bluuebunny/crossref_metadata_2025 huggingface dataset:
In vivo cross‐linking of nucleosomal histones catalyzed by nuclear transglutaminase in starfish sperm and its induction by egg jelly triggering the acrosome reaction
Authors: Nunomura Kazuto , Kawakami Satoru , Shimizu Takahiko , Hara Tomohiro , Nakamura Kazuhiro , Terakawa Yudai , Yamasaki Akiko , Ikegami Susumu
Published: August 2003

A histone heterodimer, designated as p28, which contains an Nε(γ‐glutamyl)lysine cross‐link between Gln9 of histone H2B and Lys5 or Lys12 of histone H4, is present in starfish (Asterina pectinifera) sperm. Treatment of sperm nuclei with micrococcal nuclease produced soluble chromatin, which was size‐fractionated by sucrose‐gradient centrifugation to give p28‐containing oligonucleosome and p28‐free mononucleosome fractions, indicating that the cross‐link is internucleosomal. When sperm nuclei were incubated with monodansylcadaverine, a fluorescent amine, in the presence or absence of Ca2+, histone H2B was modified only in the presence of Ca2+. Gln9, in the N‐terminal region, was modified, but the other Gln residues located in the internal region were not, suggesting that the modification takes place on the surface of the nucleosome core by the in situ action of a Ca2+‐dependent nuclear transglutaminase. Treatment of sperm with the egg jelly, which activates Ca2+ influx to induce the acrosome reaction, resulted in a significant elevation of the p28 content in the nucleus. This is the first demonstration of an in vivo activation of transglutaminase leading to the formation of a cross‐link in intracellular proteins.
Dolastatin 15 binds in the vinca domain of tubulin as demonstrated by Hummel–Dreyer chromatography
Authors: Cruz‐Monserrate Zobeida , Mullaney Jeffrey T. , Harran Patrick G. , Pettit George R. , Hamel Ernest
Published: August 2003

The antimitotic depsipeptide dolastatin 15 was radiolabeled with tritium in its amino‐terminal dolavaline residue. Dolastatin 15, although potently cytotoxic, is a relatively weak inhibitor of tubulin assembly and does not inhibit the binding of any other ligand to tubulin. The only methodology found to demonstrate an interaction between the depsipeptide and tubulin was Hummel–Dreyer equilibrium chromatography on Sephadex G‐50 superfine. The average apparent Kd value obtained in these studies was about 30 µm, with no difference observed when column size or tubulin concentration was varied. This relatively high dissociation constant is consistent with the apparent weak interaction of dolastatin 15 with tubulin demonstrated indirectly in the assembly assay. We attempted to gain insight into the binding site for dolastatin 15 on tubulin by studying inhibitory effects of other drugs when the gel filtration column was equilibrated with both [3H]dolastatin 15 and a second, nonradiolabeled drug. No inhibition was detected with either the colchicine site agent combretastatin A‐4 or with an analog of the antimitotic marine peptide diazonamide A (both the analog and diazonamide A are potent inhibitors of tubulin assembly). Weak inhibition was observed with cemadotin, a structural analog of dolastatin 15, and with the depsipeptide cryptophycin 1. Moderate inhibition occurred with vinblastine and vincristine, and strong inhibition with maytansine, halichondrin B, and the peptides dolastatin 10 and phomopsin A. These observations suggest that the binding site(s) for peptide and depsipeptide antimitotic drugs may consist of a series of overlapping domains rather than a well‐defined locus on the surface of β‐tubulin.
Proper targeting and activity of a nonfunctioning thyroid‐stimulating hormone receptor (TSHr) combining an inactivating and activating TSHr mutation in one receptor
Authors: Agretti Patrizia , De Marco Giuseppina , Collecchi Paola , Chiovato Luca , Vitti Paolo , Pinchera Aldo , Tonacchera Massimo
Published: August 2003

Activating mutations of the thyroid‐stimulating hormone receptor (TSHr) have been identified as a cause of toxic adenomas. Germline‐inactivating TSHr mutations have been described as a cause of congenital hypothyroidism. The effects of combining activating and inactivating mutations within a single receptor was studied. The double mutant T477I/P639S contained an activating TSHr mutation (P639S) together with an inactivating one (T477I). The other one (I486M/P639S) contained two activating mutations. Constructs were expressed in COS‐7 cells and basal and TSH‐stimulated cyclic AMP (cAMP) accumulation and inositol phosphate (IP) production were determined. The expression at the cell surface was studied both with binding and fluorescence‐activated cell scanning analysis. Our results show that the effect of combining the two activating mutations is an increase in the constitutive activity only for the cAMP pathway and not for the IP pathway suggesting that different mutations result in receptor conformations with different relative abilities to couple to Gs‐alpha or Gq‐alpha. Surprisingly the double mutant containing the T477I behaves as an activating receptor with constitutive activity both for the cAMP and IP pathways. These data show that an inactive form of the TSHr which is trapped inside a cell after transfection is able to gain the membrane surface when combined with an activated form of the receptor.
Immunohistochemical Localization of Substance P, Calcitonin Gene‐related Peptide, Galanin and Calcium‐Binding Proteins in Trigeminal Ganglia of Goat (Capra hircus)
Authors: Shin N. S. , Lee I.‐S , Yoon Y.‐S , Lee H. S.
Published: September 2003

The objectives of this study was to provide a quantitative analysis of calcium‐binding proteins, calbindin (CB), parvalbumin (PA), substance P (SP), calcitonin gene‐related peptide (CGRP) and galanin (GAL), in trigeminal ganglia of goats, to establish whether they exhibit coexistence relationships between each other, and to examine possible colocalization with SP, CGRP and GAL, which have been well characterized according to their distributions in an abundance of large and/or small neurones. CB (12.78%), PA (31.91%), SP (24.63%), CGRP (44.44%) and GAL (3.29%) immunoreactive (IR) cells were observed. About 38.37, 8.7 and 0.73% of CGRP‐IR neurones in the trigeminal ganglion were also immunoreacted with SP, GAL and CB, respectively. Almost all SP‐IR cells are labelled with CGRP (approximately 92.52%), whereas only 16.02 and 0.44% of SP‐IR neurones colocalized with GAL and CB. Approximately 4.65 and 1.10% of the CB‐IR cells were found to contain CGRP and SP immunoreactivity, respectively. Conversely, no CB‐IR cell exhibited GAL immunoreactivity. In addition, all the GAL‐IR cells showed CGRP and SP immunoreactivity. The number of CB‐, PA‐, SP‐, CGRP‐ and GAL‐IR neurones in goat trigeminal ganglion are abundant than that of other animals. These results elucidate that the goat differs from other mammalian species in the distribution and localization of neurochemical substances in trigeminal ganglia, and suggest that this difference may be relevant to the morphological characteristics of cerebral vasculatures such as epidural rete mirabile of goat.
Arthroconidial formation in Trichophyton raubitschekii
Authors: Gupta A. K. , Ahmad I. , Porretta M. , Summerbell R. C.
Published: September 2003

Arthroconidia produced by dermatophytic fungi are considered to be the primary cause of skin and nail infections in humans and animals. Trichophyton rubrum is currently the most common cause of tinea pedis all over the world. The common form of T. rubrum produces a cottony colony in cultures that is characteristically low in conidia formation. The attempts to produce arthroconidia in T. rubrum have shown little success so far. Recently, Trichophyton raubitschekii, an anthropophilic dermatophyte prevalent in Asia, Africa, and the Mediterranean, has been recognized as a variant of T. rubrum. In cultures, T. raubitschekii is characterized by a granular colony form, and an abundance of both micro‐ and macroconidia. The present study reveals a predominance of arthroconidia in two T. raubitschekii cultures isolated from clinical materials. These isolates were able to maintain arthroconidiation in bimonthly subcultures throughout the entire course of this study. The growth parameters for in vitro cultivation of arthroconidia are described here. Arthroconidia prepared from T. raubitschekii cultures showed greater than 95% germination within 21 h of suspension in phosphate‐buffered saline. The availability of arthroconidia in T. raubitschekii cultures appears to offer a practical means of characterizing infective cells in T. rubrum.
An outbreak of candidemia due to Candida tropicalis in a neonatal intensive care unit
Authors: Chowdhary A. , Becker K. , Fegeler W. , Gugnani H. C. , Kapoor L. , Randhawa V. S. , Mehta G.
Published: September 2003

An outbreak of candidemia due to Candida tropicalis involving 16 neonates (gestational age 28–36 weeks) is reported. All infants had received hyperalimentation and at least one course of antibiotics. The commonest clinical manifestations included episodes of acute respiratory distress and lack of response to antibacterial antibiotic therapy. Candida tropicalis was recovered from blood in all the 16 infants and urine cultures were positive in 14 infants. Environmental sampling yielded C. tropicalis from one each of the blankets and mattresses used for neonates. Four of five urinary tract isolates and both environmental isolates genotyped by arbitrarily primed‐PCR with several random primers were shown to belong to the same genotype.
Intrabronchial lesion due to Cladosporium sphaerospermum in a healthy, non‐asthmatic woman
Authors: Yano S. , Koyabashi K. , Kato K.
Published: September 2003

An intrabronchial lesion caused by to Cladosporium sphaerospermum in a healthy and non‐asthmatic 59‐year‐old woman is reported. Intrabronchial infusion of amphotericin B was repeated three times followed by oral administration of prednisolone and itraconazole. The findings on chest radiographs subsequently improved. The possibility of intrabronchial lesions caused by C. sphaerosporum even in a healthy and non‐asthmatic person is remarkable.
Deep mycosis caused by Trichophyton mentagrophytes in a diabetic patient
Authors: Hohaus K. , Vennewald I. , Wollina U.
Published: September 2003

We report on a 65‐year‐old diabetic patient, who developed a deep fungal infection in the beard region after initial therapy with systemic antibiotics and topical corticosteroids. We were able to isolate Trichophyton mentagrophytes and treated him successfully with terbinafine 250 mg day−1 orally in combination with topical ciclopirox and polyhexanide. In follicular inflammation in diabetics, deep mycosis has to be considered and mycologic diagnostics should be performed before starting any other treatment.
Surgical treatment of tinea capitis in childhood
Authors: Thoma‐Greber E. , Zenker S. , Röcken M. , Wolff H. , Korting H. C.
Published: September 2003

Fungal infections of the scalp can cause kerion, pus‐filled swellings, that may look like bacterial abscesses. We report on two children who underwent incision and drainage of their kerions under local and general anesthesia. This treatment was inappropriate: it carried the risk associated with general anesthesia and surgery without providing the therapeutic chance linked to adequate antimicrobial chemotherapy. We recommend that children who are present at emergency departments with pus‐filled swellings on the scalp should be referred to a dermatology unit where appropriate clinical and laboratory investigations and antifungal treatment can be provided, if considered adequate.
Presence of dermatophytes on the nails of tinea capitis patients. Prospective study in the area of Sfax (Tunisia)
Authors: Cheikhrouhou F. , Makni F. , Sellami H. , Besbes M. , Ayadi A.
Published: September 2003

Between January 1995 and December 2000, 512 cases with mycologically confirmed tinea capitis have been diagnosed in our laboratory. In addition, finger nail samples have been taken from 211 patients out of 512. The culture of the nail samples taken was positive for 80 patients (38%). The isolated dermatophytes were the same in the nails and the scalp. Microsporum canis was isolated in 82% of nail samples. Trichophyton violaceum grew only in 18% and Trichophyton quinckeanum in one case. A T. violaceumonychomycosis was found in two patients with tinea capitis. Twenty‐one cases of tinea were resistant to 6 weeks treatment with griseofulvin. Thirty per cent of them have had fungal elements in nails. Dermatophyte colonization of the nails in tinea patients could be a factor of tinea capitis transmission and could explain some recurrent tinea capitis cases and therapy resistance.
Favus due toTrichophyton mentagrophytesvar.quinckeanum
Authors: Besbes M. , Cheikhrouhou F. , Sellami H. , Makni F. , Bouassida S. , Ayadi A.
Published: September 2003

A case of inflammatory tinea capitis caused byTrichophyton mentagrophytesvar.quinckeanumin a 3‐year‐old Tunisian girl is presented. The disease healed after treatment with griseofulvin for 6 weeks and topical application of econazole.
The yeast species causing fungemia at a university hospital in Riyadh, Saudi Arabia, during a 10‐year period
Authors: Al‐Hedaithy Saleh S. A.
Published: September 2003

This study is a retrospective investigation to determine the species of yeasts causing fungemia in a university hospital in Saudi Arabia during the years 1991–2000. A total of 189 episodes of fungemia were encountered, of which 121 (64%) occurred during 1991–1995, whereas only 68 cases (36%) were found between 1996 and 2000. Overall, 50.3% episodes were due to Candida albicans including five episodes of C. dubliniensis, followed by C. tropicalis (27%), C. parapsilosis (7.9%), C. glabrata (7.4%), C. krusei (3.2%), C. famata (1.0%); 3.2% were due to other species, namely Blastoschizomyces capitatus, Hansenula anomala, Rhodotorula rubra, and Trichosporon beigelii. The percentage of episodes of fungemia caused by C. albicans ranged from 36.4% in 1991 to 71.4% in 2000, revealing an increase in recent years. The incidence of non‐C. albicans fungemia decreased from 63 (33.3%) during the first 5 years (1991–1995) to 31 (16.4%) episodes during the second 5 years. Moreover, no fungemia due to C. glabrata and C. krusei were observed during the last 3 years. Overall, during the years of the study, a decreasing incidence of yeast fungemia was observed. Fungemia occurred more frequently in patients with leukemia (24%), prematurity (16%), postsurgery (10.6%), and lymphoma (9.5%). Patients with respiratory infections and preterm infants more often had C. albicans fungemia, whereas C. tropicalis predominated in patients with hepatic disorders and leukemia. The study reports for the first time the involvement of C. dubliniensis in yeast fungemia occurring in Saudi Arabia.
Isolation and identification of Madurella mycetomatis from two cases of black grain mycetoma in Libya
Authors: Ellabib M. S. , Refaai A. , Khalifa Z. , Kavanagh K.
Published: September 2003

Two cases of mycetoma of the foot caused by Madurella mycetomatis are reported in which identification of the etiologic agents was confirmed by culture. A Libyan male aged 40 years and a Chadian female aged 30 years, exhibited eumycetoma of the foot 1 and 2 years, respectively, after a local injury. The diagnoses were based on the clinical presentation and confirmed by mycologic analysis of the grains and culture isolation of the etiologic agent. Prior to this report M. mycetomatis has not been recorded in Libya as a cause of eumycetoma.
Abbreviated oral itraconazole therapy for tinea corporis and tinea cruris
Authors: Sanmano B. , Hiruma M. , Mizoguchi M. , Ogawa H.
Published: September 2003

The present study was designed to determine the lowest dose of orally administered itraconazole and the shortest duration of therapy necessary for treatment of tinea corporis and tinea cruris. For all patients, the itraconazole dose was 100 mg twice a day immediately after meals. Twenty‐eight patients received itraconazole on days 1 and 8, 12 patients received itraconazole on days 1 and 2, and five patients received itraconazole only on day 1. Clinical and mycological evaluations were performed at baseline and on day 14. Based on the clinical and mycological responses, treatment efficacy was classified as excellent, good, fair, or poor. ‘Excellent’ and ‘good’ responses made up 86% of the first group, 100% of the second group, and 20% of the third group. A comparison of efficacy ratings of the three regimens showed that the patients who received a single 200‐mg dose had a significantly inferior outcome compared with the other two groups. We conclude that an abbreviated oral regimen of itraconazole for treatment of tinea corporis and tinea cruris requires a total dose of at least 400 mg to induce a favorable outcome.
Oropharyngeal carriage of Candida species in HIV‐infected patients in India
Authors: Gugnani H. C. , Becker K. , Fegeler W. , Basu S. , Chattopadhya D. , Baveja U. , Satyanarayana S. , Kalghatgi T. , Murlidhar A.
Published: September 2003

The present investigation represents the first study of oropharyngeal carriage of Candida and other yeasts in HIV‐infected patients in India. One hundred and fifty HIV‐positive patients were investigated by culturing their swish samples on plates of CHROMagar Candida. Ninety‐eight patients (65.3%) were positive for Candida and four (2.7%) were positive for other yeasts. Among them, the first Indian C. dubliniensis isolate has been recovered. Molecular typing of selected C. albicans isolates by AP‐PCR revealed two major genotypes based on the banding patterns. The susceptibilities of 30 Candida isolates to five antifungal agents including the new triazole voriconazole were determined in a micro‐dilution test, according to the NCCLS protocol M 27. All the 22 C. albicans isolates were susceptible to five antimycotic agents (flucytosine, amphotericin B, fluconazole, voriconazole and itraconazole) except one isolate (VPCI‐122), which was resistant to flucytosine (MIC ≥ 64 mg l−1). The azole‐resistant isolates reported here endorse the role of antifungal susceptibility testing whenever antifungal treatment with azoles is planned.
Isolation of dermatophytes and non‐dermatophytic fungi from soil in Nigeria
Authors: Oyeka C. A. , Okoli I.
Published: September 2003

A total of 60 soil samples were collected from Ifite Awka, Nnamdi Azikiwe University and Amawbia, all located in Awka Urban, Anambra State, Nigeria. An additional sample was collected from a household rug‐carpet vacuum cleaner from a house located in Enugu city, Enugu State (a neighbouring state). The 61 samples were investigated for the occurrence of dermatophytic and non‐dermatophytic fungi, using the hair‐bait technique and agar dilution procedure. The medical importance of the isolates in the samples is discussed.
Prevalence and causative agents of superficial mycoses in a textile factory in Adana, Turkey
Authors: Çelik E. , İlkit M. , Tanır F.
Published: September 2003

This study was carried out in a textile factory settled in the city center of Adana, Turkey. The workers were evaluated for the presence of superficial mycoses and the interaction of their working environment or working condition. A total of 431 textile workers were included in the study, with a male to female ratio of 378 (87.7%) to 53 (12.3%) and an age range of 19–52 (mean: 33.7 ± 6.8). Direct examination and/or culture revealed superficial mycoses in 73 (16.9%) workers, among them 56 (76.7%) were classified as dermatophytoses, 8 (11.0%) as Pityriasis versicolor while in nine (12.3%) of the cases, no causative agent could be determined. Trichophyton rubrum (57.1%) and T. mentagrophytes (42.9%) were the two species isolated on culture. This study emphasized that textile workers should be admitted as a risk group for superficial mycoses, especially tinea pedis.
Disseminated paracoccidioidomycosis: correlation between clinical and in vitro resistance to ketoconazole and trimethoprim sulphamethoxazole
Authors: Hahn Rosane Christine , Morato Conceição Yvelise Teresinha , Santos Niriana Lara , Ferreira Jussara Fialho , Hamdan Júnia Soares
Published: September 2003

The present study relates to a case of subacute multifocal paracoccidioidomycosis where the upper intestinal tract is involved. The involvement of the upper digestive tract is uncommon. The recommended therapeutic treatment plans and the difficulty in the treatment of paracoccidioidomycosis are discussed in association with susceptibility tests to antifungal drugs in vitro. This is the first report available in the literature showing, in parallel, clinical and in vitro resistance to ketoconazole and trimethoprim sulphamethoxazole, studied during the course of the disease.
Microbiological study of external otitis in Rosario City, Argentina
Authors: Amigot Susana L. , Gomez C. R. , Luque A. G. , Ebner G.
Published: September 2003

Mycological and/or bacteriological studies were performed on 294 samples isolated from the external auditory control (EAC). It was observed that 185 (81.5%) of the mycological analysis were negative while 42 (18.5%) were positive with the following distribution: 22 Candida (9.7%), 15 Aspergillus (6.5%) and five associations of Aspergillus and Candida (2.2%). The bacteriological studies were negative in 52 cases (23.6%) and the frequency of the bacterial agents (75.5%) isolated were as follows: 41 Pseudomonas aeruginosa (18.6%), 24 Proteus mirabilis (10.9%), 24 Staphylococcus aureus (10.9%), and three associations of Ps. aeruginosa and Pr. mirabilis (1.4%). Pseudomonas aeruginosa, which was the most frequent bacterial species isolated, did not present associations with any fungus.
Antifungal susceptibility testing of Candida albicans by flow cytometry
Authors: Gökahmetoǧlu Selma , Nedret Koç A. , Patiroǧlu T.
Published: September 2003

Antifungal susceptibilities of 28 Candida albicans isolates and two quality control strains to amphotericin B and fluconazole were determined by flow cytometry and microdilution method. Minimum inhibitory concentrations (MICs) obtained by flow cytometry were compared with the results obtained by The National Committee for Clinical Laboratory Standards Subcommittee (NCCLS) broth microdilution method. The agreement of results (within two dilution) obtained was found as 96 and 93% for amphotericin B and fluconazole, respectively. At least 24 h incubation was required for reading the microdilution assays. Four hours of incubation was required for fluconazole, whereas 2‐h incubation was sufficient for amphotericin B to provide MIC by flow cytometry. Results of this study show that flow cytometry provides a rapid and sensitive in vitro method for antifungal susceptibility testing of Candida albicans isolates.
Characteristics of chemotherapy practice in rural and remote area health facilities in Queensland
Authors: McCarthy Alexandra , Hegney Desley , Brown Leisa , Gilbar Peter , Brodribb T. Robert , Swales June
Published: September 2003

Objective: The overall objective of this study was to document the nature of the chemotherapy nursing practice of rural and remote area nurses in Queensland.

Design: A questionnaire survey that elicited descriptive quantitative and qualitative data.

Setting: Forty‐seven rural and remote area health facilities in Queensland involved in the administration of chemotherapy.

Subjects: Sixty‐seven Queensland rural and remote area nurses involved in the administration of cytotoxic drugs.

Main outcome measures: Characteristics of chemotherapy practice including context of practice, amount and type of chemotherapy administered, logistical problems, level of support from referral centres, policies and procedures, safety issues.

Results: The results indicate that the risks to nursing staff and the potential for poor patient outcomes are higher than in specialist chemotherapy facilities. This is largely due to the human and material resource constraints characteristic of rural practice. These include a lack of understanding on the part of metropolitan‐based health departments and the specialist cancer centres that refer patients to rural areas of the constraints that may adversely influence patient outcomes.

Conclusions: It is essential that steps are taken to ensure that rural and remote area cancer patients have equitable access to safe and competent chemotherapy care delivered in their choice of context, and the results of this study provide guidance on ways that this can be achieved.
Towards a health career for rural and remote students: cultural and structural barriers influencing choices
Authors: Durey Angela , McNamara Beverley , Larson Ann
Published: September 2003

Objective: To promote tertiary health careers to rural and remote young people.

Design: Qualitative research using large and small group discussions and semistructured interviews.

Setting: Fifteen secondary schools in rural and remote Western Australia including five senior secondary schools and 10 district high schools.

Subjects: One hundred and twenty students from eight year 10 groups, 35 students from three year 11 groups, 54 students from five year 12 groups, 52 parents, 10 grandparents, 76 teachers and four Aboriginal and Islander Education Officers (AIEO).

Results: Students prefer information about the range of health careers to be delivered interactively. Choices to follow a health career at tertiary level were constrained by structural and cultural issues including geographical isolation, financial cost, stereotyping of health professions, insufficient information about the diversity of health careers, obligation to family, community and place and a devalued rural culture.

Conclusions: The under representation of rural and remote students in health related university courses needs to be addressed by long‐term strategies taking into account both structural and cultural barriers when making career choices. Health policies should include the provision of financial support for rural and remote students and promote a broad range of health careers as challenging and rewarding life choices that offer much needed services to rural communities.

What this paper adds: In 1997, only 19.2% of Australian university students came from rural and remote areas, a figure dramatically below the equity reference point of 28.8% of the population living in rural areas derived from the 1996 census data.1 In 2001, the figure remained steady with 19.1% of rural students attending university.2 These data highlight the need for developing higher education opportunities for all Australians regardless of where they live. However, despite ongoing concern about attracting rural and remote students to health careers, limited success has been achieved to date.

Barriers to students choosing health careers at tertiary level include lack of information about the range of health careers available, the cost of tertiary education for families, social dislocation and a perceived lack of support structure for students at university. These are underpinned by cultural assumptions about gender, occupational roles in rural communities and professed lack of academic ability. Strategies to overcome barriers must be situated within a broad socio‐cultural context to understand the complexity of issues underpinning students’ choices.
Evaluation of the rural South Australian Tri‐division Adolescent Health Project
Authors: Naccarella Lucio
Published: September 2003

ABSTRACT: The Adolescent Health Project (AHP) was a rural pilot project aimed at strengthening the relationship between general practitioners (GPs) and adolescents within three Divisions of general practice. The evaluation assessed the implementation of the AHP model and strategies and their impact.

 The AHP used a centralised management/support and local delivery model. The AHP improved GP relationships and comfort with dealing with young people, and improved GP relationships with school counsellors. Divisional relationships with local schools improved. Students reported increased knowledge about GPs, increased confidence and comfort with accessing GPs.

The AHP delivered a popular project to GPs, GP clinics, schools, school counsellors and students, which built the capacity of divisions, GPs, and schools to improve adolescent health care provision. Further research questions have emerged: What are the patterns of relationships between GPs and adolescents, and between GPs and school counsellors, and what strategies work best to sustain such relationships?
Student attitudes to surgical teaching in provincial hospitals
Authors: Bruening Martin H. , Maddern Guy J.
Published: September 2003

Objective: The ever‐increasing pressure on metropolitan teaching hospitals to rationalise budgets and increase productivity has resulted in a dwindling amount of teaching opportunity for the medical student population. One solution to the problem was to utilise a largely untapped resource in South Australia, namely the provincial hospitals, however, student opinion regarding such a radical change had yet to be determined.

Design: A questionnaire was circulated among an entire year group of medical students who would be undertaking the revised surgical curriculum with rural attachments.

Setting: In October 1997, a decision was made by the Department of Surgery at the University of Adelaide to proceed with optional rural surgical attachments in 1998.

Subjects: The survey was distributed to the 125 members of the 1997 fifth year medical student group.

Results: A total of 92 questionnaires were returned giving a response rate of 75%. Thirty‐nine students ranked a rural term in their top half of preferences, while a further 18 indicated that they would go to a rural centre if they had to.

Conclusion: Despite having little warning of the impending changes to their surgical curriculum, the majority of students who responded to the questionnaire stated that they would be willing to venture to the country locations. Before planning significant changes to an established curriculum, the student group should be consulted to gauge their opinion.

What is already known: Within the medical literature, studies have been performed with regard to student opinions regarding postgraduate internships in rural locations, but to our knowledge, this survey represents the first study into student opinion with particular reference to rural surgical attachments prior to their commencement within a medical school curriculum.

What this study adds: As a result of this study, it can now be concluded that a considerable amount of interest exists within the student population to undertake rural surgical rotations.
Continuum of care and the antenatal record in rural New South Wales
Authors: Patterson Karen , Logan‐Sinclair Patricia
Published: September 2003

Objective: The aim of the study was to determine the effect of the woman held antenatal record card (PNC2) on the continuity of maternity care received when presenting to the acute rural setting for clinical assessment.

Design: Qualitative, open‐ended questionnaires.

Setting: Rural New South Wales public hospital.

Subjects: Maternity consumers, 50 women who were inpatients receiving antenatal or postnatal care between August and October 1998. A stratified sample of healthcare professionals employed by the service, 12 midwives and 13 general practitioners.

Main outcome measure: The self reported use of the antenatal card and the viewed effects of the card on the continuity of healthcare received.

Results: The study identified a significant difference between the responding professionals (93%) positive perception of the effect of the PNC2 on the women's pregnancy continuum of care and the maternity consumer (36%), who felt it bore little impact on their care. The study findings suggested a lack of compliance and standardisation in usage of the antenatal card negated any flow on effects for the women.

Conclusions: The intended purposes of the PNC2 were compromised in this rural setting. The study recommends that stakeholders in rural maternity care be accountable for examining the benefits and barriers of their antenatal practices, that the rural community's expectations of ‘continuity of maternity care’ are sought and that there should be a review of the available models of rural antenatal care.

What is already known: The woman held antenatal record has been reported to be an effective approach for enabling consumers to participate in their maternity care, whilst also address the concerns of continuity, safety and information sharing. This form of medical record has been strongly supported by the National Health and Medical Research Council and NSW Health as a professional and consumer friendly strategy. The usage or the effects of the antenatal record in rural New South Wales settings have yet to be widely evaluated.

What this study adds: The study's questionnaire responses identified that the antenatal record may have met the needs of rural health professionals, however, the maternity care consumers were unaware of these benefits. The study suggests that the antenatal record was operationalised at the discretion and for the convenience of the rural health care professional. Identifying rural communities perceptions of continuity of care and the need to explore models of care that promote continuity in rural areas, where significant findings of the study.
Rural sports and recreational injuries in Australia: what do we know?
Authors: Finch Caroline , Mahoney Mary , Townsend Mardie , Zazryn Tsharni
Published: September 2003

Objective: It is widely recognised that individuals residing in regional or rural areas have poorer health outcomes than those from metropolitan areas. Factors associated with these poorer health outcomes include geographical isolation, population declines, limited health care provision and higher levels of inactivity compared to urban areas. The mental, social and physical health of individuals and communities in rural areas can be improved through active participation in sport and recreation activities. Unfortunately, participation in such activities can potentially lead to injury. There is a suggestion that there is an increased risk of sports injuries in rural areas due to the lack of health professionals and coaching personnel, fewer available volunteers to organise and deliver sport, and the general attitude towards injuries in rural settings.

Results: There is very limited information about the number and types of injuries sustained during participation in sports activities in rural and regional settings. This is largely related to a lack of formal sporting structures and support mechanisms including research funding and trained personnel.

Conclusion: A range of factors need to be implemented to improve safety for sporting and recreational participants in these areas. These include improved monitoring of injury occurrence, stronger promotion of safety initiatives and wider implementation of education strategies.

What is already known: It has been speculated that there is an increased risk of injury during sport in rural areas, compared to metropolitan centres. However, there is very little information about the actual levels of sports injury risk in rural communities.

What this study adds: This review of formal and informal sources has identified significant gaps in our knowledge about sports injuries in rural Australia. It is likely that this lack of information, and the injury risk, is related to a lack of formal sporting structures and support mechanisms in these areas.
Influences on doctors’ prescribing: is geographical remoteness a factor?
Authors: Cutts Christopher , Tett Susan E.
Published: September 2003

Objective: To identify factors influencing the prescribing of medicines by general practitioners in rural and remote Australia.

Design: A qualitative study using a questionnaire to determine attitudes about prescribing, specific prescribing habits and comments on prescribing in ‘rural practice’.

Setting: General practice in rural and remote Queensland.

Subjects: General practitioners practising in rural and remote settings in Queensland (n = 258).

Main outcome measures: The factors perceived to influence the prescribing of medicines by medical practitioners in rural environments.

Results: A 58% response rate (n = 142) was achieved. Most respondents agreed that they prescribe differently in rural compared with city practice. The majority of respondents agreed that their prescribing was influenced by practice location, isolation of patient home location, limited diagnostic testing and increased drug monitoring. Location issues and other issues were more likely to be identified as ‘influential’ by the more isolated practitioners. Factors such as access to continuing medical education and specialists were confirmed as having an influence on prescribing. The prescribing of recently marketed drugs was more likely by doctors practising in less remote rural areas.

Conclusion: Practising in rural and remote locations is perceived to have an effect on prescribing. These influences need to be considered when developing quality use of medicines policies and initiatives for these locations.

What is already known: Anecdotal and audit based studies have shown that rural general practice differs to urban‐based practice in Australia, including some limited data showing some variations in prescribing patterns. No substantiated explanations for these variations have been offered. It is known that interventions to change prescribing behaviour are more likely to be effective if they are perceived as relevant and hence increasing our knowledge of rural doctors’ perceptions of differences in rural practice prescribing is required.

What this study adds: Rural doctors believed that they prescribe differently in rural compared with city practice and they described a range of influences. The more remotely located doctors were more likely to report the ‘rural’ influences on prescribing, however, most results failed to reach statistical significance when compared to the less remotely located doctors. These perceptions should be considered when developing medicines policy and education for rural medical practitioners to ensure it is perceived rurally relevant.
Assessment of handwriting speed and factors influencing written output of university students in examinations
Authors: Summers Janet , Catarro Fatima
Published: September 2003

Limited written output is of concern for students sitting examinations. Referral for assessment often states the problem as poor handwriting speed. This study investigated the ability of a short duration speed test to predict written output under examination conditions, and factors thought to influence written output. The number of words written per minute by 66 second‐year university students was calculated for three writing tasks (Handwriting Speed Test, and two examination papers) and the relationships examined. Data were collected on pencil grasp, legibility, writing style, pain, fatigue and academic ability. The results do not support the use of a short duration speed test to predict written output in an examination (r2 = 0.072). Pencil grasp, pain and academic ability were found to have some association with written output. There is a need to establish normative data for written output in examinations and to further develop assessment techniques.
Illness experience and occupations of people with chronic fatigue syndrome
Authors: Gray Melanie L. , Fossey Ellie M.
Published: September 2003

Chronic fatigue syndrome affects people's physical and cognitive capacities for participation in their occupations, but has received limited consideration by occupational therapists. This qualitative study explores the illness experiences and occupations of five people living with chronic fatigue syndrome. Narrative data were collected using the Occupational Performance History Interview‐II (OPHI‐II). Key aspects of participants’ illness experiences, identified through thematic analysis, were: (i) experiencing and understanding chronic fatigue syndrome; (ii) experiencing different types of fatigue; (iii) ‘an ending and a beginning’; (iv) experiencing doing activities; and (v) doing something towards getting well. These findings reveal participants’ life stories, identities, relationships, and occupations had been dramatically altered. Their implication is that people living with this condition face issues, for which occupational therapy can be of assistance. The efficacy of interventions to enable them to adapt their occupations and rebuild their lives merits further research. The potential usefulness of OPHI‐II for learning about how clients’ occupations are altered by chronic illness in research and practice is illustrated.
Exploring the therapeutic environment for older women with late‐life depression: An examination of the benefits of an activity group for older people suffering from depression
Authors: McWha J. Lindsay , Pachana Nancy A. , Alpass Fiona
Published: September 2003

This study examines a therapeutic activity group that was developed over a period of 4 years by occupational therapists, and includes components of psychosocial treatment. The study was designed to identify the benefits of the group activity for members and to identify whether members’ expectations of attending the group are the same as (or different to) the health professionals’ expectations of the benefits for group members. The Model of Occupational Spin‐off is applied as the theoretical basis for the study. Group members completed a specialised questionnaire and two standard assessments. Health professionals completed a separate, but similar, questionnaire. The results were analysed by using statistical tests and confirmed that the expectations of group members and health professionals are not significantly different.
Parents’ perspectives on feeding medically compromised children: Implications for occupational therapy
Authors: Franklin Lyndal , Rodger Sylvia
Published: September 2003

Managing feeding difficulties in infants and young children with chronic medical conditions can be very stressful for parents. Occupational therapists providing feeding interventions need to be sensitive to the psychological stresses experienced by families as well as the biomedical issues that can contribute to paediatric feeding disorders. Qualitative research, using the phenomenological theory, was conducted with eight families to explore parents’ perceptions of the impact of feeding difficulties on family life. This article reports on preliminary findings, describing factors that contributed to parental stress and factors that influenced their psychological adjustment. A unifying theme emerged drawing together parents’ perceptions of how they had ‘survived’ and coped with chronic stress. Parents attributed satisfaction with medical care, management of nutrition, and support from professionals, partners and family as contributing to their ability to cope and adjust over time. Based on these preliminary findings, recommendations that acknowledge the psychosocial aspects of feeding intervention in occupational therapy practice are discussed, along with recommendations for future research.
Written health education materials: Making them more effective
Authors: Griffin Janelle , McKenna Kryss , Tooth Leigh
Published: September 2003

Clients need high quality information if they are to make informed decisions about their health and to be actively involved in their care. Occupational therapists provide clients with education to equip them to participate in shared decision‐making about their treatment as well to assist them with gaining specific skills and training. One method used to educate clients is to provide information in written form. However, for these materials to be effective, they must be written at a level able to be read and understood by clients. This can only be achieved if due consideration is given to clients’ literacy levels, the readability level of the written information, and the overall design characteristics of the materials. In this paper, we review the literature in these areas and offer some guidelines that will help occupational therapists to provide clients with effective written materials.
Time use, tempo and temporality: Occupational therapy's core business or someone else's business
Authors: Farnworth Louise
Published: September 2003

A primary assumption underlying occupational therapy intervention is that peoples’ use of time, or their participation in activities, is related to their overall well‐being and quality of life. However, the translation of this assumption into occupational therapy practice often is not only invisible, but it is becoming increasingly difficult to sustain in current health care practices. This paper outlines current research and literature related to relationships between peoples’ time use, tempo and temporality, and their well‐being, and will discuss implications for occupational therapy theory, practice and research.
Expression of an active p110 catalytic subunit of phosphatidylinositol 3‐kinase alters the proliferative capacity of interleukin‐2 receptor signals
Authors: Gala Salvador , Schibeci Stephen Donald , Marreiros Alexandra , Calvo Victor , Merida Isabel , Williamson Peter
Published: September 2003

Activation of phosphatidylinositol 3‐kinase (PI3K) is an early and essential step in interleukin‐2 receptor (IL‐2R) signalling, and plays an important role in regulating both cell survival and cellular proliferation. In the present study, we utilized Baf‐B03 cells expressing mutated IL‐2R to examine the contribution of PI3K to proliferative capacity. In this model IL‐2‐mediated induction of the downstream PI3K‐dependent signalling molecule p70 S6 kinase was detected, but there was no proliferative response. Increasing the level of PI3K activity by transfection of an active form of the catalytic subunit, p110∗, enabled the proliferative capacity of the mutated receptor. Whereas, in cells without p110∗, IL‐2 lacked the capacity to induce c‐myc and to overcome an S‐phase checkpoint, S‐phase transition was restored by transfection of p110∗, and this was accompanied by an increase in the c‐myc response. Despite the presence of p110∗, activity cells still required IL‐2R‐derived signals for proliferation, and IL‐2Rβ truncated at amino acid 350 were sufficient to provide this signalling activity. The data support a model in which the level of available PI3K can determine the cellular response to IL‐2.
The latanoprost monotherapy survey in New Zealand, 2000
Authors: Elder Mark , Mora Justin
Published: September 2003

Background: A State subsidy for latanoprost has been recently introduced. It is subject to several conditions including that it should only be used as monotherapy.

Method: A prospective survey of all New Zealand ophthalmologists was undertaken to determine the outcome of the widespread trial of latanoprost monotherapy. The return rate was 82%.

Results: Of 2900 patients on latanoprost nation‐wide, 14.7% were monotherapy failures. Of these, 93% were due to inadequate intraocular pressure control but this subgroup had adequate control on two or more medications in 88%. Ophthalmologists had 635 patients that were not trialed as monotherapy, of which 565 (89%) were due to a perceived risk.

Conclusions: In those patients treated with latanoprost, 85% were adequately controlled as monotherapy.