bluuebunny/crossref_metadata_2025 huggingface dataset:
Anglo‐American capitalism: the role and potential role of social accounting
Authors: Collison David , Dey Colin , Hannah Gwen , Stevenson Lorna
Published: October 2010

Purpose

This paper seeks to consider the impact and potential impact of social accounting at the macro level. It aims to explore the potential for “silent” or “shadow” social accounting to hold Anglo‐American capitalism to account for its social outcomes relative to other “varieties of capitalism”.

Design/methodology/approach

The role of accounting in spreading Anglo‐American capitalist values is outlined. This is followed by a discussion of macro social indicators and their potential to problematise social outcomes. In particular the paper reports on, and updates, an investigation of comparative child mortality figures in wealthy countries that appeared in the medical literature. This evidence is used both as an exemplar and as a substantive issue in its own right.

Findings

The specific empirical evidence reported, based on a cross‐sectional and longitudinal analysis of child mortality and its relationship to income inequality, exemplifies the consistently poor and relatively worsening performance of the Anglo‐American capitalist model. A rationale, and evidence, is also presented for the potential of such social reporting to act as an accountability mechanism.

Originality/value

The paper introduces to the accounting literature specific evidence of poor social outcomes associated with Anglo‐American capitalism. It considers the wider potential role of social indicators, as a component of silent and shadow reporting at a macro‐level, in problematising dominant forms of economic and social organisation.
Dermoscopic findings and histological correlation of the acral volar pigmented maculae in Laugier–Hunziker syndrome
Authors: SENDAGORTA Elena , FEITO Marta , RAMÍREZ Paloma , GONZALEZ‐BEATO María , SAIDA Toshiaki , PIZARRO Angel
Published: October 2010

Laugier–Hunziker syndrome (LHS) is an acquired, benign, macular hyperpigmentation of the lips and oral mucosa, often associated with pigmentation of the nails. Volar acral maculae on the palms and fingertips of patients affected by LHS are a typical feature of this rare entity. Dermoscopic examination of these maculae has been described in a previous report, in which authors found a parallel‐furrow pattern. We describe two cases in which a parallel‐ridge pattern (PRP) was found on the dermoscopic examination of the pigmented acral lesions. Histological examination showed increased melanin in basal keratinocytes, which was most prominent in those located at the crista intermedia profunda, that is, in the epidermal rete ridges underlying the surface ridges. In our study, dermoscopic features of the pigmented maculae found on LHS differed from those previously described. In addition, by means of this case report, the histological features of these lesions are described for the first time, showing an excellent correlation with dermoscopy. The reported cases prove that although the PRP is very specific of melanoma, it is also possible to find it in benign lesions. Therefore, we must be familiar with the differential diagnosis of PRP, and take into consideration the clinical context in which we find it. Further studies are needed to increase our knowledge on the histological and dermoscopic features of acral pigmented maculae of LHS.
Multiple vascular eccrine spiradenomas: A case report and published work review of multiple eccrine spiradenomas
Authors: YOSHIDA Aki , TAKAHASHI Kazuhiro , MAEDA Fumihiko , AKASAKA Toshihide
Published: October 2010

Eccrine spiradenoma (ES) usually occurs as a solitary small nodule. It presents rarely as multifocal or multiple localized tumors arranged in a linear, zosteriform or nevoid distribution. We present a rare case of a 55‐year‐old woman who had a 48‐year history of multiple vascular eccrine spiradenomas (VES) localized on the left side of the submandibular region and neck. All five tumors were skin‐colored or pinkish‐purple, and ranged in size 1.5–2.5 cm. Histologically, each tumor was composed of two characteristic cell types and many dilated vascular spaces were noted in the stroma. Contrast‐enhanced computed tomography showed irregularly shaped, enhanced areas at the center of the tumors. A published work search revealed 35 cases of multiple ES, but multiple VES was extremely rare. We summarized the features of previously reported multiple ES and discuss the clinical and histological classification of ES.
Two cases of palmoplantar lichen planus with various clinical features
Authors: KIM Min Ji , CHOI Mira , NA Se Young , LEE Jong Hee , CHO Soyun
Published: October 2010

Two cases of palmoplantar lichen planus with various clinical features. Palmoplantar lichen planus is a rare, localized variant of lichen planus. Although several clinical features of palmoplantar lichen planus may be seen, the erythematous scaly form is most common. We present two cases of palmoplantar lichen planus that show vesicle‐like and petechia‐like features, which are uncommon variants of palmoplantar lichen planus.
Use and perceived effectiveness of non‐analgesic medical therapies for chronic pancreatitis in the United States
Authors: Burton F. , Alkaade S. , Collins D. , Muddana V. , Slivka A. , Brand R. E. , Gelrud A. , Banks P. A. , Sherman S. , Anderson M. A. , Romagnuolo J. , Lawrence C. , Baillie J. , Gardner T. B. , Lewis M. D. , Amann S. T. , Lieb J. G. , O’Connell M. , Kennard E. D. , Yadav D. , Whitcomb D. C. , Forsmark C. E. ,   for the North American Pancreatic Study Group
Published: October 2010

Aliment Pharmacol Ther 2011; 33: 149–159

Background  Effectiveness of medical therapies in chronic pancreatitis has been described in small studies of selected patients.

Aim  To describe frequency and perceived effectiveness of non‐analgesic medical therapies in chronic pancreatitis patients evaluated at US referral centres.

Methods  Using data on 516 chronic pancreatitis patients enrolled prospectively in the NAPS2 Study, we evaluated how often medical therapies [pancreatic enzyme replacement therapy (PERT), vitamins/antioxidants (AO), octreotide, coeliac plexus block (CPB)] were utilized and considered useful by physicians.

Results  Oral PERT was commonly used (70%), more frequently in the presence of exocrine insufficiency (EI) (88% vs. 61%, P < 0.001) and pain (74% vs. 59%, P < 0.002). On multivariable analyses, predictors of PERT usage were EI (OR 5.14, 95% CI 2.87–9.18), constant (OR 3.42, 95% CI 1.93–6.04) or intermittent pain (OR 1.98, 95% CI 1.14–3.45). Efficacy of PERT was predicted only by EI (OR 2.16, 95% CI 1.36–3.42). AO were tried less often (14%) and were more effective in idiopathic and obstructive vs. alcoholic chronic pancreatitis (25% vs. 4%, P = 0.03). Other therapies were infrequently used (CPB – 5%, octreotide – 7%) with efficacy generally <50%.

Conclusions  Pancreatic enzyme replacement therapy is commonly utilized, but is considered useful in only subsets of chronic pancreatitis patients. Other medical therapies are used infrequently and have limited efficacy.
Integrated analysis of preclinical data to support the design of the first in man study of LY2181308, a second generation antisense oligonucleotide
Authors: Callies Sophie , André Valérie , Patel Bharvin , Waters David , Francis Paul , Burgess Michael , Lahn Michael
Published: October 2010

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• The plasma pharmacokinetics (PK) of second generation antisense oligonucleotides (ASOs) are fairly well understood with well conserved pharmacokinetic properties across species, moderate clearance and extensive volume of distribution.

WHAT THIS STUDY ADDS

• The tissue distribution and exposure and the pharmacodynamic (PD) or target inhibition following ASO administration are not yet well understood leading to still fairly empiric early clinical development strategies. This paper illustrates how preclinical PK and PD data were used to predict more accurately the ASO tissue exposure in humans and to support the early clinical development strategy.

AIMS To predict the concentration and target inhibition profiles of the survivin inhibitor antisense oligonucleotide LY2181308 in humans.

METHODS An indirect pharmacokinetic/pharmacodynamic (PK/PD) model was built to predict the inhibition of survivin mRNA and protein in humans following LY2181308 dosing. Plasma and tissue PK data from cynomolgus monkeys were analyzed by non‐linear mixed effect modelling techniques. Human PK parameters were predicted using allometric scaling. Assumptions about the pharmacodynamic parameters were made based upon the target and tumour growth inhibition data from mouse xenograft models. This enabled the prediction of the clinical PK/PD profiles.

RESULTS Following a 750 mg dose, LY2181308 tumour concentrations ranging from 18.8 to 54 µg g−1 were predicted to lead to 50 to 90% target inhibition. In humans, LY2181308 tumour concentrations from 13.9 to 52.8 µg g−1 (n = 4, LY2181308 750 mg) were observed associated with a median survivin mRNA and protein inhibition of 20% ± 34 (SD) (n = 9) and 23% ± 63 (SD) (n = 10), respectively. The human PK parameters were adequately estimated: central Vd, 4.09 l (90% CI, 3.6, 4.95), distribution clearances, 2.54 (2.36, 2.71), 0.0608 (0.033, 0.6) and 1.67 (1.07, 2.00) l h−1, peripheral Vds, 25 900 (19 070, 37 200), 0.936 (0.745, 2.07) and 2.51 (1.01, 2.922) l, mean elimination clearance 23.1 l h−1 (5.6, 33.4) and mean terminal half‐life, 32.7 days (range 22–52 days).

CONCLUSION The model reasonably predicted LY2181308 PK in humans. Overall, the integration of preclinical PK/PD data enabled to appropriately predict dose and dosing regimen of LY2181308 in humans with pharmacologically relevant survivin inhibition achieved at 750 mg.
Population pharmacokinetic model and Bayesian estimator for two tacrolimus formulations – twice daily Prograf® and once daily Advagraf®
Authors: Woillard Jean‐Baptiste , de Winter Brenda C. M. , Kamar Nassim , Marquet Pierre , Rostaing Lionel , Rousseau Annick
Published: October 2010

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Tacrolimus is an immunosuppressant agent, largely used in kidney transplantation, with a narrow therapeutic range.

• Therapeutic drug monitoring of tacrolimus exposure improves the efficacy and toxicity of this drug.

• Separated Bayesian estimators have been developed to estimate tacrolimus exposure following administration of Prograf® and the prolonged release formulation Advagraf®.

WHAT THIS STUDY ADDS

• A population model was developed to compare the pharmacokinetics of 32 patients treated with Prograf® and 41 treated with Advagraf®.

• A mixture model and a model using formulation as covariates were developed to describe the bimodal distribution in the absorption rate following Advagraf® administration. Comparison of these two models showed that the nonmixture model was adequate.

• A single Bayesian estimator was developed to estimate the exposure for both formulations, which is more suitable for clinical practice.

AIM To investigate the differences in the pharmacokinetics of Prograf® and the prolonged release formulation Advagraf® and to develop a Bayesian estimator to estimate tacrolimus inter‐dose area under the curve (AUC) in renal transplant patients receiving either Prograf® or Advagraf®.

METHODS Tacrolimus concentration–time profiles were collected, in adult renal transplant recipients, at weeks 1 and 2, and at months 1, 3 and 6 post‐transplantation from 32 Prograf® treated patients, and one profile was collected from 41 Advagraf® patients more than 12 months post‐transplantation. Population pharmacokinetic (popPK) parameters were estimated using nonmem®. In a second step, the popPK model was used to develop a single Bayesian estimator for the two tacrolimus formulations.

RESULTS A two‐compartment model with Erlang absorption (n= 3) and first‐order elimination best described the data. In Advagraf® patients, a bimodal distribution was observed for the absorption rate constant (Ktr): one group with a Ktr similar to that of Prograf® treated patients and the other group with a slower absorption. A mixture model for Ktr was tested to describe this bimodal distribution. However, the data were best described by the nonmixture model including covariates (cytochrome P450 3A5, haematocrit and drug formulation). Using this model and tacrolimus concentrations measured at 0, 1 and 3 h post‐dose, the Bayesian estimator could estimate tacrolimus AUC accurately (bias = 0.1%) and with good precision (8.6%).

CONCLUSIONS The single Bayesian estimator developed yields good predictive performance for estimation of individual tacrolimus inter‐dose AUC in Prograf® and Advagraf® treated patients and is suitable for clinical practice.
Equilibrative nucleoside transporter 1 genotype, cytidine deaminase activity and age predict gemcitabine plasma clearance in patients with solid tumours
Authors: Gusella Milena , Pasini Felice , Bolzonella Caterina , Meneghetti Silvia , Barile Carmen , Bononi Antonio , Toso Silvia , Menon Daniela , Crepaldi Giorgio , Modena Yasmina , Stievano Laura , Padrini Roberto
Published: October 2010

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Gemcitacine is taken up by the cell through various nucleoside transporters of either the concentrative (CNT) or equilibrative type (ENT) and is then transformed into the inactive metabolite, dFdU, by cytidine deaminase (CDA) and into the active metabolite, dFdCMP, by deoxycytidine kinase (dCK).

• While the major contribution of CDA to gemcitabine elimination is well recognized no data about the role of CNT and ENT activities have yet been reported. Both nucleoside transporters exhibit genetic polymorphisms characterized by different expression levels or nucleoside affinity.

WHAT THIS STUDY ADDS

• The plasma clearance (CL) of gemcitabine has been determined following the standard 30 min infusion of 1000–1250 mg m−2. The in vivo CDA activity was measured as end of infusion metabolic ratio (MR = dFdU : gembitabine) and the variant hCNT‐1 and hENT‐1 alleles were genotyped.

• Our results confirmed that gemcitabine CL is directly correlated with CDA activity and inversely correlated with age and, for the first time, show that patients heterozygous for the –706 G > C hENT‐1 mutation have a lower CL as compared with wild type patients.

AIM Gemcitabine (GEM) enters normal and tumour cells via concentrative (CNT) and equilibrative nucleoside transporters (ENT) and is subsequently deaminated to the inactive difluorodeoxyurine (dFdU) by cytidine deaminase (CDA). The aim of our study was to ascertain whether the nucleoside transporter genotype and the CDA activity phenotype can predict total GEM plasma clearance.

METHODS Forty‐seven patients received GEM 1000–1250 mg m−2 i.v. over 30 min. Plasma concentrations of GEM and dFdU were measured and individual pharmacokinetic profiles were determined. CDA activity was measured ex vivo in plasma samples. The two most common hENT1 and hCNT1 polymorphisms were determined from genomic DNA.

RESULTS Multivariate analysis revealed that GEM plasma clearance (CL) was positively correlated with the end of infusion dFdU : GEM ratio (P < 0.0001), which is a marker of in vivo CDA activity. The ENT1 genotype characterized by high transport capacity (G/G) and age were inversely correlated with CL (P= 0.027 and 0.048, respectively). A strong correlation was found between end of infusion GEM concentration and area under the concentration–time curve from time 0 to infinity (AUC(0,∞)) (r2= 0.77).

CONCLUSIONS Our results confirm the role of CDA and age on the interindividual variability of GEM CL and show the contribution of the hENT1 genotype for the first time.
Normal red blood cells partially decrease diepoxybutane‐induced chromosome breakage in cultured lymphocytes from Fanconi anaemia patients
Authors: Porto B. , Sousa R. , Malheiro I. , Gaspar J. , Rueff J. , Gonçalves C. , Barbot J.
Published: October 2010

Objectives:  Fanconi anaemia (FA) is a cancer‐prone chromosome instability syndrome characterized by hypersensitivity to DNA cross‐linking agents, such as diepoxybutane (DEB). Previous studies have shown that normal red blood cells (RBC) can protect cultured lymphocytes against chromosomal breaks induced by DEB. The present study was designed to analyse influence of RBCs from normal individuals on frequency of DEB‐induced chromosome breaks in lymphocyte cultures from FA patients.

Materials and methods:  A comparative study was performed between DEB‐induced chromosome breaks in cultures of FA lymphocytes with either autologous or heterologous RBCs. A further comparative study was carried out between whole blood cultures from FA patients performed on two occasions, before and 1 week after transfusion of RBCs.

Results:  It was observed that normal RBCs compared to FA RBCs, partially reduced chromosome breaks in cultured FA lymphocytes. A significant reduction in DEB‐induced breaks was also observed in FA cultured lymphocytes obtained 1 week after transfusion of RBCs, in comparison to those observed in the same patients before RBC transfusion.

Conclusions:  This study shows that DEB‐induced chromosome instability in FA lymphocytes is partially reduced by normal RBCs. This effect may have some clinical relevance in vivo, whenever FA patients receive a RBC transfusion.
Chromatin‐bound PCNA as S‐phase marker in mononuclear blood cells of patients with acute lymphoblastic leukaemia or multiple myeloma
Authors: Zölzer F. , Basu O. , Devi P. U. , Mohanty S. P. , Streffer C.
Published: October 2010

Objectives:  Proliferating cell nuclear antigen (PCNA) has often been used as a marker to aid assessment of tumour growth fraction. This paper addresses the question of whether it can be used as an S‐phase marker, when the non‐chromatin‐bound form of the protein is removed by pepsin treatment.

Materials and methods:  Cytofluorometric measurements were carried out after immunofluorescence staining of PCNA and counterstaining of DNA. S‐phase fraction was determined with the help of windows on PCNA versus DNA scattergrams, or mathematically from DNA histograms.

Results:  S‐phase fractions obtained using the two methods correlated well, but did not always agree, exact discrepancies depending on the mathematical model used for histogram analysis.

Conclusions:  Determination of S‐phase fractions with the help of PCNA immunofluorescence staining is possible, and probably more reliable than calculation of S‐fractions from DNA histograms. It thus offers an alternative to assays involving BrdU labelling in vivo.
Experimental analysis and modelling ofin vitroHUVECs proliferation in the presence of various types of drugs
Authors: Mancuso L. , Scanu M. , Pisu M. , Concas A. , Cao G.
Published: October 2010

Objectives: This study focuses on experimental analysis and corresponding mathematical simulation ofin vitroHUVECs (human umbilical vein endothelial cells) proliferation in the presence of various types of drugs.

Materials and methods: HUVECs, once seeded in Petri dishes, were expanded to confluence. Temporal profiles of total count obtained by classic haemocytometry and cell size distribution measured using an electronic Coulter counter, are quantitatively simulated by a suitable model based on the population balance approach. Influence of drugs on cell proliferation is also properly simulated by accounting for suitable kinetic equations.

Results and discussion: The models’ parameters have been determined by comparison with experimental data related to cell population expansion and cell size distribution in the absence of drugs. Inhibition constant for each type of drug has been estimated by comparing the experimental data with model results concerning temporal profiles of total cell count. The reliability of the model and its predictive capability have been tested by simulating cell size distribution for experiments performed in the presence of drugs. The proposed model will be useful in interpreting effects of selected drugs on expansion of readily available human cells.
Ectosomes as modulators of inflammation and immunity
Authors: Sadallah S , Eken C , Schifferli J A
Published: October 2010

Vesicles released by cells have been described using various names, including exosomes, microparticles, microvesicles and ectosomes. Here we propose to differentiate clearly between ectosomes and exosomes according to their formation and release. Whereas exosomes are formed in multi-vesicular bodies, ectosomes are vesicles budding directly from the cell surface. Depending upon the proteins expressed, exosomes activate or inhibit the immune system. One of the major properties of exosomes released by antigen-presenting cells is to induce antigen-specific T cell activation. Thus, they have been used for tumour immunotherapy. By contrast, the major characteristics of ectosomes released by various cells, including tumour cells, polymorphonuclear leucocytes and erythrocytes, are the expression of phosphatidylserine and to have anti-inflammatory/immunosuppressive activities similarly to apoptotic cells.
Intercellular adhesion molecule-1 on synovial cells attenuated interleukin-6-induced inhibition of osteoclastogenesis induced by receptor activator for nuclear factor κB ligand
Authors: Suzuki M , Hashizume M , Yoshida H , Shiina M , Mihara M
Published: October 2010

In a co-culture of osteoclast precursor cells and synovial cells, interleukin-6 (IL-6) induces osteoclast formation. In contrast, in a monoculture of osteoclast precursor cells, IL-6 directly suppresses receptor activator for nuclear factor κB ligand (RANKL)-induced differentiation of osteoclast precursor cells into osteoclasts. In the present study, we explored why the effect of IL-6 differed between the monoculture and the co-culture systems. In the monoculture, mouse osteoclast precursor cell line, RAW 264·7 (RAW) cells were cultured with soluble RANKL (sRANKL) for 24 h or 3 days. sRANKL increased both expression of osteoclastogenesis marker, tartrate-resistant acid phosphatase isoform 5b (TRAP5b) and nuclear factor of activated T cells cytoplasmic 1 (NFATc1), whereas the co-addition of IL-6 decreased them both in a dose-dependent manner. In the co-culture, RAW cells and human synovial cell line, SW982 cells were cultured with IL-6 + soluble IL-6 receptor (sIL-6R) for 3 days. TRAP5b and NFATc1 expression reduced by IL-6 was increased by the addition of SW982 cells in a manner dependent upon the number of added cells. IL-6 + sIL-6R treatment significantly induced RANKL production in SW982 cells, and anti-RANKL antibody inhibited IL-6 + sIL-6R-induced osteoclastogenesis. SW982 cells expressed high levels of ICAM-1 originally, and ICAM-1 expression was increased significantly by IL-6 + sIL-6R. Anti-ICAM-1 antibody suppressed IL-6-induced osteoclastogenesis. Finally, in the monoculture system, addition of sICAM-1 dose-dependently restored the expression of TRAP5b reduced by IL-6. Similar results were obtained when the formation of TRAP-positive multi-nuclear cells were examined using mouse bone marrow cells. In conclusion, IL-6 gave different results in the co-culture and monoculture systems because in the co-culture, ICAM-1 from the synovial cells restored osteoclastogenesis suppressed by IL-6.
Reduced levels of both circulating CD4+CD25+CD127low/neg and CD4+CD8neg invariant natural killer regulatory T cells in stable heart transplant recipients
Authors: Chen M , Mohtize M , Matteï M-F , Villemot J-P , Kohler C , Faure G C , Béné M C , De Carvalho Bittencourt M
Published: October 2010

A cross-regulation between two regulatory T cell (Treg) subsets [CD4+CD25+ and invariant natural killer (NK) T – iNK T] has been described to be important for allograft tolerance induction. However, few studies have evaluated these cellular subsets in stable recipients as correlates of favourable clinical outcome after heart transplantation. Treg and iNK T cell levels were assayed by flow cytometry in peripheral blood samples from 44 heart transplant recipients at a 2-year interval in 38 patients, and related to clinical outcome. Multi-parameter flow cytometry used CD4/CD25/CD127 labelling to best identify Treg, and a standard CD3/CD4/CD8/Vα24/Vβ11 labelling strategy to appreciate the proportions of iNK T cells. Both subtypes of potentially tolerogenic cells were found to be decreased in stable heart transplant recipients, with similar or further decreased levels after 2 years. Interestingly, the patient who presented with several rejection-suggesting incidents over this period displayed a greater than twofold increase of both cell subsets. These results suggest that CD4+CD25+CD127low/neg Treg and iNK T cells could be involved in the local control of organ rejection, by modulating immune responses in situ, in clinically stable patients. The measurement of these cell subsets in peripheral blood could be useful for non-invasive monitoring of heart transplant recipients, especially in the growing context of tolerance-induction trials.
Utilizing spiral computerized tomography during the removal of a fractured endodontic instrument lying beyond the apical foramen
Authors: Wang H. , Ni L. , Yu C. , Shi L. , Qin R.
Published: October 2010

Wang H, Ni L, Yu C, Shi L, Qin R. Utilizing spiral computerized tomography during the removal of a fractured endodontic instrument lying beyond the apical foramen. International Endodontic Journal, 43, 1143–1151, 2010.

Aim  To present a case that used spiral computerized tomography (CT) to locate and successfully remove a fractured endodontic instrument lying beyond the apical foramen using a surgical approach.

Summary  The fracture of an endodontic instrument beyond the apical foramen is rare. In this case report, after an attempt to remove a fractured instrument failed, a multi‐slice spiral computerized tomography (MSCT) was used for diagnosis and treatment planning. The fractured segment was precisely located and found in the soft tissue and successfully removed by surgery. For the successful removal of a fractured endodontic instrument beyond the apical foramen, the following are necessary: (i) knowledge of the cause of fracture and how to plan treatment; (ii) determining the precise location of the fractured segment using CT; and 3) skilful operation.

Key learning points 

Fractured endodontic instruments might lie within the soft tissue.

Computerized tomography is an effective diagnostic aid for localizing the precise position of fractured instruments.
An evaluation of a mental health screening and referral pathway for community nursing care: nurses’ and general practitioners’ perspectives
Authors: Annells Merilyn , Allen Jacqui , Nunn Russell , Lang Lyn , Petrie Eileen , Clark Eileen , Robins Alan
Published: October 2010

Aims and objectives.  To evaluate a feasible, best practice mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia.

Background.  War veterans commonly experience mental health difficulties and do not always receive required treatment, as can also occur for war widow(er)s. Whenever opportunity arises, such as during community nursing care, it is vital to identify mental health problems in a health promotion framework.

Design.  A clinical pathway was developed by literature review and consultation and then trialled and evaluated using mixed methods – quantitative and qualitative.

Methods.  Community nurses who trialled the pathway completed an evaluation survey and attended focus groups. General practitioners responded to an evaluation survey.

Results.  Most nurses found the pathway clear and easy to understand but not always easy to use. They emphasised the need to establish trust and rapport with clients prior to implementing the pathway. It was sometimes difficult to ensure effective referral to general practitioners for clients who screened positive for a mental health problem. When referral was accomplished, general practitioners reported adequate and useful information was provided. Some general practitioners also commented on the difficulty of achieving effective communication between general practitioners and nurses.

Conclusions.  Nurses and some general practitioners found the pathway useful for their practice. They offered several suggestions for improvement by simplifying the trialled pathway and accompanying guidelines and strategies to improve communication between nurses and general practitioners. This study adds understanding of how community nurses might productively screen for mental health difficulties.

Relevance to clinical practice.  The trialled pathway, which was modified and refined following the study, is an evidence‐based resource for community nurses in Australia and similar contexts to guide practise and maximise holistic care for war veterans and war widow(er)s and possibly other client groups.
Validity and reliability of the ‘good perioperative nursing care scale’ for Turkish patients and nurses
Authors: Donmez Yelda Candan , Ozbayır Turkan
Published: October 2010

Aim.  To test the validity and reliability of the Turkish version of Good Perioperative Nursing Care Scale for nurses and patients.

Background.  The nursing care in operating departments has an important role in modern health care and therefore more research concerning perioperative care quality is needed and the development of a measurement tool is necessary.

Design.  The study was designed as a cross‐sectional survey.

Method.  The research population was 346 patients who had surgery and 159 operating room nurses who worked at 11 hospitals. The GPNCS contains 32 items. The items on the nurses’ form were changed as little as possible to create the form for patients to be able to directly compare them. To determine the tool’s language equivalency/adaptation of the questionnaire for both nurses and patients, the tool was translated into Turkish then retranslated, and a pilot study was conducted.

Results.  The total scale’s total mean score and standard deviation for nurses was determined to be 113·23 (SD 2·13) and for patients was 128·23 (SD 1·27). To test the scale’s stability over time, a test‐retest was conducted and the results showed a strong confirmatory correlation.

Conclusions.  The GPNCS was determined to be a tool that had indicators of being adequate, reliable and valid for the Turkish population.

Relevance to clinical practice.  This study highlighted the importance of comparing the quality and effectiveness of nursing care in different operating departments. It is recommended that it be used to determine the quality of perioperative nursing care in Turkey.
What accounts for hospital readmission?
Authors: Wong Frances KY , Chan Moon Fai , Chow Susan , Chang Katherine , Chung Loretta , Lee Wai‐man , Lee Rance
Published: October 2010

Aims. This study was launched to address the knowledge gap regarding factors leading to readmission to hospital.

Background. Repeated hospital admission is an issue of concern for health care service providers. Research findings reveal that multiple factors can contribute to the phenomenon, but no study has examined the direct and indirect effects of these variables on hospital readmission.

Design. A survey conducted during the period from 2003–2005 in three hospitals in Hong Kong.

Methods. Patients who were readmitted to the same hospital within 28 days during the study periods were included. Data were collected using structured interviews. A structural equation model was employed to examine what factors will contribute to hospital readmission.

Results. The final model showed that subjective health outcome was the only significant variable that had a direct effect on readmission, and it had indirect effects on readmission mediating through the variables of age, income and satisfaction with care.

Conclusions. A literature review reveals that none of the studies has recognised patients’ subjective appraisal of their health condition as a significant variable to predict hospital readmission. Results did not find an association between evaluated and perceived need. In other words, patients who felt a higher need for hospital care were not necessarily sicker. It is possible that if patients can be empowered to manage their own health condition and make a fair appraisal of their well‐being, unnecessary use of hospital services can be reduced.

Relevance to clinical practice. This study provides evidence to support the notion that an effective transitional care programme needs to incorporate patients’ own subjective assessment of health in the intervention and measurement of the outcome. We cannot solely use providers’ judgment to measure health outcomes, for patients are active agents in seeking health care, and the use of services is to an extent self‐selective.
Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient?
Authors: Massey Debbie , Aitken Leanne M , Chaboyer Wendy
Published: October 2010

Aims. To conduct a literature review that explores the impact of rapid response systems on reducing major adverse events experienced by deteriorating ward patients.

Background. Patients located on hospitals wards are frequently older, have multiple co‐morbidities and are often at risk of life‐threatening clinical deterioration. Rapid response systems have been developed and implemented to provide appropriate and timely intervention to these patients.

Design. A comprehensive review of the literature.

Methods. This review used the rapid response systems framework recently developed by experts in the area. Medline, CINAHL, Embase and Cochrane databases were searched from January 1995–June 2009. Sixteen papers were selected that most clearly reflected the research aim. Each paper was critically appraised and systematically assessed. Major themes and findings were identified for each of the studies.

Results. The effectiveness of rapid response systems in reducing major adverse events in deteriorating ward patients remains inconclusive. Six studies demonstrated that the introduction of a rapid response systems positively impacted on patient outcomes, but three studies demonstrated no positive impact on patient outcomes. Nursing staff appear reluctant to use rapid response systems; the rationale for this is unclear. However, the continued underuse and inactivation may be one reason why research findings evaluating rapid response systems have been inconclusive.

Conclusions. The paper illustrates two important gaps in the literature. First, ‘ramp‐up’ systems have not been subjected to formal evaluation. Second, rapid response systems are under‐activated and underused by nursing staff. There is an urgent need to explore the reasons for this and to identify interventions to improve the activation of these systems in an effort to promote safe and effective care to the deteriorating ward patient.

Relevance to clinical practice. Rapid response systems are multidimensional models. They are relatively new innovations that have important implications for clinical research and implementation policy. This review contributes to the emerging debate on rapid response systems.
Don’t ask don’t tell: substance abuse and addiction among nurses
Authors: Monroe Todd , Kenaga Heidi
Published: October 2010

Aim.  The purpose of this manuscript is to illustrate the challenges faced by nurses who abuse substances and to promote international dialogue about what practitioners, administrators, health care providers and students can do when they suspect someone in the profession is abusing substances, or they may themselves be suffering from addiction.

Background.  Addiction among nurses has been recognised by professionals in the field for over 100 years, and current estimates place rates of substance misuse, abuse and addiction rates as high as 20% among practicing nurses. Unfortunately, fear of punishment and discipline may keep nurses or students from asking for help for themselves or from reporting a colleague or friend who is in need of help.

Design.  Discursive paper.

Method.  This paper synthesises the results of three previous papers conducted on substance abuse policies in the nursing profession. In the first paper, the authors reviewed the history of addiction in nursing and compared disciplinary and alternative‐to‐discipline policies. The second focused on the development of an alternative‐to‐dismissal policy for substance abuse in a school of nursing and using telephone and email interviews, and the final paper reported findings of what types of polices seem to be working to retain and rehabilitate nurses who suffer from addiction in the USA. Lastly, this paper introduces international policy for nurses with addictions.

Conclusions.  Poor or ineffective policies that mandate punitive action endanger the public by making it difficult for impaired students or professionals to ask for help. Providing early intervention and assistance is essential in helping colleagues and students recover from an addictive disorder and providing a non‐punitive atmosphere of support may well be a life‐saving first step for nurses and those in their care. Many territories and countries throughout the world now offer confidential, non‐punitive, assistance for nurses suffering from addictions.

Relevance to clinical practice.  Recognition of a colleague’s need of treatment is the important first step in the rehabilitation process. Early intervention and assistance are essential for helping colleagues and students to recover from an addictive disorder and providing a confidential, non‐punitive atmosphere of support may well be a life‐saving first step for nurses and those in their care.
Stress tolerance and biotic interactions determine plant zonation patterns in estuarine marshes during seedling emergence and early establishment
Authors: Engels J. Gesina , Rink Florian , Jensen Kai
Published: October 2010

1. Transplant experiments with adult plants showed that marsh plant zonation along estuarine salinity gradients develops according to species tolerances of abiotic factors and biotic interactions. Thus, glycophytes are restricted from salt marshes by abiotic stress, whereas halophytes are excluded from freshwater marshes by competition. We hypothesized that adult plant zonations along estuarine stress gradients are predefined by processes affecting plants during their seedling phase. In an experimental glasshouse study, we tested how a mixed community of glycophytes and halophytes developed during the first months of early establishment affected by different flooding and salinity regimes.

2. We set up two factorial mesocosm experiments that tested the effects of three tidal regimes (daily tide, spring tide, no tide) and three salinity levels (fresh, brackish, salt) on the emergence and early establishment of glycophyte and halophyte seedlings. In the Emergence Experiment seedlings were identified and removed once per week. In the Establishment Experiment species cover was estimated every 2 weeks, and after 15 weeks final above‐ground biomass of each species was determined.

3. Both glycophytes and halophytes showed highest seedling emergence under freshwater conditions. Emergence of halophytes was less impaired by increased salinities than that of glycophytes. Emergence and establishment of glycophytes were extremely reduced under brackish and salt conditions, whereas under freshwater conditions, glycophytes showed a consistent increase in cover over time. Cover of halophytes showed a similar increase in brackish and salt treatments; however, in freshwater treatments it significantly decreased after week 9. While daily tides predominantly decreased seedling emergence and establishment, spring tides had no significant effects on seedlings in freshwater and negative effects in saltwater treatments.

4. Synthesis. The ability of a species to germinate and emerge under conditions representing a particular position along an environmental gradient is necessary but not solely responsible for determining plant zonation patterns along estuarine marsh gradients. Our results show that competitive exclusion of halophytes by glycophytes as an important driver of marsh plant zonations along estuarine salinity gradients takes effect already during the early seedling establishment phase of the co‐occurring plants.
Leftovers in seed dispersal: ecological implications of partial seed consumption for oak regeneration
Authors: Perea Ramón , San Miguel Alfonso , Gil Luis
Published: October 2010

1.Successful seed dispersal by animals is assumed to occur when undamaged seeds arrive at a favourable microsite. Most seed removal and dispersal studies consider only two possible seed fates, predation or escape intact. Whether partial consumption of seeds has ecological implications for natural regeneration is unclear. We studied partial consumption of seeds in a rodent‐dispersed oak species.

2.Fifteen percent of dispersed acorns were found partially eaten in a field experiment. Most damage affected only the basal portion of the seeds, resulting in no embryo damage. Partially eaten acorns had no differences in dispersal distance compared to intact acorns but were recovered at farther distances than completely consumed acorns.

3.Partially eaten acorns were found under shrub cover unlike intact acorns that were mostly dispersed to open microhabitats.

4.Partially eaten acorns were not found buried proportionally more often than intact acorns, leading to desiccation and exposure to biotic agents (predators, bacteria and fungi). However, partial consumption caused more rapid germination, which enables the acorns to tolerate the negative effects of exposure.

5.Re‐caching and shrub cover as microhabitat of destination promote partial seed consumption. Larger acorns escaped predation more often and had higher uneaten cotyledon mass. Satiation at seed level is the most plausible explanation for partial consumption.

6.Partial consumption caused no differences in root biomass when acorns experienced only small cotyledon loss. However, root biomass was lower when acorns experienced heavy loss of tissue but, surprisingly, they produced longer roots, which allow the seeds to gain access sooner to deeper resources.

7.Synthesis.Partial consumption of acorns is an important event in the oak regeneration process, both quantitatively and qualitatively. Most acorns were damaged non‐lethally, without decreasing both dispersal distances and the probability of successful establishment. Faster germination and production of longer roots allow partially eaten seeds to tolerate better the exposure disadvantages caused by the removal of the pericarp and the non‐buried deposition. Consequently, partially consumed seeds can contribute significantly to natural regeneration and must be considered in future seed dispersal studies.
Dominant frequency of loud mew calls of felids (Mammalia: Carnivora) decreases during ontogenetic growth
Authors: PETERS Gustav
Published: October 2010

A negative correlation between body weight and frequency characteristics of a species' vocalizations exists in mammals, due to the acoustics of vocal sound production (‘source‐filter theory’; source = larynx; filter = supralaryngeal vocal tract) and the strong positive correlation between body weight and vocal tract length.

A negative correlation is hypothesized to exist between increasing body weight and frequency characteristics of calls during ontogeny as well.

This hypothesis is tested for mean dominant frequency (maximum spectral energy peak) of intense mew calls in juveniles of five species of the Felidae: lion Panthera leo, jaguar Panthera onca, leopard Panthera pardus, tiger Panthera tigris and puma Puma concolor.

In the five felid species in which the hyoid is incompletely ossified (genera Panthera and Uncia), the larynx undergoes a considerable ontogenetic descent, resulting in a proportionally longer vocal tract in adult individuals than in all other species of the family, which have a fully ossified hyoid without a descent.

In all five species studied here, mean dominant frequency decreases as body weight increases during growth. In the four Panthera species (with laryngeal descent) dominant frequency is determined by the vocal tract (the filter), and dominant frequency is largely similar at similar weights, indicating a similar correlation between the ontogenetic increase in body weight (and vocal tract length) and the decrease in mean dominant frequency. In the puma (without laryngeal descent) dominant frequency is determined by the larynx (the source), it is considerably higher than in the Panthera species, and the course of its ontogenetic decrease differs considerably from that in Panthera.

The data do not support a uniform scaling relationship between body weight and mean dominant frequency of intense mew calls in the Felidae during ontogenetic growth.
Landscape genetics of the key African acacia species Senegalia mellifera (Vahl)– the importance of the Kenyan Rift Valley
Authors: RUIZ GUAJARDO J. C. , SCHNABEL A. , ENNOS R. , PREUSS S. , OTERO‐ARNAIZ A. , STONE G.
Published: October 2010

Acacias across Africa have enormous ecological and economic importance, yet their population genetics are poorly studied. We used seven microsatellite loci to investigate spatial genetic structure and to identify potential ecological and geographic barriers to dispersal in the widespread acacia, Senegalia (Acacia) mellifera. We quantified variation among 791 individuals from 28 sampling locations, examining patterns at two spatial scales: (i) across Kenya including the Rift Valley, and (ii) for a local subset of 11 neighbouring locations on Mpala Ranch in the Laikipia plateau. Our analyses recognize that siblings can often be included in samples used to measure population genetic structure, violating fundamental assumptions made by these analyses. To address this potential problem, we maximized genetic independence of samples by creating a sibship‐controlled data set that included only one member of each sibship and compared the results obtained with the full data set. Patterns of genetic structure and barriers to gene flow were essentially similar when the two data sets were analysed. Five well‐defined geographic regions were identified across Kenya within which gene flow was localized, with the two strongest barriers to dispersal splitting the Laikipia Plateau of central Kenya from the Western and Eastern Rift Valley. At a smaller scale, in the absence of geographic features, regional habitat gradients appear to restrict gene flow significantly. We discuss the implications of our results for the management of this highly exploited species.