bluuebunny/crossref_metadata_2025 huggingface dataset:
Bargaining Power, Political Transaction Costs and Institutional Change: Private and Public Dental Care in Denmark1
Authors: Andersen Lotte Bøgh
Published: December 2004

Rational choice institutionalism underexposes institutional change as well as the interaction between institutions at different levels, and this article therefore investigates national and local institutional change. In the Danish dental care sector private and public provision of services have coexisted since the establishment of a publicly financed dental health care system, and the fight between supporters of the two solutions has generated many institutional changes, both nationally and locally. This article analyses all Danish parliamentary proposals and local decisions regarding dental care coverage and provision. The general finding is that increasing pro‐public bargaining power seems to promote higher coverage and public provision, while increasing pro‐private bargaining power leads to stable coverage and private provision. The institutions do not, however, change whenever bargaining power changes, and national institutional change does not necessarily result in local change. The article explains this in terms of political transaction costs. These costs might also explain why national institutions change more often than local ones, and why local pro‐public changes are faster and more frequent than local pro‐private changes.
Four Miniature Species of Aloe from Madagascar
Authors: Du Puy David
Published: December 2004

Summary.  The habitats and distribution of four Aloe species from Madagascar are described and illustrated, and their conservation status is discussed.
Low Temperature Stimulates α‐Melanophore‐Stimulating Hormone Secretion and Inhibits Background Adaptation in Xenopus laevis
Authors: Tonosaki Y. , Cruijsen P. M. J. M. , Nishiyama K. , Yaginuma H. , Roubos E. W.
Published: December 2004

It is well‐known that α‐melanophore‐stimulating hormone (α‐MSH) release from the amphibian pars intermedia (PI) depends on the light condition of the animal's background, permitting the animal to adapt the colour of its skin to background light intensity. In the present study, we carried out nine experiments on the effect of low temperature on this skin adaptation process in the toad Xenopus laevis, using the skin melanophore index (MI) bioassay and a radioimmunoassay to measure skin colour adaptation and α‐MSH secretion, respectively. We show that temperatures below 8 °C stimulate α‐MSH secretion and skin darkening, with a maximum at 5 °C, independent of the illumination state of the background. No significant stimulatory effect of low temperature on the MI and α‐MSH plasma contents was noted when the experiment was repeated with toads from which the neurointermediate lobe (NIL) had been surgically extirpated. This indicates that low temperature stimulates α‐MSH release from melanotrope cells located in the PI. An in vitro superfusion study with the NIL demonstrated that low temperature does not act directly on the PI. A possible role of the central nervous system in cold‐induced α‐MSH release from the PI was tested by studying the hypothalamic expression of c‐Fos (as an indicator for neuronal activity) and the coexistence of c‐Fos with the regulators of melanotrope cell activity, neuropeptide Y (NPY) and thyrotrophin‐releasing hormone (TRH), using double fluorescence immunocytochemistry. Upon lowering temperature from 22 °C to 5 °C, in white‐adapted animals c‐Fos expression decreased in NPY‐producing suprachiasmatic‐melanotrope‐inhibiting neurones (SMIN) in the ventrolateral area of the suprachiasmatic nucleus (SC) but increased in TRH‐containing neurones of the magnocellular nucleus. TRH is known to stimulate melanotrope α‐MSH release. We conclude that temperatures around 5 °C inactivate the SMIN in the SC and activate TRH‐neurones in the magnocellular nucleus, resulting in enhanced α‐MSH secretion from the PI, darkening the skin of white‐adapted X. laevis.
Mechanisms of N‐methyl‐d‐Aspartate Receptor Inhibition by Melatonin In the Rat Striatum
Authors: Escames G. , León J. , López L. C. , Acuña‐Castroviejo D.
Published: December 2004

N‐methyl‐d‐aspartate (NMDA) receptor activation comprises multiple regulatory sites controlling Ca2+ influx into the cell. NMDA‐induced increases in intracellular [Ca+2] lead to nitric oxide (NO) production through activation of neuronal NO synthase (nNOS). Melatonin inhibits either glutamate or NMDA‐induced excitation, but the mechanism of this inhibition is unknown. In the present study, the mechanism of melatonin action in the rat striatum was studied using extracellular single unit recording of NMDA‐dependent neuronal activity with micro‐iontophoresis. Melatonin inhibited neuronal excitation produced by either NMDA or l‐arginine. The effects of both NMDA and l‐arginine were blocked by nitro‐l‐arginine methyl ester, suggesting that nNOS participates in responses to NMDA. However, excitation of NMDA‐sensitive neurones induced by the NO donor sodium nitroprusside was only slightly modified by melatonin. Melatonin iontophoresis also counteracted excitation induced by tris(2‐carboxyethyl)phosphine hydrochloride, showing that the redox site of the NMDA receptor may be a target for melatonin action. The lack of effects of the membrane melatonin receptor ligands luzindole, 4‐phenyl‐2‐propionamidotetralin and 5‐methoxycarbonylamino‐N‐acetyltryptamine, and the nuclear melatonin ligand, CGP 52608, a thiazolidine dione, excluded the participation of known membrane and nuclear receptors for melatonin. The data suggest that inhibition of NMDA‐dependent excitation by melatonin involves both nNOS inhibition and redox site modulation.
Identification of allergens responsible for canine cutaneous adverse food reactions to lamb, beef and cow's milk
Authors: MARTÍN ÁUREA , SIERRA MARÍA‐PAZ , GONZÁLEZ JOSÉ L. , ARÉVALO MARÍA‐ÁNGELES
Published: December 2004

Abstract Lamb, beef and cow's milk are common causes of cutaneous adverse food reactions in dogs. The aim of this study was to identify the proteins responsible for cutaneous adverse reactions to these foods. Ten dogs with allergen‐specific serum immunoglobulin (Ig)E to lamb, beef and cow's milk were included in the study. These dogs had been diagnosed with cutaneous adverse food reactions by convincing clinical history and food‐elimination diet trials followed by challenge exposure. Sera were analysed by enzyme‐linked immunosorbent assay with bovine proteins and SDS–PAGE immunoblots with lamb, beef and cow's milk extracts. All the dogs had specific IgE against bovine IgG, and it was the only protein in the cow's milk extract that bound IgE from the sera studied. In the lamb and beef extracts, the major allergens recognized by the specific IgE of most sera had molecular masses between 51 and 58 kDa, which were identified as phosphoglucomutase and the IgG heavy chain. Other IgE‐binding proteins with molecular masses of 27, 31, 33, 37 and 42 kDa were also detected with some sera. Our results indicate that bovine IgG is a major allergen in cow's milk and hence it appears to be a source of cross‐reactivity with beef and probably with lamb because of the high homology with ovine immunoglobulins. These results are similar to those found for meat allergy in humans. However, this is the first time that phosphoglucomutase has been identified as an important allergen involved in allergic reactions to lamb and beef.
Pectin in pig nutrition, a comparative review
Authors: Drochner W. , Kerler A. , Zacharias B.
Published: December 2004

A comprehensive review is given on pectin effects in pigs. Its effects on feed passage and digestion in the small intestine, the composition of ileal digesta and fermentation in the colon are described. Pectins promote fermentation at the terminal ileum and in the first part of the colon. It is shown, that pectin opposite to cellulose is degraded to high extents in the colon. Dietetic effects in relation to composition of ileocaecal digesta, endogenous secretions, buffering and pH‐stability, high fermentability of organic matter in the colon and resulting volatile fatty acids (VFA) in the cranial part of the colon and even its possible interactions to colonization of the gut by infectious bacteria are described. Pectin effects concerning volume of the intestinal tract, distribution of VFA and lactic acid, role of endogenous secretions are described. The negative effect of pectins on praecaecal digestibility, their high degradation rates in the large intestine and consequences for their dietetic effects are discussed.
An Experimental Infection (II) to Investigate the Importance of Indirect Classical Swine Fever Virus Transmission by Excretions and Secretions of Infected Weaner Pigs
Authors: Ribbens S. , Dewulf J. , Koenen F. , Laevens H. , Mintiens K. , de Kruif A.
Published: December 2004

An experiment was set up to investigate the role of excretions and secretions in the indirect transmission of classical swine fever virus (CSFV). In five small pens, 10 weaner pigs (two pigs per pen) were housed and inoculated with CSFV. Experimental infection was successful in all pigs. The infected pigs were kept in the pens for a period of 15 days after which the pens were depopulated and pigs were killed. At the moment of depopulation, all inoculated pigs were visibly clinically diseased and had high fever. Ten hours later the same pens were repopulated with five pairs of susceptible pigs. From inoculation onwards and especially between depopulation and restocking, the pens were neither cleaned nor disinfected. Four days post‐repopulation, three of the susceptible pigs were detected positive on virus isolation. A fourth pig was detected positive 2 days later. Later on, the remaining pigs also became infected, most probably due to contact and between pen infections. It can be concluded that transmission of the virus via excretions and secretions succeeded in four of 10 pigs. This result indicates that transmission of CSFV via excretions and secretions can be of importance in a late, clinical stage of disease.
Mycobacterium avium ssp. paratuberculosis – Combined Serological Testing and Classification of Individual Animals and Herds
Authors: Böttcher J. , Gangl A.
Published: December 2004

Several serological tests for detection of antibodies to Mycobacterium avium ssp. paratuberculosis, which is the causative agent of Johne's disease are validated, some of which are available commercially. These tests differ in sensitivity and specificity. Test results reported to farmers or veterinarians are therefore dependent upon the test in use. In the present study, three commercially available tests are used to test 2748 bovine sera from 119 Bavarian herds serologically. Serological results are compared with individual animals and on herd level. A scheme for serological testing and classification of herds as well as of individual animals based on a combination of serological test results is proposed.
Functional mechanism underlying cyclooxygenase‐2 expression in rat small intestine following administration of indomethacin: Relation to intestinal hypermotility
Authors: TANAKA AKIKO , MATSUMOTO MASAHIRO , HAYASHI YUJIRO , TAKEUCHI KOJI
Published: December 2004

Background and Aim:  We recently reported that cyclooxygenase (COX)‐2 is upregulated in the rat small intestine after administration of indomethacin, and this may be the key to non‐steroidal anti‐inflammatory drug (NSAID)‐induced intestinal damage. The present study investigated the mechanism for COX‐2 expression induced in the rat small intestine by indomethacin, in relation with ulcerogenic processes.

Methods:  Animals were given indomethacin or SC‐560 p.o., and the intestinal mucosa was examined 24 h later.

Results:  Indomethacin caused hemorrhagic lesions in the small intestine, accompanied with an increase in intestinal motility, bacterial invasion and inducible nitric oxide synthase (iNOS) activity, as well as the expression of COX‐2 mRNA in the mucosa. Although SC‐560 did not cause any damage, this agent caused intestinal hypermotility, the bacterial invasion and the upregulation of COX‐2 expression. The mucosal PGE2 content was decreased by SC‐560 at 3 h but recovered 12 h later, and this recovery of PGE2 was attenuated by both atropine and ampicillin, in addition to rofecoxib. The intestinal hypermotility response to indomethacin was prevented by both 16,16‐dimethyl PGE2 and atropine, but not ampicillin.  Yet  all  these  agents  inhibited  not  only  the  bacterial  invasion  but  also  the  expression  of COX‐2 and iNOS activity in the intestinal mucosa following indomethacin treatment, resulting in the prevention of intestinal lesions.

Conclusion:  These results suggest that COX‐2 expression in the intestinal mucosa following the administration of indomethacin is associated with intestinal hypermotility and bacterial invasion. The intestinal hypermotility caused by COX‐1 inhibition may be a key to COX‐2 expression after administration of NSAIDs and their intestinal ulcerogenic properties.
Stool decay‐accelerating factor as a marker for monitoring the disease activity during leukocyte apheresis therapy in patients with refractory ulcerative colitis
Authors: KOHNO HIROYUKI , MIZUNO MOTOWO , NASU JUNICHIROU , MAKIDONO CHIHO , HIRAOKA SAKIKO , INABA TOMOKI , YAMAMOTO KAZUHIDE , OKADA HIROYUKI , FUJITA TEIZO , SHIRATORI YASUSHI
Published: December 2004

Background and Aims:  We have shown previously that concentrations of stool decay‐accelerating factor (DAF; CD55), a complement regulatory protein, in patients with ulcerative colitis (UC) are increased in relation to the severity of the colonic mucosal inflammation. In the present study, we evaluated the usefulness of stool DAF as a marker for monitoring disease activity in patients with steroid‐resistant active UC being treated with leukocyte apheresis performed with a centrifugal cell separator.

Methods:  Twenty‐one patients with active and steroid‐resistant UC were treated with leukocyte apheresis once a week for 4 weeks, and stool DAF concentrations were determined weekly by immunoassay.

Results:  After treatment, 11 (52%) of the 21 UC patients went into remission. Stool DAF concentrations decreased promptly and steadily in the responsive group. The difference reached statistical significance as soon as after the second apheresis session (P < 0.003), compared with values before the therapy and corresponding values in the non‐responsive group (P = 0.024). The reduction in stool DAF concentrations after the second apheresis session was significantly greater in the responsive group (median 90%, range 22–90%) than in the non‐responsive group (median −13%, range −307–94%) (P = 0.008). Hematological tests, that is, white blood cell (WBC) count and C‐reactive protein, declined significantly during the apheresis therapy, but not in relation to therapeutic response.

Conclusion:  Stool DAF concentration is a useful marker in the clinical response of UC patients to treatment with leukocyte apheresis.
Holocene boundary dynamics of a northern Australian monsoon rainforest patch inferred from isotopic analysis of carbon, (14C and δ13C) and nitrogen (δ15N) in soil organic matter
Authors: BOWMAN D. M. J. S. , COOK G. D. , ZOPPI U.
Published: December 2004

Abstract  Soil organic matter (SOM) was sampled from lateritic soil profiles across an abrupt eucalypt savanna–monsoon rainforest boundary on the north coast of Croker Island, northern Australia. Accelerator mass spectrometry dating revealed that SOM that had accumulated at the base of these 1.5 m profiles had a radiocarbon age of about 5000 years. The mean carbon and nitrogen stable isotope composition of SOM from 10 cm deep layers from the surface, middle and base of three monsoon rainforest soil profiles was significantly different from the means for these layers in three adjacent savanna soil profiles, suggesting the isotopic ‘footprint’ of the vegetation boundary has been stable since the mid Holocene. Although there were no obvious environmental discontinuities associated with the boundary, the monsoon rainforest was found to occur on significantly more clay rich soils than the surrounding savanna. Tiny fragments of monsoon rainforest and abandoned ‘nests’ (large earthen mounds) of the orange‐footed scrubfowl, an obligate monsoon rainforest species, occurred in the savanna, signalling that the rainforest was once more extensive. Despite episodic disturbances, such as tropical storm damage and fires, the stability of the boundary is probably maintained because clay rich soils enable monsoon rainforest tree species to grow rapidly and achieve canopy closure, thereby excluding grass and reducing the risk of fire. Conversely, slower tree growth rates, grass competition and fire on the savanna soils would impede the expansion of the rainforest although high rainfall periods with shorter dry seasons may enable rainforest trees to grow sufficiently quickly to colonize the savanna successfully.
Estimating the maximum interval between repeat surveys
Authors: BROWN JENNIFER A. , HARRIS SIMON , TIMMINS SUSAN M.
Published: December 2004

Abstract  Surveying species that are present in low numbers is difficult because often the survey fails to locate any individuals. One strategy to improve the sample design is to survey the site repeatedly. With repeat surveys the abundance of the target species, and hence likelihood of detection, may change between visits. We present a model for deciding on the maximum surveillance interval between repeat surveys so that there is a high probability of detecting the species. We use as an example surveys for new weed infestations and model the chance of detecting the weed before control costs reach a threshold. The maximum surveillance interval depends on the rate of weed growth, the ability to detect the weed, and the cost of controlling the weed. Typically weed growth rates are high. Fast growing plants need to be detected early before they spread, but often weeds are difficult to detect when young and still comparatively cheap to control. Results from the model to determine maximum surveillance intervals are given for five broad habitat types and seven weed types. Surveillance intervals ranged from 1 to 10 years. Longer intervals are appropriate when searching for weeds with slower growth rates, that are easier to detect, and those that can be controlled cheaply.
The molecular staging of prostate cancer
Authors: McIntyre Iain G. , Hart Claire A. , Brown Michael D. , Ross David G. , George Nicholas J.R. , Clarke Noel W.
Published: December 2004

The four mini‐reviews are all descriptive of various aspects of prostatic disease. The first three relate to prostate cancer; the molecular staging of prostate cancer is a potential high‐technology way of helping to decide more accurately which is the most appropriate treatment for a given patient. Transition zone cancers are reviewed extensively in two papers, the first dealing with pathological aspects and the second with clinical aspects.

Finally, the three methods of treating chronic prostatitis are reviewed, and suggestions made as to the correct selection of treatment for a particular type of patient.
The 12‐year outcome analysis of an endourethral wallstent for treating benign prostatic hyperplasia
Authors: Masood Shikohe , Djaladat Hooman , Kouriefs Chryssanthos , Keen Margaret , Palmer John H.
Published: December 2004

OBJECTIVE

To evaluate the long‐term results of using the UrolumeTM endourethral prosthesis (American Medical Systems, Minnetonka, MN, USA) for managing benign prostatic hyperplasia (BPH), an alternative minimally invasive option.

PATIENTS AND METHODS

Sixty‐two patients with moderate/severe lower urinary tract symptoms secondary to BPH were treated with the Urolume stent by one surgeon (J.H.P.). They were followed up at 12 weeks, 6 months and then yearly. Data recorded before and after treatment included symptom scoring, peak urinary flow rate (PFR) and postvoid residual volume (PVR). A one‐way anova was used to compare baseline and the 5‐ and 12‐year follow‐up data.

RESULT

Twenty‐two and 11 patients completed the 5‐ and 12‐year follow‐up, respectively. Twenty‐one (34%) patients died with the stent in situ from causes unrelated to BPH and Urolume insertion. Twenty‐nine (47%) stents were removed; 18 in the first 2 years, seven at 3–5 years and four at 9–10 years. Early stent explantation was primarily a result of poor case selection, or stent malposition/migration. Four stents were removed because the patient was dissatisfied. Late stent explantation was for symptom progression. At 5 years, the symptom score and PFR were 6.82 an 11.7 mL/s, respectively, compared with 20.4 and 9 mL/s at basleine (P < 0.05); at 12 years, the symptom score, PFR and PVR were 10.82, 11.5 mL/s and 80 mL, respectively. The mean quality of life score was 2 and no patient opted for any further treatment.

CONCLUSION

The Urolume wallstent is a safe treatment for BPH, in selected patients. Careful case selection and experience is mandatory. This stent can provide the urologist with an alternative along with other minimally invasive treatments for men with BPH at high risk of requiring transurethral resection.
Shared care and the management of lower urinary tract symptoms
Authors: Wolters Rene , Wensing Michel , Klomp Maarten , Van Weel Chris , Grol Richard
Published: December 2004

OBJECTIVE

To investigate associations between the level of shared care and the clinical management of patients with uncomplicated lower urinary tract symptoms (LUTS).

SUBJECTS AND METHODS

A cross‐sectional survey study was conducted comprising all urologists and a random selection of general practitioners (GPs) in the Netherlands. Questionnaire responses were obtained from 182 urologists (70%) and 261 GPs (55%). The first part of the questionnaire established the physicians’ characteristics and the second the level of familiarity with the national shared‐care guidelines, arrangements between urologists and GPs, and the availability of a shared‐care prostate clinic. The third part presented a written case of a 50‐year‐old man with clinical uncomplicated LUTS, and asked questions about diagnostic and therapeutic care.

RESULTS

The clinical management of LUTS by GPs and urologists differed, particularly for diagnostic procedures. Only a minority of GPs (8%) and urologists (18%) had a shared‐care clinic at their disposal. Such clinics were associated with an increase in tests ordered by the GP, e.g. creatinine levels (odds ratio, OR 3.83) and PSA levels (OR 5.93), and a decrease in choosing a watchful‐waiting strategy for patients with mild symptoms (OR 0.24). Furthermore, urologists more often chose surgical intervention for moderate symptoms (OR 9.80).

CONCLUSION

A shared‐care clinic may lead to a shift in primary care towards the working style of urologists. This healthcare may not be as cost‐effective as expected by policy makers. Prospective studies are needed to provide better insight in the health outcomes and efficiency of shared‐care clinics.
Preoperative pressure‐flow studies: useful variables to predict the outcome of continence surgery
Authors: Digesu Giuseppe Alessandro , Khullar Vik , Cardozo Linda , Sethna Farah , Salvatore Stefano
Published: December 2004

OBJECTIVE

To determine whether the acceleration of flow rate (AFR), pressure flow variables and urethral pressure profilometry (UPP) measurements might have a role in evaluating women with urodynamic stress incontinence (USI), to predict the surgical outcome and de novo detrusor overactivity after Burch colposuspension.

PATIENTS AND METHODS

Women with a urodynamic diagnosis of USI (209) who had a modified Burch colposuspension were assessed retrospectively. The AFR, the opening (ODP) and closing detrusor pressure (CDP), DP at maximum flow rate and UPP values were calculated for each woman before surgery.

RESULTS

The preoperative AFR was significantly higher in women who developed de novo detrusor overactivity after surgery. The women who had persistent USI after colposuspension had significantly lower preoperative ODP and CDP than women who were continent after colposuspension. Other variables were not significantly different between the groups of women.

CONCLUSIONS

The AFR and ODP appear to be useful preoperative measures to predict the outcome of continence surgery and the emergence of de novo detrusor overactivity.
Lessons learned from stomal complications in children with cutaneous catheterizable continent stomas
Authors: Barqawi Albaha , De Valdenebro Miguel , Furness Peter D. , Koyle Martin A.
Published: December 2004

OBJECTIVE

To evaluate the impact of various factors that might ultimately influence the stoma complication rate associated with the construction of a continent catheterizable urinary (CCU) and Malone antegrade colonic enema (MACE) stoma in children.

PATIENTS AND METHODS

Retrospectively, we reviewed our experience in patients who had a CCU and/or MACE stoma reconstructed at our institution from 1992 to 2003. Diagnosis, type of stoma constructed (CCU vs MACE), single vs dual stomas, stomal site, conduit material (appendix, split appendix, Monti‐Yang or ureter), sex, age, patient mobility and body mass index, race and concomitant surgery (e.g. bladder augmentation with or without bladder neck reconstruction) were evaluated for stoma‐related complications. In all, 109 patients (64 males and 45 female), with a mean (sd, range) age of 8.6 (5.7, 2–37) years, had 151 stomas constructed during the period of analysis, comprising 56 CCU only, 11 MACE only and 42 (84 stomas) both simultaneously.

RESULTS

The mean (range) follow‐up was 48 (6–144) months. The primary diagnoses were neurogenic bladder in 60 (55%), bladder exstrophy/epispadias in 17 (16%) and posterior urethral valves in 11 (9%) patients. The umbilicus was the primary site for the CCU stoma in 88 of 98 (90%) cases, while the right lower quadrant was the primary site for MACE in 46 of 53 (87%). After surgery complete stomal continence was provided in 95 of 98 (97%) CCU stoma, whereas the MACE was successful in 52 of 53 (99%). The stoma‐related complications included stenosis in 27, leakage in eight, false passage in four, atrophy in two, keloid in one, and breakdown of the stoma in two. Individually, only greater age and a primary diagnosis of neurogenic bladder were independent risk factors associated with an increased rate of stomal complications and higher incidence of revision (P < 0.05).

CONCLUSION

Stomal complications are extremely common whether CCU or MACE stomas are constructed individually or together. Nevertheless, despite the need for revision, the high stoma continence rate supports their use. Greater age at surgery and a primary diagnosis of neurogenic bladder were associated with a significant increase in the stoma‐related complications and the need for revision.
The prevalence of urinary incontinence in community‐dwelling married women: a matter of definition
Authors: Vandoninck Vera , Bemelmans Bart L.H. , Mazzetta Chiara , Robertson Chris , Keech Martin , Boyle Peter , Kiemeney Lambertus A.
Published: December 2004

OBJECTIVE

To determine the prevalence of female urinary incontinence (UI) and its impact on quality of life.

SUBJECTS AND METHODS

In a Dutch national postal questionnaire survey, 1460 spouses of 1771 men in the town of Boxmeer, age‐stratified and randomly selected, were asked to participate. The prevalence of UI in the women was assessed in two ways. First, a total score on a short UI‐specific questionnaire differentiated them into three groups, i.e. no symptoms (score 0–2), minimally (3–6) or severely incontinent (7–14). Second, a self‐reported UI prevalence was calculated by asking respondents if they ever had urine loss. To conform to the International Continence Society standard definition, spouses were also asked to complete a general (Short Form‐12) and lower urinary tract disease‐specific quality‐of‐life questionnaire, and were asked about their need to seek help.

RESULTS

The questionnaires were returned by 1071 women (mean age 57 years, range 29–79; response rate 73%); 34% were regarded as minimally and 12% as severely incontinent. The self‐reported UI rate was 40%. Disease‐specific and general quality of life was significantly lower for women with UI than for those with minimal or no urine loss; 38% of incontinent respondents had consulted a physician for their UI, and among respondents with minimal complaints this was 28%.

CONCLUSIONS

Up to 46% of the married female population had some degree of UI, and severe UI significantly compromised their quality of life.
Social and political barriers to the use of Marine Protected Areas for conservation and fishery management in Melanesia
Authors: Foale Simon , Manele Bruno
Published: December 2004

Abstract: In this paper we examine the strengths and weaknesses of state‐supported Customary Marine Tenure (CMT) systems in two independent Melanesian states (Solomon Islands and Papua New Guinea) in the context of the management of rapidly intensifying commercial and subsistence fisheries. We focus particularly on the proposed use of permanent no‐take Marine Protected Areas (MPAs), which are at present strongly favoured by scientists and environmentalists around the world, as the most versatile marine fishery management tool, especially in poor developing countries. We argue that, with some exceptions, typical Melanesian CMT regimes make MPAs difficult to establish, primarily due to issues of scale. We look closely at the ecological rationale for no‐take MPAs, for different coral‐reef based species, and assess the likelihood that populations of these species are self‐replacing on the same scale as CMT territories for most of coastal PNG and Solomon Islands. We argue that with some exceptions (mainly species with short‐lived larvae), the dynamics and scale of population replacement processes for most fished species make no‐take permanent closures largely incompatible with traditional CMT systems, and therefore unlikely to prove a successful management tool in this socio‐political context.
Productivity and Comparative Advantage in Rice Agriculture in South‐East Asia Since 1870*
Authors: Van Der Eng Pierre
Published: December 2004

Rice long dominated the agricultural economies of South‐East Asia. Given the economic predominance of agriculture, the development of rice production had a significant bearing on the economies in the region. This article explains why the countries of mainland South‐East Asia long dominated the international rice market. It quantifies labor productivity in rice production and argues that simple, low‐cost and labor‐extensive, but low‐yielding production technology allowed farmers in mainland South‐East Asia to achieve significantly higher levels of labor product‐ivity than in the more densely populated rice‐producing areas in South‐East Asia and Japan. High levels of labor productivity were a major source of comparative advantage in rice production for Burma, Thailand and Southern Vietnam.
From Ambivalence to Influence: Australia and the Negotiation of the 1968 Nuclear Non‐Proliferation Treaty
Authors: Hubbard Christopher
Published: December 2004

In early 1967 it appeared that the Eighteen Nation Disarmament Committee in Geneva would successfully negotiate a multilateral treaty to curb global proliferation of nuclear weapons. This triggered an urgent review by the Australian Government of its policies on the civil and military applications of nuclear technology. The need to build a coherent response to a US expectation that its Pacific ally would sign the prospective Nuclear Non‐Proliferation Treaty imposed discipline upon a hitherto ad hoc approach to nuclear policy development. Those in the new Gorton Government and the nuclear science bureaucracy who advocated the embrace of nuclear technology—in both its civil and military applications—fought, and ultimately lost, a battle against proponents of the NPT. The resolution of the struggle for supremacy within elements of the policy community impelled the Government to demand and receive concessions from the USA. Originally silent on how the NPT might be interpreted and operationalised in order to maximise support, the US now shared its views with the members of the Western Alliance. US willingness to compromise with Australia in this way exceeded what its Pacific ally had cause to expect and illustrates that middle powers can wield influence on a global scale when circumstances permit.
Painful Stimulation of the Temple Induces Nausea, Headache and Extracranial Vasodilation in Migraine Sufferers
Authors: Drummond PD , Granston A
Published: December 2004

To determine whether painful stimulation of the temple would induce nausea, ice was applied to the temple for 30 s, three times at 4-min intervals in 23 migraine sufferers and 22 age- and sex-matched controls. On one occasion, the ice was applied in the presence of residual motion sickness induced by optokinetic stimulation. On another occasion, the ice application was not preceded by optokinetic stimulation (the baseline condition). In the baseline condition, nausea had developed in migraine sufferers but not controls by the third application of ice. In the presence of residual motion sickness, each painful stimulus intensified nausea and headache in migraine sufferers whereas symptoms were minimal in controls. Changes in frontotemporal pulse amplitude were monitored with photoelectric pulse transducers. The extracranial blood vessels dilated in migraine sufferers but not controls before the first application of ice in the baseline condition, presumably due to anticipatory anxiety. In contrast, the ice application did not provoke extra-cranial vasodilation in either group after optokinetic stimulation. The findings show that susceptibility to nausea and stress-induced extracranial vascular hyper-reactivity are associated with the migraine predisposition. They also suggest that head pain might intensify gastrointestinal disturbances during attacks of migraine.
Symbolic violence and the neighbourhood: the educational aspirations of 7–8 year old working‐class girls1
Authors: Connolly Paul , Healy Julie
Published: December 2004

This article focuses on the experiences of 7–8 year old working‐class girls in Belfast, Northern Ireland and their attitudes towards education. It shows how their emerging identities tend to emphasize relationships, marriage and motherhood at the expense of a concern with education and future careers. The article suggests that one important factor that can help explain this is the influence of the local neighbourhood. In drawing upon Bourdieu’s concepts of symbolic violence and habitus and Elias’ notion of figuration, the article shows how the local neighbourhood represents the parameters of the girls’ social worlds. It provides the context within which the girls tend to focus on social relations within their community and particularly on family relationships, marriage and children. It also provides the context within which the girls tend to develop strong interdependent relationships with their mothers that also tend to encourage and reinforce the girls’ particular gendered identities. The article concludes by arguing that there is a need for more research on working‐class girls and education to look beyond the school to incorporate, more fully, an understanding of the influence of the family and local neighbourhood on their attitudes towards education and their future career aspirations.
Sport in changing times and places
Authors: Jarvie Grant
Published: December 2004

Bale, J.

2003

London
:

196
pp. £

21.99

 

Eitzen, S.

2003

Oxford
:

187
pp. £

17.95

 

Hill, J.

2002

Basingstoke
,

232
pp. £

15.99

 

Houlihan, B.

2003

London
:

379
pp. £

19.99

 

Sugden, J. and
Tomlinson, A.

2002

London
:

304
pp. £

21.99
Determining the fetal scalp lactate level that indicates the need for intervention in labour
Authors: ALLEN Rod M. , BOWLING Francis G. , OATS Jeremy J. N.
Published: December 2004

Background: Fetal scalp lactate testing has been shown to be as useful as pH with added benefits. One remaining question is ‘What level of lactate should trigger intervention in the first stage of labour?’

Aims: This study aimed to establish the lactate level in the first stage of labour that indicates the need for intervention to ensure satisfactory outcomes for both babies and mothers.

Methods: A prospective study at Mater Mothers’ Hospital, Brisbane, Australia, a tertiary referral centre. One hundred and forty women in labour, with non‐reassuring fetal heart rate traces, were tested using fetal blood scalp sampling of 5 µL of capillary blood tested on an Accusport (Boeringer, Mannheim, East Sussex, UK) lactate meter. Decision to intervene in labour was based on clinical assessment plus a predetermined cut off. Main outcome measures were APGAR scores, cord arterial pH, meconium stained liquor and Intensive Care Nursery admission.

Results: Two‐graph receiver operating characteristic (TG‐ROC) analysis showed optimal specificity, and sensitivity for predicting adverse neonatal outcomes was a scalp lactate level above 4.2 mmol/L.

Conclusions: Fetal blood sampling remains the standard for further investigating‐non‐reassuring cardiotocograph (CTG) traces. Even so, it is a poor predictor of fetal outcomes. Scalp lactate has been shown to be at least as good a predictor as scalp pH, with the advantages of being easier, cheaper and with a lower rate of technical failure. Our study found that a cut off fetal scalp lactate level of 4.2 mmol/L, in combination with an assessment of the entire clinical picture, is a useful tool in identifying those women who need intervention.
Ethnicity and birth outcome: New Zealand trends 1980–2001: Part 4. Pregnancy outcomes for European/other women
Authors: CRAIG Elizabeth D. , MITCHELL Ed A. , STEWART Alistair W. , MANTELL Colin D. , EKEROMA Alec J.
Published: December 2004

Background: In the early 1980s European/other women made up 80% of New Zealand's population and experienced rates of preterm birth that were lower than for other ethnic groups. Rates of small for gestational age (SGA) and late fetal death were intermediate between those of Maori and Pacific women.

Aims: To examine trends in preterm birth, SGA and late fetal death for European/other women during 1980–2001 and to explore risk factors which make this group vulnerable to adverse birth outcome.

Methods: De‐identified birth registration data from 1 189 120 singleton live births and 5775 stillbirths were analysed for 1980–2001. Outcomes of interest included preterm birth, SGA and late fetal death while explanatory variables included maternal ethnicity, age and NZ Deprivation Index decile. Trend analysis was undertaken for 1980–1994 and multivariate logistic regression was used to explore risk factors for 1996–2001.

Results: During 1980–1994, rates of preterm birth rose by 30% for European/other women, in contrast to a non‐significant decline of 7% for Maori women and 4% for Pacific women. Rates of SGA declined 19% for European/other women, compared to 25% for Maori and 30% for Pacific women. Preterm birth and SGA were positively associated with teenage pregnancy and increasing NZDep deprivation. During 1980–1994, rates of late fetal death declined by 49%, with declines being similar for all ethnic groups.

Conclusions: The progressive rise in preterm birth during the past two decades is a cause of concern for European/other women, particularly as it appears confined to this ethnic group. While rates of SGA have declined, albeit at a slower rate than for other ethnic groups, the elevated risk amongst teenagers and those living in the more deprived NZDep areas suggests that greater gains are achievable if interventions are targeted towards these particular groups.
Development of a Rapid PCR Method Using the Insertion Sequence IS
1203
for Genotyping Shiga Toxin-Producing
Escherichia coli
O157
Authors: Suzuki Masahiro , Matsumoto Masakado , Hata Mami , Takahashi Masao , Sakae Kenji
Published: December 2004

We developed a rapid PCR method utilizing the diversity of the insertion site IS
1203
for genotyping Shiga toxin-producing
Escherichia coli
(STEC) O157 (IS
1203
PCR typing). DNA fragments digested by PvuII, which cut IS
1203
at one site, were ligated with themselves and detected by PCR with outward-facing primer pairs for IS
1203
. To minimize nonspecific bands, nested PCR was also performed. Two fingerprinting patterns produced from the upstream or downstream regions of IS
1203
were obtained within 1 or 2 days. By combining the two patterns, 79 STEC O157 isolates were classified into 39 types, which were then classified into 36 subtypes by pulsed-field gel electrophoresis (PFGE). The discriminatory power of IS
1203
PCR typing (
D
= 0.974) is similar to that of PFGE (
D
= 0.981). This method can be used for rapid and simplified genotyping.
Sequencing Needs for Viral Diagnostics
Authors: Gardner Shea N. , Lam Marisa W. , Mulakken Nisha J. , Torres Clinton L. , Smith Jason R. , Slezak Tom R.
Published: December 2004

We built a system to guide decisions regarding the amount of genomic sequencing required to develop diagnostic DNA signatures, which are short sequences that are sufficient to uniquely identify a viral species. We used our existing DNA diagnostic signature prediction pipeline, which selects regions of a target species genome that are conserved among strains of the target (for reliability, to prevent false negatives) and unique relative to other species (for specificity, to avoid false positives). We performed simulations, based on existing sequence data, to assess the number of genome sequences of a target species and of close phylogenetic relatives (near neighbors) that are required to predict diagnostic signature regions that are conserved among strains of the target species and unique relative to other bacterial and viral species. For DNA viruses such as variola (smallpox), three target genomes provide sufficient guidance for selecting species-wide signatures. Three near-neighbor genomes are critical for species specificity. In contrast, most RNA viruses require four target genomes and no near-neighbor genomes, since lack of conservation among strains is more limiting than uniqueness. Severe acute respiratory syndrome and Ebola Zaire are exceptional, as additional target genomes currently do not improve predictions, but near-neighbor sequences are urgently needed. Our results also indicate that double-stranded DNA viruses are more conserved among strains than are RNA viruses, since in most cases there was at least one conserved signature candidate for the DNA viruses and zero conserved signature candidates for the RNA viruses.
Exploration of Biases That Affect the Interpretation of Restriction Fragment Patterns Produced by Pulsed-Field Gel Electrophoresis
Authors: Singer Randall S. , Sischo William M. , Carpenter Tim E.
Published: December 2004

Pulsed-field gel electrophoresis (PFGE) has been used extensively in epidemiological investigations of bacteria, especially during food-borne outbreaks or nosocomial infections. The relationship between similarities in PFGE patterns and true genetic relatedness is poorly understood. In this study, computer-simulated populations of
Escherichia coli
isolates were created by mutating the sequence of
E. coli
K-12 strain MG1655. The simulated populations of isolates were then digested, again through simulation, with different restriction enzymes and were analyzed for their relatedness by different techniques. Errors associated with band determination and band matching were incorporated into the analyses, as both of these error types have been shown to affect PFGE interpretations. These errors increased the apparent similarities of the isolates. The use of multiple enzymes improved the fidelity between the results of PFGE analyses and the true sequence similarities. These findings, when they are combined with results from laboratory studies, emphasize the need for the inclusion of multiple enzymes and additional epidemiological data in order to make more accurate interpretations.
Shedding of Ovine Herpesvirus 2 in Sheep Nasal Secretions: the Predominant Mode for Transmission
Authors: Li Hong , Taus Naomi S. , Lewis Gregory S. , Kim Okjin , Traul Donald L. , Crawford Timothy B.
Published: December 2004

Ovine herpesvirus 2 (OvHV-2), the major causative agent of malignant catarrhal fever in ruminant species worldwide, has never been propagated in vitro. Using real-time PCR, a striking, short-lived, peak of viral DNA, ranging from 10
5
to over 10
8
copies/2 μg of DNA, was detected in nasal secretions from over 60.7% of adolescent sheep (
n
= 56) at some point during the period from 6 to 9 months of age. In contrast, only about 18% of adult sheep (
n
= 33) experienced a shedding episode during the study period. The general pattern of the appearance of viral DNA in nasal secretions was a dramatic rise and subsequent fall within 24 to 36 h, implying a single cycle of viral replication. These episodes occurred sporadically and infrequently, but over the 3-month period most of the 56 lambs (33, or 60.7%) experienced at least one episode. No corresponding fluctuations in DNA levels were found in either peripheral blood leukocytes or plasma. In a DNase protection assay, complete, enveloped OvHV-2 virions were demonstrated in the nasal secretions of all sheep examined during the time when they were experiencing an intense shedding episode. OvHV-2 infectivity in nasal secretions was also demonstrated by aerosolization of the secretions into OvHV-2-negative sheep. The data herein show that nasal shedding is the major mode of OvHV-2 transmission among domestic sheep and that adolescents represent the highest risk group for transmission.
Direct Identification of Gram-Positive Cocci from Routine Blood Cultures by Using AccuProbe Tests
Authors: Lindholm Laura , Sarkkinen Hannu
Published: December 2004

Rapid and reliable identification of bacteria directly from blood cultures is important in clinical practice to guide appropriate antibiotic therapy. In this study, the performance of the AccuProbe (Gen-Probe, Inc., San Diego, Calif.) in direct identification of
Staphylococcus aureus
,
Streptococcus pneumoniae
, enterococci, and group A and B streptococci from positive blood culture bottles was evaluated by using 6-year routine clinical laboratory blood culture material from Päijät-Häme Central Hospital, Lahti, Finland. With the enterococcal and group A and B streptococcal probes, the diagnostic performance of the test was excellent at a cutoff value of 50,000 relative light units (RLU) as recommended by the manufacturer. However, with the
S. aureus
probe, although the specificity was very high (99.8%), the sensitivity was low (72.4%). To improve the clinical usability of the direct AccuProbe identification, optimal cutoff values for the individual AccuProbe tests were defined by using receiver-operating characteristic analysis. Consequently, cutoff values for
S. aureus
and
S. pneumoniae
tests were adjusted to 30,000 RLU and for enterococci and to 55,000 RLU for group A and B streptococci. With these adjustments, the performance of the AccuProbe tests, especially that for
S. aureus
, was significantly improved.