Causal attributions, lifestyle change and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the UK

OBJECTIVE We examined and compared the illness beliefs of South Asian and European patients with coronary heart disease (CHD) about causal attributions and lifestyle change. METHODS This was a qualitative study that used framework analysis to examine in-depth interviews. SAMPLE The study comprised 65 subjects (20 Pakistani-Muslim, 13 Indian-Hindu, 12 Indian-Sikh, and 20 Europeans) admitted to one of three UK sites within the previous year with unstable angina or myocardial infarction, or to undergo coronary artery bypass surgery. RESULTS Beliefs about CHD cause varied considerably. Pakistani-Muslim participants were the least likely to report that they knew what had caused their CHD. Stress and lifestyle factors were the most frequently cited causes for CHD irrespective of ethnic grouping, although family history was frequently cited by older European participants. South Asian patients were more likely to stop smoking than their European counterparts but less likely to use audiotape stress-relaxation techniques. South Asian patients found it particularly difficult to make dietary changes. Some female South Asians developed innovative indoor exercise regimens to overcome obstacles to regular exercise. CONCLUSION Misconceptions about the cause of CHD and a lack of understanding about appropriate lifestyle changes were evident across ethnic groups in this study. The provision of information and advice relating to cardiac rehabilitation must be better tailored to the context of the specific needs, beliefs, and circumstances of patients with CHD, regardless of their ethnicity

Blood and milk neutrophil chemiluminescence and viability in primiparous and pluriparous dairy cows during late pregnancy, around parturition and early lactation.

Extensive studies have shown the polymorphonuclear leukocytes (PMN) dysfunction inextricably links to parturition. To investigate the effect of parity on PMN function, phorbol 12-myristate 13-acetate (PMA) stimulated luminol-amplified chemiluminescence (CL) and viability. of blood and milk PMN were investigated in primiparous and pluriparous dairy cows during periparturient period. The CL kinetics of blood and milk PMN and hematological profiles were also, assessed. Milk PMN CL was always lower than blood PMN CL. Blood and milk PMN CL and milk PMN viability were significantly higher in primiparous cows throughout the study. Blood PMN CL in pluriparous cows showed a,sharper decrease. Both in pluriparous and in primiparous cows, minimal blood PMN CL appeared at periparturient day (PPD) 2. After PPD 7, blood PMN CL recovery rate was faster in primiparous cows. Milk PMN CL was minimal at PPD 2. in both groups. Whereas no changes were observed in blood PMN viability, the viability of milk PMN in. primiparous cows was substantially higher than in pluriparous cows. The number of circulating eosinophils and immature neutrophils was substantially higher in primiparous cows throughout the study. The CL kinetics of blood PMN at PPD -2 and 2 and of milk PMN at PPD 2 exhibited different responses to PMA, with higher intensity and durability, peaking and subsiding more slowly in primiparous dairy cows. The pronounced. reduction in PMN CL and viability in milk PMN of pluriparous cows may be involved in the underlying mechanisms that make these animals more susceptible to periparturient infectious diseases

Assessing branching structure for biomass and wood quality estimation using terrestrial laser scanning point clouds

Terrestrial laser scanning (TLS) accompanied by quantitative tree-modeling algorithms can potentially acquire branching data non-destructively from a forest environment and aid the development and calibration of allometric crown biomass and wood quality equations for species and geographical regions with inadequate models. However, TLS's coverage in capturing individual branches still lacks evaluation. We acquired TLS data from 158 Scots pine (Pinus sylvestris L.) trees and investigated the performance of a quantitative branch detection and modeling approach for extracting key branching parameters, namely the number of branches, branch diameter (b(d)) and branch insertion angle (b) in various crown sections. We used manual point cloud measurements as references. The accuracy of quantitative branch detections decreased significantly above the live crown base height, principally due to the increasing scanner distance as opposed to occlusion effects caused by the foliage. b(d) was generally underestimated, when comparing to the manual reference, while b was estimated accurately: tree-specific biases were 0.89cm and 1.98 degrees, respectively. Our results indicate that full branching structure remains challenging to capture by TLS alone. Nevertheless, the retrievable branching parameters are potential inputs into allometric biomass and wood quality equations.Peer reviewe

The effect of a comprehensive lifestyle intervention on cardiovascular risk factors in pharmacologically treated patients with stable cardiovascular disease compared to usual care: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>The additional benefit of lifestyle interventions in patients receiving cardioprotective drug treatment to improve cardiovascular risk profile is not fully established.</p> <p>The objective was to evaluate the effectiveness of a target-driven multidisciplinary structured lifestyle intervention programme of 6 months duration aimed at maximum reduction of cardiovascular risk factors in patients with cardiovascular disease (CVD) compared with usual care.</p> <p>Methods</p> <p>A single centre, two arm, parallel group randomised controlled trial was performed. Patients with stable established CVD and at least one lifestyle-related risk factor were recruited from the vascular and cardiology outpatient departments of the university hospital. Blocked randomisation was used to allocate patients to the intervention (n = 71) or control group (n = 75) using an on-site computer system combined with allocations in computer-generated tables of random numbers kept in a locked computer file. The intervention group received the comprehensive lifestyle intervention offered in a specialised outpatient clinic in addition to usual care. The control group continued to receive usual care. Outcome measures were the lifestyle-related cardiovascular risk factors: smoking, physical activity, physical fitness, diet, blood pressure, plasma total/HDL/LDL cholesterol concentrations, BMI, waist circumference, and changes in medication.</p> <p>Results</p> <p>The intervention led to increased physical activity/fitness levels and an improved cardiovascular risk factor profile (reduced BMI and waist circumference). In this setting, cardiovascular risk management for blood pressure and lipid levels by prophylactic treatment for CVD in usual care was already close to optimal as reflected in baseline levels. There was no significant improvement in any other risk factor.</p> <p>Conclusions</p> <p>Even in CVD patients receiving good clinical care and using cardioprotective drug treatment, a comprehensive lifestyle intervention had a beneficial effect on some cardiovascular risk factors. In the present era of cardiovascular therapy and with the increasing numbers of overweight and physically inactive patients, this study confirms the importance of risk factor control through lifestyle modification as a supplement to more intensified drug treatment in patients with CVD.</p> <p>Trial registration</p> <p>ISRCTN69776211 at <url>http://www.controlled-trials.com</url></p

Revealing Changes in the Stem Form and Volume Allocation in Diverse Boreal Forests Using Two-Date Terrestrial Laser Scanning

Tree growth is a multidimensional process that is affected by several factors. There is a continuous demand for improved information on tree growth and the ecological traits controlling it. This study aims at providing new approaches to improve ecological understanding of tree growth by the means of terrestrial laser scanning (TLS). Changes in tree stem form and stem volume allocation were investigated during a five-year monitoring period. In total, a selection of attributes from 736 trees from 37 sample plots representing different forest structures were extracted from taper curves derived from two-date TLS point clouds. The results of this study showed the capability of point cloud-based methods in detecting changes in the stem form and volume allocation. In addition, the results showed a significant difference between different forest structures in how relative stem volume and logwood volume increased during the monitoring period. Along with contributing to providing more accurate information for monitoring purposes in general, the findings of this study showed the ability and many possibilities of point cloud-based method to characterize changes in living organisms in particular, which further promote the feasibility of using point clouds as an observation method also in ecological studies.Peer reviewe

Assessing log geometry and wood quality in standing timber using terrestrial laser-scanning point clouds

Wood procurement in sawmills could be improved by resolving detailed three-dimensional stem geometry references from standing timber. This could be achieved, using the increasingly available terrestrial point clouds from various sources. Here, we collected terrestrial laser-scanning (TLS) data from 52 Scots pines (Pinus sylvestris L.) with the purpose of evaluating the accuracy of the log geometry and analysing its relationship with wood quality. For reference, the log-specific top-end diameter, volume, tapering, sweep, basic density and knottiness were measured in a sawmill. We produced stem models from the TLS data and bucked them into logs similar to those measured in the sawmill. In comparison to the sawmill data, the log-specific TLS-based top-end diameter, volume, taper and sweep estimates showed relative mean differences of 1.6, -2.4, -3.0 and 78 per cent, respectively. The correlation coefficients between increasing taper and decreasing wood density and whorl-to-whorl distances were 0.49 and -0.51, respectively. Although the stem-model geometry was resolved from the point clouds with similar accuracy to that at the sawmills, the remaining uncertainty in defining the sweep and linking the wood quality with stem geometry may currently limit the method's feasibilities. Instead of static TLS, mobile platforms would likely be more suitable for operational point cloud data acquisition.Peer reviewe

Hyperinsulinaemia as long-term predictor of death and ischaemic heart disease in nondiabetic men: The Malmö Preventive Project.

Objectives. Prospective studies have indicated that hyperinsulinaemia/insulin resistance is a risk factor for ischaemic heart disease (IHD), the risk decreasing with time of follow-up. Few studies have so far investigated the role of hyperinsulinaemia in the prediction of long-term total mortality. Setting. Section of Preventive Medicine, Department of Medicine, University Hospital, Malmö, Sweden. Subjects. A total of 6074 nondiabetic, middle-aged, healthy Swedish males. Screening examination. We determined IHD risk factors including blood glucose and plasma insulin before and 2 h after an oral glucose tolerance test (OGTT). Total follow-up time was 19 years. Hyperinsulinaemia was defined as values above the 10th decentile of fasting or 2 h insulin concentration. Main outcome measures. Total mortality and cardiac event (CE) rate for IHD. Results. Unadjusted relative risks (RRs) for both death and CE were J-shaped with the highest relative risk (RR: 1.4-1.6) in the hyperinsulinaemic group compared with all other men. The RRs for death and CE were significant for fasting insulin but became nonsignificant after adjustment for other risk factors and also with a longer follow-up. The risk of death in hyperinsulinaemic men, defined on the basis of 2-h insulin level, increased with time of follow-up and was still significantly increased after 19 years [RR: 1.32 (95% CI: 1.05-1.65], even after adjustment for other risk factors. Conclusions. Fasting hyperinsulinaemia was a predictor of total mortality and IHD in nondiabetic men, although not more significantly after adjustment for other risk factors and with lengthening of follow-up time. The 2-h postglucose hyperinsulinaemia appeared to be a stronger and independent predictor of mortality over long-term follow-up. These findings support the view that insulin resistance with associated cluster of risk factors predicts increased long-term risk of mortality and IHD