bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of light availability on the carbon gain of beech (Fagus crenata) seedlings with reference to the density of dwarf bamboo (Sasa kurilensis) in an understory of Japan Sea type beech forest
Authors: KOBAYASHI TSUYOSHI , SHIMANO KOJI , MURAOKA HIROYUKI
Published: April 2004

In the understory of Japan Sea type beech (Fagus crenata Bl.) forests, a beech seedling bank persists at the forest floor where the seedlings are shaded by dwarf bamboo (Sasa kurilensis Makino et Shibata). The culm density of dwarf bamboo is reduced by shading from the overstory. To determine the effect of the dwarf bamboo on the photosynthetic productivity of beech seedlings, we evaluated the leaf carbon gain of the beech seedlings with respect to the spatiotemporal variation in light regimes and CO2 concentration in a forest at Buna‐Daira, Fukushima Prefecture, central Japan. In midsummer, we measured photosynthetic photon flux density (PPFD) and air CO2 concentration (Camb) at the beech seedling height in the understory beneath the forest canopy with less dwarf bamboo, and in a canopy gap with dense dwarf bamboo. A frequency distribution of log10‐transformed PPFD showed that the mode PPFD class was greater beneath the closed canopy patch than in the gap (51–109 µmol/m2 per s vs 24–52 µmol/m2 per s), which was close to the estimated mean background PPFD (diffuse light) in each understory. The total sunfleck period during the midday hours and the mean PPFD of each sunfleck were also greater beneath the closed canopy than in the gap. From the diurnal course of PPFD and Camb, we simulated the midday carbon gain of beech seedlings using the CO2 assimilation (A)–PPFD and A–CO2 curves of beech leaves in the closed canopy patch. The total carbon gain of beech leaves beneath the canopy was 2.35‐fold greater than that in the gap, whether the simulation incorporated photosynthetic induction responses to sunflecks or not. High Camb at the forest floor (380–420 µmol/mol) enhanced the total carbon gain 1.12‐fold. The simulation indicated that an increase in diffuse light under sparse dwarf bamboo, which could accelerate the photosynthetic responses to sunflecks and high Camb, contributed to the photosynthetic carbon gain of beech leaves beneath the forest canopy. These findings suggest that the light environment of the understory can be determined by the effects of forest canopy structure on the density of understory dwarf bamboo and that the photosynthetic productivity of beech seedlings mainly depends on the diffuse light intensity.
Fatal complication from central venous cannulation in a paediatric liver transplant patient
Authors: LOVELL MARK , BAINES DAVID
Published: April 2004

We report a fatal complication from central venous cannulation in a child undergoing heterotropic liver transplantation. Following the attempted placement of a cannula in the left internal jugular vein, extravasation of blood products via the cannula resulted in haemothorax, hypotension and eventual brain death. Possible causes and strategies for prevention of this complication are discussed.
Assessment of autonomic cardiovascular changes associated with recovery from anaesthesia in children: a study using spectral analysis of blood pressure and heart rate variability
Authors: CONSTANT ISABELLE , LAUDE DOMINIQUE , ELGHOZI JEAN‐LUC , MURAT ISABELLE
Published: April 2004

Recovery from anaesthesia is associated with large changes in cardiovascular autonomic activity, which are poorly documented in children. This study was undertaken to investigate the cardiovascular autonomic activity in anaesthetized and recovering children, using a noninvasive approach based on spectral analysis of heart rate (HR) and blood pressure (BP) variability. Ten children (aged 5–13 years) undergoing major surgery were studied. Continuous HR and BP were recorded using a noninvasive device during deep anaesthesia and recovery. Spectral analysis was used to determine the main oscillatory components of HR and BP signals. For each power spectrum, the frequency components were identified as follows (i): the low frequency (LF) component (0.04–0.14 Hz) both parasympathetically and sympathetically mediated for HR and corresponding to vasomotor sympathetic modulation for BP; and (ii) the high frequency (HF) component (0.2–0.6 Hz) parasympathetically mediated for HR, and reflecting mechanical influence of ventilation on cardiac output for BP. In addition, the LF : HF ratio for HR, reflecting the cardiac sympathovagal balance, was calculated. Under deep anaesthesia, HR variability and BP variability were very low and mainly due to mechanical influence of intermittent positive pressure ventilation. Conversely, the recovery period was associated with a marked increase of HR and BP overall variability. Compared to anaesthesia, spectral analysis of HR and BP revealed that the LF component of BP and HR spectra increased 40‐fold during recovery; the LF : HF ratio of HR was also increased during recovery (0.1 ± 0.1 versus 1.3 ± 1.2, P=0.008). The results of this study demonstrate that the recovery period is associated with an increase of cardiovascular sympathetic drive in children after major surgery.
Anaesthesiological considerations in patients with Sneddon's syndrome
Authors: HEESEN MICHAEL , ROSSAINT ROLF
Published: April 2004

Sneddon's syndrome is a rare disease with strong gender prevalence of females. This syndrome is characterized by livedo racemosa and cerebrovascular lesions. Since no specific test is available, the clinical differentiation from other disorders with similar symptomatology may raise difficulties. The cerebral involvement includes strokes with cases of more than one ischaemic event having been reported. Associations with convulsions, heart valve disease, systemic hypertension, and renal impairment have been described. We report the case of a 5‐year‐old boy who was anaesthesized for dental surgery. Due to the fact that 50% of Sneddon's syndrome patients develop mental retardation, even minor procedures require general anaesthesia. A review of the literature is added and specific anaesthesiological aspects of the perioperative care of Sneddon's syndrome are discussed.
Impact of infusion line compliance on syringe pump performance
Authors: WEISS MARKUS , NEFF THOMAS , GERBER ANDREAS , FISCHER JOACHIM
Published: April 2004

To determine the impact of infusion line compliance on the time to occlusion alarm (occlusion time) and the size of the subsequent occlusion release bolus, we studied three different infusion lines in combination with a 50‐ml and a 10‐ml syringe. The mean occlusion time of the 50‐ml syringe amounted to 20.3 ± 0.28 min and increased to 26.2 ± 0.19 min with the infusion line yielding the largest compliance (P < 0.0001). The mean occlusion time of the 10‐ml syringe was 2.5 ± 0.75 min and showed a 2.7‐fold variation with the three infusions lines (2.6 ± 0.08, 5.6 ± 0.28 and 6.9 ± 0.35 min, respectively; P < 0.0001). Occlusion times correlated strongly to the calculated estimated compliance of the syringe‐infusion line assembly (Pearson's r=0.998, P < 0.0001). Infusion line compliance has an important impact on time to occlusion, particularly when using small, low compliant infusion pump syringes.
Species distributions, surrogacy, and important conservation regions in Canada
Authors: Warman Leanna D. , Forsyth David M. , Sinclair A. R. E. , Freemark Kathryn , Moore Harold D. , Barrett Thomas W. , Pressey R. L. , White Denis
Published: April 2004

Conservation actions could be more efficient if there is congruence among taxa in the distribution of species. Patterns in the geographical distribution of five taxa were used to identify nationally important regions for conservation in Canada. Two measures of surrogacy were significantly and positively correlated among taxa, and conservation areas selected for one taxon represented other taxa significantly better than random selections. However, few large protected areas exist in the sites of highest conservation value in southern Canada; these regions are therefore a priority for future conservation regard. By focusing this effort on threatened and endangered species, which are a national priority in Canada, most other species could also benefit.
Species richness–decomposition relationships depend on species dominance
Authors: Dangles Olivier , Malmqvist Björn
Published: April 2004

Human disturbances both decrease the number of species in ecosystems and change their relative abundances. Here we present field evidence demonstrating that shifts in species abundances can have effects on ecosystem functioning that are as great as those from shifts in species richness. We investigated spatial and temporal variability of leaf decomposition rates and community metrics of leaf‐eating invertebrates (shredders) in streams. The shredder community composition dramatically influenced the diversity–function relationship; decomposition was much higher for a given species richness at sites with high species dominance than at sites where dominance was low. Decomposition rates also markedly depended on the identity of the dominant species. Further, dominance effects on decomposition varied seasonally and the number of species required for maintaining decomposition increased with increasing evenness. These findings reveal important but less obvious aspects of the biodiversity–ecosystem functioning relationship.
Sensitivity analysis of equilibrium in density‐dependent matrix population models
Authors: Caswell Hal , Takada Takenori , Hunter Christine M.
Published: April 2004

We consider the effects of parameter perturbations on a density‐dependent population at equilibrium. Such perturbations change the dominant eigenvalue λ of the projection matrix evaluated at the equilibrium as well as the equilibrium itself. We show that, regardless of the functional form of density dependence, the sensitivity of λ is equal to the sensitivity of an effective equilibrium density , which is a weighted combination of the equilibrium stage densities. The weights measure the contributions of each stage to density dependence and their effects on demography. Thus, is in general more relevant than total density, which simply adds all stages regardless of their ecological properties. As  log λ is the invasion exponent, our results show that successful invasion will increase , and that an evolutionary stable strategy will maximize . Our results imply that eigenvalue sensitivity analysis of a population projection matrix that is evaluated near equilibrium can give useful information about the sensitivity of the equilibrium population, even if no data on density dependence are available.
The performance of models relating species geographical distributions to climate is independent of trophic level
Authors: Huntley Brian , Green Rhys E. , Collingham Yvonne C. , Hill Jane K. , Willis Stephen G. , Bartlein Patrick J. , Cramer Wolfgang , Hagemeijer Ward J. M. , Thomas Christopher J.
Published: April 2004

Species–climate ‘envelope’ models are widely used to evaluate potential climate change impacts upon species and biodiversity. Previous studies have used a variety of methods to fit models making it difficult to assess relative model performance for different taxonomic groups, life forms or trophic levels. Here we use the same climatic data and modelling approach for 306 European species representing three major taxa (higher plants, insects and birds), and including species of different life form and from four trophic levels. Goodness‐of‐fit measures showed that useful models were fitted for >96% of species, and that model performance was related neither to major taxonomic group nor to trophic level. These results confirm that such climate envelope models provide the best approach currently available for evaluating reliably the potential impacts of future climate change upon biodiversity.
Abdominal stapled side‐to‐end anastomosis (Baker type) in low and high anterior resection: experiences and results in 69 consecutive patients at a regional general hospital in Japan
Authors: Nakada I. , Kawasaki S. , Sonoda Y. , Watanabe Y. , Tabuchi T.
Published: April 2004

Objective  The technique of transanally introducing a circular stapled device to accomplish colorectal anastomoses has been widely used. However, the widespread popularity of this technique may have created the potential of anal sphincter injury during transanal insertion of the anastomosing stapler. Thus, to avoid the risk of anal sphincter injury during anal manipulation, we have been performing an abdominal approach, namely abdominal stapled side‐to‐end anastomosis (ASSEA) using a Purstring and premium curved EEA stapler in low and high anterior resection. This study will present our experience and results of consecutive resections.

Methods  ASSEA following a resection of the rectum and sigmoid colon for carcinomas was consecutively performed between October 1998 and May 2002. Age, sex, pre‐operative anal function, the TNM classification by the UICC rules, operative methods, postoperative morbidity, mortality, anal function and bowel frequency were evaluated.

Results  Sixty‐nine consecutive patients underwent a resection of the rectum and sigmoid colon with ASSEA. There were three (4.3%) clinical anastomotic leakages in the cases studied. Anastomoses that were located above the peritoneal reflection leaked in one (2.5%) of 40 cases, while anastomoses below the peritoneal reflection leaked in two (6.9%) of 29 cases. A diverting stoma was performed in five (17%) of the 29 cases with low anastomosis. Postoperative anal function was stable without soiling or faecal leakage and bowel frequency two months after surgery was less than four times in all 61 patients. There was no postoperative mortality related to the anastomosis.

Conclusions  Abdominal stapled side‐to‐end anastomosis(Baker type)was found to be a safe and relatively easy method in both low and high anterior resection in association with a good quality of life.
High compliance rates observed for follow up colonoscopy post polypectomy are achievable outside of clinical trials: efficacy of polypectomy is not reduced by low compliance for follow up
Authors: Colquhoun P. , Chen H.‐C. , Kim Jong Ik , Efron J. , Weiss E. G. , Nogueras J. J. , Vernava A. M. , Wexner S. D.
Published: April 2004

Introduction  The National Polyp Study demonstrated that removal of adenomas with at least a three‐year follow up reduced the incidence of colorectal cancer. However, compliance with follow up colonoscopy may affect the estimates of reduction in colorectal cancer incidence demonstrated by the National Polyp Study. While an 80% compliance rate for follow up colonoscopy was achieved during the National Polyp Study, the compliance rate for follow up colonoscopy is unknown in the general population. The aim of this study was to determine the compliance rate for follow up colonoscopy and factors which affect follow up.

Methods  A retrospective medical record review to identify patients who had adenomatous polyps excised in 1997 was undertaken. Patients who had inflammatory bowel disease, a prior history of colorectal cancer, familial adenomatous polyposis syndrome, colonic surgery; incomplete polypectomy or incomplete colonoscopy, and those patients who died before planned follow up, were excluded from analysis. Follow up was performed by telephone survey.

Results  Three hundred and thirty‐three patients were identified (196 males; 147 females) with a mean age of 70 years. Three hundred and thirty‐one (99%) of 333 had a documented recommendation for follow up of three years or less. Thirty‐four percent (113 of 333) had previously undergone colonoscopy; 29% (98 of 333) had previously undergone polypectomy and 54% (180 of 333) were symptomatic at the time of the colonoscopy. Twenty‐eight percent (40 of 141) had a family history of colorectal cancer. Pathology at polypectomy included a single polyp and polyps less than 10 mm in 68% and 88% of cases, respectively. Follow up was available in 211 of these cases, 179 (85%) of which had been compliant with follow up colonoscopy. In a univariate analysis, previous colonoscopy (P = 0.035), previous polyps (P = 0.043), asymptomatic status at time of colonoscopy (P = 0.021), polyp size (P = 0.008) and number of polyps (P = 0.010) were significantly associated with patients who were compliant with follow up colonoscopy. A multivariate logistics regression analysis revealed number of polyps (P = 0.036) and polyp size (P = 0.045) to be statistically significantly associated with compliance.

Conclusion  Compliance with follow up colonoscopy after polypectomy is greater than 80%, regardless of age, education, family history, prior colonoscopy, or prior polypectomy. Risk reduction published in the National Polyp Study may likely reflect what can be achieved through the general use of colonoscopy for surveillance.
Long‐term urinary dysfunction after rectal cancer surgery
Authors: Del Río C. , Sánchez‐Santos R. , Oreja V. , De Oca J. , Biondo S. , Parés D. , Osorio A. , Martí‐Ragué J. , Jaurrieta E.
Published: April 2004

Objective  Urinary dysfunction is a well‐known complication of rectal surgery, secondary to injury to the autonomic nervous plexus. The object of this study was to evaluate the incidence, prevalence and type of micturition disorders following rectal cancer surgery and their reversibility during long‐term follow‐up.

Patients and methods  A prospective study of 45 patients who underwent surgery for rectal cancer between 1993 and 1998 was undertaken. Those with pre‐operative urinary dysfunction were excluded after sequential uroflowmetry and clinical interview. Ten of the surgical interventions were high anterior resections, 18 low anterior resections, and 17 abdominoperineal amputations. Pre‐operative radiotherapy was performed in 47.9% of patients. All patients underwent sequential uroflowmetry and a clinical interview 3 and 12 months after the intervention. Subjects who presented micturition disorders underwent urodynamic examination The follow up period was three years.

Results  Three months after surgery alterations were found in 14 (31.3%) patients; the most frequent were stress incontinence, urinary tenesmus and the urge to urinate. At the 12‐month assessment only 6 (13.3%) patients had urinary symptomatology or uroflowmetry abnormalities. After three years, micturition disorders persisted in 3 (6.6%) patients.

Conclusion  Urinary dysfunction after rectal cancer excision is associated with a high degree of reversibility. Seventy‐eight percent of the alterations detected after three months and 50% of those that persisted after a year disappeared during follow up.
Regulatory Transparency in OECD Countries: Overview, Trends and Challenges
Authors: Deighton‐Smith Rex
Published: April 2004

The concept of transparency has rapidly gained prominence in Organisation for Economic Cooperation and Development (OECD) countries. It is particularly associated with the rise of the governance agenda, as transparency is a core governance value. The regulatory activities of government constitute one of the main contexts within which transparency must be assured. There is a strong public demand for greater transparency, which is substantially related to the rapid increase in number and influence of nongovernmental organisations (NGOs) or ‘civil society groups’, as well as to increasingly well educated and diverse populations.

Transparency initiatives now form a major part of the regulatory policies of many OECD countries: in 2000, 20 of the 30 OECD member countries had government‐wide transparency policies (OECD 2002a). Many OECD countries have now made substantial investments in improved regulatory transparency, and have reaped important gains in terms of regulatory quality, legitimacy and accountability.

However, despite these gains, the results have in many cases fallen short of expectations. As well, the implementation of transparency has itself led to new stresses and problems within the regulatory process. This article considers why regulatory transparency is important and points to some of the main trends in improving regulatory transparency. It also considers a range of problems and issues that arise and suggests means of resolving these.
Security, Capacity and Post‐Market Reforms: Public Management Change in 2003
Authors: Halligan John , Adams Jill
Published: April 2004

Public sector change in 2003 was a product of external demands and internal pressures for improvement. The specific areas addressed are responses to security threats in the international environment; strengthening internal capacity, particularly through whole‐of‐government approaches; and fine‐tuning the public management model in part through readjustments to the centre‐agency relationship and greater emphasis on horizontal structures and processes.

This is the ninth year an administrative essay has been published in the journal since 1996. Earlier chronicles include: J. Stewart 55(1) 1996; S. Prasser 56(1) 1997; J. Homeshaw 57(3) 1998; J. Moon 58(2) 1999; J. Curtin 59(1) 2000; C. Broughton and J. Chalmers 60(1) 2001; N. Miragliotta 61(1) 2002; and J. Nettercote 62(1) 2003.

In this issue two chronicles are published — the first, by John Halligan and Jill Adams, focuses on external security and internal capacity building. The second assessment by Scott Prasser takes a different view of compliant management, poor decisions and reactive change.
The consistency of baseline assessment schemes as measures of early literacy
Authors: Lindsay Geoff , Martineau Emma , Lewis Ann
Published: April 2004

Ninety‐one baseline assessment schemes were approved by the Qualifications and Curriculum Authority for use by schools for the assessment of all children in England in their first seven weeks in school (age 4 to 5 years). Analysis of the content of a sample of 42 of the schemes (comprising all the schemes supplied in full to the researchers) showed considerable variation both in the level of ability demanded and of the content. This paper examines the range and balance of content across baseline assessment schemes with particular reference to literacy, and particularly writing ability. The implications of the variability demonstrated are considered with reference to the purposes of baseline assessment and to political decisions regarding changes from a system of accreditation of 91 schemes at school entry to a single national scheme at the end of the foundation stage scheme implemented in England from 2003.
Issues in the assessment of literacy‐related difficulties across language backgrounds: a cross‐linguistic comparison
Authors: Everatt John , Smythe Ian , Ocampo Dina , Gyarmathy Eva
Published: April 2004

This paper focused on the assessment of phonological skills amongst children with developmental dyslexia. Findings from assessments of English and Hungarian monolingual children with and without literacy deficits and bilingual Filipino children with and without literacy deficits in English indicated that performance on phonological‐based tasks often used in dyslexia assessment batteries was influenced by the language background. Monolingual English children with poor literacy skills showed characteristic deficits in most areas of phonological ability, whereas Hungarian counterparts showed little evidence of such difficulties. Bilingual Filipino children with poor English literacy skills showed equivalent profiles to their monolingual counterparts only when assessments in both English and Filipino were considered. The paper discusses difficulties of generalising assessment procedures from one language context to another.
Postmodern principles for responsive reading assessment
Authors: Harrison Colin
Published: April 2004

This paper reviews the concept of high‐stakes assessment against a background of postmodernism, and argues that the inaccessibility of cognitive processes is only one part of the problem of reading assessment: even greater challenges are posed by a postmodern analysis, in which an ‘incredulity toward metanarratives’ leads to a series of six theoretical positions, from each of which is derived a practical imperative that might guide us in establishing postmodern principles of assessment. These six imperatives are then explored in relation to two practical contexts, one in the area of portfolio or evidence‐based assessment, the other in the area of computer‐based assessment of reading. In both cases, it is argued that, working from first principles, the case for using such approaches can be established. Second, it is argued that while both these approaches to assessment offer empirical and methodological challenges that have yet to be met, they also offer opportunities for valuing the individual subject and diminishing the authority of the author and the text in ways that are in harmony with a postmodern position.
Surgical Approaches to Recipient Vessels of the Head and Neck for Microvascular Free Tissue Transfer in Dogs
Authors: Degner Daniel A. , Walshaw Richard , Fowler J. David , Lanz Otto I. , Ocello Peter , Maier Jackie , Blaezer Loren , Smith Rick J.
Published: April 2004

Objective—To develop and evaluate surgical approaches to the arteries and veins of the head and neck for use as potential recipient vessels for free tissue transfer.

Study Design—Experimental anatomic study.

Sample Population—Eleven canine cadavers; 2 preserved cadavers and 9 fresh cadavers.

Methods—The head and neck of one preserved cadaver injected with pigmented silicone/barium, through the common carotid artery and external jugular vein, was cut in 1 cm sagittal sections and cross‐sections. These tissue sections were used to identify the location of recipient vessels >1 mm that could be used as recipient vessels for free tissue transfer. The other preserved cadaver was used to develop surgical approaches to these vessels. Three board certified surgeons evaluated the written descriptions and illustrations of the approaches using fresh cadavers. Modifications to the surgical approaches were made based on recommendations from these surgeons.

Results—Seven approaches were developed to isolate recipient vessels of the head and neck region. The infraorbital, temporal, and sublingual approaches were easily performed and provided excellent access to the vessels in the region. The approach to the caudal auricular vessels was found to be more difficult but modification of the approach resolved this problem. Access to the facial artery was difficult; it was consistently <1 mm in diameter and thus its use could not be recommended. The approach to the vessels in the cervical region was easily performed. Because of the large size of the external jugular vein and the common carotid artery, end‐to‐side anastomosis of the donor to recipient vessels is necessary. The large superficial cervical vessels were easily accessed by a lateral shoulder approach.

Conclusions—Surgical approaches to potential recipient vessels of the head and neck were consistently achieved and provided relatively easy access to the vessels.

Clinical Relevance—The surgical approaches described in this report can be used to isolate arteries and veins of the head and neck that are >1 mm in diameter. These vessels are suitable for use as recipient vessels for free tissue transfer for reconstruction of complex wounds of the head and neck.
Femoral Bone Adaptation to Stable Long‐Term Cemented Total Hip Arthroplasty in Dogs
Authors: Bergh Mary Sarah , Muir Peter , Markel Mark D. , Manley Paul A.
Published: April 2004

Objective— To quantify long‐term bone adaptation after stable cemented total hip arthroplasty (cTHA) in dogs.

Study Design— Clinical study.

Animals— Fourteen dogs.

Methods— Femoral specimens were collected from client‐owned dogs that were donated after death because of causes unrelated to their cTHA. Mean (±SEM) dog age was 11.4±0.7 years and implant duration was 5.3±0.7 years. Implant stability was established from radiographic signs and gross mechanical stability. Femurs were evaluated at 3 levels based on implant length: proximal stem (PS), mid‐stem (MS), and distal to stem (DS). Cortical area, medullary area, and porosity were measured at each level. Implanted femurs were compared to contralateral nonimplanted femurs.

Results— Cortical area and cortical porosity were significantly increased in implanted femurs compared to nonimplanted femurs. Cortical area was increased at the MS and DS levels, and porosity was increased at the PS and MS levels in implanted femurs. Porosity was greatest in the endosteal region at the PS and MS levels in implanted femurs.

Conclusions— Significant differences in femoral geometry and cortical porosity were detected after long‐term stable cTHA. Net bone loss proximally and increased bone mass distally support stress shielding as a important mechanical factor associated with bone adaptation. Distribution of porosity shifts to endosteal regions after long‐term cTHA.

Clinical Relevance— Significant site‐specific femoral adaptation occurs in response to stable cTHA and may precede implant loosening.
Endoscopic‐Assisted Lumbosacral Foraminotomy in the Dog
Authors: Wood Brett C. , Lanz Otto I. , Jones Jeryl C. , Shires Peter K.
Published: April 2004

Objective—To determine if endoscopic‐assisted foraminotomy significantly increased the area of the L7‐S1 intervertebral foramen and if, over 12 weeks, stenosis would occur.

Study Design—Prospective, experimental study.

Animal Population—Six clinically normal, 22–29 kg, adult dogs.

Methods—Using endoscopic assistance, unilateral L7‐S1 foraminotomy was performed. Computed tomography of L7‐S1 was performed preoperatively, immediately postoperatively, and at 12 weeks. Parasagittal foramen area (PFA) measurements were obtained at the entry, middle, and exit zones of the treated and control foramen for each period. Objective and subjective data were compared among dogs by time period and treatment status.

Results—Endoscopic‐assisted foraminotomy resulted in a significant increase in the mean PFA of the entry and middle zones immediately postoperatively. The exit zone was not significantly larger at any time. The foramen remained significantly larger at 12 weeks only in the middle zone; however, some decrease in the surgically created foramen enlargement occurred at all 3 levels. The procedure was well tolerated but dogs did have transient, mild delay of functional return postoperatively.

Conclusions—Endoscopic‐assisted foraminotomy in dogs can be performed for certain foraminal regions, allowing enhanced visibility of the spinal canal. The foramen can be surgically enlarged at the entry and middle zones using this technique; however, some reduction of the foraminal enlargement occurs by 12 weeks. The clinical implications of this reduction cannot be determined from this study.

Clinical Relevance—Endoscopic‐assisted foraminotomy could be used to improve intraoperative visualization in dogs with foraminal stenosis as a component of degenerative lumbosacral stenosis.
A Biomechanical Comparison of Headless Tapered Variable Pitch Compression and AO Cortical Bone Screws for Fixation of a Simulated Midbody Transverse Fracture of the Proximal Sesamoid Bone in Horses
Authors: Eddy Alison L. , Galuppo Larry D. , Stover Susan M. , Taylor Kenneth T. , Jensen David G.
Published: April 2004

Objective—To compare mechanical properties and failure characteristics of 2 methods of fixation for repair of a transverse, midbody fracture of the proximal sesamoid bone (PSB): 4.5‐mm AO cortical bone screw (AO) placed in lag fashion and 4/5‐mm Acutrak® (AT) self‐compressing screw.

Study Design—An in vitro biomechanical evaluation of intact forelimb preparations and forelimb preparations with a simulated midbody PSB fracture stabilized by a bone screw.

Sample Population—Sixteen paired and 8 unilateral cadaveric equine forelimbs.

Methods—A midbody transverse osteotomy was created in the medial PSB of bilateral forelimbs of 8 equine cadavers. The osteotomized PSB in 1 forelimb from each cadaver was repaired with an AO screw. The osteotomized PSB in each contralateral limb was repaired with an AT screw. Eight unilateral intact control limbs were also studied. Mechanical properties were determined from axial compression, single cycle to failure, load–deformation curves. Failure characteristics were determined by evaluation of video images and radiographs.

Results—No statistically significant differences were found between repair groups. Both AO and AT groups had significantly lower mechanical properties than intact limbs except for stiffness.

Conclusion—AO and AT constructs were mechanically comparable when used to stabilize a simulated midbody fracture of the medial PSB. Both constructs were mechanically inferior to intact limbs.

Clinical Relevance—The AT screw should be considered for clinical use because of the potential for less soft tissue impingement and superior biocompatibility compared with the stainless‐steel AO screw. However, postoperative external coaptation is necessary to augment initial fracture stability for either fixation method, and to maintain a standing metacarpophalangeal joint dorsiflexion angle between 150° and 155°.
Periapical Curettage: An Alternative Surgical Approach to Infected Mandibular Cheek Teeth in Horses
Authors: Carmalt James L. , Barber Spencer M.
Published: April 2004

Objective—To evaluate an alternative surgical method for treating periapical infection of the mandibular cheek teeth of horses.

Design—Retrospective study.

Animals—Eleven horses (3–13 years) with periapical mandibular tooth infection.

Methods—Hospital records (1992–2002) of horses that had periapical curettage for the treatment of mandibular cheek tooth root infection were retrieved. Clinical signs, radiographic, and surgical reports were reviewed. Outcome was obtained by telephone questionnaire for 7 horses and by physical examination in 2.

Results—Eleven horses (14 infected mandibular molariform teeth) had periapical curettage. Two horses were lost to follow‐up. Mean follow‐up was 41 months; 2 horses had subsequent tooth repulsion, 7 (78%) horses healed completely although 2 horses still had some local mandibular swelling.

Conclusion—Periapical curettage, which allows alveolar drainage, appears to be a viable treatment option for periapical infections of equine mandibular cheek teeth.

Clinical Relevance—Periapical curettage can be performed simply, without expensive imaging or surgical equipment, and thus is useful for both referral and first opinion practice.
The Effect of Stem Length on Femoral Component Positioning in Canine Total Hip Arthroplasty
Authors: Dearmin Michael G. , Schulz Kurt S.
Published: April 2004

Objective—To determine the effects of femoral prosthesis stem length on positioning of the femoral component within the canine femur.

Study Design—An in vitro experimental study.

Sample Population—Eleven adult, mixed breed, canine cadaver femurs.

Methods—Polymethylmethacrylate centralized Biomedtrixtmsize 5, 6, and 7 standard and 1cm shortened implants were placed in specimens, manipulated to achieve maximal displacements of the implant tip in each plane, and radiographed. Measurements of the implant angle, tip offset, and minimal tip to endosteal surface distance were obtained with image processing software. The effects of implant length and size on implant positioning were evaluated with the use of Student'st, χ2exact, and 2‐way ANOVA testing.

Results—Statistically significant increases were noted in tip to caudal cortex distance in the sagittal plane, and available angle variability and tip offset variability in the transverse plane for shortened size 6 and 7 stems relative to the standard stems. No significant differences were noted in size 5 stems. Statistically significant increases in tip to caudal cortex distance and transverse plane available angle variability for standard 6 compared to standard 7 stems were noted.

Conclusions—Shortened stems result in statistical improvement of several variables of femoral component positioning. However, the improvement appears to be clinically negligible.

Clinical Relevance—Alteration of current stem lengths is not recommended. The use of undersized standard implants may improve femoral component positioning in total hip arthroplasty.
Assessing the Efficacy of Perioperative Oral Carprofen after Cranial Cruciate Surgery Using Noninvasive, Objective Pressure Platform Gait Analysis
Authors: Horstman Christopher L. , Conzemius Michael G. , Evans Richard , Gordon Wanda J.
Published: April 2004

Objective—To document, using pressure platform gait analysis, the effect of perioperative oral carprofen on limb function and pain after cranial cruciate ligament surgery in dogs.

Study design—Blinded, prospective clinical investigation.

Animals—Twenty dogs with naturally occurring unilateral cranial cruciate disease.

Procedure—Physiologic indices, subjective pain scoring, and pressure platform gait analyses were performed before and 24, 48, and 72 hours after surgery. Correlations were assessed between methods of evaluation and the data was compared across treatment groups.

Results—No strong correlations were noted between physiologic data, subjective scoring systems, or gait analysis data at a walk or stance. Although average measures of limb function were nearly twice as large in dogs treated with carprofen, no significant differences between groups over time were identified. No significant differences were noted in any other measure of pain or limb function. Power analysis of peak vertical force at a walk indicated that significant difference would have been detected had the number of dogs in each group been increased to 35.

Conclusion—When limb function was assessed with pressure platform gait analysis no statistical difference was noted between groups with respect to PVF and VI at a walk or stance, although average ground reaction forces for dogs in the carprofen group were greater than the traditional pain management group at all time points.

Clinical Relevance—Oral carprofen appears to provide some benefit for the treatment of postoperative orthopedic pain.
Beyond the Significance Test in Administrative Research and Policy Decisions
Authors: Rothstein Hannah , Tonges Mary Crabtree
Published: April 2004

Purpose: To describe confidence interval (CI) analysis and show how it can be used in administrative decisions.

Organizing Construct: Statistical significance testing should be supplemented, if not replaced, by effect size (ES) estimation and confidence interval analysis. Hypothesis testing based on the statistical significance test is the dominant paradigm in statistics; however, this approach has inherent problems which can ultimately diminish the usefulness of research for perational decisions. After identifying major difficulties with significance testing, the authors use hypothetical examples to demonstrate how ES and CI analysis provide more informative answers to nursing administrative research questions.

Conclusions: CI analysis provides the basis for both improving the interpretation of findings from individual studies and for facilitating the analysis of cumulative evidence. By clarifying the meaning of results, CI analysis can increase the relevance and usefulness of research for health care executives and practitioners.
Comparison of Nurse Practitioner and Family Physician Relative Work Values
Authors: Sullivan‐Marx Eileen M. , Maislin Greg
Published: April 2004

Purpose: With the enactment of the Balanced Budget Act of 1997, American nurse practitioners were granted direct Medicare reimbursement for Part B services. Payment structures in fee‐for‐service and managed care systems are physician‐based, leading to difficulties in constructing payments for other health care professionals. The purpose of this pilot study was to examine the feasibility of using nurse practitioner data for specifying relative work values in the Medicare Fee Schedule for three office‐visit codes.

Design: An exploratory survey was designed to establish relative work values using magnitude‐estimation scaling. Nurse practitioners (N=43) responded to a structured questionnaire in a national mail survey. Physician data (N=46) were obtained from a computerized database from the American Academy of Family Physicians.

Methods: The methods used in this study were the same as the process used by the American Medical Association and the Health Care Financing Administration to establish relative work values in the Medicare Fee Schedule. Respondents established relative work values for three Current Procedural Terminology (CPT) codes for office visits (99203, 99213, 99215) commonly billed in primary care practice. Each CPT code descriptor and associated vignette were compared with reference services germane to the practice of nurse practitioners and family physicians, using magnitude‐estimation scaling. To establish relative work values for each code, respondents were asked to consider the time to provide the service and intensity of the work involved for each CPT code.

Findings: No significant differences between nurse practitioners and family physicians were found in the three CPT codes for relative work values and intensity. Nurse practitioners estimated significantly (p < .01) higher intraservice (face to face) time with patients than did family physicians, and family physicians estimated significantly (p < .05) higher pre‐service time for two codes and significantly (p < .05) higher postservice times for three codes.

Conclusions: Nurse practitioner relative work values did not differ significantly from family physician relative work values. Although the sample sizes were small, the significance of the findings support the need for further research with large data sets and additional CPT codes. Such studies could then be used as a basis for decisions about Medicare payment and public policy.
Nursing Publications Outside the United States
Authors: McConnell Edwina A.
Published: April 2004

Purpose: To replicate a 1992–1993 study of the characteristics of English‐language nursing journals originating in countries other than the United States and to compare findings. Such information heightens awareness of publishing opportunities globally and enhances dissemination of information throughout the world.

Design: Descriptive survey with a questionnaire mailed to 159 editors of nursing and nursing‐related journals. Data about the publication year, 1995, were collected from April 1996 through March 1997.

Method: A 38‐item questionnaire pertaining to journal, readership, manuscript review, and journal staff characteristics was used.

Findings: Information about 82 journals from 13 countries was collected with an overall response rate of 55%. In the 1992–1993 study the United Kingdom, Canada, and Australia accounted for the largest percent of publications. With few exceptions, results of the 1996–1997 and the earlier survey are remarkably similar. Differences include a higher total circulation, changes in circulation among journal categories, and more publications offering services to authors. Two main reasons for manuscript rejection continue to be that a manuscript is poorly written or poorly developed.

Conclusions: Increased awareness of non‐U.S. publishing outlets can lead to the acceptance of informative and well‐written manuscripts and ultimately to the dissemination of information and knowledge.
Caring for Dying Patients Who Have Air Hunger
Authors: Tarzian Anita J.
Published: April 2004

Purpose:To understand nurses' experiences of caring for dying patients who have ‘air hunger.’ When air hunger occurs in people who are close to death, it often triggers increasing panic and breathlessness. Describing this phenomenon is an initial step toward a more informed and consistent response to air‐hungry patients.

Design and Methods:Phenomenological study of 10 hospice, long‐term care, oncology, or emergency medicine nurses who cared for air‐hungry dying patients. Analysis was based on van Manen's guidelines for interpretive phenomenology. Interviews with two family members who witnessed their dying spouses suffer from air hunger were used to complement the nurses' accounts.

Findings:Themes of (a) the patient's look–panic beckons, (b) surrendering and sharing control, and (c) fine‐tuning dying indicated ways nurses responded to relieve a patient's air hunger, including being prepared before air hunger occurs, calming patients and families, medicating patients, improvising care, attending to family members' needs, and drawing a distinction between palliating and killing.

Conclusions:The three themes provide a framework for a new vision of “doing everything” for a dying person who suffers from air hunger. Care encompasses knowing what to do as well as how to stay present during suffering.
Strategies to Facilitate Lifestyle Change Associated with Diabetes Mellitus
Authors: Whittemore Robin
Published: April 2004

Purpose: To critically examine the literature about strategies and factors that influence lifestyle change in people with diabetes mellitus.

Method: This integrative literature review included an extensive search of published literature about strategies to facilitate lifestyle change related to diabetes mellitus. Articles reviewed were empirical studies focused on lifestyle change and were published between 1985 and 1999. Meta‐analyses and relevant reviews of the literature were also included. Over 90 articles were initially identified, 72 met the specified criteria and could be categorized according to a theoretical framework or a broad topic area.

Findings: Studies were clustered into the categories of educational, behavioral, cultural, and health beliefs that influence or are barriers to lifestyle change. Studies indicate that positive outcomes are associated with diabetes education programs that focus on self‐management, emphasize behavioral strategies, and provide culturally relevant information.

Conclusions: Theoretically grounded research in diabetes care is imperative for the future. Expansion of research methods, continued methodological rigor of studies, and instrument development would contribute to knowledge development in diabetes care. Research priorities are proposed.
Spirituality and Distress In Sheltered Battered Women
Authors: Humphreys Janice
Published: April 2004

Purpose: To examine the relationship between spiritual beliefs and psychological distress in sheltered battered women.

Design: A convenience sample of 50 ethnically diverse women who had resided for at least 21 days in battered women's shelters participated. Data were obtained over a 7‐month period in 1998 and 1999.

Methods: Participants completed the Spiritual Perspective Scale (SPS), Symptom Checklist‐ 90‐Revised (SCL‐90), Conflict Tactics Scale, and a demographic data sheet.

Results: These sheltered battered women placed high value on their spiritual beliefs and used a variety of spiritual practices to aid them. The relationship between the Global Severity Index as measured by the SCL‐90 and SPS scores approached statistical significance (r = ‐.27, p = 0.06). However, a significant inverse relationship was found between the SPS score and the obsessive‐compulsive score (r = ‐.34, p < 0.05), interpersonal sensitivity score (r = ‐.31, p <.05), and hostility dimensions score (r = ‐.37, p < 0.01) of the SCL‐90.

Conclusions: The findings indicated that, among these sheltered battered women, spirituality may be associated with greater internal resources that buffer distressing feelings and calm the mind. This study shows support of spirituality as a means of reducing distress through greater connection to oneself and higher powers.
Empowerment of Nursing as a Socially Significant Profession in Vietnam
Authors: Jones Patricia S. , O'Toole Marie Theresa , Hoa Ngyuen , Chau Tran Thi , Muc Pham Duc
Published: April 2004

Purpose: To describe nursing education and practice in Vietnam, and strategies that support empowerment of nursing as a socially significant profession for that country.

Design: The Jones‐Meleis health empowerment model was used as a framework to examine barriers and identify strategies that support empowerment.

Methods: Fieldwork, interviews, and participation‐observation in collaborative partnerships with the Ministry of Health, the national nurses association, and schools of nursing in Vietnam.

Findings: Nurses in Vietnam are eagerly poised to make significant and essential contributions to the well‐being of society.

Conclusions: Baccalaureate and master's degree nursing curricula taught by nurses are necessary for professionalization of nursing practice in Vietnam.