52 resultados para severity of illness


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The incidence-severity relationship for cashew gummosis, caused by Lasiodiplodia theobromae, was studied to determine the feasibility of using disease incidence to estimate indirectly disease severity in order to establish the potential damage caused by this disease in semiarid north-eastern Brazil. Epidemics were monitored in two cashew orchards, from 1995 to 1998 in an experimental field composed of 28 dwarf clones, and from 2000 to 2002 in a commercial orchard of a single clone. The two sites were located 10 km from each other. Logarithmic transformation achieved the best linear adjustment of incidence and severity data as determined by coefficients of determination for place, age and pooled data. A very high correlation between incidence and severity was found in both fields, with different disease pressures, different cashew genotypes, different ages and at several epidemic stages. Thus, the easily assessed gummosis incidence could be used to estimate gummosis severity levels.

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The effect of root-knot nematode (RKN) (Meloidogyne incognita) on Verticillium dahliae and Fusarium oxysporum f.sp. vasinfectum in cotton (Gossypium hirsutum) was investigated. Two different inoculation methods were used, one in which inoculum was added to the soil, so that nematode and fungal inoculum were in close proximity; the other, inoculation into the stem, whereby the two inocula were spatially separated. Invasion of the roots by RKN enhanced disease severity, as measured by the height of vascular browning in the stem, following inoculation with either wilt pathogen. The effect of RKN on Fusarium wilt was more pronounced than that on Verticillium wilt. Nematode-enhanced infection by F. oxysporum is a well known effect but there are few reports of enhanced infection by Verticillium due to RKN. Relative resistance of a number of cotton cultivars to both wilt diseases, as measured by height of vascular browning, was similar to the known field performance of the cultivars. The use of vascular browning as an estimate of disease severity was therefore validated.

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Background: Severe malarial anaemia is a major complication of malaria infection and is multifactorial resulting from loss of circulating red blood cells (RBCs) from parasite replication, as well as immune-mediated mechanisms. An understanding of the causes of severe malarial anaemia is necessary to develop and implement new therapeutic strategies to tackle this syndrome of malaria infection. Methods: Using analysis of variance, this work investigated whether parasite-destruction of RBCs always accounts for the severity of malarial anaemia during infections of the rodent malaria model Plasmodium chabaudi in mice of a BALB/c background. Differences in anaemia between two different clones of P. chabaudi were also examined. Results: Circulating parasite numbers were not correlated with the severity of anaemia in either BALB/c mice or under more severe conditions of anaemia in BALB/c RAG2 deficient mice (lacking T and B cells). Mice infected with P. chabaudi clone CB suffered more severe anaemia than mice infected with clone AS, but this was not correlated with the number of parasites in the circulation. Instead, the peak percentage of parasitized RBCs was higher in CB-infected animals than in AS-infected animals, and was correlated with the severity of anaemia, suggesting that the availability of uninfected RBCs was impaired in CB-infected animals. Conclusion: This work shows that parasite numbers are a more relevant measure of parasite levels in P. chabaudi infection than % parasitaemia, a measure that does not take anaemia into account. The lack of correlation between parasite numbers and the drop in circulating RBCs in this experimental model of malaria support a role for the host response in the impairment or destruction of uninfected RBC in P. chabaudi infections, and thus development of acute anaemia in this malaria model.

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This review assesses the impacts, both direct and indirect, of man-made changes to the composition of the air over a 200 year period on the severity of arable crop disease epidemics. The review focuses on two well-studied UK arable crops,wheat and oilseed rape, relating these examples to worldwide food security. In wheat, impacts of changes in concentrations of SO2 in air on two septoria diseases are discussed using data obtained from historical crop samples and unpublished experimental work. Changes in SO2 seem to alter septoria disease spectra both through direct effects on infection processes and through indirect effects on soil S status. Work on the oilseed rape diseases phoma stem canker and light leaf spot illustrates indirect impacts of increasing concentrations of greenhouse gases, mediated through climate change. It is projected that, by the 2050s, if diseases are not controlled, climate change will increase yields in Scotland but halve yields in southern England. These projections are discussed in relation to strategies for adaptation to environmental change. Since many strategies take10–15 years to implement, it is important to take appropriate decisions soon. Furthermore, it is essential to make appropriate investment in collation of long-term data, modelling and experimental work to guide such decision-making by industry and government, as a contribution to worldwide food security.

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Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.

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Our understanding of the climate system has been revolutionized recently, by the development of sophisticated computer models. The predictions of such models are used to formulate international protocols, intended to mitigate the severity of global warming and its impacts. Yet, these models are not perfect representations of reality, because they remove from explicit consideration many physical processes which are known to be key aspects of the climate system, but which are too small or fast to be modelled. The purpose of this paper is to give a personal perspective of the current state of knowledge regarding the problem of unresolved scales in climate models. A recent novel solution to the problem is discussed, in which it is proposed, somewhat counter-intuitively, that the performance of models may be improved by adding random noise to represent the unresolved processes.

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An integrated approach to climate change impact assessment is explored by linking established models of regional climate (SDSM), water resources (CATCHMOD) and water quality (INCA) within a single framework. A case study of the River Kennet illustrates how the system can be used to investigate aspects of climate change uncertainty, deployable water resources, and water quality dynamics in upper and lower reaches of the drainage network. The results confirm the large uncertainty in climate change scenarios and freshwater impacts due to the choice of general circulation model (GCM). This uncertainty is shown to be greatest during summer months as evidenced by large variations between GCM-derived projections of future tow river flows, deployable yield from groundwater, severity of nutrient flushing episodes, and Long-term trends in surface water quality. Other impacts arising from agricultural land-use reform or delivery of EU Water Framework Directive objectives under climate change could be evaluated using the same framework. (c) 2006 Elsevier B.V. All rights reserved.

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Previous research has shown that people's evaluations of explanations about medication and their intention to comply with the prescription are detrimentally affected by the inclusion of information about adverse side effects of the medication. The present study (Experiment 1) examined which particular aspects of information about side effects (their number, likelihood of occurrence, or severity) are likely to have the greatest effect on people's satisfaction, perception of risk, and intention to comply, as well as how the information about side effects interacts with information about the severity of the illness for which the medication was prescribed. Across all measures, it was found that manipulations of side effect severity had the greatest impact on people's judgements, followed by manipulations of side effect likelihood and then number. Experiments 2 and 3 examined how the severity of the diagnosed illness and information about negative side effects interact with two other factors suggested by Social Cognition models of health behaviour to affect people's intention to comply: namely, perceived benefit of taking the prescribed drug, and the perceived level of control over preventing or alleviating the side effects. It was found that providing people with a statement about the positive benefit of taking the medication had relatively little effect on judgements, whereas informing them about how to reduce the chances of experiencing the side effects had an overall beneficial effect on ratings.

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Objectives - To assess the general public's interpretation of the verbal descriptors for side effect frequency recommended for use in medicine information leaflets by a European Union (EU) guideline, and to examine the extent to which differences in interpretation affect people's perception of risk and their judgments of intention to comply with the prescribed treatment. Method - Two studies used a controlled empirical methodology in which people were presented with a hypothetical, but realistic, scenario about visiting their general practitioner and being prescribed medication. They were given an explanation that focused on the side effects of the medicine, together with information about the probability of occurrence using either numerical percentages or the corresponding EU verbal descriptors. Interpretation of the descriptors was assessed. In study 2, participants were also required to make various judgments, including risk to health and intention to comply. Key findings - In both studies, use of the EU recommended descriptors led to significant overestimations of the likelihood of particular side effects occurring. Study 2 further showed that the "overestimation" resulted in significantly increased ratings of perceived severity of side effects and risk to health, as well as significantly reduced ratings of intention to comply, compared with those for people who received the probability information in numerical form. Conclusion - While it is recognised that the current findings require replication in a clinical setting, the European and national authorities should suspend the use of the EU recommended terms until further research is available to allow the use of an evidence-based approach.

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This study evaluates computer-generated written explanations about drug prescriptions that are based on an analysis of both patient and doctor informational needs. Three experiments examine the effects of varying the type of information given about the possible side effects of the medication, and the order of information within the explanation. Experiment 1 investigated the effects of these two factors on people's ratings of how good they consider the explanations to be and of their perceived likelihood of taking the medication, as well as on their memory for the information in the explanation. Experiment 2 further examined the effects of varying information about side effects by separating out the contribution of number and severity of side effects. It was found that participants in this study did not “like” explanations that described severe side effects, and also judged that they would be less likely to take the medication if given such explanations. Experiment 3 therefore investigated whether information about severe side effects could be presented in such a way as to increase judgements of how good explanations are thought to be, as well as the perceived likelihood of adherence. The results showed some benefits of providing additional explanatory information.

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BACKGROUND: Resting-state functional magnetic resonance imaging (fMRI) enables investigation of the intrinsic functional organization of the brain. Fractal parameters such as the Hurst exponent, H, describe the complexity of endogenous low-frequency fMRI time series on a continuum from random (H = .5) to ordered (H = 1). Shifts in fractal scaling of physiological time series have been associated with neurological and cardiac conditions. METHODS: Resting-state fMRI time series were recorded in 30 male adults with an autism spectrum condition (ASC) and 33 age- and IQ-matched male volunteers. The Hurst exponent was estimated in the wavelet domain and between-group differences were investigated at global and voxel level and in regions known to be involved in autism. RESULTS: Complex fractal scaling of fMRI time series was found in both groups but globally there was a significant shift to randomness in the ASC (mean H = .758, SD = .045) compared with neurotypical volunteers (mean H = .788, SD = .047). Between-group differences in H, which was always reduced in the ASC group, were seen in most regions previously reported to be involved in autism, including cortical midline structures, medial temporal structures, lateral temporal and parietal structures, insula, amygdala, basal ganglia, thalamus, and inferior frontal gyrus. Severity of autistic symptoms was negatively correlated with H in retrosplenial and right anterior insular cortex. CONCLUSIONS: Autism is associated with a small but significant shift to randomness of endogenous brain oscillations. Complexity measures may provide physiological indicators for autism as they have done for other medical conditions.

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Experiments in controlled environments examined the effects of the timing and severity of drought, and increased temperature, on grain development of Hereward winter wheat. Environmental effects on grain specific weight, protein content, Hagberg Falling Number, SDS-sedimentation volume, and sulphur content were also studied. Drought and increased temperature applied before the end of grain filling shortened the grain filling period and reduced grain yield, mean grain weight and specific weight. Grain filling was most severely affected by drought between days 1-14 after anthesis. Protein content was increased by stresses before the end of grain growth, because nitrogen harvest index was less severely affected than was dry matter harvest index. Hagberg Falling Number was increased to the greatest extent by stresses applied 15-28 days after anthesis. Treatment effects on grain sulphur content were similar to those on protein content, such that N:S ratio was not significantly affected by drought nor temperature stresses. The effects of restricted water on grain yield and quality were linearly related to soil moisture between 44 and about 73% field capacity (FC) from days 15-28. Drought stress (but not temperature stress) before the end of grain filling decreased SDS-sedimentation volume relative to drought applied later. (C) 2003 Elsevier Science Ltd. All rights reserved.

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Root-knot nematode [RKN] (Meloidogyne incognita) can increase the severity of Verticillium (V dahliae) and Fusarium (F oxysporum f.sp. vasinfectum) wilt diseases in cotton (Gossypium hirsutum). This study was conducted to determine some of the physiological responses caused by nematode invasion that might decrease resistance to vascular wilt diseases. The effect of RKN was investigated on spore germination and protein, carbohydrate and peroxidase content in the xylem fluids extracted from nematode-infected plants. Two cotton cultivars were used with different levels of resistance to both of the wilt pathogens. Spore germination was greater in the xylem fluids from nematode-infected plants than from nematode-free plants. The effect on spore germination was greater in the Fusarium-resistant cultivar (51%). Analysis of these fluids showed a decrease in total protein and carbohydrate levels for both wilt-resistant cultivars, and an increase in peroxidase concentration. Fluids from nematode-free plants of the Verticillium-resistant cultivar contained 46% more peroxidase than the Fusarium-resistant cultivar. The results provide further evidence that the effect of RKN on vascular wilt resistance is systemic and not only local. Changes in metabolites in the xylem pass from the root to the stem, accelerating disease development.

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Two models for predicting Septoria tritici on winter wheat (cv. Ri-band) were developed using a program based on an iterative search of correlations between disease severity and weather. Data from four consecutive cropping seasons (1993/94 until 1996/97) at nine sites throughout England were used. A qualitative model predicted the presence or absence of Septoria tritici (at a 5% severity threshold within the top three leaf layers) using winter temperature (January/February) and wind speed to about the first node detectable growth stage. For sites above the disease threshold, a quantitative model predicted severity of Septoria tritici using rainfall during stern elongation. A test statistic was derived to test the validity of the iterative search used to obtain both models. This statistic was used in combination with bootstrap analyses in which the search program was rerun using weather data from previous years, therefore uncorrelated with the disease data, to investigate how likely correlations such as the ones found in our models would have been in the absence of genuine relationships.

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Disease-weather relationships influencing Septoria leaf blotch (SLB) preceding growth stage (GS) 31 were identified using data from 12 sites in the UK covering 8 years. Based on these relationships, an early-warning predictive model for SLB on winter wheat was formulated to predict the occurrence of a damaging epidemic (defined as disease severity of 5% or > 5% on the top three leaf layers). The final model was based on accumulated rain > 3 mm in the 80-day period preceding GS 31 (roughly from early-February to the end of April) and accumulated minimum temperature with a 0A degrees C base in the 50-day period starting from 120 days preceding GS 31 (approximately January and February). The model was validated on an independent data set on which the prediction accuracy was influenced by cultivar resistance. Over all observations, the model had a true positive proportion of 0.61, a true negative proportion of 0.73, a sensitivity of 0.83, and a specificity of 0.18. True negative proportion increased to 0.85 for resistant cultivars and decreased to 0.50 for susceptible cultivars. Potential fungicide savings are most likely to be made with resistant cultivars, but such benefits would need to be identified with an in-depth evaluation.