bluuebunny/crossref_metadata_2025 huggingface dataset:
Black truffle‐associated bacterial communities during the development and maturation of Tuber melanosporum ascocarps and putative functional roles
Authors: Antony‐Babu Sanjay , Deveau Aurélie , Van Nostrand Joy D. , Zhou Jizhong , Le Tacon François , Robin Christophe , Frey‐Klett Pascale , Uroz Stéphane
Published: October 2013

Although truffles are cultivated since decades, their life cycle and the conditions stimulating ascocarp formation still remain mysterious. A role for bacteria in the development of several truffle species has been suggested but few is known regarding the natural bacterial communities of Périgord Black truffle. Thus, the aim of this study was to decipher the structure and the functional potential of the bacterial communities associated to the Black truffle in the course of its life cycle and along truffle maturation. A polyphasic approach combining 454‐pyrosequencing of 16S rRNA gene, TTGE, in situ hybridization and functional GeoChip 3.0 revealed that Black truffle ascocarps provide a habitat to complex bacterial communities that are clearly differentiated from those of the surrounding soil and the ectomycorrhizosphere. The composition of these communities is dynamic and evolves during the maturation of the ascocarps with an enrichment of specific taxa and a differentiation of the gleba and peridium‐associated bacterial communities. Genes related to nitrogen and sulphur cycling were enriched in the ascocarps. Together, these data paint a new picture of the interactions existing between truffle and bacteria and of the potential role of these bacteria in truffle maturation.
Soil water flow is a source of the plant pathogen Pseudomonas syringae in subalpine headwaters
Authors: Monteil Caroline L. , Lafolie François , Laurent Jimmy , Clement Jean‐Christophe , Simler Roland , Travi Yves , Morris Cindy E.
Published: October 2013

The airborne plant pathogenic bacterium Pseudomonas syringae is ubiquitous in headwaters, snowpack and precipitation where its populations are genetically and phenotypically diverse. Here, we assessed its population dynamics during snowmelt in headwaters of the French Alps. We revealed a continuous and significant transport of P. syringae by these waters in which the population density is correlated with water chemistry. Via in situ observations and laboratory experiments, we validated that P. syringae is effectively transported with the snow melt and rain water infiltrating through the soil of subalpine grasslands, leading to the same range of concentrations as measured in headwaters (102–105 CFU l−1). A population structure analysis confirmed the relatedness between populations in percolated water and those above the ground (i.e. rain, leaf litter and snowpack). However, the transport study in porous media suggested that water percolation could have different efficiencies for different strains of P. syringae. Finally, leaching of soil cores incubated for up to 4 months at 8°C showed that indigenous populations of P. syringae were able to survive in subalpine soil under cold temperature. This study brings to light the underestimated role of hydrological processes involved in the long distance dissemination of P. syringae.
Civil Society Aid to Post-communist Countries
Authors: Spina Nicholas , Raymond Christopher
Published: October 2013

A major debate within foreign aid literature is whether civil society can be ‘purchased’ through outside assistance. We test this proposition by exploring the influence of aid provided by the United States Agency for International Development on post-communist civil rights environments. A review of research critical of international assistance highlights the risk of unsustainability, polarization and dependence among recipient civic organizations. We argue that a more effective stimulant is socio-economic growth, which stimulates committed constituencies, higher citizen expectations and pressure on the state to protect civil freedoms. Using cross-sectional, time-series data from 27 post-communist countries, we find no evidence that aid independently promotes stronger civil rights environments but that economic growth produces substantial improvements. Further, any aid effectiveness appears to be conditional on economic strength. We conclude that developmental organizations should reassess how and where civil society aid is targeted.
Taking Risks in Social Media Campaigning: The Early Adoption of Blogging by Candidates
Authors: Carlson Tom , Djupsund Göran , Strandberg Kim
Published: October 2013

This article concerns whether and how political candidates adopt social media in their election campaigns. For campaigns, the openness and interactivity of social media tools bring about risks in terms of losing control over the message. Departing from a cost‐benefit perspective, this study addresses the question as to whether certain groups of candidates – differing in incumbency status, party type, gender, generation and urbanization level of the constituency – are more prone to adopt and utilize new social media tools and practices. In order to study how candidates approach social media in an early stage when the benefits are uncertain and the risks are apparent, candidate blogging in the 2007 Finnish national elections is examined. The findings show that the candidates generally were not ready to pursue the full potential of blogs and thereby to accept the risks associated with this open, interactive and personalized way of campaigning. Rather, the candidates took a cautious approach by not engaging extensively in the social media features and practices. However, female candidates and candidates not representing major parties were more likely to utilize a broader range of social media features and practices. The study adds support to the claim that campaigns do not simply adopt and utilize novel social media tools with the purpose of being innovative; they assess risks, costs and benefits. Social media do not alter the basic need of campaigns to control the message and to avoid stress in the campaign organization.
Poor relief inElizabethanEnglish communities: an analysis ofCollectors' accounts
Authors: McIntosh Marjorie K.
Published: October 2013

This article analyses 30 accounts of income and expenditure left byCollectors for thePoor inElizabethanEngland, before the period known as the old poor law. Collectors were appointed by parishes and incorporated boroughs in accordance with the poor laws of 1552 and 1563, but few of their fragile records survive. The accounts examined here document early use of compulsory rates to provide income, but several features of the distribution of relief differ from patterns common in the seventeenth and eighteenth centuries. Adult male recipients outnumbered women in many of the parishes; children were frequently helped directly; and cities and towns assisted a smaller fraction of their total populations than did villages but awarded larger per capita payments. Accounts from the 10 villages and small towns analysed most fully show thatElizabethanCollectors were moving away from the late medieval practice of providing only occasional aid; increasingly they awarded regular payments to a selected subset of the local poor. Comparison with the early seventeenth century suggests that the poor laws of 1598 and 1601 contributed to a transition that was already underway but did not create a new system of relief.
Becoming a Slum: From Municipal Colony to Illegal Settlement in Liberalization‐Era Mumbai
Authors: Björkman Lisa
Published: October 2013

This article argues that the transformation of a Mumbai neighborhood from municipal housing colony into illegal slum has been facilitated by the politically mediated deterioration and criminalization of its water infrastructure in the context of liberalization‐era policy shifts. These policy shifts hinge upon a conceptual binary that posits the unplanned, illegal and informal ‘slum’ as the self‐evident conceptual counterpoint to a planned, formal, ‘world‐class’ city. The story of Shivajinagar‐Bainganwadi problematizes this assumption by evidencing the deeply political and highly unstable nature of this binary — and thus insists upon an account of the shifting political and economic stakes imbued in these categories. The case of Shivajinagar‐Bainganwadi reveals that the neighborhood's emergence as an illegal slum has been mediated by the liberalization‐era politics that have come to infuse the neighborhood's water pipes — dynamics that have produced the illegality/informality of the neighborhood as a discursive effect.
Diversification by Urbanization: Tracing the Property‐Finance Nexus in Dubai and the Gulf
Authors: Buckley Michelle , Hanieh Adam
Published: October 2013

This article explores the role of liberalized real estate markets in shaping financial‐sector development in the Arab Gulf region. Since 2001, record oil revenues and the inflow of repatriated wealth into the region have generated immense demand for new, productive destinations for surplus capital. Gulf Cooperation Council states have subsequently undergone rapid growth that is intimately tied to the regulatory transformation of urban real estate markets and the circulation of surplus capital from oil rents to the ‘secondary circuit’ of the built environment. With an emphasis on the city of Dubai, we employ the notion of diversification by urbanization to trace the re‐regulation of real estate markets and highlight how these strategies have subsequently shaped Gulf financial markets. Through an examination of the impacts of real estate mega‐project development on local banking credit, equities and Islamic financial markets, we reframe recent urbanization in the region as a process of financial re‐engineering, and identify the emergence of capital groups whose accumulation activities are tightly connected to both the real estate and financial circuit.
Effect of concentrated plum juice on physicochemical and sensory properties of yoghurt made at bench top scale
Authors: Hernández‐Herrero José A , Frutos María J
Published: October 2013

Yoghurt with 9% (v/v) of plum juice concentrate (PJC) was stored for 24 days in darkness at 6 °C. Titratable acidity and pH were similar in all samples during storage. The firmness was in the range of 1.7–2.3 N and correlated with total solids of the mixes (R2 = 0.982). The sample with PJC and 5.33% (w/v) nonfat dry milk had the highest firmness and the weakest creaminess. The colour in PJC yoghurt was stable during the first seven days of storage. In the ranking test for acceptability, there were no significant differences (P ≤ 0.05) between the yoghurts.
Accountable Care Organizations in the United States: Market and Demographic Factors Associated with Formation
Authors: Lewis Valerie A. , Colla Carrie H. , Carluzzo Kathleen L. , Kler Sarah E. , Fisher Elliott S.
Published: October 2013

Background

The Accountable Care Organization (ACO) model is rapidly being implemented by Medicare, private payers, and states, but little is known about the scope of ACO implementation.

Objective

To determine the number of accountable care organizations in the United States, where they are located, and characteristics associated with ACO formation.

Study Design, Methods, and Data

Cross‐sectional study of all ACOs in the United States as of August 2012. We identified ACOs from multiple sources; documented service locations (practices, clinics, hospitals); and linked service locations to local areas, defined as Dartmouth Atlas hospital service areas. We used multivariate analysis to assess what characteristics were associated with local ACO presence. We examined demographic characteristics (2010 American Community Survey) and health care system characteristics (2010 Medicare fee‐for‐service claims data).

Principal Findings

We identified 227 ACOs located in 27 percent of local areas. Fifty‐five percent of the US population resides in these areas. HSA‐level characteristics associated with ACO presence include higher performance on quality, higher Medicare per capita spending, fewer primary care physician groups, greater managed care penetration, lower poverty rates, and urban location.

Conclusions

Much of the US population resides in areas where ACOs have been established. ACO formation has taken place where it may be easier to meet quality and cost targets. Wider adoption of the ACO model may require tailoring to local context.
Massachusetts Coverage Expansion Associated with Reduction in Primary Care Utilization among Medicare Beneficiaries
Authors: Bond Amelia M. , White Chapin
Published: October 2013

Objective

To examine whether expanding coverage for the nonelderly affects primary care utilization among Medicare beneficiaries.

Data Source

Zip code–level files from Dartmouth Atlas for Massachusetts and surrounding states, including Medicare utilization for 2005 (pre expansion) and 2007 (post expansion), and health insurance coverage for 2005.

Study Design

We use two zip code–level outcomes: arc percent change in primary care visits per Medicare beneficiary per year, and percentage point change in the share of beneficiaries with one or more primary care visits. We use a regression‐based difference‐in‐difference analysis that compares Massachusetts with surrounding states, and zip codes with high, medium, and low uninsurance rates in 2005. The 2005 uninsurance rates correspond to the size of Massachusetts' coverage expansion. We use propensity scores for identification of comparable zip codes and for weighting.

Principal Findings

In areas of Massachusetts with the highest uninsurance rates—where insurance expansion had the largest impact—visits per beneficiary fell 6.9 percent (p < .001) relative to areas of Massachusetts with the smallest uninsurance rates.

Conclusions

The expansion of coverage for the nonelderly reduced primary care visits, but it did not reduce the percent of beneficiaries with at least one visit. These results could imply restricted access, increased efficiency, or some blend.
Community Health Center Efficiency: The Role of Grant Revenues in Health Center Efficiency
Authors: Amico Peter R. , Chilingerian Jon A. , van Hasselt Martijn
Published: October 2013

Objective

To test the relationship between external environments, organizational characteristics, and technical efficiency in federally qualified health centers (FQHCs). We tested the relationship between grant revenue and technical efficiency in FQHCs.

Data Sources/Study Design

Secondary data were collected in each year from the Uniform Data System (UDS) on 644 eligible U.S.‐based FQHCs between 2005 and 2007. The study employs a retrospective longitudinal cohort design with instrumental variables.

Principal Findings

Increased grant revenues did not increase the probability that a health center would be on the efficiency frontier. However, increased grant revenues had a negative association with technical efficiency for health centers that were not fully efficient.

Conclusion

If all health centers were operating efficiently, anywhere from 39 to 45 million patient encounters could have been delivered instead of the actual total of 29 million in 2007. Policy makers should consider tying grant revenues to performance indicators, and future work is needed to understand the mechanisms through which diseconomies of scale are present in FQHCs.
Breast Cancer Screening, Area Deprivation, and Later‐Stage Breast Cancer in Appalachia: Does Geography Matter?
Authors: Anderson Roger T. , Yang Tse‐Chang , Matthews Stephen A. , Camacho Fabian , Kern Teresa , Mackley Heath B. , Kimmick Gretchen , Louis Christopher , Lengerich Eugene , Yao Nengliang
Published: October 2013

Objective

To model the relationship of an area‐based measure of a breast cancer screening and geographic area deprivation on the incidence of later stage breast cancer (LSBC) across a diverse region of Appalachia.

Data Source

Central cancer registry data (2006–2008) from three Appalachian states were linked to Medicare claims and census data.

Study Design

Exploratory spatial analysis preceded the statistical model based on negative binomial regression to model predictors and effect modification by geographic subregions.

Principal Findings

Exploratory spatial analysis revealed geographically varying effects of area deprivation and screening on LSBC. In the negative binomial regression model, predictors of LSBC included receipt of screening, area deprivation, supply of mammography centers, and female population aged >75 years. The most deprived counties had a 3.31 times greater rate of LSBC compared to the least deprived. Effect of screening on LSBC was significantly stronger in northern Appalachia than elsewhere in the study region, found mostly for high‐population counties.

Conclusions

Breast cancer screening and area deprivation are strongly associated with disparity in LBSC in Appalachia. The presence of geographically varying predictors of later stage tumors in Appalachia suggests the importance of place‐based health care access and risk.
Auditor Choice in Politically Connected Firms
Authors: GUEDHAMI OMRANE , PITTMAN JEFFREY A. , SAFFAR WALID
Published: October 2013

We extend recent research on the links between political connections and financial reporting by examining the role of auditor choice. Our evidence that public firms with political connections are more likely to appoint a Big 4 auditor supports the intuition that insiders in these firms are eager to improve accounting transparency to convince outside investors that they refrain from exploiting their connections to divert corporate resources. In evidence consistent with another prediction, we find that this link is stronger for connected firms with ownership structures conducive to insiders seizing private benefits at the expense of minority investors. We also find that the relation between political connections and auditor choice is stronger for firms operating in countries with relatively poor institutional infrastructure, implying that tough external monitoring by Big 4 auditors becomes more valuable for preventing diversion in these situations. Finally, we report that connected firms with Big 4 auditors exhibit less earnings management and enjoy greater transparency, higher valuations, and cheaper equity financing.
Why keep lions instead of livestock? Assessing wildlife tourism‐based payment for ecosystem services involving herders in the Maasai Mara, Kenya
Authors: Osano Philip M. , Said Mohammed Y. , de Leeuw Jan , Ndiwa Nicholas , Kaelo Dickson , Schomers Sarah , Birner Regina , Ogutu Joseph O.
Published: October 2013

This paper examines the effects of wildlife tourism‐based payments for ecosystem services (PES) on poverty, wealth inequality and the livelihoods of herders in the Maasai Mara Ecosystem in south‐western Kenya. It uses the case of Olare Orok Conservancy PES programme in which pastoral landowners have agreed to voluntary resettlement and exclusion of livestock grazing from their sub‐divided lands. These lands are set aside for wildlife tourism, in return for direct monetary payments by a coalition of five commercial tourism operators. Results show that, on the positive side, PES is the most equitable income source that promotes income diversification and buffers households from the livestock income declines during periods of severe drought, such as in 2008‐2009. Without accounting for the opportunity costs, the magnitude of the PES cash transfer to households is, on average, sufficient to close the poverty gap. The co‐benefits of PES implementation include the creation of employment opportunities in the conservancy and provision of social services. There is however a need to mitigate the negative effects of PES, including the widening inequality in income between PES and non‐PES households and the leakages resulting from the displacement of settlements and livestock to currently un‐subdivided pastoral commons.
The Distinctiveness of Democratic Political Leadership
Authors: Teles Filipe
Published: October 2013

One recognises that political leadership still makes a difference. However, scholarship seems incapable of offering the proper tools to provide further and relevant understanding on the theme, particularly when we consider liberal democracy's current trends, namely its egalitarian ethos and the personalisation of politics. One of its key features, even in strongly controlled democracies, with tight systems of checks and balances, is the ascendancy of assertive leaders, to whom voters look when deciding on which party to vote for. Therefore, a dispassionate assessment of political leadership is needed in order to adjust our analysis: from the qualities of particular individuals, their intentions, perspectives and preferences, to the way leaders perform their role. This article intends to identify what is the specific nature and distinctiveness of contemporary political leadership, arguing that the nature of the task sets new problems in the political science literature and asks for new approaches.
Raising the Bar: Core Executive Studies, Public Value and a Changing World
Authors: Shaw Richard
Published: October 2013

Core executive studies is now the dominant lens through which the distributed arrangements characteristic of the hollow state are studied; public value has emerged as a normative prescription for citizen engagement with policy making in the context of the very institutional conditions theorised by core executive studies scholars. Yet there has been surprisingly little intellectual engagement between the two. This article assesses the consequences for core executive studies – both epistemologically and analytically – of the empirical circumstances presaged by public value. It concludes that while the asymmetric power variant of core executive studies can accommodate public value, the epistemological basis of the differentiated polity model is challenged by public value's distributed decision-making arrangements. The article also finds that core executive studies needs a more nuanced empirical conception of policy making in order to account for a fully fledged public value landscape.
Latent Fingerprint Visualization using a Scanning Kelvin Probe in Conjunction with Vacuum Metal Deposition
Authors: Dafydd Hefin , Williams Geraint , Bleay Stephen
Published: October 2013

The application of vacuum metal deposition before scanning Kelvin probe visualization of fingerprints is investigated. The potential contrast between fingerprint ridges and furrows is maximized by the use of silver deposition for non‐noble metals and gold–zinc deposition for noble metals. The higher susceptibility of eccrine fingerprints to vacuum metal overdeposition is confirmed. Additionally, fingerprints are best developed individually and by building the metal deposition slowly to protect against overdevelopment and variation in the rate of metal condensation. The progress of the metal deposition can be monitored using the scanning Kelvin probe by reference to the change in potential and continuity of the new potential on the surface. The use of acetic acid solution for the recovery of overVMD‐developed samples is shown not to be useful. Applying the metal deposition has the additional prospect of increasing surface conductivity and homogeneity and both can aid fingerprint visualization using the scanning Kelvin probe.
Combustion and Toxic Gas Production from Disposable Barbecues in Enclosures
Authors: Crewe Robert J. , Andrews Stephen P. , Hull T. Richard , Birbeck Paul N. , Stec Anna A.
Published: October 2013

The production of carbon monoxide from disposable barbecues in an enclosed room has been investigated. Hazard calculations have shown that lethal concentrations of CO and CO2 can be produced easily. Burning rates and the relative formation of CO and CO2 depend on the ambient oxygen concentration. Smoke does not correlate with CO concentration as it is mostly produced by the combustion of volatile hydrocarbons added to facilitate ignition. In a typical room, this results in smoke clearing before the maximum CO concentration is reached. Smoke obscuration is therefore a poor indicator of the danger posed by CO. This is an important observation for those discovering or attempting to resuscitate or rescue comatose victims. Dilution caused by ventilation is described numerically and has allowed total volumes of CO and CO2 produced to be estimated.
A Safer Method for Body Restoration Following Autopsy
Authors: Duflou Johan , McNamara Bradley , Cluney Robert
Published: October 2013

Restoration of autopsy incisions can result in inadvertent needle stick injury to the prosector, which can be difficult to prevent even with the use of personal protective equipment such as Kevlar cut resistant gloves. We present a new technique for closure of autopsy incisions using a commonly available commercial hardware tool, a hole punch with a lever enhanced action, combined with blunt probe sewing, which results in an esthetic and leak‐proof means of restoring cadavers. This technique is especially useful in cases which may pose blood‐borne infection risks to the prosector.
The Role of DNA‐Stained Currency in Gang Robberies within the United Kingdom
Authors: Mead Breanna K. , Hayward James , Liang Benjamin , Wan MeiLin , Benson Tony , Karp Jennifer
Published: October 2013

Cash‐and‐valuables‐in‐transit (CViT) robberies have become a substantial problem—especially in the current global economy. Over £19.4 million were stolen in 2008 and £17.1 million in 2009 in the United Kingdom alone. The transportation of cash and valuable items between financial institutions has long been a target of robberies in the U.K. After a robbery has occurred, police collect evidence in the form of ink‐stained currency. These stained notes are submitted for analysis. Samples are subjected to polymerase chain reaction in order to amplify any possible botanically derived DNA markers present on the notes. After amplification, capillary electrophoresis allows for the deciphering of the “DNA profile.” The DNA profile is then linked to a particular cash box, and this information is compared with records of whether or not that box had been stolen. The cases below are three such instances where botanically marked currency was used to help solve robberies.
The “Bestie di Satana” Murders
Authors: Birkhoff Jutta , Candelli Chiara , Zeroli Stefania , La Tegola Donatella , Carabellese Felice
Published: October 2013

In recent years, satanic groups have been responsible for various types and degrees of crimes. We report the case of a number of murders committed inItaly by a group of young people calling themselves the “Bestie diSatana”. Forensic psychiatric assessment of the members of a satanic sect charged with the crime revealed that all the young people had a fragile, immature personality, a very low level of education and were socially disadvantaged. The trial of the members of the “Bestie diSatana” sect was concluded with the verdict of deliberate murder, and all the members were given long jail sentences. This report should lead us to explore social and cultural responses to juvenile satanism, statistically shown to be a relatively rare phenomenon but with a high criminal potential.
Review article: Burnout in emergency medicine physicians
Authors: Arora Manit , Asha Stephen , Chinnappa Jason , Diwan Ashish D
Published: October 2013

Training and the practice of emergency medicine are stressful endeavours, placing emergency medicine physicians at risk of burnout. Burnout syndrome is associated with negative outcomes for patients, institutions and the physician. The aim of this review is to summarise the available literature on burnout among emergency medicine physicians and provide recommendations for future work in this field. A search of MEDLINE (1946–present) (search terms: ‘Burnout, Professional’ AND ‘Emergency Medicine’ AND ‘Physicians’; ‘Stress, Psychological’ AND ‘Emergency Medicine’ AND ‘Physicians’) and EMBASE (1988–present) (search terms: ‘Burnout’ AND ‘Emergency Medicine’ AND ‘Physicians’; ‘Mental Stress’ AND ‘Emergency Medicine’ AND ‘Physicians’) was performed. The authors focused on articles that assessed burnout among emergency medicine physicians. Most studies used the Maslach Burnout Inventory to quantify burnout, allowing for cross‐study (and cross‐country) comparisons. Emergency medicine has burnout levels in excess of 60% compared with physicians in general (38%). Despite this, most emergency medicine physicians (>60%) are satisfied with their jobs. Both work‐related (hours of work, years of practice, professional development activities, non‐clinical duties etc.) and non‐work‐related factors (age, sex, lifestyle factors etc.) are associated with burnout. Despite the heavy burnout rates among emergency medicine physicians, little work has been performed in this field. Factors responsible for burnout among various emergency medicine populations should be determined, and appropriate interventions designed to reduce burnout.
Involuntary admissions under the Mental Health Act 2007 (New South Wales): A comparison of patients detained by ambulance officers, medical practitioners and accredited persons in an emergency department
Authors: Cutler Dawn , Smith Mechelle , Wand Timothy , Green Timothy , Dinh Michael , Gribble Robert
Published: October 2013

Objective

The Mental Health Act (MHA) 2007 (New South Wales [NSW]) is used to transport to, detain and treat individuals in a mental health facility. Patients are frequently taken to EDs under the MHA or detained in the ED for a mental health assessment. In NSW, medical practitioners, accredited persons, police and more recently ambulance officers, are authorised to write certificates under the MHA. There is an absence of research on the use of the MHA in NSW EDs. The primary research question for this study was: ‘What is the involuntary admission rate for persons detained under the MHA in an NSW tertiary referral ED?’

Methods

After gaining ethics approval, the research team prospectively collected the MHA certificates written for patients in the ED over a 3 month period from February to May 2011. The research team reviewed the MHA certificate and medical records to characterise demographics, outcome, length of stay in ED and certificate suitability. Outcomes of interest were involuntary psychiatric admission or any inpatient admission, and were compared between the different professional groups completing the certificate.

Results

The involuntary admission rate for patients certified by ambulance officers under the NSW MHA was 27%, compared with a 60% involuntary admission rate when certified by medical practitioners or accredited persons. The mean average length of stay in the ED for patients certified under the MHA was 10 h. Seventy‐five per cent of patients presented out of hours.

Conclusion

Ambulance officer certification was a poor predictor of involuntary psychiatric admission in the Royal Prince Alfred Hospital Emergency Department. ED physicians should have the authority to revoke the certificate if, following assessment and treatment, the patient no longer fulfils criteria for detention under the MHA.
Clinical research priorities in emergency medicine
Authors: Keijzers Gerben , Thom Ogilvie , Taylor David , Knott Jonathan ,   Clinical Trials Group, Australasian College for Emergency Medicine
Published: October 2013

Objective

To determine the clinical research priorities of Fellows of the Australasian College for Emergency Medicine (ACEM) in order to inform the strategic research agenda specific to multicentre clinical research.

Methods

An anonymous survey of all ACEM Fellows (FACEMs) listed on the ACEM researcher database was conducted between January and March 2013.

Results

Of 108 FACEMs invited to participate, 54 (50%) responded. Over half of respondents (61%) had a higher research degree but only a minority (24%) had funded research positions. The top research categories identified as priorities were resuscitation, trauma, cardiology, ED ultrasound, acute behavioural disturbance and geriatrics. The most common specific sub‐categories included anterior chest pain, fluid resuscitation in trauma, and drug therapy for both atrial fibrillation and acute behavioural disturbance. Several specific research questions related to chest pain, resuscitation/sepsis, stroke, paediatrics and pulmonary embolus.

Conclusion

The findings provide guidance and support for research areas amenable to collaborative multicentre clinical research within emergency medicine. Discussion rounds are planned to translate these perceived research priorities to actual priorities.
Bacterial microbiome of Coptotermes curvignathus (Isoptera: Rhinotermitidae) reflects the coevolution of species and dietary pattern
Authors: King Jie Hung Patricia , Mahadi Nor Muhammad , Bong Choon Fah Joseph , Ong Kian Huat , Hassan Osman
Published: October 2013

Coptotermes curvignathus Holmgren is capable of feeding on living trees. This ability is attributed to their effective digestive system that is furnished by the termite's own cellulolytic enzymes and cooperative enzymes produced by their gut microbes. In this study, the identity of an array of diverse microbes residing in the gut of C. curvignathus was revealed by sequencing the near‐full‐length 16S rRNA genes. A total of 154 bacterial phylotypes were found. The Bacteroidetes was the most abundant phylum and accounted for about 65% of the gut microbial profile. This is followed by Firmicutes, Actinobacteria, Spirochetes, Proteobacteria, TM7, Deferribacteres, Planctomycetes, Verrucomicrobia, and Termite Group 1. Based on the phylogenetic study, this symbiosis can be a result of long coevolution of gut enterotypes with the phylogenic distribution, strong selection pressure in the gut, and other speculative pressures that determine bacterial biome to follow. The phylogenetic distribution of cloned rRNA genes in the bacterial domain that was considerably different from other termite reflects the strong selection pressures in the gut where a proportional composition of gut microbiome of C. curvignathus has established. The selection pressures could be linked to the unique diet preference of C. curvignathus that profoundly feeds on living trees. The delicate gut microbiome composition may provide available nutrients to the host as well as potential protection against opportunistic pathogen.
The Japanese ladybirds, Coccinula crotchi and Coccinula sinensis, are infected with very closely related strains of male‐killing Flavobacterium
Authors: Elnagdy Sherif , Messing Susan , Majerus Michael E. N.
Published: October 2013

Male‐killing is 1 of 4 known strategies that inherited parasitic endosymbionts have evolved to manipulate their host's reproduction. In early male‐killing, infected male offspring are killed early in embryogenesis. Within the Insecta, male‐killing bacteria have been found in a wide range of hosts. The Coccinellidae families of beetles, better known as ladybirds, are particularly prone to male‐killer invasion. In samples of the coccinellid, Coccinula crotchi, from Japan, a new male‐killing bacterium was revealed by phenotypic assay. Molecular genetic analysis revealed the identity to be a tetracycline‐sensitive Flavobacterium that causes female‐biased offspring sex ratio. Furthermore, that Flavobacterium strain was found to be closely related to the Flavobacterium causing male‐killing in the congeneric Japanese coccinellid, Coccinula sinensis, which was collected from the same region. However, we found slightly different Flavobacterium strains infecting C. sinensis from regions with different environmental conditions. This may be an indication of horizontal transmission of male‐killing Flavobacterium between these 2 ladybird spices. Finally, environmental conditions may affect the spread of male‐killing bacteria among their hosts.
Role of Testosterone in the Pathogenesis, Progression, Prognosis and Comorbidity of Men With Chronic Kidney Disease
Authors: Dousdampanis Periklis , Trigka Konstantina , Fourtounas Costas , Bargman Joanne M.
Published: October 2013

Testosterone deficiency and hypogonadism are common conditions in men with chronic kidney disease (CKD). A disturbed hypothalamic‐pituitary‐gonadal axis due to CKD is thought to contribute to androgen deficiency. Data from experimental studies support the hypothesis that exogenous administration of testosterone may induce the activation of the renin–angiotensin system (RAS), the production of endothelin and the regulation of anti‐ or/and proinflammatory cytokines involved in the pathogenesis of hypertension and kidney damage. On the other hand, low testosterone levels in male patients with CKD are paradoxically associated with a higher risk of morbidity and mortality, possibly explained by anemia, osteoporosis and cardiovascular disease. In this article, we present an overview of clinical and experimental studies of the impact of testosterone on the progression and prognosis of male patients with CKD; even today, this remains a controversial issue.
Serum Hepcidin Levels Are Associated With Serum Triglycerides and Interleukin‐6 Concentrations in Patients With End‐Stage Renal Disease
Authors: Samouilidou Elisabeth , Pantelias Konstantinos , Petras Dimitrios , Tsirpanlis George , Bakirtzi Joulia , Chatzivasileiou George , Tzanatos Helen , Grapsa Eirini
Published: October 2013

Hepcidin has emerged as a peptide with a key role in the regulation of iron homeostasis in patients with chronic kidney disease (CKD), having a strong dependence on inflammation. Recent studies reveal that hepcidin may be also associated with the progression of atherosclerosis. This study was performed to analyze the relation of hepcidin to markers of atherosclerosis and inflammation in patients on dialysis. A total of 90 individuals were enrolled. Sixty patients with end‐stage renal disease, who were on hemodialysis (HD) (N = 30) and peritoneal dialysis (N = 30) were compared with 30 normal controls (NC). Age, body mass index, time on dialysis, serum lipids, C‐reactive protein (CRP) and interleukin‐6 (IL‐6) were measured and analyzed in correlation with hepcidin concentration. It was found that patients on HD and peritoneal dialysis have significantly higher (P < 0.0001) levels of hepcidin, CRP and IL‐6 than NC. Hepcidin in dialysis patients is significantly related to age (r = 0.373, P = 0.012), serum triglycerides (r = 0.401, P = 0.005), HDL‐C (r = −0.268, P = 0.048), CRP (r = 0.436, P = 0.0007) and IL‐6 (r = 0.569, P < 0.0001). In multiple regression analysis, hepcidin correlated independently with triglycerides (β = 0.402, P = 0.041) and IL‐6 (β = 0.559, P = 0.006). Moreover, patients with high triglycerides in combination with high IL‐6 levels have significantly increased concentrations of hepcidin than those with low triglycerides and low IL‐6 levels (P < 0.0001). Elevated levels of hepcidin in patients with CKD on dialysis may be related to the occurrence of high triglycerides and high IL‐6 serum concentrations. This probably suggests that hepcidin may play a role to the progression of atherosclerosis and inflammation, but this hypothesis should be further evaluated.
Periodontal Treatment Reduces Chronic Systemic Inflammation in Peritoneal Dialysis Patients
Authors: Siribamrungwong Monchai , Yothasamutr Kasemsuk , Puangpanngam Kutchaporn
Published: October 2013

Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis‐related data as well as highly sensitive C‐reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C‐reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P < 0.01, periodontal disease index; r = 0.56, P < 0.01). After completion of periodontal therapy, clinical periodontal indexes were significantly lower and high sensitivity C‐reactive protein significantly decreased from 2.93 to 2.21 mg/L. Moreover, blood urea nitrogen increased from 47.33 to 51.8 mg/dL, reflecting nutritional status improvement. Erythropoietin dosage requirement decreased from 8000 to 6000 units/week while hemoglobin level was stable. Periodontitis is an important source of chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients.
Subdivision Policy and Planning for Bushfire Defence: A Natural Hazard Mitigation Strategy for Residential Peri‐Urban Regions in Victoria, Australia
Authors: BOND TESSA , MERCER DAVID
Published: October 2013

From time to time, catastrophic bushfires cause substantial losses of life and property in southern Australia. Moreover, recent analyses of longitudinal fire weather behaviour point to a steady increase in the Forest Fire Danger Index. Although natural hazards such as bushfires can rarely be prevented, effective hazard‐mitigation strategies can manage and lessen the impact on humans and the environment. This paper investigates subdivision design as one such mitigation technique. Roads and other forms of access are vital to successful bushfire response by fire brigades. The research examines the effectiveness of current policy to provide adequate access and suppression opportunities for firefighters in peri‐urban areas, with particular reference to Victoria. Subdivision policies applicable to development in bushfire‐prone areas throughout Australia and the United States are assessed and compared. Interviews with firefighters, planners, and researchers provided insight into the key components of the road network which facilitate firefighter access and identified major shortfalls of current policy and practice in Victoria.
Enduring mentoring partnership: A reflective case study and recommendations for evaluating mentoring in dietetics
Authors: Hawker Jillian , McMillan Anita , Palermo Claire
Published: October 2013

Aim

There are little published data on the effectiveness and outcomes of mentoring in nutrition and dietetics. The aim of this case study was to determine the characteristics of an effective and enduring mentoring partnership.

Methods

A qualitative case study research approach using critical reflexivity was used to examine a mentoring relationship. Mentoring partnership data were collected through memory work and the review of written records was kept by the mentor and mentee of their meetings. Data were analysed using a thematic analysis approach and rigor enhanced through triangulation of data analysis.

Results

Six key themes emerged from the data. Compatibility and commitment to the mentoring partnership by mentor and mentee were essential elements in this relationship. The mentee found that long‐term support offered by the mentor and facilitation of reflective practice were the key benefits of the relationship. The mentor found it rewarding to observe the mentee's development from new graduate to experienced and confident practitioner and learned skills in facilitating learning. The experience has helped the mentor take a more proactive and outcome‐based approach to her mentoring relationships.

Conclusions

Sole practitioners, in the absence of the support from supervisors and coworkers, may benefit more from mentoring beyond the provisional year. There is a need for the provision of training opportunities for those dietitians wishing to embark on a mentoring role as most mentors learn on the job. The profession needs to look at ways of measuring the effectiveness of mentoring partnerships.
Current practice in nutrition assessment for the management of Parkinson's disease in Australia and Canada
Authors: Sheard Jamie M , Ash Susan
Published: October 2013

Aim

To document and compare current practice in nutrition assessment of Parkinson's disease by dietitians in Australia and Canada in order to identify priority areas for review and development of practice guidelines and direct future research.

Methods

An online survey was distributed to DAA (Dietitians Association of Australia) members and PEN (Practice‐based Evidence in Nutrition) subscribers through their email newsletters. The survey captured current practice in the phases of the Nutrition Care Plan. The results of the assessment phase are presented here.

Results

Eighty‐four dietitians responded. Differences in practice existed in the choice of nutrition screening and assessment tools, including appropriate body mass index ranges. Nutrition impact symptoms were commonly assessed, but information about Parkinson's disease medication interactions was not consistently assessed.

Conclusions

The variation in practice related to the use of screening and assessment methods may result in the identification of different goals for subsequent interventions. Even more practice variation was evident for those items more specific to Parkinson's disease and may be due to the lack of evidence to guide practice. Further research is required to support decisions for nutrition assessment of Parkinson's disease.
Effects of enteral protein supplements on nutritional status and clinical outcome in unconscious elderly malnourished patients
Authors: Gülşen Atalay Betül , Yagmur Cahide , Nursal Tarık , Atalay Hakan , Sezgin Nurzen , Giray Semih , Selçuk Haldun
Published: October 2013

Aim

Unconscious malnourished patients have reduced serum proteins. Enteral protein supplements may improve their nutritional status and clinical outcome. Our aim for the present study was to determine the effect on nutritional status and patient prognosis of enteral protein supplementation in tube‐fed hospitalised unconscious elderly malnourished patients.

Methods

In total, 20 patients were fed a standard enteral nutrition formula during the four‐day adaptation period. The study group (n = 10) received an enteral protein supplement (2 g/kg/day protein) and the control group (n = 10) received only standard enteral nutrition (1 g/kg/day protein) during the 12‐day study period. Nutritional status and clinical outcome were assessed.

Results

No difference was observed between the groups with regard to biochemical, inflammatory parameters, anthropometric measurements or nitrogen balance (P > 0.05). Triceps and subscapular skinfold thickness mean levels were elevated in the study group at the end of the study compared with the beginning of the study (P < 0.05). No significant difference was observed between the groups with regard to complications or mortality rate (P > 0.05).

Conclusions

In the present study, the use of enteral protein support (EPS) in unconscious malnourished patients provided some advantages in the early stages of medical treatment. Triceps skinfold thickness and subscapular skinfold thickness mean levels were increased significantly in our study group. Although there was no significant difference, serum insulin‐growth factor, retinol‐binding protein and prealbumin mean values showed a tendency to increase in the study group at the end of the study. We believe that further research is required to determine the effects of EPS on these values in malnourished elderly patients.