Avian influenza risk perception, Europe and Asia

During autumn 2005, we conducted 3,436 interviews in European and Asian countries. We found risk perceptions of avian influenza to be at an intermediate level and beliefs of efficacy to be slightly lower. Risk perceptions were higher in Europe than in Asia; efficacy [corrected] beliefs were lower in Europe than in Asia.     

Radiographic progression is getting milder in patients with early rheumatoid arthritis. Results of 3 cohorts over 5 years

OBJECTIVE: There is a common impression, rarely documented, that the outlook of patients with rheumatoid arthritis (RA) is different today compared to previous decades. We investigated the 5-year radiographic progression of 3 cohorts of patients with early RA enrolled in the 1980s and 1990s. METHODS: Patients with early RA were enrolled into 3 separate studies in 1983-85 (n = 58; Cohort A), 1988-89 (n = 77; Cohort B), and 1995-96 (n = 62; Cohort C) at one rheumatology center; all were subsequently treated actively with disease-modifying antirheumatic drugs according to the "sawtooth strategy" to control inflammation, and monitored regularly to collect data for evaluation of longterm outcome. Evaluation over 5 years included disease activity measures and medications. Radiographs of hands and feet taken at baseline and at 2 and 5 years were analyzed by Larsen score (0-100). RESULTS: Larsen score increased by a median of 12, 6, and 4 points by Year 5 in cohorts A, B, and C, respectively (p = 0.001), adjusted for age, sex, rheumatoid factor (+/-), and the baseline values for Larsen score and erythrocyte sedimentation rate. RF positivity and persistent high disease activity over 5 years were associated with greater progression of radiographic damage. CONCLUSION: Radiographic progression was greatest in the earliest cohort and mildest in the most recent cohort, a phenomenon that was also seen in the literature review. The reasons for the observation may include (1) improved therapy, (2) milder disease, and (3) patient selection.     

Acute central nervous system toxicity during treatment of pediatric acute lymphoblastic leukemia: phenotypes,risk factors and genotypes

Central nervous system (CNS) toxicity is common at diagnosis and during treatment of pediatric acute lymphoblastic leukemia (ALL). We studied CNS toxicity in 1,464 children aged 1.0–17.9 years, diagnosed with ALL and treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol. Genome-wide association studies, and a candidate single-nucleotide polymorphism (SNP; n=19) study were performed in 1,166 patients. Findings were validated in an independent Australian cohort of children with ALL (n=797) in whom two phenotypes were evaluated: diverse CNS toxicities (n=103) and methotrexate-related CNS toxicity (n=48). In total, 135/1,464 (9.2%) patients experienced CNS toxicity for a cumulative incidence of 8.7% (95% confidence interval: 7.31–10.20) at 12 months from diagnosis. Patients aged ≥10 years had a higher risk of CNS toxicity than had younger patients (16.3% vs. 7.4%; P<0.001). The most common CNS toxicities were posterior reversible encephalopathy syndrome (n=52, 43 with seizures), sinus venous thrombosis (n=28, 9 with seizures), and isolated seizures (n=16). The most significant SNP identified by the genome-wide association studies did not reach genomic significance (lowest P-value: 1.11x10^-6), but several were annotated in genes regulating neuronal functions. In candidate SNP analysis, ATXN1 rs68082256, related to epilepsy, was associated with seizures in patients <10 years (P=0.01). ATXN1 rs68082256 was validated in the Australian cohort with diverse CNS toxicities (P=0.04). The role of ATXN1 as well as the novel SNP in neurotoxicity in pediatric ALL should be further explored.     

Infants sleeping outdoors in a northern winter climate: skin temperature and duration of sleep

Aim: The aim of the study is to describe the relationships among thermal environment, skin temperatures and infants’ daytime outdoor sleep duration in northern winter conditions. Methods: This study is a cross‐over observational study. Skin temperatures of three‐month‐old infants were recorded from seven skin sites continuously throughout outdoor (n = 34) and indoor sleep (n = 33) in the families’ homes. The duration of the sleep was observed, and temperature and the air velocity of the environment were recorded. Results: Skin temperatures increased towards the end of indoor sleeping, whereas they decreased during outdoor sleeping. The cooling rate of mean skin temperature (T_sk) increased in lower outdoor temperatures (r_s = 0.628, p < 0.001) in spite of increased clothing. On some occasions, cold extremities were observed, suggesting slight deviations from thermoneutrality. Sleep time was 92 min longer in outdoors than in indoors. However, outdoor sleep duration was shortened when the cooling rate of T_sk increased (r_s = 0.611, p < 0.001). Conclusion: The longest sleep was recorded outdoors when the cooling rate of T_sk was minimal. Restriction of movements by clothing probably increases the length of sleep, and a cold environment makes swaddling possible without overheating. A decrease in ambient temperature increased the cooling rate, suggesting that the cold protection of the clothing compensated only partly for the increased heat loss.     

Promoting participation of informal caregivers in the hospital care of the elderly patient: informal caregivers' perceptions

A study to identify informal caregivers' perceptions of factors promoting or inhibiting their participation in the care of elderly patients was conducted An open-ended questionnaire was completed by 369 informal caregivers during 2-month periods in late 1991,1992 and 1993 Several factors related to the patient, informal caregiver, nurse and environment were identified The findings and implications for nursing are discussed The data presented here are from a larger study which is reported in earlier issues of the Journal of Advanced Nursing     

Humour in nursing care

Humour is an integral part of everyday life and therefore also a component of the care and treatment of patients in the modern health care system This paper looks at the role of humour in practical nursing in the light of earlier research literature on the subject It also describes some preliminary results of our studies on the meaning of humour to professional nurses We opted to use a qualitative approach in this study because the focus of interest was on an issue that has received only little attention in earlier research Nurses were presented with a set of unstructured, open-ended questions requiring short, essay-type answers The data obtained were analysed using the qualitative method of content analysis In the light of our findings here, humour can be described as a joie de vivre which is manifested in human interaction in the form of fun, jocularity and laughter Humour is a meaningful factor, both with regard to the patient's well-being and to coping, and also with regard to the interaction of nurse and patient Humour also allows for more job satisfaction and better motivation Research should be continued and intensified into the role and use of humour in everyday life and particularly in nursing care     

Dental caries and mutans streptococci in relation to plasma ascorbic acid

Ascorbic acid (AA) affects in vitro growth of bacteria and may also act in vivo to decrease caries activity. The aim of this study was to evaluate the possible association of AA level in plasma with number of caries lesions, relative numbers of some species of oral cariogenic flora, and rate of salivary secretion. The caries status and some bacteriologic variables of dentulous adult subjects with a low level of AA in the plasma (≤25 μmol/1; n =75) were compared with those of controls (plasma level ≥50 μmol/1; n =75) matched for age, sex, and number of teeth. For each subject, site-specific recordings of the presence or absence of plaque, dental caries, fillings, and erosions were recorded clinically by the same dentist in a double-blind system. The amounts of visible plaque and numbers of decayed tooth surfaces were significantly higher in the low AA group than in the controls. No between-group differences were found in the number of fillings and the amount of oral bacterial growth. The frequencies of consumption of vegetables, berries, and other fruit were significantly lower in the low AA group than in the controls.     

Self polycondensation of oxalohydrazide, 2. Studies on the synthesis of poly(hydrazooxalyl)

A series of poly(hydrazooxalyl)s ( 2 ) is prepared by self polycondensation of oxalohydrazide ( 1a ) and by polycondensation of various derivatives of oxalic acid with 1a or hydrazine hydrate under a variety of reaction conditions. The molecular weights of the polymers were found to remain low. IR spectroscopy, X-ray diffraction, and thermogravimetry were used to study the structure and thermal properties of the prepared polymers. The structure and properties of the polymers were found to depend largely on the monomers and the reaction conditions used in the synthesis, most polymers being partially cyclodehydrated and semicrystalline. 2 seems to possess an extended planar zigzag chain conformation similar to that of polyamides of aliphatic acids, although several crystalline modifications were observed for this polymer. It could also be enolized with strong bases and behaves like a polyelectrolyte in aqueous base solutions.