bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of interdecadal climate variability on the oceanic ecosystems of the NE Pacific
Authors: FRANCIS ROBERT C. , HARE STEVEN R. , HOLLOWED ANNE B. , WOOSTER WARREN S.
Published: May 2003

A major reorganization of the North‐east Pacific biota transpired following a climatic `regime shift' in the mid 1970s. In this paper, we characterize the effects of interdecadal climate forcing on the oceanic ecosystems of the NE Pacific Ocean. We consider the concept of scale in terms of both time and space within the North Pacific ecosystem and develop a conceptual model to illustrate how climate variability is linked to ecosystem change. Next we describe a number of recent studies relating climate to marine ecosystem dynamics in the NE Pacific Ocean. These studies have focused on most major components of marine ecosystems – primary and secondary producers, forage species, and several levels of predators. They have been undertaken at different time and space scales. However, taken together, they reveal a more coherent picture of how decadal‐scale climate forcing may affect the large oceanic ecosystems of the NE Pacific. Finally, we synthesize the insight gained from interpreting these studies. Several general conclusions can be drawn.

1 There are large‐scale, low‐frequency, and sometimes very rapid changes in the distribution of atmospheric pressure over the North Pacific which are, in turn, reflected in ocean properties and circulation.

2 Oceanic ecosystems respond on similar time and space scales to variations in physical conditions.

3 Linkages between the atmosphere/ocean physics and biological responses are often different across time and space scales.

4 While the cases presented here demonstrate oceanic ecosystem response to climate forcing, they provide only hints of the mechanisms of interaction.

5 A model whereby ecosystem response to specified climate variation can be successfully predicted will be difficult to achieve because of scale mismatches and nonlinearities in the atmosphere–ocean–biosphere system.
The fin whaleBalaenoptera physalus(L. 1758) in the Mediterranean Sea
Authors: NOTARBARTOLO‐DI‐SCIARA GIUSEPPE , ZANARDELLI MARGHERITA , JAHODA MADDALENA , PANIGADA SIMONE , AIROLDI SABINA
Published: May 2003

1. The ecology and status of fin whalesBalaenoptera physalusin the Mediterranean Sea is reviewed. The species’ presence, morphology, distribution, movements, population structure, ecology and behaviour in this semi‐enclosed marine region are summarized, and the review is complemented with original, previously unpublished data.

2. Although the total size of the fin whale population in the Mediterranean is unknown, an estimate for a portion of the western basin, where most of the whales are known to live, was approximately 3500 individuals. High whale densities, comparable to those found in rich oceanic habitats, were found in well‐defined areas of high productivity. Most whales concentrate in the Ligurian‐Corsican‐Provençal Basin, where their presence is particularly noticeable during summer; however, neither their movement patterns throughout the region nor their seasonal cycle are clear.

3. Based on genetic studies, fin whales from the Mediterranean Sea are distinct from North Atlantic conspecifics, and may constitute a resident population, separate from those of the North Atlantic, despite the species’ historical presence in the Strait of Gibraltar. Fin whales are known to calve in the Mediterranean, with births peaking in November but occurring at lower rates throughout the year. They feed primarily on krillMeganyctiphanes norvegicawhich they capture by diving to depths in excess of 470 m. It is suggested that the extensive vertical migratory behaviour of its main prey may have influenced the social ecology of this population.

4. Known causes of mortality and threats, including collisions with vessels, entanglement in fishing gear, deliberate killing, disturbance, pollution and disease, are listed and discussed in view of the implementation of appropriate conservation measures to ensure the species’ survival in the region.
Comparative genomic hybridization and pathological findings in atypical teratoid/rhabdoid tumour of the central nervous system
Authors: Wharton S. B. , Wardle C. , Ironside J. W. , Wallace W. H. , Royds J. A. , Hammond D. W.
Published: May 2003

The atypical teratoid/rhabdoid tumour (AT/RT) is an uncommon tumour of the central nervous system in children, characterized by the presence of a rhabdoid cell component associated with variable combinations of primitive neuroectodermal tumour, mesenchymal and epithelial differentiation. Immunohistochemistry reveals a complex pattern of antigen expression and cytogenetic studies have demonstrated losses from chromosome 22. We have performed comparative genomic hybridization (CGH) on paraffin‐embedded material from three cases of AT/RT. Two cases showed losses from chromosome 22 associated with other chromosome imbalances including losses from 1p in both cases. The third case demonstrated a loss from 8p as the sole abnormality. While monosomy or deletion from chromosome 22 is a useful diagnostic marker for AT/RT, it is not present in all cases. The variation in cytogenetic patterns reported for this tumour type raises the possibility that different genetic pathways may underlie this tumour phenotype and warrants the further definition of the cytogenetic spectrum for this rare tumour.
Misrouted olfactory fibres and ectopic olfactory glomeruli in normal humans and in Parkinson and Alzheimer patients
Authors: Hoogland P. V. , Van Den Berg R. , Huisman E.
Published: May 2003

The presence and distribution of misrouted (MR) olfactory projection fibres were studied in the olfactory bulbs of control human brains and in the brains of people who had suffered from Parkinson's and Alzheimer's disease. It appeared that MR fibres, that is, fibres that terminate deep into the glomerular layer, are a common phenomenon in the bulbs of aged people. In all but one of the bulbs studied, MR fibres are present. The amount of MR fibres is not related to age. With a few exceptions, the MR fibres are restricted to the external plexiform layer (EPL). Only in Parkinson bulbs the MR fibres occasionally form glomerulus‐like structures. These pseudo glomeruli are located in the EPL. It is concluded that MR olfactory projection fibres are a normal phenomenon in the human olfactory bulb. In nonhuman mammalians, MR fibres have only been observed in foetal and neonatal olfactory bulbs. Possibly, the age‐related loss of mitral cells, which are the natural synaptic targets for the olfactory projection fibres, may play a role in the aberrant behaviour of the MR olfactory receptor cell axons. The ectopic glomerulus‐like structures in Parkinson bulbs share some characteristics with normal rat glomeruli that are not observed in normal human olfactory glomeruli. This may refer to possible changes in the genetic content of olfactory structures in Parkinson patients.
Pathological inclusion bodies in tauopathies contain distinct complements of tau with three or four microtubule‐binding repeat domains as demonstrated by new specific monoclonal antibodies
Authors: De Silva R. , Lashley T. , Gibb G. , Hanger D. , Hope A. , Reid A. , Bandopadhyay R. , Utton M. , Strand C. , Jowett T. , Khan N. , Anderton B. , Wood N. , Holton J. , Revesz T. , Lees A.
Published: May 2003

Pathological inclusions containing fibrillar aggregates of hyperphosphorylated tau protein are a characteristic feature in the tauopathies, which include Alzheimer's disease, frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP‐17), progressive supranuclear palsy, corticobasal degeneration and Pick's disease. Tau isoform composition and cellular and regional distribution as well as morphology of these inclusions vary in each disorder. Recently, several pathological missense and exon 10 splice‐donor site mutations of the tau gene were iden‐tified in FTDP‐17. Exon 10 codes for the second of four microtubule‐binding repeat domains. The splice‐site mutations result in increased inclusion of exon 10 which causes a relative increase in tau isoforms containing four microtubule‐binding repeat domains over those containing three repeat domains. This could be a central aetiological mechanism in FTDP‐17 and, perhaps, other related tauopathies. We have investigated changes in the ratio and distribution of three‐repeat and four‐repeat tau in the different tauopathies as a basis of the phenotypic range of these disorders and the selective vulnerability of different subsets of neurones. In this study, we have developed two monoclonal antibodies, RD3 and RD4 that effectively distinguish these closely related tau isoforms. These new isoform‐specific antibodies are useful tools for analysing tau isoform expression and distribution as well as pathological changes in the human brain.
α‐Synuclein‐positive structures in association with diffuse neurofibrillary tangles with calcification
Authors: Hishikawa N. , Hashizume Y. , Ujihira N. , Okada Y. , Yoshida M. , Sobue G.
Published: May 2003

α−Synuclein is known to be a major constituent of the Lewy bodies (LBs) in Parkinson's disease (PD) and the neuronal and glial cytoplasmic inclusions (NCIs, GCIs) in multiple system atrophy. α−Synuclein‐positive inclusions such as LBs, NCIs and GCIs sometimes show colocalization with tau‐positive neurofilaments. Studies using α−synuclein immunohistochemistry have often found LBs in the amygdala of patients with familial or sporadic Alzheimer's disease (AD), as well as in patients with Down's syndrome and AD. However, no studies have reported α−synuclein‐positive structures in cases of diffuse neurofibrillary tangles with calcification (DNTC), which is characterized by numerous neurofibrillary tangles (NFTs) throughout the cerebral cortex but few, if any, senile plaques. We investigated the distribution of α−synuclein‐positive structures in two cases of DNTC: a 65‐year‐old woman (brain weight, 850 g) and a 75‐year‐old woman (brain weight, 800 g). In both cases, severe cerebral atrophy predominant in the temporal lobe was noted. Microscopically, α−synuclein‐positive intracytoplasmic inclusions and neurites were found in the superior temporal lobe (within the temporal pole), amygdala, parahippocampus, entorhinal cortex and insula, the regions most affected by the NFTs. α−Synuclein‐positive intracytoplasmic inclusions were rare or absent in other regions of the cerebral cortex and brainstem. This distribution pattern differs from that of PD or dementia with LBs. Our findings suggest that the accumulation pattern of α−synuclein is a pathological feature of DNTC, and that DNTC is associated with accumulation of both tau and α−synuclein.
Neurotrophins and neurodegeneration
Authors: Dawbarn D. , Allen S. J.
Published: May 2003

There is growing evidence that reduced neurotrophic support is a significant factor in the pathogenesis of neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS). In this review we discuss the structure and functions of neurotrophins such as nerve growth factor, and the role of these proteins and their tyrosine kinase (Trk) receptors in the aetiology and therapy of such diseases. Neurotrophins regulate development and the maintenance of the vertebrate nervous system. In the mature nervous system they affect neuronal survival and also influence synaptic function and plasticity. The neurotrophins are able to bind to two different receptors: all bind to a common receptor p75NTR, and each also binds to one of a family of Trk receptors. By dimerization of the Trk receptors, and subsequent transphosphorylation of the intracellular kinase domain, signalling pathways are activated. We discuss here the structure and function of the neurotrophins and how they have been, or may be, used therapeutically in AD, PD, Huntington's diseases, ALS and peripheral neuropathy. Neurotrophins are central to many aspects of nervous system function. However they have not truly fulfilled their therapeutic potential in clinical trials because of the difficulties of protein delivery and pharmacokinetics in the nervous system. With the recent elucidation of the structure of the neurotrophins bound to their receptors it will now be possible, using a combination of in silico technology and novel screening techniques, to develop small molecule mimetics with much improved pharmacotherapeutic profiles.
Economic effects of childhood cancer on families
Authors: Dockerty JD , Skegg DCG , Williams SM
Published: May 2003

Objective:  To assess the financial impact of childhood cancer on families.

Methods:  This was a cross‐sectional survey of parents caring for children who were diagnosed with cancer during the period 1990−1993. Self‐administered questionnaires were completed by the parents of 237 children from throughout New Zealand with different types of cancer. Dollar amounts were adjusted to the equivalent of December 2000.

Results:  Eighty‐six per cent of the 192 living children were well or in remission. A further 45 children had died. The average extra amount spent, because of the child's illness, by the family of a living child in the 30 days prior to participation in the study was NZ$220 (SD NZ$330). On average, this was 13% of the family income after tax. After reported entitlement to compensation from various sources was allowed for, families were left with a mean deficit of NZ$157 (SD NZ$278) for the 30 days. Twelve families had a shortfall of more than NZ$500, including three families that had a shortfall of more than NZ$1000. Expenditure was greater for those whose children spent more time in hospital (P = 0.003). There was no significant association between the total cost and the distance travelled to the treatment centre (P = 0.96). For 24 families, after‐tax income in the month prior to participation in the study was at least NZ$500 lower than it had been in the month before the child's diagnosis. Thirty‐seven per cent of families reported that they needed to borrow money because of the financial effects of the child's illness. Bereaved parents spent an average of NZ$3065 (SD NZ$2168) on funeral expenses.

Conclusion:  There is a large financial burden on families who have a child with cancer.
Heparin‐induced thrombocytopenia in children
Authors: Newall F , Barnes C , Ignjatovic V , Monagle P
Published: May 2003

Objective:  To audit the frequency of heparinoid (standard heparin and low molecular weight heparin) use in a tertiary paediatric hospital, and to determine the occurrence of heparin‐induced thrombocytopenia (HIT).

Methods:  A 1‐week cross‐sectional audit of all heparinoids given to inpatients at a tertiary paediatric hospital was undertaken and a retrospective medical record review of all suspected HIT cases at the tertiary paediatric centre over a 2‐year period was carried out.

Results:  One hundred and sixteen patients received heparinoid medications over a 7‐day period. An average of 29 children received heparin daily. The retrospective medical record review identified four patients with suspected HIT over a 2‐year period. Two patients developed thrombotic complications, which were fatal in one patient.

Conclusion:  Heparin is used frequently in paediatric tertiary hospitals, yet the occurrence of HIT in children is much lower than that reported in adults. Improved laboratory techniques could facilitate improved screening and diagnosis of this serious adverse drug reaction.
Acute opioid withdrawal on accidental injection of naltrexone
Authors: Yeo M , Campbell V , Bonomo Y , Sawyer SM
Published: May 2003

Abstract:  We report two 16‐year‐old female intravenous drug users who, after making purchases from street suppliers, both presented with symptoms of acute opioid withdrawal. Urine toxicology revealed naltrexone, a long‐acting opioid antagonist used in detoxification and maintenance therapy in opioid dependence. While the safety and efficacy of opiate antagonist treatment is being debated, the present case highlights the vulnerability of this young population. The recent availability of non‐prescribed opiate antagonists suggests that both health professionals and young people themselves need to be aware of their effects.
Parents, infants and health care: Utilization of health services in the first 12 months of life
Authors: Goldfeld SR , Wright M , Oberklaid F
Published: May 2003

Objective:  To describe patterns of health‐service use in the first 12 months of life.

Methods:  In this prospective cohort study, 173 first‐born infants and their families living in two middle socio‐economic urban areas of Melbourne were enrolled consecutively when presenting for their initial maternal and child health nurse (MCHN) visit (at approximately 4 weeks of age). Families kept a daily ‘health diary’ for the entire 12‐month period, recording use of all health services for their infant, and reasons for the contact.

Results:  There was an 87% completion rate of diaries. The mean number of visits to any health service, including medical, hospitals, MCHN services, pharmacists, allied health services and naturopaths, was 35.7 (95% CI 34.7−36.6) during the 12 months. Of these, 31% (mean 10.9 visits) were visits to a general practitioner (GP) and 41.5% (mean 14.3 visits) were visits to the MCHN. Infants’ visits to the MCHN were far more frequent in the first 6 months of life compared with the second 6 months (10.3 vs 3.6, P < 0.001). Rates of GP use were constant over the same periods (5.3 vs 5.7, P = 0.8).

Conclusions:  In a universal health‐care system, this high rate of health‐service use equates to approximately one visit to a health service every 2 weeks in the first year of life. The majority of these visits appeared unrelated to illness. This previously undocumented data has implications for future integrated service delivery, health‐professional training and policy development for this age group.
Unintentional ingestion of over the counter medications in children less than 5 years old
Authors: Chien C , Marriott JL , Ashby K , Ozanne‐Smith J
Published: May 2003

Objective:  Childhood ingestion of medications remains a substantial problem. Medication available over the counter (OTC) is widely used and has significant toxicity. The present study aims to investigate the nature and extent of unintentional ingestion of OTC medication in children < 5 years old in Victoria, Australia, during the period 1996−2000, in order to highlight critical factors.

Methods:  Numbers of enquiries relating to unintentional ingestion of OTC medication in children < 5 years old and medication types were obtained from the Victorian Poisons Information Centre for 1998−2000. Emergency Department presentations involving poisoning of children < 5 years old, the medication types and subsequent admissions were obtained from the Victorian Emergency Minimum Dataset for 1996−2000.

Results:  Numbers of enquiries and Emergency Department attendances for poisoning were substantially higher for OTC medication than for prescription medication; however, a lower proportion of cases involving ingestion of OTC medication (24.8%) required hospital admission during the study period compared with cases involving ingestion of prescription medications (33.8%). Overall, the peak incidence was at 2 years of age, with a slight male over‐representation. Paracetamol and cough/cold preparations were the most common agents.

Conclusions:  The causes of unintentional ingestion of OTC medications by children might include lack of child‐resistant closure (CRC), inadequate design of CRC, attitudes concerning the toxicity of OTC medications, or lack of vigilance by parents and carers in the storage and administration of OTC medications. Consideration should be given to restricting sales of toxic OTC medications to pharmacies, and increasing counselling of consumers concerning the toxicity and safe storage of OTC medications and the correct usage of CRC. The adequacy of CRC design and OTC medications warranting CRC should be reviewed by the relevant authorities.
Effect of detergent‐coated versus non‐coated spacers on bronchodilator response in children with asthma
Authors: Barben JU , Roberts M , Robertson CF
Published: May 2003

Objective:  Previous studies have demonstrated that coating spacers with ionic detergents minimizes the static charge and thereby improves in vivo drug deposition. The present study aims to examine the effect of coated spacers versus non‐coated spacers in the clinical situation.

Methods:  A randomized, double‐blind study in children with asthma and a ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) of ≤72% predicted was carried out. Spirometry was performed at baseline and at 10 min and 20 min after inhalation of two puffs of salbutamol (100 µg/puff) through either a detergent‐coated or a non‐coated spacer.

Results:  Fifty children were studied (mean age 11.6 years, range 7−18 years): 26 in the group using coated spacers (CG); and 24 in the group using non‐coated spacers (NCG). The mean percentage change in FEV1 from baseline 10 min after inhalation was 18.8% (range 5−50%) in the CG versus 18.5% (range 3−35%) in the NCG. At 20 min after inhalation, the per cent increase in FEV1 was 19.8% (range 0−50%) in the CG versus 19.5% (range 9−35%) in the NCG. There was no significant difference between groups in the percentage change in FEV1 after 10 min (P = 0.91), or after 20 min (P = 0.93).

Conclusions:  There was no improvement in bronchodilatation from detergent‐coated spacers in the present study, possibly because a maximal bronchodilator response was achieved with the lower output.
Correlates of specific childhood feeding problems
Authors: Field D , Garland M , Williams K
Published: May 2003

Objective:  The correlates of specific childhood feeding problems are described to further examine possible predisposing factors for feeding problems. We report our experience with 349 participants evaluated by an interdisciplinary feeding team.

Methods:  A review of records was conducted and each participant was identified as having one or more of five functionally defined feeding problems: food refusal, food selectivity by type, food selectivity by texture, oral motor delays, or dysphagia. The prevalence of predisposing factors for these feeding problems was examined. Predisposing factors included developmental disabilities, gastrointestinal problems, cardiopulmonary problems, neurological problems, renal disease and anatomical anomalies.

Results:  The frequencies of predisposing factors varied by feeding problem. Differences were found in the prevalence of the five feeding problems among children with three different developmental disabilities: autism, Down syndrome and cerebral palsy. Gastro‐oesophageal reflux was the most prevalent condition found among all children in the sample and was the factor most often associated with food refusal. Neurological conditions and anatomical anomalies were highly associated with skill deficits, such as oral motor delays and dysphagia.

Conclusions:  Specific medical conditions and developmental disabilities are often associated with certain feeding problems. Information concerning predisposing factors of feeding problems can help providers employ appropriate primary, secondary and tertiary prevention measures to decrease the frequency or severity of some feeding problems.
An unusual presentation of idiopathic bilateral avascular necrosis of the femoral heads
Authors: Parmar Kalpesh A
Published: May 2003

A case report is presented of a patient with an unusual presentation of idiopathic bilateral avascular necrosis of the femoral heads after a period of multiple presentations and misdiagnoses in the ED. This is the first such case described presenting in this way and highlights the importance of establishing a firm diagnosis and instituting appropriate management.
Abnormal vaginal bleeding
Authors: Bryan Sheila
Published: May 2003

The complaint of abnormal vaginal bleeding in a non‐pregnant patient is not a common presentation to a general ED. However, the bleeding may in itself be significant or it may be a harbinger of serious underlying pathology. A systematic approach to diagnosis is required. An initial approach to vaginal bleeding can be to categorize the bleeding by the anatomical site. This article discusses some of the common causes of upper tract or uterine bleeding and outlines the basic approach to diagnosis and management.
Current challenges in the assessment and management of patients with bleeding in early pregnancy
Authors: Bryan Sheila
Published: May 2003

Bleeding in early pregnancy occurs in approximately 20% of clinically diagnosed pregnancies. History and physical examination are unable to reliably determine the anatomical location of the pregnancy (ectopic or intrauterine) or whether or not the fetus is alive. Ultrasound is the best tool for assessing these clinical questions and it is increasingly being used in the ED. This article looks at some of the common ultrasound findings and discusses the management options for failed and ectopic pregnancies.
Female sexual health
Authors: Bryan Sheila
Published: May 2003

Many aspects of sexual health relate to either preventative medicine (contraception) or managing normal physiological states (pregnancy, menopause). This article looks at some of the emergency aspects of female sexual health including genital tract trauma and genital infections.
Obstetric haemorrhage
Authors: Higgins Shane
Published: May 2003

Few obstetric emergencies cause greater concern than haemorrhage in late pregnancy and the immediate postpartum period. Massive haemorrhage can occur without forewarning with few reliable clinical indicators available to predict those at greatest risk. Patients may remain haemodynamically stable until a sudden deterioration in condition takes place. In many cases the extent of the bleeding can be unclear as the haemorrhage may be concealed behind the placenta. This article reviews the common causes of ante and postpartum haemorrhage, their associated factors and the immediate and subsequent management of the conditions. A variety of uterotonic agents is available for the treatment of postpartum haemorrhage and a structured approach for their use is required.
Re‐framing the clinician's role in collaborative clinical decision making: re‐thinking practice knowledge and the notion of clinician–patient relationships
Authors: Trede Franziska , Higgs Joy
Published: May 2003

Many clinicians are moving away from the traditional expert role towards a more collaborative approach to clinical decision making. Collaboration with patients has implications for the power distribution between clinician and patient, how health is defined, and what counts as evidence in the decision‐making process. A critical social science perspective provides the philosophical and theoretical underpinnings for collaborative clinical decision making. Key issues of critical social science are critical self‐reflection, questioning taken‐for‐granted practice, and transforming current practice. The way that clinicians define their role in clinical decision making reflects their beliefs and values about health, power and practice knowledge. Clinicians who adopt a collaborative clinical decision‐making approach reject the objective scientific view of evidence‐based practice, and embrace cultural and political influences on what counts as evidence. The purpose of collaboration is to increase understanding between the clinician and the patient. A distinction is made in this debate between manipulating and emancipating patients. Including patients in the decision‐making process promises to result in more realistic and appropriate treatments, reduced patient concerns and complaints and better, sustainable health outcomes, and increased patient and clinician satisfaction. In this article we re‐think practice knowledge and the notion of clinician–patient relationships.
Facilitating undergraduate interprofessional learning in healthcare: comparing classroom and clinical learning for nursing and medical students
Authors: Morison Sue , Boohan Mairead , Jenkins John , Moutray Marianne
Published: May 2003

There has been increasing emphasis on the important role that interprofessional education (IPE) must play in educating and developing present and future healthcare professionals. However, clarity is urgently needed regarding appropriate strategies for its timing, content, delivery and assessment. This study focuses on the development of an undergraduate IPE programme for medical and nursing students. It compares learning opportunities in classroom and clinical areas and identifies suitable pedagogical strategies and subject areas. The programme consisted of 2 weeks of classroom‐based learning for all 130 participating students, followed by 6 weeks on shared placement for 35 of the 113 medical and all 17 nursing students. A triangulation of data‐collection methods was used to help strengthen reliability and validity and provide a more comprehensive analysis. In both classroom and clinical areas, successful methods of delivery for IPE were those that enabled exchanges of perspectives. Ward‐based IPE was regarded as particularly effective in encouraging students to begin to feel part of a clinical team. In contrast, classroom‐based learning enabled them to know about teamwork, but not to experience it. Practical issues of shift and timetable incompatibility were the most significant barriers to successful placement‐shared learning. Developments in this area will need to focus on those elements of clinical practice which bring students together for collaborative involvement in activities that maximize the benefits resulting from the investment of time and effort involved. We conclude that undergraduate IPE opportunities have an important role to play in enabling students to learn about the roles and responsibilities of others and the impact of this on their own practice. It should be the first step towards developing practitioners who, whilst retaining their own unique professional identity, are able to understand and respect the roles of other healthcare professionals and work collaboratively to improve patient care.
Do Perceived Attitudes of Physicians and Hospital Staff Affect Breastfeeding Decisions?
Authors: DiGirolamo Ann M. , Grummer‐Strawn Laurence M. , Fein Sara B.
Published: May 2003

ABSTRACT:  Background: In the United States, since a substantial percentage of mothers are not breastfeeding, research is needed to assess important influences on breastfeeding. The current study assessed the impact on breastfeeding of the perceived attitudes of health care providers about infant feeding.

Methods: A longitudinal mail survey (1993–1994) was administered to 1620 women prenatally through 12 months postpartum; the current study focused on the prenatal and neonatal periods (66% response rate). The outcome variable was failure to breastfeed beyond 6 weeks. Predictor variables were the mother's perceptions of her prenatal physician's and hospital staff's attitudes on infant feeding. Analysis controlled for mother's prenatal breastfeeding intentions, father's feeding preference, and demographic and psychosocial variables.

Results: Forty‐one percent of the mothers were not breastfeeding at 6 weeks postpartum. Substantial percentages of mothers reported that physicians and hospital staff expressed a preference for breastfeeding (38% and 57%, respectively), or expressed no preference (61% and 42%, respectively), whereas few favored formula feeding. Adjusted analyses indicated that “no preference” by hospital staff was a significant risk factor for failure to breastfeed beyond 6 weeks. “No preference” by physicians did not significantly influence breastfeeding outcome in these analyses. Further analyses indicated that the effects of perceived hospital staff attitudes were only present for mothers who intended prenatally to breastfeed for 2 months or less.

Conclusions: Many women did not report receiving positive breastfeeding messages from their health caregivers and hospital staff. A perceived neutral attitude from the hospital staff is related to not breastfeeding beyond 6 weeks, especially among mothers who prenatally intended to breastfeed for only a short time. (BIRTH 30:2 June 2003)
A Simplified Predictive Index for the Detection of Women at Risk for Postnatal Depression
Authors: Webster Joan , Pritchard Margo A. , Creedy Debra , East Chris
Published: May 2003

Background: Many women who suffer from postnatal depression are never diagnosed or treated. The objective of this study was to develop an index for use in maternity settings that identifies women who may be at risk for postnatal depression.

Methods: Women (n = 1762) attending the ‘‘booking‐in’’ clinic were screened for antenatal risk factors for postnatal depression. On the third postnatal day eligible women were screened for postnatal risk factors. The Edinburgh Postnatal Depression Scale was mailed to participants16 weeks after the birth. A predictive index was developed, based on the mean Edinburgh Postnatal Depression Scale scores for each risk factor. The sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the diagnostic value of the index.

Results: Seven hundred and twenty‐three (50.1%) of the eligible women completed all phases of the study. Of this group, 93 (12.2%) women scored higher than 12 on the Edinburgh Postnatal Depression Scale. At a cutoff of 6, the index had positive predictive value of 39.8 percent for postnatal depression, a threefold improvement over the base rate.

Conclusion: The Brisbane Postnatal Depression Index provides a clinically useful method for identifying women at risk for developing postnatal depression. It has applications for early intervention or to identify high‐risk groups for research purposes. (BIRTH 30:2 June 2003)
LIGHT MICROSCOPY AND ELECTRON MICROSCOPY OF NEPHROSELMIS SPINOSA SP. NOV. (PRASINOPHYCEAE, CHLOROPHYTA)1
Authors: Suda Shoichiro
Published: May 2003

Nephroselmis spinosa Suda sp. nov. is described based on LM and EM observations. Two strains of N. spinosa (S222 and SD959‐3) were isolated from sand samples collected from the northwest coast of western Australia. The cells were remarkably right–left flattened and appeared ellipse or bean‐shaped when viewed from their right or left side. A single, parietal, crescent chloroplast was pale green to yellowish green and contained one conspicuous eyespot in its anterior ventral edge near the base of the short flagellum. A pyrenoid with three starch plates was located at the dorsal of the chloroplast. The cells divided by transverse binary cell division, as is common in other species of this genus. This alga possessed four types of body scales, and three scale types were similar to N. olivacea Stein and N. astigmatica Inouye & Pienaar. However, the fourth and outermost scale type was distinctive because although it was a spiny stellate scale with nine spines, one of them extended about 1 μm and was slightly curved with a hook at the end. This scale morphology, an important taxonomic characteristic, has never been described for the genus Nephroselmis. The cell's morphology, pyrenoid structure, hair scales, and cell size were distinctive from previously described Nephroselmis species, and its unique scale characteristic led me to name this newly proposed species “spinosa,” meaning spiny.
GROWTH REGULATION OF rRNA CONTENT IN PROCHLOROCOCCUS AND SYNECHOCOCCUS (MARINE CYANOBACTERIA) MEASURED BY  WHOLE‐CELL HYBRIDIZATION OF rRNA‐TARGETED PEPTIDE NUCLEIC ACIDS1
Authors: Worden Alexandra Z. , Binder Brian J.
Published: May 2003

The cyanobacteria Synechococcus and Prochlorococcus are important primary producers in marine ecosystems. Because currently available approaches for estimating microbial growth rates can be difficult to apply in the field, we have been exploring the feasibility of using quantitative rRNA measurements as the basis for making such estimates. In this study we examined the relationship between rRNA and growth rate in several Synechococcus and Prochlorococcus strains over a range of light‐regulated growth rates. Whole‐cell hybridization with fluorescently labeled peptide nucleic acid (PNA) probes was used in conjunction with flow cytometry to quantify rRNA on a per cell basis. This PNA probing technique allowed rRNA analysis in a phycoerythrin‐containing Synechococcus strain (WH7803) and in a non–phycoerythrin‐containing strain and in Prochlorococcus. All the strains showed a qualitatively similar tri‐phasic relationship between rRNA·cell−1 and growth rate, involving relatively little change in rRNA·cell−1 at low growth rates, linear increase at intermediate growth rates, and a plateau and/or decrease at the highest growth rates. The onset of each phase was associated with the relative, rather than absolute, growth rate of each strain. In the Synechococcus strains, rRNA normalized to flow cytometrically measured forward angle light scatter (an indicator of size) was well‐correlated with growth rate across strains. These findings support the idea that cellular rRNA may be useful as an indicator of in situ growth rate in natural Synechococcus and Prochlorococcus populations.
EFFECTS OF METAL AND PETROLEUM HYDROCARBON CONTAMINATION ON BENTHIC DIATOM COMMUNITIES NEAR CASEY STATION, ANTARCTICA: AN EXPERIMENTAL APPROACH1
Authors: Cunningham Laura , Stark Jonathan S. , Snape Ian , McMinn Andrew , Riddle Martin J.
Published: May 2003

The effects of metals and petroleum hydrocarbons on benthic marine diatom communities were assessed using a manipulative field experiment at Casey Station, Antarctica. Uncontaminated, metal contaminated, and petroleum hydrocarbon contaminated sediments were deployed for 11 weeks during the 1999 austral summer. The treatments were deployed at three different locations: Brown Bay, which has elevated levels of anthropogenic contaminants, and two uncontaminated reference locations, O'Brien Bay and Sparkes Bay, the latter of which has naturally occurring high concentrations of some heavy metals. At each location, significant differences between the composition of diatom communities recruiting to control and petroleum hydrocarbon contaminated treatments were observed. Navicula directa (Smith) Ralfs occurred at lower abundances in the petroleum hydrocarbon contaminated treatments than in the control treatments. In contrast, Navicula cancellata Donkin occurred at higher relative abundances in both contaminated treatments relative to the control treatment. Interactions between treatment and location were also observed for several species, including Navicula glaciei Van Heurck. Significant differences in the overall community composition of diatom communities between control and metal contaminated treatments and metal contaminated and petroleum hydrocarbon contaminated treatments were only observed within Brown Bay. The location of deployment also had a significant influence on the composition of diatom communities. Brown Bay had higher abundances of Achnanthes brevipes Agardh but lower abundances of Navicula aff. cincta (Ehrenberg) Van Heurck than either reference locations. This experiment demonstrated that benthic diatom communities are sensitive to sediment contamination and would be suitable for future monitoring work within this and other areas of Antarctica.
CULTURE OF THE TERRESTRIAL CYANOBACTERIUM, NOSTOC FLAGELLIFORME (CYANOPHYCEAE), UNDER AQUATIC CONDITIONS1
Authors: Gao Kunshan , Ye Changpeng
Published: May 2003

Both colonies and free‐living cells of the terrestrial cyanobacterium, Nostoc flagelliforme (Berk. & Curtis) Bornet & Flahault, were cultured under aquatic conditions to develop the techniques for the cultivation and restoration of this endangered resource. The colonial filaments disintegrated with their sheaths ruptured in about 2 days without any desiccating treatments. Periodic desiccation played an important role in preventing the alga from decomposing, with greater delays to sheath rupture with a higher frequency of exposure to air. The bacterial numbers in the culture treated with seven periods of desiccation per day were about 50% less compared with the cultures without the desiccation treatment. When bacteria in the culture were controlled, the colonial filaments did not disintegrate and maintained the integrity of their sheath for about 20 days even without the desiccation treatments, indicating the importance of desiccation for N. flagelliforme to prevent them from being disintegrated by bacteria. On the other hand, when free‐living cells obtained from crushed colonial filaments were cultured in liquid medium, they developed into single filaments with sheaths, within which multiple filaments were formed later on as a colony. Such colonial filaments were developed at 15, 25, and 30° C at either 20 or 60 μmol photons·m−2·s−1; colonies did not develop at 180 μmol photons·m−2·s−1, though this light level resulted in the most rapid growth of the cells. Conditions of 60 μmol photons·m−2·s−1 and 25° C appeared to result in the best colonial development and faster growth of the sheath‐held colonies of N. flagelliforme when cultured indoor under aquatic conditions.
FINE CHEMICAL STRUCTURE OF CARRAGEENAN FROM THE COMMERCIALLY CULTIVATED KAPPAPHYCUS STRIATUM (SACOL VARIETY) (SOLIERIACEAE, GIGARTINALES, RHODOPHYTA)1
Authors: Villanueva Ronald D. , Montaño Marco Nemesio E.
Published: May 2003

The polysaccharide extracted from Kappaphycus striatum (Schmitz) Doty (sacol variety), a recently farmed eucheumoid seaweed, was characterized by Fourier transform infrared and NMR spectroscopy. The extract is composed mainly of 3‐linked β‐d‐galactopyranosyl‐4‐sulfate residues alternating with 4‐linked 3,6‐anhydro‐α‐d‐galactopyranosyl residues (κ‐carrageenan). Minor components include 3,6‐anhydrogalactopyranosyl‐2‐sulfate residues (ι‐carrageenan) and 6‐O‐methylgalactopyranosyl‐4‐sulfate residues (methylated carrageenan). The substitution pattern of carrageenan in the tribe Eucheumatoideae and the family Solieriaceae is revisited in terms of chemotaxonomic affiliation.
A NEW LARVAL FISH BIOASSAY FOR TESTING THE PATHOGENICITY OF PFIESTERIA SPP. (DINOPHYCEAE)1
Authors: Lovko Vincent J. , Vogelbein Wolfgang K. , Shields Jeffrey D. , Haas Leonard W. , Reece Kimberly S.
Published: May 2003

Water quality, microbial contamination, prior fish health, and variable results have been major impediments to identifying the cause and mechanism of fish mortality in standard aquarium‐format Pfiesteria bioassays. Therefore, we developed a sensitive 96‐h larval fish bioassay for assessing Pfiesteria spp. pathogenicity using six‐well tissue culture plates and 7‐day‐old larval cyprinodontid fish. We used the assay to test pathogenicity of several clonal lines of Pfiesteria piscicida Steidinger and Burkholder and P. shumwayae Glasgow and Burkholder that had been cultured with algal prey for 2 to 36 months. The P. shumwayae cultures exhibited 80%–100% cumulative mortality in less than 96 h at initial zoospore densities of approximately 1000 cells·mL−1. No fish mortalities occurred with P. piscicida at identical densities or in controls. In a dose‐response assay, we demonstrated a strong positive correlation between dinospore density and fish mortality in a highly pathogenic culture of P. shumwayae, generating a 96‐h LD50 of 108 zoospores·mL−1. Additionally, we applied the assay to evaluate a 38‐L P. shumwayae bioassay that was actively killing fish and compared results with those from exposures of juvenile tilapia (Oreochromis niloticus) in a 500‐mL assay system. Water from the fish‐killing 38‐L assay was filtered and centrifuged to produce fractions dominated by dinoflagellates, bacteria, or presumed ichthyotoxin (cell‐free fraction). After 96 h, the larval fish assay exhibited 50%–100% cumulative mortality only in fractions containing dinoflagellates, with no mortalities occurring in the other fractions. The 500‐mL bioassay with tilapia produced inconsistent results and demonstrated no clear correlation between mortality and treatment. The new larval fish bioassay was demonstrated as a highly effective method to verify and evaluate dinoflagellate pathogenicity.
INTERACTIVE EFFECTS OF PAR AND UV‐B RADIATION ON PSII ELECTRON TRANSPORT IN THE MARINE ALGA DUNALIELLA TERTIOLECTA (CHLOROPHYCEAE)1
Authors: Shelly Kirsten , Heraud Philip , Beardall John
Published: May 2003

To better understand the interactions between PAR and UV‐B radiation in microalgae, the marine chlorophyte alga Dunaliella tertiolecta was subjected to a UV‐B flux of 4.1 W·m−2 (unweighted) with varying PAR fluxes. Rate constants for damage and repair processes during UV‐B exposure increased with PAR flux. However, recovery after UV‐B exposure increased with PAR up to 300 μmol quanta·m−2·s−1, beyond which photoinhibition of PSII electron transport was found to decrease recovery rates. In the absence of PAR during the post UV‐B exposure period, no recovery was seen, indicating that perhaps the lack of light available for photosynthesis depresses repair either directly or indirectly by affecting ATP synthesis. Possible mechanisms for the observed interactions between PAR and UV‐B exposure are discussed.
THE COMPLEX POLYSACCHARIDES OF THE RAPHID DIATOM PINNULARIA VIRIDIS (BACILLARIOPHYCEAE)1
Authors: Chiovitti Anthony , Higgins Michael J. , Harper Ruth E. , Wetherbee Richard , Bacic Antony
Published: May 2003

A combination of carbohydrate analysis and atomic force microscopy (AFM) was used to characterize the polysaccharides of the pennate diatom, Pinnularia viridis (Nitzsch) Ehrenberg. Polymeric substances were fractionated into those in the spent culture medium (SCM) and those sequentially extracted from the cells with water at 45° C (WW), NaHCO3 containing EDTA at 95° C (HB), and 1 M NaOH containing NaBH4 at 95° C. Carbohydrate, protein, and sulfate were detected in all the fractions, but their relative proportions differed significantly. Nineteen sugars were identified, including pentoses, hexoses, 6‐deoxyhexoses, O‐methylated sugars, aminohexoses, and traces of uronic acids. To some extent, the same constituent monosaccharides and a proportion of the linkage patterns occurred in all four fractions, indicating the fractions contained a spectrum of highly heterogeneous but structurally related polysaccharides. Several carbohydrates were enriched in specific fractions. A soluble, partially substituted, 3‐linked galactan was slightly enriched in the SCM. The WW fraction was highly enriched in 3‐linked glucan, presumably derived from chrysolaminaran. Chemical and AFM data for the WW and HB fractions indicated that compositional differences were associated with substantial changes in the morphology and properties of the cell surface mucilage. Soluble polymers relatively enriched in fucose conferred a degree of softness and compressibility to the mucilage, whereas most of the mucilage comprised firmer more gelatinous polymers comparatively enriched in rhamnose. The frustule residue dissolved during extraction with NaOH, and a partially substituted 3‐linked mannan, together with relatively large amounts of protein, was obtained.
NOVEL DINOFLAGELLATE CLOCK‐RELATED GENES IDENTIFIED THROUGH MICROARRAY ANALYSIS1
Authors: Okamoto O. Keith , Hastings J. Woodland
Published: May 2003

In a genome‐wide study of circadian gene expression, we constructed microarrays containing 3500 cDNAs from the dinoflagellate Pyrocystis lunula Schütt and compared the abundance of transcripts at circadian times separated by 12 h. About 3% of the unique genes screened were identified as circadian controlled, more than 50% of which could be identified with diverse known genes. Most were preferentially expressed in either early subjective day or late subjective night. Light exposures at times expected to induce phase shifts in the rhythm revealed 30 differentially expressed genes, including some potentially participating in photic entrainment and others in pathways connecting a central oscillator to output rhythms. Those that appeared in both screens were considered as possible core clock genes, but there were no similarities with such genes from other organisms. This is the first report of circadian regulation of transcript levels in a dinoflagellate.