bluuebunny/crossref_metadata_2025 huggingface dataset:
Learned Recognition of Heterospecific Alarm Signals: The Importance of a Mixed Predator Diet
Authors: Mirza Reehan S. , Chivers Douglas P.
Published: March 2003

A wide diversity of aquatic organisms release alarm signals upon being attacked by a predator. Alarm signals may ‘warn’ nearby individuals of danger. Moreover, the signals may be important in facilitating learned recognition of unknown stimuli. It is common for different prey species to respond to each other’s chemical alarm signals. In many cases, the responses are learned but no learning mechanisms have been identified to date. In this study we tested whether prey fish can learn the identity of an unknown alarm signal when they detect it in association with conspecific alarm cues in the diet of a predator. Chemical alarm cues are known to be conserved in the diet of predators. We conditioned fathead minnows (Pimephales promelas) with chemical stimuli from predatory yellow perch (Perca flavescens) fed a mixed diet of minnows and brook stickleback (Culaea inconstans), perch fed a mixed diet of swordtails (Xiphophorus helleri) and stickleback or distilled water. Minnows were subsequently exposed to chemical alarm cues of injured stickleback alone. Those minnows previously conditioned with perch fed a mixed diet of minnows and stickleback increased their use of shelter and ‘froze’ significantly more than minnows previously conditioned with perch fed a diet of swordtails and stickleback or those exposed to distilled water. These data demonstrate a mechanism by which minnows can learn the identity of a heterospecific alarm signal.
Measurement for Solitariness and Gregarism: Analysing Spacing, Attraction and Interactions in Four Species of Zetoborinae (Blattaria)
Authors: Baaren Joan van , Deleporte Pierre , Grandcolas Philippe , Biquand Véronique , Pierre Jean‐Sébastien
Published: March 2003

Abstract Distinguishing gregarism based on attraction between conspecifics from aggregation based on environmental factors is not a trivial task. In this paper, we propose a laboratory experimental design for characterizing gregarism, using Zetoborine cockroaches as a model. Three complementary tests were used: the classical spacing and attraction tests, complemented by analyses of social interactions with flow charts on factorial maps. Convergent results from the three tests allowed a tentative characterization of solitariness and different degrees of gregarism. These elements were used to improve the interpretation of spacing patterns of four species of cockroaches observed in the field.
No Evidence of Social Hierarchy amongst Feeding Badgers, Meles meles
Authors: Macdonald David W. , Stewart Paul D. , Johnson Paul J. , Porkert Jiri , Buesching Christina
Published: March 2003

Linear or despotic dominance hierarchies are common in carnivore societies. However, in feeding experiments in the field with wild European badgers, Meles meles, we found no compelling evidence for any such hierarchies within badger groups, or even between the members of neighbouring groups. The outcome of dyadic encounters within groups was partly determined by asymmetries in weight and length, but these predictors were readily confounded by ownership. Aggression between members of neighbouring groups during encounters at feeding sites at territorial borders was extremely rare. These rather ad hoc aspects of social organization reinforce the view that badger societies are somewhat loosely structured.
Coercive Copulation in the Alpine Bushcricket Anonconotus alpinus Yersin (Tettigoniidae: Tettigoniinae: Platycleidini)
Authors: Vahed Karim
Published: March 2003

Sexual coercion in the form of forced copulation is widespread in the animal kingdom and has been documented in several insect taxa. In crickets and bushcrickets (sub‐order Ensifera), however, mating typically involves luring acts as opposed to forcing acts. The mating behaviour of the tettigoniid Anonconotus alpinus Yersin, which is described in this paper, appears to be unique amongst the Tettigoniidae (and possibly amongst the Ensifera) in that it is coercive, involving forced matings. Males did not stridulate immediately prior to mating but instead leapt on passing females, using their anal cerci as pincers to maintain a hold on the female's abdomen (which was sometimes damaged in the process). Males appeared to lack a sexual refractory period and attempted to copulate again as little as 18 s following the previous mating.
Maternal Watchfulness in Black Howler Monkeys (Alouatta pigra)
Authors: Treves Adrian , Drescher Ann , Snowdon Charles T.
Published: March 2003

In many vertebrates, parents protect their young by detecting predators and aggressive conspecifics before they attack. But parental investment in protection is a limited resource, whose allocation to offspring should reflect optimization strategies. Thus, we tested if maternal investment in vigilance varied with the risk faced by young black howler monkeys (Alouatta pigra). Twelve females in six groups were compared, including those with and without young and those with immatures of differing ages. The greatest increase in vigilance was seen when immatures were conspicuous, and to a lesser extent, among mothers of dependent young (neonates and infants). These findings support the idea that parents adjust their behavior to both chronic and episodic risk faced by young. We explore the possible role of predation and infanticide in shaping the vigilance of mothers.
Role of Phialemonium curvatum as a potential biological control agent against a blue stain fungus on aspen
Authors: Hiratsuka Y. , Chakravarty P.
Published: March 2003

Ophiostoma crassivaginatum is the most important blue stain fungus on Populus tremuloides and causes considerable reduction in the value of the end product. The effect of a hyphomycetous fungus, Phialemonium curvatum, on the in vitro growth and wood chip colonization by O. crassivaginatum was studied. The in vitro growth of O. crassivaginatum was significantly inhibited when grown in dual culture or when treated with culture filtrate of P. curvatum. Ophiostoma crassivaginatum failed to colonize P. tremuloides wood chips when they were pre‐inoculated with mycelial suspension of P. curvatum. The potential use of P. curvatum as a biological control agent against O. crassivaginatum is suggested.
Growth reactions of a Gremmeniella abietina isolate and Scots pine embryogenic tissue cultures differ in a host–parasite in vitro system
Authors: Terho M. , Pappinen A. , Von Weissenberg K.
Published: March 2003

Summary The aim of this study was to screen Scots pine embryogenic tissue culture material to Gremmeniella abietina. According to the results Scots pine (Pinus sylvestris) embryogenic tissue lines (27 lines) could be ranked based on significant differences in G. abietina effects estimated by changes in glucosamine concentrations, growth, and dry matter contents of inoculated tissue pieces. The ranking order of the extreme tissue lines stayed basically similar, regardless of the variable measured. These findings imply a possibility to use the ranked embryogenic tissue lines in more detailed investigations of interactions between G. abietina and its host. This is the first report of using embryogenic tissue cultures in studying host–parasite interaction between Scots pine and G. abietina.
Reliability of field, greenhouse and cut‐shoot screening procedures for evaluating susceptibility of Scots pine to Melampsora pinitorqua
Authors: Quencez C. , Desprez‐Loustau  , Bastien
Published: March 2003

The reliability of field, greenhouse and cut‐shoot screening procedures for the assessment of the susceptibility of Scots pine (Pinus sylvestris) genotypes to Melampsora pinitorqua, the causal agent of twisting rust, was evaluated. Fourteen genotypes evaluated on half‐sib progenies after natural infection of 2‐year‐old plants showed comparable rank for rust susceptibility with those evaluated after controlled inoculation of 1‐year‐old seedlings in a greenhouse. The dynamic of pycnia production was assessed at 2‐day intervals in cut‐shoot assays under controlled conditions, giving reliable rankings of Scots pine genotypes between years and being significantly correlated with rust susceptibility assessed after natural infection of 2‐year‐old progenies. These results underlined the importance of some critical factors such as inoculum load and host phenology in the reliability of susceptibility evaluations assessed under different experimental conditions. Artificial inoculation of 1‐year‐old seedlings in greenhouse experiments could provide a useful early test for the management of Scots pine breeding programmes and study of inheritance of twisting rust susceptibility. However, in specific investigations the cut‐shoot assay would constitute a reliable laboratory test for studying host–pathogen interactions and the variability in pathogenicity of Melampsora pinitorqua populations.
The use of the green fluorescent protein as a biomarker for sapstain fungi
Authors: LEE S. , KIM S. H. , BREUIL C.
Published: March 2003

To understand wood colonization by sapstain fungi and their potential biocontrol agents, it is necessary to differentiate these organisms directly on their natural substrates. In the present study the feasibility of transforming with the green fluorescent protein (GFP), the sapstain fungus Ophiostoma piceae and a potential biocontrol agent Cartapip®, an Ophiostoma piliferum albino strain was assessed. Transformants of the two fungal species were screened by polymerase chain reaction and Southern blot analyses. The GFP was expressed in spores, synnemata and mycelia of the transformants grown in artificial media or wood. The growth, pigmentation and wood colonization of the transformants were similar to that of the non‐transformants, suggesting that the presence of the gfp gene had no negative effect on the biology of the transformants. Using fluorescence and confocal microscopy, the GFP‐expressing fungi were easily differentiated from the wild‐type strains and other fungal species in wood, even 4 months after inoculation. The results show that the use of the GFP system is feasible to monitor Ophiostoma fungi in wood.
Genetic relationships among genetically distinct forms of Melampsora larici‐epitea and related species based on AFLP data
Authors: Samils B. , Lagercrantz U. , Gullberg U.
Published: March 2003

Amplified Fragment Length Polymorphism (AFLP) was used to study genetic relationship among leaf rust fungi (Melampsora spp.) occurring on Salix species in short‐rotation coppice. Special interest was paid to a newly identified rust fungus found on S. viminalis in southern Sweden, morphologically similar to M. larici‐epitea but with a distinct DNA profile. Genetic distances among 40 Melampsora isolates collected from S. viminalis, S. dasyclados, S. viminalis x dasyclados, S. daphnoides, S. acutifolia and M. larici‐populina were calculated based on 101 AFLP markers. Neighbour‐joining analysis revealed the presence of six clusters, which corresponded exactly to predefined groups, namely three formae speciales of M. larici‐epitea, a stem‐infecting form of Melampsora on S. viminalis, the newly identified Melampsora on S. viminalis and a group consisting of two isolates from the poplar rust M. larici‐populina. All six clusters were well supported by bootstrap analysis (84 to 100% support). The newly identified Melampsora on S. viminalis was indicated to be genetically separated from M. larici‐epitea as well as from the stem‐infecting form of Melampsora.
Collaboration or chaos: A consumer perspective
Authors: Connor Helen
Published: March 2003

ABSTRACT

Consumer participation in all levels of mental health service provision is now government policy throughout Australia. However, effective participation by consumers requires collaboration between mental health nurses and consumers. Effective collaboration and the partnership between those who provide and receive services requires trust and respect on both sides. Accompanying consumers on their ‘journey’ of wellness and recovery is likely to also provide mental health nurses with opportunities for personal and professional growth.
Collaborative education and social stereotypes
Authors: Clinton Michael
Published: March 2003

The purpose of this paper is to present results from a two‐year collaborative education project conducted with people with a serious mental illness and senior undergraduate students of nursing at the Centre for Mental Health Nursing Research at Queensland University of Technology. The study was funded by the Australian Commonwealth Government and was completed in June 1998. The results suggest that collaborative education is an effective means for breaking down social stereotypical thinking about people with a mental illness. A similar finding with respect to the stigmatization of undergraduates supports this hypothesis. Implications for psychiatric rehabilitation and the undergraduate education of students of nursing are explored.
Charting the future today: Psychiatric and mental health nurses in cyberspace
Authors: Lakeman Richard
Published: March 2003

ABSTRACT
:

The development of the Internet is happening at a staggering pace and promises to have a dramatic impact on human relations. If nursing is to adapt to and benefit from these changes, consideration ought to be given to the experiences and opinions of nurses who have adapted to and use the technology. This paper provides an outline of the findings of an Email survey of psychiatric and mental health nurses who are experienced in using the Internet. Questions focused on what psychiatric and mental health nurses use the Internet for, how their use has changed, work‐related benefits, and what impact they see the Internet having in the future.
‘Psychiatric nursing was great, but I want to be a “real” nurse’: Is psychiatric nursing a realistic choice for nursing students?
Authors: Rushworth Louise , Happell Brenda
Published: March 2003

ABSTRACT

The present paper reports the results of a quasi‐experimental study that examined the relationship between exposure to the theory and practice of psychiatric nursing and the desirability of psychiatric nursing as a future career choice. A time series design was utilized to enable a comparison between pre‐ and post‐test scores. A significant increase in the popularity of psychiatric nursing was evident in the experimental group in the post‐test phase, while no significant change was detected in the control group. Despite this increase, a large number of students from the experimental group indicated their reluctance to undertake a career in psychiatric nursing without first consolidating their skills in the medical–surgical area. This situation reflects an image of nursing that is contrary to the caring philosophy it purports to embrace, but which appears to favour certain areas of nursing practice at the expense of others.
Are universities preparing nurses to meet the challenges posed by the Australian mental health care system?
Authors: Wynaden Dianne , Orb Angelica , McGowan Sunita , Downie Jill
Published: March 2003

ABSTRACT

The preparedness of comprehensive nurses to work with the mentally ill is of concern to many mental health professionals. Discussion as to whether current undergraduate nursing programs in Australia prepare a graduate to work as a beginning practitioner in the mental health area has been the centre of debate for most of the 1990s. This, along with the apparent lack of interest and motivation of these nurses to work in the mental health area following graduation, remains a major problem for mental health care providers. With one in five Australians now experiencing the burden of a major mental illness, the preparation of a nurse who is competent to work with the mentally ill would appear to be a priority. The purpose of the present study was to determine third year undergraduate nursing students’ perceived level of preparedness to work with mentally ill clients. The results suggested significant differences in students’ perceived level of confidence, knowledge and skills prior to and following theoretical and clinical exposure to the mental health area. Pre‐testing of students before entering their third year indicated that the philosophy of comprehensive nursing: integration, although aspired to in principle, does not appear to occur in reality.
Does drawing up technique influence patients’ perception of pain at the injection site?
Authors: Rock Danny
Published: March 2003

ABSTRACT

Traditionally nurses have used one of two drawing up techniques for the administration of intramuscular (IM) injections. In the first, the injectable is drawn up using one needle, which is then discarded before administration using a new needle. Alternatively, the injectable is drawn up and administered without changing the needle. Advocates of the two‐needle technique suggest that this method reduces pain at the injection site. In the present study, 70 subjects completed an independently validated pain scale following administration of an IM depot neuroleptic. The conclusion, that there is a significant reduction in injection site pain, using the two‐needle technique, is not supported by the data obtained in this study.
Scoping the prospects of Australian mental health nursing
Authors: Clinton Michael , Hazelton Mike
Published: March 2003

ABSTRACT:

In March 2000 the Australian & New Zealand College of Mental Health Nurses submitted the final report on the National Scoping Study of Mental Health Nursing in Australia to the Mental Health Branch of the Department of Health and Aged Care. In this final article, in a series of four, the authors present an overview of the future prospects of mental health nursing in Australia.
SOCIAL CONSTRUCTION OF ANANGU DISABILITY
Authors: Ariotti Louis
Published: March 2003

The usual and common‐sense definition of disability is based on a medical model that sees disability as a limitation or lack of competence on the part of the individual. This definition fails to acknowledge that in some cultures disability as a concept does not exist. This paper, based on research undertaken in 1994/1995, examines how the social construction of disability among the Anangu of the cross border region of Western Australia, South Australia and the Northern Territory, takes into consideration the important factors of history, culture and language. The theoretical underpinning of the research was symbolic interactionism, which led to collaborative ethnography becoming the methodology employed to collect and analyse the data. The findings of the research indicate that the social construction of disability among the Anangu occurs in three historical phases: the impairment, oppression and empowerment phases. The paper’s purpose is to offer service providers to Aboriginal people with disabilities, information that will help them understand some of the attitudes, customs, mores and beliefs of their clientele.
THE ROLE OF ULTRASOUND IN THE ASSESSMENT OF THE TRAUMA PATIENT
Authors: Freeman Peter
Published: March 2003

Ultrasound assessment of the patient with blunt abdominal trauma will enhance diagnostic accuracy and facilitate decision making about the need for urgent surgery. Numerous studies have reported the role of ultrasound in the assessment of the trauma patient. Focused ultrasound has been shown to compare in sensitivity to diagnostic peritoneal lavage and is helpful in assessing the need for a laparotomy. Ultrasound is safe, cheap and portable. The investigation is non‐invasive and painless. The trauma ultrasound scan can be completed in under 3 minutes and should be performed during the initial trauma assessment. The technique is not difficult to learn. Advances in technology are likely to make portable ultrasound increasingly appropriate to rural clinical practice. Detection of haemoperitoneum will be more accurate when ultrasound is available in the early care of trauma on a 24 hour basis and, to achieve this, clinicians managing trauma will need to become competent in the application of the focused ultrasound exam.
ESTABLISHING A NEW UNIVERSITY DEPARTMENT OF RURAL HEALTH: THE FIRST 2 YEARS OF THE SOUTH AUSTRALIAN CENTRE FOR RURAL AND REMOTE HEALTH
Authors: Wilkinson David , Blue Ian , Symon Brian , Fuller Jeff , Smith Mark
Published: March 2003

This study aimed to describe the establishment of a new University Department of Rural Health (UDRH) in South Australia and to report early achievements. In May 1997, the UDRH was established, key staff were recruited, infrastructure was developed and in April 1998 a Joint University Committee on Rural and Remote Health was formed. By mid‐1999, 14 full‐time equivalent staff were employed in Whyalla and Adelaide. Early achievements include: review of undergraduate rural placements; increased rural clinical placements by 1000 student‐weeks; partnership with the Dental School resulting in training opportunities and falling public dental waiting lists; multidisciplinary teaching practices in four rural sites; priority public health projects established; competitive research grants won; and a capital grant to strengthen Aboriginal health services infrastructure secured. These early achievements demonstrate UDRH potential to have a real impact on health worker education, service delivery, and public health status in rural and remote areas. This strong foundation must now be built on.
Differences in Cardiac Procedures Among Patients in Metropolitan and Non‐Metropolitan Hospitals in New South Wales After Acute Myocardial Infarction and Angina
Authors: Heller Richard F. , O’Connell Rachel L. , D’Este Catherine , Lim Lynette L.‐Y. , Fletcher Peter J.
Published: March 2003

An observational cohort study examined the difference in use of cardiac procedures during and after hospital admission for acute chest pain in 47 metropolitan or non‐metropolitan hospitals across New South Wales (NSW). There were 3836 patients, represented by 4151 admissions to hospital after acute myocardial infarction (AMI), unstable angina or other angina. Follow up at 22 months was completed on 1695 patients. Patients admitted to metropolitan hospitals had higher rates of most cardiac procedures while in‐patients than did patients in non‐metropolitan hospitals. Odds ratios (95% confidence intervals) for the use of exercise stress tests, echocardiograms, nuclear studies and coronary angiography were 3.30 (1.38, 7.90), 9.34 (4.07, 21.44), 4.87 (2.08, 11.39) and 68.64 (17.29, 272.49), respectively, for patients with AMI and 1.93 (0.91, 4.12), 5.60 (1.60, 19.57), 3.51 (1.48, 8.33) and 38.57 (9.36, 158.94), respectively, for patients with unstable angina. Rates were similar between hospital types during the 22 months after discharge. The appropriateness of this large variation in resource use between metropolitan and non‐metropolitan hospitals requires examination.
Is Australian Rural Practice Changing? Findings from the National Rural General Practice Study
Authors: Strasser Roger P. , Hays Richard B. , Kamien Max , Carson Dean
Published: March 2003

The National Rural General Practice Study (NRGPS) was the first comprehensive national study covering rural and remote general practitioners throughout Australia. It was undertaken in 1996–1997 and drew on data from existing sources such as the Australian Bureau of Statistics and the Australian Institute of Health and Welfare, together with a postal survey of general practitioners in rural and remote areas. There was a 75% response rate to the survey, which covered professional issues, personal and social issues, personal background, patient issues, recruitment and retention programs and changing health services. Overall, the study findings confirmed those of previous individual State‐based studies in the early 1990s and showed that there had been some changes since those previous studies. In particular, access to continuing medical education has improved, the rural medical workforce appears to be ageing, the proportion of women rural doctors is increasing and the projected length of stay in rural practice is decreasing. Whereas in the early 1990s the projection for rural doctor numbers was continuing decline, the NRGPS projected overall numbers in rural practice as staying approximately the same over the next 5 years. In the light of these trends, the challenge is to implement targeted initiatives that improve the recruitment and retention of rural and remote general practitioners.
RECALL OF FARM HAZARDS IN AUSTRALIAN PRIMARY SCHOOL AGE CHILDREN USING A 3‐D VISUAL CUE TEST
Authors: Page Andrew N. , Fragar Lyn J.
Published: March 2003

This paper evaluates the effectiveness of the ‘Spot the Hazard’ farm safety resource which employs 3‐D visual stimuli to develop rudimentary risk assessment skills in children. Primary school children from three local schools in north‐west New South Wales were presented with the resource and talked about the farm hazards present. Children’s recall of the hazards and the extent to which they compared the resource to their own farm was assessed after an initial presentation at post‐tests of 1, 14 and 28 days, across three experimental groups. Individual differences in achievement were controlled for using the Wechsler Individual Achievement Test‐Screener (WIAT). Analysis revealed that children exposed to the resource recalled significantly more hazards and made more comparisons to their own farm experiences than controls. However, differences on individual achievement were observed between groups due to a lack of randomisation. Farm safety educational resources for children are more effective when verbal and nonverbal strategies are used and when children are exposed to such cues repeatedly. The development of farm safety educational resources for children which employ spatial cues is encouraged. Further clarification of results would entail a more rigorous randomised control trial.
Management of Episodes of Incapacity by Families in Rural and Remote Queensland
Authors: Jirojwong Sansnee , MacLennan Robert
Published: March 2003

Abstract: People in rural and remote areas have relatively poor health, so limited availability of and accessibility to doctors are major health issues. This cross‐sectional study was conducted in rural and remote areas of Central Queensland. Using telephone interviews, the study described the use of formal and informal health services by families in response to episodes of incapacity. An episode of incapacity was defined as inability to conduct ordinary activities for at least half a day due to new or continued illness. Of the 394 households contacted, 270 (68.5%) provided information about 698 household members, of whom 269 (38.5%) reported at least one episode of incapacity in the previous 12 months. The respondents could report more than one type of management of an illness episode. The management of the most recent episode in each member included 68% visiting doctors and 8.2% using services at an accident and emergency unit. Persons living in ‘least’ medically resourced areas were more likely than persons in relatively ‘high’ and ‘moderate’ areas to consult doctors, but were also more likely to first consult books and delay their visits. They also consulted by telephone three times more frequently. Only 7% consulted other health practitioners including nurses and chemists, suggesting that these health practitioners were not used by families in rural and remote areas during episodes of incapacity. Increasing the availability and accessibility of medical care resources in rural and remote areas, using alternative delivery methods such as telemedicine, may meet the health needs of rural populations.
Different faces of the white cataract: A phaco surgeon’s perspective
Authors: Basti Surendra
Published: March 2003

Purpose: To develop a system of categorizing white cataracts so that the salient features, as would be pertinent to phacoemulsification surgery, could be recognized pre‐operatively.

Methods: Patients with total cataracts were carefully evaluated using slit‐lamp biomicroscopy and slit‐lamp photography. An attempt was made to determine whether pre‐operative evaluation could ascertain the presence or absence of features of these cataracts that often cause surgical difficulties, namely, increased intralenticular pressure (ILP), milky cortex and brown nuclear colour.

Results: Using a standardized method of biomicroscopic evaluation, it was found that the status of the ILP, cortex and nuclear colour could be determined consistently. Surgical strategies based on such a system of categorization has permitted white cataracts to be consistently managed using phacoemulsification.

Conclusions: Systematic pre‐operative evaluation and categorization of white cataracts based on the ILP, status of the cortex and nuclear colour can permit proper surgical planning and successful management of such cases with phacoemulsification.
Contact or immersion technique for axial length measurement?
Authors: ChB Adam Watson, Mb , Armstrong Robyn
Published: March 2003

Purpose: The purpose of the present study was to determine whether contact and immersion A‐scan techniques produce comparable measures of the magnitude of eye axial length.

Method: A prospective study in which 225 consecutive patients scheduled for cataract surgery in a private day surgery setting had axial lengths measured with an Alcon Ocuscan machine (Alcon Australia, Frenchs Forest, NSW, Australia) using both contact and immersion techniques. Twelve patients had both techniques repeated on a separate occasion.

Results: Measurements of eye axial length obtained by the immersion technique averaged 0.1 mm longer than those obtained by the contact technique. A difference in axial length values was confirmed in eyes subjected to repeated measurements.

Conclusions: Both techniques give consistent results, but the difference between axial lengths measured by the two techniques has implications for choice of intra‐ocular lens power.
Unusual presentations of pleomorphic adenoma and adenoid cystic carcinoma of the lacrimal gland
Authors: Wharton Jessica Acl , O’Donnell Brett A
Published: March 2003

Purpose: To report two atypical cases of pleomorphic adenoma and adenoid cystic tumours of the lacrimal gland.

Methods: Two case reports are presented. The first is of a 65‐year‐old female with a long history of right hypoglobus with sudden recent worsening. Computed tomography (CT) showed a round, well‐defined lesion in the fossa for the lacrimal gland with an anterior hypodense exten‐ sion suggestive of possible malignancy in a pleomorphic adenoma. The tumour in the second case, a 35‐year‐old male, was diagnosed after presentation following a relatively minor periorbital injury. The smooth rounded mass on CT scan was suggestive of a benign lacrimal gland tumour.

Results: The lesion in case 1 was excised with a diagnosis of haemorrhage within a pleomorphic adenoma. The lesion in case 2 was excised with a diagnosis of adenoid cystic carcinoma of the lacrimal gland with pseudocapsule.

Conclusions: Haemorrhagic cyst developing beneath the pseudocapsule of a pleomorphic adenoma should be considered in the differential diagnosis of secondary development of malignancy in a pleomorphic adenoma. Adenoid cystic tumours of the lacrimal gland can present with a pseudocapsule.
Number needed to treat: A useful new method of assessing the magnitude of treatment effect and its application to the management of diabetic retinopathy*
Authors: Laureano Joseph A San , Briganti Esther M , Colville Deborah J
Published: March 2003

The magnitude of treatment effect from randomized controlled trials can be measured in various ways. The number needed to treat is a recently described measure that has been shown to offer several advantages in the clinical interpretation and application of reported treatment effects. It quantifies the number of patients that must be treated in order to prevent one patient from developing the specified outcome. The methods necessary to calculate traditional measures of treatment effect, as well as the number needed to treat, are outlined using the management of diabetic retinopathy as an example. The uses and limitations of the number needed to treat are also discussed.
Diagnostic Efficiency of the Hospital Anxiety and Depression Scale in Women with Early Stage Breast Cancer
Authors: Love Anthony W , Kissane David W , Bloch Sidney , Clarke David M
Published: March 2003

Objective: To investigate the diagnostic efficiency of the Hospital Anxiety and Depression Scale (HADS) in patients with breast cancer.

Methods: Women (303) recently diagnosed with stage I or II breast cancer completed the HADS and were psychiatrically assessed. Recommended cut-off scores for Depression (D) and Anxiety (A) Scales identified probable caseness and the accuracy was compared with DSM-IV diagnoses. Cut-off scores were varied to establish optimal accuracy.

Results: One hundred and eleven (36.6%) met criteria for depressive disorders and 25 (8.3%) met criteria for anxiety disorders. At the recommended cut-off score of 11 for the D scale, positive and negative predictive values were.75 and.64, respectively, while sensitivity and specificity were.05 and.99, respectively. For the A scale, positive predictive value (PPV) was.15; negative predictive value (NPV),.90; sensitivity,.08; and specificity,.87. Reducing the cut-off score to 5 produced PPV of.63, NPV of.74, sensitivity of.49 and specificity of.83 for the D scale;.14,.94,.75 and.45, respectively, for the A scale. Composite scores (cut-off of 22) had a PPV of.92, NPV of.57, sensitivity of.09 and specificity of.99.

Conclusions: Recommended cut-off scores for the HADS may result in under-reporting of psychiatric morbidity among women with early stage breast cancer. These results are consistent with other recent studies of the HADS. The type of constructs measured by the scale is the likely explanation for its limited utility when screening for psychiatric morbidity in early stage breast cancer.
USE OF FINE‐NEEDLE ASPIRATION CYTOLOGY AND FROZEN SECTION EXAMINATION IN DIAGNOSIS OF THYROID NODULES
Authors: Chow T. L. , Venu V. , Kwok S. P. Y.
Published: March 2003

Background: With the advent of fine‐needle aspiration cytology (FNAC), the role of frozen section (FS) in the management of non‐toxic thyroid nodules has become uncertain.

Methods: During the period from January 1993 to December 1995, a total of 84 patients have undergone operative treatment for non‐toxic thyroid nodules at the United Christian Hospital, Kowloon. The medical records of these patients were studied retrospectively.

Results: In the benign group, the diagnostic accuracy of FNAC was 94% and that of FS was 91%. If FNAC reported malignancy, the diagnostic accuracy was 70%. If FS reported malignancy, the report was accurate in 100%. Among the 43 cases reported as benign on FNAC, FS did not alter the surgical management in any case. In 10 cases reported as suspicious on FNAC, FS altered the surgical treatment in one (10%). However, among the 10 cases reported as malignant on FNAC, FS subsequently altered the surgical management in five cases (50%). In three cases of malignancy on FNAC, both FS and the final histopathology report showed benign disease. Hence, FS avoided overtreatment in three patients.

Conclusion: Frozen section is indicated if pre‐operative FNAC of the thyroid nodules suggests malignancy, in order to determine the extent of the operation and to avoid overtreatment of benign disease. However, FS can be omitted if FNAC is reported as benign or suspicious.
THE USE OF SPIRAL COMPUTED TOMOGRAPHIC ANGIOGRAPHY FOR THE ASSESSMENT OF LIVING KIDNEY DONORS
Authors: Lionel G. , Sebben R. A. , Costello P. , Mohan Rao M.
Published: March 2003

Background: Recent reports suggest that spiral computed tomographic (CT) angiography can replace conventional angiography and intravenous urography for the assessment of potential kidney donors. The purpose of this study is to assess the accuracy of spiral CT in potential kidney donor workup.

Methods: Over a period of 1 year, from December 1995 to December 1996, 16 consecutive potential renal donors had intravenous pyelography, percutaneous transfemoral angiography with selective renal angiography and spiral CT angiography. The spiral CT and renal angiograms were assessed independently by two radiologists. The number of renal arteries, presence or absence of renal artery stenoses and associated parenchymal abnormalities were assessed.

Results: A total of 39 renal arteries were detected. Conventional transverse scans viewed in a cine loop format detected all 39 vessels, while the maximum intensity projection and shaded surface display demonstrated only 37. All 39 vessels were detected by the catheter angiography. With the exception of one potential donor with fibromuscular dysplasia, 15 donors were accepted. There was 100% accuracy between the two methods of visualization for the renal arteries. A simple renal cyst was noted in both spiral CT and conventional angiogram, while another had gallstones in spiral CT.

Conclusions: Spiral CT angiography performed as an outpatient procedure is less invasive, less expensive, and provides good images of the arterial and venous anatomy. It has the potential to replace conventional catheter angiography and intravenous pyelogram in the assessment of potential renal donors.
EARLY GASTRIC CANCER IN THE YOUNG: CLINICOPATHOLOGICAL STUDY
Authors: Yokota Takashi , Takahashi Naonori , Teshima Shin , Yamada Yasuo , Saito Toshihiro , Kakizaki Kenji , Kikuchi Shu , Kunii Yasuo , Yamauchi Hidemi
Published: March 2003

Background: Thirty‐four cases of early gastric carcinoma in patients under 50 years of age treated in the period from 1985 to 1995 were reviewed.

Methods: These constituted 3.7% of 923 cases of gastric cancer in patients of all ages that were treated at Sendai National Hospital during the same 10‐year period. Data were compared with those of 194 patients 50 years of age or older.

Results: The incidence of gastric cancer in men and women was almost the same in both groups. Tumours tended to be located distally in the stomach. Macroscopically, depressed lesions were more common in younger patients. Significant differences were observed in depth of invasion, histological type and histological growth patterns.

Conclusions: The distinctive histological features of early gastric cancer in younger patients were a diffuse type of cancer with infiltrative tumours in the mucosal layer. The prognosis of younger patients was similar to that of older patients.
EARLY EXPERIENCE WITH THE LAPAROSCOPIC ACE PROCEDURE
Authors: Robertson Robert W. , Craig Lynch A. , Beasley Spencer W. , Morreau Phil N.
Published: March 2003

Background: In 1990 Malone et al. introduced the reversed appendicocaecostomy as a technique to enable an antegrade continence enema (ACE) to be administered. The aim is to achieve colonic emptying and thus prevent soiling in children with faecal incontinence. The procedure has been modified by suturing the opened appendix directly to the skin as a stoma, and can now also be performed laparoscopically.

Methods: All children undergoing laparoscopic ACE procedures at Christchurch Hospital, Christchurch, New Zealand and Princess Margaret Hospital, Perth, Australia, were reviewed. Intra‐operative and postoperative problems were identified retrospectively and questionnaires were completed by the children’s caregivers detailing their experience with managing their children following the ACE procedure.

Results: Thirty children have had a laparoscopic ACE procedure performed since 1994. Two required conversion to an open procedure because of difficulty locating the appendix. Twenty‐nine children are currently using the stoma for regular antegrade colonic washouts. Improvement in continence was seen in 27 children, 15 of whom have been completely continent. Stenosis of the stoma occurred in eight children, two of whom required operative revision of the stoma; the others have been managed by daily dilatation, either with the irrigation catheter or a small perspex dilator. More recently, spatulating the appendix tip has reduced the incidence of stenosis. Two children have had troublesome leaks.

Conclusions: The laparoscopic approach to the ACE procedure results in an improved level of continence in this difficult group of children with faecal incontinence. It is a simpler alternative to previously described methods and causes minimal morbidity. Results to date suggest a satisfactory outcome for both the children and their families.
PRE‐OPERATIVE LOCALIZATION AND TISSUE UPTAKE STUDY IN PARATHYROID IMAGING WITH TECHNETIUM‐99m‐SESTAMIBI
Authors: Takami H. , Oshima M. , Sugawara I. , Satake S. , Ikeda Y. , Nakamura K. , Kubo A.
Published: March 2003

Background: The diagnostic ability of 99mTc‐sestamibi was compared with other techniques and the mechanism of parathyroid uptake was investigated.

Methods: Double‐phase 99mTc‐sestamibi scanning was performed in 52 primary and 28 renal hyperparathyroidism patients. Gene expressions of mdr1 and mrp were examined by reverse transcriptase polymerase chain reaction in parathyroid tissue.

Results: The sensitivity of 99mTc‐sestamibi in primary and renal hyperparathyroidism was 91% and 75%, respectively, higher than for ultrasonography, Tl/Tc subtraction scintigraphy, or computed tomography. Early 99mTc‐sestamibi uptake was washed out in delayed images in 7% and 30% of glands in primary and renal hyperparathyroidism, respectively. Expression of mdr1 and mrp mRNA was found in 5 of 23 and 16 of 31 glands, respectively, and their expression correlated with washout in delayed images.

Conclusion: 99mTc‐sestamibi was the best localization test. mdr1 and mrp were associated with 99mTc‐sestamibi washout, but their role in the parathyroid remains unclear.
PREDICTORS OF BREAST CANCER IN WOMEN RECALLED FOLLOWING SCREENING
Authors: Price MELANIE A. , Tennant CHRISTOPHER C. , Smith ROSS C. , Kennedy SUSAN J. , Butow PHYLLIS N. , Kossoff MARJORIE B. , Dunn STEWART M.
Published: March 2003

Background: Established risk factors are associated with between 25 and 56% of breast cancer cases, but the relative importance and relevance to different age groups is unclear.

Methods: This case‐control study examines established risk factors in 298 women with breast cancer and 1926 women without breast cancer aged 40–87 who were recalled for assessment following routine mammography.

Results: The cancer group were significantly older than the non‐cancer group (F1,222 = 107.6; P < 0.0001). Postmenopausal obesity increased the odds of developing breast cancer (OR: 2.35; CI: 1.33–4.16). The breast cancer group were more likely to have used oral contraceptives (OR: 1.50; CI: 1.09–2.05), and women who used contraceptives for more than 10 years in total were at the highest risk (OR: 1.73; CI: 1.13–2.65). Daily consumption of alcohol was also associated with increased risk of developing breast cancer (OR: 1.62; CI: 1.13–2.33). Reproductive factors and a family history of breast cancer did not affect the odds of developing breast cancer and the reasons for these findings are explored.

Conclusions: Results suggest that the effects of weight reduction in reducing postmenopausal breast cancer risk should be assessed.
FACTORS PREDICTING LOCAL RECURRENCE OF DESMOID TUMOURS INCLUDING PROLIFERATING CELL NUCLEAR ANTIGEN
Authors: Serpell Jonathon W. , Siew‐Khin Tang H. , Donnovan Mark
Published: March 2003

Background: A series of 24 patients with desmoid tumours were studied to determine factors predicting local recurrence, and to establish whether these desmoid tumours were oestrogen receptor‐positive or ‐negative.

Methods: Histology was reviewed and immunohistochemical studies were undertaken. Risk factors for local recurrence were analysed.

Results: The findings indicate that the 24 desmoid tumours were oestrogen receptor‐ and progesterone receptor‐negative. Most tumours were proliferating cell nuclear antigen (PCNA)‐positive, and positivity was graded by percentage of cells staining and the intensity of the staining. The presence of incomplete macroscopic or histological surgical resection margins did not correlate with local recurrence. Although all tumours that recurred were strongly PCNA‐positive with a high percentage of positive cell staining, this trend was not significant. Local recurrence was more common in desmoid tumours arising in extra‐abdominal sites (P = 0.03). Extra‐abdominal desmoid tumours were significantly more likely to have incomplete histological margins following resection (P < 0.05).

Conclusion: Desmoid tumours are oestrogen receptor‐ and progesterone receptor‐negative. Of factors analysed for local recurrence, only the extra‐abdominal site was significant.
A COMMUNITY STUDY OF LOWER URINARY TRACT SYMPTOMS IN OLDER MEN IN SYDNEY, AUSTRALIA
Authors: Sladden Michael J. , Hughes Ann‐Maree , Hirst Geoffrey H. L. , Ward Jeanette E.
Published: March 2003

Background: The aim of the present paper was to determine the prevalence, bother attributable to and self‐reported management of uncomplicated lower urinary tract symptoms (LUTS) in men aged 40–80 years in Sydney, Australia.

Methods: A total of 340 randomly selected men aged 40–80 years (65% response rate) participated in a community‐based study (computer‐assisted telephone survey).

Results: Lower urinary tract symptoms are common: 54% of men needed to wake up at least once at night to urinate; 47% indicated they had terminal dribbling ‘sometimes’ or ‘frequently’; 30% experienced urgency although few (4%) had urge incontinence; 21% experienced hesitancy; and 19% could retain urine in their bladder during the day for no more than 2 hours. Urinary symptoms correlated poorly with self‐rated bother and there was no increase in age‐specific prevalence of bothersome symptoms with increasing age. Only 37 (26%) men inconvenienced by urinary symptoms had seen a general practitioner (GP) about these symptoms in the last 5 years: of these, two‐thirds had been referred to a urologist and half of these received surgical treatment. Independent predictors of attending a GP were increasing age (adjusted odds ratio (AOR) = 12.3; P = 0.0015); place of birth outside Australia (AOR = 3.8; P = 0.0036) and anxiety about prostate cancer (AOR = 2.6; P = 0.0318), but not the degree of worry due to urinary symptoms.

Conclusion: Lower urinary tract symptoms are common in men, but their experiences of bother correlate weakly with symptoms and do not appear to influence referral and treatment. Public and professional campaigns might increase wider understanding of the benefits of surgery for bothersome symptoms, not symptoms per se.