bluuebunny/crossref_metadata_2025 huggingface dataset:
Strengthening health promotion in Australian workplaces
Authors: John Fisher K , Deeds Sigrid , Siebel Roderick
Published: February 2010

The Australian workplace has emerged as an important venue for influencing thehealth of employees through regulations and behaviour change programs. Recentsurveys have highlighted a growth in this activity but the effectiveness of these programsin changing unhealthy work practices and policies is questionable. The need forstrengthening programs by stronger designs and evaluation, and addressingorganisational factors and employee participation in planning and implementationprocesses is documented. Efforts in that direction in Queensland are cited. Buildingon these existing foundations, redirecting existing resources, and building intersectoralcooperation in public?private partnerships hold a creative, exemplary vision of thefuture for Australian workplace programming.
The Home Based Rehabilitation Service: Rationale, operation and outcomes
Authors: Bairstow Phillip J , Ashe Sarah , Heavens Mary
Published: February 2010

The Home Based Rehabilitation Service was established as an allied health earlydischarge and outreach service from a major metropolitan post-acute teaching hospital.Two hundred and eighty-two patients were discharged to the service according toestablished criteria from the following specialities: neurology, neurosurgery,rheumatology, amputation, orthopaedic and spinal. Inpatient length of stay wasreduced by 19 days on average (the range was 3?75 days). Inpatient throughput wasincreased equivalent to 10 extra beds on an annual basis. The cost of home-basedservices was 11- per cent of the cost of the inpatient services they replaced. There werelow rates of hospital readmissions, and users registered high levels of satisfaction withthe service.
Corporate information systems in health organisations
Authors: Smith Jack
Published: February 2010

This paper presents an overview of the nature of corporate information systems and their applications in health organisations. It emphasises the importance of financial and human resource information in the creation of a corporate data model. The paper summarises the main features of finance and human resource systems as they are used in health organisations. It looks at a series of case studies carried out in healthorganisations, which were selected on the basis of their representation of different aspects of service delivery. It also discusses the theoretical and practical perspectives of the systems themselves, their roles in information management, executive and decisionsupport, and in planning and forecasting.
A partnership of care:An approach to the management of adults with cystic fibrosis
Authors: Gledhill Susan
Published: February 2010

Several factors occurring more or less simultaneously have led to a major change in the management of adults with cystic fibrosis at The Prince Charles Hospital,Brisbane. Less than 50 years ago, 80- per cent of infants born with cystic fibrosis did not survive the first two years of life. In Australia today, the median survival is around30 years of age, with many surviving into their fourth decade (Landau & Ryan 1991,p 4). Recent developments in the management and treatment of cystic fibrosis provide an exciting and promising foundation for further development and a changing focus in cystic fibrosis management.Increased longevity has significant implications for the management of adults with cystic fibrosis. Until recently, most people with cystic fibrosis were managed within the paediatric setting, with the expectation that life expectancy would not exceed adolescence. In reality, there has been a dramatic increase in the number transferring from children's hospitals to adult facilities, and a subsequent need to provide optimal care to a group of patients coming to terms with their own perceptions of being adolescents with a life-shortening condition.From an organisational perspective, the increased demand for resources has generated the need to consider alternative methods of providing care. Such options include home intravenous therapy, day admission, alternative accommodation and education of staff in remote health centres. Home intravenous therapy has proven to be a popular alternative to hospital treatment and has significant implications for reducing lengths of stay and occupied bed-days.Within the current focus on best practice, developing strategies for providing optimal health care in the hospital setting are paramount. A multidisciplinary team focus based on a 'partnership of care' philosophy underpinned by best practice principles describes the approach adopted by the cystic fibrosis team at The Prince Charles Hospital that has led to successful outcomes in meeting challenges inherent in the care of young adults with cystic fibrosis.
The Balmain Hospital General Practice Casualty: An alternative model of primary health care provision
Authors: Bolton Patrick , Mira Michael , Sullivan Mary
Published: February 2010

The Balmain Hospital General Practice Casualty is a unique casualty style service,staffed and run by local general practitioners. It is a joint initiative of the CentralSydney Area Health Service and the Division of General Practice, Central SydneyArea, and is jointly funded by the Area Health Service and the Commonwealth.The casemix seen and type of services provided suggest that the service is intermediatebetween that provided by general practitioners and that provided by emergencydepartments. The service is well accepted by patients and local general practitioners.A number of benefits are seen by both service providers and users in terms ofcontinuity of care and increased general practitioner skills.
Defining an episode of care: A study of five Case Types
Authors: Eagar Kathy
Published: February 2010

This is the first study in Australia to test definitions of various types of episodes of care. The definitions reported here are those used in the 1996 National Sub-Acuteand Non-Acute Patient (SNAP) Casemix Classification Study.The study collected data on a total of 683 patients at 10 hospitals and two communityhealth services providing a range of rehabilitation, aged care and community careservices. The kappa statistic (k) was used to determine the significance of the level ofagreement between raters. The value of kappa was 0.838 with a 95per cent confidence interval of 0.801 to 0.975.The results of this study are encouraging and support the use of the five Case Types? Palliative Care, Rehabilitation, Psychogeriatric, Geriatric Evaluation and Management, and Maintenance Care. All five Case Types proved to have good inter-raterreliability, there was a good fit for most patients, and staff found the definitionseasy to use.
Using partner hospitals in collaborative benchmarking
Authors: Robinson Maureen , Campton Janet
Published: February 2010

In May 1994 the Physiotherapy Department at John Hunter Hospital received a Commonwealth Best Practice in the Health Sector grant to design a critical pathway for the treatment of stroke.The implementation of the pathway at John Hunter Hospital and the introduction of the methodology to secondary sites (The Alfred Healthcare Group, Melbourne, and Royal Hobart & Repatriation General Hospitals, Hobart) resulted in the development of a Benchmarking Consortium.This paper will discuss the importance of benchmarking in understanding clinical processes, and the methodology employed to ensure that meaningful benchmarks wereachieved.
Elective admission policies in New South Wales public hospitals
Authors: Wolk Jael , Baume Peter
Published: February 2010

Objective: To assess the existence and content of elective admission policies in New South Wales acute public hospitals.Methods: A questionnaire was sent to managers of all acute public hospitals (n=76).Copies of elective admission policies were sought from respondents. Results wereanalysed with EpiInfo 5.01b and policy content by thematic analysis.Results: Survey response was 91% (69/76). Policies existed in 71% (49/69) of hospitals. Of these, 96% (47/49) disseminated their policy, with 23% (11/47)disseminating it at least annually, 41% (19/47) only when updated, and 32% (15/47) infrequently, with one policy being new (2%) and one hospital not statingits frequency (2%). Policy compliance was assessed in 86% (42/49) of hospitals andguidelines reviewed periodically in 92% (45/49) of hospitals. Twenty per cent(10/49) of the policies had been developed since a departmental instruction of May 1994. Of the 20 acute hospitals with no policy, 75% (15/20) were rural and 85%(17/20) thought they should have a policy. Analysis of policy content revealed emphases on resource availability and clinical need as determinants of elective admission, aninstitutional rather than a patient focus, and a high level of senior nurse managerinvolvement in admission decisions in rural hospitals.Conclusions: Despite a specific departmental instruction, nearly one-third of hospitals still had no admission policy 18 months later. This could be indicative of miscommunication between hospitals and NSW Health or perceived irrelevance ofdepartment guidelines by hospital managers. Existing policies were mostlyinstitutionally focused and dominated by perceived resource limitations. NSW Health might consider other medico-social factors and manager involvement in future policy development.
The Commonwealth's proposal for the 1998-2003 Health Care Agreements
Authors: Bigg Ian , Amzi Susan , Maskell-Knight Charles
Published: February 2010

8The new Health Care Agreements for 1998?2003 are currently being negotiatedbetween the Commonwealth and State and Territory governments. TheCommonwealth?s offer aims to address the major problems associated with the currentAgreements, including cost-shifting incentives and funding rigidities.It has proposed a funding model whereby admitted and non-admitted patient servicesare funded on an output basis. Other aspects of the proposal include funding forquality enhancement and structural change, and specific funds for mental health andpalliative care. The proposal also aims to achieve a more equal sharing of risks andbenefits between the Commonwealth and the States and Territories.The views expressed are those of the authors and should not be taken as an officialview of the Department or the Minister. While the authors have had primaryresponsibility for the development of the Commonwealth model and the preparationof this paper, they wish to thank other members of the Health Care Agreements Branch(Heather Cocks, Ian Macdonald, Elaine Pringle and Shane Wright) for theirassistance.
Status of total quality management in Australian public health organisations
Authors: Turner Ruth , Hartley Ross
Published: February 2010

Research suggests that there is some confusion among quality improvement managersabout the differences between quality management and traditional quality assurance.This lack of understanding would appear to be the same among rural and urbanhealth staff, although there is a higher percentage of staff engaged in multidisciplinaryactivities in the rural health services. Education of staff and commitment from topmanagement would seem to be the factors inhibiting the health industry fromincorporating quality management into their cultures.
Provider and consumer perceptions of allied health service needs
Authors: Rowan Sue
Published: February 2010

The study reported in this paper compared data from 20 separate focus groups,representing providers and consumers of health services in the Grampians region,Victoria, on their perceptions of the allied health service issues in that region. Theresults of the study indicated that providers and consumers raised many similar issuesin regard to allied health services ? access to allied health services, service delivery,social and rural issues ? but discussed the issues from different perspectives. Theprovider discussion was concerned with service delivery issues and the consumerdiscussion was focused on broader social issues which affect health.
Future financial impact of the current health financing system
Authors: Badham Jenny
Published: February 2010

Major political parties remain publicly committed to Medicare and community-ratedvoluntary health insurance. It is important to understand the future financialconsequences of this policy in order to assist community debate about whether sucha commitment is appropriate or some other policy should be developed.This paper describes development of, and results from, the APHA health financingmodel. It suggests that health expenditure would represent 12.9percent; of gross domesticproduct by 2021, compared to 8.5percent; in 1995. Increasing per capita expenditureis the major contributor to the growth, with demographic changes responsible foronly 14.3percent;.
An emergency department tackles bed management and home-based care
Authors: Brierley Stephen , King David
Published: February 2010

Ipswich Hospital Emergency Department played a vital role in the Post AcuteTreatment in the Home Program (PATH) of West Moreton District Health Service.PATH used two strategies to reduce the district reliance on acute hospital beds: a short-stayunit for rapid assessment, treatment and early discharge of patients with simpleconditions; and a hospital-in-the-home program utilising community health servicesto treat acute conditions.The program enhanced existing services to create a new treatment stream for acutepatients and to promote a cultural shift from fragmented care to district responsibilityfor total episode of patient care.
The development and evaluation of satellite endoscopy services in Western Australia
Authors: Bramston Brian A , Logan Julia
Published: February 2010

A satellite endoscopy service was formally established in late January 1997 in oneperipheral hospital, a second service commencing in April 1997, and a third inDecember 1997. More than 500 patients underwent gastrointestinal endoscopicprocedures at these satellite services during 1997. The feedback received to dateindicates that the establishment of this service is supported by patients and theperipheral hospitals. It is expected that this project will achieve all its stated objectives.In addition, the implementation of this service will assist in improved waiting listmanagement at Royal Perth Hospital. The satellite endoscopy service is a uniquedevelopment in Western Australia and has demonstrated definite benefits to patientsin less than six months of operation.
Case management at Warringal Private Hospital: Challenges of development, implementation and evaluation
Authors: Yarmo Deborah , McDonald Melissa
Published: February 2010

Case management has the potential to improve the quality of care for patients,streamline efficiencies within organisations, and ultimately lower health careexpenditure. This article explores why Warringal Private Hospital embraced theconcept and how the chosen model of case management was developed. It describesthe implementation and evaluation of the model and how it was received, accepted,and applied by the various stakeholders. The cardiac and orthopaedic units will becited as case studies in order to emphasise some of the challenges encountered in thisprocess as well as the successful outcomes. It should be noted, however, that each unitwithin the hospital is unique and, although the principles of case management havebeen applied throughout the hospital, the development, implementation andevaluation has been specific to each unit.
Rationalising the ordering of bloodcultures
Authors: Kelly Anne-Maree
Published: February 2010

In 1996 a project was undertaken to determine the clinical impact of blood culturestaken in the emergency department. It found that 1.6 percent; of all blood cultures takenresulted in changes in patient management. In response to these findings, guidelineswere developed for more appropriate utilisation of blood cultures. It was predictedthat the guidelines would result in a reduction in test ordering of approximately 40 percent;and an annual saving of approximately $18 000. The guidelines were implementedin mid-1997. An audit of test ordering for the months of January to August 1998shows a 53 percent; reduction in the ordering of blood cultures.
Prescribed drugs: A major cause of ill health
Authors: Mackay Michael
Published: February 2010

Harm caused by ill-effects of prescribed drugs is largely unrecognised, but when lookedfor has been found to be an important cause of ill health. Perhaps 6% of all hospitaladmissions and some 800 deaths a year are caused by prescribed medication inAustralia. The elderly, especially those in institutions, are particularly prone to injuryby drugs. Attempts to use visiting pharmacists to influence the prescribing habits ofdoctors have resulted in unspectacular success. It is suggested that prescribing habitsmay more effectively be changed by visiting from specially trained practising doctors.
The effect of the 30% private health insurance rebate on the purchasing behaviour and intentions of the Australian popula
Authors: Clarke Philip M
Published: February 2010

This article examines the likely effect of the 30% private health insurance rebate on private health insurance coverage. It is based on a survey of the Australia population conducted in April-May 1999 which collected information on health insurance purchasing behaviour and intentions. These data are used to predict the subsidy's likely effect on hospital insurance coverage, with estimates ranging from 30.5% to 34.3% by May 2000. Ancillary insurance membership is forecast to increase to between 32.7% and 37.2% of the population over the same period. The 30% insurance rebate will probably produce, at best, a small increase in hospital insurance membership. The cost of the rebate is estimated at$1.4 billion in 1999-2000. Given the small increases in projected membership, the cost of the initiative is very- high.
A review of the role of information technology in discharge communications in Australia
Authors: Bolton Patrick
Published: February 2010

Information technology is believed to be useful for the communication of discharge information between hospitals and community-based health practitioners. At least 20 projects were conducted in Australia between 1993 and 1997 to explore this idea. The value of these projects was at least $618- 000. Despite this level of activity there is no good evidence, either from these projects or the international literature, to suggest that information technology can improve the quality of discharge communications.
Occupational stress in the operating theatre suite: Should employers be concerned?
Authors: Lynne Johnstone P
Published: February 2010

Research conducted amongst perioperative nurses during 1996 investigated both the causes of occupational stress and nurses' perceptions of the effects of modern medical technologies on several aspects of their work life during the preceding three years. It found that there was a strong perception amongst the 433 nurses in the study that medical technologies had contributed to their increased workloads and higher levels of stress. This article presents the key findings on occupational stress and discusses some of their implications for health service managers who have responsibility for the occupational health and safety of nurses working in the operating theatre environment.
Health sector liability under the Trade Practices Act
Authors: Kamvounias Patty
Published: February 2010

Following the implementation of the national competition policy and the consequent exposure of unincorporated businesses to trade practices regulation, the health sector has faced increasing exposure to fair trading and competition issues. This article examines the rights and the obligations of health sector participants under the consumer protection and the restrictive trade practices provisions of the Trade Practices Act 1974 (Cwlth). The article outlines the relevant provisions and identifies examples of conduct that has breached the Act or that has the potential to breach the Act. The author notes that the Act has been applied to the health sector in the same way as it has been applied to all other sectors of the economy.
Nursing as a career choice: Perceptions of students speaking Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese at home
Authors: Cho Tang Kwok , Duffield Christine , Chen Xc , Choucair Sam , Creegan Reta , Mak Christine , Lesley Geraldine
Published: February 2010

Australia is a multicultural society and nowhere is this more evident than in Sydney where 25 percent of the population speaks a language other than English. In one of the largest area health services in New South Wales, the five most frequently spoken languages at home are Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese, with these language groups comprising 12percent of Sydney's population. Yet nurses speaking one of these five languages comprise less than 1 percent of the nursing workforce. A cost-effective method of addressing the shortage of nurses speaking languages other than English is to recruit students who already speak another language into the profession.This study examined high school students' perceptions of nursing in order to determine appropriate methods of recruiting students speaking one of these languages.Implications for the design of recruitment campaigns are also discussed.
A future for primary health care in New Zealand [Commentary by Rob Pegram, pp. 132–134]
Authors: Gribben Barry , Coster Gregor
Published: February 2010

The attempt to implement a health market in New Zealand by separating funders and providers in 1992 has not delivered improved health outcomes. Indeed there is increasing concern that deprived populations are not accessing appropriate health care. This article describes the models of primary care that have evolved in the new environment and suggests that these new structures, given appropriate support, are ideally placed to increase the focus of primary care on population health. A capitation funding model with patient enrolment and low fee-for-service barriers is proposed as the most promising model for delivering improved health outcomes. The model incorporates a needs-based funding formula, locality health needs assessment, an increased role for primary care nurses and improved responsiveness to local communities, especially Maori.
A national day only surgery benchmarking basket
Authors: Cleary Michael , Lloyd Sheree , Maguire Ann
Published: February 2010

The efficient management of day surgery facilities benefits both patients and health administrators. Patients can benefit through minimisation of hospital stay while day surgery has the potential to increase elective surgery throughput and to reduce waiting times. This paper explores whether routinely collected morbidity data from Queensland public hospitals can be used to benchmark levels of day only surgery between hospitals. Thirteen procedures were identified that met criteria for inclusion in a day only surgery bench marking basket. Queensland public hospitals and individual procedures were benchmarked against one another and analysed to determine whether hospitals performing the 13 procedures demonstrate the same rates of day only surgery. With the development of a clinically meaningful and administratively simple tool for comparing hospital day surgery rates using routinely collected morbidity data, the opportunity now exists for health services to compare the performance of clinical services both within and between hospitals. It is also suggested that the basket of procedures identified in this study could form the basis of a national day only surgery benchmarking process.
Forecasting hospital expenditure in Victoria: Lessons from Europe and Canada
Authors: Antioch Kathryn M , Walsh Michael K , Anderson David , Brice Richard
Published: February 2010

This paper specifies an econometric model to forecast State government expenditure on recognised public hospitals in Victoria. The OECD's recent cross-country econometric work exploring factors affecting health spending was instructive. The model found that Victorian Gross State Product, population aged under 4 years, the mix of public and private patients in public hospitals, introduction of case mix funding and funding cuts, the proportion of public beds to total beds in Victoria and technology significantly impacted on expenditure. The model may have application internationally for forecasting health costs, particularly in short and medium-term budgetary cycles.
Humbug, health and humanity: A patient's tale of care in a public teaching hospital [Commentary by Michael Walsh, pp. 139–140]
Authors: Scotford Narelle
Published: February 2010

Humbug is the word used by traditional Aborigines in the remote communities of the Northern Territory for anything that goes wrong. Red tape, any contact with any sort of government organisation and just plain old bullshit.
Managing unstable angina and coronary care beds effectively
Authors: Kelly Anne-Maree , Edmonds Elizabeth , Newman Roberte , Amsing Nicole
Published: February 2010

This article is an evaluation of a new chest pain admission policy at Western Hospital. Our aim was to determine the clinical outcomes of patients with unstable angina treated according to this new policy. It involved attempting to identify a group at low risk of serious complications and to manage them in a general ward area without cardiac monitoring, to reduce the pressure on coronary care unit beds. We conducted a retrospective case note review and concluded that that selected patients with an admission diagnosis of unstable angina can be safely managed in unmonitored medical beds provided mechanisms are in place for their transfer to the coronary care unit if recurrent pain or a complication occurs.
Organisational culture, organisational learning and total quality management: A literature review and synthesis
Authors: Bloor Geoffrey
Published: February 2010

As health services face increasing pressure to meet the expectations of different stakeholders,they must continuously improve and learn from their experience. Many fail in attempts at continuous improvement programs because managers have not understood the complexity of making changes in organisations with multiple subcultures and interests. This article examines the related concepts of organisational culture, organisational learning and total quality management and shows how a synthesis of this knowledge can assist in develop ingcontinuous organisational learning and improvement.
Do Musical Works Contain an Implied Listener? Towards a Theory of Musical Listening
Authors: Butt John
Published: February 2010

This study presents the sketch of a theory of musical listening based on historical considerations of the role of music in Western culture. A universal element of musical listening might lie in the notion that all music is the product of a fundamental human capacity to hear, harnessed in countless ways by diverse cultures. Secondly, there is the type of music, covering very broad historical and cultural boundaries, that presupposes attentive listening or even a participating audience; this is perhaps the simplest and most familiar category, at least in the West. Finally, there is the range of music that might contain an ‘implied listener’, something which I suggest is much more elusive, with specific historical and cultural boundaries within Western modernity. While this sense of the implied listener – someone developing the sense of a consistent and unitary self over time – is understandable today and might well still be employed in a broad range of new music, I would suggest that it now reflects only one way of being human among an alarmingly broad array of choices.
Sound Gazes?
Authors: Etherington Ben
Published: February 2010

This response considers whether it is possible to think of listening as a non-coercive alternative to ‘the gaze’. An attention to the work of ancient and modern thinkers provides a starting point for conceptualizing musical ‘possession’ in a way that is not bound to asymmetrical, subject–object relations.
Metabolic flux analysis of wild-type Escherichia coli and mutants deficient in pyruvate-dissimilating enzymes during the fermentative metabolism of glucuronate
Authors: Murarka Abhishek , Clomburg James M. , Gonzalez Ramon
Published: February 2010

The fermentative metabolism of d-glucuronic acid (glucuronate) in Escherichia coli was investigated with emphasis on the dissimilation of pyruvate via pyruvate formate-lyase (PFL) and pyruvate dehydrogenase (PDH). In silico and in vivo metabolic flux analysis (MFA) revealed that PFL and PDH share the dissimilation of pyruvate in wild-type MG1655. Surprisingly, it was found that PDH supports fermentative growth on glucuronate in the absence of PFL. The PDH-deficient strain (Pdh−) exhibited a slower transition into the exponential phase and a decrease in specific rates of growth and glucuronate utilization. Moreover, a significant redistribution of metabolic fluxes was found in PDH- and PFL-deficient strains. Since no role had been proposed for PDH in the fermentative metabolism of E. coli, the metabolic differences between MG1655 and Pdh− were further investigated. An increase in the oxidative pentose phosphate pathway (ox-PPP) flux was observed in response to PDH deficiency. A comparison of the ox-PPP and PDH pathways led to the hypothesis that the role of PDH is the supply of reducing equivalents. The finding that a PDH deficiency lowers the NADH : NAD+ ratio supported the proposed role of PDH. Moreover, the NADH : NAD+ ratio in a strain deficient in both PDH and the ox-PPP (Pdh−Zwf−) was even lower than that observed for Pdh−. Strain Pdh−Zwf− also exhibited a slower transition into the exponential phase and a lower growth rate than Pdh−. Finally, a transhydrogenase-deficient strain grew more slowly than wild-type but did not show the slower transition into the exponential phase characteristic of Pdh− mutants. It is proposed that PDH fulfils two metabolic functions. First, by creating the appropriate internal redox state (i.e. appropriate NADH : NAD+ ratio), PDH ensures the functioning of the glucuronate utilization pathway. Secondly, the NADH generated by PDH can be converted to NADPH by the action of transhydrogenases, thus serving as biosynthetic reducing power in the synthesis of building blocks and macromolecules.
A new small regulatory protein, HmuP, modulates haemin acquisition in Sinorhizobium meliloti
Authors: Amarelle Vanesa , Koziol Uriel , Rosconi Federico , Noya Francisco , O'Brian Mark R. , Fabiano Elena
Published: February 2010

Sinorhizobium meliloti has multiple systems for iron acquisition, including the use of haem as an iron source. Haem internalization involves the ShmR haem outer membrane receptor and the hmuTUV locus, which participates in haem transport across the cytoplasmic membrane. Previous studies have demonstrated that expression of the shmR gene is negatively regulated by iron through RirA. Here, we identify hmuP in a genetic screen for mutants that displayed aberrant control of shmR. The normal induction of shmR in response to iron limitation was lost in the hmuP mutant, showing that this gene positively affects shmR expression. Moreover, the HmuP protein is not part of the haemin transporter system. Analysis of gene expression and siderophore production indicates that disruption of hmuP does not affect other genes related to the iron-restriction response. Our results strongly indicate that the main function of HmuP is the transcriptional regulation of shmR. Sequence alignment of HmuP homologues and comparison with the NMR structure of Rhodopseudomonas palustris CGA009 HmuP protein revealed that certain amino acids localized within predicted β-sheets are well conserved. Our data indicate that at least one of the β-sheets is important for HmuP activity.
Impact of frost and plant age on compensatory growth in timothy and perennial ryegrass during winter
Authors: Østrem L. , Rapacz M. , Jørgensen M. , Höglind M.
Published: February 2010

Two cultivars of each of two contrasting grass species, timothy (Phleum pratense L.) and perennial ryegrass (Lolium perenne L.), sown either in May or July, were sampled for dry matter (DM) weight of roots and herbage in late October (end of main growing season) and examined for regrowth when exposed to a frost treatment (−8 to −10°C in darkness for 48 h) in late January, early March and late April. The frost treatment caused compensatory root and herbage growth, and regrowth of roots in March and April was greater than regrowth of herbage. Early‐sown plants had higher DM weights of roots and herbage than late‐sown plants in October but had the lowest survival rate when exposed to the frost treatment in April. Compensatory growth of root and herbage in response to moderate frosts occurred in January and March in all cultivars, and in the most frost‐resistant timothy cultivar in April. Concentration of total carbohydrates increased from October to March with the greatest increase in the most winter‐hardy cultivar of each species, and then decreased in April. An indirect correlation between concentration of total carbohydrates and tolerance to moderate frost was indicated, and plant survival and ability for compensatory growth were also associated with differences in adaptation related to winter survival in the cultivars tested.
Rensch’s rule inverted – female‐driven gigantism in nine‐spined stickleback Pungitius pungitius
Authors: Herczeg Gábor , Gonda Abigél , Merilä Juha
Published: February 2010

1. Allometric scaling of sexual size dimorphism (SSD) with body size is a commonplace occurrence in intraspecific or interspecific comparisons. Typically, SSD increases with body size when males, and decreases when females are the larger sex – a pattern known as Rensch’s rule. Intraspecific studies of Rensch’s rule in vertebrates are extremely scarce.

2. In an allometric SSD–body size relationship, the sex with the larger body size variation is the driver of size divergence whereas the other sex is following it owing to correlational selection. Hence, one can test which sex is responsible for the observed body size divergence within this framework.

3. Nine‐spined stickleback (Pungitius pungitius) provides an excellent model to study intraspecific variation in SSD owing to the large interpopulation variation in mean body size. Using data on body size variation in 11 nine‐spined stickleback populations covering the full known size range of the species, we investigated: (i) whether variation in SSD scales allometrically with mean body size across the populations; (ii) which sex is driving the allometric relationship and (iii) whether the observed pattern is likely to have a genetic component. In addition, we analysed the size dependency of female reproductive output.

4. We found strong support for an inverse of Rensch’s rule: level of female‐biased SSD increased with increasing mean size while females were the more variable sex. Results from a common garden experiment supported the pattern found in the wild. Females from giant populations had 2–3 times larger reproductive output than normal‐sized females.

5. The fact that females were the more variable sex indicates that the evolution of gigantism in nine‐spined sticklebacks is driven by females, and the 2–3 times larger reproductive output per clutch of giant vs. normal‐sized females suggests fecundity selection to have an important role in it. Our results oppose the commonly held view that males drive the evolution of SSD as a result of sexual selection favouring larger males.
Early successional woody plants facilitate and ferns inhibit forest development on Puerto Rican landslides
Authors: Walker Lawrence R. , Landau Frederick H. , Velázquez Eduardo , Shiels Aaron B. , Sparrow Ashley D.
Published: February 2010

1. The experimental removal of early successional species can explain how plant communities change over time.

2. During a 7.3‐year period, early successional woody species, scrambling ferns and tree ferns were removed from a total of 10 landslides in the Luquillo Experimental Forest in north‐eastern Puerto Rico.

3. Early successional woody plants in combination with tree ferns decreased species richness and cover of forbs and increased richness of late‐successional woody plants compared to removals, facilitating long‐term forest development.

4. Dense stands of scrambling ferns decreased both forb and woody plant richness compared to removals, inhibiting forest development.

5. Stands of monospecific tree ferns initially increased woody plant richness compared to removals, but overall decreased woody plant richness and cover, inhibiting forest development.

6.
Synthesis. Early successional species both facilitate and inhibit succession on tropical landslides, but detailed predictions of successional trajectories remain elusive and are influenced by stochastic processes including arrival order, the life‐form of colonizing species and their competitive interactions.
Evaluation of sensory irritation caused by topical medications using a novel technique
Authors: Uliasz Annemarie , Lebwohl Mark
Published: February 2010

Background  Topical medications are often the first line therapy utilized by dermatologists for a variety of conditions. However, a common side effect of topical medications is application site irritation. The aim of this study was to evaluate and compare the sensory irritation caused by hydrocortisone butyrate lipocream 0.1% using a non‐invasive and inexpensive technique.

Methods  Twenty participants with corticosteroid‐responsive dermatoses were enrolled. Three target areas of unaffected skin were abraded. A negative control (petrolatum ointment), a positive control (an over‐the‐counter [OTC] anti‐itch preparation containing benzyl alcohol), and a test product (hydrocortisone butyrate lipocream 0.1%) were each applied to separate target areas on the legs. Participants rated the irritation of each target area using a 10‐point scale (1 [no symptoms] to 10 [intolerable burning/ stinging requiring removal of the medication]).

Results  The mean irritation scores for petrolatum ointment, the OTC anti‐itch preparation, and hydrocortisone butyrate lipocream 0.1% were 1.30, 5.70, and 1.95, respectively. The difference in irritation between the OTC anti‐itch preparation and hydrocortisone butyrate lipocream 0.1% was highly significant (P < 0.0001). The difference in irritation between the OTC anti‐itch preparation and petrolatum ointment also was highly significant (P < 0.0001). The difference in irritation between hydrocortisone butyrate lipocream 0.1% and petrolatum ointment also was statistically significant (P = 0.0265). Irritation scores were then standardized on a 10‐point scale, with the irritation score of the negative control given a value of 1.00 and the irritation score of the positive control given a value of 10.00. The standardized irritation score of the test product, hydrocortisone butyrate lipocream 0.1%, was calculated to be 2.33.

Conclusion  Our study, using a novel technique to measure sensory irritation, establishes hydrocortisone butyrate lipocream 0.1% to be minimally irritating. We hope to use this simple and easy‐to‐use assay to measure and compare the severity of the sensory irritation of various commercially available topical preparations. In doing so, we hope to ultimately create a sensory irritation ranking scale, which would enable physicians to choose less irritating products, thereby enhancing adherence to treatment regimens and patient satisfaction.
Extract of Punica granatum inhibits skin photoaging induced by UVB irradiation
Authors: Park Hye Min , Moon Eunjung , Kim Ae‐Jung , Kim Mi Hyun , Lee Sanghee , Lee Jung Bok , Park Yong Kon , Jung Hyuk‐Sang , Kim Yoon‐Bum , Kim Sun Yeou
Published: February 2010

Background  Punica granatum (pomegranate) is kind of a fruit consumed fresh or in beverage. It has been widely used in traditional medicine in various parts of the world. In this study, we examined the efficacy of a Punica granatum (PG) extract in protecting skin against UVB‐induced damage using cultured human skin fibroblasts.

Methods  A Korean red PG sample was used, and its effects classified according to if the PG source originated from the rind, seed and fruit. The polyphenol content of PG, which is known to prevent other adverse cutaneous effects of UV irradiation, was measured by GC‐MS. The protective effects of PG on UVB‐induced skin photoaging were examined by determining the level of procollagen type I and MMP‐1 after UVB irradiation.

Results  Based on the GC‐MS quantitative analysis, catechin, quercetin, kaempferol, and equol were the predominant compounds detected in PG. In the changes of expression of procollagen type I and MMP‐1 in UV irradiated human skin fibroblasts treated PG, especially extract prepared from rind, the synthesis of collagen was increased and the expression of MMP‐1 was decreased.

Conclusion  The major polyphenols in PG, particularly catechin, play a significant role in its photoprotective effects on UVB‐induced skin damage.
Cutaneous vascular patterns in psoriasis
Authors: Micali Giuseppe , Lacarrubba Francesco , Musumeci Maria Letizia , Massimino Doriana , Nasca Maria Rita
Published: February 2010

Microvascular abnormalities are a characteristic feature of psoriasis and play a crucial role in its pathogenesis. Investigational studies have shown that activated keratinocytes in lesional skin undergo an accelerated epidermal cell turnover and are a major source of pro‐angiogenic cytokines, like as VEGF, ESAF, PDECGE/TP, TNF‐α, TGF‐α and PDGF, suggesting that the epidermis is capable of inducing vascular proliferation. On the other hand, microvascular alterations are essential for the development and persistence of the psoriatic lesions as they provide cellular and tissue nutrition to hyperplastic keratinocytes and promote inflammatory cell migration. Also, dilated and slightly tortuous blood vessels within dermal papillae represent one of the earliest detectable histological changes for all stages of lesional development. Videodermatoscopy is a new non invasive imaging technique able to identify modifications of microvascular architecture in vivo and such evaluation will be useful for the dermatologist both for diagnostic and prognostic evaluation, as well as for post‐therapeutic follow‐up. In this review, the role of microvascular abnormalities in the pathogenesis of psoriasis as well as the mechanisms underlying vascular changes and their primary therapeutic implications will be reviewed and discussed.
Combination excision and liposuction in a single‐stage treatment of various skin disorders
Authors: Lei Hua , Ma Gui‐e , Chen Jian , Liu Zhen‐jun
Published: February 2010

Objectives  The repair of skin defects resulting from the excision of large skin disorders is always challenging for surgeons as many methods have varied disadvantages. Therefore, we attempt to overcome frequent disadvantages of other surgical methods in repairing skin defects with the help of liposuction.

Methods  Before excision of skin disorders, liposuction was performed in regions where they were located followed by complete excision. The sliding flaps on both sides of the defect created by liposuction were pulled together to cover the defect. In our study, 40 skin disorders located on the upper arm, thigh, and trunk were treated by this technique.

Results  Forty skin disorders were excised and resulting skin defects were repaired in one stage by the surrounding sliding flaps without wound dehiscence, infection, incision edge necrosis, sensory deficit, or severe scar recurrence. The regions of liposuction presented a harmonious result and simultaneously the body contour was well‐balanced.

Conclusion  Some large skin disorders at sites rich in subcutaneous fat can be treated in one stage by combining excision and liposuction with good functional and esthetic outcomes with few complications. Although the indications for this technique are limited, it is really a good option for appropriate cases.
Clinical study of repigmentation patterns with either narrow‐band ultraviolet B (NBUVB) or 308 nm excimer laser treatment in Korean vitiligo patients
Authors: Yang Yun‐Seok , Cho Hee‐Ryung , Ryou Ji‐Ho , Lee Mu‐Hyoung
Published: February 2010

Background  Various repigmentation patterns such as perifollicular, marginal, diffuse, and mixed configuration can occur in vitiligo. The aim of this study was to clinically assess the types of repigmentation patterns obtained with narrow‐band ultraviolet B (NBUVB) phototherapy or targeted phototherapy using a 308 nm excimer laser and to reveal whether the repigmentation patterns have any relationship to the location of lesions, patient’s age, duration of lesions, or speed of improvement.

Methods  This study enrolled 51 patients who had effective responses as compared with baseline when treated with NBUVB alone and 52 patients who had effective responses as compared with baseline when treated with excimer laser alone. We evaluated the repigmentation patterns when the responses to treatments appeared.

Results  The most frequent repigmentation pattern was the perifollicular type in both groups treated with NBUVB (42.2%) or excimer laser (51.3%), followed by marginal, diffuse, and combined, in that order. There was no significant difference in the repigmentation pattern according to the location of lesions, patient’s age, or duration of lesions. The marginal pattern was predominant in both NBUVB and excimer laser‐treated groups when excellent responses (more than 75% repigmentation achieved at 12 weeks) appeared.

Conclusions  The repigmentation patterns according to location, age, duration of lesions, and speed of response showed similarities in both the NBUVB and excimer laser‐treated groups.
Efficacy of chemical and botanical over‐the‐counter pediculicides available in Brazil, and off‐label treatments, against head lice ex vivo
Authors: Asenov André , Oliveira Fabíola Araújo , Speare Rick , Liesenfeld Oliver , Hengge Ulrich R. , Heukelbach Jorg
Published: February 2010

Background  There is a lack of reliable data on the efficacy of over‐the‐counter (OTC) pediculicides in Brazil.

Methods  We performed ex vivo assays of eight marketed pediculicides: 1% permethrin (Kwell®, Clean Hair®, Keltrina®, Nedax®), 0.02% deltamethrin (Deltacid®, Pediderm®), and two “natural” products (Piolho e Lêndea®, Pilogenio®). We also tested 5% permethrin (Keltrina Plus®), traditional home remedies and an ivermectin‐based product used in veterinary medicine. Head lice (49–52 per group) were immersed in the compound for 3 min and washed after 20 min to simulate the typical in vivo treatment protocol. Lice were examined for activity up to 24 h using stringent criteria for survival.

Results  Of the permethrin containing products, highest mortality was observed with Kwell® and Clean Hair® (97.9 and 90.2% after 4 h). Keltrina®, Nedax®, Keltrina Plus®, and the two deltamethrin‐based products showed only a low efficacy of <60% after 4 h. With exception of pure coconut oil (80% mortality after 4 h), home remedies showed a very low efficacy, and both marketed products killed few lice. The ivermectin‐based product caused a mortality of 100% after 4 h.

Conclusions  Most Brazilian OTC products did not show a satisfactory efficacy against head lice. Resistance may be present. Ivermectin and coconut oil are promising compounds for topical treatment. Laboratory‐based tests should be used to assess resistance patterns and to identify formulations of the active ingredient that increase the efficacy. Standardized testing should be performed before a product is licensed for head lice treatment.