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Objective: A systematic review was carried out to determine the evidence for teaching pursed lips breathing (PLB) to patients with stable chronic obstructive pulmonary disease (COPD). Exertional dyspnoea is the single most important factor limiting function for people with COPD and PLB is commonly advocated for its management. Method: A literature search of Medline, PEDro and CINAHL Plus was conducted. Articles were included if they studied the effects of PLB in stable COPD and excluded when proxy interventions or significant modifications of PLB were used. Where comparable data were available they were pooled using weighted means. Results: Eleven studies involving 226 participants were included; four of the studies were of moderate quality according to the grading of recommendations assessments, development and evaluation (GRADE) system; the remaining studies were of low quality. Although no high quality evidence was identified, the direction of effect for PLB was consistently towards benefit, with the exception of one low quality study. Moderate quality evidence demonstrates that in stable COPD pursed lips breathing increases oxygen saturation and tidal volume, reduces respiratory rate at rest and reduces time taken to recover to pre-exercise breathlessness levels. One RCT showed reduction in exertional dyspnoea and improvement in functional performance at 3 months. Additionally, the evidence suggests that not all patients with COPD respond equally to PLB: those with moderate to severe COPD are most likely to benefit. Conclusion: High quality studies are required to identify PLB responders from non-responders and to determine whether short-term effects translate into clinically significant benefit. [ABSTRACT FROM AUTHOR]

Aims: To establish the causes and circumstances of all deaths occurring at work or related to work among fishermen in British commercial fishing between 1976 and 1995. Methods: A retrospective study, based on official mortality files, with a population of 440 355 fishermen-years at risk. Results: Of 616 deaths in British fishing, 454 (74%) were due to accidents at work, and 394 (87%) of these fishermen drowned. A total of 270 accidents were caused by casualties to vessels and 184 by personal accidents. There was no significant decline in the fatal accident rate, 103.1 per 100 000 fishermen-years, between 1976 and 1995. The fatal accident rate was 52.4 times higher (95% CI 42.9 to 63.8) than for all workers in Great Britain during the same period, and this relative risk increased through the 1980s up to 76.6 during 1991-95. Relative risks with the construction (12.3) and manufacturing (46.0) industries were higher than 5 and 20 respectively, during 1959-68. Trawlers foundering in adverse weather was the most frequent cause of mortality from casualties to vessels (115 deaths), and 82 of 145 personal accidents at sea arose during operations involving trawling nets. Conclusions: When compared with shore based industries, fishing remains at least as hazardous as before. Prevention should be aimed, most importantly, at the unnecessary operation of small vessels and trawling net manoeuvres in hazardous weather and sea conditions. Other measures should focus on preventing falls overboard, reducing fatigue, a more widespread use of personal flotation devices, and improvements in weather forecast evaluation. [ABSTRACT FROM AUTHOR]

Focuses on a quantitative polymerase chain reaction (PWACR) method for determining copy number within the Prader-Willi/Angelman syndrome critical region. Methods that are available for the diagnosis of Prader-Willi syndrome; Ability of the method to distinguish patients with deletions, disomy and additional copies of PWACR.

BACKGROUND: Data on long-term trends in mortality are generally unavailable for multiple-cause coding of deaths. We wanted to know whether multiple-cause coding of deaths for myocardial infarction contributes much to the interpretation of death certificate data on mortality rates for this condition. METHODS: We analysed all causes of death on death certificates in the former Oxford health service region from 1979 to 1998. RESULTS: Of 69,333 death certificates that included myocardial infarction as a cause of death, it was the underlying cause of death in 93.6 per cent. The ratio of 'mentions' to 'underlying cause' was broadly similar over the study period, during which time there were substantial falls in mortality rates. There were significant changes to the ratios, associated with timing of changes to coding rules; but their effects were small. The ratio of mentions to underlying cause was similar in men and women and in different age groups. CONCLUSION: The underlying cause of death was a robust and almost complete measure of certified deaths for myocardial infarction. [ABSTRACT FROM AUTHOR]