bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of variability and reliability of manual and automated blood pressure readings
Authors: Skirton Heather , Chamberlain Wendy , Lawson Caroline , Ryan Helen , Young Emma
Published: February 2011

Aims and objectives.  To compare the accuracy and appropriateness of auscultatory (manual) and oscillometric (automated) devices for measuring blood pressure in clinical settings.

Background.  Accurate measurement of blood pressure is integral to early recognition of deterioration in the condition of a patient. Despite recommendations regarding the use of auscultatory devices in situations where treatment decisions are made dependent on blood readings, the use of automated machines is becoming common practice.

Design.  Systematic review.

Methods.  A search of the Medline, CINAHLPlus and The Cochrane Library databases was undertaken for papers published in English between January 1997–May 2009. Sixteen studies were identified that fulfilled the inclusion criteria. After quality assessment, all were included in the review. Results are presented in tabular and narrative form.

Results.  In 10 of the studies reviewed, the authors came to the conclusion that oscillometric devices were less accurate than auscultatory devices. However, in most cases the oscillometric device appears sufficiently accurate for clinical use, the exceptions being use with hypertensive patients, patients with arrhythmia and after trauma. Only two studies assessed the comparative accuracy of aneroid devices, and these indicated that they were more accurate than oscillometric devices, but the differences were not clinically important.

Conclusions.  There are situations where the substitution of oscillometric for auscultatory devices could have particularly serious repercussions for the patient, such as when the patient is either hypertensive or hypotensive. However, further research is required on the use of aneroid sphygmomanometers as a replacement for mercury devices.

Relevance to clinical practice.  Practitioners should be made aware of the need to use auscultatory devices in specific circumstances, such as in management of hypertension, after the patient has experienced trauma or where there is significant potential for deterioration in the patient’s condition.
Biopsychosocial risk factors for preterm birth and postpartum emotional well‐being: a case–control study on Turkish women without chronic illnesses
Authors: Gungor Ilkay , Oskay Umran , Beji Nezihe Kizilkaya
Published: February 2011

Aims and objectives.  The study aimed to determine bio‐psycho‐social risk factors for preterm birth in a sample of Turkish women without chronic illnesses and evaluate their anxiety and depression in early postpartum period.

Background.  Preterm birth is a devastating event with long‐term health and social implications. Studies have identified several risk factors; however, the contribution of these causes differs by ethnic groups.

Design.  This case–control study was conducted in a tertiary hospital in Istanbul over one year. In total, 149 preterm mothers were included in the case group and 150 term mothers who delivered in the same day with a case group woman were included in the control group. Chronic illnesses and anomalies were excluded.

Method.  Data were gathered using a form that addressed risk factors for preterm birth. Multidimensional Scale of Perceived Social Support, Beck Depression Inventory and Spielberger’s State‐Trait Anxiety Inventory were administered within 24–72 hours after birth.

Results.  Logistic regression analysis revealed that partner’s lower education (≤8 years), history of preterm birth, antenatal hospitalisation, genitourinary infection and irregular prenatal care were significant risk factors. Perceived social support from family and friends were significantly lower in preterm group. Preterm mothers experienced significantly more anxiety and depressive symptoms in early postpartum.

Conclusion.  Many of the socio‐economical and obstetric causes of preterm births were similar to other countries with higher preterm birth rates. Preterm births were associated with lower social support along with more anxiety and depressive symptoms in early postpartum.

Relevance to clinical practice.  Women who have established risk factors can be targeted for more intensive antenatal care for the prevention of preterm birth. Increased maternal anxiety and depression reveal the necessity of emotional support immediately after birth.
Difficulties in the daily life of patients with osteoarthritis of the knee: scale development and descriptive study
Authors: Tanimura Chika , Morimoto Michiko , Hiramatsu Kimiko , Hagino Hiroshi
Published: February 2011

Aim.  The aim of this study was to develop an instrument to assess difficulties in daily life experienced by patients with osteoarthritis of the knee and to investigate factors influencing difficulties in daily life.

Background.  Osteoarthritis of the knee is commonly associated with clinical symptoms and disabilities. No scale has been available to assess the comprehensive and subjective difficulties felt in daily life by patients affected in social and cultural lifestyle. Therefore, little is known about difficulties in osteoarthritis of the knee patients and supportive care necessary for them.

Design.  A scale development and descriptive study.

Methods.  The participants consisted of 362 patients with osteoarthritis of the knee. The scale development involved several phases including item development, reliability testing, criterion‐related validity testing and construct validity testing.

Results.  The exploratory factor analysis included three domains: ‘suffering in social life’, ‘hardship in activities in daily life’ and ‘apprehension about the future life’. A confirmatory factor analysis confirmed validity of the construct, with a demonstrated good fit between the factor structure of the new scale and the observed data. Difficulties in daily life scores were significantly influenced by pain, loss of balance, muscle weakness, stiffness and swelling.

Conclusion.  We developed a reliable and valid scale for the measurement of difficulties in daily life experienced by patients with osteoarthritis of the knee. It is important for healthcare professionals to understand these difficulties in daily life experienced by patients with osteoarthritis of the knee and to educate patients with practical information and self‐management strategies.

Relevance to clinical practice.  This new scale could provide useful information to guide clinical practice in assessing and managing difficulties in daily life experienced by patients with osteoarthritis of the knee.
A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long‐term feeding
Authors: Lin Li‐Chan , Li Mei‐Hui , Watson Roger
Published: February 2011

Aims.  To investigate why patients do not choose percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy as a route for long‐term feeding.

Background.  Home enteral tube feeding is well recognised as a valuable therapeutic option for patients requiring nutritional support following discharge from hospital. The number of patients discharged from hospital and receiving home enteral tube feeding increases annually in Taiwan.

Design.  A cross‐sectional study.

Method.  Participants (n = 607) were chosen from one free‐standing home care agency and three hospital‐based home care departments in Taipei. A review of the patients’ records to gather demographic data, medical diagnosis, length of home care and length of intubation prior to the home visit was conducted. A face‐to‐face interview was conducted at the time of the home visit.

Findings.  The prevalence rate of home enteral tube feeding was 70·3% (n = 427). Of the 427 tube‐fed subjects, 93·4% were fed with a nasogastric tube. The most common reasons for refusing to use percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy were ‘too old to suffer from an operation’, ‘worried about wound infection or leakage after performing percutaneous endoscopic gastrostomy’ and ‘to keep subjects’ body integrity’. Stroke, no dementia, poor activities of daily living and poor cognitive status were significant predictors of being tube‐fed, while higher education and better cognitive status were significant predictors of percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy use.

Conclusion.  The reasons patients refused to use percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy reflect the influence of cultural values and the level of patients’ education, which home health care nurses need to discuss with patients in detail.

Relevance to clinical practice.  Investigating patients’ perspective on the meaning of ‘body’ in Taiwanese culture and the decision‐making processes related to home enteral tube feeding is recommended for nurses to provide better care and support when home enteral tube feeding in an option.
Facing death, facing self: nursing students’ emotional reactions during an experiential workshop on life‐and‐death issues
Authors: Liu Ying‐Chun , Su Pi‐Yu , Chen Chih‐Hao , Chiang Hsing‐Hsing , Wang Kwua‐Yun , Tzeng Wen‐Chii
Published: February 2011

Aim and objectives.  This study presents the findings of a qualitative study exploring the experiences of undergraduate nursing students imagining the possibility of their own death during a workshop on life‐and‐death issues.

Background.  Didactic instruction in end‐of‐life care is a critical element of nursing education and for most health professions training in general. Properly implementing this often‐overlooked educational process requires providing students with opportunities to reflect on death and dying along with guidance during nursing practice in coping with emotional reactions to caring for dying patients.

Design.  An interpretive descriptive design was adopted.

Method.  Data were gathered from the text of 20 students’ reflective journals and workshop evaluations and researchers’ field notes on observations during the workshop at a Taiwan university in August 2007.

Results.  Students experienced a process of dying, death and rebirth. Students not only expressed emotional responses that included surprise, reluctance to let go and gratitude but also realised the importance of cherishing the present, committing to the nursing profession and valuing their own lives.

Conclusions.  Students can learn their fear of death and possible emotional reactions towards dying patients through self‐reflection during a workshop on life‐and‐death issues. The foundation for facilitating students’ self‐awareness is a safe environment for them to gain experiential knowledge of the dying process and end‐of‐life care. Experiential education not only helps students grow personally but also increases their motivation to learn.

Relevance to clinical practice.  Students’ ability to recognise and manage their own emotional reactions towards death and dying patients should be included as part of end‐of‐life education. A workshop on life‐and‐death issues can help students discover that they are not alone and that they can support each other and learn how to manage their own emotions.
The profile of absconding psychiatric inpatients in Australia
Authors: Muir‐Cochrane Eimear , Mosel Krista , Gerace Adam , Esterman Adrian , Bowers Len
Published: February 2011

Aims and objectives.  The purpose of this study was to examine absconding behaviour (a patient leaving the hospital without permission) in acute and rehabilitation wards of one Australian psychiatric institution to describe the characteristics of the absconding patient and these events.

Background.  Absconding is a significant issue in psychiatric inpatient settings, with risks that include patient harm, aggression and violence. In spite of this, limited research has been conducted in Australia on patients who abscond while receiving psychiatric care.

Design.  The study was a retrospective descriptive analysis.

Method.  Absconding events from three acute and seven rehabilitation wards over a 12‐month period were studied.

Results.  The rate of absconding events by detained patients was 20·82%. Gender was not significantly associated with absconding, although 61·19% of those who absconded were men diagnosed with schizophrenic disorders. Over half of acute care patients who absconded left during their first 21‐day detention order. More than half of absconding events were by patients that absconded more than once. There was limited support for the efficacy of locking ward doors. Age and diagnosis emerged as particularly important factors to consider.

Discussion.  The study revealed that men are not more likely to abscond than women, that locking ward doors does not deter the determined absconders and that once a person has absconded, they are more likely to do so again. Younger patients and those with a schizophrenic disorder may be particularly likely to abscond. There also appears to be a link between continuing detention orders and an absconding event.

Conclusions.  Findings provide new data about the profile of absconding patients in Australia. Exploration of the reasons why patients abscond and why many do so repeatedly warrants further investigation.

Relevance to clinical practice.  Risk management approaches taking into account factors associated with absconding could be trialled to reduce the incidence of absconding in psychiatric inpatient settings.
A cross‐sectional study on nurses’ oral care practice for mechanically ventilated patients in Malaysia
Authors: Soh Kim Lam , Soh Kim Geok , Japar Salimah , Raman Rosna A , Davidson Patricia M
Published: February 2011

Aims and objectives.  This study sought to determine the strategies, methods and frequency of oral care provided for mechanically ventilated patients in Malaysian intensive care units. The study also described nurses’ attitudes to providing oral care and their knowledge of the mode of transmission of ventilator‐associated pneumonia.

Background.  Oral care is an important nursing intervention in the intensive care unit to reduce dental plaque. Dental plaque provides a repository for respiratory pathogens contributing to ventilator‐associated pneumonia in the critically ill.

Design.  Cross‐sectional study.

Methods.  This study used both survey and observational methods. The observational study was conducted by a nurse, trained in the study protocol. The observation period a selected shift over three weeks in 2007.

Findings.  Intensive care unit nurses (n = 284) participated in the survey. Respondents had a positive attitude towards providing oral care. On a 10‐point Likert scale, aspiration of contaminated secretions from the oropharynx was identified by nurses as the highest risk factor for ventilator‐associated pneumonia (mean response 6·8, SD 2·0). The majority of nurses used cotton and forceps for oral care. Toothbrushes were not used in any of the study sites.

Conclusions.  Although nurses had a positive attitude to oral hygiene, this study found no intensive care units incorporated a soft toothbrush in oral care protocols which is recommended in best practice guidelines. A review of strategies to implement evidence‐based practice in the intensive care unit is warranted.

Relevance to clinical practice.  This study has identified a failure to adhere with evidence‐based practice. Implementing and evaluating protocols for oral hygiene in the intensive care unit has the potential to improve patient outcomes.
Antibiotic‐induced ribosomal assembly defects result from changes in the synthesis of ribosomal proteins
Authors: Siibak Triinu , Peil Lauri , Dönhöfer Alexandra , Tats Age , Remm Maido , Wilson Daniel N. , Tenson Tanel , Remme Jaanus
Published: February 2011

Inhibitors of protein synthesis cause defects in the assembly of ribosomal subunits. In response to treatment with the antibiotics erythromycin or chloramphenicol, precursors of both large and small ribosomal subunits accumulate. We have used a pulse‐labelling approach to demonstrate that the accumulating subribosomal particles maturate into functional 70S ribosomes. The protein content of the precursor particles is heterogeneous and does not correspond with known assembly intermediates. Mass spectrometry indicates that production of ribosomal proteins in the presence of the antibiotics correlates with the amounts of the individual ribosomal proteins within the precursor particles. Thus, treatment of cells with chloramphenicol or erythromycin leads to an unbalanced synthesis of ribosomal proteins, providing the explanation for formation of assembly‐defective particles. The operons for ribosomal proteins show a characteristic pattern of antibiotic inhibition where synthesis of the first proteins is inhibited weakly but gradually increases for the subsequent proteins in the operon. This phenomenon most likely reflects translational coupling and allows us to identify other putative coupled non‐ribosomal operons in the Escherichia coli chromosome.
Calcineurin is required for Leishmania major stress response pathways and for virulence in the mammalian host
Authors: Naderer Thomas , Dandash Orwa , McConville Malcolm J.
Published: February 2011

Leishmania parasites must adapt to elevated temperatures and other environmental stresses during infection of their mammalian hosts. How these environmental cues are sensed is poorly understood. In this study we show that calcium uptake is required for parasite thermotolerance at 34–37°C. To identify potential downstream targets of calcium influx, a Leishmania major mutant lacking the essential regulatory subunit (CnB) of the Ca2+/calmodulin‐dependent serine/threonine‐specific phosphatase, calcineurin, was generated. The Δcnb mutant grew as well as wild‐type parasites at 27°C and differentiated normally to infective metacyclic promastigotes. However, Δcnb parasites lost viability when exposed to increased temperature (34°C) and were hypersensitive to endoplasmic reticulum and membrane stress, induced by tunicamycin and inhibitors of sterol and sphingolipid biosynthesis respectively. Δcnb promastigotes were internalized by macrophages, but their differentiation to the heat adapted amastigote stage was delayed and the resulting parasites failed to proliferate. Strikingly, the Δcnb parasites were completely cleared by susceptible BALB/c mice. Complementation of Δcnb parasites with CnB restored thermotolerance and infectivity in both macrophages and animal models. Our results suggest that Ca2+ influx and calcineurin signalling are required for both early and long‐term adaptive parasite responses to environmental stresses encountered in the mammalian host.
Is most hummocky cross‐stratification formed by large‐scale ripples?
Authors: QUIN JAMIE G.
Published: February 2011

Although normal isotropic hummocky cross‐stratification is commonly interpreted to be the deposit of large‐scale ripples, there are many reasons why this may not usually be the case. These reasons include: (i) that the stratification produced by large‐scale ripples does not particularly look like isotropic hummocky cross‐stratification; (ii) that it is difficult reconciling the abundance of HCS with the restricted hydraulic stability of large‐scale ripples in silt to fine sand (i.e. the grain sizes in which hummocky cross‐stratification is usually found); (iii) that the distribution of hummocky cross‐stratification within ancient storm beds is not the distribution that would be expected from large‐scale ripples; (iv) that the flows calculated to have formed ancient examples of hummocky cross‐stratification would be expected to generate an upper stage plane bed rather than ripples; and (v) that it is difficult to explain why large‐scale ripples would predominate in the proximal parts of storm beds when modern storm flows commonly exceed the threshold for entrainment. In contrast to the various hypotheses which propose that isotropic hummocky cross‐stratification is generated by ripples, an alternative hypothesis which suggests that it is generated by instabilities, does seem to adequately explain the origin of hummocky cross‐stratification. However, it is difficult to accept this hypothesis given that the origin of the proposed instabilities is unproven. These conclusions highlight the continued uncertainty regarding the process, which generates hummocky cross‐stratification.
Apogean–perigean signals encoded in tidal flats at the fluvio–estuarine transition of Glacier Creek, Turnagain Arm, Alaska; implications for ancient tidal rhythmites
Authors: GREB STEPHEN F. , ARCHER ALLEN W. , DEBOER DARRON G.
Published: February 2011

Turnagain Arm is a macrotidal fjord‐style estuary. Glacier Creek is a small, glacially fed stream which enters the estuary tangentially near Girdwood, Alaska. Trenches and daily sedimentation measurements were made in a mudflat along the fluvio–estuarine transition of Glacier Creek during several summers since 2003. Each year, the flats appear to erode during the winter and then accrete vertically in the spring and summer. In each of the years studied, tidal laminae in vertically thickening and thinning laminae bundles were deposited by twice daily tides in neap–spring tidal cycles. In 2004, bundles of thickening and thinning laminae couplets were noted in trenches cut into the flats. Five laminae bundles alternated between thicker and thinner bundles, corresponding to the perigean (high spring) and apogean (low spring) tides. Well‐preserved apogean–perigean cycles have rarely been documented in modern tidal flat sediments. At this location, vertical accretion of tidal rhythmites with well‐developed neap–spring cyclicity is possible because of the near‐complete removal of the flat from the previous year, which creates accommodation space for vertical accretion without significant reworking. Macrotidal conditions, no reworking by infaunal invertebrates, protection from the main tidal channel by a gravel bar and protection from storm waves and fluvial erosion by a recess in the sedge marsh that surrounds the flats all aid in preservation of rhythmites during aggradation. The position of the flats relative to tidal range allows for accumulation of complete spring cycles and incomplete neap cycles. In the summer of 2004, apogee and perigee were closely aligned with the new and full moons, resulting in successive strong perigee and apogee tides which probably aided in the accumulation of successive thick–thin spring cycles encoding the apogean and perigean tidal cycle. The apogean–perigean signal was not observed in subsequent years.
Drowning of a carbonate platform as a precursor stage of the Early Toarcian global anoxic event (Southern Provence sub‐Basin, South‐east France)
Authors: LÉONIDE PHILIPPE , FLOQUET MARC , DURLET CHRISTOPHE , BAUDIN FRANÇOIS , PITTET BERNARD , LÉCUYER CHRISTOPHE
Published: February 2011

The Toarcian Oceanic Anoxic Event is well‐known as coinciding with a carbonate crisis, coupled with organic matter accumulation and perturbation of the carbon cycle expressed by carbon‐isotope excursions. In this palaeoenvironmental setting, the present research attempts to better constrain the palaeoenvironmental conditions leading to the drowning of a carbonate platform during Late Pliensbachian to Early Toarcian times. This study is based on the integrated sedimentological, diagenetic and geochemical (stable isotopes and Rock‐Eval pyrolysis) analysis of several stratigraphic successions located in the Southern Provence sub‐Basin (South‐east France). Eodiagenetic ferroan calcite cements below two hardground surfaces at the Pliensbachian–Toarcian transition record episodic eutrophication events. Such events were precursor stages of a global palaeoenvironmental perturbation (i.e. a global carbon cycle perturbation) that led to the demise of the carbonate platform and occurred prior to the Toarcian Oceanic Anoxic Event. Subsequently, the acme of the palaeoenvironmental deterioration that coincided with the Toarcian Oceanic Anoxic Event is recorded by a pronounced negative carbon‐isotope excursion (−3‰) followed by a positive one (2·87‰), organic matter preservation and inferred high temperature of surface sea water (ca 25°C) as given by oxygen‐isotope values from chondrichthyan tooth enamel. Sedimentological comparisons, as well as chemostratigraphic and biostratigraphical correlations between the Early Toarcian sedimentary series of the Southern Provence and Eastern Dauphinois sub‐basins, indicate that tectonic tilting occurred earlier in the Southern Provence sub‐Basin; this resulted in the preservation of organic‐rich deposits in the first sub‐basin and depositional hiatus in the second sub‐basin. Thus, local conditions, such as contrasting structural setting, could markedly modify the sedimentary signature of a global climatic event.
Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub‐Saharan African countries with high burdens of TB and HIV
Authors: Finnie Ramona K. C. , Khoza Lunic Base , van den Borne Bart , Mabunda Tiyane , Abotchie Peter , Mullen Patricia D.
Published: February 2011

Objective  To identify factors causing delayed diagnosis and treatment for tuberculosis in high tuberculosis (TB)/HIV burden African countries.

Methods  We searched Ovid Medline, CINAHL, PsychInfo, Scopus and Sabinet–South African journals and reference lists, Google, Google Scholar and Google SA for reports in English, ≥1992, of original data from sub‐Saharan countries on patient or system delay in TB diagnosis or treatment with populations ≥15 years old. Two reviewers extracted data independently for each study. We categorized independent variables as predisposing, enabling or reinforcing (PRECEDE model). Meta‐analysis was conducted for factors associated with delay in ≥2 studies.

Results  Of 20 eligible studies, 12 assessed both sources of delay; 1, system delay; and 7, patient delay only. Most were cross‐sectional surveys (k = 13) with samples of consecutive patients (k = 13) and bivariate analyses (k = 11). Starting and endpoints for patient delay were consistent, but not system delay. Patient characteristics were studied frequently; HIV stigma and enabling factors were studied infrequently, although the last were most often associated with delay. Consulting traditional healers first – usually by rural residents – consistently led to patient delay; OR = 3.45 (1.91–6.21). Travel time for the return visit was consistently associated with system delay OR = 1.87 (1.378–2.531).

Conclusions  We recommend partnerships with traditional healers and research emphasizing HIV and system factors, standard definitions of delay and qualitative and cohort studies to identify enabling and reinforcing factors related to delay.
Risk factors for non‐communicable diseases among older adults in rural Africa
Authors: Negin Joel , Cumming Robert , de Ramirez Sarah Stewart , Abimbola Seye , Sachs Sonia Ehrlich
Published: February 2011

Objective  To expand the evidence base on the prevalence of non‐communicable disease (NCD) risk factors in rural Africa, in particular among older adults aged 50 and older.

Methods  Cross‐sectional study in three rural sites in Malawi, Rwanda and Tanzania. One person was interviewed from each of 665 households selected through a stratified random sampling procedure across the three sites. The questionnaire included socio‐demographic characteristics, smoking and alcohol intake as well as a food frequency questionnaire.

Results  Smoking rates among older men and women were higher than among adults under 50. While only 2.3% of women under 50 were current smokers, 21.0% of older women smoked (P < 0.0001). Among men, 19.0% of men under 50 smoked versus 36.6% of older men (P = 0.001). Alcohol consumption among older women aged 50 and older (45.0%) was more common (P = 0.005) than among women under 50 (27.6%). Examining a set of five risk factors, more men aged 50 and older (49.5%) had two or more risk factors than men under 50 (25.5%) (P < 0.0001). Similarly, 52.0% of women aged 50 and older had two or more risk factors, versus 24.1% of women under 50 (P < 0.0001).

Conclusion  Contrary to what is seen in developed country settings, this study reveals high rates of smoking and alcohol consumption among men and women aged 50 years and older in rural Africa that puts them at risk of NCDs. The health of older adults in rural Africa has been neglected, and these findings highlight the importance of reaching out to older adults with messaging regarding diet, smoking, alcohol use and general health.
Tracking progress towards safe motherhood: meeting the benchmark yet missing the goal? An appeal for better use of health‐system output indicators with evidence from Zambia and Sri Lanka
Authors: Gabrysch Sabine , Zanger Philipp , Seneviratne Harshalal R. , Mbewe Reuben , Campbell Oona M. R.
Published: February 2011

Objectives  Indicators of health‐system outputs, such as Emergency Obstetric Care (EmOC) density, have been proposed for monitoring progress towards reducing maternal mortality, but are currently underused. We seek to promote them by demonstrating their use at subnational level, evaluating whether they differentiate between a high‐maternal‐mortality country (Zambia) and a low‐maternal‐mortality country (Sri Lanka) and assessing whether benchmarks are set at the right level.

Methods  We compared national and subnational density of health facilities, EmOC facilities and health professionals against current benchmarks for Zambia and Sri Lanka. For Zambia, we also examined geographical accessibility by linking health facility data to population data.

Results  Both countries performed similarly in terms of EmOC facility density, implying this indicator, as currently used, fails to discriminate between high‐ and low‐maternal‐mortality settings. In Zambia, the WHO benchmarks for doctors/midwives were met overall, but distribution between provinces was highly unequal. Sri Lanka overshot the suggested benchmarks by three times for midwives and over 30 times for doctors. Geographical access in Zambia – which is much less densely populated than Sri Lanka – was poor, less than half the population lived within 15 km of an EmOC facility.

Conclusions  Current health‐system output indicators and benchmarks on EmOC need revision to enhance discriminatory power and should be adapted for different population densities. Subnational disaggregation and assessing geographical access can identify gaps in EmOC provision and should be routinely considered. Increased use of an improved set of output indicators is crucial for guiding international efforts towards reducing maternal mortality.
Species richness and evenness as a function of biomass in arable plant communities
Authors: POGGIO S L , GHERSA C M
Published: February 2011

Poggio SL & Ghersa CM (2011). Species richness and evenness as a function of biomass in arable plant communities. Weed Research51, 241–249.

We evaluated the hypothesis that competitive dominants change the species richness and evenness of arable plant communities. Three field experiments including cool‐season crops and unsown short fallows were carried out in Buenos Aires, Argentina. Ground cover, biomass and species richness of crops and weeds were assessed. Evenness was calculated by using species biomass data. Richness and evenness were correlated with total community biomass, and with the biomass of either weeds or the dominant species in the community. Crops, through growth and shading effects, affected the species richness and evenness of arable plant communities. Conversely, the dominant weed in fallows was not as suppressive as crops. Species richness and evenness were constrained by community biomass. Species richness of understory weeds decreased as crops suppressed weed growth. Evenness also decreased as the dominant species became increasingly productive, regardless of their identity (weeds or crops). Our findings provide valuable models to characterise the trajectories that species richness and evenness may follow in different farming scenarios. Community biomass is a major constraint on the maximum diversity of local communities and, consequently, of substantial ecological importance for both biodiversity conservation and weed management purposes.
Inhibitory effects of albuterol and fenoterol on RANTES and IP‐10 expression in bronchial epithelial cells
Authors: Lam Ka‐Pan , Chu Yu‐Te , Lee Min‐Sheng , Chen Huan‐Nan , Wang Wei‐Li , Tok Teck‐Siang , Chin Yow‐Yue , Chen Solomon Chih‐Cheng , Kuo Chang‐Hung , Hung Chih‐Hsing
Published: February 2011

To cite this article: Lam KP, Chu YT, Lee MS, Chen HN, Wang WL, Tok TS, Chin YY, Chen SC, Kuo CH, and Hung CH. Inhibitory Effects of Albuterol and Fenoterol on RANTES and IP‐10 Expression in Bronchial Epithelial Cells. Pediatric Allergy Immunology 2011; 22: 431–439.

Short‐acting β2‐adrenoreceptor agonist (SABA) is the major asthma reliever as indicated in the GINA guidelines. Regulated on activation, normal T expressed and secreted (RANTES) is a chemokine that attracts eosinophils, mast cells, and basophils toward site of allergic inflammation. Interferon γ‐inducible protein (IP)‐10 is a Th1‐related chemokine that is also important in asthmatic inflammation and also involved in our immune defense against pathogens. Bronchial epithelial cells are first‐line barrier against invasive pathogen and also have immunomodulatory function. However, whether albuterol and fenoterol (two SABAs) have modulatory effects on RANTES and IP‐10 expression in bronchial epithelial cells is unknown. The human bronchial epithelial cell lines, BEAS‐2B cells, were pre‐treated with different concentrations of albuterol, fenoterol or dibutyryl‐cAMP (a cyclic AMP analog) before polyinosinic‐polycytidylic acid (poly I:C) stimulation. In some condition, BEAS‐2B cells were pre‐treated with ICI‐118551, a selective β2‐adrenoreceptor antagonist, 30 min before albuterol or fenoterol treatment. The levels of RANTES and IP‐10 were measured by ELISA. Intracellular signaling was investigated using cAMP assay, mitogen‐activated protein kinase (MAPK) inhibitor, nuclear factor (NF)‐κB inhibitor, and western blot. Albuterol and fenoterol suppressed poly I:C‐induced RANTES and IP‐10 expression of BEAS‐2B cells. ICI‐118551 could partly reverse the suppressive effects of albuterol and fenoterol on RANTES and IP‐10 expression. Albuterol and fenoterol increased intracellular cAMP levels. Dibutyryl‐cAMP conferred the similar effects of albuterol and fenoterol. Western blot revealed that albuterol suppressed p‐ERK, p‐JNK and pp38, and also their associated kinase expression. Albuterol had no effect on pp65 expression. Albuterol and fenoterol could suppress poly I:C‐induced RANTES and IP‐10 expression in human bronchial epithelial cells via at least partly the β2‐adrenoreceptor‐cAMP and the MAPK pathways, implicating that albuterol and fenoterol could exert anti‐inflammatory effect and benefit asthmatic patients by suppressing RANTES and IP‐10 expression. However, these suppressive effects of albuterol and fenoterol may inhibit the defense against viral infection.
Extraperitoneal renal transplantation in small children results in a transient improvement in early graft function
Authors: Heap Sarah L. , Webb Nicholas J.A. , Kirkman Matthew A. , Roberts Denise , Riad Hany
Published: February 2011

Heap SL, Webb NJA, Kirkman MA, Roberts D, Riad H. Extraperitoneal renal transplantation in small children results in a transient improvement in early graft function. Pediatr Transplantation 2011: 15: 362–366. © 2011 John Wiley & Sons A/S.

Abstract:  Renal transplantation is considered more technically challenging in small children compared to adults, especially when live donor adult kidneys are used. Transplanted kidneys have traditionally been placed intraperitoneally, although over the last decade extraperitoneal positioning has been attempted. The aim of this study was to establish whether there is a difference in kidney function and outcome dependent on the surgical approach to transplantation. The medical notes of all children under the age of six who received a renal transplant at our unit between January 1998 and October 2009 were reviewed. Demographic data, operation details, HLA mismatch, immunosuppression regime, complications, and function of the graft were analyzed. A total of 30 transplants were performed in children under six yr of age. The one‐yr patient and graft survival were 97% and 93%, respectively. Eighteen were undertaken via an intraperitoneal approach, with the remaining being placed extraperitoneally. There were no significant differences in the number of complications observed between the two groups, and median length of stay was comparable (extraperitoneal 19.5 days vs. intraperitoneal 20.5 days). The plasma creatinine values for the two groups were compared using multivariate linear regression analysis and adjusted for age, weight, gender and baseline plasma creatinine. Between days 2 and 14 post‐operatively, there was a significant difference in absolute plasma creatinine between the two surgical approaches. However, the trend of change in mean plasma creatinine values over time did not differ significantly between the two groups. Extraperitoneal kidney transplantation in small children is safe and technically feasible. From our series, there appears to be early improved function, although there is no long‐term difference in function between approaches.
Sugar ratios, glutathione redox status and phenols in the resurrection species Haberlea rhodopensis and the closely related non‐resurrection species Chirita eberhardtii
Authors: Djilianov D. , Ivanov S. , Moyankova D. , Miteva L. , Kirova E. , Alexieva V. , Joudi M. , Peshev D. , Van den Ende W.
Published: February 2011

Because of their unique tolerance to desiccation, the so‐called resurrection plants can be considered as excellent models for extensive research on plant reactions to environmental stresses. The vegetative tissues of these species are able to withstand long dry periods and to recover very rapidly upon re‐watering. This study follows the dynamics of key components involved in leaf tissue antioxidant systems under desiccation in the resurrection plant Haberlea rhodopensis and the related non‐resurrection species Chirita eberhardtii. In H. rhodopensis these parameters were also followed during recovery after full drying. A well‐defined test system was developed to characterise the different responses of the two species under drought stress. Results show that levels of H2O2 decreased significantly both in H. rhodopensis and C. eberhardtii, but that accumulation of malondialdehyde was much more pronounced in the desiccation‐tolerant H. rhodopensis than in the non‐resurrection C. eberhardtii. A putative protective role could be attributed to accumulation of total phenols in H. rhodopensis during the late stages of drying. The total glutathione concentration and GSSG/GSH ratio increased upon complete dehydration of H. rhodopensis. Our data on soluble sugars suggest that sugar ratios might be important for plant desiccation tolerance. An array of different adaptations could thus be responsible for the resurrection phenotype of H. rhodopensis.
Distribution of Apa I and Cfo I polymorphisms of the porcine growth‐hormone (pGH) gene in two ryr 1 genotyped Austrian pig breeds
Authors: Handler J. , Schmoll F. , Stur I. , Brem G. , Schellander K.
Published: February 2011

Apa I and Cfo I polymorphisms in the fragment spanning from the first exon to the third intron of the growth‐hormone gene were analysed in 77 Österreichischen Edelschwein and 269 Österreichischen Landrasse pigs. The interrelationships between them and the Hae II, Msp I, and ryr 1 polymorphisms were investigated. The differences in distribution between the two breeds were significant at all loci (p < 0.05 to P < 0.01). It is concluded that the Apa I, Cfo I, Hae II, and Msp I pGH polymorphisms analysed can be used as genetic markers for the breeds. The interactions between the analysed polymorphic systems vary considerably. The strongest interaction was found between Cfo I and Hae II in both breeds (C = 0.85). This might be a result of similarity in their restriction enzyme sites. No interactions could be found between the pGH and the ryr 1 locus.

Apa I‐ und Cfo I‐Polymorphismen des porcinen Wachstumshormongens (pGH‐Gen) bei zwei ryr 1‐genotypisierten, österreichischen Schweinerassen

An 77 Tieren des Österreichischen Edelschweins und 269 Tieren der Österreichischen Landrasse wurden die Verteilungen des Apa I‐ und des Cfo I‐Polymorphismus des porcinen Wachstumshormongens ermittelt, und ihre Beziehungen zu den Hae II‐ und Msp I‐Polymorphismen am selben Genom, sowie zum MHS‐Locus untersucht.

Die Verteilungsunterschiede zwischen des beiden Rassen war bei Ana I mit p < 0,05 statistisch signifikant, bei den anderen Polymorphismen mit p < 0,01 statistisch hoch signifikant. Daraus läßt sich eine gute Eignung von Apa I, Cfo I, Hac II und Msp I als genetische Marker für die untersuchten Rassen ableiten.

Die Zusammenhänge zwischen des polymorphen Systemen sind zum Teil sehr unterschiedlich ausgeprägt. Den höchsten Beziehungsgrad konnte bei beiden Rassen zwischen Cfo 1 und Hae II nachgewiesen werden (C = 0,85), was auf die Ähnlichkeit ihrer Restriktionsenzym‐Erkennungs‐Sequenzen zurückgeführt werden kann.

Zwischen dcm pGH‐ und dcm ryr 1‐Locus konnten keine nennenswerten Interaktionen festgestellt werden.
Exploitation of microsatellites as genetic markers of beef‐performance traits in Piemontese × Chianina crossbred cattle
Authors: Napolitano F. , Leone P. , Puppo S. , Moioli B. M. , Pilla F. , Comincini S. , Ferretti L. , Carretta A.
Published: February 2011

Three microsatellites—IDVGA‐2, IDVGA‐3 and IDVGA‐46, composed of a (AC) motif, were associated to beef performance traits of 54 female crossbred cattle from two specialized Italian beef breeds, Piemontese for muscling and meat quality and Chianina for high daily gain and size. Association was tested by a general linear mixed model in which the genotypes for each microsatellite were fixed factors and which considered the additive genetic random effect. Microsatellite IDVGA‐46 is associated to most conformation parameters while IDVGA‐2 and IDVGA‐3 do not seem to affect much performance traits. In fact homozygous individuals carriers of allele 205 (IDVGA‐46) show a global better structure because they have bigger body size which is one of the goals of improving beef.

Verwendung von Mikrosatelliten als genetische Marker der Fleischleistungsmerkmale in Kreuzungstieren der Rassen Piemontese × Chianina

Drei aus einem (AC) Motiv gebildete Mikrosatelliten—IDVGA‐2, IDVGA‐3 und IDVGA‐46—wurden Fleischleistungsmerkmalen von 54 Kreuzungskühen aus zwei spezialisierten italienischen Fleischrassen zugeordnet, Piemontese zur Verbesserung der Muskelentwicklung und Fleischqualität und Chianina zur Verbesserung des Tageszuwachses. Die Assoziation wurde mit einem linearen Modell getestet, mit fixen Faktoren fur die Genotypen eines jeden Mikrosatelliten.

Bei Mikrosatelliten IDVGA‐2 und 3 wurden keine Beziehungen zu Fleischleistungsmerkmalen festgestellt, wohingegen Mikrosatellit IDVGA‐46 einen signifikanten Einfluß auf Körperbeschaffenheit zeigt. Der 205 homozygote Genotyp (IDVGA‐46) hat eine bessere Muskel‐ und Skelettentwicklung aufgewiesen, was eines der Zuchtziele bei der Produktion von Fleischrindern darstellt.
Temperament and reproductive success in farmbred silver foxes housed with and without platforms
Authors: Korhonen H. , Niemelä P.
Published: February 2011

Human, strike, pencil, confrontation, feeding, and disturbance tests were used to study fear‐motivated behaviour in farmed silver foxes (Vulpes vulpes), housed with and without wooden platforms. The results showed that the number of fearful animals was highest and lowest in the confrontation and feeding tests, respectively. Foxes that had used platforms most frequently before the behavioural tests, were also most often found on platforms during the tests. Temperament differences between control and platform animals were slight. Only the human test gave statistically significant (p < 0.05) confirmation that animals housed with platforms were less fearful of humans than those housed without platforms. The fear index (FI), based on all other tests except for the disturbance test, showed that the number of fearless individuals was equal (FI = 0.50) in both the platform and control groups. Regardless of the testing, breedings and whelpings succeeded equally well in fearful and fearless vixens. Only the feeding test showed a tendency (p < 0.08) for higher kit mortality in fearful vixens. During severe disturbances, 47.4% of the experimental animals used the platforms for hiding. It is obvious that the temperament of farmed silver foxes is not substantially affected by the presence of a platform in the cage, but that platforms would otherwise promote animal welfare by providing the possibility for more complex behaviours and a place of refuge.

Temperament und Fortpflanzungserfolg bei Silberfüchsen‐altung mit und ohne Plattformen

Menschen, Schlag‐, Bleistift‐, Kampf‐Futter‐ und Störungstests wurden zur Untersuchung Angstmotivierten Verhaltens von Silberfüchsen (Vulpes vulpes) angewendet, die in Käfigen mit und ohne Holzplattformen gehalten worden sind. Die Zahl ängstlicher Tiere ist am höchsten bzw. niedrigsten in den Kampf‐bzw. Futtertests. Füchse, die Plattformen vor den Verhaltenstests verwendet hatten, waren am häufigsten auch auf diesen während der Tests. Temperamentunterschiede zwischen Kontrol‐ und Plattformtieren waren geringfügig. Nur der Menschentest ergab statistisch signifikante (p < 0,05) Bestätigung daß Tiere in mit Plattform versehenen Käfigen weniger ängstlich waren, als jene ohne Plattform. Der Furchtindex (FI) ermittelt aus allen anderen außer dem Störtest, zeigte, daß die Zahl furchtloser Tiere gleich war (FI = 0,5) in Plattform‐ und in Kontrollgruppen. Unabhängig vom Testen waren Befruchtung und Geburten in ängstlichen und angstfreien Füchsinnen gleich erfolgreich. Nur beim Fütterungstest ergab sich eine Tendenz (p < 0,08) zu höherer Welpenmortalität in furchtsamen Füchsinnen. Von den Versuchstieren verwendeten 47,4% der Tiere Plattformen zum Verstecken während starker Störungen. Es scheint offensichtlich, daß das Temperament von Silberfüchsen durch Plattformen nicht substantiell tangiert wird, aber Plattformen sind in anderer Weise für das Verhalten der Tiere günstig, weil sie die Möglichkeit komplexeren Verhaltens und einen Fluchtplatz bieten.