apply observational designs when the factors leading to the applications of different treatments are strongly related to the patient's perceived prognosis. However, observational designs may be successfully applied when regional or temporal variations in care are studied. Moreover, a number of developments in measurement, study design, and statistical analysis may expand the role of observational studies in answering questions of rehabilitation efficacy and effectiveness."
0042818,"Strasser DC, Solomon DH, Burton JR","Geriatrics and physical medicine and rehabilitation: common principles, complementary approaches, and 21st century demographics",Arch Phys Med Rehabil 2002 Sep;83(9):1323-4,,"GERIATRICS, PHYSICAL MEDICINE","REHABILITATION, GUIDELINES",,,,0003-9993,AB,"The demographic changes occurring in the United States transcend the capabilities of any specific medical specialty to provide optimum care for the elderly. This commentary discusses a statement of principles drafted by representatives of the American Academy of Physical Medicine and Rehabilitation who collaborated with members of 9 other medical and surgical specialties. In this commentary, we argue that geriatrics and physical medicine and rehabilitation (PM&R) share common principles and complementary approaches. We urge physiatrists and other rehabilitation professionals to address the needs of elderly patients and recommend that these principles be incorporated into PM&R practice."
0042819,"Berlowitz DJ, Brown DJ",Sleep-disordered breathing,Arch Phys Med Rehabil 2002 Sep;83(9):1325,,"SLEEP APNEA SYNDROMES, SPINAL CORD INJURIES, MUSCLE STRENGTH",PROGNOSIS,(Letter),,,0003-9993,,
0042820,Frost F,"Antihypertensive therapy, nifedipine, and autonomic dysreflexia",Arch Phys Med Rehabil 2002 Sep;83(9):1325-6,,"AUTONOMIC NERVOUS SYSTEM DIS, ANTIHYPERTENSIVE AGENTS",HETEROCYCLIC COMPOUNDS,(Letter),,,0003-9993,,
0042821,"Laban MM, Esmail Z, Shalansky KF, Sunderji R, Anton H, Chambers K",Community-based referrals for electrodiagnostic studies involving possible carpal tunnel syndrome,Arch Phys Med Rehabil 2002 Sep;83(9):1326-7,,CARPAL TUNNEL SYNDROME,"ELECTRODIAGNOSIS, REFERRAL AND CONSULTATION",(Letter),,,0003-9993,,
0042822,"Wirz S, Thomas M",Evaluation of community-based rehabilitation programmes: a search for appropriate indicators,Int J Rehabil Res 2002 Sep;25(3):163-71,,"REHABILITATION, COMMUNITY HEALTH SERVICES, DISABILITY EVALUATION",,,,,0342-5282,AB,"Community-based rehabilitation (CBR) is a common form of service delivery and can provide services for people with disabilities in otherwise underserved areas. Despite a 20-year history of service delivery in many parts of the world by both government and non-government organization sectors, there are few indicators with which to measure the effectiveness of programmes. Among evaluations that have been undertaken there has been a tendency to describe practice rather than the effectiveness of that practice. One reason for this is the lack of robust indicators against which to measure practice. This study examines the activities and outcomes of 10 published evaluations of CBR programmes and proposes indicators for some of CBR practices based upon this examination. Readers are invited to comment upon these indicators or to try using them in their practice."
0042823,"Blokhorst MG, Lousberg R, Vingerhoets AJ, Winter FA, Zilvold G",Daily hassles and stress vulnerability in patients with a whiplash-associated disorder,Int J Rehabil Res 2002 Sep;25(3):173-9,,WHIPLASH INJURIES,"EPIDEMIOLOGIC METHODS, STRESS PSYCHOLOGICAL, COMPLICATIONS",,,,0342-5282,AB,"The objectives of this study were to examine the self-reported, daily problems of patients with a whiplash-associated disorder (WAD) and a healthy control group, with the hypothesis that WAD patients would report more person-dependent hassles and perceive them as more serious than the healthy control group, due to the prior experience of a whiplash injury. In addition, it was expected that the person-independent seriousness rating would be elevated, reflecting the increased vulnerability of WAD patients to common stressors. Finally, a strong relationship was expected between frequency or seriousness of daily problems on the one hand and level of distress on the other. Forty-seven WAD patients seeking treatment and 47 matched healthy control participants completed the everyday problem checklist (EPCL). The level of distress was measured by the symptom checklist (SCL-90). As expected, most EPCL-scores in the WAD group were higher than the scores of the healthy participants. Regression analysis further revealed that 61% of the variance in general distress in the WAD group could be explained by EPCL scores and educational background. Chronic WAD patients report a high stress load, which is related specifically to personal functioning after the whiplash injury. In addition, WAD patients (especially those with low educational level) appear to be more vulnerable and react with more distress than healthy people to all kinds of stressors. Stress responses probably play an important role in the maintenance or deterioration of whiplash-associated complaints."
0042824,"Kyhlback M, Thierfelder T, Soderlund A",Prognostic factors in whiplash-associated disorders,Int J Rehabil Res 2002 Sep;25(3):181-7,,"WHIPLASH INJURIES, PAIN MEASUREMENT, SELF ASSESSMENT, DISABILITY EVALUATION","COMPLICATIONS, PROGNOSIS",,,,0342-5282,AB,"Whiplash-associated disorders (WADs) have become an increasing problem over the years and many authors have addressed the issue. The aim of the present study is to identify predictors for perceived disability and self-registered pain from a functional perspective, as well as to study the temporal evolution of patients' complaints. Eighty-three patients suffering from pain in the neck following acute whiplash injury were included in the study and they were consecutively monitored at three weeks, three months and one year after injury. The results suggest that a linear combination of sex, self-efficacy and WAD grade significantly explains 24% of the variation observed in pain intensity at the one-year follow-up, whereas a linear combination of self-efficacy, sex and age significantly explains 36% of the variation observed in disability at the one-year follow-up. Five per cent of the patients were non-symptomatic at the first monitoring occasion and 16% at the one-year follow-up. It is concluded that WAD patients' self-efficacy at an early stage after whiplash injury significantly predicts the temporal development of pain intensity and disability. It may therefore be suggested that patients' confidence in performing daily activities should be reinforced in order to optimize treatment after whiplash injury."
0042825,"Tsang HW, Ng BF, Chiu FP",Job profiles of people with severe mental illness: implications for rehabilitation,Int J Rehabil Res 2002 Sep;25(3):189-96,,"MENTAL DISORDERS, EMPLOYMENT",REHABILITATION,,,,0342-5282,AB,"Employment history is known to be a consistent predictor of vocational functioning of people with mental illness. A review of the literature, however, shows that studies that describe the employment pattern of those with psychiatric disabilities are limited. This study aimed to explore the employment histories and job profiles of people with severe mental illness in the Special Administrative Region of the Chinese Mainland: Hong Kong. The participants consisted of 64 patients (46 men and 18 women) recruited from two mental hospitals. A specially designed and validated instrument (work history record sheet) was used to collect data including medical history, educational and training background and employment information of the participants for the past 5 years. Some results were consistent with previous findings. All participants had a work history and had roughly 2 years of employment in a job; most of the jobs were in low-wage and low-prestige positions. In addition, interpersonal competence was of paramount importance for getting and keeping jobs. Some findings are different from earlier studies. For instance, most of the jobs were full time. The ways that people secured their jobs were not the same as in Western studies. Possible cultural differences leading to different findings and implications for rehabilitation services are discussed."
0042826,"Bullinger M, Schmidt S, Petersen C, DISABKIDS Group",Assessing quality of life of children with chronic health conditions and disabilities: a European approach,Int J Rehabil Res 2002 Sep;25(3):197-206,,"CHRONIC DIS, QUALITY OF HEALTH CARE","DISABLED CHILDREN, QUALITY OF LIFE, RESEARCH DESIGN",,,,0342-5282,AB,"Quality of life has been used as a synonym for a subject-centred or individually appraised perspective on health. Despite the increase in quality of life research in adults, quality of life in children is relatively neglected. While generic measures begin to emerge now, methods to assess the quality of life of children with chronic conditions are still in development. The design of such an assessment tool for different age groups and different levels of disabilities is the objective of a European-Union-funded study: the DISABKIDS project. In addition, it addresses the psychosocial determinants of quality of life in children with disabilities. A major aim of the project is to develop and test instruments for children and adolescents with disabilities (as well as for their families) in seven countries, to assess the impact of the chronic health conditions on quality of life and to provide a tool for systematic monitoring of the quality of care given to children with disabilities. Assessment and monitoring will allow identification of unmet health care needs and, it is hoped, ultimately, the fostering of the development of effective intervention strategies."
0042827,"Duvdevany I, Keren N","Thought, consideration and future planning for out-of-home placement among parental caregivers of dependent adult children with psychiatric disabilities",Int J Rehabil Res 2002 Sep;25(3):207-13,,"MENTAL DISORDERS, PATIENT CARE PLANNING","ADULT, PARENTS, PARENTS, ISRAEL",,,,0342-5282,AB,"Israeli parents caring for their adult children with psychiatric disabilities (n = 89) were studied with regard to their thoughts, considerations and future planning for out-of-home placement. These placement variables were examined as a function of their age, emotional stress (marital, parental and domestic), cognitive appraisal, social support and self-esteem. Major findings show that parental stress (low) was correlated with thought and consideration regarding out-of-home placement, whereas marital stress (low) was associated with future planning. A regression analysis found that parental thought and consideration regarding placement was predicted by low marital stress, whereas future planning was also predicted by high parental cognitive appraisal."
0042828,Dunn P,The evolution of government independent living policies and programmes for Canadians with disabilities,Int J Rehabil Res 2002 Sep;25(3):215-24,,"DELIVERY OF HEALTH CARE, DISABILITY","INDEPENDENT LIVING, CANADA, LEGISLATION",,,,0342-5282,AB,"Government policies and programmes in Canada have been slowly evolving from a focus on institutional care to traditional programmes in the community. Now, a new paradigm of services is emerging which emphasizes the concepts of independent living. This study collected extensive information from government officials and consumer groups across Canada regarding the trends in barrier-free housing, accessible transportation and personal supports from 1980 to the present time. The research documents some of the major issues with government initiatives as well as promising innovations. Although many positive changes were made during the Decade of Disabled Persons (1983-1992), many of these initiatives were eroded with major funding cutbacks in the mid- to late 1990s. This paper concludes with ways to change the present service delivery system to ensure that everyone can live independently in the community."
0042829,"Brzek A, Nowak Z, Plewa M",Modified programme of in-patient (phase I) cardiac rehabilitation after acute myocardial infarction,Int J Rehabil Res 2002 Sep;25(3):225-9,,MYOCARDIAL INFARCTION,"REHABILITATION, ERGOMETRY, COMPARATIVE STUDY, METHODS",,,,0342-5282,AB,"A group of 61 men who suffered from myocardial infarction (MI) were divided into two groups: group A (31 patients post MI, one day at intensive care unit (ICU), no beta-blockers, physical therapy according to a seven-day programme) and group B (30 patients post MI, two days at ICU, with beta-blockers, physical therapy according to a seven-day programme). Results from both groups were compared with a control group (C) (38 patients post MI, three days at ICU, physical therapy according to a longer ten-day graded programme). The objective of this study was to assess the efficacy of a proposed modified rehabilitation programme in patients after acute MI on the basis of a submaximal stress test performed on a cycle ergometer and to find out which stress test parameters might be used for the selection of an appropriate phase 2 rehabilitation programme. The performed analysis of correlation between exercise and resting parameters showed statistical relevancy with regard to systolic blood pressure in group A. Maximal load (WATs), metabolic cost (METs), maximal heart rate (beats/min), stress-test time (-test) and time of normalization for the exercise parameters (tn) are the parameters of the stress test that should be taken into consideration for appropriate selection of an out-patient (phase 2) rehabilitation programme."
0042830,"Puckree T, Kasiram R, Moodley M, Singh RM, Lin J","Physiotherapists and human immunodeficiency virus/acquired immune deficiency syndrome: knowledge and prevention: a study in Durban, South Africa",Int J Rehabil Res 2002 Sep;25(3):231-4,,"HIV INFECTIONS, KNOWLEDGE","ACQUIRED IMMUNODEFICIENCY SYNDROME, PHYSIOTHERAPISTS, PREVENTION, ATTITUDE TO DISABILITY",,,,0342-5282,AB,"This study determined what physiotherapists in Durban, South Africa know about human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), their attitudes towards patients and how they cope as individuals. Data were collected using a validated questionnaire. One-hundred-and-fourteen physiotherapists in Durban hospitals participated in the study. Seventy-two per cent of the questionnaires met the criteria for analysis. Ninety per cent of the participants believed that they knew about HIV/AIDS, but only 78% could identify all viral transmission modes. Of the 38 physiotherapists who believed that they knew the stages of an HIV infection, only 11% actually knew the stages, 28% could not explain them and 61% were vaguely aware. Fifty-six per cent of the respondents had treated patients who had died from HIV/AIDS. Only 38% of physiotherapists were completely at ease when treating HIV/AIDS patients despite the fact that 98% believed that physiotherapy was an integral component of the management of an AIDS patient. Fifty-one per cent of the respondents were unaware of support structures provided by their employers. The authors conclude that the perceptions of physiotherapists about their knowledge about HIV/AIDS do not stand up to scrutiny. Significantly more attention should be paid to the development, implementation and evaluation of the effectiveness of educational programmes on HIV/AIDS for physiotherapists in the workplace."
0042831,"Yavuzer G, Ataman S, Suldur N, Atay M",Bone mineral density in patients with stroke,Int J Rehabil Res 2002 Sep;25(3):235-9,,"BONE DENSITY, CEREBROVASCULAR DISORDERS, OSTEOPOROSIS, HEMIPLEGIA",RISK,,,,0342-5282,AB,"The objectives of this study were to investigate the development and pathogenesis of osteoporosis in stroke in-patients, to compare the bone mineral density (BMD) of the paretic and non-paretic sides, to study longitudinal changes during the period on the rehabilitation ward and to relate BMD to demographic, impairment and disability variables. Participants were 32 first-stroke in-patients (19 men), with an average age of 62.4 +/- 8.1 years. Demographic and clinical characteristics were documented. The BMD of lumbar spine, bilateral distal radius and femoral neck were measured and compared at admission and discharge. The associations between bone loss and age, sex, time since stroke, Brunnstrom motor recovery scores and functional independence measure motor (mFIM) scores were assessed. The mean percentage differences in BMD between paretic and non-paretic arms at discharge were 12% (less than 0.001) and 3.5% (less than 0.05), respectively, and between paretic and non-paretic legs were 5% (less than 0.01) and 2% (less than 0.05), respectively. There was a statistically significant correlation between BMD loss and Brunnstrom stage (= -0.41) and mFIM score at admission (= -0.42). In conclusion, patients with hemiparesis due to stroke are at increased risk of developing osteoporosis on the paretic side. Higher motor impairment and functional dependency at admission increases the risk. New strategies are needed for stroke patients to prevent further decreases in BMD and reduce the risk of fractures."
0042832,"Fortinsky RH, Bohannon RW, Litt MD, Tennen H, Maljanian R, Fifield J, Garcia RI, Kenyon L",Rehabilitation therapy self-efficacy and functional recovery after hip fracture,Int J Rehabil Res 2002 Sep;25(3):241-6,,"HIP FRACTURES, SELF EFFICACY, PSYCHOLOGY","REHABILITATION, TREATMENT OUTCOME",,,,0342-5282,AB,"Little is known about the role of psychological factors in the functional recovery process of hip fracture patients. This study employed a prospective cohort design to test the hypothesis that hospitalized hip fracture patients with greater reported self-efficacy for conducting rehabilitation therapy would have a greater likelihood of recovering to a pre-fracture level of locomotion function six months after the fracture. This hypothesis was tested controlling for pre-fracture level of function and depressive symptoms reported during hospitalization for surgical repair. An original measure of rehabilitation therapy self-efficacy was evaluated prior to hypothesis testing. Study patients were recruited from two hospitals, interviewed during hospitalization and followed up six months later. Patients included in hypothesis test analyses (n = 24) were mostly women (82%) with a mean age of 79 years. Results showed that patients with higher self-efficacy scores had a greater likelihood of locomotion recovery, controlling for pre-fracture locomotion function level (adjusted odds ratio (AOR) = 1.21; 95% confidence interval (CI) = 1.00-1.45; = 0.05). This positive association between rehabilitation therapy self-efficacy and likelihood of locomotion recovery persisted after adding depressive symptoms (the Center for Epidemiological Studies-depression (CES-D) score) to this logistic regression model (AOR for self-efficacy = 1.18; 95% CI = 0.99-1.42; = 0.07). It is concluded that rehabilitation therapy self-efficacy is a potentially important psychological factor in helping hip fracture patients recover locomotion functioning."
0042833,"Gaumer G, Koren A, Gemmen E",Barriers to expanding primary care roles for chiropractors: the role of chiropractic as primary care gatekeeper,J Manipulative Physiol Ther 2002 Sep;25(7):427-49,,"PRIMARY HEALTH CARE, CHIROPRACTIC","EVIDENCE BASED MEDICINE, ROLE",,,,0161-4754,AB,"OBJECTIVE: To examine the feasibility of broader and more frequent primary care roles for chiropractors. Data Collection: Literature review and analysis of existing databases. Six types of barriers were examined, including legal, financial, professional, accessibility or geographic location, consumer preference, and self-imposed barriers. RESULTS: Although research into the barriers of an expanded primary care role for chiropractors is inconclusive, several inferences can be drawn from this analysis. First, prevailing state practice acts preclude only a limited number of activities that are necessary for chiropractors to serve in a primary care capacity. The self-perception by a portion of the chiropractic profession that as neuromusculoskeletal system specialists, they are either uninterested or ill-prepared for providing primary care serves as a second barrier. Third, payment provisions that do not permit chiropractors to be reimbursed for primary care services significantly limit their ability to expand primary care capacity. Fourth, consumer perceptions of chiropractors as neuromusculoskeletal system specialists are a persistent barrier to expanding status. Given the current importance of managed care, the fifth and most crucial barrier for chiropractic may be managed care organizations' lack of interest in having chiropractors in primary care roles. CONCLUSION: Research on the barriers to a more expanded primary care role for chiropractors is incomplete. The available research helps little in ruling out plausible barriers that might make it possible to narrow the scope of subsequent research."
0042834,"Axen I, Rosenbaum A, Robech R, Wren T, Leboeuf-Yde C",Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain?,J Manipulative Physiol Ther 2002 Sep;25(7):450-4,,"LOW BACK PAIN, MANIPULATION CHIROPRACTIC","ATTITUDE TO DISABILITY, PROGNOSIS",,,"Improvement was defined at the 4th visit as self-reported \"definitely improved\" (the best of 5 choices). The hypothesized most favorable prognostic group had immediate improvement reported on the 1st visit, reduced pain intensity reported on the 2nd visit, reduced disability reported on the 2nd visit, and a common reaction or no reaction reported on the 2nd visit. The hypothesized least favorable prognostic group had no immediate improvement on the 1st visit, no reduction of pain intensity on the 2nd visit, no reduced disability on the 2nd visit, and no reaction or an uncommon reaction reported on the 2nd visit. The hypothesized intermediate prognostic group included all patients who did not fit into the hypothesized most favorable or least favorable groups. COVARIABL\r\nAge, sex, pain intensity during past 24 hours, description of disability, duration and pattern of pain during present attack, duration and pattern of pain during past 12 months. (ABSTRACT TRUNCATED).",0161-4754,AB,"OBJECTIVE: To investigate whether 3 distinct patterns of reactions to chiropractic care predict early favorable treatment outcome in patients with persistent low back pain. DESIGN AND SETTING: Multicenter, clinic-based prospective outcome study with standardized interview questionnaires conducted in private chiropractic practices in Sweden. STUDY SUBJECTS: Previously compliant chiropractors were invited to participate in the study. A maximum of 20 consecutive patients (per chiropractor) who sought chiropractic care for low back pain with or without sciatica with a duration of more than 2 weeks at the time of consultation and for a minimum of 30 days total during the past year. INTERVENTION: Chiropractic management as decided by the treating chiropractor. OUTCOME AND PREDICTOR VARIABL"
0042835,"Duval C, Lafontaine D, Hebert J, Leroux A, Panisset M, Boucher JP",The effect of Trager therapy on the level of evoked stretch responses in patients with Parkinson's disease and rigidity,J Manipulative Physiol Ther 2002 Sep;25(7):455-64,Trager therapy,"PARKINSON DIS, REFLEX, MUSCULOSKELETAL MANIPULATIONS",TREATMENT OUTCOME,,,,0161-4754,AB,"OBJECTIVE: To quantify changes of evoked stretch responses (ESR) in the most rigid arm of patients with Parkinson's disease (PD) after Trager therapy. METHODS: Gentle rocking motion associated with this type of manual therapy was imparted to the upper limbs and body of 30 patients for 20 minutes. A pretest and 2 posttests (at 1 and 11 minutes after the treatment, respectively) were performed, consisting of electromyographic (EMG) recordings of the flexor carpi radialis and extensor digitorum communis while the patient's wrist was passively flexed and extended with an amplitude of 60 degrees and a frequency of 1 Hz. Patients received the treatment on the most rigid side of their bodies (ipsi-group) or on the contralateral side (contra-group). Half of patients in each group received the treatment while lying supine on a massage table (ipsi- and contra-supine) or sitting in a chair (ipsi- and contra-sitting). RESULTS: In general, the level of ESR were reduced by 36% immediately after treatment and remained 32% lower than pretest values 11 minutes after treatment (F = 41.45, P less than .05). Patients who received the treatment lying supine benefited from a 42% reduction of ESR (F = 4.07, P less than .05). The side on which the treatment was performed did not significantly influence the outcome of the treatment (F = 0.50, P greater than .05). However, post hoc analysis of the triple interaction (test x side x position) indicated that the sitting position was much less efficient for sustained contralateral effect (P greater than .05). CONCLUSIONS: Results from the present study strongly suggest that it is possible to modify the level of ESR by using Trager therapy. This stretch reflex inhibition may induce a reduction of the muscle rigidity seen in these patients. (ABSTRACT TRUNCATED)."
0042836,"Kuhn DR, Yochum TR, Cherry AR, Rodgers SS",Immediate changes in the quadriceps femoris angle after insertion of an orthotic device,J Manipulative Physiol Ther 2002 Sep;25(7):465-70,,"ORTHOTIC DEVICES, THIGH, MUSCLES",TREATMENT OUTCOME,,,,0161-4754,AB,"OBJECTIVE: To measure changes in the quadriceps femoris angle (Q-angle) after the insertion of full-length flexible orthotics. SETTING: Outpatient health center of Logan College of Chiropractic. SUBJECTS: A total of 40 male subjects were included in the study population. The selected population all demonstrated bilateral pes planus or hyperpronation syndrome. DESIGN: Before-after trial. METHOD: A cohort demonstrating bilateral hyperpronation was recruited. The subjects were cast according to standard protocols provided by the manufacturer. Subject right and left Q-angles were measured with and without the orthotic in place. The landmarks used were marked with a permanent marker, and great care was taken to accurately assess the angles formed. The evaluator was not told whether the measure was before or after orthotic insertion. A modified quailcraft goniometer was used. Data Analysis: The data set was collected and assessed by the t test. RESULTS: Thirty-nine of 40 test subjects showed reduced Q-angle, which was in the direction of correction. A 2-tailed matched sample showed statistically significant mean reduction in Q-angle measures. There was a minority of patients who showed asymmetrical Q-angle measures. Within this group there was greater symmetry of Q-angle measures after placement of the orthotic. CONCLUSION: Insertion of full-length, flexible orthotic devices significantly improves the Q-angle in hyperpronating male subjects. If the literature accurately links an increase in the Q-angle with a predisposition for knee injury, then the possibility of long-term benefits following the use of flexible orthotics exists. More research is required to determine whether these biomechanical changes are maintained after use of these orthotics."
0042837,"Marcotte J, Normand MC, Black P",The kinematics of motion palpation and its effect on the reliability for cervical spine rotation,J Manipulative Physiol Ther 2002 Sep;25(7):471,,"CERVICAL VERTEBRAE, ROTATION, MANIPULATION CHIROPRACTIC","KINEMATICS, CLINICAL ASSESSMENT SCALES, CONSISTENCY AND RELIABILITY",,,,0161-4754,AB,"Background: The reliability of a test depends on its standardization. Instrumental measurement of the reproducibility of the test is an effective way to evaluate the level of standardization obtained. Improved standardization is believed to yield greater reliability. Objective: The objectives of this study were to measure the technical ability of an examiner to reproduce the 'kinematics of motion palpation for cervical spine rotation and to evaluate the effect of standardization on the reliability of the test. Design: A study of reproducibility of the kinematics of the test for cervical spine rotation was conducted by means of a computerized system of analysis of movement. The reliability when reproducibility was achieved was compared with reliability when it failed. Results: The data collected enable us to establish a standardized protocol for the execution of the test. The standardized palpation is executed within 6 degrees of inclination from the pure plane of rotation. The successful reproduction of the kinematics of the test raises its reliability to detect the presence of fixations (kappa raising from 0.337 and 0.352 to 0.682). Conclusions: A greater reliability, arising from a high level of reproducibility, enables us to document the advantages of the standardization of motion palpation in chiropractic. (Published as an abstract only. Full article is only available online)."
0042838,Michaud TC,Uneventful upper cervical manipulation in the presence of a damaged vertebral artery,J Manipulative Physiol Ther 2002 Sep;25(7):472-83,,"VERTEBRAL ARTERY, CERVICAL VERTEBRAE, SPINAL MANIPULATION, HEART DIS, MANIPULATION CHIROPRACTIC","CASE REPORT, SAFETY",,,,0161-4754,AB,"OBJECTIVE: To discuss a case in which a patient with a previously injured vertebral artery underwent manipulation in the upper cervical spine without alteration of her symptom pattern. The literature concerning the relative safety of specific upper cervical manipulative techniques is reviewed. Clinical Features: A 42-year-old woman had a 3-week history of unilateral suboccipital pain that she related to a sudden twisting of her head and neck that occurred while she was putting sheets of drywall on top of her car. Subsequent examination by a neurologist 2 weeks later was unremarkable, and a tension-type headache was diagnosed. Approximately 10 days later (3 weeks after injury), a single high-velocity upper-cervical manipulation (incorporating slight rotation and full lateral flexion) was performed with no change in her symptom pattern. Two weeks after that, the patient had development of a lateral medullary syndrome (also known as Wallenberg syndrome) after she briefly extended and rotated her upper cervical spine while painting a ceiling. Intervention and Outcome: The patient was treated with anticoagulant therapy, and the lateral medullary infarct healed without incident. The spinocerebellar and subtle motor symptoms also resolved, but the ipsilateral suboccipital headache and the loss of temperature sensation associated with the spinothalamic tract lesion were still present 9 months later. CONCLUSION: This case report demonstrates that vigorous manipulation of the upper cervical spine is possible without injuring an already damaged vertebral artery. It is suggested that the line of drive used during the single manipulation, almost pure lateral flexion with slight rotation, was responsible for the apparent innocuous response. Guidelines for the evaluation and management of vertebral artery dissection are reviewed. (ABSTRACT TRUNCATED)."
0042839,Smith RO,AJOT online: an opportunity for universal accessibility,Am J Occup Ther 2002 Sep-Oct;56(5):487-8,,"OCCUPATIONAL THERAPY, JOURNALS, INTERNET",INFORMATION SERVICES,(Editorial),,,0272-9490,,
0042840,"Trombly CA, Radomski MV, Trexel C, Burnet-Smith SE",Occupational therapy and achievement of self-identified goals by adults with acquired brain injury: phase II,Am J Occup Ther 2002 Sep-Oct;56(5):489-98,,"BRAIN INJURIES, OCCUPATIONAL THERAPY, GOALS, DISABILITY","METHODS, TREATMENT OUTCOME, PATIENT SATISFACTION, DISABILITY EVALUATION, ETIOLOGY, REHABILITATION",,,,0272-9490,AB,"OBJECTIVE: The purpose of this study was to investigate the association between participation in goal-specific outpatient occupational therapy and improvement in self-identified goals in adults with acquired brain injury. METHOD: Thirty-one persons with traumatic brain injury of mixed chronicity participated at three sites located in different regions of the United States. Using a repeated-measures design, therapy that usually was offered at each site to achieve specific goals was followed by a no-treatment period. Participants completed the Canadian Occupational PerFormance Measure Performance subscale (COPM-P) and Satisfaction subscale (COPM-S), and the Community Integration Questionnaire (CIQ) at admission, discharge, and 1 to 18 weeks after discharge. Goal attainment scales were developed at admission and scored at discharge; the differences for each site were tested, using dependent t tests. Gains for the treatment period (admission to discharge) in COPM subscales and the CIQ were compared with gains during the no-treatment period (discharge to follow-up) for each site, using dependent t tests. The results were synthesized meta-analytically across the sites. RESULTS: The participants identified a total of 149 goals, 81% of which were achieved. Goal attainment T scores improved significantly (Z = 7.52, p less than .001), and the combined effect size was large (r = .94). The COPM-P (Z = 4.13, p less than .001) and COPM-S (Z = 4.25, p less than .001) showed significantly greater gains during the treatment (average 15.3 weeks) versus the no-treatment (average 9.9 weeks) period. Effect size estimates were large: .71 and .76, respectively. Gain scores of the CIQ did not differ significantly (Z = .75, p = .22, r = .29) between periods. CONCLUSION: Participation in goal-specific outpatient occupational therapy that focused (ABSTRACT TRUNCATED)."
0042841,"Gardarsdottir S, Kaplan S",Validity of the Arnadottir OT-ADL Neurobehavioral Evaluation (A-ONE): performance in activities of daily living and neurobehavioral impairments of persons with left and right hemisphere damage,Am J Occup Ther 2002 Sep-Oct;56(5):499-508,,"ACTIVITIES OF DAILY LIVING, NEUROLOGIC MANIFESTATIONS, DISABILITY EVALUATION, CEREBROVASCULAR DISORDERS","CONSISTENCY AND RELIABILITY, DIAGNOSIS, PHYSIOPATHOLOGY, ETIOLOGY",,,,0272-9490,AB,"OBJECTIVE: The Arnadottir OT-ADL Neurobehavioral Evaluation (A-ONE) is a standardized assessment that links performance in activities of daily living (ADL) to neurobehavioral impairments. This study tested the construct validity of the A-ONE. METHOD: From two hospitals in Iceland, 42 patients between 45 and 87 years of age who had sustained either a right or a left cerebrovascular accident (CVA) were evaluated on the Functional Independence Scale (FIS) and Neurobehavioral Specific Impairment Subscale (NSIS) of the A-ONE. The Mann Whitney Utest and chi-square test were used to explore possible differences between the performance of participants with left and right CVA. Descriptive statistics were calculated for demographic data and for items on the FIS and NSIS. The level of significance was set at p less than .05. RESULTS: Three of 18 ADL items observed on the FIS and 13 of 46 items on the NSIS discriminated at a statistically significant level between the left and right CVA groups. CONCLUSION: The results provide minimal support for the construct validity of the A-ONE related to differentiating between ADL performance of persons with left and right CVA. However, results regarding the ability of the A-ONE to detect and lateralize impairments agreed with literature regarding lesion sites for the impairments."
0042842,"Goverover Y, Hinojosa J",Categorization and deductive reasoning: predictors of instrumental activities of daily living performance in adults with brain injury,Am J Occup Ther 2002 Sep-Oct;56(5):509-16,,"BRAIN INJURIES, ACTIVITIES OF DAILY LIVING, MENTAL PROCESSES, COGNITION, DISABILITY EVALUATION","PREDICTIVE VALUE OF TESTS, CLINICAL ASSESSMENT SCALES, PHYSIOPATHOLOGY",,,,0272-9490,AB,"OBJECTIVE: The purpose of this study was to examine the predictive relationship of categorization and deductive reasoning abilities to performance of instrumental activities of daily living (IADL) among adults with brain injury. METHOD: A correlational research design was used to examine the performance of 19 patients from a neurosurgery acute care unit on Toglia's Category Assessment (TCA), the Deductive Reasoning test (DR), and the Observed Tasks of Daily Living-Revised. RESULTS: Multiple regression analysis indicated that categorization and deductive reasoning accounted for a significant proportion of the variance in IADL performance scores, with deductive reasoning making the greater contribution. Demographic characteristics such as age and education reduced the power of the previous variables, especially of the categorization. CONCLUSION: The results of this study indicate that assessments of categorization and deductive reasoning abilities of persons with brain injury may be good predictors of IADL functional performance. Results support the use of the TCA and DR as quick measures of a person's cognitive and functional abilities. Furthermore, this study provides preliminary results to support that categorization and deductive reasoning abilities are fundamental for the performance of IADL skills."
0042843,Peloquin SM,Reclaiming the vision of reaching for heart as well as hands,Am J Occup Ther 2002 Sep-Oct;56(5):517-26,,"OCCUPATIONAL THERAPY, PROFESSIONAL PATIENT RELATIONS","PHILOSOPHY, PROFESSIONAL PRACTICE",,,,0272-9490,AB,"Although infrequently discussed in the professional literature, visionary language and visual imagery are identifiable elements within occupational therapy's culture. They seem part of the profession's desire to characterize, affirm, and renew itself. One early vision of practice, that of reaching for heart as well as hands, is the subject of this inquiry that extends a prior discussion of visions in occupational therapy. Central to the inquiry are the early vision's (a) origin, exemplification, and clarity of meaning within one autobiographical text and (b) merits for the profession's characterization, affirmation, and renewal. The early vision of reaching for heart as well as hands may benefit the profession today by characterizing the ethos of occupational therapy as integrative, affirming its practice as occupational, and inspiring its practitioners to renew a commitment to caring."
0042844,"Lohman H, Royeen C",Posttraumatic stress disorder and traumatic hand injuries: a neuro-occupational view,Am J Occup Ther 2002 Sep-Oct;56(5):527-37,,"STRESS DISORDERS POST TRAUMATIC, HAND INJURIES","NEUROSCIENCES, MODELS THEORETICAL, PSYCHOLOGY, OCCUPATIONAL THERAPY",,,,0272-9490,AB,"Using the clinical phenomenon of posttraumatic stress disorder related to traumatic hand injuries, this article conceptually explores the theoretical construct of neuro-occupation on the basis of these conditions. Neuro-occupation is an evolving concept that combines knowledge and understanding of occupation with knowledge and understanding of how the human brain functions in environmental context; thus, the concept is important to the core of occupational therapy practice. The first section of the article introduces the concept of neuro-occupation; the second provides an overview of posttraumatic stress disorder and traumatic hand injury. To help therapists better understand behavior seen in clinical settings, the third section presents key neuro-occupational processes pertaining to posttraumatic stress disorder, using clinical application examples. Finally, a query about the value of neuro-occupation as a developing theoretical construct is put forth."
0042845,"Baranek GT, Chin YH, Hess LM, Yankee JG, Hatton DD, Hooper SR",Sensory processing correlates of occupational performance in children with fragile X syndrome: preliminary findings,Am J Occup Ther 2002 Sep-Oct;56(5):538-46,fragile x syndrome,"SENSORY INTEGRATION, SELF CARE, TASK PERFORMANCE AND ANALYSIS","MENTAL RETARDATION, CHROMOSOME ABNORMALITIES, CHILD, PHYSIOPATHOLOGY, MALE, INTELLIGENCE, AGE FACTORS, DEFENSE MECHANISMS",,,,0272-9490,AB,"OBJECTIVES. This preliminary study examined sensory processing and its relationship to occupational performance in children with fragile X syndrome (FXS) to guide research and evidence-based practice. METHOD. Fifteen school-aged boys with full-mutation FXS were assessed with three occupational performance measures (School Function Assessment, Vineland Adaptive Behavior Scales, play duration) and three sensory processing measures (Sensory Profile, Tactile Defensiveness and Discrimination Test-Revised, Sensory Approach-Avoidance Rating). Data were analyzed using partial correlation procedures. RESULTS. Several significant correlations were found, independent of effects of age and IQ. Avoidance of sensory experiences (internally controlled) was associated with lower levels of school participation, self-care, and play. Aversion to touch from externally controlled sources was associated with a trend toward greater independence in self-care--opposite of expectations. CONCLUSION. This study links sensory processing vulnerabilities with individual differences in occupational performance and supports a dynamic view of self-organizing systems. Children's uses of avoidant versus independent behaviors may reflect different self-regulatory or coping strategies that potentially mediate the relationship between sensory processing deficits and occupational behaviors and warrant further investigation."
0042846,"Parush S, Winokur M, Goldstand S, Miller LJ",Prediction of school performance using the Miller Assessment for Preschoolers (MAP): a validity study,Am J Occup Ther 2002 Sep-Oct;56(5):547-55,,"READING, HANDWRITING, EDUCATIONAL MEASUREMENT","SCHOOLS, CHILD PRESCHOOL, PREDICTIVE VALUE OF TESTS, CONSISTENCY AND RELIABILITY, FOLLOW UP STUDIES",,,,0272-9490,AB,"OBJECTIVE: The purpose of this study was to examine the ability of the Miller Assessment for Preschoolers (MAP) to predict academic performance of Israeli preschoolers after a period of 5 to 7 years. METHOD: Thirty children who were classified according to the MAP as preschoolers at risk (n = 15) and not at risk (n = 15) for pre-academic problems were tracked after 5 to 7 years. Follow-up evaluations were done on motor, visual-motor integrative, and cognitive performance components; reading and handwriting academic performance areas; and a variety of measures taken to establish overall school functional status. RESULTS: Results indicate that children classified by the MAP as preschoolers at risk performed significantly worse 5 to 7 years later on visual-motor, cognitive, and reading and handwriting tests than those preschoolers classified not at risk and demonstrated reduced overall school functional status. CONCLUSION: The findings indicate that the MAP can predict academic performance even over a 5-year to 7-year interval. Furthermore, by linking academic performance data to performance components of children in different cultures, our investigation contributes to the overall understanding of children's functioning."
0042847,"Hinojosa J, Sproat CT, Mankhetwit S, Anderson J",Shifts in parent-therapist partnerships: twelve years of change,Am J Occup Ther 2002 Sep-Oct;56(5):556-63,,"PROFESSIONAL FAMILY RELATIONS, CHILD DEVELOPMENT DISORDERS, ATTITUDE OF HEALTH PERSONNEL","OCCUPATIONAL THERAPY, CHILD PRESCHOOL, KNOWLEDGE, PROFESSIONAL PRACTICE",,,,0272-9490,AB,"OBJECTIVE: A national survey was conducted to identify occupational therapists' current attitudes and values in their working relationships with parents of preschool children with developmental disabilities. This study replicated a 1987 national survey that examined therapists' relationships with parents of preschool children with cerebral palsy. METHOD: Surveys were sent to a random sample of 400 therapists, with 199 returned from respondents who identified themselves as working with preschool children with developmental disabilities. After calculating descriptive statistics for each item in the survey, a one-way analysis of variance was performed to test for differences based on four demographic variables. RESULTS: Respondents reported that working with parents, more than any other aspect of intervention, had the greatest impact on the progress of a child with disabilities. Consistent with the 1987 survey, respondents believed that parents focus on their own adjustment to their child's disability as well as on their child's progress more than any other issues. Therapists continue to report satisfaction when generating positive change for child and parent through education and use of clinical knowledge and skill. CONCLUSION: Results suggest that efforts to foster family-centered intervention in occupational therapy educational programs are increasing therapists' confidence and skills in working with parents of children with disabilities. Implications for occupational therapy practice and education include a need for therapists to expand their knowledge and expertise in working effectively with vulnerable families. Educators need to focus on teaching strategies not only to refine the role of occupational therapy as a direct treatment provider, but also to incorporate creative ways to deal with the psychosocial issues of parents and families."
0042848,"Yakimishyn JE, Magill-Evans J","Comparisons among tools, surface orientation, and pencil grasp for children 23 months of age",Am J Occup Ther 2002 Sep-Oct;56(5):564-72,,"PSYCHOMOTOR PERFORMANCE, HANDWRITING","INFANT, TASK PERFORMANCE AND ANALYSIS, COMPARATIVE STUDY",,,,0272-9490,AB,"OBJECTIVE: The purpose of this study was to determine whether writing tool type and angle of writing surface affect grasp. METHOD: Fifty-one children 23 to 24 months of age who were typically developing drew with a primary marker, colored pencil, and small piece of crayon on a table and an easel. The marker and pencil were presented pointing left, right, and toward the child. The order of writing tool presentation was counterbalanced. Grasps were scored with a 5-point rating system and analyzed with dependent t tests. RESULTS: Children used a more mature grasp when drawing with a piece of crayon than with a pencil. No difference in grasp maturity was found when using a pencil compared with a marker. A more mature grasp when drawing on the easel compared with the table was used with the crayon but not with the marker or pencil. CONCLUSION: Results imply that a short writing tool combined with a vertical surface can influence the grasp of young children."
0042849,"Sharry R, McKenna K, Tooth L",Occupational therapists' use and perceptions of written client education materials,Am J Occup Ther 2002 Sep-Oct;56(5):573-6,,"OCCUPATIONAL THERAPY, ATTITUDE OF HEALTH PERSONNEL, PATIENT EDUCATION","STANDARDS, COMMUNICATION, KNOWLEDGE, AGE FACTORS",,,,0272-9490,AB,"OBJECTIVE: The purpose of this study was to examine occupational therapists' use and perceptions of written education materials for clients and the factors that therapists consider before distributing written materials to clients. This study also aimed to determine whether use and perceptions of these materials differed for older clients. METHOD: A random sample of 50 occupational therapists from Queensland, Australia, working in adult physical disabilities settings was surveyed with a structured questionnaire. Data were analyzed descriptively and with nonparametric statistics. RESULTS: Of 49 participants who used written materials, 54% had given them to more than half of their last 10 clients, regardless of the clients' age. Written materials, most often information sheets developed by the participants themselves; handwritten notes; and pamphlets were principally used to reinforce verbal information. Clients' cognitive abilities, primary language, communication skills, vision, and level of education most often were considered before distributing written materials. Although participants generally were positive about the content and effectiveness of materials, ratings were significantly less positive related to older clients. CONCLUSION: Client education was a core treatment modality for participants in this study, with written media most commonly being used to supplement verbal education. Because participants were least positive about the effectiveness of written materials for older clients, further development of materials for this audience may be indicated."
0042850,"Salls JS, Silverman LN, Gatty CM",The relationship of infant sleep and play positioning to motor milestone achievement,Am J Occup Ther 2002 Sep-Oct;56(5):577-80,,"MOTOR SKILLS, SLEEP, PLAY AND PLAYTHINGS, PRONE POSITION, SUPINE POSITION","CHILD DEVELOPMENT, COMPARATIVE STUDY, INFANT",,,,0272-9490,AB,"OBJECTIVE: Limited information is available on how sleep and play positions affect infant gross motor skills and occupational development. The overall objective of this descriptive developmental pilot study was to compare normative and sampled infants relative to sleep and awake positioning using the Denver II Gross Motor Sector. METHOD: A cross-sectional sample of 66 infants 2.0 (n = 23), 4.1 (n = 26), and 6.0 (n = 17) months of age were administered the Denver II Gross Motor Sector. Caregivers identified infants' primary sleep positions and amount of awake-time in prone. Data were analyzed using chi-square goodness-of-fit tests. RESULTS: The sample of 2.0-month-old supine and side sleeping infants differed significantly from the normative population on three gross motor milestones. Two-month-old infants spending 15 min or fewer of awake-time in prone passed the gross motor milestones at significantly lower percentages than the normative population. No significant differences were noted between sampled and normative populations at 4.1 and 6.0 months of age. CONCLUSION: Results suggest that infant gross motor development may be related to sleep and play positioning. Information regarding infants' sleep and awake positioning may be important to occupational therapists when evaluating gross motor development. Implications for caregiver education and future research are proposed."
0042851,"Su CT, Parham LD",Generating a valid questionnaire translation for cross-cultural use,Am J Occup Ther 2002 Sep-Oct;56(5):581-5,,"OCCUPATIONAL THERAPY, LANGUAGE, QUESTIONNAIRES","CULTURE, PROGRAM DEVELOPMENT, CASE REPORT",,,,0272-9490,AB,Occupational therapists who are interested in exporting occupational science concepts or occupational therapy practice principles to different cultural groups often encounter problems surrounding the translation of information from one language to another. The case example presented in this article illustrates how one might go about generating a valid translation of a questionnaire with the use of current cross-cultural research guidelines for the translation process. Issues surrounding cultural relevance and linguistic meaning are of central concern in the translation process.
0042852,"Colon H, Haertlein C",Spanish translation of the role checklist,Am J Occup Ther 2002 Sep-Oct;56(5):586-9,,"OCCUPATIONAL THERAPY, CLINICAL ASSESSMENT SCALES, QUESTIONNAIRES, ROLE, LANGUAGE","SPAIN, CONSISTENCY AND RELIABILITY, CULTURE, PROGRAM DEVELOPMENT",,,,0272-9490,AB,"OBJECTIVE: The purpose of this study was to create a Spanish version of the Role Checklist that is content valid and reliable and to demonstrate usefulness of a translation method. METHOD: A modified version of the translation method of Hachey, Jumoorty, and Mercier was used to translate the English Role Checklist into Spanish. The English and Spanish versions were then evaluated for test-retest reliability at a 2-week interval, using 14 bilingual college students. RESULTS: The intralanguage correlation was .907 for Part I and .798 for Part II. CONCLUSION: A content valid and reliable Spanish version of the Role Checklist was created, using replicable translation methods."
0042853,Dimeo SB,How can professional activity at the student level be increased?,Am J Occup Ther 2002 Sep-Oct;56(5):590-2,,"OCCUPATIONAL THERAPY, ATTITUDE OF HEALTH PERSONNEL","STUDENTS, EDUCATION PROFESSIONAL",,,,0272-9490,,
0042854,"Meltzer DD, Pels S, Payne WG, Mannari RJ, Ochs D, Forbes-Kearns J, Robson MC",Decreasing amputation rates in patients with diabetes mellitus. An outcome study,J Am Podiatr Med Assoc 2002 Sep;92(8):425-8,,"DIABETES MELLITUS, AMPUTATION, WOUND HEALING, AMPUTATION STUMPS, DIABETIC FOOT, PATIENT CARE TEAM","COMPLICATIONS, EPIDEMIOLOGY, ETIOLOGY, TREATMENT OUTCOME, LEG, OUTCOME AND PROCESS ASSESSMENT",,,,8750-7315,AB,"The lower-extremity amputation rate in people with diabetes mellitus is high, and the wound failure rate at the time of amputation is as high as 28%. Even with successful healing of the primary amputation site, amputation of part of the contralateral limb occurs in 50% of patients within 2 to 5 years. The purpose of this study was to provide valid outcome data before (control period) and 18 months after (test period) implementation of a multidisciplinary team approach using verified methods to improve the institutional care of wounds. Retrospective medical chart review was performed for 118 control patients and 116 test patients. The amputation rate was significantly decreased during the test period, and the amputations that were required were at a significantly more distal level. No above-the-knee amputations were required in 45 patients during the test period, compared with 14 of 76 patients during the control period. These outcome data suggest that unified care is an effective approach for the patient with diabetic foot problems."
0042855,"Wang JC, Le AW, Tsukuda RK",A new technique for Charcot's foot reconstruction,J Am Podiatr Med Assoc 2002 Sep;92(8):429-36,,"PERIPHERAL NERVOUS SYSTEM DIS, FOOT DEFORMITIES, RECONSTRUCTIVE SURGICAL PROCEDURES, DIABETES MELLITUS","COMPLICATIONS, METHODS, DISLOCATIONS, FRACTURE FIXATION, TREATMENT OUTCOME",,,,8750-7315,AB,"External fixation was used to reduce or arrest progressive degeneration in 28 patients with Charcot's foot dislocations. Adjunctive procedures included tendo Achilles lengthening and application of an external bone stimulator. Advantages of using external fixation are that surgeries are usually performed percutaneously and that most patients are weightbearing in 10 to 14 days. There was no incidence of pin tract infection or further foot collapse, with the longest follow-up period being 24 months. The authors propose that use of external fixation with bone stimulation may be an effective alternative method of treating the Charcot foot."
0042856,"Friedlander AH, Jones LJ","The biology, medical management, and podiatric implications of menopause",J Am Podiatr Med Assoc 2002 Sep;92(8):437-43,,"MENOPAUSE, ESTROGEN REPLACEMENT THERAPY, OSTEOPOROSIS, FOOT INJURIES","PHYSIOLOGY, DRUG THERAPY, ETIOLOGY, FRACTURES, BIOMECHANICS",,,,8750-7315,AB,"Approximately 36 million women in the United States are in the postmenopausal phase of life, creating unique challenges for the provision of compassionate, comprehensive podiatric medical treatment. Long-term estrogen deprivation arising from menopause in association with age-related factors disproportionately increases the risk of ischemic heart disease, osteoporosis, and concomitant podiatric complications. This article discusses the physiologic basis of menopause, hormone replacement therapy and its effects on osteoporosis, and other podiatric implications of menopause. Podiatric physicians caring for larger numbers of peri- and postmenopausal women must formulate a comprehensive management plan for treating fractures that arise from a combination of estrogen-deprivation osteoporosis and abnormal foot biomechanics."
0042857,"Vohra PK, Kincaid BR, Japour CJ, Sobel E",Ultrasonographic evaluation of plantar fascia bands. A retrospective study of 211 symptomatic feet,J Am Podiatr Med Assoc 2002 Sep;92(8):444-9,,"FASCIITIS PLANTAR, HEEL, PAIN","ULTRASONOGRAPHY, PATHOLOGY, DIAGNOSIS",,,,8750-7315,AB,"The authors measured the thickness of the medial, central, and lateral bands of the plantar fascia using ultrasonographic techniques in 109 symptomatic patients with 211 painful heels. Plantar fasciitis was diagnosed by the presence of plantar heel pain and tenderness of the plantar fascia on palpation and was correlated with plantar fascia thickness. All of the symptomatic feet had medial band tenderness, with an average thickness of 5.9 mm, 68% had central band tenderness, with an average thickness of 5.3 mm, and 26% had lateral band tenderness, with an average thickness of 4.4 mm. The average thickness of all symptomatic bands was 5.35 mm, which was significantly greater than that for all asymptomatic bands, which was 2.70 mm. There were also significant differences in the thickness of the three plantar fascia bands in symptomatic patients. A plantar fascia index was established consisting of the ratio of the mean thickness of symptomatic medial, central, and lateral plantar fascia bands to that of asymptomatic bands; for this study, the index value is 1.98 (5.35/2.70 mm)."
0042858,"Chan MK, Chong LY",A prospective epidemiologic survey on the prevalence of foot disease in Hong Kong,J Am Podiatr Med Assoc 2002 Sep;92(8):450-6,,"FOOT DIS, HEALTH SURVEYS, QUALITY OF LIFE","HONG KONG, EPIDEMIOLOGY",,,,8750-7315,AB,"A prospective epidemiologic survey on the prevalence of foot disease in Hong Kong found foot disease in 64% of patients screened. All of the patients were ethnically Chinese. Of the conditions specified in the questionnaire, fungal foot infection, tinea pedis, and toenail onychomycosis were the most frequently encountered conditions, followed by metatarsal corns, eczema, psoriasis, and pes planus. Vascular disease, osteoarticular pathology, diabetes mellitus, obesity, atopy, and participation in sports were the main factors coexisting with the foot conditions. Of the study population, 17% and 21% reported that their quality of life was affected by pain and discomfort, respectively. These percentages are much lower than those obtained in other studies; it may therefore be inferred that foot complaints are being neglected by the ethnic Chinese population in Hong Kong."
0042859,"DeNamur C, Pupp G",Diabetic limb salvage: a team approach at a teaching institution,J Am Podiatr Med Assoc 2002 Sep;92(8):457-62,limb salvage,"DIABETES MELLITUS, AMPUTATION, DIABETIC FOOT, PATIENT CARE TEAM","RECONSTRUCTIVE SURGICAL PROCEDURES, PREVENTION, LEG, COMPLICATIONS, METHODS",,,,8750-7315,AB,"In this retrospective review, 19 diabetic patients with significant lower-extremity pathology were assessed to determine the success of limb salvage in cases of varying complexity. The patients were either scheduled or at risk for below-the-knee amputation before intervention. After the limb-salvage procedure, patients were followed for 4 months to 9 years. Eighteen patients went on to have successful procedures, avoiding below-the-knee amputation; one patient had an above-the-knee amputation. The results demonstrate the benefits of an aggressive team approach with limb salvage as a goal."
0042860,"Deroy AR, Clause CC, Baskin ES, Bauer GR",Recognition of the flexor digitorum accessorius longus,J Am Podiatr Med Assoc 2002 Sep;92(8):463-6,,"MUSCLE SKELETAL, FOOT","ANATOMY, CADAVER, EDUCATION MEDICAL",,,,8750-7315,AB,"The flexor digitorum accessorius longus muscle was observed during a cadaveric surgery course on the foot and ankle for third-year podiatric medical students. The cadaveric foot had been amputated just proximal to the ankle level so that the muscle origin could not be determined; its insertion, however, was found to be into the flexor digitorum longus tendon, just before the tendon split into its digital slips. This article reviews the literature on the muscle and its clinical implications and describes and shows the muscle as it was seen in this case."
0042861,"Zielaskowski LA, Pontious J",Extensor hallucis longus tendon rupture repair using a fascia lata allograft,J Am Podiatr Med Assoc 2002 Sep;92(8):467-70,,"TENDON INJURIES, RUPTURE, HALLUX VALGUS, RECONSTRUCTIVE SURGICAL PROCEDURES","COMPLICATIONS, ETIOLOGY, METHODS, CASE REPORT",,,,8750-7315,AB,"The authors present a case of a traumatic extensor hallucis longus tendon rupture sustained 2 days after hallux valgus and hammer toe correction. The ruptured tendon, separated by a 6-cm defect, was repaired using a fascia lata allograft. This case demonstrates a serious complication of a commonly performed procedure and a salvage technique useful for dealing with large tendon defects."
0042862,"Angirasa AK, Koch AZ",P-glycoprotein as the mediator of itraconazole-digoxin interaction.,J Am Podiatr Med Assoc 2002 Sep;92(8):471-2,itraconazole,"DRUG INTERACTIONS, ANTIFUNGAL AGENTS, DIGOXIN, GLYCOPROTEINS, FOOT DERMATOSES","PHARMACOLOGY, ADVERSE EFFECTS, PHYSIOLOGY, DRUG THERAPY",(Letter),,,8750-7315,,
0042863,Naas JE,Secondary erythromelalgia,J Am Podiatr Med Assoc 2002 Sep;92(8):472-4,erythromelalgia,"FOOT DIS, ASPIRIN","VASCULAR DIS, ETIOLOGY, DIAGNOSIS, CASE REPORT, DRUG THERAPY, TREATMENT OUTCOME",(Letter),,,8750-7315,,
0042864,Viehe RB,Diabetic foot care: podiatric physicians are the experts,J Am Podiatr Med Assoc 2002 Sep;92(8):477,,"DIABETIC FOOT, PODIATRY","THERAPY, KNOWLEDGE",,,,8750-7315,,
0042865,"McCormick D, Himmelstein DU, Woolhandler S, Wolfe SM, Bor DH",Relationship between low quality-of-care scores and HMOs' subsequent public disclosure of quality-of-care scores,JAMA 2002 Sep 25;288(12):1484-90,disclosure,"QUALITY OF HEALTH CARE, HEALTH MAINTENANCE ORGANIZATIONS","COMMUNICATION, UNITED STATES, DATA COLLECTION",,,,0098-7484,AB,"CONTEXT: Public disclosure of quality data on health maintenance organizations (HMOs) might improve public accountability, inform consumer decision making, and promote quality improvement. But, because disclosure is voluntary, some HMOs could subvert these objectives by refusing to release unfavorable data. OBJECTIVE: To determine the association between HMO quality of care and withdrawal from public disclosure of quality-of-care data the subsequent year. DESIGN AND SETTING: Retrospective cohort study of administrative and quality-of-care data on HMOs from the National Committee for Quality Assurance (NCQA) annual Quality Compass databases for 1997, 1998, and 1999, including Health Plan Employer Data and Information Set (HEDIS) quality scores. MAIN OUTCOME MEASURE: One-year rates of HMO withdrawal from public disclosure of HEDIS scores for plans in the highest and lowest tertiles of HEDIS scores, adjusted for method of data collection and plan model type. RESULTS: Of the 329 HMOs that publicly disclosed HEDIS scores in 1997, 161 plans (49%) withdrew from public disclosure in 1998. Of the 292 HMOs that disclosed their scores in 1998 (including 130 newly participating plans), 67 plans (23%) withdrew from public disclosure in 1999. Plans whose scores ranked in the lowest-quality tertile were much more likely than plans ranking in the highest-quality tertile to withdraw from public disclosure in 1998 (odds ratio (OR), 3.6; 95% confidence interval (CI), 2.1-7.0) and 1999 (OR, 5.7; 95% CI, 2.7-17.7). CONCLUSION: Compared with HMOs receiving higher quality-of-care scores, lower-scoring plans are more likely to stop disclosing their quality data. Voluntary reporting of quality data by HMOs is ineffective; selective nondisclosure undermines both informed consumer decision making and public accountability."
0042866,"Roberts L, Little P, Chapman J, Cantrell T, Pickering R, Langridge J",The back home trial: general practitioner-supported leaflets may change back pain behavior,Spine 2002 Sep 1;27(17):1821-8,,"BACKACHE, PATIENT EDUCATION, PUBLICATIONS, HEALTH BEHAVIOR, ATTITUDE TO HEALTH","LOW BACK PAIN, RANDOMIZED CONTROLLED TRIALS, KNOWLEDGE, SELF CARE, FOLLOW UP STUDIES",,,,0362-2436,AB,"STUDY DESIGN: A single-blind randomized controlled trial of a leaflet developed for people with acute low back pain was compared with the usual general practitioner management of back pain. OBJECTIVE: To test the effectiveness of a patient information leaflet on knowledge, attitude, behavior, and function. SUMMARY OF BACKGROUND DATA: Despite the commonality of back pain in general practice, little evidence on the effectiveness of simple interventions such as leaflets and advice on self-management has been reported. On the basis of a five-stage needs analysis, a simple leaflet was developed that considered the views of patients and health professionals. METHODS: For this study, 64 patients with acute back pain were assigned to the leaflet or control group. The participants were visited at home after 2 days, 2 weeks, then 3, 6, and 12 months, where they completed a range of self-report measures. Behavioral aspects were discretely recorded by a \"blinded\" researcher. Primary outcomes were knowledge, attitude, behavior, and function. RESULTS: In all, 272 home visits were undertaken. The findings show that at 2 weeks, knowledge about sitting posture was greater in the leaflet group (P = 0.006), which transferred to a behavioral difference (sitting with lumbar lordosis support) when participants were unaware that they were being observed (P = 0.009). This difference remained significant at 3 months. Patients in the leaflet group also were better at maintaining a wide base of support when lifting a light object than the control subjects throughout all five assessments. There were no significant differences in the functional outcomes tested. CONCLUSIONS: This trial demonstrates that written advice for patients can be a contributory factor in the initial general practitioner consultation because it may change aspects of knowledge and behavior. (ABSTRACT TRUNCATED)."
0042867,"Rittweger J, Just K, Kautzsch K, Reeg P, Felsenberg D",Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: a randomized controlled trial,Spine 2002 Sep 1;27(17):1829-34,,"LOW BACK PAIN, VIBRATION, EXERCISE THERAPY, RESISTANCE TRAINING","CHRONIC DIS, TREATMENT OUTCOME, RANDOMIZED CONTROLLED TRIALS, FOLLOW UP STUDIES, METHODS, COMPARATIVE STUDY",,,,0362-2436,AB,"STUDY DESIGN: A randomized controlled trial with a 6-month follow-up period was conducted. OBJECTIVE: To compare lumbar extension exercise and whole-body vibration exercise for chronic lower back pain. SUMMARY OF BACKGROUND DATA: Chronic lower back pain involves muscular as well as connective and neural systems. Different types of physiotherapy are applied for its treatment. Industrial vibration is regarded as a risk factor. Recently, vibration exercise has been developed as a new type of physiotherapy. It is thought to activate muscles via reflexes. METHODS: In this study, 60 patients with chronic lower back pain devoid of \"specific\" spine diseases, who had a mean age of 51.7 years and a pain history of 13.1 years, practiced either isodynamic lumbar extension or vibration exercise for 3 months. Outcome measures were lumbar extension torque, pain sensation (visual analog scale), and pain-related disability (pain disability index). RESULTS: A significant and comparable reduction in pain sensation and pain-related disability was observed in both groups. Lumbar extension torque increased significantly in the vibration exercise group (30.1 Nm/kg), but significantly more in the lumbar extension group (+59.2 Nm/kg; EM 10 .2; P less than 0.05). No correlation was found between gain in lumbar torque and pain relief or pain-related disability (P greater than 0.2). CONCLUSIONS: The current data indicate that poor lumbar muscle force probably is not the exclusive cause of chronic lower back pain. Different types of exercise therapy tend to yield comparable results. Interestingly, well-controlled vibration may be the cure rather than the cause of lower back pain."
0042868,"Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C",A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache,Spine 2002 Sep 1;27(17):1835-43,,"HEADACHE, MANIPULATION, EXERCISE THERAPY","RANDOMIZED CONTROLLED TRIALS, TREATMENT OUTCOME, ETIOLOGY, NECK PAIN",,,"To determine the effectiveness of manipulative therapy and a low-load exercise program for cervicogenic headache when used alone and in combination, as compared with a control group. SUMMARY OF BACKGROUND DATA: Headaches arising from cervical musculoskeletal disorders are common. Conservative therapies are recommended as the first treatment of choice. Evidence for the effectiveness of manipulative therapy is inconclusive and available only for the short term. There is no evidence for exercise, and no study has investigated the effect of combined therapies for cervicogenic headache. METHODS: In this study, 200 participants who met the diagnostic criteria for cervicogenic headache were randomized into four groups: manipulative therapy group, exercise therapy group, combined therapy group, and a control group. The primary outcome was a change in headache frequency. Other outcomes included changes in headache intensity and duration, the Northwick Park Neck Pain Index, medication intake, and patient satisfaction. Physical outcomes included pain on neck movement, upper cervical joint tenderness, a craniocervical flexion muscle test, and a photographic measure of posture. RESULTS: There were no differences in headache-related and demographic characteristics between the groups at baseline. The loss to follow-up evaluation was 3.5%. At the 12-month follow-up assessment, both manipulative therapy and specific exercise had significantly reduced headache frequency and intensity, and the neck pain and effects were maintained (P less than 0.05 for all). (ABSTRACT TRUNCATED).",0362-2436,AB,"STUDY DESIGN: A multicenter, randomized controlled trial with unblinded treatment and blinded outcome assessment was conducted. The treatment period was 6 weeks with follow-up assessment after treatment, then at 3, 6, and 12 months. OBJECTIV"
0042869,"Verbeek JH, Van Der Weide WE, Van Dijk FJ",Early occupational health management of patients with back pain: a randomized controlled trial,Spine 2002 Sep 1;27(17):1844-51,,"LOW BACK PAIN, OCCUPATIONAL HEALTH SERVICES","RANDOMIZED CONTROLLED TRIALS, OCCUPATIONAL THERAPY, TREATMENT OUTCOME, FOLLOW UP STUDIES, COMPARATIVE STUDY, SICK LEAVE",,,,0362-2436,AB,"STUDY DESIGN: A randomized controlled trial in occupational health practice was conducted. OBJECTIVE: To study the efficacy of early management of workers with low back pain by occupational physicians, as compared with management by the supervisor only. SUMMARY OF BACKGROUND DATA: Health care and university workers with back pain and on sick leave for less than 1 month were included in the study. METHODS: Patients with low back pain for at least 10 days on sick leave were randomly assigned to early management by the occupational physician (n = 61) or to a reference group with management by the worker's supervisor during the first 3 months of sick leave (n = 59). The patients were observed for 1 year and compared in terms of time until return to work, pain intensity, functional disability, and general health perception. The occupational physicians were provided with management guidelines. RESULTS: No significant differences were found after 3 and 12 months of follow-up evaluation in terms of time until return to work (hazard ratio, 1.3; 95% CI, 0.90-1.90) or in terms of other health outcomes. Recurrences, however, occurred more frequently in the intervention group, but the total duration of sick leave in 1 year did not differ between the groups. CONCLUSIONS: The findings do not show a significant positive effect of an early intervention by occupational physicians on workers with low back pain. This might reflect the early phase of disability or the low intensity of the intervention resulting from overestimation of the physicians' compliance with the guidelines."
0042870,"Crawford NR, Duggal N, Chamberlain RH, Chan Park S, Sonntag VK, Dickman CA",Unilateral cervical facet dislocation: injury mechanism and biomechanical consequences,Spine 2002 Sep 1;27(17):1858-64,,"DISLOCATIONS, CERVICAL VERTEBRAE, JOINT INSTABILITY","CADAVER, BIOMECHANICS, WEIGHT BEARING, ETIOLOGY, ROTATION",,,"To assess the relative stability and kinematics of the spine in the normal condition, after unilateral facet lock without bony injury and after reducing (unlocking) the facet dislocation. SUMMARY OF BACKGROUND DATA: Experimental unilateral facet dislocation has been studied only when associated with extensive damage to disc, bone, or both. The relative stability of the normal, locked, and unlocked cervical spine has not been studied. METHODS: Unilateral facet dislocation with minimal associated injury was created by slowly applying axial torque while specimens were bent laterally and flexed. Before and after injury, nondestructive torques were applied about each anatomic axis, while three-dimensional specimen motion was recorded stereophotogrammetrically. RESULTS: Unilateral facet dislocation was created with a mean axial torque of 10.2 +/- 2.7 Nm. After locking, range of motion, lax zone, and stiff zone were significantly reduced relative to normal (P less than 0.05). After unlocking, the same parameters were significantly increased relative to normal. The position of the axis of rotation shifted when the facet was locked and the centrode elongated after the facet was unlocked. CONCLUSIONS: Unilateral facet dislocation without fracture can be created with moderate loads when axial torque is applied while the facet is distracted. The spine is stable while the articular masses are locked unilaterally; however, the motion segment becomes overtly unstable after the facet dislocation is reduced.",0362-2436,AB,"STUDY DESIGN: Human cadaveric cervical spines were subjected to nondestructive repeated-measures flexibility tests before, during, and after unilateral facet dislocation. OBJECTIV"
0042871,"Lund T, Nydegger T, Schlenzka D, Oxland TR",Three-dimensional motion patterns during active bending in patients with chronic low back pain,Spine 2002 Sep 1;27(17):1865-74,,"LOW BACK PAIN, MOVEMENT, ROTATION, SPINE","BIOMECHANICS, PHYSIOPATHOLOGY, COMPARATIVE STUDY, TASK PERFORMANCE AND ANALYSIS",,,,0362-2436,AB,"STUDY DESIGN: The three-dimensional motion patterns of chronic low back pain (LBP) patients were studied during active motions. OBJECTIVE: To evaluate whether the motion patterns of coupling and asymmetry in chronic LBP patients differ from those in the normal population according to previous literature. SUMMARY OF BACKGROUND DATA: There exists little data that correlates vertebral motion with LBP symptoms despite extensive research. Several studies have suggested that patterns of motion are sensitive indicators of spinal pathology, including coupled motion patterns and asymmetry of motion. METHODS: In this study, 34 chronic LBP patients enrolled for an external fixation test performed active bending maneuvers, during which the three-dimensional intervertebral motions were measured continuously with an optoelectronic camera via markers attached to the percutaneous transpedicular screws. If a solid connection between each marker carrier and vertebrae was verified, the three-dimensional rotations of the vertebrae were analyzed with special reference to motion asymmetries and patterns of coupled motion. All data were compared to the normal values in the literature since the methodology is not possible in asymptomatic control subjects. RESULTS: Seven patients were removed from the analysis because of a loose screw-bone interface. In the remaining patients, three distinct patterns of motion were observed in each direction of movement. Significant differences in the extension-flexion ratio, the lateral bending asymmetry, and the coupled axial rotation-lateral bending ratio were found between the chronic LBP group and the normal literature values. CONCLUSIONS: Chronic LBP patients exhibited motion patterns altered from those of the normal population. (ABSTRACT TRUNCATED)."
0042872,"Balabaud L, Gallard E, Skalli W, Lassau JP, Lavaste F, Steib JP",Biomechanical evaluation of a bipedicular spinal fixation system: a comparative stiffness test,Spine 2002 Sep 1;27(17):1875-80,,"THORACIC VERTEBRAE, SPINAL FRACTURES, FRACTURE FIXATION, ORTHOPEDIC FIXATION DEVICES","BIOMECHANICS, CADAVER, METHODS, COMPARATIVE STUDY, RANGE OF MOTION",,,,0362-2436,AB,"STUDY DESIGN: This biomechanical study using cadaver thoracic spines evaluated the initial stiffness of two different fixation constructs using a new spinal implant: the bipedicular spinal fixation device (BSF). OBJECTIVE: To compare the biomechanical stiffness of a new construct using BSF with a regular construct using pedicular and laminar hooks. SUMMARY OF BACKGROUND DATA: Disadvantages of thoracic posterior implants and developments in in situ rod contouring led to the creation of a new implant for spine deformity surgery that would provide immediate stiffness to preserve spine correction, allow efficient postoperative rehabilitation, and obtain a good fusion rate. METHODS: Two age-paired groups of six human thoracic spines each (T3-T12) were compared: a regular group whose construct was in accordance with the Cotrel-Dubousset technique and the BSF group. In both groups, the spines were tested intact and then after injury. An injury was induced by transections of interspinous and anterior longitudinal ligaments and anterior discectomies. A three-dimensional ultrasonic measurement device, the Zebris 3D Motion Analyzer, was used to record the motion of the T6 relative to the T8 vertebra under loads, and to determine the ranges of motion (ROMs) between intact spines and the spine construct. RESULTS: In flexion-extension, the regular construct showed a significantly greater mean of relative ROMs than the BSF construct for principal rotation (88% and 69% respectively, P = 0.015). However, no significant differences were demonstrated in any of the other motions. CONCLUSION: The BSF construct showed stiffness similar to that of the regular construct, encouraging clinical investigation."
0042873,"Lee YH, Lee TH",Human muscular and postural responses in unstable load lifting,Spine 2002 Sep 1;27(17):1881-6,,"LIFTING, POSTURE, MUSCLE SKELETAL, WORKPLACE, WEIGHT BEARING","SAFETY, TASK PERFORMANCE AND ANALYSIS, MUSCLE CONTRACTION, ELECTROMYOGRAPHY",,,"To investigate muscular and postural responses during unstable load lifting, and to quantify the threat posed by such loads in the workplace. SUMMARY OF BACKGROUND DATA: Accurate assessment of load weight is important for lifters. Unfortunately, this information is not always available to individuals handling containers of liquids or shifting loads, or those encountering impact loading or a sudden unexpected load. METHODS: In this study, 12 subjects were subjected to time-variant loads, in which a box weighing 18 kg was used to generate a sudden 12 (kg. m)/second load impact internally during the lifting process. Responses were investigated as a function of different load-shift conditions (anterior-to-posterior and posterior-to-anterior rolling loads and stable load), two foot placements (wide and narrow stance), and two lifting techniques (stoop and squat). Normalized electromyography signals, joint angles, and total linear length for center of pressure (COP-length) were investigated. RESULTS: Lifting an unstable load significantly increases total lifting time, COP-length, and muscular contraction levels. When responding to impact momentum, subjects attempted to lift with greater elbow extension and shoulder and trunk flexion. A more flexed knee joint (approximately an additional 5 degrees) was observed during preparation for load impact in the anterior-to-posterior rolling task, allowing the formation of a more stable platform to compensate for the load variation. The largest erector spinae contraction for unstable lifting was approximately 12% to 25% greater maximal voluntary contraction than for the stable analog. (ABSTRACT TRUNCATED).",0362-2436,AB,STUDY DESIGN: Most studies of manual material handling have focused on stable (fixed) loads. The muscular response during unstable load handling deserves more investigative attention. OBJECTIV
0042874,"Furlan AD, Brosseau L, Imamura M, Irvin E",Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group,Spine 2002 Sep 1;27(17):1896-910,,"MASSAGE, LOW BACK PAIN, ACUPRESSURE","RANDOMIZED CONTROLLED TRIALS, TREATMENT OUTCOME, COMPARATIVE STUDY",,,"To assess the effects of massage therapy for nonspecific LBP. SEARCH STRATEGY: We searched MEDLINE, Embase, Cochrane Controlled Trials Register, HealthSTAR, CINAHL, and dissertation abstracts through May 2001 with no language restrictions. References in the included studies and in reviews of the literature were screened. Contact with content experts and massage associations was also made. SELECTION CRITERIA: The studies had to be randomized or quasirandomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific LBP. DATA COLLECTION AND ANALYS","0362-2436\r\nTwo reviewers blinded to authors, journals, and institutions selected the studies, assessed the methodologic quality using the criteria recommended by the Cochrane Collaboration Back Review Group, and extracted the data using standardized forms. The studies were analyzed in a qualitative way because of heterogeneity of population, massage technique, comparison groups, timing, and type of outcome measured. RESULTS: Nine publications reporting on eight randomized trials were included. Three had low and five had high methodologic quality scores. One study was published in German, and the rest, in English. Massage was compared with an inert treatment (sham laser) in one study that showed that massage was superior, especially if given in combination with exercises and education. In the other seven studies, massage was compared with different active treatments. They showed that massage was inferior to manipulation and transcutaneous electrical nerve stimulation; massage was equal to corsets and exercises. (ABSTRACT TRUNCATED).",AB,BACKGROUND: Low back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability and speed return-to-normal function. OBJECTIV
0042875,"Nault ML, Allard P, Hinse S, Le Blanc R, Caron O, Labelle H, Sadeghi H",Relations between standing stability and body posture parameters in adolescent idiopathic scoliosis,Spine 2002 Sep 1;27(17):1911-7,,"SCOLIOSIS, POSTURE, BALANCE","ADOLESCENT, PHYSIOPATHOLOGY, BIOMECHANICS",,,,0362-2436,AB,"STUDY DESIGN: A retrospective study of standing imbalance and body posture in 71 able-bodied girls and subjects with adolescent idiopathic scoliosis was conducted. OBJECTIVE: To test the hypothesis that postural parameters are related to standing stability parameters. SUMMARY OF BACKGROUND DATA: Spinal deformity not only modifies the shape of the trunk, but also changes the relations between body segments affecting posture in scoliotic children. These postural adaptations to the scoliotic curve progression could be linked in part to increased body sway in upright standing. This has not yet been related to specific postural parameters involving the head, trunk, and pelvis in nontreated idiopathic scoliosis. METHODS: The head, trunk, and pelvis orientations of each subject were measured by a Flock of Bird system. An AMTI force platform was used to assess quiet standing stability and to monitor the position and displacement of the center of pressure (COP). The center of mass (COM) excursion was estimated from a biomechanical model using force plate information only. Analyses of variance (ANOVAS) were performed to determine the statistical differences between the scoliotic and nonscoliotic subjects, and backward stepwise multiple regression analyses were performed to identify any correlation between measures of quiet standing stability and body postural parameters. RESULTS: The scoliotic group was characterized by a decrease in standing stability. There was an increase in the sway areas measured by the variations of the COP and COM. From the backward stepwise multiple regression analysis, it appears that for the able-bodied girls, the body posture parameters were correlated only with the mean anteroposterior center of pressure (COP(AP)) position. (ABSTRACT TRUNCATED)."
0042876,"Haig AJ, Weiner JB, Tew J, Quint D, Yamakawa K","The relation among spinal geometry on MRI, paraspinal electromyographic abnormalities, and age in persons referred for electrodiagnostic testing of low back symptoms",Spine 2002 Sep 1;27(17):1918-25,,"MAGNETIC RESONANCE IMAGING, SPINE, ELECTRODIAGNOSIS, LOW BACK PAIN, SPINAL STENOSIS","ELECTROMYOGRAPHY, AGE FACTORS, METHODS, PATHOLOGY, DENERVATION",,,,0362-2436,AB,"STUDY DESIGN: A retrospective EMG study with blinded radiologic measurement was conducted. OBJECTIVE: To determine the relation among spinal measurements on MRI, paraspinal denervation, and age in patients referred for electrodiagnostic and radiologic evaluation of low back pain. SUMMARY OF BACKGROUND DATA: Spinal pathology, including disc herniation and spinal stenosis, can cause denervation of the paraspinal muscles. Various mechanisms including direct compression, inflammation, vascular compromise, and mechanical stretch of the posterior primary ramus may play a role in denervation. The relation between the amount of denervation and the size of the spinal canal can assist in understanding the pathophysiology of back pain. Since paraspinal denervation may increase with age in asymptomatic persons, age is an important covariable. METHODS: At a university hospital, 44 patients referred to undergo both electrodiagnostic evaluation and MRI for low back pain were studied. The study investigated the relation among the following: 1) axial MRI spinal measurements (canal transverse diameter, anteroposterior diameter, and area; thecal sac anteroposterior diameter and area; and the radiologist's overall impression at each level) and denervation measurements in terms of scores on the MiniPM, a quantified needle electromyographic measure of paraspinal denervation; 2) various models of multilevel spinal compression (smallest, smallest two, and average spinal levels for each measurement) and MiniPM scores; and 3) MRI spinal canal measurements and age. RESULTS: Although individual MRI measurements and combinations of measurements did not relate to MiniPM scores, the radiologist's impression was significantly related. The \"smallest two\" levels measurement had the strongest relation (r = 0.400; P less than 0.007). (ABSTRACT TRUNCATED)."
0042877,"de Zoete A, Assendelft WJ, Algra PR, Oberman WR, Vanderschueren GM, Bezemer PD","Reliability and validity of lumbosacral spine radiograph reading by chiropractors, chiropractic radiologists, and medical radiologists",Spine 2002 Sep 1;27(17):1926-33,,"CHIROPRACTIC, RADIOGRAPHY, LUMBOSACRAL REGION, INFECTION, INFLAMMATION","CONSISTENCY AND RELIABILITY, COMPARATIVE STUDY, OBSERVER VARIATION, DIAGNOSIS, PROFESSIONAL COMPETENCE",,,,0362-2436,AB,"STUDY DESIGN: A cross-sectional diagnostic study was conducted in two sessions. OBJECTIVE: To determine and compare the reliability and validity of contraindications to chiropractic treatment (infections, malignancies, inflammatory spondylitis, and spondylolysis-listhesis) detected by chiropractors, chiropractic radiologists, and medical radiologists on plain lumbosacral radiographs. SUMMARY OF BACKGROUND DATA: Plain radiography of the spine is an established part of chiropractic practice. Few studies have assessed the ability of chiropractors to read plain radiographs. METHODS: Five chiropractors, three chiropractic radiologists and five medical radiologists read a set of 300 blinded lumbosacral radiographs, 50 of which showed an abnormality (prevalence, 16.7%), in two sessions. The results were expressed in terms of reliability (percentage and kappa) and validity (sensitivity and specificity). RESULTS: The interobserver agreement in the first session showed generalized kappas of 0.44 for the chiropractors, 0.55 for the chiropractic radiologists, and 0.60 for the medical radiologists. The intraobserver agreement showed mean kappas of 0.58, 0.68, and 0.72, respectively. The difference between the chiropractic radiologists and medical radiologists was not significant. However, there was a difference between the chiropractors and the other professional groups. The mean sensitivity and specificity of the first round, respectively was 0.86 and 0.88 for the chiropractors, 0.90 and 0.84 for the chiropractic radiologists, and 0.84 and 0.92 for the medical radiologists. No differences in the sensitivities were found between the professional groups. The medical radiologists were more specific than the others. CONCLUSIONS: Small differences with little clinical relevance were found. (ABSTRACT TRUNCATED)."
0042878,"Stranzl H, Gabor S, Mayer R, Prettenhofer U, Wurzinger G, Hackl A",Fractionated intraluminal HDR 192Ir brachytherapy as palliative treatment in patients with endobronchial metastases from non-bronchogenic primaries,Strahlenther Onkol 2002 Aug;178(8):442-5,,"BRONCHIAL NEOPLASMS, PALLIATIVE TREATMENT, BRACHYTHERAPY, NEOPLASM METASTASIS","METHODS, TREATMENT OUTCOME, FOLLOW UP STUDIES",,,,0179-7158,AB,"AIM: To evaluate the efficacy of iridium-192 high-dose rate (HDR) endobronchial brachytherapy for the palliation of symptoms caused by endobronchial metastases of non-bronchogenic primaries. PATIENTS AND METHOD: Between 1991 and 1998, eleven patients (female n = 3, male n = 8; age: median 66 years, range 44-81 years) underwent intraluminal HDR brachytherapy for histologically confirmed endobronchial metastases from non-pulmonary primary tumors of various sites like urogenital tract (n = 5), gastrointestinal tract (n = 3), ear/nose/throat (n = 2) and breast (n = 1). The median time between diagnosis of the primary non-bronchogenic tumor and histopathological diagnosis of the endobronchial metastases was 39 months, range 1-99 months. A total dose of 15-20 Gy was delivered in three to four fractions of 5-6 Gy once a week. No palliative chemotherapy was added. RESULTS: Median follow-up after palliative brachytherapy was 15 months (range 1.4-59 months). Objectively, complete endoscopic response was observed in three (27%) patients, and in five (46%) others partial opening of the initially obstructed airway was achieved. Treatment was judged unsuccessful in three (27%) patients. No patient showed up with local progression. At date of analysis five patients were alive with documented residual tumor (80%) or complete response (20%). Relief of symptoms occurred in the vast majority of patients (n = 8, 73%). CONCLUSION: HDR intraluminal brachytherapy palliates symptoms in patients suffering from endobronchial metastases of non-pulmonary primary tumors. The applied treatment is a safe, effective and well tolerated palliative procedure leading to an improved patient quality of life."
0042879,"McCahill LE, Krouse RS, Chu DZ, Juarez G, Uman GC, Ferrell BR, Wagman LD",Decision making in palliative surgery,J Am Coll Surg 2002 Sep;195(3):411-22,,"PALLIATIVE TREATMENT, SURGERY OPERATIVE, DECISION MAKING, NEOPLASMS, TERMINAL ILLNESS, ATTITUDE OF HEALTH PERSONNEL","PSYCHOLOGY, ETHICS MEDICAL, REFERRAL AND CONSULTATION, DISEASE MANAGEMENT",,,,1072-7515,AB,"BACKGROUND: Palliative surgery for advanced cancer patients involves complex decision making. Surgeons with a cancer-focused practice were surveyed to determine the extent to which palliative surgery was currently practiced, to identify ethical dilemmas and barriers they faced in performing palliative surgery, and to evaluate their treatment choices in four different clinical scenarios. STUDY DESIGN: A 110-item survey was devised after extensive review of the palliative care and palliative surgery literature to evaluate current practices and attitudes regarding palliative surgery. Case vignettes were devised to evaluate clinical factors influencing surgeons' selection of treatment for symptomatic patients with advanced malignancy. RESULTS: Survey response rate was 24% (419 of 1,740). Respondents reported 74% of their surgery caseload as cancer related, and 21% of these as palliative. On a scale of 1 (uncommon problem) to 7 (common problem), surgeons reported that the most common ethical dilemmas in palliative surgery were providing patients with honest information without destroying hope (5.6 +/- 1.4) (mean +/- standard deviation), and preserving patient choice (5.0 +/- 1.7). Bound on error of the average frequency estimate for ethical dilemmas, based on response rate, was 0.08. On a scale of 1 (not a barrier) to 7 (a severe barrier), surgeons rated the most severe barriers to optimum use of palliative surgery as limitations of managed care (4.1 +/- 2.0) and referral to surgery by other specialists (3.9 +/- 1.8). Bound on error of the estimate for average severity of barriers, based on response rate, was 0.09. They rated the least severe barriers to palliative surgery as surgeon avoidance of dying patients (3.0 +/- 1.8) and surgery department reluctance to perform palliative surgery (2.6 +/- 1.6). (ABSTRACT TRUNCATED)."
0042880,"Hanratty B, Hibbert D, Mair F, May C, Ward C, Capewell S, Litva A, Corcoran G",Doctors' perceptions of palliative care for heart failure: focus group study,BMJ 2002 Sep 14;325(7364):581-5,,"HEART FAILURE CONGESTIVE, TERMINAL CARE, ATTITUDE OF HEALTH PERSONNEL, HEALTH SERVICES NEEDS AND DEMAND","DELIVERY OF HEALTH CARE, HEALTH ADMINISTRATION",,,"To identify doctors' perceptions of the need for palliative care for heart failure and barriers to change. DESIGN: Qualitative study with focus groups. SETTING: North west England. PARTICIPANTS: General practitioners and consultants in cardiology, geriatrics, palliative care, and general medicine. RESULTS: Doctors supported the development of palliative care for patients with heart failure with the general practitioner as a central figure. They were reluctant to endorse expansion of specialist palliative care services. Barriers to developing approaches to palliative care in heart failure related to three main areas: the organisation of health care, the unpredictable course of heart failure, and the doctors' understanding of roles. The health system was thought to work against provision of holistic care, exacerbated by issues of professional rivalry and control. The priorities identified for the future were developing the role of the nurse, better community support for primary care, and enhanced communication between all the health professionals involved in the care of patients with heart failure. CONCLUSIONS: Greater consideration should be given to the care of patients dying with heart failure, clarifying the roles of doctors and nurses in different specialties, and reshaping the services provided for them. Many of the organisational and professional issues are not peculiar to patients dying with heart failure, and addressing such concerns as the lack of coordination and continuity in medical care would benefit all patients.",0959-535X,AB,OBJECTIV
0042881,"Gibbs JS, McCoy AS, Gibbs LM, Rogers AE, Addington-Hall JM",Living with and dying from heart failure: the role of palliative care,Heart 2002 Oct;88 Supp 2:ii36-9,,"HEART FAILURE CONGESTIVE, PALLIATIVE TREATMENT, TERMINAL CARE",PROGNOSIS,(Review),,,1355-6037,,
0042882,"Rozanes I, Poyanli A, Acunas B",Palliative treatment of inoperable malignant esophageal strictures with metal stents: one center's experience with four different stents,Eur J Radiol 2002 Sep;43(3):196,,"PALLIATIVE TREATMENT, ESOPHAGEAL NEOPLASMS, STENTS, DEGLUTITION DISORDERS","EQUIPMENT DESIGN, TREATMENT OUTCOME, COMPLICATIONS, ADVERSE EFFECTS, THERAPY",,,,0720-048X,AB,"PURPOSE: Our center's experience with Ultraflex, Flamingo, SR stent and Flexstent for the palliation of malignant esophageal strictures is reported, and current pertinent literature is reviewed. MATERIAL AND METHODS: Stents have been placed under fluoroscopic guidance between August 1993 and February 2002 for the palliation of malignant dysphagia in 116 patients. 59 patients received Ultraflex, 33 patients received Flamingo Wallstent, 20 patients received the SR stent and four patients received Flexstent. RESULTS: Stent placement was successful in all the patients, with good symptomatic control in 123 out of 126 patients (98%) and no procedure-related complications. Four esophagorespiratory fistulas were successfully closed with covered Flamingo stents. Repeat intervention was necessary in 30 patients (51%) who received the Ultraflex stent, secondary to tumor ingrowth, overgrowth, ulceration, fistula and incomplete expansion. Two patients (6%) who received Flamingo Wallstent died due to gastrointestinal bleeding and one patient had proximal migration. Four patients (20%) who received the SR stent had complete migration of the stent. CONCLUSION: Covered stents were found to provide better long-term palliation compared to uncovered stents. The covered Flamingo Wallstent seems to be the best choice of stent for lesions where crossing the esophagogastric junction is not necessary. For lesions where it is mandatory to cross the junction it may be preferable to use a stent with an antireflux mechanism."
0042883,"Rollins JA, Riccio LL",ART is the heART: a palette of possibilities for hospice care,Pediatr Nurs 2002 Jul-Aug;28(4):355-63,,"HOSPICE CARE, ART, PALLIATIVE TREATMENT, ADAPTATION PSYCHOLOGICAL","PROGRAM EVALUATION, TREATMENT OUTCOME, CHILD, FAMILY",,,,0097-9805,AB,"Comprehensive hospice care for children who are dying or dealing with the death of a parent, sibling, or other family member must include psychologic, emotional, and spiritual support. Increasingly, the arts are being recognized as a powerful tool for this support. In 1999, WVSA arts connection, a community-based, arts and education, non-profit organization in Washington, DC, developed and launched a unique arts-in-health care program, ART is the heART. The program trains and brings artists to children and families in home or hospice care. Through ART is the heART, children learn to use the arts as a healthy and effective coping strategy. The program is now being replicated in other communities across America."
0042884,"Tataryn D, Chochinov HM",Predicting the trajectory of will to live in terminally ill patients,Psychosomatics 2002 Sep-Oct;43(5):370-7,,"TERMINAL ILLNESS, ATTITUDE TO HEALTH, ATTITUDE TO DEATH, NEOPLASMS","PSYCHOLOGY, DEMOGRAPHY",,,,0033-3182,AB,"Will to live has been shown to vary considerably during the final course of a terminal illness. The goal of this study was to identify illness-related and demographic variables predicting will to live among dying patients. Subjects were 168 patients with cancer who were admitted for palliative care. Will to live was measured twice daily for the duration of hospitalization by using a self-report 100-mm visual analogue scale. Will-to-live data for each patient were summarized into two statistics, intercept and slope, by using simple linear regression analyses. Intercept-slope pairs for all patients were classified into the following five clusters by using spatial and conceptual criteria: patients with sustained high will to live (58%), patients with sustained moderate will to live (11%), patients with sustained low will to live (3%), will-to-live relinquishers (18%), and will-to-live acquirers (10%). Discriminant analyses revealed seven variables that accounted for 69% of the variance in cluster membership: anxiety, shortness of breath, nausea, length of survival from time of admission, having a diagnosis of colon cancer, having no religion, and living with a spouse."
0042885,"Mitchell M, Catron G",Teaching grief and bereavement. involving support groups in educating student midwives,Pract Midwife 2002 Sep;5(8):26-7,,"BEREAVEMENT, GRIEF, TEACHING, MIDWIFERY, SELF HELP GROUPS","GRIEF, EDUCATION NURSING, METHODS",,,,1461-3123,,
0042886,"Burden B, Stuart PC","Bereavement, grief and the midwife",Pract Midwife 2002 Sep;5(8):14-7,,"BEREAVEMENT, MIDWIFERY, ATTITUDE TO DEATH, ATTITUDE OF HEALTH PERSONNEL","GRIEF, PSYCHOLOGY",,,,1461-3123,,
0042887,"Yick AG, Gupta R","Chinese cultural dimensions of death, dying, and bereavement: focus group findings",J Cult Divers 2002 Summer;9(2):32-42,,"BEREAVEMENT, ATTITUDE TO DEATH","CULTURE, CHINA, UNITED STATES, RELIGION",,,,1071-5568,AB,"The purpose of this qualitative study is to describe Chinese immigrants and Chinese Americans' attitudes and practices about death, dying, and bereavement. To this end, three focus groups were conducted with social work graduate students, pastors and religious leaders, and service providers working in the Chinese American community in New York City. The United States is becoming increasingly multicultural, and Chinese Americans are the most rapidly growing Asian American group. Findings from this study revealed that many Chinese attitudes and practices about death and dying are rooted in Asian cultural values such as filial piety, centrality of the family, and emphasis of hierarchy. In addition, strains of Confucianism, Buddhism, Taoism, and local folklore are embedded in these death attitudes and practices. Based on themes extrapolated from the focus groups, recommendations are delineated for service providers in order to implement culturally-sensitive bereavement practices."
0042888,"Wiles R, Jarrett N, Payne S, Field D",Referrals for bereavement counselling in primary care: a qualitative study,Patient Educ Couns 2002 Sep;48(1):79,,"BEREAVEMENT, COUNSELING, PRIMARY HEALTH CARE, ATTITUDE OF HEALTH PERSONNEL","REFERRAL AND CONSULTATION, DECISION MAKING, PROFESSIONAL PRACTICE",,,,0738-3991,AB,The growth in the provision of counselling services in British primary care offers an opportunity for general practitioners (GPs) to refer patients to counsellors following bereavement. This study explores the factors that influence GPs referral decisions. Qualitative interviews were conducted with 50 GPs from two cities in southern UK. The study found that GPs draw on notions of abnormal bereavement in making referral decisions. Indicators of bereavement problems related to: the nature of the death; level of social support; and reaction to the death. GPs views about the types of patients likely to benefit from counselling were further criteria employed in referral decisions. The study indicated that consideration of these factors may discriminate against certain types of patients being referred. Further education in the range of psychological theories of bereavement may assist GPs in understanding their bereaved patients' experiences and in developing their skills in recognising abnormal reactions and making appropriate referrals.
0042889,"McPhee SJ, Markowitz AJ",Reflections at a palliative care unit,JAMA 2002 Sep 11;288(10):1279,,"PALLIATIVE TREATMENT, HOSPITAL UNITS","DEATH, BEREAVEMENT",,,,0098-7484,,
0042890,Warren NA,Critical care family members' satisfaction with bereavement experiences,Crit Care Nurs Q 2002 Aug;25(2):54-60,,"BEREAVEMENT, CRITICAL CARE, PERSONAL SATISFACTION","FAMILY RELATIONS, PSYCHOLOGY",,,,0887-9303,AB,"Heideggerian hermeneutics is used to illuminate the dialogues of 23 participants who experienced the death of a family member in the critical care unit within the past year. Those constructs that were considered helpful and satisfying during the process of losing the family member included information from the hospital staff, support from the family, and unrestricted visits. Those that were considered unhelpful and dissatisfying during the process of losing the family member included inaccessibility of the physician, cause of death, inadequate treatment, uncaring staff, and not being present at time of death. Constructs that were considered helpful and satisfying in the time since death were family, friends, and clergy. Those that were considered unhelpful and dissatisfying since death included legal/financial problems, dealing with bureaucracies, dealing with other bereaved family members, funeral homes, and organ donation."
0042891,"Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P","High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis",Hum Reprod 2002 Oct;17(10):2715-24,endometriosis,"FIBROMYALGIA, AUTOIMMUNE DIS, ENDOCRINE DIS, FATIGUE SYNDROME CHRONIC","GENITAL DISEASES FEMALE, EPIDEMIOLOGY, COMORBIDITY, HEALTH SURVEYS",,,,0268-1161,AB,"BACKGROUND: Women with endometriosis may also have associated disorders related to autoimmune dysregulation or pain. This study examined whether the prevalence of autoimmune, chronic pain and fatigue and atopic disorders is higher in women with endometriosis than in the general female population. METHODS AND RESULTS: A cross-sectional survey was conducted in 1998 by the Endometriosis Association of 3680 USA members with surgically diagnosed endometriosis. Almost all responders had pain (99%), and many reported infertility (41%). Compared with published rates in the general USA female population, women with endometriosis had higher rates of hypothyroidism (9.6 versus 1.5%, P less than 0.0001), fibromyalgia (5.9 versus 3.4%, P less than 0.0001), chronic fatigue syndrome (4.6 versus 0.03%, P less than 0.0001), rheumatoid arthritis (1.8 versus 1.2%, P = 0.001), systemic lupus erythematosus (0.8 versus 0.04%, P less than 0.0001), Sjogren's syndrome (0.6 versus 0.03%, P less than 0.0001) and multiple sclerosis (0.5 versus 0.07%, P less than 0.0001), but not hyperthyroidism or diabetes. Allergies and asthma were more common among women with endometriosis alone (61%, P less than 0.001 and 12%, P less than 0.001 respectively) and highest in those with fibromyalgia or chronic fatigue syndrome (88%, P less than 0.001 and 25%, P less than 0.001 respectively) than in the USA female population (18%, P less than 0.001 and 5%, P less than 0.001 respectively). CONCLUSIONS: Hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma are all significantly more common in women with endometriosis than in women in the general USA population."
0042892,"Brouwers FM, Van Der Werf S, Bleijenberg G, Van Der Zee L, Van Der Meer JW",The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial,QJM 2002 Oct;95(10):677-83,,"FATIGUE SYNDROME CHRONIC, DIETARY SUPPLEMENTS, NUTRITION","RANDOMIZED CONTROLLED TRIALS, DIET THERAPY, TREATMENT OUTCOME, SYMPTOMS",,,,1460-2725,AB,"BACKGROUND: The efficacy of dietary supplements in chronic fatigue syndrome (CFS) is uncertain, with conflicting evidence. Aim: To assess the effect of a polynutrient supplement on fatigue and physical activity of patients with CFS. DESIGN: Prospective randomized placebo-controlled, double-blind trial. METHODS: Fifty-three patients (16 males, 37 females) fulfilling the CDC criteria of CFS. The entry criteria were a score on the Checklist Individual Strength subscale fatigue severity (CIS fatigue) greater than or = to 40 and a weighted sum score of greater than or = to 750 for the eight subscales of the Sickness Impact Profile (SIP8) and no use of nutritional supplements in the 4 weeks prior to entry. The exclusion criteria were pregnancy and lactose intolerance. The intervention-a polynutrient supplement containing several vitamins, minerals and (co)enzymes, or placebo, twice daily for 10 weeks-was preceded by 2 weeks of baseline measurements. Outcome measurements took place in week 9 and 10 of the intervention. Five participants dropped out (4 supplement, 1 placebo). The main outcome measures were CIS fatigue score, number of CDC symptoms and SIP8 score. Efficacy analyses were performed on an intention-to-treat basis. RESULTS: No significant differences were found between the placebo and the treated group on any of the outcome measures: CIS fatigue +2.16 (95% CI -4.3 to +4.39, p = 0.984); CDC symptoms +0.42 (95% CI -0.61 to +1.46, p = 0.417); SIP8 +182 (95% CI -165 to +529, p = 0.297). No patient reported full recovery. DISCUSSION: The findings do not support the use of a broad-spectrum nutritional supplement in treating CFS-related symptoms."
0042893,"Torres-Harding SR, Jason LA, Cane V, Carrico A, Taylor RR",Physicians' diagnoses of psychiatric disorders for people with chronic fatigue syndrome,Int J Psychiatry Med 2002;32(2):109-24,,"MENTAL DISORDERS, FATIGUE SYNDROME CHRONIC, PATIENT ASSESSMENT","DIAGNOSIS, SELF ASSESSMENT, CONSISTENCY AND RELIABILITY",,,,0091-2174,AB,"OBJECTIVE: To examine rates of psychiatric diagnoses given by patients' primary or regular physicians to persons with chronic fatigue syndrome (CFS), persons with psychiatrically explained fatigue, and a control group. Physicians' psychiatric diagnosis and participants' self-reported psychiatric diagnoses were compared to lifetime psychiatric diagnoses as measured by a structured psychiatric interview. METHOD: Participants were recruited as part of a community-based epidemiology study of chronic fatigue syndrome. Medical records of 23 persons with chronic fatigue syndrome, 25 persons with psychiatrically explained chronic fatigue, and 19 persons without chronic fatigue (controls) were examined to determine whether their physician had given a diagnosis of mood, anxiety, somatoform, or psychotic disorder. Lifetime psychiatric status was measured using the Structured Clinical Interview for the DSM-IV (SCID). Participants' self reports of specific psychiatric disorders were assessed as part of a detailed medical questionnaire. RESULTS: Physicians' diagnosis of a psychiatric illness when at least one psychiatric disorder was present ranged from 40% in the psychiatrically explained group, 50% in the control group, and 64.3% in the CFS group. Participants in the psychiatrically explained group were more accurate than physicians in reporting the presence of a psychiatric disorder, and in accurately reporting the presence of a mood or anxiety disorder. CONCLUSIONS: The present investigation found underrecognition of psychiatric illness by physicians, with relatively little misdiagnosis of psychiatric illness. Physicians had particular difficulty assessing psychiatric disorder in those patients whose chronic fatigue was fully explained by a psychiatric disorder."
0042894,Goudsmit E,Chronic fatigue syndrome/myalgic encephalitis,Br J Gen Pract 2002 Sep;52(482):763-4,,FATIGUE SYNDROME CHRONIC,,(Letter),,,0960-1643,,
0042895,Pall ML,Chronic fatigue syndrome/myalgic encephalitis,Br J Gen Pract 2002 Sep;52(482):762; discussion 763-4,,FATIGUE SYNDROME CHRONIC,,(Letter),,,0960-1643,,
0042896,Sykes R,Chronic fatigue syndrome/myalgic encephalitis,Br J Gen Pract 2002 Sep;52(482):762-3; discussion 763-4,,FATIGUE SYNDROME CHRONIC,,(Letter),,,0960-1643,,
0042897,"Reid S, Chalder T, Cleare A, Hotopf M, Wessely S",Chronic fatigue syndrome,Clin Evid 2002 Jun;(7):966-78,,FATIGUE SYNDROME CHRONIC,,,,,1462-3846,,
0042898,"Barron DF, Cohen BA, Geraghty MT, Violand R, Rowe PC",Joint hypermobility is more common in children with chronic fatigue syndrome than in healthy controls,J Pediatr 2002 Sep;141(3):421-5,,"FATIGUE SYNDROME CHRONIC, JOINT INSTABILITY, SKIN DIS","EPIDEMIOLOGY, COMORBIDITY, COMPARATIVE STUDY, CHILD",,,,0022-3476,AB,"OBJECTIVE: To determine whether children with chronic fatigue syndrome (CFS) have a higher prevalence of joint hypermobility than gender-matched controls. STUDY DESIGN: Matched case-control study comparing the Beighton joint hypermobility scores in 58 consecutive children with CFS (incident cases) with 58 otherwise healthy controls referred to a dermatology clinic for evaluation of common skin problems. A second group of 58 patients previously diagnosed with CFS (prevalent cases) was matched by gender to the incident cases to evaluate temporal changes in referral patterns. RESULTS: Of the 58 patients in each group, 71% were female. The median Beighton scores were higher in incident CFS cases than in healthy controls (4 vs 1, P less than .001). More incident CFS cases had Beighton scores greater than or = to 4 (consistent with joint hypermobility), 60% versus 24%, P less than .0001. Incident and prevalent CFS cases had similar Beighton scores. The odds ratio for hypermobility in all patients with CFS versus healthy controls was 3.5 (P less than .001; 95% CI, 1.6-7.5). CONCLUSIONS: Joint hypermobility is more common in patients with CFS than in otherwise healthy children with common skin disorders. The etiologic significance of the observed association remains to be defined."
0042899,"Creswell C, Chalder T",Underlying self-esteem in chronic fatigue syndrome,J Psychosom Res 2002 Sep;53(3):755,,"FATIGUE SYNDROME CHRONIC, SELF CONCEPT","SELF ASSESSMENT, COMPARATIVE STUDY, DEFENSE MECHANISMS, PSYCHOLOGY",,,,0022-3999,AB,"OBJECTIVE: It has been suggested that people with chronic fatigue syndrome (CFS) have low self-esteem; however, this is not necessarily apparent when self-esteem is measured overtly. This study is the first to investigate underlying self-esteem using information-processing measures and overtly administered measures of self-esteem with this population. METHODS: The study comprised 68 participants (24 CFS, 24 healthy volunteers, and 20 chronic illness volunteers). A Self-Statements Questionnaire (SSQ) and an Emotional Stroop Test (EST) using neutral, positive, and negative trait words were administered. RESULTS: Participants with CFS reported lower self-esteem than the two comparison groups on overt measures. Overt responses, however, did not fully account for the full extent of the interference effect from the negative word Stroop compared to the positive word Stroop. CONCLUSION: In contrast to previous studies, participants with CFS reported lower levels of self-esteem on overt measures than two comparison groups. It is suggested, however, that the extent to which participants reported low self-esteem did not fully reflect their underlying low self-esteem and that this may result from the use of rigidly held defence mechanisms. Further use of information-processing measures, in contrast to relying only on self-report measures, is advocated for future research."
0042900,"van der Werf S, de Vree B, Alberts M, van der Meer J, Bleijenberg G",Natural course and predicting self-reported improvement in patients with chronic fatigue syndrome with a relatively short illness duration,J Psychosom Res 2002 Sep;53(3):749,,FATIGUE SYNDROME CHRONIC,"PROGNOSIS, SELF ASSESSMENT, FOLLOW UP STUDIES, SOCIAL SUPPORT, FORECASTING",,,,0022-3999,AB,"OBJECTIVE: To describe the course of fatigue in chronic fatigue syndrome (CFS) patients with a relatively short duration of complaints and to test which psychosocial factors predict spontaneous improvement 1 year later. METHODS: Seventy-nine patients with a complaint duration of less than 2 years were tested at baseline and 78 of the same group at 1-year follow-up. During this time period, no systematic intervention took place. Self-reported improvement and fatigue severity were the main outcome measures. RESULTS: Forty-six percent (95% confidence intervals, 95CI=35-58%) of the patients with a short illness duration reported to be improved. This was a significantly (chi(2) = 20.3, P less than .001) higher percentage compared to the 20% (95CI=15-26%) self-reported improvement in a previously published natural-course study among 246 CFS patients with a longer illness duration. Persistence of complaints after 1-year follow-up was associated with high baseline levels of experienced concentration problems, less strong psychosocial causal explanations for the complaints, and higher levels of the experienced lack of social support. Baseline fatigue severity predicted fatigue severity at follow-up. CONCLUSION: The results showed that CFS patients with a relatively short duration of complaints had a more favourable outcome compared to patients with a long illness duration. The data also indicated that complete recovery only occurred in patients with a complaint duration of less than 15 months. This finding has important implications, since it suggests that after such a time period spontaneous recovery hardly occurs."
0042901,"Arnold MC, Papanicolaou DA, O'Grady JA, Lotsikas A, Dale JK, Straus SE, Grafman J",Using an interleukin-6 challenge to evaluate neuropsychological performance in chronic fatigue syndrome,Psychol Med 2002 Aug;32(6):1075-89,,"FATIGUE SYNDROME CHRONIC, INTERLEUKINS, NEUROPSYCHOLOGY, COGNITION","SYMPTOMS, PHYSIOPATHOLOGY, PREDICTIVE VALUE OF TESTS, DRUG EFFECTS",,,,0033-2917,AB,"BACKGROUND: Individuals with acute infections experience a range of symptoms including fatigue, malaise, muscle aches, and difficulties with concentration and memory that are usually self-limited. This cluster of symptoms is otherwise, similar to those that characterize chronic fatigue syndrome (CFS). The goal of the present study was to evaluate the cognitive and psychological functioning of CFS patients and normal controls (NCs) when they both were experiencing acute influenza-like symptoms. To induce influenza-like symptoms, we administered interleukin-6 (IL-6), a cytokine that temporarily activates the acute phase immunological and endocrine responses. METHODS: Nineteen patients who met the 1994 International CFS Study Group Criteria and ten normal controls (NCs)completed routine clinical evaluations, neuropsychological tests of short-term memory, selective attention, and executive control, and self-ratings of somatic symptoms and psychological mood before, shortly following, and 1 day after IL-6 administration. RESULTS: CFS patients consistently reported more somatic symptoms, even when both groups perceived that they were ill. Both groups somatic symptoms increased during the IL-6 challenge, but the CFS patients symptoms increased more rapidly than controls. In general, the CFS patients performed similarly to NCs on the cognitive measures before, during, and after the IL-6. In contrast to predictions, IL-6 provocation did not impair the cognitive performance of either CFS patients or NCs. CONCLUSIONS: The IL-6 provocation exacerbated the patients self-reported symptoms but did not reveal notable cognitive impairments between patients and controls during cytokine-induced acute influenza-like symptoms."
0042902,"Ohashi K, Yamamoto Y, Natelson B",Activity rhythm degrades after strenuous exercise in chronic fatigue syndrome,Physiol Behav 2002 Sep;77(1):39,,"FATIGUE SYNDROME CHRONIC, EXERCISE, CIRCADIAN RHYTHM","EXERCISE TESTING, SYMPTOMS, PHYSIOPATHOLOGY",,,,0031-9384,AB,"Post-exertional exacerbation of symptoms is one of the major characteristics of chronic fatigue syndrome (CFS). In this study, we evaluated the hypothesis that disturbances in circadian chronobiological regulation may play a role in generating this phenomenon. We recorded physical activity for 6-day periods in 16 women (10 CFS and 6 sedentary healthy controls, CON) before and after performing a maximal treadmill test. We calculated activity rhythms by computing autocorrelation coefficients by cutting 1 day apart from the data as a template and sliding it sequentially through each of the other days; all of 6 days were used as the templates. The peak value of autocorrelation coefficient (R) and the time between peak R's (circadian period, CP) were calculated. CFS patients had a lengthening (P less than .05) of mean circadian period (MCP) that was longer than 24 h (P less than.05), while MCP in CON remained unchanged. No difference was found in the standard error of each subject's MCP (circadian period variability, CPV) before and after exercise for both groups. We interpret this increase in circadian rest-activity period seen in CFS patients following exercise to indicate that exhaustive exercise interferes with normal entrainment to 24-h zeitgeber(s). This effect may be associated in part with the common patient complaint of symptom worsening following exertion."
0042903,"White PD, Pinching AJ, Rakib A, Castle M, Hedge B, Priebe S",A comparison of patients with chronic fatigue syndrome attending separate fatigue clinics based in immunology and psychiatry,J R Soc Med 2002 Sep;95(9):440-4,,"FATIGUE SYNDROME CHRONIC, IMMUNOLOGIC DIS, STRESS PSYCHOLOGICAL, ATTITUDE TO HEALTH","REHABILITATION PSYCHOSOCIAL, COMPARATIVE STUDY, REFERRAL AND CONSULTATION",,,,0141-0768,AB,"Hospital clinics for patients with chronic unexplained fatigue are held in departments of various disciplines. This causes difficulties for referrers in choosing the appropriate clinic and for researchers in generalizing findings from one type of clinic to others. We randomly selected 37 outpatients attending an immunology fatigue clinic and 36 outpatients attending a psychiatry fatigue clinic, all of whom had chronic fatigue syndrome. We compared demographic factors, symptoms, disability, quality of life, psychological distress and illness attributions. The patients from the two clinics were closely similar in their specific symptoms, disability, quality of life, psychological distress and previous attendance to mental health professionals. Psychological distress was high and equal in the two samples. The proportion of men was greater among patients attending the immunology clinic. In a post-hoc analysis, 64% of immunology attenders attributed their fatigue to physical factors, compared with 31% of psychiatry clinic attenders (chi(2) = 6.35, 1 d.f., P = 0.01). These findings suggest that research data from one type of chronic fatigue clinic can be generalized to others. Clinically similar patients are referred to different clinics, and the choice of clinic may be influenced by the patients' illness beliefs. The high levels of emotional distress suggest that psychosocial management is as important as physical management in hospital outpatients with chronic fatigue syndrome, irrespective of its aetiology."
0042904,"Walker EA, Keegan D, Gardner G, Sullivan M, Bernstein D, Katon WJ","Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect",Psychosom Med 1997;59:572-7,,"FIBROMYALGIA, ARTHRITIS RHEUMATOID, VIOLENCE, EMOTIONS","COMPARATIVE STUDY, PSYCHOLOGY SOCIAL, CRIME, RISK",,,,0033-3174,AB,"Two recent reports have found associations between fibromyalgia and sexual victimization, but had methodologic characteristics that limited their interpretation. The authors compared 36 patients with fibromyalgia and 33 patients with rheumatoid arthritis by using structured interviews for sexual, physical, and emotional victimization histories, as well as dimensional self-report measures of victimization severity. Compared with the patients with rheumatoid arthritis, those with fibromyalgia had significantly higher lifetime prevalence rates of all forms of victimization, both adult and adulthood, as well as combinations of adult and childhood trauma. Although childhood maltreatment was found to be a general risk factor for fibromyalgia, particular forms of maltreatment (e.g., sexual abuse per se) did not have specific effects. Experiences of physical assault in adulthood, however, showed a strong and specific relationship with unexplained pain. Trauma severity was correlated significantly with measures of physical disability, psychiatric distress, illness adjustment, personality, and quality of sleep in-patients with fibromyalgia but not in those with rheumatoid arthritis. Fibromyalgia seems to be associated with increased risk of victimization, particularly adult physical abuse. Sexual, physical, and emotional trauma may be important factors in the development and maintenance of this disorder and its associated disability in many patients."
0042905,"Alamo M, Moral R, Perula de Torres L",Evaluation of a patient-centred approach in generalized musculoskeletal chronic pain/fibromyalgia patients in primary care,Patient Educ Couns 2002 Sep;48(1):23,,"PAIN, FIBROMYALGIA, PATIENT CARE MANAGEMENT, PRIMARY HEALTH CARE","CHRONIC DIS, COMPARATIVE STUDY, TREATMENT OUTCOME, STRESS PSYCHOLOGICAL",,,,0738-3991,AB,"The aim of this paper is to assess whether patient-centred consultations are more effective than the usual style of consultations used by general practitioners with patients suffering from benign chronic musculoskeletal pain and fibromyalgia. It also seeks to evaluate the differential characteristics of these two clinical groups of symptoms. The study was designed as a cluster randomised and simple blind trial. Twenty general practitioners took part and 110 patients were recruited. Compared with patients who received the usual treatment from their family physician, those who received a patient-centred approach showed greater improvement after 1 year in terms of psychological distress (anxiety) and number of tender points, as well as showing positive trends in some important outcomes such as pain intensity. Significantly better results were observed in those patients suffering chronic pain than in those with fibromyalgia, particularly as regards associated symptoms, self-rated pain and physical mobility as measured by the Nottingham health profile."
0042906,"Cohen H, Neumann L, Haiman Y, Matar MA, Press J, Buskila D",Prevalence of post-traumatic stress disorder in fibromyalgia patients: overlapping syndromes or post-traumatic fibromyalgia syndrome?,Semin Arthritis Rheum 2002 Aug;32(1):38-50,,"STRESS DISORDERS POST TRAUMATIC, FIBROMYALGIA, ANXIETY, DEPRESSIVE DISORDERS","EPIDEMIOLOGY, COMORBIDITY, MALE, FEMALE, PHYSIOPATHOLOGY",,,"The primary aim of this study was to assess the frequency of post-traumatic stress disorder (PTSD) in patients with the fibromyalgia syndrome (FMS). The influence of gender on measures of PTSD in fibromyalgia (FM) patients also was examined. METHODS: Seventy-seven consecutive patients (40 women and 37 men) who fulfilled the criteria for FM were asked to complete questionnaires measuring the prevalence and severity of symptoms of PTSD, anxiety, and depression. The subjects were divided in 2 groups based on the presence or absence of PTSD symptoms. RESULTS: In this study, 57% of the FM sample had clinically significant levels of PTSD symptoms. The FM patients with PTSD reported significantly greater levels of avoidance, hyperarousal, reexperiencing, anxiety, and depression than did the patients without clinically significant levels of PTSD symptoms. The prevalence of PTSD among the FM patients in this study was significantly higher than in the general population. Women with FM and PTSD reported a greater number of past traumatic events than did their male counterparts. CONCLUSIONS: The results represent the first comprehensive study applying structured clinical assessment of trauma exposure and PTSD to a group of FM patients. This study shows a significant overlap between FM and PTSD, according to the currently accepted diagnostic criteria for each.",0049-0172,AB,OBJECTIV
0042907,"Goldenberg DL, Sandhu HS",Fibromyalgia and post-traumatic stress disorder: another piece in the biopsychosocial puzzle,Semin Arthritis Rheum 2002 Aug;32(1):1-2,,"STRESS DISORDERS POST TRAUMATIC, FIBROMYALGIA",PSYCHOLOGY SOCIAL,,,,0049-0172,,
0042908,"Raphael J, Southall J, Treharne G, Kitas G",Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome,Musculoskelet Disord 2002 Sep 8;3(1):21,,"LIDOCAINE, FIBROMYALGIA","DRUG THERAPY, ADVERSE EFFECTS, TREATMENT OUTCOME, INJECTIONS",,,,1471-2474,AB,BACKGROUND: To investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia. METHODS: Prospective study of the adverse effects of IV lignocaine in 106 patients with fibromyalgia; retrospective questionnaire study of the efficacy of IV lignocaine in 50 patients with fibromyalgia. RESULTS: Prospective study: Two major (pulmonary oedema and supraventricular tachycardia) and 42 minor side-effects were reported. None had long-term sequelae. The commonest was hypotension (17 cases). Retrospective study: Pain and a range of psychosocial measures (on single 11-point scales) improved significantly after treatment. There was no effect of the treatment on work status. The average duration of pain relief after the 6-day course of treatment was 11.5 PlusMinus; 6.5 weeks. CONCLUSIONS: Intravenous lignocaine appears to be both safe and of benefit in improving pain and quality of life for patients with fibromyalgia. This needs to be confirmed in prospective randomised controlled trials.
0042909,"Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Ataoglu S","Effects of low power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fibromyalgia: a single-blind, placebo-controlled trial",Rheumatol Int 2002 Sep;22(5):188-93,,"AMITRYPTILINE, FIBROMYALGIA, QUALITY OF LIFE, LASER THERAPY LOW LEVEL","DRUG THERAPY, TREATMENT OUTCOME, SYMPTOMS, COMPARATIVE STUDY",,,,0172-8172,AB,"The purpose of this study was to examine the effectiveness of low power laser (LPL) and low-dose amitriptyline therapy and to investigate effects of these therapy modalities on clinical symptoms and quality of life (QOL) in patients with fibromyalgia (FM). Seventy-five patients with FM were randomly allocated to active gallium-arsenide (Ga-As) laser (25 patients), placebo laser (25 patients), and amitriptyline therapy (25 patients). All groups were evaluated for the improvement in pain, number of tender points, skin fold tenderness, morning stiffness, sleep disturbance, muscular spasm, and fatigue. Depression was evaluated by a psychiatrist according to the Hamilton Depression Rate Scale and DSM IV criteria. Quality of life of the FM patients was assessed according to the Fibromyalgia Impact Questionnaire (FIQ). In the laser group, patients were treated for 3 min at each tender point daily for 2 weeks, except weekends, at each point with approximately 2 J/cm(2) using a Ga-As laser. The same unit was used for the placebo treatment, for which no laser beam was emitted. Patients in the amitriptyline group took 10 mg daily at bedtime throughout the 8 weeks. Significant improvements were indicated in all clinical parameters in the laser group (P = 0.001) and significant improvements were indicated in all clinical parameters except fatigue in the amitriptyline group (P = 0.000), whereas significant improvements were indicated in pain (P = 0.000), tender point number (P = 0.001), muscle spasm (P = 0.000), morning stiffness (P = 0.002), and FIQ score (P = 0.042) in the placebo group. A significant difference was observed in clinical parameters such as pain intensity (P = 0.000) and fatigue (P = 0.000) in favor of the laser group over the other groups, and a significant difference was observed in morning stiffness (P = 0.001), FIQ (P = 0.003), (ABSTRACT TRUNCATED)."
0042910,"Targino RA, Imamura M, Kaziyama HH, Souza LP, Hsing WT, Imamura ST",Pain treatment with acupuncture for patients with fibromyalgia,Curr Pain Headache Rep 2002 Oct;6(5):379-83,,"FIBROMYALGIA, PAIN","ACUPUNCTURE THERAPY, TREATMENT OUTCOME, COMPARATIVE STUDY",,,,1531-3433,AB,"Fibromyalgia is a chronic, painful musculoskeletal syndrome of unknown etiopathogenesis. In addition to medicamentous and physical and psychologic therapies, several other adjunct therapies have been used as alternatives in the attempt to obtain analgesia and decrease the symptoms that are characteristic of this problem. This article presents a literary review on the use of acupuncture as an adjunct or chief treatment for patients with fibromyalgia, comparing it with an ongoing clinical experience that has been carried out at Hospital das Clinicas in the city of Sao Paulo. The results were found by applying traditional acupuncture, which demonstrated positive rates in the Visual Analogue Scale, myalgic index, number of tender points, and improvement in quality of life based on the SF-36 questionnaire."
0042911,"Guo L, Liu Y, Wang H",Prof. Ye Chuanhui's experience in treating nephritic proteinuria,J Tradit Chin Med 2002 Sep;22(3):163-9,proteinuria,"TRADITIONAL MEDICINE CHINESE, UROLOGIC DIS","METHODS, THERAPY, GLOMERULONEPHRITIS",,,,0254-6272,,
0042912,"Wang H, Yuan L",TCM treatment of hypertrophic cardiomyopathy - a case report,J Tradit Chin Med 2002 Sep;22(3):170-3,cardiomyopathy hypertrophic,"TRADITIONAL MEDICINE CHINESE, HEART DIS","HEART VALVE DIS, MYOCARDIAL DIS, CASE REPORT, TREATMENT OUTCOME",,,,0254-6272,,
0042913,"Wang P, Geng S",Sixty-seven cases of abnormal movement of the cardiac apex treated with Bu Xin Tang,J Tradit Chin Med 2002 Sep;22(3):174-7,,"DRUGS CHINESE HERBAL, HEART DIS, MOVEMENT","DRUG THERAPY, TRADITIONAL MEDICINE CHINESE, PREVENTION, TREATMENT OUTCOME",,,,0254-6272,AB,"Bu Xin Tang (heart-reinforcement decoction) was used to treat 67 cases of abnormal movement of the cardiac apex based on differentiation of symptoms and signs. The results showed that, in most patients, there were remarkable improvement not only for the symptoms but also for the abnormal movement of the cardiac apex. The cured plus remarkably effective rate was 87%, suggesting that it can postpone or prevent coronary heart attacks for the patient of prophase coronary heart disease."
0042914,"Xia J, Zhu X, Feng B, Cao Z, Zhu J",Treatment of rheumatic arthritis with Jiang Chen Pian in 114 cases,J Tradit Chin Med 2002 Sep;22(3):178-9,,"ARTHRITIS RHEUMATOID, DRUGS CHINESE HERBAL","DRUG THERAPY, TRADITIONAL MEDICINE CHINESE, TREATMENT OUTCOME",,,,0254-6272,,
0042915,Chen Y,The anatomical physiology and clinical application of the points Huiyang and Zhonglushu,J Tradit Chin Med 2002 Sep;22(3):180-2,,"ACUPOINTS, MERIDIANS, BLADDER DIS","PHYSIOLOGY, ANATOMY, TRADITIONAL MEDICINE CHINESE, ACUPUNCTURE THERAPY",,,,0254-6272,,
0042916,"Wang H, Chen H, Jiang H",Experience in acupuncture treatment of occipital neuralgia,J Tradit Chin Med 2002 Sep;22(3):183,,"NEURALGIA, EYE","ACUPUNCTURE THERAPY, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042917,Wang J,Differential acupuncture treatment of hyperplasia of mammary glands,J Tradit Chin Med 2002 Sep;22(3):184-6,,"HYPERPLASIA, BREAST","ACUPUNCTURE THERAPY, TRADITIONAL MEDICINE CHINESE, DIAGNOSIS, TREATMENT OUTCOME",,,,0254-6272,,
0042918,Wang H,Observation on the therapeutic effects of acupuncture for 60 cases of simple obesity,J Tradit Chin Med 2002 Sep;22(3):187-9,,"OBESITY, DRUGS CHINESE HERBAL","ACUPUNCTURE THERAPY, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE, DRUG THERAPY, COMPARATIVE STUDY",,,,0254-6272,,
0042919,Tang W,Clinical observation on scalp acupuncture treatment in 50 cases of headache,J Tradit Chin Med 2002 Sep;22(3):190-2,,"SCALP ACUPUNCTURE, HEADACHE","THERAPY, METHODS, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE, ACUPOINTS",,,,0254-6272,,
0042920,Lu Z,Scalp and body acupuncture for treatment of senile insomnia - a report of 83 cases,J Tradit Chin Med 2002 Sep;22(3):193-4,,"INSOMNIA, ACUPUNCTURE THERAPY","SCALP ACUPUNCTURE, AGED, THERAPY, METHODS, TREATMENT OUTCOME, DRUG THERAPY, COMPARATIVE STUDY, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042921,Chen X,Acupuncture treatment for 57 cases of hiccup,J Tradit Chin Med 2002 Sep;22(3):195-6,,HICCUP,"ACUPUNCTURE THERAPY, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042922,"Li B, Chai F, Gao H",Cervical spondylopathy involving the vertebral arteries treated by body-acupuncture combined with scalp-acupuncture in 72 cases,J Tradit Chin Med 2002 Sep;22(3):197-9,,"VERTEBRAL ARTERY, SPONDYLITIS, ACUPUNCTURE THERAPY, BLOOD CIRCULATION","METHODS, SCALP ACUPUNCTURE, THERAPY, TREATMENT OUTCOME, ULTRASONOGRAPHY, PATHOLOGY, DIAGNOSIS",,,,0254-6272,,
0042923,Song J,Ischemic apoplexy-induced sequelae treated by penetrating puncture with long needles,J Tradit Chin Med 2002 Sep;22(3):200-2,,"CEREBROVASCULAR DISORDERS, NEEDLING","METHODS, ACUPUNCTURE THERAPY, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042924,"Wang H, Hou Q",Acupuncture and moxibustion for treating ectopic endometrium,J Tradit Chin Med 2002 Sep;22(3):203-4,endometriosis,"GENITAL DISEASES FEMALE, ACUPUNCTURE THERAPY","MOXIBUSTION, THERAPY, TRADITIONAL MEDICINE CHINESE, TREATMENT OUTCOME",,,,0254-6272,,
0042925,"Pouresmail Z, Ibrahimzadeh R",Effects of acupressure and Ibuprofen on the severity of primary dysmenorrhea,J Tradit Chin Med 2002 Sep;22(3):205-10,,"DYSMENORRHEA, IBUPROFEN, ACUPRESSURE","THERAPY, DRUG THERAPY, TREATMENT OUTCOME, COMPARATIVE STUDY, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,AB,"The present study aims at comparing the effects of acupressure using new combination of acupoints, and Ibuprofen on the severity of primary dysmenorrhea (PD). 216 female high school students, aged between 14 to 18 years, were randomly selected and divided into three groups. Each group underwent different treatment techniques: acupressure, Ibuprofen and sham acupressure as a placebo. The results indicated that the three therapeutic techniques were significantly effective in reducing the pain. However the therapeutic efficacies of acupressure and Ibuprofen were similar with no significant difference, and were significantly better than the placebo. Thus acupressure, with no complications, is recommended as an alternative and also a better choice in the decrease of the severity of PD."
0042926,"Zhu X, Bi A, Han X",Treatment of retinal vein obstruction with acupuncture and Chinese medicinal herbs,J Tradit Chin Med 2002 Sep;22(3):211-3,,"DRUGS CHINESE HERBAL, RETINAL DIS, REGIONAL BLOOD FLOW","DRUG THERAPY, ACUPUNCTURE THERAPY, TREATMENT OUTCOME",,,,0254-6272,AB,We have treated thirty-two cases (52 eyes) of retinal vein obstruction by acupuncture and oral administration of Huo Xue Ming Mu Decoction. The total effective rate of 90.38% demonstrated that the treatment was definitely effective.
0042927,Shi C,Thirty-six cases of respiratory dysfunction treated with the modified Sheng Xian Tang,J Tradit Chin Med 2002 Sep;22(3):214-5,,"RESPIRATION DISORDERS, DRUGS CHINESE HERBAL","DRUG THERAPY, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042928,Zhang S,Examples for clinical use of Ma Zi Ren Wan,J Tradit Chin Med 2002 Sep;22(3):216-7,,"DRUGS CHINESE HERBAL, COUGH, DYSPNEA, DIABETES MELLITUS","DRUG THERAPY, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042929,"Hu D, Zhuang Q",Clinical experience in application of the point Zhaohai,J Tradit Chin Med 2002 Sep;22(3):218-20,,"ACUPUNCTURE THERAPY, QI, INSOMNIA","ACUPOINTS, THERAPY, TREATMENT OUTCOME, MERIDIANS",,,,0254-6272,,
0042930,Huang H,Combined use of the points Shenmai and Zhaohai for treatment of craniofacial diseases,J Tradit Chin Med 2002 Sep;22(3):221-3,,"CRANIAL NERVE DIS, ACUPUNCTURE THERAPY","ACUPOINTS, TREATMENT OUTCOME, TRADITIONAL MEDICINE CHINESE, THERAPY",,,,0254-6272,,
0042931,"Zhang D, Lu Y",Clinical application of the point Baihui,J Tradit Chin Med 2002 Sep;22(3):224-7,,"URINATION DISORDERS, ACUPUNCTURE THERAPY","ACUPOINTS, TREATMENT OUTCOME, THERAPY, TRADITIONAL MEDICINE CHINESE",,,,0254-6272,,
0042932,"Xue C, Xue P, Wang Q, Guo X",Advances in TCM treatment of senile vascular dementia,J Tradit Chin Med 2002 Sep;22(3):228-37,,"DEMENTIA SENILE, TRADITIONAL MEDICINE CHINESE, DRUGS CHINESE HERBAL","THERAPY, METHODS, TRENDS, ETIOLOGY, PHYSIOPATHOLOGY, DRUG THERAPY",,,,0254-6272,,
0042933,Hu J,Questions and answers,J Tradit Chin Med 2002 Sep;22(3):238-40,,"SPRAINS AND STRAINS, BACK INJURIES, LUMBOSACRAL REGION, ACUPUNCTURE THERAPY","THERAPY, ACUTE DIS, METHODS",,,,0254-6272,,
0042934,"Graninger M, Grassberger M, Galehr E, Huemer F, Gruschina E, Minar E, Graninger W","Comments, opinions, and brief case reports: biosurgical debridement facilitates healing of chronic skin ulcers",Arch Intern Med 2002 Sep 9;162(16):1906-7,lava,"SKIN ULCER, WOUND HEALING","THERAPY, TREATMENT OUTCOME, SURGERY OPERATIVE",,,,0003-9926,,
0042935,Konnur MK,Vertigo and vestibular rehabilitation,J Postgrad Med 2000 Jul-Sep;46(3):222-3,,"VERTIGO, ACTIVITIES OF DAILY LIVING","OCCUPATIONAL THERAPY, REHABILITATION, VESTIBULE",(Review),,,0022-3859,AB,"The role of rehabilitation in the management of vertigo is limited to a very specific group of conditions. An Occupational therapist who is a part of the multidisciplinary team treating the vertiginous patient, with the knowledge of physiology and therapeutic benefit of vestibular rehabilitation can widen the rehabilitation spectrum for various diseases producing vertigo and dysequilibrium, to resolve or minimise these symptoms. The present article reviews the need for vestibular rehabilitation and the different conditions needing the same along with its characteristics, physiology and various exercises prescribed."
0042936,"Gupta D, Aggarwal AN, Chaganti S, Jindal SK",Reducing the number of daily measurements results in poor estimation of diurnal variability of peak expiratory flow in healthy individuals,J Postgrad Med 2000 Oct-Dec;46(4):262-4,,"RESPIRATORY FUNCTION TESTS, VITAL CAPACITY, ASTHMA","MEASUREMENT, DIAGNOSIS",,,,0022-3859,AB,"AIM: To determine the effect of reducing number of daily measurements on estimation of diurnal variability (DV) of peak expiratory flow (PEF). SUBJECTS AND METHODS: PEF was recorded five times daily for three days in 152 healthy adults. Amplitude percent mean (A%M) and standard deviation percent mean (SD%M) were calculated on third day from five, four, three and two daily readings. Proportion of variability explained by partial schedules was calculated and limits of agreement derived to assess if these methods could be used interchangeably. RESULTS: Four, three and two measurements explained 90-95%, 70-82% and 55% DV respectively using A%M. All schedules of partial measurement using SD%M explained greater than 90% DV. Limits of agreement for A%M and SD%M widened as number of measurements were reduced. CONCLUSIONS: DV obtained by fewer daily measurements agrees poorly with results obtained from five measurements. SD%M is a better alternative if DV is assessed from fewer readings."
0042937,"Zargar AH, Bhat MH, Laway BA, Masoodi SR",Clinical and aetiological profile of early onset diabetes mellitus: data from a tertiary care centre in the Indian subcontinent,J Postgrad Med 2001 Jan-Mar;47(1):27-9,,"DIABETES MELLITUS, EPIDEMIOLOGY","AGE FACTORS, SEX, COMPLICATIONS",,,,0022-3859,AB,"BACKGROUND: Type 2 diabetes mellitus (DM) in youth is emerging as a serious clinical entity and its incidence has increased over the years. AIM: To analyse the causes of DM in the age group of less than 40 years of age. SETTINGS AND DESIGN: Tertiary care centre; retrospective analysis of data from January 1990 to December 1999. SUBJECTS AND MATERIAL: Analysis of data of all the subjects of DM in whom disease started before the 40th birthday. RESULTS: 724 subjects were detected to have diabetes mellitus before their 40th birthday. Of these, 205 had Type 1, 174 had Type 2 and 48 had fibrocalculous pancreatic diabetes. Males outnumbered in Type 1 and fibrocalculous pancreatic diabetes while as females in Type 2 diabetes mellitus. Chronic complications were more common in Type 2 diabetes mellitus. CONCLUSION: Type 2 diabetes mellitus is becoming an important cause of diabetes in subjects with onset of disease at younger age."
0042938,"Al-Haddad MK, Sequeira RP, Nayar U",Neurobiological correlates of panic disorder and agoraphobia,J Postgrad Med 2001 Jan-Mar;47(1):55-61,,"PANIC, AGORAPHOBIA","PROGNOSIS, COGNITIVE THERAPY",,,,0022-3859,AB,"Panic Disorder and agoraphobia offer considerable diagnostic and management challenges, particularly in general practice. We describe a typical case of panic disorder in a young adult. The recent advances in our understanding of brain functions can be used to explain to a certain extent the biologic basis of panic disorder. A hypothetical model integrating current views on panic disorder and agoraphobia has been proposed. The management principles including the role of cognitive therapy and pharmacotherapy have been discussed."
0042939,"Pandey M, Thomas BC",Rehabilitation of cancer patients,J Postgrad Med 2001 Jan-Mar;47(1):62-5,,"NEOPLASMS, PATIENT CARE TEAM, COMMUNICATION","REHABILITATION, OCCUPATIONAL THERAPY, HEALTH PERSONNEL",,,,0022-3859,AB,"With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation."
0042940,"Cronin JB, McNair PJ, Marshall RN",Is velocity-specific strength training important in improving functional performance?,J Sports Med Phys Fit 2002 Sep;42(3):267-73,,"EXERCISE TESTING, PHYSICAL ENDURANCE, MUSCLE STRENGTH",ATHLETES,,,,0022-4707,AB,"A variable considered when designing programs to optimize athletic performance is training velocity. It has been suggested that training at a specific velocity improves strength mainly at that velocity and as velocity deviates from the trained velocity, the less effective training will be. However, the research describing velocity-specific adaptation and the transference of these adaptations to other movement velocities is by no means clear. Compounding the problem in this area is the failure of research to detail the relationship between training velocity and actual movement velocity of a given task or athletic pursuit. In most cases there is a great disparity between training velocity and actual movement velocity. Factors that may better develop and explain velocity-specific adaptation in relation to functional performance are discussed. Developing qualities such as strength, power and rate of force development would appear of greater importance than training at the actual movement velocity of a task. It may be that irrespective of load and limb velocity, the repeated intent to move an isoinertial load as rapidly as possible might be an important stimulus for functional high velocity adaptation. The ability of the nervous system to activate and coordinate agonist, synergist and antagonist activity would seem essential. It was suggested training techniques that simulate the velocity and acceleration profiles associated with the desired functional performance, such as throw or jump training, may optimize functional adaptation. Furthermore combination training that incorporates same session sport specific training with either a heavy load or a mixed training load approach might provide an optimal strategy for promoting intramuscular and intermuscular co-ordination and improving functional performance."
0042941,"Young WB, James R, Montgomery I",Is muscle power related to running speed with changes of direction?,J Sports Med Phys Fit 2002 Sep;42(3):282-8,,"MUSCLE SKELETAL, RUNNING, EXERCISE TESTING","BIOMECHANICS, ENERGY METABOLISM",,,,0022-4707,AB,"BACKGROUND: The purpose of this study was to identify the relationships between leg muscle power and sprinting speed with changes of direction. METHODS: Experimental design: the study was designed to describe relationships between physical qualities and a component of sports performance. Setting: testing was conducted in an indoor sports hall and a biomechanics laboratory. Participants: 15 male participants were required to be free of injury and have recent experience competing in sports involving sprints with changes of direction. Measures: subjects were timed in 8 m sprints in a straight line and with various changes of direction. They were also tested for bilateral and unilateral leg extensor muscle concentric power output by an isokinetic squat and reactive strength by a drop jump. RESULTS: The correlations between concentric power and straight sprinting speed were non-significant whereas the relationships between reactive strength and straight speed were statistically significant. Correlations between muscle power and speed while changing direction were generally low and non-significant for concentric leg power with some moderate and significant (p less than 0.05) coefficients found for reactive strength. The participants who turned faster to one side tended to have a reactive strength dominance in the leg responsible for the push-off action. CONCLUSIONS: The relationships between leg muscle power and change-of-direction speed were not consistent. Reactive strength as measured by the drop jump appears to have some importance for lateral change-of-direction speed, possibly because of similar push-off actions. It was concluded that reactive strength of the leg extensor muscles has some importance in change-of-direction performance but the other technical and perceptual factors than influence agility performance should also be considered."
0042942,"Vuillerme N, Nougier V, Teasdale N",Effects of lower limbs muscular fatigue on anticipatory postural adjustments during arm motions in humans,J Sports Med Phys Fit 2002 Sep;42(3):289-94,,"MUSCLE SKELETAL, POSTURE, MUSCLE FATIGUE","LEG, PHYSIOLOGY, ELECTROMYOGRAPHY",,,,0022-4707,AB,"BACKGROUND: The purpose of the present experiment was to examine the effects of lower limbs muscular fatigue on the anticipatory postural adjustments during a voluntary arm raising movement. METHODS: Eight adult males (mean age 29 +/- 6 years) voluntarily participated to the experiment. Subjects' task consisted in performing an unilateral ante-flexion of the right arm over 90 deg, holding a 500 g weight, once having stabilized their upright posture. A similar movement execution was required. Measurements were made in a no-fatigue situation and under a high level of fatigue of lower limbs. Surface EMG of four postural muscles (the ipsilateral and contralateral Gastrocnemius and the ipsilateral and contralateral Semitendinosus) and of one muscle involved in the arm raising (the Anterior Deltoideus of the right arm) was recorded. Body sway was also monitored using a force platform. RESULTS: With fatigue, quantitative EMG analysis showed a decrease of the ipsilateral Semitendinosus activity whereas the temporal EMG analysis showed an increase of its latency with respect to movement onset. CONCLUSIONS: These data suggested a functional adaptation resulting in an invariance of global anticipatory postural adjustments for the two conditions of no-fatigue and fatigue and ensuring an adequate execution of the movement."
0042943,"Rozenek R, Ward P, Long S, Garhammer J",Effects of high-calorie supplements on body composition and muscular strength following resistance training,J Sports Med Phys Fit 2002 Sep;42(3):340-7,,"DIETARY SUPPLEMENTS, RESISTANCE TRAINING, BODY COMPOSITION, MUSCLE STRENGTH","NUTRITION, ENERGY METABOLISM",,,,0022-4707,AB,"BACKGROUND: Seventy-three healthy, male subjects randomly divided into 3 groups participated in a study to determine the effects of 2 high-calorie nutritional supplements on body composition, body segment circumferences, and muscular strength following a resistance-training (RT) program. METHODS: In addition to their normal diets group 1 (CHO/PRO; n = 26) consumed a 8.4 Mj x day-1 (2010 kcal) high calorie, high protein supplement containing 356 g carbohydrate and 106 g protein. Group 2 (CHO; n = 25) consumed a carbohydrate supplement that was isocaloric with CHO/PRO. Group 3 (CTRL; n = 22) received no supplement and served as a control. All subjects were placed on a 4-day x week-1 RT program for 8 weeks. RESULTS: Dietary analysis revealed no significant differences in total energy consumption or nutrients at any time in the non-supplemented diets of the 3 groups. Significant (p = less than 0.05) increases in body mass (BM) and fat-free mass (FFM) were observed in CHO/PRO and CHO compared to CTRL. Mean (+/- SD) increases in BM were 3.1 +/- 3.1 kg and 3.1 +/- 2.2 kg, respectively. Fat-free mass significantly (p = less than 0.05) increased 2.9 +/- 3.4 kg in CHO/PRO and 3.4 +/- 2.5 kg in CHO. Muscular strength, as measured by a one-repetition maximum in the bench press, leg press, and lat-pull down increased significantly (p = less than 0.05) in all groups. No significant differences in strength measures were observed among groups following training. CONCLUSIONS: Results indicate that high-calorie supplements are effective in increasing BM and FFM when combined with RT. However, once individual protein requirements are met, energy content of the diet has the largest effect on body composition."
0042944,"Buckworth J, Wallace LS",Application of the Transtheoretical Model to physically active adults,J Sports Med Phys Fit 2002 Sep;42(3):360-7,,"EXERCISE TESTING, HEALTH PROMOTION","ADULT, PSYCHOLOGY",,,,0022-4707,AB,"BACKGROUND: A physically activity lifestyle has established health benefits, but interventions to increase exercise adherence have had mixed success. Examining physically active individuals could provide insight into strategies that are effective for exercise maintenance. The purpose of this study was to compare active adults based on exercise stage classification (action (ACT) and maintenance (MT)) according to the Transtheoretical Model (TTM). Physiological and psychosocial differences between stages were hypothesized to be consistent with theory and previous research. METHODS: A cross-sectional design was used to examine components of the TTM, exercise behavior, resting cardiovascular variables, and VOpeak. Data from 57 physically active college students (age = 21.2 +/- 3.7 yrs, 67% female, 71.9% Caucasian) were included in the analysis. TTM variables and self-report of behavior were measured with established questionnaires. VOpeak was determined from expired gases during a maximal exercise test. RESULTS: Volume of weekly exercise and number of months consistently active were significantly greater for MT (n = 35) than for ACT (n = 22). When controlling for gender effects, VOpeak and systolic blood pressure were also greater in MT than ACT. MT also scored higher than ACT on decisional balance (pros-cons of exercise) and 4 processes of change. CONCLUSIONS: Membership in MT and ACT stages was corroborated by aerobic capacity. Predicted differences in TTM components were only partially supported, but behavioral strategies were used more by participants who were consistently active longer. Physically active individuals should be studied over time to determine if targeting behavioral processes of change will enhance long-term exercise adherence."
0042945,Shephard RJ,Exercise under hot conditions: a major threat to the immune response?,J Sports Med Phys Fit 2002 Sep;42(3):368-78,,"BODY TEMPERATURE, EXERCISE, IMMUNE SYSTEM","ATHLETES, ENVIRONMENTAL EXPOSURE",,,,0022-4707,AB,"It seems likely that the disturbances of immune response induced by prolonged competitive exercise are exacerbated if athletes also face the stress of hot environmental conditions. We have investigated this question by manipulating the exercise-induced increases of body temperature in a climatic chamber and by submersion of exercisers in a large water-bath. Hot conditions increase the stress of a given bout of exercise, as assessed by personal perceptions, objective (heart rate variability) measures of autonomic nerve balance, and the secretion of \"stress\" hormones, with a parallel increase in effects upon critical lymphocyte subsets. Changes in the immune response show substantial correlations with plasma concentrations not only of epinephrine (which modulates the adhesiveness of peripherally sequestered lymphocytes), but also with norepinephrine. The latter hormone may mobilize leukocytes from the spleen and lymph glands, or it may act by increasing cardiac output and thus intravascular shear forces. Given the cumulative impact of various environmental stressors upon the immune system, every effort should be made to minimize the athlete's exposure to stresses other than the exercise to be performed. In some circumstances, the use of medications to reduce the overall stress response may also be warranted."
0042946,"Thomas C, Morris SM",Informal carers in cancer contexts,Eur J Cancer Care 2002 Sep;11(3):178-82,,"CAREGIVERS, NEOPLASMS, ADAPTATION PSYCHOLOGICAL","PATIENT CARE, INTERPERSONAL RELATIONS",,,,0961-5423,AB,"This paper considers some of the challenges involved in studying informal carers in cancer contexts. It reviews current knowledge by examining, first, the dominant psycho-oncological research tradition that focuses on psychological distress among carers and, second, the more recent sociologically informed body of work examining what carers actually do and the contribution that they make to patient care. The authors suggest that this second sociologically informed approach offers an important counter-weight to the psycho-oncological perspective. The developing research agenda for a sociology of cancer caring is briefly outlined."
0042947,"Morris SM, Thomas C",The need to know: informal carers and information,Eur J Cancer Care 2002 Sep;11(3):183-7,,"NEOPLASMS, COMMUNICATION, PATIENT CARE",CAREGIVERS,,,,0961-5423,AB,"There is a growing recognition that the carers of cancer patients require information. A key source of this information is the formal health care system that patients, and thus carers, encounter. However, the research literature suggests a lack of clarity on the part of service providers concerning the type, amount, timing and purpose of information for carers. This lack of clarity is reflected in the ways carers have been 'tacked on' to patients and thus are often treated as co-clients. That carers are also an active participants in the illness scenario is not always fully recognized, resulting in failure to provide appropriate information. Carers' interactions with health service providers are complex and context bound, and entail potential tensions of allegiance in the arena of information exchange. This article suggests that the following research and practice is required: a clearer understanding of the informational needs of carers in variable situations, specific ways to address these needs, where carers 'fit in' to the health care system, and how processes of information exchange with carers can be improved."
0042948,Addington-Hall J,Research sensitivities to palliative care patients,Eur J Cancer Care 2002 Sep;11(3):220-4,,"TERMINAL ILLNESS, PATIENT CARE, RESEARCH, ETHICS",PALLIATIVE TREATMENT,,,,0961-5423,AB,"This paper considers the methodological challenges of researching the health care experiences of palliative care patients and their families. Difficulties in defining a 'palliative care patient' are highlighted, and the question of whether there are specific ethical issues when researching palliative care explored. Methodological issues are discussed, including the negotiation of access via health professionals, the choice of appropriate data collection methods and tools, the consequences of high attrition rates and the use of retrospective surveys of bereaved relatives. Key areas for research are identified. These include patients' and families' experiences of research participation, the impact of being approached on those who decline, how the characteristics of those who participate differ from those who do not and the likely impact of this on findings. Research is also needed into patient and family motivations for participation, and whether and how these change as the disease progresses. To ensure that the voices of palliative care patients and their families are heard by both service providers and policy-makers, research in this area needs to address the methodological challenges raised in this paper, as well as continuing to explore users' views."
0042949,Rio R,Improvization with the elderly: moving from creative activities to process-oriented therapy,Arts Psychother 2002;29(4):191-201,,"MUSIC, INSTITUTIONALIZATION, COMMUNICATION","THERAPY, AGED",,,,0197-4556,,
0042950,Wood MJ,Researching art therapy with people suffering from AIDS related dementia,Arts Psychother 2002;29(4):207-19,,"ART THERAPY, DEMENTIA, HIV INFECTIONS","RESEARCH, COGNITION",,,,0197-4556,AB,"This report begins with a survey of the literature on art therapy with people suffering from a variety of dementias, thus providing a context within which to understand the present study. The next section provides a detailed description of the methodology used and is followed by a section detailing the findings of the research. These findings are then discussed and propositions are made about the nature of the art therapy relationship with people who have AIDS dementia. Some areas are also suggested as worthy of further research."
0042951,"Speed CA, Nichols D, Richards C, Humphreys H, Wies JT, Burnet S, Hazleman BL",Extracorporeal shock wave therapy for lateral epicondylitis - a double blind randomised controlled trial,J Orthop Res 2002 Sep;20(5):895-8,,"TENNIS ELBOW, ULTRASONICS","THERAPY, TREATMENT OUTCOME",,,,0736-0266,AB,"Extracorporeal shock wave therapy (ESWT) is an increasingly popular therapeutic approach to the treatment of a number of soft tissue complaints. Whilst benefit has been demonstrated in calcific tendinitis, evidence is lacking for benefit in the management of non-calcific rotator cuff disorders. Aims: To perform a double-blind placebo controlled trial of moderate dose ESWT in chronic lateral epicondylitis. Methods: Adults with lateral epicondylitis were randomised to receive either active treatment (1500 pulses ESWT at 0.12 mJ/mm2) or sham therapy, monthly for three months. All were assessed before each treatment and one month after completion of therapy. Outcome measures consisted of visual analogue scores for pain in the day and at night. Results: Seventy-five subjects participated and there were no significant differences between the two groups at baseline. The mean duration of symptoms was 15.9 and 12 months in the ESWT and sham groups, respectively. Both groups showed significant improvements from two months. No significant difference existed between the groups with respect to the degrees of change in pain scores over the study period. In the ESWT group the mean (SD, range) pain score was 73.4 (14.5, 38-99) at baseline and 47.9 (31.4, 3-100) at three months. In the sham group the mean (SD, range) pain score was 67.2 (21.7, 12-100) at baseline and 51.5 (32.5, 3-100) at three months. At three months, 50% improvement from baseline was noted in 35% of the ESWT group and 34% of the sham group with respect to pain. Conclusions: There appears to be a significant placebo effect of moderate dose ESWT in subjects with lateral epicondylitis but there is no evidence of added benefit of treatment when compared to sham therapy."
0042952,"Palmes D, Spiegel HU, Schneider TO, Langer M, Stratmann U, Budny T, Probst A",Achilles tendon healing: long-term biomechanical effects of postoperative mobilization and immobilization in a new mouse model,J Orthop Res 2002 Sep;20(5):939-46,,"ACHILLES TENDON, MOBILISATION, POSTOPERATIVE CARE","MICE, BIOMECHANICS",,,,0736-0266,AB,"The aim of the study was to investigate the long-term effects of postoperative immobilization as opposed to mobilization on the biomechanical attributes of healing Achilles tendons in a new experimental mouse model. In 114 Balb-C-mice the left Achilles tendon was transected and sutured by the Kirchmayr-Kessler technique. The tendons healed either under postoperative immobilization effected by fixing the upper ankle joint in equinus position or under mobilization through a limited range of movement. The contralateral Achilles tendons served as internal control. All tendons were tested biomechanically at short intervals up to the 112th postoperative day in terms of load to failure (N), tendon deflection (mm) and tendon stiffness (N/mm), and were evaluated histologically after 8 and 112 days. Postoperative mobilization resulted in a continuous and significantly more rapid restoration of load to failure in comparison to the immobilization group. Tendon deflection was decreased by postoperative mobilization, whereas under immobilization it paradoxically increased still further in the later course. After 112 days the tendons of the mobilization group had regained their original tendon stiffness, whereas the tendons after immobilization reached only about half the values seen in the control tendons. Histologically, postoperative mobilization led to increased immigration of inflammatory cells in the early phase. In the late phase, as compared to immobilization, tendon structure was more mature, with fibre bundles arranged in parallel and interposed tendocytes. Tensile loading of the healing tendon by postoperative mobilization leads to fundamental changes in the biological process of tendon healing resulting in accelerated restoration of load to failure and reduced tendon deflection."
0042953,"Grealou L, Aubin CE, Labelle H",Rib cage surgery for the treatment of scoliosis: a biomechanical study of correction mechanisms,J Orthop Res 2002 Sep;20(5):1121-8,,"SCOLIOSIS, SURGERY OPERATIVE, RIBS","BIOMECHANICS, TREATMENT OUTCOME",,,,0736-0266,AB,"Rib shortening or lengthening are surgical options that are used to address the cosmetic rib cage deformity in scoliosis, but can also alter the equilibrium of forces acting on the spine, thus possibly counteracting in a mechanical way the scoliotic process and correcting the spinal deformities. Although rib surgeries have been successful in animal models, they have not gained wide clinical acceptance for mechanical correction of scoliosis due to the lack of understanding of the complex mechanisms of action involved during and after the operation. The objective of this study was to assess the biomechanical action of different surgical approaches on the rib cage for the treatment of scoliosis using a patient-specific finite element model of the spine and rib cage. Several unilateral and bilateral rib shortening/lengthening procedures were tested at different locations on the ribs (convex/concave side of the thoracic curvature; at the costo-transverse/costo-chondral joint; 20 and 40 mm adjustments). A biomechanical analysis was performed to assess the resulting geometry and load patterns in ribs, costo-vertebral articulations and vertebrae. Only slight immediate geometric variations were obtained. However, concave side rib shortening and convex side rib lengthening induced important loads on vertebral endplates that may lead to possible scoliotic spine correction depending on the remaining growth potential. Convex side rib shortening and concave side rib lengthening produced mostly cosmetic rib cage correction, but generated inappropriate loads on the vertebral endplates that could aggravate vertebral wedging. This study supports the concept of using concave side rib shortening or convex side rib lengthening as useful means to induce correction of the spinal scoliotic deformity during growth. (ABSTRACT TRUNCATED)."
0042954,"Schnelle JF, Alessi CA, Simmons SF, Al-Samarrai NR, Back JC, Ouslander JG",Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents,J Am Geriatr Soc 2002 Sep;50(9):1476-83,,"EXERCISE, URINARY INCONTINENCE","RESIDENTIAL FACILITIES, TREATMENT OUTCOME",,,,0002-8614,AB,"Objectives: To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention. Design: Randomized controlled trial with blinded assessments of outcomes at three points over 8 months. Setting: Four nursing homes. Participants: Two hundred fifty-six incontinent residents. Intervention: Research staff provided the intervention, which integrated incontinence care and exercise every two hours from 8.00 a.m. to 4.00 p.m. 5 days a week. Measurements: Average and maximum distance walked or wheeled, level of assistance required to stand, maximum pounds lifted by arms, fecal and urinary incontinence frequency, and time required to implement intervention. Results: Intervention residents maintained or improved performance whereas the control group's performance declined on 14 of 15 outcome measures. Repeated measures analysis of variance group-by-time significance levels ranged from P less than .0001 to .05. The mean time required to implement the intervention each time care was provided was 20.7 + or - 7.2 minutes. We estimate that a work assignment of approximately five residents to one aide would be necessary to provide this intervention. Conclusions: The incontinence care and exercise intervention resulted in significant improvement for most residents, and most who could be reliably interviewed expressed a preference for such care. Fundamental changes in the staffing of most nursing homes will be necessary to translate efficacious clinical interventions into everyday practice."
0042955,"Dey DK, Rothenberg E, Sundh V, Bosaeus I, Steen B","Waist circumference, body mass index, and risk for stroke in older people",J Am Geriatr Soc 2002 Sep;50(9):1510-18,,"BODY WEIGHTS AND MEASURES, CEREBROVASCULAR DISORDERS, OBESITY","AGED, RISK, SWEDEN, SEX",,,,0002-8614,AB,"Objectives: To investigate waist circumference (WC) and body mass index (BMI) at age 70 as risk factors for stroke. Design: Cohort study of 70-year-olds with 15-year-follow-up. Setting: Geriatric Medicine Department, Goteborg University, Sweden. Participants: Two thousand two hundred eighty-seven (1,045 men; 1,242 women) 70-year-olds examined between 1971 and 1981 in Goteborg, Sweden. Measurements: Cox regression model was used to calculate relative risk (RR) and 95% confidence interval (CI) for first-ever stroke (fatal and nonfatal) in reference to the lowest quartiles of WC and BMI. Tests for trend were performed fitting WC and BMI in their original continuous form. Results: In men and women, RRs for stroke, in the highest WC quartile were 1.65 (95% CI = 1.08-2.51) and 1.31 (95% CI = 0.88-1.92), respectively, after adjustment for cohorts, smoking habit, coronary heart disease (CHD), diabetes mellitus, total cholesterol (TC), systolic blood pressure (SBP), and height at age 70. In men, RR for stroke in the highest BMI quartile (more than or equal to 28 kg/m2) was 1.68 (95% CI = 1.12-2.53) after adjustment for cohorts, smoking habits, CHD, diabetes mellitus, TC and SBP at age 70. In women, adjusted RRs for stroke across the BMI quartiles were not significantly different. In men, population attributable fractions of stroke were 24.8% and 25.2% for the highest quartiles of WC and BMI, respectively. Conclusions: High WC (less than or equal to 99 cm) and BMI (less than or equal to 28 kg/m2) are risks for stroke in older men but not in older women."
0042956,"Phelan EA, Williams B, Leveille S, Snyder S, Wagner EH, LoGerfo JP",Outcomes of a community-based dissemination of the health enhancement program,J Am Geriatr Soc 2002 Sep;50(9):1519-24,,"HEALTH PROMOTION, HEALTH SERVICES, SELF CARE, CHRONIC DIS","AGED, BEHAVIOR, RISK, DISABILITY EVALUATION",,,,0002-8614,AB,"Objectives: We previously found in an efficacy trial that a health promotion program prevented functional decline and reduced hospitalizations in community-dwelling older people with chronic conditions. We sought to evaluate the effectiveness of the program in its dissemination phase. Design: Outcome evaluation using a within-group, pretest-posttest design. Setting: fourteen senior centers located throughout western Washington. Participants: Three hundred four community-dwelling men and women aged 65 and older. Intervention: A disability-prevention, chronic disease-self management program. Measurements: Participant characteristics, risk factors for disability, change in health and functional status, and healthcare use over 1 year of enrollment; participant satisfaction. Results: Participants were 71% female, had a mean age of 76, and reported three chronic health conditions on average. The percentage of participants found to be depressed decreased (28% at time of enrollment vs 17% at 1-year follow-up, P = .005). The percentage of physically inactive participants decreased (56% vs 38%, P=.001). physical activity level and exercise readiness improved (Physician-based Assessment and Counseling for Exercise mean score 4.3 vs 5.1, P = .001). At follow-up, 83% rated their health the same as or better than a year ago, compared with 73% at time of enrollment. The proportion with impaired functional status, as measured by bed days and restricted activity days, stayed the same. The proportion hospitalized remained stable (23% at enrollement and follow-up, P = 1.0). Conclusions: Under real world conditions, the Health Enhancement Program reaches older people at risk of functional decline. Those enrolled for 1 year experience a reduction in disability risk factors, improvement in health status, and no increase in self-reported healthcare use."
0042957,"Herman R, McGory JT",The conceptual similarity of intonational tones and its effects on intertranscriber reliability,Lang Speech 2002 Mar;45(1):1-36,,SPEECH,SPEECH LANGUAGE PATHOLOGY,,,,0023-8309,AB,"Tests of intertranscriber agreement in prosodically-labelled corpora have been used as an objective performance measure of reliability. Reasonably high agreements among labelers have been found, but systematic disagreements exist, indicating that some intonational patterns are more difficult for transcribers to label while others are easier. This may be due to differences in the way transcribers distinguish between tonal labels for pitch events. We developed a method to map the subjective similarity space for the categories in an intonational transcription system. From this map, we derived a conceptual similarity index indicating the distance between tone categories. This subjective similarity index is used to predict the intertranscriber reliability. It is found that tones which are conceptually similar result in higher transcriptional disagreements while tones which are conceptually dissimilar result in lower disagreement."
0042958,Weber A,Assimilation violation and spoken-language processing: a supplementary report,Lang Speech 2002 Mar;45(1):37-46,,"SPEECH, LANGUAGE, NOSE",SPEECH LANGUAGE PATHOLOGY,,,,0023-8309,AB,"Previous studies have shown that spoken-language processing is inhibited by violation of obligatory regressive assimilation. Weber (2001) replicated this inhibitory effect in a phoneme-monitoring study examining regressive place assimilation of nasals, but found facilitation for violation of progressive assimilation. German listeners detected the velar fricative (x) more quickly when fricative assimilation was violated (e.g. (bixt) or (blinxen)) than when no violation occurred (e.g. (baxt) or (blu:xen)). It was argued that a combination of two factors caused facilitation: (1) progressive assimilation creates different restrictions for the monitoring target than regressive assimilation does, an (2) the sequences violating assimilation (e.g. (1X)) are novel for German listeners and therefore facilitate fricative detection (novel popout). The present study tested progressive assimilation violation in non-novel sequences using the palatal fricative (c). Stimuli either violate fricative assimilation (e.g. (ba:cel)) or did not (e.g. (bi:cel)). This manipulation does not create novel sequences: sequences like (a:c) can occur across word boundaries, while (1X) cannot. No facilitation was found. However, violation also did not significantly inhibit processing. The results confirm that facilitation depends on the combination of progressive assimilation with novelty of the sequence."
0042959,"Cowie R, Douglas-Cowie E, Wichmann A",Prosodic characteristics of skilled reading: fluency and expressiveness in 8 - 10-year-old readers,Lang Speech 2002 Mar;45(1):47-82,,READING,"CHILD, SPEECH LANGUAGE PATHOLOGY",,,,0023-8309,AB,"Statistical methods of describing prosody were used to study fluency, expressiveness and their relationship among 8-10-year-old readers. 67 children were rated on fluency and expressiveness. The two were partially independent in the full sample: expressiveness rarely occurred without fluency, but fluency occurred without expressiveness. A balanced subsample of 24 was selected for closer instrumental and statistical analysis. There were robust relationships between expressiveness and variables associated with pitch mobility, and between fluency and measures associated with temporal organization. Interactions indicated that the relationships were not simple. Differences between groups depended on sentence content and position-expressive readers distinguished sentences more sharply according to content, and the groups diverged on some measures as the passage progressed. Also, measures associated primarily with either fluency or expression often showed secondary sensitivity to the other: temporal organization was associated with fluency, but worsened over time among inexpressive readers; and readers who were both fluent and expressive were distinctive in several respects. Some measures offer a basis for rules aimed at assigning individuals to skill categories, particularly the magnitude of pitch movements and reading time per syllable. The rules distinguish well among readers who were either at one of the extremes of skill, or fluent but inexpressive; it is harder to discriminate among the other readers (who have mixed skill patterns). The effects suggest psychological hypotheses about the underlying mechanisms."
0042960,Rossignol S,Locomotion and its recovery after spinal injury in animal models,Neurorehabil Neural Repair 2002 Jun;16(2):201-6,,"LOCOMOTION, SPINAL INJURIES","ANIMALS, PHYSIOPATHOLOGY",,,,,,
0042961,Wilson BA,Cognitive rehabilitation in the 21st century,Neurorehabil Neural Repair 2002 Jun;16(2):207-10,,"COGNITION, BRAIN INJURIES",REHABILITATION,,,,,,
0042962,Hallett M,Recent advances in stroke rehabilitation,Neurorehabil Neural Repair 2002 Jun;16(2):211-7,,CEREBROVASCULAR DISORDERS,"REHABILITATION, THERAPY, TREATMENT OUTCOME",,,,,,
0042963,"Parino E, Pisani PC, Milano L",Interposition arthroplasty with periosteal graft of the lesser metatarsophalangeal joints: first long term results,Chir Piede 2002 Apr;26(1):1-7,,"METATARSOPHALANGEAL JOINT, ARTHROPLASTY, JOINT DIS, FOOT DIS","TREATMENT OUTCOME, SURGERY OPERATIVE, METHODS, FOLLOW UP STUDIES",,Italian,English Summary,0392-0771,AB,"Background: Surgery treatment of an isolated arthropathy of the external metatarsophalangeal joint, outside rheumatoid pathology, presents a number of problems that are difficult to resolve. The rigidity of the metatarsophalangeal joint, axial deviations, metatarsalgia and load transfer phenomena to contiguous rays represent the most common disabling sequelae to surgery. The disappointing medium-term results of silicone prostheses prompted us to explore surgical techniques that would preserve joint function without resorting to demolitive surgery. Interposition arthroplasty with periosteal graft appears to achieve to this aim. Methods: We report the results of a retrospective study of 12 patients treated between 1991 and 2000 with a mean follow-up of 43 months. The pathology causing arthropathy was: surgical sequelae in 6 cases, Koeffier's disease in 4 cases, 2nd metatarsophalangeal joint syndrome in 2 cases, one case of trauma and isolated psoriasic arthropathy respectively. Surgery consisted of the interposition of a periosteal graft taken from the anterior proximal region of the tibia and positioned between the remodelled joint surfaces of the metatarsophalangeal joint and sutured to the joint capsule. Results: The results were assessed using a AOFAS score card (acc. Kitaoka) with a mean score of 65 out of 100. The best results were obtained in cases suffering sequelae of Koeffier's disease (5 procedures) with 75.5 points. The subjective assessment of surgery was positive in 8 cases, with reserves in 3 cases and negative in 1 case. Conclusions: The technique is easy to carry out and allows difficult clinical situations to be overcome, preserving function and stability of the external metatarsophalangeal joints, albeit with a little loss of movement."
0042964,"Prina P, Caruso E, Franceschini M, Franceschini R",Failures and complications of bunion correction,Chir Piede 2002 Apr;26(1):9-16,,HALLUX VALGUS,"POSTOPERATIVE COMPLICATIONS, SURGERY OPERATIVE, TREATMENT OUTCOME",,Italian,English Summary,0392-0771,AB,"Hallux valgus has multiple origins. Over the years, several explanations have been given for such deformity and many surgical options have been mentioned. In this paper, failures and complications of these surgical procedures are described, comparing the available literature. The authors report their personal experience showing description and illustration of the most significant cases, operated in the last years in this hospital. The aim is not to criticize choices that have been made, but to point out all the problems that can affect the outcome of bunion surgery. In some cases, in which our experience is directly involved, the causes of such problems are analysed in order to avoid to repeat them in the future."
0042965,"Parino E, Pisani PC, La Motta R",Childhood foot pathology: statistical clinical report,Chir Piede 2002 Apr;26(1):17-34,,"FOOT DIS, FOOT DEFORMITIES","CHILD, EPIDEMIOLOGY, DIAGNOSIS",,Italian,English Summary,0392-0771,AB,"Background: We report a descriptive epidemiological study carried out between April 1989 and December 2000 on foot pathologies in childhood. Methods: A total of 1978 patients were examined and, in overall terms, a preliminary analysis revealed a slight predominance of males and a prevalent incidence in the 1st year of life and between 9-11 years old. Results: The various pathologies were subdivided into large groups: malformations 22%, dysontomorphogenesis 60%, deformity 10%, misalignments 6%, osteochondrosis 1% and lastly miscellaneous pathologies 1% comprising individual case and rarer forms. Among these, there was a higher incidence of dysontomorphogenesis followed by malformations, deformitis, misalignments, miscellaneous forms and osteochondrosis. Congenital clubfoot was the most frequent pathology in the group of malformations, representing 60%; this was followed by toe malformation and tarsal synostosis, vertical astragalus and agenesis. Among the cases of dysontomorphogenesis, we included evolutive splayfoot (talipes calcaneovalgus, talipes cavovalgus, flatfoot), metatarsus varus, juvenile hallux valgus, macrosomia and, lastly, dysmetric tarsal flatfoot. With regard to deformities, namely acquired pathologies, these included: neurological foot, talipes talovalgus, toe deformities and lastly, deformities linked to ulcerotic amniotic disease. Another group was represented by morphofunctional misalignments of the foot in association with sovrasegmentary misalignment. The cases of osteochondrosis included forms affecting the calcaneus, astragalus and scaphoid and metatarsal bones. Lastly, but only in term of the small number of cases, the miscellaneous group included rare pathologies or single cases: subastragalar instability, exostosis, tumours, tibio-tarsal instability, talipes calcaneovarus in the sequelae to rickets. (ABSTRACT TRUNCATED)."
0042966,Pisani G,Functional interaction of the lower extremity,Chir Piede 2002 Apr;26(1):35-49,,"HIP, FOOT, KNEE, WALKING, RUNNING, JUMPING","BIOMECHANICS, PHYSIOLOGY, GRAVITATION",,Italian,English Summary,0392-0771,AB,"The foot as object is discussed within a mechanically defined lower extremity context and reference is made to how the mechanisms that take part in the three levels of space come together in segmentary functional integration of the extremity. On this basis, the antigravity mechanisms which, within neuromotor integration, act so that the foot as object can be an \"instrument\" for erect posture, walking, running and jumping are analysed. Finally, the problem of how, for example, in a poliomyelitic paraplegia with loss of antigravity servomechanisms it is possible to achieve a passive static posture of the lower extremity, is discussed."
0042967,"Napoli V, Napoli E",Operative risk in foot surgery,Chir Piede 2002 Apr;26(1):51-5,,"FOOT, SURGERY OPERATIVE","RISK, COMPLICATIONS",,Italian,English Summary,0392-0771,AB,"Operative risk is an inalienable component and generally refers to the possibility of an adverse event occurring as a consequence of surgery. The present paper indicates the basic elements for a balanced preoperative judgement of risk in foot surgery subdivided into two categories: general and specific. General risk is common to all surgical operations and escapes any type of evaluation insofar as it is bound up with fatality, error, the technical capacity of the operators and the structures. The specific risk consists of four indispensable elements: 1) the patient's clinical condition; 2) preoperative diagnosis; 3) biological impact; 4) anaesthesiological approach and represents the basis for evaluating the assignment of the extent of operative risk. The great variability of the elements in question does not allow standard evaluation criteria to be adopted but demands a personalised judgement depending on the patient and the operation."
0042968,Sheridan M,Assessment of deaf and hard-of-hearing persons: a strength-based transactional deafness paradigm,JADARA 1999 Fall;33(1):1-9,,"HEARING DISORDERS, PATIENT ASSESSMENT","CULTURE, SEX, DISCRIMINATION",,,,0899-9228,AB,"This article discusses the existence of a cultural and professional obsession with pathology which has jaded mental health assessments of consumers. The importance of incorporating ecological and strengths perspectives into the assessment process is discussed. It is suggested that individual and environmental strengths need to be taken into consideration for a more positive, respectful and empowering shift in assessment paradigms to occur. Deaf knowledgeable mental health professionals have an ethical obligation to consider the strengths and meanings of various d/Deaf, hard-of-hearing and late deafened realities as well as the individual's ancestral, cultural, spiritual and gender realities. A strengths based transactional deafness paradigm allows us to assess and incorporate the strengths and limitations of the person-environment fit and paves the way for a more humane and respectful approach to intervention."
0042969,Leigh IW,From traditional to innovative assessment: the case of depression,JADARA 1999 Fall;33(1):10-19,,"HEARING DISORDERS, PATIENT ASSESSMENT, DEPRESSION, MENTAL HEALTH","METHODS, TRENDS",,,,0899-9228,AB,"This article reviews various approaches to the assessment of depression in deaf people as based on current research. Studies comparing traditional paper and pencil instrumentation with American Sign Language (ASL) videotape approaches are presented. Results indicate that both approaches do work with deaf clients, depending on language proficiency in either English or ASL. Exploration of computerized technology is warrented."
0042970,"Eckhardt E, Steinberg A, Lipton DS, Montoya L, Goldstein MF",Innovative directions in mental health assessment part III: use of interactive video technology in assessment: a research project,JADARA 1999 Fall;33(1):20-30,,"MENTAL HEALTH, PATIENT ASSESSMENT, RESEARCH DESIGN","VIDEOTAPE RECORDING, METHODS, CLINICAL ASSESSMENT SCALES",,,,0899-9228,AB,"This article will report the steps and procedures implemented in the development and testing of the Diagnostic Interview Schedule for the Deaf-1V (DDIS-1V). The DDIS-1V is a standardized mental health assessment instrument developed for use with individuals who are deaf, it is self-administered in American Sign Language (ASL) on laptop computer. This research is supported by a Small Business Innovations Research Grant from the National Institute of Mental Health. The translation procedure consisted of two translation teams, advisors, and back translation. The technological procedure included the digital videotaping of assessment items in ASL, the use of interactive video software and the development of a database and scoring program. During the testing phase, individuals who are deaf and receiving inpatient and outpatient mental health services will be tested two times, once using self-administered version of the instrument and the second time receiving the same test in ASL by a mental health clinician."
0042971,Siedlecki T,Intelligent use of the Rorschach Inkblot Technique with deaf persons,JADARA 1999 Fall;33(1):31-46,,"PSYCHOLOGICAL TESTS, HEARING DISORDERS, CLINICAL ASSESSMENT SCALES","CONSISTENCY AND RELIABILITY, LANGUAGE",,,,0899-9228,AB,The Rorschach Inkblot Technique can be a valuable component of a psychological assessment of deaf persons if the clinician takes into account the available research data on how normal deaf persons respond to the Rorschach. Relying solely on norms from hearing persons can lead to erroneous conclusions. This article provides guidelines for administering and interpreting the Rorschach with deaf clients. A case example demonstrates how the Rorschach can be valuable even with a client with limited language skills.
0042972,Hoy A,New horizons,Eur J Palliat Care 2002 Jul-Aug;9(4):136,,"RESEARCH DESIGN, PUBLICATIONS",PALLIATIVE TREATMENT,,,,1352-2779,,
0042973,"Vielvoye-Kerkmeer A, van Tinteren H, Mattern C, Schuller J",Sustained-release morphine sulphate in cancer pain,Eur J Palliat Care 2002 Jul-Aug;9(4):137-40,,"NEOPLASMS, MORPHINE, QUALITY OF LIFE, SAFETY","DRUG THERAPY, PATIENT CARE, ADVERSE EFFECTS",,,,1352-2779,AB,"The authors discuss dosing frequency with maintained efficacy, safety and tolerability of an oral sustained-release morphine formulation."
0042974,Lowton K,Can we provide effective palliative care for adults with cystic fibrosis?,Eur J Palliat Care 2002 Jul-Aug;9(4):142-4,,"CYSTIC FIBROSIS, DELIVERY OF HEALTH CARE","PALLIATIVE TREATMENT, PREVENTION, ADULT, TREATMENT OUTCOME",,,,1352-2779,AB,The author explores whether adult patients with cystic fibrosis would benefit from a palliative care approach.
0042975,"Andrien M, Franck C, Joslet I, Lenaerts C",Training in palliative care,Eur J Palliat Care 2002 Jul-Aug;9(4):148-9,,"HEALTH PERSONNEL, EDUCATION",PALLIATIVE TREATMENT,,,,1352-2779,AB,The authors present a proposal for an objectives tree for training healthcare professionals.
0042976,"Cabaret W, Krerbi Y, Saravane D",Palliative care in psychiatric institutions,Eur J Palliat Care 2002 Jul-Aug;9(4):150-2,,"DELIVERY OF HEALTH CARE, PATIENT CARE, MENTAL DISORDERS","PSYCHIATRY, PALLIATIVE TREATMENT",,,,1352-2779,AB,"The authors present a clinical observation of a psychotic patient suffering from cancer, illustrating the quality of palliative care that can be offered in a psychiatric hospital."
0042977,"Noble S, Hargreaves P",Hospice day care,Eur J Palliat Care 2002 Jul-Aug;9(4):153-5,,"DELIVERY OF HEALTH CARE, HOSPICE CARE","PALLIATIVE TREATMENT, ECONOMICS",,,,1352-2779,AB,The authors examine whether the doctor in palliative day care is a help or a hindrance.
0042978,Dom H,Spiritual care and spirituality in the hospice movement,Eur J Palliat Care 2002 Jul-Aug;9(4):156-9,,"SPIRITUALITY, HOSPICE CARE","CAREGIVERS, EDUCATION, RELIGION",,,,1352-2779,AB,"The author discusses whether nurses, doctors and carers should be educated in matters relating to death and dying across the religious and spiritual spectrum."
0042979,"Wright B, Elvans H, King P, Schneider J, Thompson R, Gillance H",Developing a multi-agency bereavement service,Eur J Palliat Care 2002 Jul-Aug;9(4):160-3,,"BEREAVEMENT, HEALTH SERVICES, ADAPTATION PSYCHOLOGICAL","CHILD, FAMILY, DELIVERY OF HEALTH CARE",,,,1352-2779,AB,The authors explain the process of establishing a bereavement agency for children and their families.
0042980,Brockbank J,What relevance do community hospital beds have for palliative care patients?,Eur J Palliat Care 2002 Jul-Aug;9(4):164-6,,"DELIVERY OF HEALTH CARE, COMMUNITY HEALTH SERVICES","PALLIATIVE TREATMENT, HOSPITALS",,,,1352-2779,AB,The author examines the role of the community hospital and asks where does the palliative care patient lie in all of this.
0042981,Howells L,Simple steps to better health. Part eight: relaxation,Heres Health 2002 Sep;2002(9):54-5,,"RELAXATION, MENTAL HEALTH",HOMEOPATHY,,,,0018-0696,AB,"If you're one of those people who can never switch off, life can be exhausting. So stop, sit back and learn how to relax..."
0042982,Haigh C,Osteopathy - it's not just for bad backs,Heres Health 2002 Sep;2002(9):68-9,,"OSTEOPATHY, MUSCULOSKELETAL DIS",TREATMENT OUTCOME,,,,0018-0696,AB,"Although a great way to help ease a bad back, this versatile therapy can help a wide range of conditions and boost your general health. The author explains."
0042983,"Goeman DP, Aroni RA, Stewart K, Sawyer SM, Thien FC, Abramson MJ, Douglass JA",Patients' views of the burden of asthma: a qualitative study,Med J Aust 2002 Sep 16;177(6):295-9,,"ASTHMA, EMERGENCY MEDICAL SERVICES, PATIENT SATISFACTION","AUSTRALIA, HEALTH SERVICES, PATIENT ASSESSMENT",,,"To explore the burden of asthma on the lives of people presenting to hospital emergency departments for asthma treatment. DESIGN: A qualitative study. Consenting individuals with asthma who presented to emergency departments were interviewed in-depth, and interviews were taped, transcribed and thematically analysed. Questionnaire data on medication use, respiratory health and asthma knowledge were also collected. Asthma severity was determined from the medical records. SETTING: A tertiary teaching hospital and a suburban hospital during March and April 2000, and a rural hospital during July and August 2000. PARTICIPANTS: Sixty-two participants (19 male and 43 female), aged 18-70 years. RESULTS: The burden of asthma was broad, affecting social life, personal relationships, employment and finances. The cost of asthma medication was an issue for nearly two-thirds of participants. Individuals performed their own \"cost-benefit analysis\" for medication use, weighing up expense, perceived side effects and potential benefits. As a consequence, several participants chose to alter their medication dose, or not to take prescribed medications. For some participants, asthma directly contributed to diminished employment opportunities. CONCLUSIONS: To achieve a therapeutic partnership, doctors need to be aware of the substantial social, personal and financial burden of asthma for their patients. They should also recognise that patients' perceptions of treatment cost may compromise treatment adherence.",0025-729X,AB,OBJECTIV
0042984,"Allison G, Cross W, Galea M, Herbert R, Hodges P, Grimmer K, Maher C",More than skin deep,Aust J Physiother 2002;48(2):69-70,,JOURNALS,"AUSTRALIA, PHYSIOTHERAPY",(Editorial),,,0004-9514,,
0042985,"Jesudason C, Stiller K",Are bed exercises necessary following hip arthroplasty?,Aust J Physiother 2002;48(2):73-81,,"EXERCISE, ARTHROPLASTY, HIP, BEDS, POSTOPERATIVE CARE","HOSPITALIZATION, DISABILITY EVALUATION",,,,0004-9514,AB,"This study investigated whether a program of bed exercises increased the effectiveness of a mobility regimen during the acute period of hospitalisation, for patients who had undergone primary hip arthroplasty. Forty-two patients were randomly allocated, using a concealed allocation procedure, to one of two groups. Patients in the control group were mobilised according to a standard post-operative protocol. Patients in the exercise group were also mobilised using this protocol but in addition received a program of bed exercises. Severity of pain, range of active hip flexion and hip abduction, and a functional assessment were measured by a blinded assessor on the third or fourth post-operative day and again on the seventh or eighth post-operative day. Significant improvements were found in all outcome measures from the third or fourth post-operative day to the seventh or eighth post-operative day. No significant differences were seen between groups for any outcome measures at either measurement time. Bed exercises do not appear to be of additional benefit to a mobility regimen during the period of acute hospitalisation after primary hip arthroplasty."
0042986,"Grimmer K, Kumar S, Gilbert A, Milanese S","Non-steroidal anti-inflammatory drugs (NSAIDs): physiotherapists' use, knowledge and attitudes",Aust J Physiother 2002;48(2):82-92,,"ANTIINFLAMMATORY AGENTS, ETHICS, ATTITUDE","PHYSIOTHERAPISTS, ADVERSE EFFECTS, DRUG THERAPY",,,,0004-9514,AB,"This paper reports on a survey regarding physiotherapists' knowledge, use and attitudes to non-steroidal anti-inflammatory drugs (NSAIDs), some of which have recently been re-scheduled to non-prescription dispensing. A written survey instrument was developed and administered to 750 physiotherapists in South Australia, Tasmania and the Australian Capital Territory (50% of the registered physiotherapists). Responses were received from 285 physiotherapists. The survey identified opportunities for patient misuse and misadventures with NSAIDs in conjunction with physiotherapy management. Differences in physiotherapist understanding of the dosage and actions of oral and topic administrations of NSAIDs were highlighted, as were the moral and ethical responsibilities of physiotherapists to patients considering taking NSAIDs. The study identified the need for regular professional updates on quality use of NSAIDs."
0042987,"Badr C, Elkins MR, Ellis ER",The effect of body position on maximal expiratory pressure and flow,Aust J Physiother 2002;48(2):95-102,,"POSTURE, PEAK EXPIRATORY FLOW RATE, RESPIRATION DISORDERS","COUGH, COMPLICATIONS",,,,0004-9514,AB,"Positioning combined with coughing and huffing is frequently used to promote secretion clearance. Maximum expiratory pressure (MEP) and peak expiratory flow rate (PEFR) have been used as surrogate measures of cough and huff strength. This study investigated the effect of body position on MEP and PEFR. Repeated measures of MEP and PEFR were performed across seven randomised positions (standing, chair sitting, sitting in bed with backrest vertical, sitting in bed with backrest at 45 degrees, supine, side lying, and side lying with head down tilt 20 degrees) on 25 adults with normal respiratory function (NRF) and 11 adults with chronic airflow limitation (CAL). For the NRF group, MEP in standing (143 +/- 10cmH2O, mean +/- SEM) was significantly higher than MEP in chair sitting (133 +/- 10cmH2O) which in turn was significantly higher than in the remaining positions. The MEP in head down tilt (108 +/- 9cmH2O) was significantly lower than in all other positions. The PEFR in standing (571 +/- 24L/min) was significantly higher and head down tilt (486 +/- 23L/min) was significantly lower than in all other positions. For the CAL group, MEP in standing (134 +/- 18cmH2O) was significantly higher, while in head down tilt (96 +/- 15cmH2O) was significantly lower, than in most other positions. For the CAL group, PEFR in standing (284 +/- 40ml/sec) was significantly higher, while in head down tilt (219 +/- 38ml/sec) was significantly lower, than in most other positions. Body position has a significant effect on MEP and PEFR in NRF and CAL subjects, with the lowest values in the head down position. Thus, to maximise the strength of expiratory manoeuvres during treatments that use the head down position, patients should be encouraged to adopt a more upright position when coughing or huffing."
0042988,"Litchfield R, MacDougall C",Professional issues for physiotherapists in family-centred and community-based settings,Aust J Physiother 2002;48(2):105-12,,"QUALITY OF HEALTH CARE, COMMUNITY HEALTH SERVICES","FAMILY, PHYSIOTHERAPY",,,,0004-9514,AB,"This paper reports results from a qualitative study of physiotherapists in a community-based and family-centred setting in which a growing awareness of the family-centred approach accompanied the transition from an institutional structure to a predominantly community-based structure. The goal was to gain insight into how a family-centred philosophy was working and to explore the benefits and dilemmas for physiotherapists in such a setting. Semi-structured interviews were conducted with 10 physiotherapists working with children with disabilities. Analysis of the results against a continuum of family control versus physiotherapist control showed that physiotherapists saw their roles as working with the family to discuss shared goals. However, qualitative analyses showed tensions between the policy of family involvement and another influential policy in physiotherapy: evidence-based practice. Further, there were tensions if the desires of the family could not be matched with available resources. The results show benefits and barriers to working in a community-based, family-centred approach. Barriers included practical dilemmas, policy dilemmas, and career dilemmas. This paper argues that, while family-centred practice is supported by the literature and physiotherapists, significant policy and professional issues need to be addressed before such practice can be fully adopted."
0042989,"Oldmeadow LB, McBurney H, Robertson VJ",Hospital stay and discharge outcomes after knee arthroplasty: implications for physiotherapy practice,Aust J Physiother 2002;48(2):117-21,,"ARTHROPLASTY, KNEE, PATIENT DISCHARGE, LENGTH OF STAY","AUSTRALIA, DISABILITY EVALUATION, POSTOPERATIVE CARE",,,,0004-9514,AB,"Patient outcomes at discharge from acute care after knee arthroplasty were investigated in a prospective observational outcome study at three Melbourne public acute care hospitals during a five-month period from November 1999 to March 2000. The participants were 105 consecutive patients (35 at each hospital), with a mean age of 71 years. Outcome measures were length of stay, destination (home or rehabilitation), knee range of movement, and functional mobility at discharge from the acute care facility. During the study period, mean hospital length of stay across the three hospitals was 6.5 days, more than 30% less than the Victorian average for the preceding year. In that time, 56% of patients had achieved functional independence sufficient for discharge directly home, however only 36% were actually discharged home. The reasons identified for discharge to rehabilitation despite the achievement of sufficient functional independence included pressure on clinicians to decrease length of stay and the need to make decisions regarding discharge early in the post-operative recovery when the eventual patient outcome may still be unclear. Unnecessary discharges to rehabilitation increase the overall length of stay in the health care system and costs per patient. This finding suggests a method of risk screening is required to assist clinical decision making with regard to discharge."
0042990,Turner P,Multidimensional scaling analysis of techniques used by physiotherapists in Southeast Australia: a cross-national replication,Aust J Physiother 2002;48(2):123-30,,"EXERCISE THERAPY, MANIPULATION, ULTRASONOGRAPHY, HEAT THERAPY","PHYSIOTHERAPY, AUSTRALIA, METHODS, ENGLAND",,,,0004-9514,AB,"Much of the research concerning techniques used by physiotherapists has focused upon electrothermal agents, so neglecting fundamental questions concerning practice and differences in technique use. A recent study in England addressed these deficits, and determined that techniques were used in ordered combinations, which differentiate the profession into 'typologies' or specialities. The purpose of the present study was to determine whether a similar picture would emerge in Australia, and to determine the type and extent of technique use amongst Australian physiotherapists. This replication study comprised a questionnaire survey of 141 hospital physiotherapists working in Southeast Australia. Information concerning the range and frequency of techniques used over the preceding six months was obtained. Descriptive analyses indicated high frequency use of exercise therapy, manipulation, heat packs, massage and ultrasound. Multidimensional scaling revealed a clear structure concerning combination use of techniques, and a coherent typology based on this usage. Differentiation of the profession according to the typologies supports the specialist areas identified in England, namely respiratory, neurological and orthopaedic/musculoskeletal physiotherapy. A further subdivision of the latter was possible in Australia, with the emergence of both a manipulative speciality, and an exercise rehabilitation speciality. While this study confirms the findings of the earlier research, it identifies important differences in practice between Australia and England."
0042991,Keating J,Physical examination can detect the presence or absence of cruciate ligament injury,Aust J Physiother 2002;48(2):132,,"ANTERIOR CRUCIATE LIGAMENT, INJURIES","DIAGNOSIS, METHODS",(Commentary),,,0004-9514,,
0042992,Holm I,Fusion surgery is slightly better than non-surgical treatment in patients with severe chronic non-specific low back pain,Aust J Physiother 2002;48(2):133,,"LOW BACK PAIN, SURGERY OPERATIVE, DISABILITY EVALUATION",TREATMENT OUTCOME,(Commentary),,,0004-9514,,
0042993,MacDermid J,A hand brace improve symptoms and function in carpal tunnel syndrome,Aust J Physiother 2002;48(2):134,,"BRACING, HAND, CARPAL TUNNEL SYNDROME",TREATMENT OUTCOME,(Commentary),,,0004-9514,,
0042994,Davies B,The wisdom of children,Int J Palliat Nurs 2002 Sep;8(9):416,,ATTITUDE TO DEATH,"CHILD, HEALTH PERSONNEL",(Editorial),,,1357-6321,,
0042995,Steele R,Experiences of families in which a child has a prolonged terminal illness: modifying factors,Int J Palliat Nurs 2002 Sep;8(9):418-434,,"TERMINAL ILLNESS, ADAPTATION PSYCHOLOGICAL, ATTITUDE TO DEATH","CHILD, FAMILY, PALLIATIVE TREATMENT",,,,1357-6321,AB,"A significant proportion of children requiring palliative care have neurodegenerative life-threatening illnesses (NLTIs). While most of their care is provided at home by their families over many years, there is a paucity of research examining families' experiences when a child with an NLTI is dying at home. In this grounded theory study, data were collected from eight families through observations and audiotaped interviews. Families moved through a process of 'navigating uncharted territory' as they lived with their dying child. The strategies that families used to manage this phenomenon were influenced by four intervening conditions that reflected the broader structural context of the phenomenon; relationships with healthcare providers, availability of information, gender differences, and communication between parents. Each condition facilitated or constrained the strategies that families were able to use. Implications for research, education and practice are discussed."
0042996,"De Graves S, Aranda S",Exploring documentation of end-of-life care of children with cancer,Int J Palliat Nurs 2002 Sep;8(9):435-43,,"NEOPLASMS, MEDICAL RECORDS, DEATH","CHILD, PEDIATRICS, PROGNOSIS, PALLIATIVE TREATMENT",,,,1357-6321,AB,"This article presents the findings of a study that explored documentation surrounding the end-of-life care of children with cancer. An in-depth history audit of 18 children with cancer, who died from disease progression at a single tertiary paediatric centre during 1999, was performed to explore the extent and the ways in which the shift from cure to palliation was reflected in the child's medical record. The study found that while physical aspects of care were documented there was little evidence of the human-to-human aspects of care or processes of decision-making when cure was no longer a possibility. Relapse and disease progression were identified as critical junctures for families and health professionals and an important area for future research. Further, the medical records documented ill-defined periods of palliation, with the child's approaching death appearing as a gradual awareness rather than a distinct shift in goals of care from cure to palliation."
0042997,"Todd M, Welsh J, Moriarty D",The experience of parents of children with primary lymphoedema,Int J Palliat Nurs 2002 Sep;8(9):444-51,,"LYMPHOMA, ADAPTATION PSYCHOLOGICAL","CHILD, DIAGNOSIS, PARENTS, INTERPERSONAL RELATIONS",,,,1357-6321,AB,"This article presents the findings of a qualitative study looking at the experiences of parents of children with primary lymphoedema. Six parents participated in the study, which was conducted in Glasgow, and verbatim transcripts of the interviews were analysed for recurring themes. The findings showed that these parents endured a difficult time before receiving a diagnosis and appropriate treatment, caused by a lack of professional awareness of the condition. Their day-to-day management of the illness was hampered by the psychological effects on the children. Parents also found a reluctance by professionals to seek information on their behalf. Professional awareness of this condition needs to be raised and improved information and support made available for those involved in the care of children with lymphoedema. The article discusses how this may be achieved."
0042998,Rowa-Dewar N,Do interventions make a difference to bereaved parents? A systematic review of controlled studies,Int J Palliat Nurs 2002 Sep;8(9):452-7,,"BEREAVEMENT, ADAPTATION PSYCHOLOGICAL, HEALTH SERVICES","PARENTS, QUALITY OF HEALTH CARE",,,,1357-6321,AB,"The provision of bereavement support for parents who have lost a child is based on the assumption that it will lead to better subsequent adjustment. To determine the validity of this assumption, a systematic review of studies was undertaken, looking at bereavement support programmes for parental grief between 1990 and 2001. This review focused on controlled studies. The exclusion of non-controlled studies, case studies and those using only participant evaluation as an outcome measure, left only three studies. No overall benefit for the interventions was shown. However, for highly distressed mothers, psychological symptoms and marital dysfunction were significantly reduced. Disparities in the findings, such as the effects of interventions on fathers, may be explained by flawed methodology. Applied to practice, these findings suggest that only some bereaved parents benefit from bereavement support programmes. A targeted approach may therefore be the best use of resources."
0042999,Johnson B,What is it like being a sibling of a child with cancer?,Int J Palliat Nurs 2002 Sep;8(9):458-9,,"NEOPLASMS, ADAPTATION PSYCHOLOGICAL","CHILD, SIBLING RELATIONS",,,,1357-6321,,
0043000,"Bailey C, Froggatt K, Field D, Krishnasamy M",The nursing contribution to qualitative research in palliative care 1990-1999: a critical evaluation,J Adv Nurs 2002 Oct;40(1):48-60,,"RESEARCH DESIGN, NURSING CARE, QUALITY OF HEALTH CARE",PALLIATIVE TREATMENT,,,,0309-2402,AB,"Background: Qualitative research plays an important part in providing evidence for practice in nursing, and is gaining greater acceptance within medicine. However, questions remain about what criteria are most appropriate for evaluating qualitative research. To date, little systematic evaluation of qualitative research in palliative care has been conducted. Aims: This paper is based on a larger study in which we conducted a critical review of qualitative research in palliative care from nursing, medicine, specialist palliative care, sociology, death studies, medical anthropology, and gerontology journals published between 1990 and 1999. The aim of this paper is to present an account of the strengths and weaknesses of qualitative palliative care research in nursing, using data from this review. Methods: In the larger study, 138 papers from 50 journals were reviewed critically using a tool developed to assess both content and quality; in one part of this tool reviewers recorded open-ended comments on the strengths and weaknesses of each paper. In this paper, we present a thematic analysis of reviewers' comments on a subgroup of 67 nursing papers from the main review, together with an analysis of comments on 29 papers from a comparison group of death studies, medical anthropology, and sociology journals. Patterns of positive and negative evaluation are identified and used to generate an account of strengths and weaknesses in qualitative palliative care research in nursing. Findings: Over 40% of the subgroup of papers from nursing journals received positive comments on topic and quality of writing; around 30% received positive comments on contribution to understanding, practical value, and conceptual or theoretical issues. Less than 20% received positive comments on other critical dimensions. (ABSTRACT TRUNCATED)."
0043001,"Paulson M, Norberg A, Danielson E",Men living with fibromyalgia-type pain: experiences as patients in the Swedish health care system,J Adv Nurs 2002 Oct;40(1):87-95,,"FIBROMYALGIA, QUALITY OF HEALTH CARE","SWEDEN, MALE, ATTITUDE TO HEALTH",,,,0309-2402,AB,"Background: Individuals with fibromyalgia (FM) frequently use health care services and experience only short-term improvements. They often feel that health care staff do not take them seriously. This increases the burden of living with the illness. Aim: To describe how men living with fibromyalgia-type pain experienced being patients in the Swedish health care system. Method: Narrative interviews with 14 men who fulfilled the American College of Rheumatology criteria for classification of fibromyalgia. Content analysis was used when analysing the data. Results: The results are described using five themes. Theme I 'Feeling afraid of being looked upon as being a whiner' highlights how the men endured a lot of pain before they sought health care, and how difficult it was to find a receptive listener. Theme 2 'Feeling like a guinea pig' shows that the men's feelings were twofold; they wanted examinations, even if these made them feel that they were being exposed to numerous treatments without any cure. Theme 3 'Feeling hopeful' describes the hope for a cure after having been referred to a specialist clinic. Theme 4 'Feeling neglected' illustrates being looked upon as an uninteresting patient and theme 5 'Feeling no recovery' illustrates the pain relief they gained, but not the actual cure. Conclusion: Men with FM type pain experienced a long wait before treatment at a specialist clinic as well as no continuity and follow-ups in primary care and general hospitals. Encounters with engaged and skilful staff promoted the men's well-being despite the fact that no cure was available. Not being respected led to a feeling of being neglected despite the care received. Thus, the men had to accept the fact that they would never recover."
0043002,"Johnson HM, Weerakoon P, Stricker P","The incidence, aetiology, and presentation of Peyronie's disease in Sydney, Australia",Sexuality Disabil 2002 Summer;20(2):109-16,penile induration,"GENITAL DISEASES MALE, EPIDEMIOLOGY","AUSTRALIA, CATHETERIZATION",,,,0146-0144,AB,"This paper reports on the incidence, presentation, and aetiological factors of Peyronie's disease in a sexual centre over an 8 year period. Of approximately 13,000 male patients, 672 (5%) were diagnosed with Peyronie's disease. The mean age was 55.6 years. Presenting symptoms included penile curvature (82%), erectile dysfunction (66%), and a history of penile pain (47%). Where possible aetiological data were recorded, 37% (of 340) had been catheterised and 42% (of 257) had a history of penile trauma. Of those presenting with penile curvature, the majority (76.4%) had a dorsal curve and the commonest plaque site was the dorsal tunica albuginea. The incidence of erectile dysfunction, catheterisation, and penile trauma is higher than that reported in many studies. This is likely to be due to the specialist nature of the clinic and the variability of information in patient files."
0043003,Fitzmaurice S,A mother's narrative: reflections on life with disability,Sexuality Disabil 2002 Summer;20(2):117-23,,"DOWNS SYNDROME, DISABILITY, ADAPTATION PSYCHOLOGICAL","MOTHERS, LIFE STYLE, CASE REPORT",,,,0146-0144,AB,"Disabilities, especially cognitive and developmental disabilities, are often represented as causing negative life experiences. The acquisition of disability later in life is frequently compared to death. In this narrative, disability is viewed as a life-enhancing experience. A son's need for independence as a person with Down syndrome is described as complementary to the accommodations his mother needs for her acquired physical and sensory disabilities. After helping her son to live with his disability, learning to adjust on her own comes with relative ease. The ironies that face this mother and son, who want a typical life, and a life with their special needs accommodated, is also examined."
0043004,Cheausuwantavee T,Sexual problems and attitudes toward the sexuality of persons with and without disabilities in Thailand,Sexuality Disabil 2002 Summer;20(2):125-34,,"SEXUALITY, ATTITUDE, DISABILITY","COMPARATIVE STUDY, ASIA, QUESTIONNAIRES",,,,0146-0144,AB,"The purposes of this descriptive study are to survey and compare the following criteria: estimated prevalence of sexual problems, the development of love, and attitudes toward sexuality between persons with and without disabilities. The sample was 25 persons with disabilities and 76 persons without disabilities. The questionnaires consisted of 35 questions and were distributed to the sample. Research results showed that sexual problems occurred in 36% of persons with disabilities and in 12% of persons without. Both samples were not significantly different as to the kinds of love they want. In contrast, both samples are significantly different in their consideration for selecting lovers. Most attitudes toward sexuality between persons with and without disabilities were not significantly different. This is a good sign since it implies that there are more opportunities and possibilities for persons with and without disabilities to establish love, to form attachment, and to marry if sexual education and appropriate sexual communication are facilitated."
0043005,Lowenstein LF,Fetishes and their associated behavior,Sexuality Disabil 2002 Summer;20(2):135-47,,"SEX BEHAVIOR, DISABILITY",PSYCHOLOGY,,,,0146-0144,AB,"This article provides an overview as to the definition and history of fetishes. The paper reviews early and recent research regarding fetishes and explores behaviors often associated with fetishes. In addition, various types of fetishes are examined, including a number of fetishes that are unique to people with disabilities. Finally, coming from a psychoanalytical perspective, a number of treatment approaches are reviewed and discussed."
0043006,Elmore JL,Fluoxetine-associated remission of ego-dystonic male homosexuality,Sexuality Disabil 2002 Summer;20(2):149-51,fluoxetine,"SEX BEHAVIOR, HOMOSEXUALITY, ANTIDEPRESSIVE AGENTS","DRUG THERAPY, ADVERSE EFFECTS",,,,0146-0144,AB,Selective serotonin reuptake inhibitors (SSRIs) have been reported to decrease sexual activity across a broad diagnostic spectrum in men and women. We present a serendipitous finding of fluoxetine-associated suppression of ego-dystonic homosexual activity in a fifty-three year old male for a period of thirteen years thus far. His determination to remain sexually abstinent has been key in his successful treatment.
0043007,"White A, Hart A",Cheap research is likely to be biased,Complement Ther Med 2002 Jun;10(2):59-60,,CLINICAL TRIALS,"RESEARCH, COMPLEMENTARY THERAPIES",(Editorial),,,0965-2299,,
0043008,"MCCarney R, Fisher P, van Haselen R",Accruing large numbers of patients in primary care trials by retrospective recruitment methods,Complement Ther Med 2002 Jun;10(2):63-8,,"PRIMARY HEALTH CARE, HEADACHE, ACUPUNCTURE","COMPLEMENTARY THERAPIES, REPRODUCIBILITY OF RESULTS",,,,0965-2299,AB,"There is a need for large scale, pragmatic trials of complementary and alternative medicine in a primary care setting to answer questions about the 'real world' effectiveness of such methods. Randomisation and treatment in such trials should be prospective, but retrospective recruitment is possible, especially in chronic conditions. This involves contacting patients who have previously consulted their GP (identified through GP database searches) rather than encouraging GPs to refer patients as they present. We describe a prospective randomised trial of acupuncture for chronic headache, currently underway, as an example of retrospective recruitment. A pilot study of recruitment and recruitment modelling was undertaken. The target sample size was 300, 26% (n = 36) of general practices approached took part in the study, 32 completed the required database search. Practices used diagnostic term searches, prescription searches, or a combination of both. On average 1.7% of the total practice populations were identified as headache consulters, letters were sent to 4128 patients. 12% of identified patients were randomised (n = 401). Retrospective recruitment methods are feasible for CAM trials in chronic, stable conditions modelling can provide accurate data for planning such studies. Retrospective recruitment can be more efficient than prospective, further research is required on the generalisibility of results from populations recruited in this way."
0043009,"Lewith GT, Chan J",An exploratory qualitative study to investigate how patients evaluate complementary and conventional medicine,Complement Ther Med 2002 Jun;10(2):69-77,,"COMPLEMENTARY THERAPIES, MEDICINE","COMPARATIVE STUDY, PATIENT SATISFACTION",,,,0965-2299,AB,"Objective: We wish to determine the constructs used by patients to evaluate conventional and complementary medicine (CAM), prioritise these constructs and determine how these characterise patients' choice for CAM and conventional medicine. Methods: A repertory grid technique was employed, in interviews of 20 patients, 10 from a general practice and 10 from a CAM clinic. Results: CAM was used with greater frequency in chronic illness and generated more constructs than conventional medicine, although the constructs were similar. The priorities for these constructs were different: specificity of treatment and severity of illness were prioritised for conventional medicine and lack of science was prioritised for CAM. The CAM characteristic most commonly cited was non-chemical. Conclusion: This exploratory initial study suggests that people use very similar criteria to evaluate CAM and conventional medicine. Their choice of treatment was based largely on the type of illness from which they were suffering. Further research is needed in this area."
0043010,"Smith C, Crowther C, Beilby J",Pregnancy outcome following women's participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy,Complement Ther Med 2002 Jun;10(2):78-83,,"PREGNANCY, NAUSEA, ACUPUNCTURE","TREATMENT OUTCOME, ADVERSE EFFECTS",,,,0965-2299,AB,"Objectives: Recent studies have concluded that acupuncture is safe in the hands of a qualified practitioner. This study assessed the risk of adverse effects of acupuncture administered during pregnancy. Methods: 593 women with nausea and vomiting in early pregnancy volunteered to participate in a randomised controlled trial, conducted at the Women's and Children's Hospital, in South Australia. Patients were given either traditional acupuncture, formula acupuncture, sham acupuncture or no acupuncture. Outcome Measures: Data were collected on perinatal outcome, congenital abnormalities, pregnancy complications and the newborn. Results: No differences were found between study groups in the incidence of perinatal outcome, congenital abnormalities, pregnancy complications and other infant outcomes. Conclusion: Our findings suggest that no serious adverse effects arise from acupuncture administered in early pregnancy."
0043011,"Yamashita H, Tsukayama H, Sugishita C",Popularity of complementary and alternative medicine in Japan: a telephone survey,Complement Ther Med 2002 Jun;10(2):84-93,,"DELIVERY OF HEALTH CARE, ECONOMICS, PATIENT SATISFACTION","COMPLEMENTARY THERAPIES, JAPAN",,,,0965-2299,AB,"Objective: To obtain information on the use of complementary and alternative medicine (CAM) in Japan. Design: Nationwide, random-sampled and population-weighted telephone survey. Methods: The survey was conducted by a telephone survey company in April 2001. The sample size of respondents was 1000. Using a region-, gender- and age-weighted sampling table, professional operators called respondents with random-digit dialling. Respondents were asked questions about their use of CAM in the past 12 months, out-of-pocket expenditures on CAM and orthodox Western medicine, reasons for the use of CAM and so on, as well as general socio-demographics. Results: The percentage of respondents who had used at least one CAM therapy in the past 12 months was greater than those who had used orthodox Western medicine (76.0% (95% CI: 73.4-78.6) vs 65.6% (95% CI: 62.7-68.5). The percentage of use for each CAM therapy was as follows: nutritional and tonic drinks (43.1%), dietary supplements (43.1%), health-related appliances (21.5%), herbs or over-the-counter Kampo (17.2%), massage or acupressure (14.8%), ethical Kampo (Kampo prescribed by medical doctors) (10.0%), aromatherapy (9.3%), chiropractic or osteopathy (7.1%), acupuncture and moxibustion (6.7%), homeopathy (0.3%), and other therapies (6.5%). Regarding the reasons for the use of CAM, 60.4% responded that 'the condition was not serious enough to warrant orthodox Western medicine', and 49.3% were 'expecting health promotion or disease prevention'. Average annual out-of-pocket expenditures of all the 1000 respondents for CAM were half as much as those for orthodox Western medicine (19,080 yen (95% CI: 15,824-22,336) vs 38,360 yen (95% CI: 30,439-46,280)). Conclusions: CAM is very popular in Japan and the expenditures for them are not negligible (ABSTRACT TRUNCATED)."
0043012,"Ceylan S, Hamzaolu O, Komurcu S, Beyan C, Yalcin A",Survey of the use of complementary and alternative medicine among Turkish cancer patients,Complement Ther Med 2002 Jun;10(2):94-9,,"NEOPLASMS, PATIENT SATISFACTION",COMPLEMENTARY THERAPIES,,,,0965-2299,AB,"Objectives: To measure the frequency of use of complementary and alternative medicine (CAM) among patients with malignancy undergoing or following conventional treatment, to determine demographic characteristics associated with the use of CAM, and to find out how benefits, if any, were perceived by patients. Design: A 35-item survey questionnaire administered to 305 return patients with malignancy. Setting: Clinical wards of the Oncology and Haematology departments of Gulhane Military Medical Academy, Ankara, Turkey. Methods: Questionnaire-based measures of demographics, motives, expectations and effects of using CAM, and types and reported perceived benefits of CAM practised on patients with malignancy. Results: The majority of return patients (n = 186, 61.0%) used at least one CAM practice; and birthplace, educational status, and family type were significant factors in such behaviour. Conclusions: Patients with malignancy born in villages, having less education and living in large families were more likely to use folk medicine. More than half of those using CAM (n = 99, 53.2%) reported as benefits the feelings of either strengthening of the body, being in good psychological condition, or the disappearance of several symptoms."
0043013,"Lewith GT, Broomfield J, Prescott P",Complementary cancer care in Southampton: a survey of staff and patients,Complement Ther Med 2002 Jun;10(2):100-6,,"NEOPLASMS, ATTITUDE, DELIVERY OF HEALTH CARE","COMPLEMENTARY THERAPIES, ENGLAND",,,,0965-2299,AB,"Background: Complementary and alternative medicine (CAM) is used by one in ten of the UK population yearly and 47% during their lifetime. One-third of cancer patients seek some form of CAM treatment during their illness. Aim: To evaluate the use of and attitudes to CAM among patients and all healthcare staff in the Southampton Cancer Care Directorate (UK). Setting: The Royal South Hants Hospital, Countess Mountbatten and Oakhaven Hospices. Method: A questionnaire-based survey performed between January 2001 and March 2001. Results: Two hundred and seventy questionnaires were distributed to patients and 162 responses received. The distribution of cancers within this population was generally typical of those in the community. Thirty-two percent (n = 52) were receiving some form of CAM, half of those receiving CAM were in hospice care. Forty-nine percent of those not receiving CAM would like to, and 76% of all patients would be prepared to pay for this treatment. The five most popular treatments were massage, nutrition, aromatherapy, relaxation and reflexology. While most patients expected CAM to palliate their symptoms (n = 149, 92%), some had unrealistic expectations that CAM would cure their cancer (n = 13, 8%). Four hundred and forty-eight staff questionnaires were distributed and 196 responses were received: 148 (75.5%) from nurses. Twenty-one percent of staff responding had CAM training and two-thirds would like to receive training. The most popular therapies used by staff were the same as those identified by the patients. Ninety-nine percent of staff and 98.5% of patients wished to see CAM treatments introduced into service provision within the Cancer Care Directorate. Conclusions: The use of CAM for cancer care in Southampton is widespread and consistent with its use nationally. (ABSTRACT TRUNCATED)."
0043014,Thompson T,CAM before the storm - alternative medicine and the great MMR debate,Complement Ther Med 2002 Jun;10(2):126-7,,"INTERNET, IMMUNIZATION, ATTITUDE, HOMEOPATHY",COMPLEMENTARY THERAPIES,,,,0965-2299,,
0043015,"Kuklo TR, Lenke LG, Graham EJ, Won DS, Sweet FA, Blanke KM, Bridwell KH","Correlation of radiographic, clinical, and patient assessment of shoulder balance following fusion versus non fusion of the proximal thoracic curve in adolescent idiopathic scoliosis",Spine 2002 Sep 15;27(18):2013-20,,"SCOLIOSIS, SURGERY OPERATIVE, PATIENT ASSESSMENT","TREATMENT OUTCOME, SHOULDER, BALANCE, ADOLESCENT",,,,0362-2436,AB,"Study Design: Retrospective clinical, radiographic, and patient outcome review of surgically treated adolescent idiopathic scoliosis. Objectives: To correlate radiographic and clinical features of shoulder balance and the proximal thoracic curve with patient satisfaction outcomes at a minimum 2-year follow-up. Summary of Background Data: Traditionally, radiographic features of a structural proximal thoracic curve have been T1 tilt, proximal thoracic Cobb angle, and proximal thoracic side-bending Cobb; however, these do not always correlate with clinical shoulder balance. Methods: A total of 112 patients (single surgeon) with adolescent idiopathic scoliosis and a proximal thoracic curve equal to 20 degrees (average 32 degrees, range 20-78 degrees) were evaluated in terms of shoulder balance and curve flexibility/correction. Four groups were analyzed: Group 1, posterior spinal fusion to T2 (proximal thoracic curve included, n = 24); Group 2, posterior spinal fusion to T3 (proximal thoracic curve partially included, n = 23); Group 3, posterior spinal fusion to T4 or T5 (proximal thoracic curve not included, n = 21); and Group 4, anterior spinal fusion to T4 or below (proximal thoracic not included, n = 44). Proximal thoracic, main thoracic, and thoracolumbar-lumbar upright coronal, side-bending, and sagittal Cobb measurements were assessed before surgery, 1 week after surgery, and at a minimum 2-year postoperative follow-up (average 3.8 years, range 2.0-7.6 years). (ABSTRACT TRUNCATED)."
0043016,"Lenke LG, White DK, Kemp JS, Bridwell KH, Blanke KM, Engsberg JR",Evaluation of ventilatory efficiency during exercise in patients with idiopathic scoliosis undergoing spinal fusion,Spine 2002 Sep 15;27(18):2041-5,,"SCOLIOSIS, SPINAL FUSION, EXERCISE, RESPIRATION","OXYGEN CONSUMPTION, PATIENT ASSESSMENT",,,,0362-2436,AB,"Study Design: A prospective evaluation of ventilatory function following spinal fusion in adolescent idiopathic scoliosis. Objectives: To prospectively evaluate pulmonary function, maximal oxygen uptake, and ventilatory efficiency during exercise in patients with adolescent idiopathic scoliosis before surgery and a minimum of 2 years postoperation. Summary of background Data: For reasons that are unclear, patients with untreated adolescent idiopathic scoliosis tend to avoid aerobic exercise. Their reluctance may be the result of low ventilatory efficiency, as they often approach their ventilatory ceiling at maximum oxygen uptake despite forced vital capacities that are near normal. This inefficiency of ventilation with exercise may explain the reluctance of patients with scoliosis to pursue aerobic fitness. No study has evaluated the effect spinal fusion has on the ventilatory function of patients with scoliosis during exercise. Methods: Forty-two patients with adolescent idiopathic scoliosis (36 female and 6 male) at an average age of 14 + or - 3 years (range 10-18 years) underwent spinal fusion. Twenty patients underwent a posterior spinal fusion alone, 20 an anterior spinal fusion alone, and 2 an anterior spinal fusion and posterior spinal fusion. The average Cobb measurement was 55 degrees (range 40-85 degrees). Pulmonary function values (forced vital capacity, total lung capacity, maximum voluntary ventilation), maximum oxygen uptake (VO2max), and ventilatory efficiency were obtained before surgery and a minimum of 2 years postoperation. Results: For all patients, forced vital capacity percent predicted decreased from 88.1% to 81.4% (P less than 0.0001). Total lung capacity also declined from 90.5% to 88.5% but was not statistically significant (P = 0.189). (ABSTRACT TRUNCATED)."
0043017,"Lerman JA, Sullivan E, Haynes RJ",The Pediatric Outcomes Data Collection Instrument (PODCI) and functional assessment in patients with adolescent or juvenile idiopathic scoliosis and congenital scoliosis or kyphosis,Spine 2002 Sep 15;27(18):2052-8,,"SCOLIOSIS, KYPHOSIS, CLINICAL ASSESSMENT SCALES, DISABILITY EVALUATION","DATA COLLECTION, CONSISTENCY AND RELIABILITY, ADOLESCENT",,,,0362-2436,AB,"Study Design: An initial examination of functional assessment scores in scoliosis and kyphosis populations. Objective: Examination of scores from the Pediatric Outcomes Data Collection Instrument for patients with idiopathic scoliosis, congenital scoliosis, and congenital kyphosis, comparing scores with those of children without orthopedic disabilities. Summary of Background Data: Little information has been presented regarding performance of scoliosis patients on the Pediatric Outcomes Data Collection Instrument. Methods: A total of 102 patients with adolescent idiopathic scoliosis, 47 with congenital scoliosis without kyphosis, and 9 with congenital kyphosis completed the Pediatric Outcomes Data Collection Instrument. Responses were compared with those from a \"normal\" population. Subgroup analyses were performed for patients with adolescent idiopathic scoliosis. A P value less than 0.05 was considered statistically significant. Results: Scores in Transfers, Sports, Comfort, and Happiness were significantly lower than \"normal\" in adolescent idiopathic scoliosis. In congenital scoliosis without kyphosis, scores in all categories except Happiness were significantly lower than \"normal.\" All category scores were significantly lower than \"normal\" in congenital kyphosis. In adolescent idiopathic scoliosis, age and curve location did not influence Comfort scores. Comfort scores were significantly lower than \"normal\" for all curve locations and for all ranges of Cobb angle. Happiness scores were significantly lower in adolescent idiopathic scoliosis patients with Cobb angles less than 50 degrees who had not received surgery when compared with either patients who had received surgery or patients with Cobb angles less than 50 degrees. (ABSTRACT TRUNCATED)."
0043018,Elliott T,Managing schizophrenia in older people,Nurs Residential Care 2002 Oct;4(10):489-91,,"SCHIZOPHRENIA, EPIDEMIOLOGY, ETIOLOGY","AGED, DIAGNOSIS",,,,1465-9301,,
0043019,Bannigan K,A positive attitude is a professional imperative,Spine 2002 Sep 15;27(18):397,,"ATTITUDE, PROFESSIONAL COMPETENCE",OCCUPATIONAL THERAPY,,,,0308-0226,,
0043020,Brown CA,Occupational therapists' beliefs regarding treatment options for people with chronic pain,Spine 2002 Sep 15;27(18):398-404,,"PAIN, CHRONIC DIS, PATIENT CARE TEAM","OCCUPATIONAL THERAPY, DECISION MAKING",,,,0308-0226,AB,"An expanding body of chronic pain research is now evident within occupational therapy and strong support had developed during the last 10 years for the multidisciplinary approach to the management of chronic pain. Although this stand is now subject to growing scrutiny, a multidisciplinary structure continues to be the environment for most outcome studies. Occupational therapists, as accepted and involved members of pain management programmes, need to examine the values and beliefs that they bring to the treatment team. As part of a wider research study of the congruence between what service providers and service users believe to be necessary treatments for chronic pain, the members of the National Occupational Therapy Pain Association were surveyed in January 2001. The survey asked therapists' opinion about whether specific treatment components were needed for people with chronic pain. The survey also included Skevington's (1990) Beliefs about Pain Control Questionnaire (BPCQ), which measures beliefs in the internal or personal control of pain, beliefs that powerful others (doctors) control pain and beliefs that pain is controlled by chance events. The findings showed that there were few treatment components that 100% of the respondents agreed were needed. Endorsements clustered around treatments that focused on self-management and a statistically significant relationship emerged between certain treatment components and BPCQ scores. The paper concludes by discussing some possible influences on occupational therapists' decision making in relation to treatments for chronic pain."
0043021,"Hammond A, Jeffreson P, Jones N, Gallagher J, Jones T",Clinical applicability of an educational-behavioural joint protection programme for people with rheumatoid arthritis,Spine 2002 Sep 15;27(18):405-12,,"ARTHRITIS RHEUMATOID, EDUCATION, BEHAVIOR, JOINTS","PROGRAM EVALUATION, OCCUPATIONAL THERAPISTS",,,,0308-0226,AB,"Joint protection is a major part of rheumatology occupational therapy. Recent research emphasises that an educational-behavioural approach is more effective than current practice in enabling people with rheumatoid arthritis (RA) to increase their use of joint protection and benefit from reduced pain and inflammation and improved function. The aim of this study was to evaluate whether occupational therapists, following a 2-day training course in delivering an educational-behavioural joint protection programme, could enable people with RA to improve use of joint protection significantly and obtain similar results to previous clinical trials. This tested whether it would be feasible to introduce the programme into clinical practice. Three occupational therapists attended a 'Looking After Your Joints' training course for leaders. A single-blind crossover trial was conducted. Three centres participated, with each therapist delivering two or three joint protection programmes. Thirty participants with RA attended: 27 women and 3 men, with a mean age of 52.3 years (SD 12.08 and a mean disease duration of 6.76 years (SD 7.02). The primary outcome measure was an observational assessment of use of joint protection, the Joint Protection Behaviour Assessment (JPBA; Hammond and Lincoln 1999b). The median baseline JPBA score for all 30 participants was 15.39% (IQR 11.45-26.82%), which rose significantly to 35% (IQR 25-42.40%) (Z = 3.97; p = 0.0001) at 6 months following the programme. Both participants and therapists expressed positive views of the efficacy of this training approach. Sixteen participants increased use of joint protection by 20% or more. The findings highlight that the 2-day training course facilitated therapists in delivering the programme effectively and they could gain similar behavioural improvements to previous clinical trials."
0043022,"Britton C, Moore A","Views from the inside, part 2: what the children with arthritis said, and the experiences of siblings, mothers, fathers and grandparents",Spine 2002 Sep 15;27(18):413-9,,"ARTHRITIS JUVENILE RHEUMATOID, ADAPTATION PSYCHOLOGICAL","FAMILY, QUESTIONNAIRES, DATA COLLECTION",,,,0308-0226,AB,"This second article in a series of three presents some of the findings from a study involving 46 families of children with juvenile idiopathic arthritis (JIA). The aim of the study overall was to describe and explore what life was like for families that include a child with JIA in the United Kingdom today. The study deployed a grounded theory approach, collecting different sorts of data over time in order to build up a picture of how these families lived with such a changeable long-term condition. In the first stage, data were collected using a self-completion questionnaire from 46 families, whose children attended a regular outpatient appointment at the paediatric rheumatology clinic. These data formed the contextual landscape to further in-depth data collected in stage two, from a cohesive group of nine families of girls selected from those who had already taken part in stage one. In stage two, the families were interviewed in their own homes, the children wrote diaries and the families recorded a video tape diary. All the data related to the respondents' recollections of events and their thoughts, feelings and perspectives: they formed the insiders' view of the experiences. This article presents the findings about the common themes that emerged from the data about children with JIA and their siblings, mothers, fathers and grandparents. It also discussed the key elements of the families' experiences and concludes with recommendations for health care practitioners. A distillation of the views of the majority of parents is provided in these two statements by different mothers: 'Immobility and pain makes the joy of play, just armchair viewing' and 'it's a stolen childhood, really, isn't it?'"
0043023,"Berry J, Ryan S",Frames of reference: their use in paediatric occupational therapy,Spine 2002 Sep 15;27(18):420-7,,"CEREBRAL PALSY, PEDIATRICS","OCCUPATIONAL THERAPY, CHILD, GREAT BRITAIN",,,,0308-0226,AB,"The aim of this study was to explore how paediatric occupational therapists provide intervention for children with cerebral palsy in the United Kingdom. A survey design was used with a sample of 120 paediatric occupational therapists. The results of this study were representational of practice among members of the National Association of Paediatric Occupational Therapists. It was found that 91.7% of occupational therapists in this study used an eclectic treatment approach. Treatment was usually provided on a case-by-case basis, taking into consideration the individual needs of the child, and family-centered functional therapy was valued. Postgraduate training in the areas of neurodevelopmental treatment and sensory integration is recommended in a continuing capacity if therapists choose to use these frames of reference to guide treatment for children with cerebral palsy."
0043024,"Butler J, Smith T",Reflections on cross-cultural research: some lessons learnt,Spine 2002 Sep 15;27(18):428-30,,"CULTURE, RESEARCH DESIGN","JAPAN, ENGLAND, DATA COLLECTION",,,,0308-0226,,
0043025,Gore H,OT stands for 'ought to',Spine 2002 Sep 15;27(18):435,,"PROFESSIONAL COMPETENCE, TRENDS",OCCUPATIONAL THERAPY,(Letter),,,0308-0226,,
0043026,Hyde P,RCTs: legitimate research tool or fancy mathematics?,Spine 2002 Sep 15;27(18):435-6,,"RESEARCH DESIGN, RANDOMIZED CONTROLLED TRIALS","OCCUPATIONAL THERAPY, REPRODUCIBILITY OF RESULTS",(Letter),,,0308-0226,,
0043027,Tarleton B,Time pot for the family,Community Care 2002 Sep 26;1441:38-9,,"AUTISM, CAREGIVERS","CHILD, FAMILY",,,,0307-5508,AB,The number of children with an autistic spectrum disorder is rising yet their parents often feel isolated and unsupported. The author reports on research that highlights the importance of short breaks for the families affected.
0043028,Friese KH,Die homoopathische Behandlung von Larynxerkrankungen,Allgen Homoopath Zeit 2002;247(5):181-6,,"LARYNGEAL DIS, HOMEOPATHY","DIAGNOSIS, DRUG THERAPY",,German,English Summary,0175-7881,AB,"Homeopathic treatment of diseases of the larynx and vocal cords is easy, if direct larynx-inspection is given. Morphological and functional aspects quickly lead to the choice of a homeopathic remedy. Whereas, if direct inspection with specula or laryngoscope is not possible one has to rely on vocal phenomena, the task is much more difficult. A hoarse throat, lasting for longer than two weeks, has to be checked by a specialist in ears, nose and mouth in any case, to exclude a maligne process. The specialist's description of the larynx can therefore help finding the right therapy."
0043029,Lang G,"Die gelegentliche Uberlegenheit der homoopathischen Therapie: dargestellt an drei Fallen: Intraokulare Blutung, Pericarditis rheumatica, Polyarthritis rheumatica",Allgen Homoopath Zeit 2002;247(5):187-94,,"ARTHRITIS RHEUMATOID, HOMEOPATHY, EYE DIS","KNOWLEDGE, DRUG THERAPY",,German,English Summary,0175-7881,AB,It is demonstrated how the state of knowledge of the practical homeopath influences his technique of handling the cases. This is shown by three cases being treated first by traditional medicine and then cured successfully by homeopathy.
0043030,Bleul G,Pseudokrupp (Laryngitis subglottica),Allgen Homoopath Zeit 2002;247(5):195-201,,"LARYNGEAL DIS, HOMEOPATHY","DRUG THERAPY, REPERTORY",,German,English Summary,0175-7881,AB,"In the repertory's clinical rubrics for laryngitis subglottica 40-60 remedies are quoted. The choice in the individual case must be based on modalities and concomitants. The corresponding rubrics are mentioned, six main remedies are briefly described."
0043031,"Vigoureux K, Vigoureux R",Homoopathie in Australien,Allgen Homoopath Zeit 2002;247(5):202-8,,HOMEOPATHY,"AUSTRALIA, HISTORY",,German,English Summary,0175-7881,AB,This article is based on an investigational journey through Australia and on conversations with homoeopaths of the country. The history of Australian homoeopathy and current practices in education and treatment are covered.
0043032,Weigelt E,Immunthyreoiditis - Hyperthyreose,Allgen Homoopath Zeit 2002;247(5):209-10,,"THYROTOXICOSIS, HOMEOPATHY","DRUG THERAPY, TREATMENT OUTCOME, CASE REPORT",,German,,0175-7881,,
0043033,"Suminski RR, Mattern CO, Devor ST",Influence of racial origin and skeletal muscle properties on disease prevalence and physical performance,Sports Med 2002;32(11):667-73,,"MUSCLE SKELETAL, PHYSICAL FITNESS, OBESITY, CULTURE",MUSCLE PHYSIOLOGY,,,,0112-1642,AB,"Skeletal muscle properties are related to disease (e.g. obesity) and physical performance. For example, a predominance of type I muscle fibres is associated with better performance in endurance sports and a lower risk of obesity. Disease and physical performance also differ among certain racial groups. African Americans are more likely than Caucasians to develop obesity, diabetes mellitus and hypertension. Empirical studies indicate that aerobic capacity is lower in African Americans than Caucasians. Because genetics is a partial determinant of skeletal muscle properties, it is reasonable to assume that skeletal muscle properties vary as a function of race. As such, genetically determined and race-specific skeletal muscle properties may partially explain racial disparities in disease and physical performance. However, additional research is needed in this area to enable the development of more definitive conclusions."
0043034,"Bosquet L, Leger L, Legros P",Methods to determine aerobic endurance,Sports Med 2002;32(11):675-700,,"PHYSIOLOGICAL TESTING, OXYGEN CONSUMPTION, ANAEROBIC THRESHOLD","ATHLETES, ENERGY METABOLISM",,,,0112-1642,AB,"Physiological testing of elite athletes requires the correct identification and assessment of sports-specific underlying factors. It is now recognised that performance in long-distance events is determined by maximal oxygen uptake (V-dot(2max)), energy cost of exercise and the maximal fractional utilisation of V-dot(2max) in any realised performance or as a corollary a set percentage of V-dot(2max) that could be endured as long as possible. This later ability is defined as endurance, and more precisely aerobic endurance, since V-dot(2max) sets the upper limit of aerobic pathway. It should be distinguished from endurance ability or endurance performance, which are synonymous with performance in long-distance events. The present review examines methods available in the literature to assess aerobic endurance. They are numerous and can be classified into two categories, namely direct and indirect methods. Direct methods bring together all indices that allow either a complete or a partial representation of the power-duration relationship, while indirect methods revolve around the determination of the so-called anaerobic threshold (AT). With regard to direct methods, performance in a series of tests provides a more complete and presumably more valid description of the power-duration relationship than performance in a single test, even if both approaches are well correlated with each other. However, the question remains open to determine which systems model should be employed among the several available in the literature, and how to use them in the prescription of training intensities. As for indirect methods, there is quantitative accumulation of data supporting the utilisation of the AT to assess aerobic endurance and to prescribe training intensities. (ABSTRACT TRUNCATED)."
0043035,"Van Praagh E, Dore E",Short-term muscle power during growth and maturation,Sports Med 2002;32(11):701-28,,"GROWTH, EXERCISE, LACTATES, MUSCLE STRENGTH","SPORTS, ENERGY METABOLISM, CHILD, ADULT",,,,0112-1642,AB,"During growth and maturation, the study of very brief high-intensity exercise has not received the same attention from researchers as, for instance, aerobic function. In anaerobic tasks or sports events such as sprint cycling, jumping or running, the children's performance is distinctly lower than that of adults. This partly reflects children's lesser ability to generate mechanical energy from chemical energy sources during short-term intensive activity. For many years, various attempts have been made to quantify the anaerobic energy yield in maximal-intensityexercise, but many assumptions have had to be made with respect to mechanical efficiency, lactate turnover, dilution space for lactate, and so on. During childhood and adolescence, direct measurements of the rate or capacity of anaerobic pathways for energy turnover presents several ethical and methodological difficulties. Thus, rather than measure energy supply, paediatric exercise scientists have concentrated on measuring short-term muscle power (STMP) by means of standardised tests. Previously, investigators have used various protocols such as short-term cycling power tests, vertical jump tests or running tests. Cycling ergometer tests are the most common. There is, however, no ideal test, and so it is important to acknowledge the limitations of each test. Progress has been made in assessing instantaneous cycling STMP from a single exercise bout. Several investigators have reported STMP increases with age and have suggested that late pubertal period may accentuate anaerobic glycolysis. Mass-related STMP was shown to increase dramatically during childhood and adolescence, whereas the corresponding increase in peak blood lactate was considerably lower. (ABSTRACT TRUNCATED)."
0043036,"Vad V, Hong HM, Zazzali M, Agi N, Basrai D",Exercise recommendations in athletes with early osteoarthritis of the knee,Sports Med 2002;32(11):729-39,,"OSTEOARTHRITIS, KNEE, EXERCISE, QUALITY OF LIFE","ATHLETES, PHYSICAL FITNESS, REHABILITATION",,,,0112-1642,AB,"Osteoarthritis of the knee is a common condition that afflicts millions of individuals annually. The benefits of exercise are self evident as athletes and middle-aged individuals grow older, and the focus has centered on pain-free participation in their sports and activities. In the past, medical treatment has primarily relied on oral medications to manage symptoms, without the incorporation of therapeutic exercise. Consequently, as the osteoarthritis progresses, patients are offered surgical management and eventual joint replacement. A goal-oriented progressive rehabilitation programme that incorporates medical management in the initial stages would allow patients a greater ability to participate in sports, thereby obtaining the numerous benefits of exercise and perhaps delaying surgery. A progressive rehabilitation programme consists of five stages (I to V). Medical management is primarily reserved for stage I: protected mobilisation and pain control. It entails the use of pain medications, nonsteroidal anti-inflammatory drugs, with or without the use of chondroprotective agents such as glucosamine. Injection therapy is usually incorporated at this stage with intra-articular injections of corticosteroids or viscosupplementation, either of which may be combined with minimally invasive single-needle closed joint lavage procedure. Stages II and III introduce open kinetic-chain nonweightbearing exercises to the affected joint, with progression to closed kinetic-chain exercises. Stage IV focuses on return to sporting activities, with continued closed kinetic-chain exercises. There is also the incorporation of sport-specific exercises to improve neuromuscular coordination, timing and protect against future injury. Finally, stage V, or the maintenance phase, is primarily aimed at educating the patient on how to reduce the risk of re-injury. (ABSTRACT TRUNCATED)."
0043037,"Belza B, Topolski T, Kinne S, Patrick DL, Ramsey SD",Does adherence make a difference?: results from a community-based aquatic exercise program,Nurs Res 2002 Sep-Oct;51(5):285-91,,"OSTEOARTHRITIS, EXERCISE, QUALITY OF LIFE","WATER, PROGRAM EVALUATION, ADULT",,,,0029-6562,AB,"BACKGROUND: Evidence exists demonstrating the benefits of exercise for people with osteoarthritis, but little is known about whether exercise programs are effective, that is, whether the benefits of exercise can be seen in \"real life\" programs for \"normal\" people under nonlaboratory conditions. OBJECTIVE: To identify characteristics of and outcomes for participants who adhere to a community-based aquatic exercise program. METHOD: Two hundred and forty-nine adults with osteoarthritis were recruited from Washington State for randomization to a 20-week Arthritis Foundation aquatic exercise program (n = 125) or a wait-list control group (n = 124). Adherers were defined as those attending at least two classes per week for 16 of 20 weeks. Measures included: Quality of Well Being Scale, Health Assessment Questionnaire, Center for Epidemiological Studies-Depression Scale, and a single arthritis quality of life rating-item. RESULTS: Baseline to postintervention change scores revealed that treatment-group adherers (n = 35) reported improved quality of well-being, physical function, and change in arthritis quality of life compared to controls (n = 124). When comparing treatment-group adherers (n = 35) to treatment-group nonadherers (n = 67), quality of well-being and depressed mood improved for adherers, but not for nonadherers. CONCLUSION: When analyzed for level of participation, exercise benefits adults with osteoarthritis. Consistent participation in exercise programs results in better outcomes. Improved methods are needed to enhance adherence, with increased attention to the role of intrinsic factors such as self-efficacy and belief systems."
0043038,Remington R,Calming music and hand massage with agitated elderly,Nurs Res 2002 Sep-Oct;51(5):317-23,,"NURSING HOMES, MUSIC, RELAXATION, MASSAGE","AGED, TREATMENT OUTCOME",,,,0029-6562,AB,"BACKGROUND: Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care. OBJECTIVE To examine whether modifying environmental stimuli by the use of calming music and hand massage affects agitated behavior in persons with dementia. METHOD: A four group, repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music, hand massage, or calming music and hand massage simultaneously, or no intervention (control) on the frequency and type of agitated behaviors in nursing home residents with dementia (n = 68). A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors. RESULTS: Each of the experimental interventions reduced agitation more than no intervention. The benefit was sustained and increased up to one hour following the intervention (F = 6.47, less than .01). The increase in benefit over time was similar for each intervention group. When types of agitated behaviors were examined separately, none of the interventions significantly reduced physically aggressive behaviors (F = 1.93, =.09), while physically nonaggressive behaviors decreased during each of the interventions (F = 3.78, less than 01). No additive benefit resulted from simultaneous exposure to calming music and hand massage. At one hour following any intervention, verbally agitated behavior decreased more than no intervention. CONCLUSION: Calming music and massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding, offsetting disturbing stimuli, but no additive benefit was found by combining interventions simultaneously."
0043039,"Bach P, Hayes SC",The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial,J Consult Clin Psychol 2002 Oct;70(5):1129-39,,"PSYCHOTIC DISORDERS, HOSPITALIZATION","THERAPY, TREATMENT OUTCOME",,,,0022-006X,AB,"The present study examined the impact of a brief version of an acceptance-based treatment (acceptance and commitment therapy; ACT) that teaches patients to accept unavoidable private events; to identify and focus on actions directed toward valued goals; and to defuse from odd cognition, just noticing thoughts rather than treating them as either true or false. Eighty inpatient participants with positive psychotic symptoms were randomly assigned to treatment as usual (TAU) or to 4 sessions of ACT plus TAU. ACT participants showed significantly higher symptom reporting and lower symptom believability and a rate of rehospitalization half that of TAU participants over a 4-month follow-up period. The same basic pattern of results was seen with all participant subgroups except delusional participants who denied symptoms."
0043040,"Anastos K, Barron Y, Miotti P, Weiser B, Young M, Hessol N, Greenblatt RM, Cohen M, Augenbraun M, Levine A, Munoz A",Risk of progression to AIDS and death in women infected with HIV-1 initiating highly active antiretroviral treatment at different stages of disease,Arch Intern Med 2002 Sep 23;162(17):1973-80,"antiretroviral therapy, highly active","HIV INFECTIONS, MORTALITY","DRUG THERAPY, FEMALE, TREATMENT OUTCOME",,,,0003-9926,AB,"BACKGROUND: The optimal virologic and immunologic stage at which to initiate antiretroviral therapy in individuals infected with human immunodeficiency virus type 1 (HIV-1) is undefined. METHODS: Among 1054 HIV-1-infected women in a prospective cohort study, we determined the time from initiation of highly active antiretroviral treatment (HAART) to acquired immunodeficiency syndrome (AIDS) and death. RESULTS: Median follow-up was 3.4 years. Of 553 women without AIDS at HAART initiation, 62 (11%) developed AIDS. Compared with women with CD4(+) cell counts greater than 350/microL at HAART initiation, women with cell counts of 200 to 350/microL and less than 200/microL had relative hazards (RHs) for progression to AIDS of 0.93 (95% confidence interval (CI), 0.46-1.86) and 2.48 (95% CI, 1.39-4.42), respectively. Compared with those with HIV-1 RNA values less than 5000 copies/mL, women with 5000 to 50,000 copies/mL and greater than 50,000 copies/mL had RHs of 1.39 (95% CI, 0.74-2.64) and 2.09 (95% CI, 1.09-3.99), respectively. Among women with AIDS at HAART initiation (n = 501), RHs of death were 1.97 (95% CI, 0.84-4.66) and 3.35 (95% CI, 1.59-7.08) with CD4(+) cell counts of 200 to 350/microL and less than 200/microL, respectively, relative to those with greater than 350/microL, and 1.90 (95% CI, 0.84-4.30) and 3.70 (95% CI, 1.81-7.54) for those with HIV-1 RNA values of 5000 to 50,000 and greater than 50,000 copies/mL, respectively, relative to those with less than 5000 copies/mL. CONCLUSIONS: Progression to AIDS and death was predicted by pre-HAART values of less than 200/microL for CD4(+) cells and greater than 50,000 HIV-1 RNA copies/mL, indicating that deferral of HAART until the CD4(+) cell count is between 350 and 200/microL is a valid strategy in the clinical management of HIV-1 infection."
0043041,Rousseau PC,Palliative sedation,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):295-7,,"PAIN, ANESTHESIA, TERMINAL ILLNESS","PALLIATIVE TREATMENT, PROGNOSIS",(Editorial),,,1049-9091,,
0043042,Baumrucker SJ,"Sedation, dehydration, and ethical uncertainty",Am J Hosp Palliat Care 2002 Sep-Oct;19(5):299-300,,"ANESTHESIA, DEHYDRATION, ETHICS",PALLIATIVE TREATMENT,,,,1049-9091,,
0043043,"Sarhill N, Christie R",Early satiety in advanced cancer: a common unrecognized symptom?,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):305,,"NEOPLASMS, EATING DISORDERS",PALLIATIVE TREATMENT,(Letter),,,1049-9091,,
0043044,"Demmer C, Sauer J",Assessing complementary therapy services in a hospice program,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):306-14,,"TERMINAL ILLNESS, HOSPICE CARE, QUALITY OF LIFE","COMPLEMENTARY THERAPIES, PATIENT SATISFACTION",,,,1049-9091,AB,"Increasing numbers of people have been supplementing their health care needs with complementary therapies. Complementary therapies have been used to promote health and treat patients with a variety of ailments. Types of complementary therapies used with terminally ill patients have included massage, therapeutic touch, Reiki, art and music therapy, aromatherapy, and hypnotherapy. The purpose of this study was to survey primary caregivers (PCGs) regarding their perceptions and satisfaction with a hospice complementary therapy program. Perhaps this study's most interesting finding is that patients who received complementary therapies were generally more satisfied with overall hospice services."
0043045,"Patterson LB, Dorfman LT",Family support for hospice caregivers,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):315-23,,"CAREGIVERS, COMMUNICATION, ADAPTATION PSYCHOLOGICAL","FAMILY, PALLIATIVE TREATMENT, INTERPERSONAL RELATIONS",,,,1049-9091,AB,"This qualitative study investigated family supports for primary caregivers of hospice patients, as perceived by both the primary caregiver and other family members involved in patient care. Family support was conceptualized in terms of (1) who offers support; (2) types of support; (3) frequency of support; (4) family communication; and (5) change in family relationship during the caregiving process. Twenty-four interviews were conducted with 10 primary caregivers and six family members identified by the caregiver as the person they could most call on for help. Interviews were conducted shortly after admission to hospice and approximately two months after the death of the hospice patient. Primary caregivers and other family members involved in care agreed that the primary caregiver provided most care. They also agreed that family members provided instrumental and emotional support, the frequency of assistance was appropriate, and families had grown closer since learning of the terminal illness. There was less agreement regarding family communication during the caregiving process. Implications for interventions with families of hospice patients are discussed."
0043046,Myers GE,Can illness narratives contribute to the delay of hospice admission?,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):325-30,,"HOSPICE CARE, PATIENT ADMISSION, QUALITY OF LIFE","DECISION MAKING, COMMUNICATION",,,,1049-9091,AB,"Patients who could benefit from the end-of-life care that hospice provides frequently underuse this service because their admission occurs very late in the course of their dying. Admission to hospice requires that patients and their physicians shift their treatment goals from cure to comfort care. However, this shift is not likely to occur unless there is a parallel shift of hope, from hope for a cure to hope for the best possible quality of life. This study considers how a prominent type of illness narrative, the restitution narrative, delays decisions for hospice by inhibiting the transformation of hope from a hope for cure to a hope for quality at life's end."
0043047,"Kutner JS, Blake M, Meyer SA",Predictors of live hospice discharge: data from the National Home and Hospice Care Survey (NHHCS),Am J Hosp Palliat Care 2002 Sep-Oct;19(5):331-7,,"PATIENT DISCHARGE, HOSPICE CARE",EPIDEMIOLOGY,,,,1049-9091,AB,"In the context of the current regulatory environment, patients may be discharged from hospice if their condition stabilizes or improves over time and the certifying physician is unable to provide a conscientious recertification of the six-month prognosis. Little is known about the characteristics or outcomes of patients who are determined by physicians to no longer be eligible for hospice care. This retrospective study was designed to characterize the rates and predictors of live hospice discharge using data from the 1996 and 1998. National Home and Hospice Care Survey (NHHCS). We compare records of live hospice discharge with hospice discharges due to death from the discharge patient files of the 1996 and the 1998 NHHCS. Of the 807,733 patients in the combined 1996 and 1998 NHHCS discharge patient file who met study inclusion criteria, 761,858 (94%) were deceased and 45,875 (6%) were discharged alive. Those who were discharged alive were more likely to be female, have received hospice care for more than 60 days, and to have had a noncancer diagnosis, particularly advanced cardiopulmonary or neurologic disease. Mean age and total number of assistive medical devices used did not differ significantly between patients who were discharged alive and those who died in hospice care. Factors most associated with live hospice discharge, using bivariate analyses, were length of service greater than 60 days (OR, 6.60; 95% CI, 6.47-6.73), cardiopulmonary diagnosis (OR, 3.24; 95% CI, 3.19-3.30), and neurologic diagnosis (OR, 2.73; 95% CI, 2.67-2.79). Multivariate logistic regression identified length of service greater than 60 days, cardiopulmonary diagnosis, neurologic diagnosis, female gender, worse functional status, and living in an institutional setting as being independently associated with live hospice discharge. (ABSTRACT TRUNCATED)."
0043048,"Jackson WC, Connor DP, Tavernier L",Antemortem care in an afternoon: a successful four-hour curriculum for third-year medical students,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):338-42,,"EDUCATION MEDICAL, CURRICULUM, DELIVERY OF HEALTH CARE","PALLIATIVE TREATMENT, STUDENTS",,,,1049-9091,AB,"Numerous well-designed studies have shown that patients near the end of life often receive substandard palliative care. Medical students have expressed a strong interest in antemortem care; however, palliative medicine education remains poorly integrated into the overall curriculum at most medical institutions in the United States. In response to this need, a palliative medicine curriculum has been developed for medical students in the required third-year clerkship in family medicine at the University of Tennessee Health Sciences Center. The implementation of this curriculum resulted in a statistically significant increase in student competence (as measured by a standardized pretest and post-test) and a significant trend in student confidence (as measured by a single-item Likert scale). The curriculum was popular with students, and encouraged many of them to request hospice clinical experiences during their family medicine clerkship, or to register for the elective fourth-year clerkship in palliative medicine."
0043049,"Glare P, Walsh D, Groh E, Nelson KA",The efficacy and side effects of continuous infusion intravenous morphine (CIVM) for pain and symptoms due to advanced cancer,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):343-50,,"NEOPLASMS, MORPHINE, PAIN, SAFETY","TREATMENT OUTCOME, DRUG THERAPY, ADVERSE EFFECTS",,,,1049-9091,AB,"Morphine is the strong opioid of choice in the management of moderate-to-severe chronic cancer pain. The preferred route of administration is oral, in individually titrated doses, regularly scheduled around the clock. We conducted a retrospective study of continuous intravenous morphine (CIVM) in a palliative medicine program in 107 consecutive patients. The results suggest CIVM is an effective, safe, and versatile method of morphine administration when used with a defined protocol. Efficacy was similar to that obtained by others with intravenous morphine sulfate and also for oral morphine. Safety was suggested by the low incidence of dose-limiting side effects, most of which responded to dose reduction. Particularly noteworthy was the flexibility of CIVM with dose reduction in 20%."
0043050,"Komurcu S, Nelson KA, Walsh D, Ford RB, Rybicki LA",Gastrointestinal symptoms among inpatients with advanced cancer,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):351-5,,"NEOPLASMS, GASTROINTESTINAL DIS","AGE FACTORS, SEX, DIAGNOSIS",,,,1049-9091,AB,"Nearly one-half of the most frequently reported and most distressing symptoms in patients with advanced cancer are gastrointestinal in nature. This prospective study was designed to assess the frequency of gastrointestinal symptoms among inpatients admitted to a palliative medicine program with advanced cancer. Twenty-nine men and 2l women, with a median age of 64 years (range, 35-84), were interviewed about 17 gastrointestinal symptoms. Age, gender, diagnosis, and medication use were also recorded. The most common diagnoses were cancers of the lung (n = 14), breast (n = 6), and prostate (n = 4). Dry mouth (84%), weight loss (76%), early satiety (71%), taste change (60%), constipation (58%), anorexia (56%), bloating (50%), nausea (48%), abdominal pain (42%), and vomiting (34%) were the 10 most common gastrointestinal symptoms. Women had more gastrointestinal symptoms than men (median 8 vs. 6, p = 0.018), although this finding was not statistically significant (p = 0.11) after excluding gender-specific cancers. Women had more taste change and diarrhea than men after excluding gender-specific cancers (p = 0.036 and p = 0.046, respectively). Those with primary gastrointestinal cancers (n = 8) had more indigestion and hiccups than those with nongastrointestinal cancers (n = 39). There was no age difference in symptomatology. The drugs prescribed most commonly were opioids (n = 40), laxatives (n = 38), H2 blockers (n = 29), appetite stimulants (n = 29), and antiemetics (n = 29). Findings support that gastrointestinal symptoms are very common in hospitalized patients with advanced cancer and that the frequency and type of symptoms differ with gender and gastrointestinal vs. nongastrointestinal primary site."
0043051,Nenner F,A good death,Am J Hosp Palliat Care 2002 Sep-Oct;19(5):356-8,,"TERMINAL ILLNESS, DECISION MAKING","PALLIATIVE TREATMENT, HOSPITALS",,,,1049-9091,,
0043052,Somerville M,Deathbed disputation: a response to Peter Singer,Can Med Assoc J 2002 Sep 17;167(6):651-4,,"EUTHANASIA, DECISION MAKING, SUICIDE ASSISTED","ETHICS, LEGISLATION",,,,0820-3946,,
0043053,"Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL",Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction,Am J Sports Med 2002 Sep-Oct;30(5):660-6,,"ANTERIOR CRUCIATE LIGAMENT, RECONSTRUCTIVE SURGICAL PROCEDURES","BIOMECHANICS, CADAVER, KNEE",,,,"0363-5465\r\nAnatomic two-bundle reconstruction restores knee kinematics more closely to normal than does single-bundle reconstruction. STUDY DESIGN: Controlled laboratory study. METHODS: Ten cadaveric knees were subjected to external loading conditions: 1) a 134-N anterior tibial load and 2) a combined rotatory load of 5-N.m internal tibial torque and 10-N.m valgus torque. Resulting knee kinematics and in situ force in the anterior cruciate ligament or replacement graft were determined by using a robotic/universal force-moment sensor testing system for 1) intact, 2) anterior cruciate ligament deficient, 3) single-bundle reconstructed, and 4) anatomically reconstructed knees. RESULTS: Anterior tibial translation for the anatomic reconstruction was significantly closer to that of the intact knee than was the single-bundle reconstruction. The in situ force normalized to the intact anterior cruciate ligament for the anatomic reconstruction was 97% +/- 9%, whereas the single-bundle reconstruction was only 89% +/- 13%. With a combined rotatory load, the normalized in situ force for the single-bundle and anatomic reconstructions at 30 degrees of flexion was 66% +/- 40%and 91% +/- 35%, respectively. CONCLUSIONS: Anatomic reconstruction may produce a better biomechanical outcome, especially during rotatory loads.",AB,BACKGROUND: The focus of most anterior cruciate ligament reconstructions has been on replacing the anteromedial bundle and not the posterolateral bundle. HYPOTHES
0043054,"Legssyer A, Ziyyat A, Mekhfi H, Bnouham M, Tahri A, Serhrouchni M, Hoerter J, Fischmeister R",Cardiovascular effects of Urtica dioica L. in isolated rat heart and aorta,Phytother Res 2002 Sep;16(6):503-7,,"PLANT EXTRACTS, HEART, AORTA, ANTIHYPERTENSIVE AGENTS, URTICA DIOICA","RATS, DRUG EFFECTS, PHARMACOLOGY",,,,0951-418X,AB,"Urtica dioica L. or Nettle (Urticaceae) is widely used in oriental Morocco to treat hypertension. Aqueous extract of Nettle (AEN) also exerts a hypotensive action in the rat in vivo. The aim of this work was to characterize the specific cardiac and vascular effects of AEN. In the isolated Langendorff perfused rat heart, AEN (1 and 2 g/l) markedly decreased heart rate and increased left ventricular pressure. Higher concentration (5 g/l) even led to cardiac arrest. Although carbachol mimicked the bradycardiac effect of AEN, atropine (a muscarinic receptor antagonist, 1 micro M) did not modify the response. Beside its action on myocardium, AEN also affected vascular contractility. Indeed, AEN (0.1-5 g/l) produced a dose-dependent increase in basal tone of isolated rat aorta. This effect was endothelium independent and was abolished by 1 micro M prazosin (an alpha1-adrenergic antagonist). AEN had little additional effects when the aorta was precontracted by noradrenaline (1 micro M) or KCl (40 mM). Our data indicate that AEN produces a vasoconstriction of the aorta which is due to activation of alpha1-adrenergic receptors. However, AEN also induces a strong bradycardia through non-cholinergic and non-adrenergic pathways which might compensate for its vascular effect and account for the hypotensive action of Urtica dioica L described in vivo."
0043055,"Shin TY, Kim SH, Lee ES, Eom DO, Kim HM",Action of Rubus coreanus extract on systemic and local anaphylaxis,Phytother Res 2002 Sep;16(6):508-13,Rubus coreanus,"PLANT EXTRACTS, ANAPHYLAXIS, HISTAMINE, IGE","PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, METABOLISM, DRUG THERAPY, MICE",,,,0951-418X,AB,"The effect was investigated of the aqueous extract of Rubus coreanus Miq. (Rosaceae) fruits (RCAE) on systemic and local anaphylaxis. RCAE (0.01-1 g/kg) dose-dependently inhibited systemic anaphylaxis induced by compound 48/80 in mice. RCAE (1 g/kg) also significantly inhibited local anaphylaxis activated by anti-DNP IgE. Pretreatment with RCAE at the same concentration before systemic anaphylaxis reduced the plasma histamine levels in a dose-dependent manner. RCAE (0.001-1 mg/mL) dose-dependently inhibited the histamine release from rat peritoneal mast cells (RPMC) activated by compound 48/80 or anti-DNP IgE. The level of cAMP in RPMC, when RCAE was added, significantly increased, compared with that of the normal control. Moreover, RCAE (0.01-1 mg/mL) had a significant inhibitory effect on anti-DNP IgE-induced tumour necrosis factor-alpha production from RPMC. These results indicate that RCAE may possess antianaphylactic action."
0043056,"Vidya L, Lenin M, Varalakshmi P",Evaluation of the effect of triterpenes on urinary risk factors of stone formation in pyridoxine deficient hyperoxaluric rats,Phytother Res 2002 Sep;16(6):514-8,Crataeva nurvala,"TRITERPENES, UROLOGIC DIS, PLANT EXTRACTS, URINARY TRACT PHYSIOLOGY","PLANTS MEDICINAL, PHARMACOLOGY, RATS, DRUG EFFECTS, ENZYMES, DRUG THERAPY",,,,0951-418X,AB,"Investigations were carried out to evaluate the efficacy of the pentacyclic triterpene, lupeol and its ester, lupeol linoleate, against calcium oxalate urolithiasis in rats. Administration of a pyridoxine deficient diet containing 3% glycollic acid for 21 days led to increased excretion of stone forming constituents such as calcium, oxalate and uric acid. Crystal deposition and subsequent renal tubular damage resulted in increased excretion of the tubular enzymes alkaline phosphatase, lactate dehydrogenase, gamma glutamyl transferase, beta glucuronidase and N-acetyl glucosaminidase along with reduced fibrinolytic enzymes. A reduction in the urinary inhibitory factors magnesium and glycosaminoglycans was also observed. Treatment with lupeol and lupeol linoleate reduced the extent of tubular damage as evidenced from reduced enzymuria and minimized the excretion of stone forming constituents."
0043057,"Suyenaga ES, Reche E, Farias FM, Schapoval EE, Chaves CG, Henriques AT",Antiinflammatory investigation of some species of Mikania,Phytother Res 2002 Sep;16(6):519-23,"Mikania laevigata, Mikania involucrata, Mikania hirsutissima","ANTIINFLAMMATORY AGENTS, PLANT EXTRACTS, EDEMA, PLEURAL EFFUSION","PLANTS MEDICINAL, PHARMACOLOGY, DRUG THERAPY, DRUG EFFECTS, LEUKOCYTES",,,,0951-418X,AB,"Mikania laevigata Schultz Bip. ex Baker, M. involucrata Hook. et Arn. and M. hirsutissima DC. (Asteraceae), commonly occurring in the southern Brazilian State of Rio Grande do Sul, were submitted to biological tests to evaluate their potential antiinflammatory activity. Decoctions from the leaves and stems were analysed by the induced rat paw oedema and pleurisy models. The animals were treated orally with different decoction doses. In the induced rat paw oedema test, the animals treated with leaf decoctions from M. laevigata (200 mg/ kg) and M. involucrata (50 mg/ kg) presented an oedema inhibition of 81.56% and 81.67%, respectively, 3 h after the administration of the phlogistic agent. Leaf decoctions from M. hirsutissima (400 mg/ kg) did not show such an activity. Stem decoctions displayed lower antiinflammatory activity when compared with the same doses and response time of the leaf decoctions for all analysed species. In the pleurisy assay, leaf decoctions from M. laevigata (400 mg/ kg) and M. involucrata (200 mg/ kg) inhibited leukocyte migration to the pleural exudate by 28.26% and 54.35%, respectively."
0043058,"Besra SE, Gomes A, Chaudhury L, Vedasiromoni JR, Ganguly DK",Antidiarrhoeal activity of seed extract of Albizzia lebbeck Benth,Phytother Res 2002 Sep;16(6):529-33,Albizzia lebbeck,"ANTIDIARRHEALS, PLANT EXTRACTS, DIARRHEA","PLANTS MEDICINAL, SEEDS, PHARMACOLOGY, DRUG THERAPY",,,,0951-418X,AB,"The antidiarrhoeal activity of the seed extract of Albizzia lebbeck (Benth.) was investigated employing conventional rodent models of diarrhoea, i.e. castor oil-induced diarrhoea, upper gastrointestinal transit (u.g.t.) and fluid secretion. It was found that the aqueous methanol extract of Albizzia lebbeck seeds (2.5-5 mg/kg i.p.) possessed antidiarrhoeal activity which strengthens the earlier use of the seeds in the treatment of diarrhoea and dysentery. The antidiarrhoeal dose of the extract was at least 10-30 times less than the LD(50) dose. The extract (2.5-5 mg/kg i.p.) potentiated the antidiarrhoeal activity of loperamide (1 mg/kg i.p.). Nalaxone (0.5 mg/kg i.p.) significantly inhibited the antidiarrhoeal activity of the extract as well as loperamide, thus indicating a role of the opioid system in the antidiarrhoeal activity of the extract."
0043059,"Tripathi YB, Upadhyay AK",Effect of the alcohol extract of the seeds of Mucuna pruriens on free radicals and oxidative stress in albino rats,Phytother Res 2002 Sep;16(6):534-8,Mucuna pruriens,"PLANT EXTRACTS, FREE RADICALS, OXIDATIVE STRESS, ANTIOXIDANTS, LIVER, LIPID PEROXIDATION","PLANTS MEDICINAL, RATS, DRUG EFFECTS, PHARMACOLOGY, PHYSIOLOGY, SEEDS",,,,0951-418X,AB,"In vitro and in vivo studies were made with an alcohol extract of the seeds of Mucuna pruriens (Fabaceae) to investigate its antioxidant property. In vitro studies were carried out in rat liver homogenate to investigate the chemical interaction of various phytochemicals with different species of free radicals. The effect was also checked on iron-induced lipid peroxidation, oxidation of GSH content, and its interaction with hydroxyl and superoxide radicals. There was no change on the rate of aerial oxidation of GSH content but it significantly inhibited FeSO(4) induced lipid peroxidation. It also inhibited the specific chemical reactions induced by superoxides and hydroxyl radicals. The removal of these species was through direct chemical interaction. An in vivo study on albino rats for 30 days showed no toxic effect up to a dose of 600 mg/kg body weight, on oral administration. There was no change in the level of TBA-reactive substances, reduced glutathione content and SOD activity in the liver. The activity of serum GOT, GPT and alkaline phosphatase was also unchanged. Thus it could be concluded that the alcohol extract of the seeds of M. pruriens has an antilipid peroxidation property, which is mediated through the removal of superoxides and hydroxyl radicals."
0043060,"Haraguchi H, Inoue J, Tamura Y, Mizutani K",Antioxidative components of Psoralea corylifolia (Leguminosae),Phytother Res 2002 Sep;16(6):539-44,Psoralea corylifolia,"PLANT EXTRACTS, ANTIOXIDANTS, BIOFLAVONOIDS, LIPID PEROXIDATION","PLANTS MEDICINAL, DRUG ISOLATION, SPECTRUM ANALYSIS, MOLECULAR STRUCTURE, PHARMACOLOGY, DRUG EFFECTS",,,,0951-418X,AB,"A meroterpene and four flavonoids were isolated from the seeds of Psoralea corylifolia as antioxidative components. Their structures were elucidated by spectral data and identified as bakuchiol (1), bavachinin (2), bavachin (3), isobavachin (4) and isobavachalcone (5). In particular, meroterpene 1 and flavonoids 4 and 5 showed broad antioxidative activities in rat liver microsomes and mitochondria. They inhibited NADPH-, ascorbate-, t-BuOOH- and CCl(4)-induced lipid peroxidation in microsomes. They also prevented NADH-dependent and ascorbate-induced mitochondrial lipid peroxidation. Bakuchiol (1) was the most potent antioxidant in microsomes and the inhibition of oxygen consumption induced by lipid peroxidation was time-dependent. Furthermore, bakuchiol (1) protected human red blood cells against oxidative haemolysis. These phenolic compounds in P. corylifolia were shown to be effective in protecting biological membranes against various oxidative stresses."
0043061,"Bedoya LM, Palomino SS, Abad MJ, Bermejo P, Alcami J",Screening of selected plant extracts for in vitro inhibitory activity on human immunodeficiency virus,Phytother Res 2002 Sep;16(6):550-554,"Hysopp officinalis, Dittrichia viscosa","PLANT EXTRACTS, HIV, ANTI HIV AGENTS","VIRUSES, DRUG EFFECTS, DRUG THERAPY, PHARMACOLOGY, PLANTS MEDICINAL",,,,0951-418X,AB,"As part of our screening of anti-AIDS agents from natural sources, extracts of 15 medicinal plants widely used in the folk medicines of North America and Europe were evaluated in vitro. Most of the extracts tested were relatively nontoxic to human lymphocytic MT-2 cells, but only the extracts of Hysopp officinalis and Dittrichia viscosa exhibited anti-HIV activity in an in vitro MTT assay. The 50% hydroalcohol extract of Hysopp officinalis and the aqueous extract of Dittrichia viscosa showed inhibitory effects against HIV-1 induced infections in MT-2 cells at concentrations ranging from 50 to 100 microg/mL and 25 to 400 microg/mL, respectively. Both extracts showed no appreciable cytotoxicity at these concentrations."
0043062,"Elegami AA, El-Nima EI, Tohami MS, Muddathir AK",Antimicrobial activity of some species of the family Combretaceae,Phytother Res 2002 Sep;16(6):555-61,Combretaceae,"ANTIINFECTIVE AGENTS, PLANT EXTRACTS, TANNINS, TRADITIONAL MEDICINE AFRICAN","PHARMACOLOGY, PLANTS MEDICINAL, FOLK REMEDIES",,,,0951-418X,AB,Forty eight extracts of four plants of the family Combretaceae were screened for antibacterial activity against standard organisms as well as clinical isolates. The extracts in different solvent systems showed high activity against both standard organisms and clinical isolates. Phytochemical screening revealed that the plants were very rich in tannins to which antibacterial activity may be attributed.
0043063,"Backhouse N, Delporte C, Negrete R, Feliciano SA, Lopez-Perez JL",Bioactive phenolic derivatives from Acaena splendens methanol extract,Phytother Res 2002 Sep;16(6):562-6,Acaena splendens,"PLANT EXTRACTS, FEVER, EDEMA, ANTIINFLAMMATORY AGENTS, BIOFLAVONOIDS","PLANTS MEDICINAL, DRUG THERAPY, PHARMACOLOGY, RODENTS, ANALGESICS",,,,0951-418X,AB,"Acaena splendens H. et A. has been used in Chilean folk medicine for the treatment of fever and inflammation. A description of the in vivo reduction of bacterial pyrogen-induced fever in rabbits and carrageenan-induced paw oedema in guinea pigs is presented. The methanol extract named ME-1, obtained after successive extractions with petroleum ether and dichloromethane, showed a strong antipyretic action (45.7% of effect), though the antiinflammatory activity was only observed after submitting this extract to column fractionation, giving a crude mixture of flavonoids named C4 with both activities (55.7% and 98.9% of antiinflammatory and antipyretic effect respectively at a dose of 600 mg/kg). The bioassay-guided fractionation by column chromatography afforded the active fraction, which contained (-,-)-epicatechin, tiliroside, 7-O-acetyl-3-O-beta-D-glucosyl-kaempferol and 7-beta-D-glucosyloxy-5-hydroxy-chromone."
0043064,"Ziyyat A, Mekhfi H, Bnouham M, Tahri A, Legssyer A, Hoerter J, Fischmeister R",Arbutus unedo induces endothelium-dependent relaxation of the isolated rat aorta,Phytother Res 2002 Sep;16(6):572-575,"Arbutus unedo, endothelium","MUSCLE RELAXATION, AORTA, MUSCLE SMOOTH, PLANT EXTRACTS, VASODILATION","PLANTS MEDICINAL, PHARMACOLOGY, DRUG EFFECTS, FOLK REMEDIES, EPITHELIUM, RATS",,,,0951-418X,AB,"Arbutus unedo L. (Ericaceae) is used in oriental Morocco to treat arterial hypertension. We studied its vasodilator effect and mechanisms of action in vitro. The root aqueous extract of Arbutus (0.25 mg/mL) produced a relaxation of noradrenaline-precontracted ring preparations of rat aorta with intact endothelium. Relaxation by Arbutus did not occur in specimens without endothelium and was inhibited by pretreatment with 100 microM N(G)-methyl-L-arginine (L-NMA), 10 microM methylene blue or 50 microM 1H-(1,2,4) oxadiazolo (4,3-a) quinoxaline-1-one (ODQ) but not by 10 microM atropine. These results suggest that Arbutus produces an endothelium-dependent relaxation of the isolated rat aorta which may be mediated mainly by a stimulation of the endothelial nitric oxide synthase by mechanisms other than activation of muscarinic receptors."
0043065,"Shetty TK, Satav JG, Nair CK",Protection of DNA and microsomal membranes in vitro by Glycyrrhiza glabra L. against gamma irradiation,Phytother Res 2002 Sep;16(6):576-8,"Glycyrrhiza glabra, microsomes liver","DNA, CELL MEMBRANE, RADIATION, PLANT EXTRACTS, LIPID PEROXIDATION, RADIATION PROTECTION","CELLS, ROOTS, RATS, DRUG EFFECTS, PHARMACOLOGY",,,,0951-418X,AB,"The radioprotective effect of the root extract of Glycyrrhiza glabra L on lipid peroxidation in rat liver microsomes and plasmid pBR322 DNA was investigated. The extract was found to protect microsomal membranes, as evident from reduction in lipid peroxidation, and could also protect plasmid DNA from radiation-induced strand breaks."
0043066,"Bhaskara Rao R, Murugesan T, Sinha S, Saha BP, Pal M, Mandal SC",Glucose lowering efficacy of Ficus racemosa bark extract in normal and alloxan diabetic rats,Phytother Res 2002 Sep;16(6):590-2,Ficus racemosa,"PLANT EXTRACTS, DIABETES MELLITUS, HYPOGLYCEMIC AGENTS","PLANTS MEDICINAL, PHARMACOLOGY, RATS, FOLK REMEDIES, DRUG THERAPY",,,,0951-418X,AB,"The glucose-lowering efficacy of a methanol extract of the stem bark of Ficus racemosa Linn. (MEBFR) (Family Moraceae) was evaluated both in normal and alloxan-induced diabetic rats. The MEBFR at the doses examined (200 and 400 mg/kg p.o.) exhibited significant hypoglycaemic activity in both experimental animal models when compared with the control group. The activity was also comparable to that of the effect produced by a standard antidiabetic agent, glibenclamide 10 mg/kg. The present investigation established pharmacological evidence to support the folklore claim that it is an antidiabetic agent."
0043067,"Akbay P, Calis I, Undeger U, Basaran N, Basaran AA",In vitro immunomodulatory activity of verbascoside from Nepeta ucrainica L.,Phytother Res 2002 Sep;16(6):593-5,"Nepeta ucrainica, acteoside","PLANT EXTRACTS, NEUTROPHILS","PLANTS MEDICINAL, GLUCOSIDES, DRUG ISOLATION, SPECTRUM ANALYSIS, DRUG EFFECTS",,,,0951-418X,AB,"Nepeta ucrainica L. is used as a herbal tea in Kazakhistan. Phytochemical investigations of the aerial parts of the plant resulted in the isolation of verbascoside (1) and 1,5,9-epi-deoxyloganic acid (2). The structures of the compounds were elucidated by spectral (UV, IR, (1)H-NMR and (13)C-NMR) methods and HPLC analysis. The in vitro immunomodulatory activity of verbascoside was investigated by assessing neutrophil function; chemotaxis and intracellular killing activity. Verbascoside showed an increased chemotactic activity in all doses applied compared with the medium used as a negative control and had a positive effect on respiratory burst of neutrophils, but there was an opposite effect with increasing doses, pointing to a possible suppression of neutrophil intracellular killing activity."
0043068,"Seal T, Mukherjee B","(+)-tiliarine, a selective in vitro inhibitor of human melanoma cells",Phytother Res 2002 Sep;16(6):596-9,Tiliacora racemosa,"MELANOMA, ALKALOIDS, PLANT EXTRACTS","ROOTS, PLANTS MEDICINAL, DRUG ISOLATION, DRUG EFFECTS, PHARMACOLOGY",,,,0951-418X,AB,"Five diphenylbisbenzylisoquinoline (DBBI) alkaloids, tiliacorinine, tiliacorine, nor- tiliacorinine A, tiliarine and tiliamosine were isolated from the ethanol extract of the roots of Tiliacora racemosa Colebr. and identified by spectral techniques. Of these (+)-tiliarine is the only one which exhibited a selective inhibitory effect against human melanoma cells (G 361) and had no activity on normal human fibroblasts (CCD 974 SK). The activity of (+)-tiliarine against the human melanoma cell line was not much modified in the presence of calcium chloride."
0043069,Rowan AJ,Fundamentals of drug management of epilepsy in the older patient,Geriatrics 2002 Sep;57(9):33-7,,"EPILEPSY, PATIENT ASSESSMENT","DRUG THERAPY, AGED, TREATMENT OUTCOME",,,,0016-867X,AB,"Although commonly perceived as a condition of the young, epilepsy has a significant presence in the geriatric population. The most common seizure types in older persons are complex partial, simple partial, and secondarily generalized tonic clonic. Patient assessment and management objectives include determining the seizure type, calculating the risk of seizure recurrence, and determining whether to initiate anticonvulsant therapy. These objectives are pursued using clinical, electroencephalographic (EEG), and neuroimaging findings. Treatment can reduce the risk of recurrence and prevent injuries likely to occur among older persons experiencing seizures."
0043070,"Moseley JB, O'Malley K, Petersen NJ",Knee surgery for OA may not produce desired results,Geriatrics 2002 Sep;57(9):43,,"OSTEOARTHRITIS, SURGERY OPERATIVE, KNEE",TREATMENT OUTCOME,,,,0016-867X,,
0043071,McConnell J,The physical therapist's approach to patellofemoral disorders,Clin Sports Med 2002 Jul;21(3):363-87,,"PATELLA, JOINT DIS","PHYSIOTHERAPY, ANATOMY, BIOMECHANICS",,,,0278-5919,AB,"Management of patellofemoral pain is no longer a conundrum if the therapist can determine the underlying causative factors and address those factors in treatment. It is imperative that the patient's symptoms are significantly reduced. This often is achieved by taping the patella, which not only decreases the pain but also promotes an earlier activation of the VMO and increases quadriceps torque. Management needs to include specific VMO training, gluteal-control work, stretching tight lateral structures, and appropriate advice regarding the foot, whether it is orthotics, training, or taping."
0043072,"Arendt EA, Fithian DC, Cohen E",Current concepts of lateral patella dislocation,Clin Sports Med 2002 Jul;21(3):499-519,,"PATELLA, DISLOCATIONS","DIAGNOSIS, ETIOLOGY",,,,0278-5919,AB,"Surgical treatment of patellar dislocations, acute and chronic, has evolved significantly over the past decade with the advance of biomechanical knowledge of patellofemoral restraints and injury patterns identified by physical examination and improved imaging techniques. There continues to be no consensus on treatment parameters. Despite the presence of predisposing factors, such as dysplasia or generalized hyperlaxity, medial retinacular injury associated with primary (first-time) patellar dislocations represents a ligament injury, which may result in residual laxity of the injured structure. This residual laxity is defined objectively by an increase in passive lateral excursion of the patella. Repair or reconstructive procedures to restore this medial constraint is considered paramount in any procedure to stabilize the patella against subsequent dislocations. How best to accomplish this continues to be a matter of debate. The establishment of a medial check-rein by either repairing or reconstructing the MPFL is the procedure of choice for stabilizing a kneecap after first-time dislocation, largely because the literature to date does not provide clear guidelines about when more extensive surgery is indicated. Whether or not all first-time dislocators have improved outcome after surgical repair remains speculative, however. Improved outcome would involve both the elimination of recurrent instability episodes and continued satisfactory function of this patella in activities-of-daily-living and sporting activities. These outcomes have not been studied critically in operative versus nonoperative treatment of first-time patellar dislocation. For the first-time dislocator, most investigators would agree that an arthroscopy should be performed if intra-articular chondral damage is suspected. (ABSTRACT TRUNCATED)."
0043073,"Dworkin JP, Culatta RA, Abkarian GG, Meleca RJ",Laryngeal anesthetization for the treatment of acquired disfluency: a case study,J Fluency Disord 2002 Autumn;27(3):215-6,,"STUTTERING, ACCIDENTS TRAFFIC, ANESTHESIA","SPEECH THERAPY, TREATMENT OUTCOME",,,,0094-730X,AB,"The subject of this case study is an adult who became severely disfluent after a motor vehicle accident in which he did not suffer significant injuries. His disfluency persisted for 4 months notwithstanding a short trial of speech therapy. Hyperfunctional phonation subsystem disturbances were identified on follow-up evaluations. Laryngeal anesthetization was achieved via a transcutaneous lidocaine injection. The patient improved dramatically within 15 min of the procedure. More than 18 months later, he has retained normal speech fluency without any additional post-injection intervention. Theoretical discussions are rendered to help interpret this treatment outcome."
0043074,Hastings RP,Parental stress and behaviour problems of children with developmental disability,J Intellect Dev Disabil 2002 Sep;27(3):149-60,,"STRESS PSYCHOLOGICAL, CHILD DEVELOPMENT DISORDERS","PARENTS, RESEARCH",,,,1366-8250,AB,"The present paper focuses on the integration of two research foci in the field of developmental disability: models of the development and maintenance of children's problem behaviours, and parental stress associated with child characteristics. I propose a simple model whereby children's behaviour problems, parental stress, and parenting behaviour are related. Evidence is found for a central part of this model (that child behaviour problems lead to parental stress), but other aspects are as yet untested in the developmental disability field. Future refinement of the model is discussed, with an emphasis on the role of parental appraisal processes in understanding the mechanisms by which child behaviour problems affect parental well being. Finally, the practical implications of integrating research on children's behaviour problems and parental stress are briefly considered."
0043075,"Kuhn DE, Matson JL",A validity study of the Screening Tool of Feeding Problems (STEP),J Intellect Dev Disabil 2002 Sep;27(3):161-7,,"FEEDING BEHAVIOR, LEARNING DISABILITY, CLINICAL ASSESSMENT SCALES","CONSISTENCY AND RELIABILITY, DIAGNOSIS",,,,1366-8250,AB,"The Screening Tool of Feeding Problems (STEP) was developed as a means to identify feeding problems presented by persons with an intellectual disability, for diagnosis, treatment and evaluating treatment outcome. Rarely is assessment comprehensive and often problems are not identified until they are severe. Items for the scale were developed to target feeding problems identified in the literature in the areas of risk of aspiration, food selectivity, feeding skills deficits, food refusal and associated behaviour problems, and nutrition related behavior problems. The current study examines the validity of the STEP as a means to identify feeding problems. Convergent validity was demonstrated by comparing STEP items targeting rumination and pica (items 18 and 9, respectively) to DSM-IV diagnoses of these disorders. Implications of the results are discussed."
0043076,"Carter M, Hotchkis GD",A conceptual analysis of communicative spontaneity,J Intellect Dev Disabil 2002 Sep;27(3):168-90,,"COMMUNICATION, DISABILITY","PUBLICATIONS, RESEARCH",,,,1366-8250,AB,"Communicative spontaneity is reported to present a significant problem for individuals with high support needs. Examination of literature addressing communicative spontaneity reveals conceptually opposing views of the phenomenon. Both the binary and the continuum conceptualisations are examined in this paper in specific relation to their logical consistency, explanatory power and limitations. It is argued that the continuum conceptualisation offers much greater explanatory power and facilitates understanding of communicative spontaneity. Several approaches to the operationalisation of the continuum approach are considered and contrasted. Limitations and problems with existing approaches to the operationalisation of spontaneity are explored and an alternative proposed."
0043077,"Chia YH, Lee KS, Teo-Koh SM",High intensity cycling performances of boys with and without intellectual disability,J Intellect Dev Disabil 2002 Sep;27(3):191-200,,"LEARNING DISABILITY, BICYCLING, EXERCISE","MALE, PATIENT ASSESSMENT, CONSISTENCY AND RELIABILITY",,,,1366-8250,AB,"The purpose of the study was to investigate the reliability, agreement and variability of high intensity cycling exercise in a group of boys with intellectual disability (ID) and also to compare the Wingate Anaerobic Test (WAnT) performances of boys with and without intellectual disability. Sixteen boys with ID and 18 boys without ID with appropriate consent participated in the study. All participants in the study performed a WAnT on two separate test occasions. The results indicate that boys with ID have comparable levels of reliability and agreement in the WAnT as boys without ID but their performances are significantly more variable. The boys with ID were markedly less powerful and had lower post-exercise blood lactate than boys without ID."
0043078,"Dempsey I, Arthur M","Support staff in a sample of Australian community-based services for people with a disability: career intentions, personal characteristics and professional development needs",J Intellect Dev Disabil 2002 Sep;27(3):201-14,,"DELIVERY OF HEALTH CARE, HEALTH PERSONNEL, EDUCATION, JOB SATISFACTION","AUSTRALIA, CAREER CHOICE",,,,1366-8250,AB,"Staff characteristics and training are two influential factors in the design and development of human service systems. Despite close scrutiny of these components of service delivery in a variety of disciplines, relatively little is known about staffing issues in the disability industry. This study reports the characteristics, career intentions and professional development needs of staff from a wide variety of services for people with a disability in NSW, Australia. Staff were predominantly female, male staff were much less likely to regard their future career as lying in the disability field, and there was evidence that employers were providing some training to staff that addressed their professional development needs. The results are discussed in relation to the wider research literature and the need for further investigation in this area."
0043079,Gray DE,Ten years on: a longitudinal study of families of children with autism,J Intellect Dev Disabil 2002 Sep;27(3):215-22,,"AUTISM, FAMILY, ADAPTATION PSYCHOLOGICAL","CHILD, FOLLOW UP STUDIES",,,,1366-8250,AB,"This paper reports the results of a longitudinal, ethnographic study of the psychosocial adaptation of parents of children with autism. The results indicate that most parents have experienced improvements in terms of their own psychological well-being, the social experiences of their immediate family members and their relations with members of their extended family. They also reported changes to the stressful situations they experience and their strategies for coping with them. Stigmatizing reactions of non-family members have also declined. The results were less favorable in the cases of families with aggressive and/or violent children. The parents in these families experienced high levels of stress and had few resources in terms of treatment or residential placement to deal with their situation."
0043080,"Ingram SR, Sedlak SK",New age in stroke treatment: the role of fibrinolytic therapy,Am J Nurs 2002 Sep;102(9 Supp):17-21,fibrinolytic therapy,"CEREBROVASCULAR DISORDERS, ETIOLOGY","DRUG THERAPY, PHYSIOPATHOLOGY, TREATMENT OUTCOME",,,,0002-936X,,
0043081,"Mantziou V, Brocalaki I, Andrea S, Ktenas E, Chatira K, Kotzabassaki S",Attitudes of registered nurses and student nurses to disabled children,Br J Nurs 2002 Sep 26;11(17):1141-6,,"ATTITUDE TO DISABILITY, EDUCATION, DISCRIMINATION","CHILD, NURSES, DATA COLLECTION",,,,0966-0461,AB,"The purpose of this study was to examine and compare the attitudes of registered nurses and student nurses towards disabled children. A convenience sample consisting of 99 registered nurses employed in paediatric hospitals and 189 student nurses was selected. The instrument used for data collection was the 'Attitudes Towards Disabled Persons' (ATDP) scale. Descriptive statistics and one-way analysis of variance were performed to test for significant differences. On the whole subjects' attitudes appeared to be poor. Student nurses had more positive attitudes in comparison to registered nurses; however, the difference was not statistically significant. There were significant differences between the different age groups and between student groups' within different educational settings. There were no significant differences in gender. Actions to improve subjects' attitudes towards disabled children are discussed and suggested."
0043082,"Miller G, Cody C",All for one in palliative care,Am J Nurs 2002 Sep;102(9):13,,"HOSPICE CARE, HOSPITALS, NURSES, COMMUNICATION","PALLIATIVE TREATMENT, PATIENT CARE TEAM",(Letter),,,0002-936X,,
0043083,"Coyne PJ, Lyne ME, Watson AC","Symptom management in people with AIDS: assessing and differentiating dyspnea, cough, dementia, and delirium",Am J Nurs 2002 Sep;102(9):48-56,,"HIV INFECTIONS, PATIENT ASSESSMENT","COMPLICATIONS, DIAGNOSIS",,,,0002-936X,,
0043084,Heffley J,"Exercise, eat right, take your vitamins, die anyway",J Appl Nutr 2002;52(1):1,,"DIETARY SUPPLEMENTS, NUTRITION, EXERCISE, HEALTH PROMOTION","PREVENTION, EDUCATION",(Editorial),,,0021-8960,,
0043085,"Childers NF, Margoles MS",Apparent relation of nightshades (Solanaceae) to arthritis and other health problems,J Appl Nutr 2002;52(1):2-10,,"ARTHRITIS, DIET, VITAMIN D, SOLANUM","ETIOLOGY, PLANTS",,,,0021-8960,AB,"Diet appears to be a factor in the etiology of arthritis based on surveys of over 1,400 cooperators and thousands of write-in reports over a 38-year period. Plants in the drug family Solanaceae (nightshades), are an important causative factor in arthritis. These plants include potato, tomato, eggplant, tobacco, and peppers of all kinds except the black pepper. A buildup of cholinesterase inhibiting glycoalkaloids and steroids from consumption and/or use of the nightshades (tobacco) and from other sources such as some pesticides (organophosphates and carbamates) may cause inflammation, muscle spasms, pain, and stiffness. Osteoarthritis appears to be a result of long-term consumption and/or use of the Solanaceae which contain naturally the very active metabolite, vitamin D3 which in excess or deficiency may cause cripploing and early disability (as occurs in livestock). Rigid omission of the Solanaceae, with other minor diet adjustments, has resulted in positive to marked improvement in arthritis and general health of humans."
0043086,Rogers SA,"Solonaceae (nightshade) sensitivity as a reversible cause of juvenile and adult rheumatoid arthritis, chronic degenerative disc pain, and osteoarthritis",J Appl Nutr 2002;52(1):11-20,,"ARTHRITIS, PAIN, DIET, SOLANUM","PLANTS, NUTRITION",,,,0021-8960,AB,"For decades veterinarians have observed animals crippled with arthritis after being turned out into new pastures that contained \"deadly nightshades\" plants. Over two decades ago, horticulturist, Dr Norm Childers, made the connection between nightshade ingestion and arthritis with people as well, then published medical papers and lay books in attempt to alleviate suffering in a greater number of people. Applying this knowledge to people with a wide range of pain syndromes for which medicine had nothing else to offer, aside from drugs and surgery, we found remarkable and total relief in surprisingly diverse types of arthritis in over 100 people. Individual case examples are described. These findings were confirmed a minimum of at least two times in all subjects, leading to the conclusion that the work-up for arthritis should include a nightshade-free diet trial."
0043087,Chilvers R,Acute nurses' perceptions of assessment and rehabilitation,Prof Nurse 2002 Oct;18(2):82-5,,"NURSES ROLE, PATIENT ASSESSMENT, ACUTE DIS","REHABILITATION, INDEPENDENT LIVING",,,,0266-8130,AB,"Research shows that nurses working in acute care perceive rehabilitation in a limited way. They believe it is the province of therapists and view nurses working in this area as performing a low-status role. However, a multidisciplinary approach to rehabilitation is required, involving a partnership between nurses and therapists. Rehabilitation nurses have a unique 'enabling' role."
0043088,Robertson CF,Long-term outcome of childhood asthma,Med J Aust 2002 Sep 16;177(6)Supp:542-4,,"ASTHMA, ETIOLOGY, LONG TERM CARE","CHILD, ADOLESCENT",,,,0025-729X,AB,"What we know: The outcome of childhood asthma is dependent on the pattern of asthma through childhood. Episodic asthma in childhood tends to resolve in adolescence and through mid-adult years, with no impairment of lung function. Persistent asthma in childhood is more likely to persist into adult years, with modest impairment of lung function. The impairment of lung function occurs early in the disease process and is not progressive, despite continuing symptoms. What we need to know: Are there clearly identifiable phenotypes of childhood asthma that have different aetiologies, responses to treatment, genotypes and natural history? Does early treatment with anti-inflammatory agents prevent impairment of lung function? Can an algorithm be developed to predict the likelihood of persistent asthma on first presentation?"
0043089,Mellis CM,Is asthma prevention possible with dietary manipulation?,Med J Aust 2002 Sep 16;177(6)Supp:578-9,,"ASTHMA, DIET","PREVENTION, GENETICS",,,,0025-729X,AB,"What we know: Primary prevention of asthma should be possible because the recent increase in asthma is due to environmental factors. The major modifiable dietary environmental risk factors for childhood asthma are lack of breastfeeding and low intake of omega-3 fatty acids. Randomised controlled trials (RCTs) have shown that interventions using probiotics, hydrolysed milk formulas, and combined dietary manipulation plus airborne allergen avoidance reduce asthma and/or atophy in newborns. Observational studies have shown a 30%-50% reduction in childhood asthma with exclusive breastfeeding for three months, and similar reductions in children who eat fish regularly (ie, have a high intake of omega-3 fatty acids). What we need to know: Will further RCTs using intervention with probiotics reveal identifiable subgroups of children who respond and children who do not respond? Will supplementation of the diet with omega-3 oil reduce the rate of significant clinical atopic disease, particularly asthma? If so, for how long will supplements need to be given? Will effective primary prevention require multiple intervention strategies? If so, how feasible are these as public health interventions? What are the benefits and harms of allergen-avoidance diets in high-risk women who are breastfeeding? Can protein hydrolysate formulas reduce rates of atophy and/or asthma?"
0043090,"Jennekens FG, Kater L, Leeman CP, Druck P",Physician-assisted death,N Engl J Med 2002 Sep 26;347(13):1041-3,,"SUICIDE ASSISTED, PHYSICIANS ROLE, ETHICS","LEGISLATION, PALLIATIVE TREATMENT",(Letter),,,0028-4793,,
0043091,Shernoff M,Uncertainty and quality of life: psychosocial realities of combination anti-retro-viral therapy,J HIV/AIDS Soc Services 2002;1(1):25-43,,"HIV INFECTIONS, QUALITY OF LIFE, COUNSELING","DRUG THERAPY, DECISION MAKING, PSYCHOTHERAPY",,,,1538-1501,AB,"The advent of combination anti-retroviral therapies has ushered in a new phase of the AIDS epidemic with resulting changes in the psychological and emotional complexities for people living with HIV and AIDS. The medical uncertainties regarding whether, when, and which drugs to begin or stop is paralleled by a constellation of psychosocial issues that has left both clients and mental health providers scrambling to adjust to the new world of HIV disease as a chronic and manageable illness for most people living in developed countries. Paramount among the emotional and psychological issues that need to be addressed are quality of life issues and how these influence a person's medical decision making and other crucial life choices. This article contains personal as well as professional reflections from the perspective of an HIV-positive psychotherapist who has worked in the field of HIV/AIDS since the onset of the epidemic."
0043092,Werner HM,Herbstbaume - Nussbaume: Symbole der Fruchtbarkeit,Natur Heilen 2002 Oct;79(10):20-6,,"SEASONS, FERTILITY, JUGLANS, PLANT EXTRACTS","PLANTS MEDICINAL, HERBAL DRUGS",,German,,0932-3503,,
0043093,Steidl G,"Die Rizol Therapie - Sehr wirksames Therapieverfahren gegen Bacterien, Pilzeund und Parasiten",Natur Heilen 2002 Oct;79(10):28-35,,"BACTERIAL INFECTIONS, FUNGI, PARASITIC DIS, PLANT OILS","DRUG THERAPY, PLANTS MEDICINAL, PHARMACOLOGY",,German,,0932-3503,,
0043094,Leibold G,Baldrian als Suchtmittel?,Natur Heilen 2002 Oct;79(10):43-5,Valeriana officinalis,"MENTAL DISORDERS, PLANT EXTRACTS","PLANTS MEDICINAL, DRUG THERAPY, FOLK REMEDIES",,German,,0932-3503,,
0043095,Messing N,Hoffnung fur den Rucken (2.Teil) - Segensreich und kaum bekannt: die Chiro-Gymnastik nach Laabs,Natur Heilen 2002 Oct;79(10):46-51,,"BACKACHE, NECK PAIN, CHIROPRACTIC, OSTEOPATHY","METHODS, THERAPY, PROGNOSIS, EXERCISE THERAPY",,German,,0932-3503,,
0043096,"Karyekar CS, Eddington ND, Dowling TC",Effect of St. John's Wort extract on intestinal expression of cytochrome P4501A2: studies in LS180 cells,J Postgrad Med 2002 Apr-Jun;48(2):97-100,cytochromes,"HYPERICUM, DRUG INTERACTIONS","ENZYMES, HERBALISM",,,,0022-3859,AB,"BACKGROUND AND AIMS: St. John's Wort (SJW) is known to induce expression and activity of cytochrome P4503A4 (CYP3A4). However, its effects on other cytochrome P450 (CYP) are not well understood. Our objective was to characterise the effect of SJW on the expression of CYP1A2 in the LS180 intestinal cell model. STUDY DESIGN AND METHODS: LS180 cells were cultured in the presence and absence of SJW extract for 48 hours. CYP1A2 protein content was measured by Western blot analysis using monoclonal antibody. Time-dependent expression of CYP1A2 was assessed during exposure to SJW extract for 24 hours and following its removal for another 24 hours. RESULTS: SJW increased the expression of CYP1A2 in the LS180 cells in a concentration dependent manner. The induction was time-dependent, as enzyme levels returned to baseline within 4-8 hours after removal of SJW. CONCLUSIONS: SJW reversibly induces expression of CYP1A2 in LS180 cells. This induction may be responsible for reduced plasma theophylline concentrations upon co-administration of SJW, as reported earlier."
0043097,"Priya V, Divatia JV, Sareen R, Upadhye S",Efficacy of intravenous ketoprofen for pre-emptive analgesia,J Postgrad Med 2002 Apr-Jun;48(2):109-12,ketoprofen,"ANALGESIA, POSTOPERATIVE CARE, BREAST NEOPLASMS, SURGERY OPERATIVE, PAIN","ORGANIC CHEMICALS, PREVENTION",,,,"0022-3859\r\nContinuous variables were analysed by the unpaired 't' test, discrete variables with the chi square test, and survival curves by the log-rank test. RESULTS: Pain scores were significantly lower in Group I till 10 hours after surgery. The number of patients requiring analgesia at 4, 6, 8 and 10 hours was significantly lower in group I (0% vs. 47% (P less than 0.0001), 0% vs. 44% (P less than 0.003), 0% vs. 80% (P less than 0.0001), 0% vs. 100% (P less than 0.0001) respectively). The mean time for rescue analgesic was 15.47 -/+ 2.87 hours in group I versus 4.22 -/+ 2.55 hours in group II (P less than 0.0001). CONCLUSION: Pre-emptive analgesia with Intravenous ketoprofen (100mg) produces better postoperative pain-relief in patients undergoing breast surgery.",AB,"AIM: To determine whether intravenous ketoprofen is effective as pre-emptive analgesia for breast surgery. DESIGN: Randomised, controlled, double blind study. PATIENTS AND METHODS: 50 patients undergoing breast surgery under general anaesthesia randomised to receive either 100 mg intravenous ketoprofen 30 minutes before (Group I), or immediately after surgical incision (Group II). Postoperatively, pain scores (Visual Analogue Scale, VAS) and time to rescue analgesic were recorded by an independent, blinded observer. The study was terminated when rescue analgesic was required (VAS greater than or = to 4 or demand for analgesic). STATISTICAL ANALYS"
0043098,"Ornstein E, Atroshi I, Franzen H, Johnsson R, Sandquist P, Sundberg M",Early complications after one hundred and forty-four consecutive hip revisions with impacted morselized allograft bone and cement,J Bone Joint Surg (Am) 2002 Aug;84(8):1323-8,,"ARTHROPLASTY, HIP, BONE CEMENTS",COMPLICATIONS,,,,0021-9355,AB,"BACKGROUND: The use of impacted morselized allograft bone and cement in hip revision arthroplasty has been popular, but studies that specifically address intraoperative and postoperative complications have been scarce. METHODS: All complications that occurred during, and within the first year after, 144 consecutive hip revision arthroplasties (108 stems and 130 sockets) performed with impacted morselized allograft bone and cement were recorded. Clinical and radiographic follow-up evaluation was performed at three months and at one year after surgery for all patients except eight (seven who had died of causes unrelated to the hip surgery and one who had sustained a stroke). Of these eight patients, seven had a six-week and/or three-month follow-up evaluation. RESULTS: Thirty-nine femoral fractures occurred in thirty-seven hips; twenty-nine of the fractures occurred during surgery and ten, within five months after surgery. Of the intraoperative femoral fractures, twelve were proximal, nine were diaphyseal, and eight involved the greater trochanter. Of the postoperative femoral fractures, one was proximal and nine were diaphyseal. Other intraoperative complications were the creation of a femoral cortical window in seven hips and incidental perforation of the femoral cortex in fourteen. Multivariate analysis showed the risk factors for femoral fracture during or after revision to be concomitant disease, greater deficiency of the femoral bone stock, and an intraoperative femoral window or perforation. Other complications included dislocation of the femoral head in nine hips, deep infection in one hip, persistence of preoperative deep infection in one hip, and superficial wound infection requiring wound debridement in two hips. (ABSTRACT TRUNCATED)."
0043099,"Joshi AB, Markovic L, Hardinge K, Murphy JC",Conversion of a fused hip to total hip arthroplasty,J Bone Joint Surg (Am) 2002 Aug;84(8):1335-41,,"ARTHROPLASTY, HIP, ARTHRODESIS","COMPLICATIONS, TREATMENT OUTCOME",,,,0021-9355,AB,"BACKGROUND: Arthrodesis of the hip remains a viable treatment for severe unilateral arthritis after traumatic injury or infection in a young but otherwise healthy individual. The goal of the present study was to review the long-term clinical and radiographic results after conversion of a fused hip to a total hip arthroplasty and to identify the risk factors that would lead to a higher rate of failure. METHODS: We performed a retrospective review of the charts and radiographs of 187 patients (208 hips) who had conversion of a fused hip to a total hip arthroplasty. The mean duration of follow-up after the conversion to total hip arthroplasty was 9.2 years (range, two to twenty-six years). RESULTS: The mean age at time of the arthroplasty was fifty-one years. The mean time-interval between the arthrodesis and the conversion to a total hip arthroplasty was twenty-seven years. According to the information in the charts, at a mean duration of follow-up of 9.2 years after the total hip arthroplasty, 79% of hips were either pain-free or had minimal pain, 83% had good-to-excellent function, and 79% had good-to-excellent range of motion. Complications, which included fifteen nerve palsies, occurred in twenty-four hips. Twenty-eight hips had heterotopic ossification, but it was not associated with a recurrence of ankylosis or a marked reduction of motion. Revision arthroplasty was performed in twelve hips. The probability of survival of the implant was 96.1% (95% confidence interval, 91.5% to 98.2%) at ten years, 89.9% (95% confidence interval, 85.3% to 96.1%) at fifteen years, and 72.8% (95% confidence interval, 36% to 90.6%) at twenty-six years. CONCLUSIONS: Conversion of a fused hip to a total hip arthroplasty has a favorable outcome. However, the technically demanding nature of the procedure should not be underestimated. (ABSTRACT TRUNCATED)."
0043100,"Gardner MJ, Flik KR, Mooar P, Lane JM",Improvement in the undertreatment of osteoporosis following hip fracture,J Bone Joint Surg (Am) 2002 Aug;84(8):1342-8,,"OSTEOPOROSIS, HIP FRACTURES","TREATMENT OUTCOME, DIAGNOSIS",,,,0021-9355,AB,"BACKGROUND: Osteoporosis is a common disease characterized by decreased bone mass and increased fracture risk in postmenopausal women and the elderly. Hip fractures are among the most common consequences of osteoporosis and unfortunately usually occur late in the course of the disease. When a patient is admitted to the hospital with a fragility hip fracture, a unique opportunity for diagnosis and treatment presents itself. Fortunately, several medications have proven to be effective in lowering the risk of future fractures. The purposes of the present study were to test the hypothesis that most fragility hip fractures go untreated and to determine whether educational efforts to raise physician awareness have led to an improvement in osteoporosis treatment rates. METHODS: A retrospective cohort study was performed with use of the patient databases at two university medical centers and one university-affiliated community hospital. The charts of 300 randomly selected patients were sorted with use of ICD-9 (International Classification of Diseases, Ninth Revision) codes for femoral neck fractures. There were 100 patients from each center, with twenty-five patients from each year between 1997 and 2000. The admitting diagnosis, mechanism of injury, admission medications, procedures performed during hospitalization, and discharge medications were then extracted and analyzed. During this period, the National Osteoporosis Foundation established guiding principles for the treatment of fragility fractures. RESULTS: Of the seventy-five patients from all centers for each year from 1997 to 2000, 11%, 13%, 24%, and 29%, respectively, were discharged with a prescription for some medication targeting osteopenia, either supplemental calcium or an antiosteoporotic medication (estrogen, calcitonin, a bisphosphonate, or raloxifene). (ABSTRACT TRUNCATED)."
0043101,"Fehringer EV, Kopjar B, Boorman RS, Churchill RS, Smith KL, Matsen FA",Characterizing the functional improvement after total shoulder arthroplasty for osteoarthritis,J Bone Joint Surg (Am) 2002 Aug;84(8):1349-53,,"OSTEOARTHRITIS, SHOULDER, ARTHROPLASTY, DISABILITY EVALUATION","SURGERY OPERATIVE, POSTOPERATIVE CARE",,,,0021-9355,AB,"BACKGROUND: Both shoulder surgeons and patients who are considering total shoulder arthroplasty are interested in the anticipated improvement in shoulder comfort and function after the procedure. The purpose of the present study was to characterize shoulder-specific functional gains in relation to preoperative shoulder function and to present this information in a way that can be easily communicated to patients who are considering this surgery. METHODS: We analyzed the preoperative and follow-up shoulder function in patients managed with total shoulder arthroplasty for the treatment of primary glenohumeral osteoarthritis. Functional self-assessments were available for 102 (80%) of 128 shoulders after thirty to sixty months of follow-up. Outcome was assessed with respect to the change in the number of shoulder functions that were performable, the change in shoulder function as a percentage of the preoperative functional deficit, and the change in the ability to perform specific shoulder functions. RESULTS: The average number of shoulder functions that were performable improved from four of twelve preoperatively to nine of twelve postoperatively (p less than 0.01). Function improved in ninety-six shoulders (94%). The number of functions that were performable at the time of follow-up was positively associated with preoperative shoulder function (p less than 0.05): the better the preoperative function, the better the follow-up function. The improvement in function was greatest for shoulders with less preoperative function (p less than 0.01). On the average, patients regained approximately two-thirds of the functions that had been absent preoperatively. Significant improvement was noted in eleven of the twelve shoulder functions that were examined (p less than 0.01). (ABSTRACT TRUNCATED)."
0043102,"Crossett LS, Sinha RK, Sechriest VF, Rubash HE",Reconstruction of a ruptured patellar tendon with achilles tendon allograft following total knee arthroplasty,J Bone Joint Surg (Am) 2002 Aug;84(8):1354-61,,"KNEE, ARTHROPLASTY, PATELLA, TENDON INJURIES","COMPLICATIONS, TREATMENT OUTCOME, RECONSTRUCTIVE SURGICAL PROCEDURES",,,,0021-9355,AB,"BACKGROUND: Rupture of the patellar tendon after total knee arthroplasty is a rare and debilitating complication. Proper surgical management of this condition remains controversial. The purpose of this study was to review the results of reconstruction of a ruptured patellar tendon with an Achilles tendon allograft following total knee arthroplasty. METHODS: We reviewed our experience with the use of a fresh-frozen Achilles tendon allograft with an attached calcaneal bone graft to restore extensor function in nine patients with patellar tendon rupture following total knee arthroplasty (five primary and four revision). All patients were examined clinically and radiographically at an average of twenty-eight months. RESULTS: The average knee and functional scores improved from 26 and 14 points, respectively, before the surgery to 81 and 53 points after the surgery. The average extensor lag decreased from 44 degrees preoperatively to 3 degrees postoperatively, and the average range of motion of the knee increased from 88 degrees to 107 degrees. Two grafts failed in the early postoperative period. Both were repaired successfully. Radiographs showed an average proximal patellar migration of 17.8 mm, which did not appear to affect extensor function. CONCLUSIONS: This short-term follow-up study showed that once an Achilles allograft has healed, it can serve as a reliable reconstruction of a ruptured patellar tendon following total knee arthroplasty. This technique may be particularly suited for patients in whom the extensor mechanism was compromised by multiple prior operations. Continued follow-up is necessary to determine the long-term durability of these results."
0043103,"Kim YH, Oh SW, Kim JS","Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement : a prospective, randomized clinical study",J Bone Joint Surg (Am) 2002 Aug;84(8):1372-9,,"ARTHROPLASTY, HIP, BONE CEMENTS, EMBOLISM",TREATMENT OUTCOME,,,,0021-9355,AB,"BACKGROUND: Controversy exists regarding the safety of bilateral simultaneous total hip arthroplasty, in part because of the potentially higher prevalence of pulmonary fat embolism. The purpose of the present study was to determine if unilateral and bilateral simultaneous total hip arthroplasty procedures resulted in different prevalences of fat embolization, different degrees of hemodynamic compromise, or different levels of hypoxemia or mental status changes. METHODS: One hundred and fifty-six consecutive patients undergoing primary total hip arthroplasty were prospectively enrolled in the study. The study group included fifty patients undergoing bilateral simultaneous total hip arthroplasty and 106 patients undergoing unilateral total hip arthroplasty. One hundred hips were treated with a cemented stem, and 106 were treated with a cementless stem. Arterial and right atrial blood samples were obtained before implantation (baseline); at one, three, five, and ten minutes after implantation of the acetabular and femoral components; and at twenty-four and forty-eight hours after the operation. Arterial blood pressure, right atrial pressure, arterial oxygen tension, and carbon-dioxide tension were also monitored at these times. The presence of lipid and cellular contents of bone marrow was determined. RESULTS: The prevalence of fat embolism was not significantly different between the groups managed with bilateral and unilateral total hip arthroplasty or between the groups managed with cemented and cementless stems. Similarly, the prevalence of bone-marrow-cell embolization was not significantly different between the groups managed with bilateral and unilateral total hip arthroplasty or between the groups managed with cemented and cementless stems. (ABSTRACT TRUNCATED)."
0043104,"Robertson DD, Mueller MJ, Smith KE, Commean PK, Pilgram T, Johnson JE",Structural changes in the forefoot of individuals with diabetes and a prior plantar ulcer,J Bone Joint Surg (Am) 2002 Aug;84(8):1395-404,,"ULCER, DIABETES MELLITUS, FOOT","PREVENTION, TREATMENT OUTCOME",,,,0021-9355,AB,"BACKGROUND: Plantar ulcers produced by diabetic foot disease are devastating and costly. Better understanding of the ulcer-producing process is important to improve detection of feet that are at risk and to improve intervention. We identified and quantified soft-tissue and osseous structural changes in the forefoot of diabetic patients with a prior plantar ulcer. METHODS: Thirty-two individuals with a mean age (and standard deviation) of 57 +/- 11 years were studied; sixteen had diabetes (of a mean of 20 +/- 11 years' duration), peripheral neuropathy, and a prior plantar ulcer, and sixteen were matched controls. Computed tomography was used to evaluate forefoot structure, including the plantar soft-tissue (muscle) density, soft-tissue thickness beneath the metatarsal heads, metatarsophalangeal joint angle, metatarsal bone density, and metatarsophalangeal joint arthropathy. RESULTS: Plantar soft-tissue (muscle) density was lower in the individuals with diabetes (mean, 1 HU (Hounsfield unit)) than it was in the controls (mean, 18 HU). There was no difference in the soft-tissue thickness beneath the metatarsal heads (mean, 10 mm) between the individuals with diabetes and the controls, but the soft-tissue thickness decreased with age. The individuals with diabetes had greater extension deformity of the first, second, and third metatarsophalangeal joints and greater arthropathy of the second, third, and fourth metatarsophalangeal joints. There were no significant differences in metatarsal bone density between the groups. CONCLUSIONS: There were significant differences between the forefeet of individuals with diabetes and a previous plantar ulcer and those of controls: plantar muscle density was decreased, and metatarsophalangeal joint extension and arthropathy were increased. (ABSTRACT TRUNCATED)."
0043105,Baldry P,Management of myofascial trigger point pain,Acupunct Med 2002 Mar;20(1):2-10,,"MYOFASCIAL PAIN SYNDROMES, NEEDLING","DIAGNOSIS, TREATMENT OUTCOME",,,,0964-5284,AB,"Successful management of myofascial trigger point (MTrP) pain depends on the practitioner finding all of the MTrPs from which the pain is emanating, and then deactivating them by one of several currently used methods. These include deeply applied procedures, such as an injection of a local anaesthetic into MTrPs and deep dry needling (DDN), and superficially applied ones, including an injection of saline into the skin and superficial dry needling (SDN) at MTrP sites. Reasons are given for believing that DDN should be employed in cases where there is severe muscle spasm due to an underlying radiculopathy. For all other patients SDN is the treatment of choice. Following MTrP deactivation, correction of any postural disorder likely to cause MTrP reactivation is essential, as is the need to teach the patient how to carry out appropriate muscle stretching exercises. It is also important that the practitioner excludes certain biochemical disorders."
0043106,"Hayhoe S, McCrossan M, Smith A, Ellis D, Croft S, Mei MF",Single-use acupuncture needles: scanning electron-microscopy of needle-tips,Acupunct Med 2002 Mar;20(1):11-8,,"NEEDLING, ACUPUNCTURE","EQUIPMENT DESIGN, SAFETY",,,,0964-5284,AB,"Unselected, disposable acupuncture needles from various manufacturers and retail suppliers were taken from a pool of donated and bought samples. Three needles of each type were prepared for electron-microscopy. The needle tips were inspected at two magnifications (x39.37 and x612.5): 52 electron-micrographs were taken of 31 individual needles from 11 different types. No needle-tip looked perfect and significant faults were seen in most; some appeared seriously deformed. The faults noted were: scratch marks along or across the needle, metallic scuff, lumps and irregularities in the needle surface, needle-tip stubbed or malformed, and needle point off-centre. An additional test made was to wipe a number of needles firmly on white paper tissue. Some left grey lines, and these were regarded as evidence of metallic or oily residue from the needle surface which could have been deposited in the patient. These unexpected findings, in a variety of popularly used needles from well-respected suppliers, suggest that most manufacturers need to reassess their quality control procedures."
0043107,"Tillu A, Tillu S, Vowler S","Effect of acupuncture on knee function in advanced osteoarthritis of the knee: a prospective, non-randomised controlled study",Acupunct Med 2002 Mar;20(1):19-21,,"OSTEOARTHRITIS, KNEE, DISABILITY EVALUATION","ACUPUNCTURE, TREATMENT OUTCOME",,,,0964-5284,AB,"We report a prospective controlled trial, comparing acupuncture with no treatment, in patients with advanced osteoarthritis of the knee awaiting total knee replacement. Knee function was assessed at the beginning of study and at the end of two months, using four parameters: HSS score, time to walk 50 metres, time to climb 20 steps, and degree of pain. Acupuncture was given at four local points around the knee and at one distal point. The acupuncture group improved in all parameters, whereas the control group deteriorated, a finding that was highly statistically significant (p less than 0.0002). Further randomised-controlled trials with longer follow-up are required to confirm these findings."
0043108,"MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R",Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations.,Acupunct Med 2002 Mar;20(1):22-5,,"CLINICAL TRIALS, ACUPUNCTURE","STANDARDS, REPRODUCIBILITY OF RESULTS",,,,0964-5284,AB,"Acupuncture treatment and control group interventions in parallel-group randomised trials of acupuncture are not always precisely reported. In an attempt to improve standards, an international group of experienced acupuncturists and researchers devised a set of recommendations, designating them STRICTA: STandards for Reporting Interventions in Controlled Trials of Acupuncture. In a further consensus-building round, the editors of several journals helped redraft the recommendations. These follow the Consolidated Standards for Reporting Trials (CONSORT) format, acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies. Participating journal editors are publishing the STRICTA recommendations and requesting prospective authors to adhere to them when preparing reports for publication. Other journals are invited to adopt these recommendations. The intended outcome is that interventions in controlled trials of acupuncture will be more adequately reported, thereby facilitating an improvement in critical appraisal, analysis and replication of trials."
0043109,"Ewies A, Olah K",Moxibustion in breech version - a descriptive review,Acupunct Med 2002 Mar;20(1):26-9,,"MOXIBUSTION, ACUPUNCTURE, PREGNANCY COMPLICATIONS",TREATMENT OUTCOME,,,,0964-5284,AB,"The management of breech presentation at term remains controversial. It appears logical that maternal and perinatal outcomes would be improved if breech presentation could be avoided. External cephalic version is considered a safe procedure if cases are selected appropriately and anaesthesia avoided. Moxibustion is a traditional Chinese method of treatment, which utilizes the heat generated by burning herbal preparations containing the plant Artemisia vulgaris to stimulate the acupuncture points. It is used for breech version with a reported success rate of 84.6% after 34 weeks gestation. Moxibustion technique is cheap, safe, simple, self-administered, non-invasive, painless and generally well tolerated. Although many studies give encouraging results regarding the use of moxibustion in inducing cephalic version of breech presentation, a definitive conclusion cannot be made as most involve small sample sizes and are not randomised. Moxibustion could be an extra option offered to women with breech presentation along with vaginal delivery, caesarean section and external cephalic version. This article discusses the possible role of moxibustion in correction of breech presentation in the hope that, some interest will be stimulated in what is a very interesting area for future research."
0043110,Freedman J,An audit of 500 acupuncture patients in general practice,Acupunct Med 2002 Mar;20(1):30-4,,"FAMILY PRACTICE, ACUPUNCTURE","STANDARDS, PATIENT SATISFACTION",,,,0964-5284,AB,"This is an audit of 500 patients treated in a general practice setting. Acupuncture clinics are provided on two evenings each week and are funded by the practice. Short treatment times are favoured but this varies according to condition and response. A wide variety of conditions have been treated the commonest being neck pain, low back pain, shoulder problems, hayfever, knee osteoarthritis, and migraine. An overall improvement of 73% was obtained with 61% classified as 'significant improvement' or 'cure'. Amongst the adverse effects recorded, retained needles and forgotten patients have been the most concerning and have led to changes in practice following 'critical incident' meetings."
0043111,"Kam E, Eslick G, Campbell I",An audit of the effectiveness of acupuncture on musculoskeletal pain in primary health care,Acupunct Med 2002 Mar;20(1):35-8,,"FAMILY PRACTICE, ACUPUNCTURE, MUSCULOSKELETAL DIS","TREATMENT OUTCOME, PAIN",,,,0964-5284,AB,"Little is known about the use of acupuncture in general practice. We performed a retrospective review of the use of acupuncture in relieving musculoskeletal pain, a condition that is commonly encountered in general practice. A sample of 116 patient records was reviewed, from which 92 patients (mean age 52 years, 64% female) met the inclusion criterion of musculoskeletal pain. Information obtained included age, sex, diagnosis, duration of the problem, length of treatment (weeks), number of treatments, duration of each treatment (minutes), number of needles used, level of benefit obtained from the treatment, and recurrence of pain. There were many different conditions encountered. We found an association between the general practitioner using fewer needles and patients experiencing greater pain relief. This could be a reflection of treating myofascial pain syndromes, which often appear to respond well to a single needle in the key trigger point. Overall, we found that sixty-nine percent of patients had a good or excellent response to acupuncture treatment. We recommend acupuncture as a treatment option for patients who do not respond to the usual therapies (non-steroidal anti-inflammatory drugs) for musculoskeletal conditions."
0043112,Freedman J,Acupuncture for carpal tunnel syndrome,Acupunct Med 2002 Mar;20(1):39-40,,"CARPAL TUNNEL SYNDROME, ACUPUNCTURE","TREATMENT OUTCOME, CASE REPORT, FEMALE",,,,0964-5284,AB,"Acupuncture was used to treat a 51-year-old 'lollipop lady' (school crossing patrol officer), with severe carpal tunnel syndrome (CTS) affecting her dominant hand, and co-existing cervical spondylosis. I postulate that her symptoms were work related. She responded well to acupuncture, which provided good symptomatic treatment rather than cure and allowed her to continue working whilst she awaited surgical release."
0043113,Gert HJ,Avoiding surprises. a model for informing patients,Hastings Cen Report 2002 Sep-Oct;32(5):23-32,,"INFORMED CONSENT, DECISION MAKING, PHYSICIANS ROLE",PATIENT PARTICIPATION,,,,0093-0334,AB,"The standard models for what doctors must tell their patients are based on the idea of informed consent: physicians must provide the information that patients need to make treatment decisions. In fact, though, they usually provide considerably more information than this model requires. And rightly so: patients should receive enough information that they will not be surprised by whatever happens - unless the physician is also surprised."
0043114,"Feldman M, Stanford R, Catcheside A, Stotter A",The use of a prognostic table to aid decision making on adjuvant therapy for women with early breast cancer,Eur J Surg Oncol 2002 Sep;28(6):615-9,,"BREAST NEOPLASMS, DECISION MAKING, CLINICAL ASSESSMENT SCALES","FEMALE, DRUG THERAPY, REPRODUCIBILITY OF RESULTS",,,,0748-7983,AB,"AIM: Understanding the likely net benefit of chemotherapy for the individual patient helps physicians to give objective information. A prognostic table has been constructed detailing the percentage absolute survival advantage offered by polychemotherapy for patients with early breast cancer, according to their age and the Nottingham Prognostic Index of their tumour. This study aims to assess its first year of use in the Leicestershire Breast Unit. METHOD:Demographic, pathological and treatment data were collected prospectively onto the Leicestershire breast cancer database. Patients with a potential survival advantage of 2% or greater in the year 01/05/99 to 30/04/00 (after the prognostic table was used routinely to determine oncology referrals) were identified. Chemotherapy usage was compared with the previous year's patient group. RESULTS: Two hundred and eighty-eight had early breast cancer, requiring surgery, eligible for consideration of adjuvant therapy. Of these, 98% of women with a potential survival advantage of 6% or more received chemotherapy. Ninety-one percent of those with a survival advantage of 4% or more was seen by an oncologist. Of those with a 2% survival advantage, 48% were referred to discuss the issues with an oncologist. Use of the table resulted in increased chemotherapy rates for women with a 4% potential survival advantage. CONCLUSIONS: We have found the prognostic table to be a useful and workable tool and advocate its use."
0043115,"Smith J, Lee J, Burke C, Contractor K, Dawson P",Major colorectal cancer resection should not be denied to the elderly,Eur J Surg Oncol 2002 Sep;28(6):661-6,,"COLORECTAL NEOPLASMS, MORTALITY, SURGERY OPERATIVE","THERAPY, AGED, POSTOPERATIVE CARE, COMPLICATIONS",,,,0748-7983,AB,"AIMS: Adjuvant therapy after surgery for colorectal cancer is often denied to the elderly for various reasons. This study was to determine morbidity and mortality risk after surgery in the elderly and whether this is affected by adjuvant therapy. METHODS: Data were collected prospectively and entered on a database for all patients undergoing resection of colorectal cancer between January 1994 and July 2000. A total of 304 patients were included, 65 aged 80 years and over. RESULTS: There were 84 deaths, 21 (30%) in the over 80s, and 63 (26%) in the under 80s (P = 0.51). The 'in-hospital' mortality was 10.1% in the over 80s and 3.8% in the under 80s (P = 0.056). In the over 80s the colon was more affected than the rectum (P = 0.002). The over 80s were less likely to be offered adjuvant therapy, 7.2% vs 42.1% (P less than 0.001). The 5 year survival (all-cause mortality) in the over 80s was 58.5% and 47.6% in the under 80s (P = 0.25). Cox's regression analysis of all patients identified the following factors to be independently related to overall survival: age greater than 80 years, post-operative leak, increasing Dukes stage and distant recurrence of disease. CONCLUSION: This study has demonstrated that surgery should not be denied to elderly patients with colorectal cancer as despite a higher post-operative morbidity and mortality rate and with the absence of adjuvant therapy, favourable long-term outcome can be achieved by resectional surgery alone."
0043116,Epstein NE,Foraminal and far lateral lumbar disc herniations: surgical alternatives and outcome measures,Spinal Cord 2002 Oct;40(10):491-500,,"LUMBAR VERTEBRAE, INTERVERTEBRAL DISK DISPLACEMENT, SURGERY OPERATIVE",TREATMENT OUTCOME,,,,1362-4393,AB,"Far lateral disc herniations constitute 7-12% of all disc herniations. They may be purely far lateral or extraforaminal in location, located beyond the pedicles, or may include intraforaminal and even intracanalicular components. Occurring predominantly at the L4-L5 and L3-L4 levels in almost equal numbers, they are occasionally noted at L5-S1. Clinical syndromes reflect compression of the superiorly exiting nerve root and ganglion; ie an L4-L5 far lateral disc produces a L4 root syndrome. Clinical complaints often include severe radicular pain accompanied by very positive mechanical signs; Lasegue and reverse Lasegue (femoral stretch test) maneuvers. Neurological deficits, including motor, reflex, and sensory findings, are seen over 75% of the time. Although conservative management is occasionally successful (10%), surgery is usually required. The extent of stenosis and attendant degenerative changes dictate whether laminectomy, hemilaminectomy or laminotomy are required along with one of several facet resection options; full facetectomy, the intertransverse approach, medial facetectomy, or an extreme lateral procedure. Postoperatively, patients' neurological outcomes based on both surgeon and patient based outcome measures (SF-36), were comparable for the different surgical procedures which had been based on the individual patient's pathology."
0043117,"Grange CC, Bougenot MP, Groslambert A, Tordi N, Rouillon JD",Perceived exertion and rehabilitation with wheelchair ergometer: comparison between patients with spinal cord injury and healthy subjects,Spinal Cord 2002 Oct;40(10):513-8,,"SPINAL CORD INJURIES, OXYGEN CONSUMPTION, EXERCISE, HEART RATE, ENERGY METABOLISM","REHABILITATION, EXERCISE TESTING",,,"The purpose of this study was to compare the effects of a rehabilitation program on the perceived exertion (PE) and the cardioventilatory responses during exercise in healthy people and paraplegics. METHODS: A group of seven healthy persons (age 26.6 SD 6.2 years) and one of seven paraplegics (age 42 SD 15.9 years) participated in a rehabilitation program composed of Square Wave Exercise Tests (SWEET) during six weeks. The maximal oxygen uptake, the power output (PO), heart rate (HR) and measures of PE using the Borg CR 10 scale were investigated during a maximal graded test performed before and after the rehabilitation program. During the first SWEET session (SWEET 1) measures of PE and HR (base and peak) were also investigated and compared to the last session (SWEET 2) of the same absolute workload after the 6 weeks. RESULTS: Statistical analysis revealed no significant difference in both groups for PE between the two maximal graded tests. However, a significant decrease in the PE values (P less than 0.01) was observed in both groups during the SWEET 2. There was no significant difference in maximal HR between the two graded tests, but a significant decrease in HR (P less than 0.0001 for base HR and P less than 0.001 for peak HR) was observed in SWEET 2 compared to 1. The maximal tolerated power (MTP) and the peak oxygen uptake increased significantly in both healthy and paraplegic groups (P less than 0.0001 and P less than 0.05 respectively) after the 6 weeks of rehabilitation exercise. CONCLUSION: The results of the present study suggest that PE could be used to control the exercise intensity during a rehabilitation training program for paraplegics, similar to healthy subjects. The increase in the peak oxygen uptake and MTP demonstrates the positive effects of the rehabilitation program on the physical fitness of the subjects.",1362-4393,AB,OBJECTIV
0043118,"Saruhashi Y, Matsusue Y, Hukuda S",Effects of serotonin 1A agonist on acute spinal cord injury,Spinal Cord 2002 Oct;40(10):519-23,,"SPINAL CORD INJURIES, SEROTONIN, EVOKED POTENTIALS",RATS,,,"To evaluate the therapeutic effects of 5-HT agonists on the recovery of compound action potentials in injured spinal cords. METHODS: Rat dorsal columns were isolated, placed in a chamber, and injured by extradural compression with a clip. Conducting action potentials were activated by supramaximal constant current electrical stimuli and recorded during perfusion with 5-HT agonists and antagonists. RESULTS: After inducing compression injuries, mean action potential amplitudes were reduced to 33.9 +/- 5.4% of the pre-injury level. After 120 min of perfusion with Ringer's solution, the mean amplitudes recovered to 62.8 +/- 8.4% of the pre-injury level. At a concentration of 100 micro M, perfusion with tandospirone (a 5-HT1A agonist) resulted in a significantly greater recovery of mean action potential amplitudes at 2 h after the injury (86.2 +/- 6.9% of pre-injury value) as compared with the control Ringer's solution (62.8 +/- 8.4% of pre-injury value, P less than 0.05). In contrast, quipazine (a 5-HT2A agonist) accelerated the decrease of amplitude (54.5 +/- 11.7% of pre-injury value). 5-HT1A and 5-HT2A agonist did not consistently alter latencies of the action potentials. CONCLUSION: The 5-HT1A receptor agonist was effective for the recovery of spinal action potential amplitudes in a rat spinal cord injury model.",1362-4393,AB,STUDY DESIGN: We evaluated the effects of serotonin (5-HT) agonists on in vitro models of spinal cord compressive injury. Evoked potentials in injured rat spinal cords (n=24) were recorded during perfusion with 5-HT agonists. OBJECTIV
0043119,"Mali P, Ansari A, Chaturvedi M",Antifertility effect of chronically administered Martynia annua root extract on male rats,J Ethnopharmacol 2002 Oct;82(2-3):61-7,Martynia annua,"PLANT EXTRACTS, REPRODUCTIVE CONTROL AGENTS, FERTILITY, GENITALIA MALE","PLANTS MEDICINAL, ROOTS, RATS, DRUG EFFECTS, MALE, PHARMACOLOGY",,,,0378-8741,AB,"The effects of 50% ethanol extract of Martynia annua L. root on reproduction was studied on male rats. The study was divided into four groups of five animals each. The first group (I) received vehicle alone to serve as control. The second, third and fourth groups (II, III and IV) of animals were administered the root extract daily at 50 mg/kg body weight, po, 100 mg/kg body weight, po, and 200 mg/kg body weight, po, respectively, for a period of 60 days. Significant decreases in the weights of testes, epididymides, seminal vesicle and ventral prostate were observed. A dose related reduction in the testicular sperm count, epididymal sperm count and motility, number of fertile males, ratio between delivered and inseminated females and number of pups were observed. The testis showed a clear correlation between the dose and severity of lesions of seminiferous epithelium. In general, the seminiferous tubules appear reduced in size with a frequently filled eosinophilic material. Spermatogenesis arrested at the secondary spermatocyte stage. Pachytene spermatocytes were undergoing degeneration. Disorganisation and sloughing of immature germ cells were visible. Leydig cells were atrophied. No morphological changes were observed in Sertoli cells. Significant reduction in serum concentration of luteinising hormone and testosterone were observed. No distinct change in serum FSII concentration was recorded. The final body weights of all groups were elevated markedly. No alterations were recorded in any hematological parameters. It is concluded that the 50% ethanol extract of M. annua root produced dose related effects on male reproduction without altering general body metabolism."
0043120,"Tan P, Nyasse B, Dimo T, Mezui C",Gastric cytoprotective anti-ulcer effects of the leaf methanol extract of Ocimum suave (Lamiaceae) in rats,J Ethnopharmacol 2002 Oct;82(2-3):69-74,Ocimum suave,"ANTIULCER AGENTS, PLANT EXTRACTS, STOMACH ULCER","PLANTS MEDICINAL, RATS, PREVENTION, PHARMACOLOGY, DRUG THERAPY",,,,0378-8741,AB,"The anti-ulcerogenic potential of the leaf methanol extract of Ocimum suave (Lamiaceae) was investigated using four methods of gastric lesion induction in experimental Wistar rats (150-200 g): (1) HCl/ethanol-induced gastric lesions, (2) Absolute ethanol-induced gastric lesions, (3) Indomethacin-HCl/ethanol-induced gastric lesions, (4) Pylorus ligation-induced gastric lesions. Administration of the extract of O. suave to the rats by oral route (75-500 mg/kg) dose-dependently prevented the formation of acute gastric lesions induced using the four experimental techniques. The dose-dependent reduction of lesion formation was in all cases accompanied by significant increases in gastric mucus production. At the dose of 250 mg/kg there was complete inhibition of gastric lesions induced using the HCl/ethanol solution. Pre-treatment, by intraperitoneal route, with indomethacin significantly reduced the ability of the extract to inhibit the formation of HCl/ethanol-induced lesions. When the rats were subjected to pylorus ligation, the dose of 500 mg/kg completely inhibited lesion formation but did not have any effect on gastric acid secretion compared with the controls. The mucus secretion promoting effect of the extract was most significant when the gastric environment was highly acidic. These results suggest that a new anti-ulcer therapy regimen may be formulated which does not require the use of antacids and anti-secretory agents."
0043121,"Sumathi T, Nayeem M, Balakrishna K, Veluchamy G, Devaraj S",Alcoholic extract of 'Bacopa monniera' reduces the in vitro effects of morphine withdrawal in guinea-pig ileum,J Ethnopharmacol 2002 Oct;82(2-3):75-81,Bacopa monniera,"PLANT EXTRACTS, MORPHINE, SUBSTANCE DEPENDENCE, ILEUM, NALOXONE, MUSCLE CONTRACTION","PLANTS MEDICINAL, DRUG EFFECTS, MUSCLE SMOOTH, ETIOLOGY, ADVERSE EFFECTS, DRUG THERAPY",,,,0378-8741,AB,"The effect of the alcoholic extract of the whole plant of Bacopa monniera (Scrophulariaceae) on morphine withdrawal was evaluated in vitro in guinea-pig ileum. After a 4 min in vitro exposure to morphine, addition of naloxone induced a strong contraction. Addition of various concentrations of the alcoholic extract of B. monniera (100-1000 microg/ml) 15 min before exposure to morphine reduced the naloxone-induced contraction in a dose-dependent manner. The results suggest that B. monniera extract may be useful in reducing the withdrawal symptoms induced by morphine."
0043122,"Hajhashemi V, Ghannadi A, Pezeshkian S",Antinociceptive and anti-inflammatory effects of Satureja hortensis L. extracts and essential oil,J Ethnopharmacol 2002 Oct;82(2-3):83-7,,"ANTIINFLAMMATORY AGENTS, OILS VOLATILE, ANALGESICS, PLANT EXTRACTS, PAIN, EDEMA, SATUREJA","PLANTS MEDICINAL, PHARMACOLOGY, RATS, DRUG THERAPY",,,,0378-8741,AB,"Satureja hortensis L. (Lamiaceae) is a medicinal plant used in Iranian folk medicine as muscle and bone pain reliever. In the present study, hydroalcoholic extract, polyphenolic fraction and essential oil of the aerial parts of the herb were prepared and evaluated for the analgesic activity using light tail flick, formalin and acetic acid-induced writhing in mice. Also, the anti-inflammatory effects of the above-mentioned preparations were assessed using carrageenan-induced paw edema in rats. Results showed that in the light tail flick test neither the essential oil nor the extracts could exert any significant effect. The hydroalcoholic extract (2000 mg/kg, p.o.) and the essential oil (200 mg/kg, p.o.) inhibited the mice writhing responses caused by acetic acid. In formalin test, hydroalcoholic extract (500-2000 mg/kg, p.o.), polyphenolic fraction (250-1000 mg/kg, p.o.) and the essential oil (50-200 mg/kg, p.o.) showed analgesic activity and pretreatment with naloxone (1 mg/kg, i.p.) or caffeine (20 mg/kg, i.p.) failed to reverse this antinociceptive activity. Polyphenolic fraction (1000 mg/kg, p.o.) and the essential oil (200 mg/kg) reduced edema caused by carrageenan. These results suggest that S. hortensis L. has antinociceptive and anti-inflammatory effects and probably mechanism(s) other than involvement of opioid and adenosine receptors mediate(s) the antinociception."
0043123,"Song Y, Jin C, Jung K, Park E",Estrogenic effects of ethanol and ether extracts of propolis,J Ethnopharmacol 2002 Oct;82(2-3):89-95,receptors estrogen,"PROPOLIS, PHYTOESTROGENS, BREAST NEOPLASMS, TUMOR CELLS CULTURED, UTERUS","DRUG EFFECTS, DRUG THERAPY, RATS, PHARMACOLOGY, PROTEINS",,,,0378-8741,AB,"Propolis obtained from honeybee hives has been used in Oriental folk medicine as an anti-inflammatory, anti-carcinogenic, or immunomodulatory agent. The potential estrogenic activity of propolis was investigated in vitro using the MCF-7 human breast cancer cell proliferation, human estrogen receptor (hER) binding and yeast-based steroid receptor transcription, and in vivo using the immature rat uterotrophic effect. Treatments with ethanol extract of propolis (EEP) and ether extract of propolis (REP) enhanced MCF-7 cell proliferation in concentrations ranging from 0.8 to 4 microg/ml. Both EEP and REP competed for binding of (3H)17beta-estradiol to the hER with IC(50) values of 9.14 and 9.72 microg/ml, respectively. In yeast estrogen receptor transcription assay, both EEP and REP were found to be estrogenic with EC(50) values of 9.48, and 8.55 microg/ml, respectively. Animals treated with EEP or REP for 4 days (500-1000 mg/kg per day, s.c.) exhibited significant dose-dependent increases in uterine wet weight. However, in the yeast androgen and progesterone receptor transcription assays, either EEP or REP was found not to be active. The results suggest that propolis produces estrogenic effects through activation of estrogen receptors."
0043124,"Eddouks M, Maghrani M, Lemhadri A, Ouahidi M, Jouad H","Ethnopharmacological survey of medicinal plants used for the treatment of diabetes mellitus, hypertension and cardiac diseases in the south-east region of Morocco (Tafilalet)",J Ethnopharmacol 2002 Oct;82(2-3):97-103,,"ETHNOPHARMACOLOGY, PLANTS MEDICINAL, DIABETES MELLITUS, HYPERTENSION, HEART DIS","DRUG THERAPY, AFRICA, DRUG THERAPY, PHYTOTHERAPY",,,,0378-8741,AB,"In this study, the medicinal plants used in the treatment of diabetes mellitus, hypertension and cardiac diseases were inventoried based on the ethnopharmacological survey in south-eastern Morocco: Tafilalet region. Seven hundred persons including 320 diabetic patients and 380 patients with hypertension and cardiac disorders and 20 traditional herbal healers were interviewed in different areas of Tafilalet. The results indicated that 80% of patients interviewed used medicinal plants to treat diabetes, hypertension and cardiac diseases because they state that phytotherapy is cheaper (58%), more efficient (40%) and better (65%) than modern medicine. In this ethnobotanic enquiry, about 92 medicinal plants were cited. A lot of them are cited for the first time in Morocco. Many parameters have been evaluated such as knowledge of the toxic plants, doses, parts used, etc. Also, we have reported that 75% of type 2 diabetic patients used medicinal plants in association with modern drugs, while 10% of type 1 diabetic patients regularly used medicinal plants combined with insulin treatment. Some toxic plants have also been reported. In conclusion Tafilalet region disposes of a large phytotherapy knowledge which must be scientifically investigated especially in treating diabetes mellitus, hypertension and cardiac diseases."
0043125,"Sayyah M, Mandgary A, Kamalinejad M",Evaluation of the anticonvulsant activity of the seed acetone extract of Ferula gummosa Boiss. against seizures induced by pentylenetetrazole and electroconvulsive shock in mice,J Ethnopharmacol 2002 Oct;82(2-3):105-9,Ferula gummosa,"ANTICONVULSANTS, PLANT EXTRACTS, SEIZURES, TERPENES, ALKALOIDS","PLANTS MEDICINAL, SEEDS, DRUG THERAPY, PHARMACOLOGY, PREVENTION",,,,0378-8741,AB,Ferula gummosa Boiss. (Apiaceae) which has been used as an antiepileptic remedy in Iranian traditional medicine was evaluated for anticonvulsant activity against experimental seizures. The seed acetone extract of F. gummosa protected mice against tonic convulsions induced by maximal electroshock (the median effective dose (ED(50)) = 198.3 mg/kg) and especially by pentylenetetrazole (ED(50) = 55 mg/kg). Neurotoxicity (sedation and motor impairment) of the extract was assessed by the rotarod test and the median toxic dose (TD(50)) value of 375.8 mg/kg was obtained. Preliminary phytochemical analysis showed the presence of terpenoids and alkaloids in the extract. The acceptable acute toxicity of the extract recommends further studies to determine the mechanism(s) and compound(s) involved in the anticonvulsant activity.
0043126,"Yadav S, Vats V, Dhunnoo Y, Grover J",Hypoglycemic and antihyperglycemic activity of Murraya koenigii leaves in diabetic rats,J Ethnopharmacol 2002 Oct;82(2-3):111-6,Murraya koenigii,"HYPOGLYCEMIC AGENTS, PLANT LEAVES, DIABETES MELLITUS","PLANTS MEDICINAL, RATS, DRUG THERAPY, PHARMACOLOGY",,,,0378-8741,AB,"The commonly used spice curry patta (Murraya koenigii) is traditionally consumed by diabetics in southern part of India. Feeding of diet containing various doses of curry leaves (5, 10 and 15%) to normal rats for 7 days as well as mild diabetic (blood glucose levels greater than 175 mg/dl induced by alloxan 35 mg/kg IP) and moderate diabetic rats (blood glucose levels greater than 250 mg/dl induced by STZ 60 mg/kg IP) for 5 weeks showed varying hypoglycemic and anti-hyperglycemic effect. In normal rats, reduction in blood glucose was almost negligible (approximately 4% with 10 and 15% diet). In mild and moderate diabetic rats, feeding of 5, 10 and 15% diet caused a maximal reduction in blood sugar by 13.1, 16.3 and 21.4% (NS, P less than 0.05 and 0.005) and 3.2, 5.58, 8.21% (NS), respectively. The mechanism of action is further discussed in light of results of previous and the present study."
0043127,"Turker A, Camper N","Biological activity of common mullein, a medicinal plant",J Ethnopharmacol 2002 Oct;82(2-3):117-25,Verbascum thapsus,"PLANT EXTRACTS, ANTIINFECTIVE AGENTS","PLANTS MEDICINAL, ADVERSE EFFECTS, PHARMACOLOGY",,,,0378-8741,AB,"Common Mullein (Verbascum thapsus L., Scrophulariaceae) is a medicinal plant that has been used for the treatment of inflammatory diseases, asthma, spasmodic coughs, diarrhea and other pulmonary problems. The objective of this study was to assess the biological activity of Common Mullein extracts and commercial Mullein products using selected bench top bioassays, including antibacterial, antitumor, and two toxicity assays-brine shrimp and radish seed. Extracts were prepared in water, ethanol and methanol. Antibacterial activity (especially the water extract) was observed with Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli. Agrobacterium tumefaciens-induced tumors in potato disc tissue were inhibited by all extracts. Toxicity to Brine Shrimp and to radish seed germination and growth was observed at higher concentrations of the extracts."
0043128,"Delaporte R, Sanchez G, Cuellar A, Giuliani A, Palazzo de Mello J",Anti-inflammatory activity and lipid peroxidation inhibition of iridoid lamiide isolated from Bouchea fluminensis (Vell.) Mold. (Verbenaceae),J Ethnopharmacol 2002 Oct;82(2-3):127-30,Bouchea fluminensis,"PLANT EXTRACTS, ANTIINFLAMMATORY AGENTS, LIPID PEROXIDATION","PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, PREVENTION, DRUG ISOLATION",,,,0378-8741,AB,"Anti-inflammatory activity of an ethanolic extract from Bouchea fluminensis leaves was demonstrated. From de ethanolic extract, the active compound was isolated and characterized as the iridoid lamiide. The activity of lamiide on rat-brain phospholipid peroxidation showed a powerful effect (IC(50) = 0.92 +/- 0.01 mM) and an anti-inflammatory activity in carrageenin-induced paw edema test (ED(50) = 62.3 +/- 7 mg/kg weight)."
0043129,"Lev E, Amar Z",Ethnopharmacological survey of traditional drugs sold in the Kingdom of Jordan,J Ethnopharmacol 2002 Oct;82(2-3):131-45,,"ETHNOPHARMACOLOGY, HERBAL DRUGS, FOLK REMEDIES, BIOLOGICAL PRODUCTS",MIDDLE EAST,,,,0378-8741,AB,"The results of a survey of present-day traditional medicinal materials conducted in 1998-1999 in the Kingdom of Jordan are reported. The study covered selected markets of medicinal substances of ethnic communities throughout the kingdom, and also included questioning of the sellers about the healing characteristics of the various materials. The survey yielded information on many and varied medicinal substances, of which 304 are identified according to the following classifications: 236 species of plants (77.6%); 30 species of animals (9.8%); 29 kinds of inorganic substances (9.6%); and 9 materials of other or mixed origin (3%). Analysis of the data showed that some substances were of local origin (41.8%), but the majority of the substances (45.4%) were imported from other countries. 12.8% of the substances were both local and imported. These data demonstrate that there is still a flourishing and well-developed trade in these materials-a trade that is the remnant of a rich and ancient medical culture, which is disappearing from the modern world."
0043130,"Louw C, Regnier T, Korsten L",Medicinal bulbous plants of South Africa and their traditional relevance in the control of infectious diseases,J Ethnopharmacol 2002 Oct;82(2-3):147-54,,"PLANTS MEDICINAL, TRADITIONAL MEDICINE AFRICAN, ANTIINFECTIVE AGENTS, ANTIINFLAMMATORY AGENTS","SOUTH AFRICA, FOLK REMEDIES",,,,0378-8741,AB,"Natural products are becoming more important in modern-day society as man is moving away from synthetic products, which can be detrimental to the environment and human health. Scientific research on the healing properties and bioactivity of natural compounds, especially of plant origin, has been extensive particularly in the Western world. However, a rich heritage of floral biodiversity is found in developing countries. South Africa, a country with a strong history of traditional healing, hosts a variety of around 30000 plant species. Indigenous bulbous plants of importance to South African traditional healers mainly belong to the Amaryllidaceae and Hyacinthaceae families. A number of these plants have particular uses as disinfectants and anti-inflammatory agents, although there is still a lack of scientific research regarding their unique pharmacological compounds."
0043131,"Baurin N, Arnoult E, Scior T, Do Q, Bernard P",Preliminary screening of some tropical plants for anti-tyrosinase activity,J Ethnopharmacol 2002 Oct;82(2-3):155-8,"Stryphnodendron barbatimao, Portulaca pilosa, Cariniana brasiliensis, Entada africana, Prosopis africana","SKIN DIS, PLANT EXTRACTS","PLANTS MEDICINAL, DRUG ISOLATION, DRUG THERAPY, PHARMACOLOGY",,,,0378-8741,AB,"In our efforts to find new active tyrosinase inhibitors for skin-whitening or antibrowning preparations, we investigated 67 tropical plants belonging to 38 families, which were evaluated for their anti-tyrosinase activity. The results of our investigation show that extracts of 5 plants, Stryphnodendron barbatimao, Portulaca pilosa, Cariniana brasiliensis, Entada africana and Prosopis africana present interesting in vitro mushroom tyrosinase inhibition (over 90%), similar to a positive control: Morus alba. These 5 plants will be studied in order to isolate and identify phytochemical compounds, involved in this biological activity."
0043132,"Brownson D, Mabry T, Leslie S","The cycad neurotoxic amino acid, ss-N-methylamino-L-alanine (BMAA), elevates intracellular calcium levels in dissociated rat brain cells",J Ethnopharmacol 2002 Oct;82(2-3):159-67,Cycas micronesica,"CALCIUM, BRAIN, PLANT EXTRACTS, AMYOTROPHIC LATERAL SCLEROSIS, PARKINSON DIS, DEMENTIA","SEEDS, METABOLISM, ADVERSE EFFECTS, ETIOLOGY, ASIA SOUTHEASTERN, PLANTS MEDICINAL",,,,0378-8741,AB,"Seeds of the Guam cycad Cycas micronesica K.D. Hill (Cycadaceae), which contain beta-methylamino-L-alanine (BMAA), have been implicated in the etiology of the devastating neurodisease ALS-PDC that is found among the native Chamorros on Guam. The disease also occurs in the native populations on Irian Jaya and the Kii Peninsula of Japan, and in all three areas the cycad seeds are used either dietarily or medically. ALS-PDC is a complex of amyotrophic lateral sclerosis and parkinsonism dementia complex with additional symptoms of Alzheimer's. It is well known that Ca(2+) elevations in brain cells can lead to cell death and neurodiseases. Therefore, we evaluated the ability of the cycad toxin BMAA to elevate the intracellular calcium concentration ((Ca(2+))(i)) in dissociated newborn rat brain cells loaded with fura-2 dye. BMAA produced an increase in intracellular calcium levels in a concentration-dependent manner. The increases were dependent not only on extracellular calcium concentrations, but also significantly on the presence of bicarbonate ion. Increasing concentrations of sodium bicarbonate resulted in a potentiation of the BMAA-induced (Ca(2+))(i) elevation. The bicarbonate dependence did not result from the increased sodium concentration or alkalinization of the buffer. Our results support the hypothesis that the neurotoxicity of BMAA is due to an excitotoxic mechanism, involving elevated intracellular calcium levels and bicarbonate. Furthermore, since BMAA alone produced no increase in Ca(2+) levels, these results suggest the involvement of a product of BMAA and CO(2), namely a beta-carbamate, which has a structure similar to other excitatory amino acids (EAA) such as glutamate; thus, the causative agent for ALS-PDC on Guam and elsewhere may be the beta-carbamate of BMAA."
0043133,"Wang Y, Zhao H, Sheng X, Gambino P, Costello B, Bojanowski K",Protective effect of Fructus Lycii polysaccharides against time and hyperthermia-induced damage in cultured seminiferous epithelium,J Ethnopharmacol 2002 Oct;82(2-3):169-75,Fructus Lycii,"POLYSACCHARIDES, PLANT EXTRACTS, EPITHELIUM, TESTIS, OXIDATIVE STRESS, LYCIUM","PLANTS MEDICINAL, TRADITIONAL MEDICINE CHINESE, DRUG EFFECTS, APOPTOSIS, HYPERTHERMIA INDUCED, FRUIT",,,,0378-8741,AB,"Lycium barbarum L. (Solanaceae) is a Chinese medicinal plant whose fruits (Fructus Lycii) are used by Chinese physicians for treatment of infertility. However, the active ingredients and the mechanism of action underlying Lycium's fertility-facilitating effects remain unknown. Here we report that Fructus Lycii polysaccharides (FLPS) inhibit time- and hyperthermia-induced structural damage in murine seminiferous epithelium, in vitro. Moreover, we found that FLPS delayed apoptosis in this system, both at normothermic and hyperthermic culture conditions. Oxidative stress was reported to be a major cause of structural degradation and apoptosis in hyperthermic testes, and thus the protective effect of FLPS could implicate an antioxidant mechanism of action. To test this hypothesis we assayed the effect of FLPS on ultraviolet light-induced lipid peroxidation, and cytochrome c reduction by free radicals. We found that FLPS is a potent inhibitor of both of these reactions. Together, these results demonstrate the protective effect of FLPS on time- and hyperthermia-induced testicular degeneration in vitro, indicate the potential mechanism of action for this protective effect, and provide a scientific basis for the traditional use of this plant."
0043134,"Aboutabl E, Nassar M, Elsakhawy F, Maklad Y, Osman A, El-Khrisy E",Phytochemical and pharmacological studies on Sideritis taurica Stephan ex Wild,J Ethnopharmacol 2002 Oct;82(2-3):177-84,,"PLANT EXTRACTS, ANALGESICS, ANTIINFLAMMATORY AGENTS, ANTIULCER AGENTS, HYPOGLYCEMIC AGENTS, SIDERITIS","PLANTS MEDICINAL, PHARMACOLOGY, DRUG ISOLATION",,,,0378-8741,AB,"Fatty acids (FA), hydrocarbons, alpha-amyrin, stigmasterol and beta-sitosterol were identified in the n-hexane extract of the aerial parts of Sideritis taurica Stephan ex Wild. Xanthotoxin, as well as 2-acetyl-3-hydroxy-5,6,8-trimethoxy-1,4-naphthoquinone were isolated from the methylene chloride extract of the plant. In addition to apigenin 7-O-beta-D-glucopyranoside and apigenin, previously reported from the plant, hypolaetin 7-O-beta-D-allopyranosyl-O-beta-D-glucopyranoside was isolated from the ethyl acetate extract. From the methanol extract, isoscutellarein 7-O-beta-D-allopyranosyl-O-beta-D-glucopyranoside was also isolated. Toxicity study of petroleum ether extract (f(1)), ethanolic extract (f(2)), dichloromethane fraction of f(2) (f(3)) and n-butanolic fraction of f(2) (f(4)) of the plant proved that it is relatively nontoxic. The tested extracts and fractions exhibited significant analgesic, anti-inflammatory, anti-ulcerogenic and antihyperglycaemic activities, but no anticonvulsant and antipyretic effects, as compared with control groups and reference drugs."
0043135,"Alarcon-Aguilar F, Hernandez-Galicia E, Campos-Sepulveda A, Xolalpa-Molina S, Rivas-Vilchis J, Vazquez-Carrillo L, Roman-Ramos R",Evaluation of the hypoglycemic effect of Cucurbita ficifolia Bouche (Cucurbitaceae) in different experimental models,J Ethnopharmacol 2002 Oct;82(2-3):185-9,Cucurbita ficifolia,"PLANTS MEDICINAL, PLANT EXTRACTS, HYPOGLYCEMIC AGENTS, DIABETES MELLITUS","CUCURBITA, DRUG THERAPY, PHARMACOLOGY, MICE, DISEASE MODELS ANIMAL",,,,0378-8741,AB,"Acute hypoglycemic effects of freeze-dried juice of Cucurbita ficifolia Bouche (Cucurbitaceae) fruits were studied in healthy and alloxan-diabetic mice. C. ficifolia fruit administered by intraperitoneal route produced, in a dose-dependent manner, a significant decrease of the glycemia in healthy mice. Although oral route of C. ficifolia fruit juice also caused significant reductions of blood glucose levels in healthy mice, the effect was minor. The juice administered by intraperitoneal route showed an acute hypoglycemic effect in alloxan-diabetic mice. In addition, daily oral administration of this preparation showed a highly significant reduction of the glycemia after 14 days of treatment. Freeze-dried juice caused acute toxicity when administered intraperitoneally, and also when it was administered daily by the oral route."
0043136,"Adzu B, Amos S, Dzarma S, Muazzam I, Gamaniel K",Pharmacological evidence favouring the folkloric use of Diospyros mespiliformis Hochst in the relief of pain and fever,J Ethnopharmacol 2002 Oct;82(2-3):191-5,Diospyros mespiliformis,"ANALGESICS, FEVER, ANTIINFLAMMATORY AGENTS, PLANT EXTRACTS","PLANTS MEDICINAL, PHARMACOLOGY, DRUG EFFECTS, MICE, RATS",,,,0378-8741,AB,"The methanol extract of Diospyros mespiliformis was evaluated for its claimed folkloric usage in the relief of pain and fever. Antipyretic, analgesic and anti-inflammatory effects of the extract were evaluated in rats and mice. Studies were carried out on yeast-induced pyrexia in rats, acetic acid-induced writhing in mice, formalin test and egg albumin-induced anti-inflammatory activity in rats. The extract (50 and 100 mg/kg i.p.) gave a potent antipyretic effect for 100 mg/kg and significant activity (P less than 0.05) against all the analgesic and anti-inflammatory models used. The LD(50) of the extract was estimated to be 513.80 +/- 33.92 mg/kg i.p. in mice. These results provide support for the use of the plant in relieving pain and fever."
0043137,"McCune L, Johns T",Antioxidant activity in medicinal plants associated with the symptoms of diabetes mellitus used by the indigenous peoples of the North American boreal forest,J Ethnopharmacol 2002 Oct;82(2-3):197-205,,"ANTIOXIDANTS, PLANTS MEDICINAL, DIABETES MELLITUS, SUPEROXIDES","DRUG EFFECTS, DRUG THERAPY, ETHNIC GROUPS, CANADA, COMPARATIVE STUDY, TRADITIONAL MEDICINE",,,,0378-8741,AB,"Thirty-five plant species were selected from the published literature as traditionally used by the indigenous peoples of the boreal forest in Canada for three or more symptoms of diabetes or its complications. Antioxidant activities in methanolic extracts support the contribution of these traditional medicines in a lifestyle historically low in the incidence of diabetes. In a DPPH assay of free radical scavenging activity 89% of the methanol extracts had activity significantly greater than common modern dietary components, 14% were statistically equal to ascorbic acid and 23% had activities similar to green tea and a Trolox(R) positive control. Superoxides produced with an NBT/xanthine oxidase assay found scavenging was significantly higher in 29% of the species as compared with the modern dietary components and Trolox(R). The methanol extracts of Rhus hirta, Quercus alba and Cornus stolonifera performed similarly to green tea's in this assay. Assessment of peroxyl radical scavenging using a DCF/AAPH assay showed 60% of the plant extracts statistically similar to Trolox(R) while R. hirta and Solidago canadensis extracts were greater than green tea, ascorbic acid and Trolox(R). The majority of the species (63 and 97%, respectively) had scavenging activities similar to ascorbic acid in the superoxide and peroxyl radical scavenging assays."
0043138,"Zetola M, De Lima T, Sonaglio D, Gonzalez-Ortega G, Limberger R, Petrovick P, Bassani V",CNS activities of liquid and spray-dried extracts from Lippia alba-Verbenaceae (Brazilian false melissa),J Ethnopharmacol 2002 Oct;82(2-3):207-15,,"CENTRAL NERVOUS SYSTEM, PLANT EXTRACTS, SEDATIVES NONBARBITURATE, ANTICONVULSANTS, MUSCLE RELAXATION, LIPPIA","PLANTS MEDICINAL, DRUG EFFECTS, PHARMACOLOGY, ETIOLOGY",,,,0378-8741,AB,"The CNS activity of Lippia alba liquid and spray-dried extracts, containing the non-volatile fraction from the leaves, was investigated. L. alba liquid extracts were prepared by percolation with EtOH 40, 60 or 80%. The liquid extracts, named ES(40%,) ES(60%) and ES(80%,) were concentrated, the ethanol eliminated and then tested in Swiss mice to evaluate its sedative and anticonvulsant effects. The animals received the extracts, orally, in doses corresponding to 200 mg of dry residue by kilogram of body weight. All mice were evaluated in the barbiturate-induced sleep test. Similarly, other groups of mice were submitted to convulsions induced by pentylenetetrazol (PTZ). The concentrated extract obtained from ES(80%) showed the most significant sedative and myorelaxant effects as well as the highest total flavonoid content (66 mg/100 g, expressed in apigenin). Two spray-dried powders, SDP(1) and SDP(2), were prepared from ES(80%) using as excipients, respectively, colloidal silicon dioxide (CSD) and CSD associated to beta-cyclodextrin. Only SDP(1) showed sedative profile similar to that presented by ES(80). In conclusion, we demonstrated that the non-volatile fraction of L. alba, extracted in ethanol 80% (v/v), presents sedative and myorelaxant effects and that, among the tested extracts, this presents the highest flavonoid content. We demonstrated also the technological feasibility of spray-dried extracts and the influence of the excipient on its sedative properties."
0043139,"Chung H, Jeong H, Han M, Park S, Seong K, Baek S, Jeong D, Kim M, Kim H",Nitric oxide and tumor necrosis factor-alpha production by Ixeris dentata in mouse peritoneal macrophages,J Ethnopharmacol 2002 Oct;82(2-3):217-22,Ixeris dentata,"NITRIC OXIDE, TUMOR NECROSIS FACTOR, PLANT EXTRACTS, MACROPHAGES","PLANTS MEDICINAL, MICE, METABOLISM, DRUG EFFECTS",,,,0378-8741,AB,"Using mouse peritoneal macrophages, we have examined the mechanism by which Ixeris dentata (IXD) regulates nitric oxide (NO) production. When IXD was used in combination with recombinant interferon-gamma (rIFN-gamma), there was a marked cooperative induction of NO production. However, IXD had no effect on NO production by itself. The increased production of NO from rIFN-gamma plus IXD-stimulated cells was almost completely inhibited by pre-treatment with pyrrolidine dithiocarbamate (PDTC), an inhibitor of nuclear factor kappa B (NF-kappaB). Furthermore, treatment with IXD alone or rIFN-gamma plus IXD in peritoneal macrophages caused a significant increase in tumor necrosis factor-alpha (TNF-alpha) production. PDTC decreased TNF-alpha production induced by IXD significantly. These findings demonstrate that IXD increases the production of NO and TNF-alpha by rIFN-gamma-primed macrophages and suggest that NF-kappaB plays a critical role in mediating these effects of IXD."
0043140,"Thomas T, Panikkar B, Subramoniam A, Nair M, Panikkar K",Antitumour property and toxicity of Barringtonia racemosa Roxb seed extract in mice,J Ethnopharmacol 2002 Oct;82(2-3):223-7,Barringtonia racemosa,"ANTINEOPLASTIC AGENTS PHYTOGENIC, PLANT EXTRACTS","PLANTS MEDICINAL, SEEDS, DOSAGE FORMS, PHARMACOLOGY",,,,0378-8741,AB,"Ethnomedical survey has shown that the seeds of Barringtonia racemosa Roxb are traditionally used in certain remote villages of Kerala (India) to treat cancer like diseases. So the seed extracts were tested for their antitumour activity and toxicity. Intraperitoneal (i.p.) daily administration of 50% methanol extract of this seed to mice challenged with 1 million Dalton's Lymphoma Ascitic (DLA) cells resulted in remarkable dose dependent anti-DLA activity in mice. The optimum dose was found to be 6 mg/kg. This dose protected all the animals challenged with the tumour cells. The efficacy of the drug was found to be better than that of a standard drug, vincristine in this tumour model. However, the oral administration showed only marginal activity compared to i.p. administration. The extract was found to be devoid of conspicuous acute and short-term toxicity to mice, when administered daily, (i.p.) for 14 days up to a dose of 12 mg/kg (which was double the concentration of optimum therapeutic dose). The treated mice showed conspicuous toxic symptoms only at 24 mg/kg. The LD(50) to male mice for a single i.p. dose was found to be 36 mg/kg. The seed extract is an attractive material for further studies leading to drug development."
0043141,"Chattopadhyay D, Arunachalam G, Mandal A, Sur T, Mandal S, Bhattacharya S",Antimicrobial and anti-inflammatory activity of folklore: Mallotus peltatus leaf extract,J Ethnopharmacol 2002 Oct;82(2-3):229-37,"Mallotus peltatus, folklore","PLANT EXTRACTS, ANTIINFLAMMATORY AGENTS, ANTIINFECTIVE AGENTS","PLANTS MEDICINAL, CULTURE, RATS, PHARMACOLOGY",.,,,0378-8741,AB,"Since ages Mallotus peltatus (Geist) Muell. Arg. var acuminatus (Euphorbiaceae) leaf and stem bark is used in folk medicine to cure intestinal ailments and skin infections. In several intestinal ailments, localized inflammation is of common occurrence and hence we have evaluated the antimicrobial as well as anti-inflammatory activity of M. peltatus leaf extract. The crude methanol extract of M. peltatus leaves was found to be active against Staphylococcus aureus, Staphylococcus saprophyticus, Streptococcus faecalis, Bacillus subtilis, Escherichia coli and Proteus mirabilis and the dermatophytic fungi Microsporum gypseum. The minimum inhibitory concentration (MIC) ranges from 128 to 2000 microg ml(-1) for bacteria and 128 mg ml(-1) for fungi, while the minimum bactericidal concentration (MBC) was 2-4-fold higher than MIC. The methanol-water fraction of the extract showed similar activity against Staphylococcus, Streptococcus, Bacillus and Proteus isolates. The anti-inflammatory activity of the extract against carrageenan (acute model) and dextran-induced (subacute model) rat paw oedema and cotton pellet-induced granuloma (chronic model) in rats were studied using indomethacin (10 mg kg(-1)), a nonsteroid anti-inflammatory drug, as standard. The methanol extract at 200 and 400 mg kg(-1), and the n-butanol fractions A and B at 25 mg kg(-1), exhibited significant anti-inflammatory activity in Albino rats, compared with indomethacin. Phytochemical study revealed the presence of tannins, saponins, terpenoids, steroids and reducing sugars in the crude extract while the n-butanol fractions showed the presence of ursolic acid, beta-sitosterol and some fatty acids as major compounds. Further study with fractions showed that the antibacterial and anti-inflammatory activity is due to either fraction A alone or the combination of fractions A and B of the extract."
0043142,"Siti Najila M, Noor Rain A, Mohamad Kamel A, Syed Zahir S, Khozirah S, Lokman Hakim S, Zakiah I, Azizol A","The screening of extracts from Goniothalamus scortechinii, Aralidium pinnatifidum and Andrographis paniculata for anti-malarial activity using the lactate dehydrogenase assay",J Ethnopharmacol 2002 Oct;82(2-3):239-42,"Goniothalamus scortechinii, Aralidium pinnatifidum, Andrographis paniculata","PLANT EXTRACTS, ANTIMALARIALS","PLANTS MEDICINAL, PHARMACOLOGY, LACTATE DEHYDROGENASE",,,,0378-8741,AB,"Goniothalamus scortechinii, Andrographis paniculata and Aralidium pinnatifidum were selected for the study based on their ethnomedicinal values. They were screened for anti-malarial activity towards Plasmodium falciparum in vitro using the lactate dehydrogenase (LDH) assay. The crude extract of G. scortechinii exhibited the most potent schizonticidal activity compared to the other extracts. It is effective against both the chloroquine resistant isolate, Gombak A and the sensitive strain, D10 of Plasmodium falciparum. Furthermore a better IC(50) value was obtained against the resistant strain, (9 microg/ml) compared to the sensitive strain, 40 microg/ml. When the crude extract was fractionated into 3 fractions, the chloroform fraction yielded the best activity, exhibiting equipotency against both strains of parasite used; IC(50) of 23.53 microg/ml against Gombak A and 21.06 microg/ml against D10."
0043143,Tews DS,Apoptosis and muscle fibre loss in neuromuscular disorders,Neuromuscul Disord 2002 Oct;12(7-8):613-22,,"APOPTOSIS, NEUROMUSCULAR DIS, MUSCLE FIBERS","OXIDATIVE STRESS, FREE RADICALS, NITRIC OXIDE",,,,0960-8966,AB,"The past decade has witnessed increasing evidence that besides necrosis, apoptotic cell death mechanisms contribute to muscle fibre loss in various neuromuscular conditions, including the muscular dystrophies, metabolic myopathies, and cases of denervation. The up-regulation of bax and bcl-2, both members of the bcl-2 family, indicate that the predominant effectors involve permeability transition pores in the mitochondrial membrane and subsequent caspase activation which confers the typical morphological and biochemical features of apoptosis such as DNA-fragmentation. It is likely that apoptotic degradation of nuclei and contractile elements is a localized event in muscle fibre segments leading to muscle fibre atrophy and finally loss in these disorders. Essential triggers of apoptosis seem to be homeostatic dysregulation as well as oxidative stress, with increased generation of free oxygen radicals and nitric oxide. In the absence of effective primary treatments, there is hope that interventions in muscle fibre apoptosis will bear promising therapeutic strategies."
0043144,"Voit T, Parano E, Straub V, Schroder J, Schaper J, Pavone P, Falsaperla R, Pavone L, Herrmann R","Congenital muscular dystrophy with adducted thumbs, ptosis, external ophthalmoplegia, mental retardation and cerebellar hypoplasia: a novel form of CMD",Neuromuscul Disord 2002 Oct;12(7-8):623-30,,"MUSCULAR DYSTROPHY, CENTRAL NERVOUS SYSTEM, MENTAL HEALTH","COMPLICATIONS, PROGNOSIS",,,,0960-8966,AB,"At least six different forms of congenital muscular dystrophy are associated with structural changes of the central nervous system, and three of these have been mapped: merosin-deficient congenital muscular dystrophy on chromosome 6q2, Fukuyama congenital muscular dystrophy on chromosome 9q31, and muscle eye brain disease on chromosome 1p32. Walker-Warburg syndrome, congenital muscular dystrophy with calf hypertrophy, pontocerebellar hypoplasia, and normal eyes, and congenital muscular dystrophy with severe mental retardation and cerebellar cysts are nosologically distinct and have been excluded from the known congenital muscular dystrophy loci with structural changes of the central nervous system. Here, we describe a novel congenital muscular dystrophy syndrome which is phenotypically distinct from the recognized forms of congenital muscular dystrophy with brain involvement. Two siblings, a boy and a girl, were born to consanguineous parents from Sicily. Both children were born with adducted thumbs and toe contractures. They were floppy from birth, walked late, showed profound generalized muscle weakness including facial muscles, elevated creatine kinase levels of 200-700U/l, and histological changes compatible with muscular dystrophy. In addition, both showed ptosis, external ophthalmoplegia, mild mental retardation, and mild cerebellar hypoplasia on MRI. Immunocytochemistry showed normal expression of muscle membrane proteins including laminin alpha 2, laminin beta 2, and alpha-dystroglycan. Linkage analysis excluded the candidate loci on chromosomes 6q2, 9q31, and 1q32. The gene locus for congenital muscular dystrophy 1B, MDC 1B, on chromosome 1q42 was also excluded. Adducted thumbs are a distinct clinical sign that has not been reported in congenital muscular dystrophy before and should facilitate recognition of further patients with this disorder."
0043145,"Ferrari G, Mavilio F",Myogenic stem cells from the bone marrow: a therapeutic alternative for muscular dystrophy?,Neuromuscul Disord 2002 Oct;12(Supp):S7-10,,"MUSCULAR DYSTROPHY, BONE MARROW, TRANSPLANTATION","MUSCLE FIBERS, MICE",,,,0960-8966,AB,"Differentiated muscle fibres can be formed by transplanted haematopoietic stem cells in models of acute or chronic muscle regeneration, including the dystrophin-deficient mdx mouse. Muscle-forming activity can be found in adult, foetal and embryonic haematopoietic tissues. The blood-to-muscle transition may be due to transdifferentiation of haematopoietic progenitors in response to local signals provided by the regenerating muscle. These signals are only poorly provided by the muscle of the mdx mouse, since transplantation into these mice of normal C57Bl/6 bone marrow gives rise only to a minimal number of muscle fibres expressing the normal dystrophin protein (less than 1%) throughout the animal life span. Expansion and active recruitment to myogenic differentiation of transplanted haematopoietic cells are therefore critical factors for a future use of bone marrow transplantation in cell/gene therapy of muscular dystrophy."
0043146,"Thirion C, Larochelle N, Volpers C, Dunant P, Stucka R, Holland P, Nalbantoglu J, Kochanek S, Lochmuller H",Strategies for muscle-specific targeting of adenoviral gene transfer vectors,Neuromuscul Disord 2002 Oct;12(Supp):S30-9,,"GENETICS, MUSCLE SKELETAL, INFECTION","MICE, TREATMENT OUTCOME",,,,0960-8966,AB,"Currently, adenoviral transfer of therapeutic genes such as dystrophin is hampered by low transduction efficiency of adult skeletal muscle. This is largely due to the lack of appropriate virus attachment receptors on the myofiber surface. Recent studies in transgenic mice revealed that upregulation of Coxsackie- and adenovirus receptor improves gene transfer efficiency by approximately ten-fold. Conversely, the vector load that needed to be administered to achieve sufficient gene transfer could be lowered significantly. Reduced viral vector loads may help to control virally mediated toxicity and immunogenicity. To date, there are no drugs or methods known to increase Coxsackie- and adenovirus receptor expression in skeletal muscle that would be easily applicable in humans. However, alternative strategies such as vectorretargeting are currently being investigated that may allow for an increase in binding of adenoviral vectors to skeletal muscle. Recent experiments have shown that directed mutagenesis of the adenoviral fiber knob allows for a significant reduction in Coxsackie- and adenovirus receptor binding and for introduction of a new binding domain. Therefore, vector retargeting towards efficient and specific infection of skeletal muscle may be achieved by directed genetic alteration of adenoviral capsid proteins."
0043147,Rando TA,Oligonucleotide-mediated gene therapy for muscular dystrophies,Neuromuscul Disord 2002 Oct;12(Supp):S55-60,gene therapy,"MUSCULAR DYSTROPHY, GENETICS","THERAPY, ANIMALS",,,,0960-8966,AB,"Several new approaches to gene therapy for the muscular dystrophies involve oligonucleotides as targeting vectors. These oligonucleotides are designed to repair genetic mutations, to modify genomic sequences in order to compensate for gene deletions, or to modify RNA processing in order to ameliorate the effects of the underlying gene mutation. Among the various approaches currently under investigation for dystrophin mutations that cause Duchenne muscular dystrophy is the use of chimeric RNA/DNA oligonucleotides (\"chimeraplasts\") to repair point mutations. Studies in the mdx mouse and the GRMD dog have demonstrated that point mutations in the dystrophin gene can be corrected by chimeraplasts that have been injected into muscles. The scope of this review includes a summary of the current status of chimeraplast-mediated gene repair for dystrophin mutations, ongoing studies to apply chimeraplast-mediated gene repair to frame-shift deletions of the dystrophin gene, and major hurdles that need to be overcome to translate current experimental successes into a viable therapeutic modality for Duchenne muscular dystrophy."
0043148,"Ruegg U, Nicolas-Metral V, Challet C, Bernard-Helary K, Dorchies O, Wagner S, Buetler T",Pharmacological control of cellular calcium handling in dystrophic skeletal muscle,Neuromuscul Disord 2002 Oct;12(Supp):S155-161,,"MUSCULAR DYSTROPHY, MUSCLE SKELETAL, CALCIUM","ANIMALS, PHARMACOLOGY",,,,0960-8966,AB,"Duchenne muscular dystrophy arises due to the lack of the cytoskeletal protein dystrophin. In Duchenne muscular dystrophy muscle, the lack of dystrophin is accompanied by alterations in the dystrophin-glycoprotein complex. We and others have found that the absence of dystrophin in cells of the Duchenne muscular dystrophy animal model, the mdx mouse, leads to elevated Ca(2+) influx and cytosolic Ca(2+) concentrations when exposed to stress. We have also shown that alpha-methylprednisolone, the only drug used successfully in the therapy of Duchenne muscular dystrophy, and creatine lowered cytosolic Ca(2+) levels in mdx myotubes. It is likely that chronic elevation of (Ca(2+)) in the cytosol in response to stress is an initiating event for apoptosis and/or necrosis in Duchenne muscular dystrophy or mdx muscle and that alterations in mitochondrial function and metabolism are involved. Other cellular signalling pathways (e.g. nitric oxide) might also be affected."
0043149,"Ballantyne JA, Macnicol MF",(i) Congenital talipes equinovarus (clubfoot): an overview of the aetiology and treatment,Curr Orthop 2002 Apr;16(2):85-95,,"CLUBFOOT, ETIOLOGY",TREATMENT OUTCOME,,,,0268-0890,,
0043150,"Davies MB, Smith TW",(ii) Neuromuscular foot deformities in childhood,Curr Orthop 2002 Apr;16(2):96-103,,"FOOT DEFORMITIES, NEUROMUSCULAR DIS","CHILD, DIAGNOSIS, TREATMENT OUTCOME",,,,0268-0890,,
0043151,"Duffy CM, Cosgrove AP",(iii) The foot in cerebral palsy,Curr Orthop 2002 Apr;16(2):104-13,,"FOOT, CEREBRAL PALSY, WALKING","ETIOLOGY, MUSCLE STRENGTH, CHILD",,,,0268-0890,AB,"The foot in cerebral palsy is subject to the normal forces applied during walking, but its means of resisting these forces is altered as a result of the muscle weakness and spasticity inherent to this condition. Abnormal muscle activity permits the foot to deform in response to the forces applied to it, as well as causing deformities in their own right. The classical equino-valgus posture adopted by the diplegic foot is principally due to spasticity of the gastrocnemius and weakness of the peroneals. The equino-varus deformity more commonly seen in the hemiplegic foot is associated with spasticity of tibialis posterior. While still flexible, the deformities of the cerebral palsy foot may be dealt with by a variety of conservative measures including casting, orthotics and botulinum injection. Once established however, bony surgery is required to correct these deformities."
0043152,"Gopal S, Templeton P",(iv) Normal feet referred to an orthopaedic surgeon,Curr Orthop 2002 Apr;16(2):114-9,,"FOOT, GROWTH, ANATOMY","CHILD, GAIT ANALYSIS",,,,0268-0890,,
0043153,Scott BW,(v) Miscellaneous foot problems in childhood,Curr Orthop 2002 Apr;16(2):120-5,,"FOOT DEFORMITIES, ETIOLOGY, PAIN",PEDIATRICS,,,,0268-0890,,
0043154,"Campbell P, McWilliams TG",Periprosthetic femoral fractures,Curr Orthop 2002 Apr;16(2):126-32,,"FEMORAL FRACTURES, ARTHROPLASTY, JOINTS","COMPLICATIONS, TREATMENT OUTCOME, POSTOPERATIVE CARE",,,,0268-0890,AB,"Periprosthetic fractures of the femur are a challenging complication following total joint arthroplasty. They can occur in either the perioperative or postoperative periods and although they are separate entities, the principles on which management decisions are based remain the same. The Vancouver classification system is becoming the most widely accepted for fractures following total hip arthroplasty and that of Lewis and Rorabeck following total knee arthroplasty, although treatment cannot be based on any one classification system alone. The aim is to achieve fracture union around a stable, well-aligned arthroplasty with preserved or restored bone stock and therefore return the patient to their previous level of function. We describe our approach to the management of perioperative and postoperative femoral fractures associated with total joint arthroplasty."
0043155,"McMahon KM, Masters RS",The effects of secondary tasks on implicit motor skill performance,Int J Sport Psychol 2002 Jul-Sep;33(3):307-24,,"PSYCHOMOTOR PERFORMANCE, TASK PERFORMANCE AND ANALYSIS","SPORTS, STRESS MECHANICAL",,,,0047-0767,AB,"Acquiring a skill in an implicit manner is thought to have a number of advantages over acquiring the same skill explicitly. In particular, implicitly learnt skills have been shown to be more durable over time and more robust to the influence of psychological stress. Implicit motor skill learning has been demonstrated on several occasions using a concurrent secondary task to curb explicit rule formation. On each occasion the benefits of learning the skill implicitly have been robustness under psychological stress, with the learners less likely to exhibit skill breakdown. The secondary task employed to curb explicit rule formation has been one that loads on the central executive component of working memory. The primary difficulty with the use of this task has been a consequent decrement in performance as a result of the attentional demands of the central executive task intruding upon the execution of the motor skill. This paper examines whether less intrusive, non-central executive, phonological loop secondary tasks prevent explicit knowledge formation whilst not impacting adversely upon performance of the primary skill. Two experiments were performed, the results of which demonstrate that phonological loop tasks do not prevent explicit knowledge acquisition. This suggest that the phonological loop is not an essential component in the development of explicit knowledge regarding a motor task. The problem of finding a secondary task to block explicit knowledge formation whilst not interfering with motor performance remains."
0043156,"Thomas O, Hanton S, Jones G",An alternative approach to short-form self-report assessment of competitive anxiety: a research note,Int J Sport Psychol 2002 Jul-Sep;33(3):325-36,,"ANXIETY, CLINICAL ASSESSMENT SCALES, EDUCATION","CONSISTENCY AND RELIABILITY, ATHLETES",,,,0047-0767,AB,"This study reports the concurrent validity testing of two short-form competitive state anxiety inventories, an Immediate Anxiety Measurement Scale (IAMS) (newly devised) and the Mental Readiness Form-3 (MRF-3) with the criterion scale, the Competitive State Anxiety Inventory-2 (CSAI-2). Encompassing dimensions of anxiety interpretation (direction), and frequency of cognitive intrusions, the investigation attempted to alleviate the time consuming assessment of anxiety through a 1-week time-to-event paradigm. Following structured education, competitive athletes (N = 82) completed the inventories at five precompetition temporal stages (1-week, 2-days, 1-day, 2-hours and 30-minutes). Relative measurement agreements and change over-time analysis indicated the IAMS displayed stronger validity than the MRF-3 especially at times close to education and competition. Results suggest athletes may be taught to recognize and report the direct constructs and dimensions of anxiety, and that the IAMS may be of use when examining anxiety states both close to and during competition."
0043157,Kennedy J,Strengthen your heart,Nat Health 2002 Oct-Nov;32(8):34,,"TERMINALIA, CARDIOVASCULAR DIS","HERBALISM, TREATMENT OUTCOME, AYURVEDIC MEDICINE",(News),,,1067-9588,AB,The herb arjuna holds promise for those with cardiovascular disease.
0043158,Ress D,Get regular with Triphala,Nat Health 2002 Oct-Nov;32(8):37,,"TERMINALIA, INTESTINAL DIS","HERBALISM, DIET",(News),,,1067-9588,AB,This supplement may relieve constipation and promote bowel health.
0043159,Schaeffer R,"When pregnant, feel good with yoga",Nat Health 2002 Oct-Nov;32(8):52-3,,"YOGA, PREGNANCY, HEALTH PROMOTION","FATIGUE, BLOOD CIRCULATION",,,,1067-9588,AB,These poses keep you comfortable and centered as you prepare for labor and parenthood.
0043160,Ullman D,Sail through surgery,Nat Health 2002 Oct-Nov;32(8):64-71,,"SURGERY OPERATIVE, HOMEOPATHY","INFECTION, PREVENTION",,,,1067-9588,AB,Homeopathy can prevent complications during and after an operation and help you get back on your feet faster.
0043161,Herbst D,Beauty and the beast,Nat Health 2002 Oct-Nov;32(8):72-5,,"PREMENSTRUAL SYNDROME, DIET, LIFE STYLE",AYURVEDIC MEDICINE,,,,1067-9588,AB,Premenstrual syndrome can turn you from nice to not so nice overnight. Reclaim your peace of mind and soothe your body with these remedies.
0043162,Claechman S,The best supplements to relieve joint pain,Nat Health 2002 Oct-Nov;32(8):86-9,,"DIETARY SUPPLEMENTS, JOINTS, PAIN","PREVENTION, TREATMENT OUTCOME",,,,1067-9588,AB,Find out which natural remedies are sure to ease the pain of arthritis.
0043163,Herbert-Ashton MJ,Getting a handle on herbals,RN 2002 Sep;65(9 Supp):16-23,,"HERBALISM, MEDICINE, SAFETY","ADVERSE EFFECTS, DRUG THERAPY",,,,0033-7021,AB,"\"Natural\" doesn't necessarily mean \"safe\" when it comes to herbal products. As the popularity of herbal medicine increases, so does our knowledge of its benefits - and its dangers."
0043164,Mulholland H,A few home truths,Nurs Times 2002 Oct 1;98(40):11,,"HOSPICE CARE, NURSES, ECONOMICS","HEALTH ADMINISTRATION, AGED",,,,0954-7762,AB,"The UK hospice sector is under pressure from an ageing population, poor government funding and difficulty in recruiting and retaining nurses who are worried about job security. The author reports."
0043165,Gillam T,Schizophrenia: care for the 21st century,Nurs Times 2002 Oct 1;98(40):36-7,,"SCHIZOPHRENIA, TREATMENT OUTCOME","DRUG THERAPY, PSYCHOLOGY",,,,0954-7762,AB,"Mental health nurses have had to come to terms with rapid developments in the psychosocial, social and pharmacological treatment of schizophrenia in recent years. This article aims to outline some of these developments, first by considering the growth in what are known as psychosocial interventions and second by reviewing the current status of antipsychotic medication. The principles and efficacy of these two aspects of treatment are discussed."
0043166,Wood S,Special focus: pain. Nursing care and implications for nursing,Nurs Times 2002 Oct 1;98(40):39-42,,"PAIN, PATIENT ASSESSMENT, NURSES ROLE","PROFESSIONAL COMPETENCE, DIAGNOSIS",,,,0954-7762,,
0043167,"Olney M, Strohmer D, Kennedy J",Why research matters: forging a reciprocal relationship between the researcher and the practitioner,Rehabil Counsel Bull 2002 Fall;46(1):2-4,,"RESEARCH DESIGN, JOURNALS",REHABILITATION,(Editorial),,,0034-3552,,
0043168,"Drebing CE, Fleitas R, Moore A, Krebs C, Van Ormer A, Penk W, Seibyl C, Rosenheck R",Patterns in work functioning and vocational rehabilitation associated with coexisting psychiatric and substance use disorders,Rehabil Counsel Bull 2002 Fall;46(1):5-13,,"SUBSTANCE USE DISORDERS, PSYCHOTIC DISORDERS, WORK CAPACITY EVALUATION",REHABILITATION VOCATIONAL,,,,0034-3552,AB,"Archival data from 25,480 adults entering the Compensated Work Therapy (CWT) program of the Veterans Health Administration were analysed to identify differences in work functioning and vocational rehabilitation among participants with psychiatric disorders alone, substance use disorders (SUD) alone, and psychiatric disorders with coexisting SUD. The co-existence of psychiatric disorders and SUD was associated with better work functioning, more participation in vocational rehabilitation, and a better outcome, compared to psychiatric disorders alone. Poorer functioning was seen on all variables relative to participants with SUD alone. These findings are due in part to correlates of substance abuse, but they may suggest that clinicians should focus on work and vocational goals to support other clinical efforts for clients with dual diagnosis."
0043169,"Groomes DA, Leahy MJ","The relationships among the stress appraisal process, coping disposition, and level of acceptance of disability",Rehabil Counsel Bull 2002 Fall;46(1):15-24,,"STRESS PSYCHOLOGICAL, ADAPTATION PSYCHOLOGICAL, DISABILITY, PATIENT ASSESSMENT","QUESTIONNAIRES, REHABILITATION, EDUCATION, RESEARCH",,,,0034-3552,AB,"The transactional theory of stress and coping (Lazarus & Folkman, 1984b) has served as a useful lens for examining the interaction between a person and his or her varying responses to situational demands. Despite this theory's helpful framework for understanding the coping dispositions that follow primary appraisals in the general population, evidence for people with disabilities requires attention. This study examined the relationships among the stress appraisal process, coping disposition, and level of acceptance of disability. One hundred fifty-one people with disabilities were randomly selected and asked to complete four survey questionnaires. Principal components analysis on data collected from the newly developed Stress Appraisal Inventory for Life Situations instrument resulted in five components that became the basis for the stress appraisal process identified in this study. The findings of this study indicate that certain subjective meanings that people with disabilities attribute to stressful situations are related to particular ways of coping and levels of acceptance of disability. Implications for education, practice, and research are provided."
0043170,"Lustig DC, Strauser DR, Rice ND, Rucker TF",The relationship between working alliance and rehabilitation outcomes,Rehabil Counsel Bull 2002 Fall;46(1):25-33,,"COUNSELING, INTERPROFESSIONAL RELATIONS, CAREER CHOICE",REHABILITATION VOCATIONAL,,,,0034-3552,AB,"A key factor in the development of an effective relationship between the client and counselor is the development of a strong working alliance (Bordin, 1979). Although considerable research has investigated the impact of the working alliance on counseling outcomes, no research has investigated the impact of this alliance between rehabilitation counselors and clients within the context of the state-federal rehabilitation system. This study used existing survey data on 2,732 vocational rehabilitation clients during fiscal year 1999-2000. Results indicated that (a) employed clients had a stronger working alliance than unemployed clients, and (b) the working alliance is related to the client's perception of future employment prospects and his or her satisfaction with the current job. Implications for rehabilitation counselors are discussed."
0043171,"Cocco KM, Harper DC",Substance use in people with mental retardation: a missing link in understanding community outcomes?,Rehabil Counsel Bull 2002 Fall;46(1):34-41,,"SUBSTANCE USE DISORDERS, MENTAL RETARDATION","COUNSELING, REHABILITATION",,,,0034-3552,AB,"Substance misuse and abuse are factors frequently contributing to poor outcomes in the general community. The literature in this area currently suggests that people with mental retardation may experience difficulties living in the community, many of which parallel the negative consequences associated with substance misuse and abuse in the general population. Although the link between substance use and misuse with level of functioning for people with mental retardation has not been established, extant data indicate further exploration might be worthwhile. This article critically reviews the available research, identifies areas for further exploration, and offers suggestions for professionals in rehabilitation counseling."
0043172,"Froehlich RJ, Linkowski DC",An assessment of the training needs of state vocational rehabilitation counselors,Rehabil Counsel Bull 2002 Fall;46(1):42-50,,"COUNSELING, EDUCATION, PROFESSIONAL COMPETENCE",REHABILITATION VOCATIONAL,,,,0034-3552,AB,"The primary purpose of this study was to identify the training needs of state vocational rehabilitation counselors. One hundred and sixty-seven vocational rehabilitation counselors completed the Rehabilitation Counseling Knowledge Inventory (Linkowski et al., 1993). The self-reported need for training across 10 components of rehabilitation counseling is described. A secondary purpose was to compare the self-perceived training needs of a sample of state vocational rehabilitation counselors with the self-perceived training needs of certified rehabilitation counselors (CRCs: Szymanski, Linkowski, Leahy, Diamind, & Thoreson, 1993a). The current sample reported significantly higher ratings of the need for training in foundations of rehabilitation, individual counseling and development, and assessment, whereas the CRC sample reported higher needs for training in the area of workers' compensation, employer services, and technology. A third purpose was to evaluate the relationship between counselor demographic variables and training needs. The highest earned degree was a significant predictor of perceived training need in the areas of group and family issues, foundations of rehabilitation, research, and individual counseling and development."
0043173,"Chen LK, Chou YC, Hsu PS, Tsai ST, Hwang SJ, Wu BY, Lin MH, Chen TW",Antibiotic prescription for fever episodes in hospice patients,Support Care Cancer 2002 Oct;10(7):538-41,,"ANTIBIOTICS, FEVER","HOSPICE CARE, PALLIATIVE TREATMENT",,,,0941-4355,AB,"Bacterial infection usually plays an important part in the fever episodes that are common in patients in the hospice palliative care unit. The physicians' attitude to use of antibiotics in such cases is usually complex. We retrospectively studied 535 admissions to a hospice and palliative care unit in a medical center in Taiwan. Ninety-three fever episodes (16.7%) were identified among these admissions, and 79 fever episodes (84.9%) were treated with antibiotics. The Karnofsky performance status (KPS), verbal communication ability (VCA) and Glasgow Coma Scale (GCS) were all significantly compromised in these febrile patients. Although KPS, VCA and GCS were similar among all patients at the date of admission, these parameters became significantly worse in fever episodes that were left untreated than in those treated with antibiotics. Patients without antibiotic treatment showed a shorter mean survival (8.7 +/- 9.9 days vs 14.6 +/- 13.1 days; P = 0.03) and a higher 3-day mortality rate than those patients with antibiotic treatment (50% vs 15.2%; P = 0.015). In conclusion, appropriate antibiotic use may cause fever to subside and thus decrease the fever-related discomfort. Physicians may tend to withhold antibiotic treatment because of the poorer KPS, VCA, and GCS and poorer estimated prognosis of patients at the time of fever."
0043174,"Ashikaga T, Bosompra K, O'Brien P, Nelson L","Use of complimentary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians",Support Care Cancer 2002 Oct;10(7):542-8,,"BREAST NEOPLASMS, PHYSICIAN PATIENT RELATIONS, COMMUNICATION","COMPLEMENTARY THERAPIES, EPIDEMIOLOGY",,,,0941-4355,AB,"This study examined the use of complementary and alternative medicine (CAM) therapies by breast cancer patients and the communication of their CAM use to their physicians relative to lymphedema symptoms and other factors. Breast cancer patients (N = 148) in the State of Vermont were interviewed 2-3 years after their primary surgery using computer-aided telephone interviewing methods. Questionnaire items included demographic information, treatment, CAM use, lymphedema symptoms, and other measures. A large proportion (72.3%) reported using at least one CAM treatment after surgery. The most frequently used treatments were vitamins and nonfood supplements (72.3%), with herbal treatments, meditation, and traditional massage each being reported by about one-fifth of the women. Age, education, adjuvant chemotherapy, and extremity swelling were associated with use of more CAM treatments in a regression model. A large proportion (73.8%) of CAM users reported their CAM use to their physicians. Correlations between patients' income, adjuvant radiation therapy, and adjuvant tamoxifen use with communication of CAM use to their physicians were sought in a logistic regression model. CAM use is high among breast cancer patients in Vermont, and the number of CAM therapies used is related to demographic factors, adjuvant treatment, and lymphedema symptoms. Communication of CAM use to physicians appears to be multifaceted."
0043175,"Goodwin DM, Higginson IJ, Myers K, Douglas HR, Normand CE",What is palliative day care? A patient perspective of five UK services,Support Care Cancer 2002 Oct;10(7):556-62,,"DAY CARE, PATIENT SATISFACTION",PALLIATIVE TREATMENT,,,,0941-4355,AB,"The goals of the work described in this paper were to describe palliative day care from the patient's perspective. Five palliative day care centres in the UK are described. The study subjects were new referrals to the five palliative day care centres, which provided facilities for medical and nursing assessment and also for social and therapeutic activities. This reflects the range of palliative day care services provided in the London region. Three interviews were carried out with each patient over a 3-month period. The descriptive data were examined for content, and the themes were analysed for the frequency of responses within and between interviews. The responses were also examined within three different models of day care (defined by the services). In all, 120 day care patients were recruited from the five centres. Patients attending for day care were mainly white, over 65 years old, retired, and with a cancer diagnosis. These were a representative sample of day care patients in the London region. Patients attended day care to 'meet people' and 'get them out of home' and found the environment 'nice and friendly'. The relationships with the staff and volunteers were also important, and they enjoyed the various activities. At each interview the most important theme identified was 'meeting people'. For this to be supported it would mean encouraging the activities within day care that provide patients with an environment in which they can meet people. This will mean different things to different people, as highlighted in the different philosophies obtained at individual centres."
0043176,"Watt MJ, Heigenhauser GJ, Spriet LL",Intramuscular triacylglycerol utilization in human skeletal muscle during exercise: is there a controversy?,J Appl Physiol 2002 Oct;93(4):1185-95,,"EXERCISE, MUSCLE SKELETAL, ENERGY METABOLISM","FATS, OXYGEN CONSUMPTION",,,,8750-7587,AB,"Intramuscular triacylglyerols (IMTGs) represent a potentially important energy source for contracting human skeletal muscle. Although the majority of evidence from isotope tracer and (1)H-magnetic resonance spectroscopy (MRS) studies demonstrate IMTG utilization during exercise, controversy regarding the importance of IMTG as a metabolic substrate persists. The controversy stems from studies that measure IMTG in skeletal muscle biopsy samples and report no significant net IMTG degradation during prolonged moderate-intensity (55-70% maximal O(2) consumption) exercise lasting 90-120 min. Although postexercise decrements in IMTG levels are often reported from direct muscle measurements, the marked between-biopsy variability (approx.23%) that has been reported with this technique in untrained subjects is larger than the expected decrease in IMTG content, effectively precluding significant findings. In contrast, recent data obtained in endurance-trained subjects demonstrated reduced variability between duplicate biopsies (approx.12%), and significant changes in IMTG were detected after 120 min of moderate-intensity exercise. Therefore, it is our contention that the muscle biopsy, isotope tracer, and (1)H-MRS techniques report significant and energetically important oxidation of free fatty acids derived from IMTGs during prolonged moderate exercise."
0043177,"Aagaard P, Simonsen EB, Andersen JL, Magnusson P, Dyhre-Poulsen P",Increased rate of force development and neural drive of human skeletal muscle following resistance training,J Appl Physiol 2002 Oct;93(4):1318-26,,"RESISTANCE TRAINING, MUSCLE SKELETAL","MUSCLE CONTRACTION, ELECTROMYOGRAPHY",,,,8750-7587,AB,"The maximal rate of rise in muscle force (rate of force development (RFD)) has important functional consequences as it determines the force that can be generated in the early phase of muscle contraction (0-200 ms). The present study examined the effect of resistance training on contractile RFD and efferent motor outflow (\"neural drive\") during maximal muscle contraction. Contractile RFD (slope of force-time curve), impulse (time-integrated force), electromyography (EMG) signal amplitude (mean average voltage), and rate of EMG rise (slope of EMG-time curve) were determined (1-kHz sampling rate) during maximal isometric muscle contraction (quadriceps femoris) in 15 male subjects before and after 14 wk of heavy-resistance strength training (38 sessions). Maximal isometric muscle strength (maximal voluntary contraction (MVC)) increased from 291.1 +/- .8 to 339.0 +/- 10.2 N. m after training. Contractile RFD determined within time intervals of 30, 50, 100, and 200 ms relative to onset of contraction increased from 1,601 +/- 117 to 2,020 +/- 119 (P less than 0.05), 1,802 +/- 121 to 2,201 +/- 106 (P less than 0.01), 1,543 +/- 83 to 1,806 +/- 69 (P less than 0.01), and 1,141 +/- 45 to 1,363 +/- 44 N. m. s(-1) (P less than 0.01), respectively. Corresponding increases were observed in contractile impulse (P less than 0.01-0.05). When normalized relative to MVC, contractile RFD increased 15% after training (at zero to one-sixth MVC; P less than 0.05). Furthermore, muscle EMG increased (P less than 0.01-0.05) 22-143% (mean average voltage) and 41-106% (rate of EMG rise) in the early contraction phase (0-200 ms). In conclusion, increases in explosive muscle strength (contractile RFD and impulse) were observed after heavy-resistance strength training. (ABSTRACT TRUNCATED)."
0043178,Abrandt Dahlgren M,Editorial,Adv Physiother 2002;4(3):97,,"PROFESSIONAL COMPETENCE, TRENDS",PHYSIOTHERAPY,,,,1403-8196,,
0043179,"Berendsen BM, van Meeteren NL, Helders PJ",Towards assessment of "motor intelligence": a kick-off for debate,Adv Physiother 2002;4(3):99-107,,"MOTOR ACTIVITY, LEARNING, PATIENT ASSESSMENT",REHABILITATION,,,,1403-8196,AB,"Motor learning is an important factor in the rehabilitation process. We suggest that measuring the motor learning capacity or \"motor intelligence\" of patients will help rehabilitation professionals to better adapt the intervention to this capacity, leading to a more effective intervention. We explored the use of the concept of motor learning in clinical practice and theory. It turns out that rehabilitation professionals hardly use the concept of motor learning in their interventions, although a lot of highly relevant literature is available on this subject. The development of cognitive intelligence and the intelligence quotient is analysed, because the framework of cognitive intelligence and intelligence tests could help us to operationalize motor intelligence, and, in the long run, to develop a motor intelligence, and in the long run, to develop a motor intelligence test. With this paper, we want to start a discussion on the subject."
0043180,Olsson H,Do we need the concept of motor intelligence?,Adv Physiother 2002;4(3):108-10,,"INTELLIGENCE, MOTOR ACTIVITY",RESEARCH,(Commentary),,,1403-8196,,
0043181,"Peolsson A, Vavruch L, Oberg B",Disability after anterior decompression and fusion for cervical disc disease,Adv Physiother 2002;4(3):111-24,,"NERVOUS SYSTEM DIS, SURGERY OPERATIVE, NECK","REHABILITATION, MAGNETIC RESONANCE IMAGING",,,,1403-8196,AB,"Few prospective studies on outcome have been conducted with respect to disability after anterior cervical decompression and fusion (ACDF), and the need for further rehabilitation after surgery is unknown. Thirty-four patients with cervical disc disease verified by magnetic resonance imaging were included before ACDF with a cervical carbon fibre intervertebral fusion cage. Measurements took place the day before, 6 months and 1 year after surgery, and consisted of both objective and subjective measurements. The results showed a significant improvement from surgery in neck muscle endurance in flexion, neck strength in lateral flexion, some of the pain variables, numbness, neck specific disability, change in general health and symptom satisfaction at the 1-year follow-up. Except for worsening in general health, there were no significant differences between the 6-month and the 1-year follow-up. Despite improvement in several of the variables, about one-third of the patients had deficits in the objective measurements and about two-thirds had deficits in the subjective variables. Only five patients were without neck problems according to average pain, the Neck Disability Index and general health. This suggests that there is still a great need for improvement both of the surgical procedure and the rehabilitation afterwards."
0043182,"Eriksson A, Nordwall V, Kurlberg G, Rydholm H, Eriksson A",Effects of body awareness therapy in patients with irritable bowel syndrome,Adv Physiother 2002;4(3):125-35,,"COLONIC DIS, BODY CONSTITUTION","THERAPY, QUESTIONNAIRES, PHYSIOTHERAPY",,,,1403-8196,AB,"The aim of the present study was to evaluate body awareness therapy (BAT) for treatment of patients with irritable bowel syndrome (IBS) and to compare these patients with apparently healthy persons using physiotherapeutic examinations and questionnaires. IBS patients in this study scored higher for different gastrointestinal and psychological symptoms compared to the healthy control group. They showed disturbed body movement pattern and they had more often a stress pattern in their body. When 16 IBS patients received BAT for 12 weeks the gastrointestinal and psychological symptoms were reduced overall. When divided into groups of predominant symptom, the effect of BAT was more obvious for the group of patients suffering from mainly constipation. The relief of both the somatic discomforts as well as psychological symptoms may indicate that elevated tension constitutes an important part of the underlying causes for clinical expression in the IBS state. It means that an established underlying global stress would worsen the psychosomatic-associated symptoms in the IBS syndrome. If using this psychosomatic view of the patients and treating the state of tension, IBS patients may reduce their gastrointestinal and psychological symptoms. Whether the treatment of an IBS patient can be shortened compared to pharmacological treatment and the relief sustained for longer periods will be addressed in further studies."
0043183,"Kindblom-Rising K, Wahlstrom R, Stenstrom CH",Effects of staff training in natural mobility: a long-term follow-up,Adv Physiother 2002;4(3):136-44,,"ATTITUDE, EDUCATION, HEALTH PERSONNEL","MOVEMENT, METHODS",,,,1403-8196,AB,"The aim of this study was to evaluate the effects of a half-day course in Natural Mobility, which is an interactive instruction method in patient-transfer. A physiotherapist communicates her tacit knowledge to caregivers, who learn how to understand and improve verbal and non-verbal communication to get patients move themselves. Two hundred and twelve caregivers responded to three questionnaires before the course and 4-5 months and one year after the course respectively. The questions ad dressed the number of transfer methods the staff used, whether they changed their use of methods, how the strain of work was affected, and how satisfied they were with their way of assisting patient-transfer. The results showed that sixty-eight percent had changed their use of methods and the change remained one year after the course. The strain experienced was significantly reduced 4-5 months after the course and this reduction was retained one year later. Work satisfaction showed a significant increase; which was retained one year after the course. The changes in working habits were few, but retained, and comments indicated that the treatment of the patients had changed. Natural Mobility training appears to be a useful complement to the patient-transfer methods used today, by involving physiotherapist's tacit knowledge in the training of health care staff."
0043184,"Pierson CM, Randall Curtis J, Patrick DL",A good death: a qualitative study of patients with advanced AIDS,Aids Care 2002 Oct;14(5):587-98,,"HIV INFECTIONS, PATIENT SATISFACTION, DEATH, QUALITY OF HEALTH CARE","SPIRITUALITY, QUALITY OF LIFE",,,,0954-0121,AB,"The objective of this study was to identify and describe the domains that define a 'good' versus 'bad' death from the perspective of patients with advanced AIDS. We analyzed qualitative data from face-to-face interviews with 35 patients with C3 AIDS. An experienced research interviewer asked the patients to describe a good and bad death. Investigators used the principles of grounded theory to analyze the interview transcripts and identify the major domains defining a 'good' versus a 'bad' death. We identified 15 domains, of which 12 were mentioned by at least two participants. The 12 domains include: symptoms, quality of life, people present, dying process, location, a sense of resolution, patient control of treatment, issues of spirituality, death scene, physician-assisted suicide, aspects of medical care, and acceptance of death. Within these, we identified 38 sub-categories representing specific aspects of the domains that shape a 'good' versus 'bad' death for the patients in this study. The identified 12 major domains encompass the major determinants of a 'good' versus 'bad' death from the perspective of patients with advanced AIDS. A better understanding of these domains may enable clinicians to more fully appreciate the experiences of their dying patients and identify ways to improve the care they provide at the end of life."
0043185,De Visser Grierson J,Use of alternative therapies by people living with HIV/AIDS in Australia,Aids Care 2002 Oct;14(5):599-606,,HIV INFECTIONS,"AUSTRALIA, COMPLEMENTARY THERAPIES",,,,0954-0121,AB,"Few studies of use of complementary and alternative medicine (CAM) among people living with HIV/AIDS (PLWHA) have been conducted since combination antiretroviral (ARV) drug therapy became widespread. In the context of changing ARV treatment options, it is important to consider the prevalence and correlates of use of CAM. In this study, a sample of 924 Australian PLWHA completed a self-administered survey that included questions on use of CAM. Half (55%) of the respondents reported using CAM. Most PLWHA did not choose CAM as an alternative to ARV drugs, but use CAM to complement ARV drugs. Use of CAM was not related to measures of progression of HIV/AIDS disease. In contrast, CAM use was related to characteristics of the ways respondents live with HIV/AIDS, and their attitudes toward treatment. The popularity of CAM among PLWHA highlights a need to ensure that PLWHA can make informed choices about CAM use."
0043186,Brown C,Introduction: recovery and wellness: models of hope and empowerment for people with mental illness,Occup Ther Ment Health 2002;17(3-4):1-3,,"MENTAL HEALTH, PATIENT CARE",OCCUPATIONAL THERAPY,,,,0164-212X,,
0043187,Deegan PE,Recovery as a self-directed process of healing and transformation,Occup Ther Ment Health 2001;17(3-4):5-21,,"SCHIZOPHRENIA, SELF CARE, ADAPTATION PSYCHOLOGICAL",TREATMENT OUTCOME,,,,0164-212X,AB,This paper describes a first person account of recovering from schizophrenia. Recovery is described as a transformative process as opposed to merely achieving stabilization or returning to baseline. The self-directed nature of the recovery process is highlighted with suggestions as to how professionals can support recovery.
0043188,Bledsoe C,Unique eyes and different windows of opportunity: the consumer provider perspective,Occup Ther Ment Health 2001;17(3-4):23-42,,"MENTAL HEALTH SERVICES, CONSUMER SATISFACTION, DELIVERY OF HEALTH CARE","TRENDS, TREATMENT OUTCOME",,,,0164-212X,AB,"The writer discusses her personal experiences of being a consumer of mental health services and, at the same time, working as a mental health professional. She includes the challenges and benefits of this experience, as well as the \"sparks, pushes, and bumps\" of this dual role. Also included are current and future trends of mental health recovery, suggested to be the key to wellness for consumers."
0043189,Mack S,Where the rainbow speaks and catches the sun: an occupational therapist discovers her true colors,Occup Ther Ment Health 2001;17(3-4):43-58,,"MENTAL HEALTH, ADAPTATION PSYCHOLOGICAL","CASE REPORT, OCCUPATIONAL THERAPISTS",,,,0164-212X,AB,"Living with a neurobiological brain disorder, c