[Consistency level of pregnancy history of the 1974 WFS data in Korea (author's transl)].
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Abortion, Induced↗
SEARCH · PubMed Health
Results for “Dual Data Collection”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Dual captures of Colorado rodents: implications for transmission of hantaviruses.
We analyzed dual-capture data collected during longitudinal studies monitoring transmission and persistence of Sin Nombre virus in rodents in Colorado. Our data indicate that multiple captures (two or more rodents captured in a single trap) may not be random, as indicated by previous studies, but rather the result of underlying, species-specific social behavior or cohesiveness. In the pairs we captured, most often, rodents were of the same species, were male, and could be recaptured as pairs. Therefore, dual captures of rodents, which are unusual but not rare, tend to occur among certain species, and appear to be nonrandom, group-foraging encounters. These demographic and ecologic characteristics may have implications for the study of the transmission of hantaviruses.
Aging↗
[An essay on birth and death reports (author's transl)].
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Asia↗
Using focus groups to identify clinical learning opportunities for registered nurses.
A series of focus groups was organized at five metropolitan teaching hospitals. Participants were encouraged to identify opportunities for and barriers to learning for registered nurses employed at ward level, and to suggest practical strategies for maximizing clinical learning. The focus groups had a dual purpose: data collection and action learning. The experience of group participation heightened awareness of learning opportunities, increased understanding and tolerance of differing viewpoints and generated commitment to identified strategies to enhance clinical learning.
Education, Nursing, Continuing↗
Identification of dual alpha 4beta1 integrin binding sites within a 38 amino acid domain in the N-terminal thrombin fragment of human osteopontin.
Previous work from our laboratory demonstrates that the alpha(4)beta(1) integrin is an adhesion receptor for OPN and that alpha(4)beta(1) binding site(s) are present in the N-terminal thrombin fragment of osteopontin (OPN) (Bayless, K. J., Meininger, G. A., Scholtz, J. M., and Davis, G. E. (1998) J. Cell Sci. 111, 1165-1174). The work presented here identifies two alpha(4)beta(1) binding sites within a recombinantly produced N-terminal thrombin fragment of human OPN. Initial experiments, using wild-type OPN containing an RGD sequence or an OPN-RGE mutant, showed identical alpha(4)beta(1)-dependent cell adhesive activity. A strategy to localize alpha(4)beta(1) binding sites within the thrombin fragment of osteopontin involved performing a series of truncation analyses. Removal of the last 39 amino acids (130) completely eliminated adhesion, indicating all binding activity was present within that portion of the molecule. Combined mutation and deletion analyses of this region revealed the involvement of dual alpha(4)beta(1) binding sites. Synthetic peptides for both regions in OPN, ELVTDFPTDLPAT (131) and SVVYGLR (162), were found to block alpha(4)beta(1)-dependent adhesion. The first peptide when coupled to Sepharose bound the alpha(4)beta(1) integrin directly whereas a mutated ELVTEFPTELPAT peptide showed a dramatically reduced ability to bind. These data collectively demonstrate that dual alpha(4)beta(1) integrin binding sites are present in a 38 amino acid domain within the N-terminal thrombin fragment of OPN.
Amino Acid Sequence↗
Attentional deficits in stroke patients: a visual dual task experiment.
OBJECTIVE: (1) To compare the performance of subjects who have suffered a single lateralized cortical, ischemic stroke versus controls on measures of attention including a computerized dual visual attentional task to determine if this task is more sensitive for detecting the presence of subtle hemi-inattention compared to traditional attention tasks; (2) to determine if there is evidence of hemi-inattention in persons who completed spontaneous neurological recovery after a cortical, ischemic stroke compared to controls. SUBJECTS: Thirty-six patients (N = 20 Right Hemisphere and N = 16 Left Hemisphere) who had previously undergone stroke rehabilitation and who were at least 1 year poststroke. All patients were currently living in the community. A control group of 20 subjects was recruited from the community. RESULTS: There was no difference in performance between the three groups on gross clinical testing for hemi-inattention, or on the traditional letter-cancellation tasks. All subjects also participated in two computer generated tasks: (1) tracking a moving stimulus and (2) detecting briefly appearing targets. On the single task performance the control group performed significantly better than both cerebrovascular accident (CVA) groups (p < .004), but with no trend for hemi-inattention in any individual group. When the two computer tasks were combined, there was a significant difference in performance between the control group and all stroke subjects (p < .02) for target detection. A fatiguing effect over time was also found in the right CVA group on the dual task. Stroke subjects driving at the time of data collection performed better on the dual attentional task compared to stroke subjects not driving (p = .05). CONCLUSIONS: On single and dual dynamic computerized visual attentional tasks, individuals who have suffered a cortical stroke more than 1 year before testing have significantly impaired attention compared to controls.
Aged↗
Attitudes of AA contact persons toward group participation by persons with a mental illness.
Alcoholics Anonymous groups are underused by persons with the dual diagnoses of mental illness and substance use disorder, and mental health professionals are cautious about referring them to AA because of fears that the AA group will discourage them from taking prescribed medication. The study assessed the attitudes of 125 AA contact persons about the participation of persons with mental illness. The majority had positive attitudes toward such persons, and 93 percent indicated that they should continue taking their medication. Fifty-four percent felt that participation in a group especially for persons with a dual diagnosis would be more desirable than in a traditional AA group. However, such groups are often not available.
Alcoholics Anonymous↗
Characteristics of dual diagnosis patients admitted to an urban, public psychiatric hospital: an examination of individual, social, and community domains.
The study provides descriptive data on a large, diverse sample of dually diagnosed patients from an urban psychiatric inpatient setting, utilizing a comprehensive array of clinical, social and community functioning measures. The intent is to provide more useful and reliable information, particularly concerning African-Americans with a dual diagnosis in the public sector. Over a one year period, all persons admitted to a public psychiatric hospital with a DSM-III-R psychiatric diagnosis and a positive screen for substance abuse problems using clinical and structured measures (n = 486) were interviewed on the Addiction Severity Index (ASI) and other measures to assess community and social functioning, alcohol and drug use, psychiatric problems, and service histories. The majority of participants were found to have serious economic and employment problems, undesirable living arrangements, limited or conflictive family or social relationships, and some record of arrest. The ASI problem areas most to least in need of treatment were: psychiatric, alcohol and drug abuse, employment, family/social, legal, and medical. Substances most often currently abused were alcohol, cocaine, and cannabis; there was a high rate of polydrug abuse. Participants had experienced a median of 3.0 previous psychiatric hospitalizations, fewer outpatient substance abuse treatments, and limited community mental health contact. Some subgroup differences based on gender, age, and race were found which have implications for community treatment planning. The study results document the extreme heterogeneity in the dually diagnosed as well as their multiple treatment needs. To better inform treatment planning, future research on dual diagnosis should attempt to establish meaningful subgroups relevant to service needs and should utilize diverse clinical and functioning measures.
Adult↗
Endothelial expression of vascular cell adhesion molecule-1 correlates with metastatic pattern in spontaneous melanoma.
OBJECTIVE: Adhesive interactions between tumor cell surface receptors and endothelial cell adhesion molecules are thought to contribute to tumor cell arrest and extravasation during hematogenous metastasis. Recent reports suggest that melanoma cell integrin alpha4beta1 (very late antigen-4, VLA-4) interaction with the inducible cell adhesion molecule, vascular cell adhesion molecule-1 (VCAM-1), is critical for tumor cell arrest. However, no information is available regarding microvascular VCAM-1 expression during spontaneous melanoma metastasis. The objectives of this study were to evaluate VCAM-1 expression in pulmonary and extrapulmonary vascular beds during melanoma progression, and to determine whether there is an organ-specific profile for VCAM-1 expression which corresponds with the clinical pattern of melanoma metastasis. METHODS: The dual-radiolabeled monoclonal antibody (mAb) technique for quantification of VCAM-1 in different vascular beds was applied to a physiological model of melanoma (B16-BL6) metastasis. Measurements of VCAM-1 were obtained when primary tumors reached 5 mm in size, and every 7 days following removal of the primary lesion. Histological examinations were performed, and mice were placed into 2 groups, based on the presence (+colonies) or absence (-colonies) of pulmonary metastases. VCAM-1 measurements obtained from several organ systems were then compared between these 2 groups of mice. Localization of VCAM-1 was achieved through immunohistochemical staining of tissues. Plasma collected from each experimental animal, as well as melanoma-conditioned media, was assayed to determine levels of the cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-1alpha (IL-1alpha). RESULTS: Data collected from the dual-radiolabeled mAb technique indicate that 3 weeks following removal of the primary lesion, there is a tendency for VCAM-1 expression to increase in cardiac, hepatic, and cerebral vascular beds. Four weeks following primary resection, when pulmonary metastatic burden was maximal, VCAM-1 was significantly upregulated in each of these vascular beds. Results obtained from the lung indicate that VCAM-1 remains unchanged in pulmonary vessels at all time points examined. Immunohistochemical staining of heart and brain support the radiolabeled mAb measurements, and reveals that these organs exhibit an inflammatory phenotype in mice with heavy pulmonary tumor burden. Furthermore, 25% of these mice had histological evidence of melanoma metastases in heart and brain. Transplantation of liver fragments from mice with advanced pulmonary metastases into subcutaneous tissue of donor mice resulted in the formation of melanotic outgrowths. Plasma levels of the cytokines TNF-alpha and IL-1alpha were negligible in both groups of mice. CONCLUSIONS: Our results indicate that upregulation of VCAM-1 is not a prerequisite for the formation of pulmonary metastases during spontaneous melanoma metastases. However, once lung metastases become well established, organ-specific increases in VCAM-1 expression become apparent. Furthermore, these organ-specific increments in VCAM-1 expression correspond with documented clinical patterns of melanoma metastasis. The enhanced expression of VCAM-1 is independent of systemic levels of TNF-alpha and IL-1alpha, but may be the result of melanoma-induced alterations at the local level, as we found evidence of melanoma cell occupation in heart, brain, and liver in pulmonary metastases-bearing mice.
Animals↗
Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders--findings from the Netherlands Mental Health Survey and Incidence Study.
BACKGROUND: Little is known about the temporal sequencing of psychiatric disorders. The aim of this study was to obtain insight into patterns of co-occurrence of DSM-III-R mood disorders in relation to anxiety and substance use disorders, their temporal sequencing and the sociodemographic and long-term vulnerability predictors of this temporal sequencing. METHODS: Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a psychiatric epidemiological study in a representative sample of 7,076 adults aged 18-64. RESULTS: Of those who had ever experienced a mood disorder, 46 % of males and 57 % of females had a history of anxiety disorders, and 43 % and 15 % of substance use disorders. Mood disorders were associated with all anxiety and substance use disorders, except with alcohol abuse among males. In the majority of anxiety-comorbid cases, the mood disorder arose after the anxiety disorder; the pattern for substance use-comorbid disorders was more variable. Deviation from the usual sequence of major depression and anxiety disorders was more often seen among females, subjects with a higher educational level, subjects who experienced childhood parental divorce, and subjects who experienced childhood emotional neglect. CONCLUSIONS: When comorbid with anxiety disorders, mood disorders clearly tend to be secondary. Few of the studied demographic factors, familial vulnerability factors and childhood life events predict the sequencing of mood disorders in relation to other disorders.
Adolescent↗
Status hearings in drug court: when more is less and less is more.
We examined the effects of increasing the number of times misdemeanor drug court clients appeared before a judge for judicial status hearings. Our previous findings showed no main effect of increased hearings during the first 14 weeks of the program. The present study examined participants' discharge status in the program, and also explored potential interactions between client characteristics and the frequency of judicial status hearings on outcomes. Results revealed no main effects for hearing frequency on graduation status. Drug offenders who satisfied DSM-IV criteria for antisocial personality disorder (APD) achieved more weeks of urinalysis-confirmed drug abstinence when assigned to more frequent judicial status hearings, whereas subjects without APD achieved more abstinence and were more likely to graduate successfully from the program when assigned to less frequent hearings. Additionally, clients with a history of substance abuse treatment achieved more weeks of abstinence when assigned to more frequent hearings. These findings lend useful guidance to drug courts. Status hearings are expensive and time consuming and should be targeted to clients who would benefit most from them.
Adult↗
Self-report and observer measures of substance abuse among homeless mentally ill persons in the cross-section and over time.
The comparability of self-report and observer measures of substance abuse among 118 homeless mentally ill persons was assessed using cross-sectional and longitudinal measures. Possible correlates of nondisclosure were identified from demographic variables and clinical indicators. Lifetime abuse reported at baseline was a sensitive predictor of subsequent abuse behavior in the project, but cross-sectional measures based only on self-report or observer ratings failed to identify many abusers. A total of 17% of the subjects never disclosed abuse that was observed during the project. The level of substance abuse is likely to be severely underestimated among homeless mentally ill persons when only one self-report measure is used at just one point in time. This problem can, however, largely be-overcome by incorporating information from observers and from multiple follow-ups or by focusing on lifetime rather than current abuse. We also conclude that underreporting may bias estimates of some correlates of substance abuse.
Adult↗
Characteristics and six-month outcome of patients who use suicide threats to seek hospital admission.
Retrospective review of patients' charts and other records was used to collect data on diagnoses, psychosocial characteristics, and subsequent suicide attempts of 45 patients who made contingent suicide threats, defined as threatened suicide or exaggerated suicidality reported to increase the likelihood of hospital admission, and 92 suicidal patients who did not make such threats. Patients who made contingent suicide threats were more likely to be substance dependent, antisocial, homeless, unmarried, and in legal difficulty. Subsequent suicide attempts were uncommon in both groups. The authors suggest that hospitalization should not be used as a substitute for social services, substance abuse treatment, and legal assistance for patients who make contingent suicide threats.
Adolescent↗
HIV infection linked to substance use among hospitalized patients with severe mental illness.
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Adult↗
Testing cognitive function in elderly populations: the PROSPER study. PROspective Study of Pravastatin in the Elderly at Risk.
OBJECTIVES: For large scale follow up studies with non-demented patients in which cognition is an endpoint, there is a need for short, inexpensive, sensitive, and reliable neuropsychological tests that are suitable for repeated measurements. The commonly used Mini-Mental-State-Examination fulfils only the first two requirements. METHODS: In the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), 5804 elderly subjects aged 70 to 82 years were examined using a learning test (memory), a coding test (general speed), and a short version of the Stroop test (attention). Data presented here were collected at dual baseline, before randomisation for active treatment. RESULTS: The tests proved to be reliable (with test/retest reliabilities ranging from acceptable (r=0.63) to high (r=0.88) and sensitive to detect small differences in subjects from different age categories. All tests showed significant practice effects: performance increased from the first measurement to the first follow up after two weeks. CONCLUSION: Normative data are provided that can be used for one time neuropsychological testing as well as for assessing individual and group change. Methods for analysing cognitive change are proposed.
Aged↗
The palliative management of fungating malignant wounds.
This study focused on the palliative management of fungating malignant wounds and individual experiences of living with such a wound. Dressings were evaluated for the ability to contain these wounds and reduce their impact on daily life. The project extended to collaboration with industry for the development and evaluation of dressings designed to meet patient needs. A longitudinal multiple case study design was adopted. The methodology evolved through three principal phases: quasi-experimental design; emergent collaborative design; and emergent theory-driven evaluation. The radical departure from the initial approach was in response to the methodological problems encountered in a study of individuals with uncontrolled disease. A non-probability sampling plan was adopted, mainly because of the lack of homogeneity in the patient population; 45 participants were included. The length of time patients remained in the study depended on how long they lived. This ranged from a few days to more than two years. A sampling plan was, however, adopted for the data collection. The study had a dual focus: methodology, and the generation of explanations for dressing performance and the management of fungating wounds. The methodological aspect included development of the Teler system as a method of measuring dressing performance against goals of optimal practice in fungating wound management. The second component was a system of reasoning developed as an analytical strategy for abstracting general issues from individual case study data in order to construct explanations. Theory was used to generalize beyond the individual cases. Two forms of explanation for fungating wound management were constructed. These included explanations of individual experiences of living with such a wound and knowledge of the elements of fungating wound management. The impact on the individual was explained in terms of the stigma attached to public disability and a revulsion in society for uncontrolled body fluids. A pivotal relationship emerged between exudate and other wound management problems, including psychosocial aspects. A final critical explanation was developed for the qualification of the theory of moist wound healing to explain the phenomenon of exudate management in fungating and, possibly, other exuding chronic wounds.
Alginates↗
Dieting to reduce body weight for controlling hypertension in adults.
OBJECTIVES: Evaluate whether weight-loss diets are more effective than regular diets or other antihypertensive therapies in controlling blood pressure and preventing morbidity and mortality in hypertensive adults. SEARCH STRATEGY: MEDLINE and The Cochrane Library were searched through November 1997. Trials known to experts in the field were included through June 1998. SELECTION CRITERIA: For inclusion in the review, trials were required to meet each of the following criteria: 1) randomized controlled trials with one group assigned to a weight-loss diet and the other group assigned to either normal diet or antihypertensive therapy; 2) ambulatory adults with a mean blood pressure of at least 140 mm Hg systolic and/or 90 mm Hg diastolic; 3) active intervention consisting of a calorie-restricted diet intended to produce weight loss (excluded studies simultaneously implementing multiple lifestyle interventions where the effects of weight loss could not be disaggregated); and 4) outcome measures included weight loss and blood pressure. DATA COLLECTION AND ANALYSIS: Studies were dual abstracted by two independent reviewers using a standardized form designed specifically for this review. The primary mode of analysis was qualitative; graphs of effect sizes for individual studies were also used. MAIN RESULTS: Eighteen trials were found. Only one small study of inadequate power reported morbidity and mortality outcomes. None addressed quality of life or general well being issues. In general, participants assigned to weight-reduction groups lost weight compared to control groups. Six trials involving 361 participants assessed a weight-reducing diet versus a normal diet. The data suggested weight loss in the range of 4% to 8% of body weight was associated with a decrease in blood pressure in the range of 3 mm Hg systolic and diastolic. Three trials involving 363 participants assessed a weight-reducing diet versus treatment with antihypertensive medications. These suggested that a stepped-care approach with antihypertensive medications produced greater decreases in blood pressure (in the range of 6/5 mm Hg systolic/diastolic) than did a weight-loss diet. Trials that allowed adjustment of participants' antihypertensive regimens suggested that patients required less intensive antihypertensive drug therapy if they followed a weight-reducing diet. Data was insufficient to determine the relative efficacy of weight-reduction versus changes in sodium or potassium intake or exercise. REVIEWER'S CONCLUSIONS: Weight-reducing diets in overweight hypertensive persons can affect modest weight loss in the range of 3-9% of body weight and are probably associated with modest blood pressure decreases of roughly 3 mm Hg systolic and diastolic. Weight-reducing diets may decrease dosage requirements of persons taking antihypertensive medications.
Adult↗
Bisphosphonates in the prevention and treatment of glucocorticoid-induced osteoporosis.
OBJECTIVE: To summarize the literature concerning the use of bisphosphonates in the prevention and treatment of corticosteroid-induced osteoporosis and make recommendations concerning the proper use of these agents. SEARCH STRATEGIES: We conducted a literature search to identify studies in the English language concerning the use of bisphosphonates in the prevention or treatment of corticosteroid-induced osteoporosis using the MEDLINE, CURRENT CONTENTS, and HEALTHSTAR electronic databases, bibliographies of selected citations, and recent meeting abstracts. SELECTION CRITERIA: We included randomized controlled trials evaluating the use of oral bisphosphonates in adults by central dual X-ray absorptiometry. DATA COLLECTION AND ANALYSIS: We assessed the methodologic quality of the trials using the Jadad criteria. Data were collected concerning bone mineral density (BMD) changes in multiple areas, fracture rates, safety, and tolerability. MAIN RESULTS: Bisphosphonates generally increased BMD at the lumbar spine. Data were less clear concerning changes in the femoral area. Little information exists about the ability of bisphosphonates to reduce fracture risk in patients with corticosteroid-induced osteoporosis. Postmenopausal women seemed to receive the most benefit. CONCLUSIONS: Bisphosphonates significantly increased BMD in patients at risk for corticosteroid-induced bone loss. However, there is a sparsity of data concerning the ability of these agents to affect the clinically important outcome of fracture rate reduction, especially among premenopausal women in whom fractures are rare within the first year or 2 of exposure to corticosteroids. Long-term studies powered to detect fracture risk reduction are needed as well as comparative trials with bisphosphonates and other agents.
Adult↗