bluuebunny/crossref_metadata_2025 huggingface dataset:
Fracture risk in patients with monoclonal gammopathy of undetermined significance
Authors: Gregersen Henrik , Jensen Paw , Gislum Mette , Jørgensen Birgit , Sørensen Henrik Toft , Nørgaard Mette
Published: August 2006

Little information is available on the risk of fractures in patients with monoclonal gammopathy of undetermined significance (MGUS). We identified 1535 patients with MGUS between 1978 and 2003 in North Jutland County, Denmark. The population control group consisted of 15 350 persons selected from the Danish Central Population Registry, matched by age and sex. Data on fractures in the two groups were obtained from the regional Hospital Discharge Registry. In the MGUS cohort, 187 first‐time fractures were identified during 9754 person‐years of follow‐up, corresponding to an incidence rate of 19/1000 person‐years. The adjusted relative risk for fractures among MGUS patients compared with population controls was 1·4 [95% confidence interval (CI), 1·2–1·6]. After 5 years of follow‐up, the risk difference was 1·8% (95% CI, 0·5–3·0). Six of the 187 MGUS patients with fractures were later diagnosed with malignant transformation. Relative risks for fractures were increased in IgG‐type MGUS [1·3 (95% CI,1·1–1·6)], IgM‐type MGUS [1·6 (95% CI, 1·1–2·2)] and MGUS with kappa light chain [1·4 (95% CI, 1·1–1·7)]. MGUS patients had an increased risk of fractures, which could not be explained by comorbidity, advanced age, gender or malignant transformation.
Early apoptosis in CD34+ cells as a potential heterogeneity in quality of cryopreserved umbilical cord blood
Authors: Shim Jae‐Seung , Cho Bin , Kim Myungshin , Park Gyeong‐Sin , Shin Jong‐Chul , Hwang Hong‐Kyu , Kim Tae‐Gyu , Oh Il‐Hoan
Published: August 2006

The increased use of umbilical cord blood (UCB) raises issues regarding the quality of cryopreserved UCB. This study investigated whether early apoptosis of CD34+ cells is part of the functional heterogeneity of cryopreserved UCB. Annexin V binding of CD34+PI(−) cells showed wide variations in both fresh and cryopreserved UCBs, with greater variation among units frozen for >5 years. Xenotransplantation of sorted cells into non‐obese diabetic severe combined immunodeficient mice demonstrated that the Annexin V assay identified most repopulating activities in UCB units. Thus, early apoptosis of CD34+ cells could influence the outcome of transplantation using cryopreserved UCB.
Effect of repeated apotransferrin administrations on serum iron parameters in patients undergoing myeloablative conditioning and allogeneic stem cell transplantation
Authors: Parkkinen Jaakko , Sahlstedt Leila , Von Bonsdorff Leni , Salo Hanna , Ebeling Freja , Ruutu Tapani
Published: August 2006

Myeloablative conditioning prior to allogeneic stem cell transplantation causes a rapid increase in transferrin saturation and potentially toxic non‐transferrin‐bound iron (NTBI) in plasma. We have studied the ability of repeatedly administered apotransferrin to maintain this iron in a transferrin‐bound form. Twenty adult patients undergoing myeloablative conditioning and allogeneic stem cell transplantation were enrolled to receive apotransferrin with one of three dosage regimens. Ten consecutive patients with the same preconditioning were studied as controls. At the highest dose level, full transferrin saturation and appearance of NTBI were prevented in five of the eight patients. Serum iron increased significantly more in the patients receiving apotransferrin than in the controls and remained elevated until erythropoietic recovery. From the increment of iron saturation and the amount of endogenous and administered apotransferrin, an average 180 μmol of iron per day was bound to transferrin during the first 4 d after the start of the conditioning therapy. Thereafter, iron accumulation levelled off in most patients. The results suggested that about half of the amount of iron normally transported to erythropoiesis was initially released to plasma after induction of the erythroid arrest. Complete iron binding with apotransferrin would apparently require very high apotransferrin doses.
Lignin turnover in arable soil and grassland analysed with two different labelling approaches
Authors: Heim A. , Schmidt M. W. I.
Published: August 2006

When modelling the carbon dynamics of temperate soils, soil organic carbon (SOC) is often represented by three kinetic pools, i.e. fast, slow and passive/inert. Lignin is often considered to be relatively resistant to decomposition, thus possibly contributing to the passive SOC pool. One way to assess SOC turnover under natural conditions is to follow the fate of 13C‐labelled biomass in soils. We used compound‐specific isotope analysis to analyse CuO oxidation products of lignin from grassland topsoils and from an arable topsoil that had received a natural (by C3‐C4 vegetation change) or an artificial (by fumigation with labelled CO2) isotopic label for 9–23 years. Results indicate faster apparent turnover for lignin (5–26 years in grassland, 9–38 years in arable soil) compared with bulk SOC (20–26 years in grassland, 51 years in arable soil). Although these calculated lignin turnover times cannot be extrapolated to the whole soil profiles, this paper provides isotopic evidence that lignin in soils is not preferentially preserved, which is a consistent result from both ways of isotopic labelling. It also demonstrates, however, that a considerable proportion of lignin in temperate soils can be stabilized for at least a few decades.
3D‐visualization and analysis of macro‐ and meso‐porosity of the upper horizons of a sodic, texture‐contrast soil
Authors: Jassogne L. , McNeill A. , Chittleborough D.
Published: August 2006

The lower E and upper B horizons of sodic, texture‐contrast soils are a formidable barrier to most annual and many perennial crops. The research presented here is part of a wider study into the nature of subsoil constraints to root exploration. The aim of this study was to characterize in three dimensions the macro‐ and meso‐porosity across the E horizon–Btn horizon interface of a sodic, texture‐contrast soil using X‐ray computed tomography (CT). Intact soil cores of 50‐cm length and 15‐cm diameter were scanned with a medical CT X‐ray machine. The pore volume reconstructed from these scans had a resolution of 0.3 × 0.3 × 0.4 cm (in the x, y, z dimensions, respectively). This resolution allowed visualization and quantification of the macroporosity of the intact cores. Undisturbed samples of 1.5‐cm diameter and 4‐cm length were carefully excised from the interface and scanned with micro‐CT X‐ray equipment. The reconstructed pore volumes had an isotropic resolution of 19 μm that allowed analysis of the mesoporosity just on the boundary between the E and Btn horizons. Mesoporosity decreased across the interface and increased lower in the Btn horizon. The distribution of the pores at the macro‐ and meso‐scales showed the importance of the smaller pores in the A and E horizons, whereas most of the porosity in the Btn horizon was attributed to the larger pores. Pores in this sodic, texture‐contrast soil were not distributed homogeneously at either the macro‐ or meso‐scale. A greater proportion of the pores in the E–B interface were horizontal than in the upper A1, upper E and lower Btn horizons. Some ‘coiling’ of the pores was also apparent in the interface. The shape of some pores (long tubular pores) suggested formation by roots as they drilled through the soil. The orientation of these pores was a function of physical (and possibly chemical) impedance at the interface.
Formation of 2,4–D complexes on montmorillonites – an ab initio molecular dynamics study
Authors: Tunega D. , Gerzabek M. H. , Haberhauer G. , Lischka H.
Published: August 2006

Sorption of the anionic form of the pesticide 2,4–D (2,4–dichlorophenoxyacetic acid) on the surface of the clay mineral montmorillonite was investigated using a short‐time ab initio molecular dynamics (MD) simulation at room temperature. Three different situations were modelled: sorption on a dry surface, on a hydrated surface and an intercalation between montmorillonite layers. In all three cases, the calcium cation compensates the excess negative charge of the montmorillonite layer and the negative charge of the 2,4–D anion. It was found that in all models with direct contact of the Ca2+ cation with the montmorillonite layer, the most stable position of Ca2+ is above the ditrigonal hole of the mineral layer. While in the case of a dry surface very stable bidentate binding is created between the 2,4–D anion and the Ca2+ cation, the formation of the monodentate complexes is preferred in all models that include water molecules. Hydrogen bonds formed between water molecules and the 2,4–D anion make a considerable contribution to the formation of the monodentate complexes. Tetrahedral substitutions in the montmorillonite layer have a significant effect on the formation of the complexes of any type. However, the MD simulations did not support the role of Ca2+ as a cation bridge in the adsorption mechanism. Calculations showed that hydrated 2,4–D···Ca2+ complexes are thermodynamically more stable than complexes in which the Ca2+ cation acts as a bridge to the surface. On the other hand, it is possible that phyllosilicates with a greater concentration of isomorphic substitutions (e.g. mica) will be able to form stable surface complexes with a cation bridge mechanism.
Alternative explanations for rising dissolved organic carbon export from organic soils
Authors: EVANS CHRISTOPHER D. , CHAPMAN PIPPA J. , CLARK JOANNA M. , MONTEITH DON T. , CRESSER MALCOLM S.
Published: August 2006

Since 1988, there has been, on average, a 91% increase in dissolved organic carbon (DOC) concentrations of UK lakes and streams in the Acid Waters Monitoring Network (AWMN). Similar DOC increases have been observed in surface waters across much of Europe and North America. Much of the debate about the causes of rising DOC has, as in other studies relating to the carbon cycle, focused on factors related to climate change. Data from our peat‐core experiments support an influence of climate on DOC, notably an increase in production with temperature under aerobic, and to a lesser extent anaerobic, conditions. However, we argue that climatic factors may not be the dominant drivers of DOC change. DOC solubility is suppressed by high soil water acidity and ionic strength, both of which have decreased as a result of declining sulphur deposition since the 1980s, augmented during the 1990s in the United Kingdom by a cyclical decline in sea‐salt deposition. Our observational and experimental data demonstrate a clear, inverse and quantitatively important link between DOC and sulphate concentrations in soil solution. Statistical analysis of 11 AWMN lakes suggests that rising temperature, declining sulphur deposition and changing sea‐salt loading can account for the majority of the observed DOC trend. This combination of evidence points to the changing chemical composition of atmospheric deposition, particularly the substantial reduction in anthropogenic sulphur emissions during the last 20 years, as a key cause of rising DOC. The implications of rising DOC export for the carbon cycle will be very different if linked primarily to decreasing acid deposition, rather than to changes in climate, suggesting that these systems may be recovering rather than destabilising.
ORIGINAL ARTICLE: Eyes wide shut: can hypometabolism really explain the primate colonization of Madagascar?
Authors: Masters J. C. , Lovegrove B. G. , De Wit M. J.
Published: August 2006

Aim  We investigate the hypothesis that it was the capacity for torpor or hibernation that enabled the lemuriforms (and possibly other mammal groups, e.g. tenrecs and rodents) to invade Madagascar by means of over‐water dispersal.

Location  Madagascar, East Africa and the Mozambique Channel.

Methods  We consider the body weights and life‐style features of living primate taxa that employ heterothermy. Using this information as a standard for comparison, we summarize the available information on the Palaeogene strepsirrhine radiation (i.e. members of the infraorder Adapiformes, the extinct sister‐taxon to the lemuriforms, as well as putative stem lemuriforms), particularly with respect to possible trends in body weight among early, middle and late Eocene adapiforms. We discuss Eocene climatic conditions in the northern hemisphere and Africa, and assess the likelihood of adaptations for heterothermy in adapiforms. Finally, we estimate the body weights of the common ancestors to the living Lemuriformes and Lemuroidea using the method of phylogenetically independent contrasts.

Results  The mean body weights estimated for the early, middle and late Eocene strepsirrhine faunas remain at approximately 2 kg, outside of the range of living primates using heterothermy. The adapiforms’ appearance coincided with the ‘initial Eocene thermal maximum’, an unusually hot period of global warming, and their demise corresponded with a major cooling event coincident with the appearance of ice sheets on Antarctica. They show no evidence of having evolved adaptations that allowed them to withstand climatic deterioration. The body weights of the ancestral lemuriform and ancestral lemuroid are of a similar order to the mean body weight estimated for the adapiforms, i.e. approximately 1.8 and 2.1 kg, respectively.

Main conclusions  The available evidence argues against the widespread use of heterothermy by adapiforms. The adapiform–lemuriform divergence may have been the result of the lemuriforms adapting to the drier and more seasonal environments that characterized the African Eocene, and this suite of adaptations may have included the use of heterothermy, but there is as yet no substantial evidence to confirm the presence of either group on the continent prior to c. 40 Ma. The estimated body weights of the common lemuriform and lemuroid ancestors are well outside the size range of living mammals that employ heterothermy. We conclude that the hypothesis that it was the ability to use heterothermy that enabled the strepsirrhines, and not the haplorhines, to invade Madagascar, is unlikely. Alternative explanations for this anomaly should be sought.
Biotic homogenization: a new research agenda for conservation biogeography
Authors: Olden Julian D.
Published: August 2006

Aim  Biotic homogenization describes the process by which species invasions and extinctions increase the genetic, taxonomic or functional similarity of two or more biotas over a specified time interval. The study of biotic homogenization is a young and rapidly emerging research area in the budding field of conservation biogeography, and this paper aims to synthesize our current knowledge of this process and advocate a more systematic approach to its investigation.

Methods  Based on a comprehensive examination of the primary literature this paper reviews the process of biotic homogenization, including its definition, quantification, underlying ecological mechanisms, environmental drivers, the empirical evidence for different taxonomic groups, and the potential ecological and evolutionary implications. Important gaps in our knowledge are then identified, and areas of new research that show the greatest promise for advancing our current thinking on biotic homogenization are highlighted.

Results  Current knowledge of the patterns, mechanisms and implications of biotic homogenization is highly variable across taxonomic groups, but in general is incomplete. Quantitative estimates are almost exclusively limited to freshwater fishes and plants in the United States, and the principal mechanisms and drivers of homogenization remain elusive. To date research has focused on taxonomic homogenization, and genetic and functional homogenization has received inadequate attention. Trends over the past decade, however, suggest that biotic homogenization is emerging as a topic of greater research interest.

Main conclusions  My investigation revealed a number of important knowledge gaps and priority research needs in the science of biotic homogenization. Future studies should examine the homogenization process for different community properties (species occurrence and abundance) at multiple spatial and temporal scales, with careful attention paid to the various biological mechanisms (invasions vs. extinctions) and environmental drivers (environmental alteration vs. biotic interactions) involved. Perhaps most importantly, this research should recognize that there are multiple possible outcomes resulting from the accumulation of species invasions and extinctions, including biotic differentiation whereby genetic, taxonomic or functional similarity of biotas decreases over time.
Five (or so) challenges for species distribution modelling
Authors: Araújo Miguel B. , Guisan Antoine
Published: August 2006

Species distribution modelling is central to both fundamental and applied research in biogeography. Despite widespread use of models, there are still important conceptual ambiguities as well as biotic and algorithmic uncertainties that need to be investigated in order to increase confidence in model results. We identify and discuss five areas of enquiry that are of high importance for species distribution modelling: (1) clarification of the niche concept; (2) improved designs for sampling data for building models; (3) improved parameterization; (4) improved model selection and predictor contribution; and (5) improved model evaluation. The challenges discussed in this essay do not preclude the need for developments of other areas of research in this field. However, they are critical for allowing the science of species distribution modelling to move forward.
Satisfied patients are also vulnerable patients – narratives from an acute care ward
Authors: Sørlie Venke , Torjuul Kirsti , Ross Anita , Kihlgren Mona
Published: August 2006

Aim. To illuminate the experience of being a patient and cared for in an acute care ward.

Background. Patients may be the best source of information for assessing the quality of care in acute care wards. Studies often show that patients’ satisfaction with their hospital stay is interpreted by managers and care providers as a measure for quality of care.

Design. Ten patients were interviewed as part of a comprehensive investigation by four researchers into the narratives of five enrolled nurses (study No. 1 – published inNursing Ethics2004), five Registered Nurses (study No. 2 published inNursing Ethics2005) and 10 patients (study No. 3) about their experiences from an acute care ward at one university hospital in Sweden.

Method. A phenomenological hermeneutical method (inspired by the French philosopher Paul Ricoeur) was conducted in all three studies.

Findings. The patients are very satisfied with their treatment and care. They also tell about factors that they do not consider as optimal, but which they explain as compromises, which must be accepted as a necessary part of their stay in the ward. This study demonstrates a close connection between patient satisfaction and vulnerability.

Conclusions. It is important for all health care providers not to be complacent and satisfied when patients express their satisfaction with their treatment and care. This can result in losing the focus on the patients’ vulnerability and existential thoughts and reflections which are difficult for them, and which need to be addressed.

Relevance to clinical practice. The findings can be seen as a challenge for the health care providers as well as the organization to provide quality of care to patients in acute care ward. When listening to the patients’ voice it makes it easier to be aware of the content of their vulnerability.
The patient's vulnerability, dependence and exposed situation in the discharge process: experiences of district nurses, geriatric nurses and social workers
Authors: Rydeman IngBritt , Törnkvist Lena
Published: August 2006

Aim.  The aim of the study was to obtain a deeper understanding of the experiences of the discharge process among different professionals.

Background.  An optimal discharge process for hospitalized elderly to other forms of care is of crucial importance, especially since health and medical policies encourages shorter hospital stays and increased healthcare service in outpatient care.

Methods.  Nurses and social workers from inpatient care, outpatient care, municipal care and social services were interviewed. Eight focus‐group interviews with a total of 31 persons were conducted. The subsequent analyses followed a phenomenological approach.

Results.  The findings revealed three themes, Framework, Basic Values and Patient Resources, which influenced the professionals’ actions in the discharge process. The overall emerging structure comprised the patient's vulnerability, dependence and exposed situation in the discharge process.

Conclusion.  In conclusion some factors are of special importance for the co‐operation and the actions of professionals involved in the discharge process. Firstly, a distinct and common framework, with conscious and organizationally based values. Secondly the need to take the patient resources into consideration. Together these factors could contribute to secure the patients involvement in the discharge process and to design an optimal, safe and good care.

Relevance to clinical practice:  Collaborative approaches among a range of professionals within a variety of organizations are common, especially in the care of the elderly. The role and support of both the organizations and the educational units are decisive factors in this area.
Experiences of African nurses in the UK National Health Service: a literature review
Authors: Likupe Gloria
Published: August 2006

Aim.  This review aims to highlight the experiences of black African nurses in the United Kingdom.

Background.  There is an acute shortage of trained nurses in the United Kingdom, which has occurred because of several factors including ageing of the nurse population and increasing demand due to an ageing population as well as under investment in nurse education during the 1980s. Government initiatives have included recruiting nurses trained overseas to meet present and future demands. Among these internationally recruited nurses, a large number came from Africa, but little is known about the experience of nurses once they are in the United Kingdom. Although it is known that ethnic minority nurses suffer discrimination in the National Health Service, experiences of internationally recruited nurses and nurses from African countries, in particular, merit attention as their nursing practices and culture in general are different from those of developed countries.

Methods.  A literature search was conducted using CINAHL, Medline and Cochrane databases by using the following terms in various combinations: Experiences, African nurses, international nurses, ethnic minorities, discrimination, equal opportunities, United Kingdom and NHS.

Conclusions.  There is very little research into the experiences of African nurses in the United Kingdom. Research has concentrated on the experience of internationally recruited nurses and ethnic minority nurses in general. There is agreement that most foreign nurses have a negative experience of working in the United Kingdom. Nurses face discrimination in pay and conditions of service and most are exploited by managers. There are also ethical questions surrounding the recruitment of nurses form developing countries and their treatment once they come to the United Kingdom.

Relevance to clinical practice.  As the nursing workforce in the United Kingdom becomes increasingly diverse through international recruitment, it is important to have knowledge of experiences of different groups of nurses. This helps to devise adaptation programs for smooth transition tailored to particular groups and training that will help United Kingdom nurses to work in harmony with their foreign colleagues.
Effectiveness of sleep management strategies for residents of aged care facilities: findings of a systematic review
Authors: Koch Susan , Haesler Emily , Tiziani Adriana , Wilson Jacinda
Published: August 2006

Aims and objectives.  The objectives of this systematic review were to determine the most effective tools for the assessment and diagnosis of sleep problems, as well as identify the most effective strategies for the promotion of sleep within this population.

Background.  Experiencing reduced sleep quality is often associated with normal ageing, however this may be exacerbated for residents of aged care facilities. External factors such as noise, light and night‐time nursing may impact negatively upon sleeping patterns.

Methods.  Eleven electronic databases and the reference lists and bibliographies of included studies were searched. Papers were grouped according to type of intervention or assessment tool and presented in a narrative summary.

Conclusions.  The review identified many interventions to promote sleep. Multidisciplinary strategies such as combining a reduction in environmental noise, reduction of night‐time nursing care and promotion of daytime activity, are likely to be most effective for promoting sleep in the population of interest. The use of sedating medications is cautioned, as their long‐term efficacy in promoting sleep is questionable. Wrist actigraphy was found to be the most accurate objective sleep assessment tool.

Relevance to clinical practice.  Lack of sleep, disturbed sleep and the overuse of medications especially sedations reduce the quality of life for older people. Effective, safe sleep interventions should be promoted and practised by nurses.
Student nurses’ experiences of caring for infectious patients in source isolation. A hermeneutic phenomenological study
Authors: Cassidy Irene
Published: August 2006

Aim.  To illuminate issues central to general student nurses’ experiences of caring for isolated patients within the hospital environment, which may assist facilitators of learning to prepare students for caring roles.

Background.  Because of the development of hospital‐resistant micro‐organisms, caring for patients in source isolation is a frequent occurrence for supernumerary students on the general nursing programme. Despite this, students’ perceptions of caring for this client group remain under researched.

Design and methods.  Through methods grounded in hermeneutic phenomenology, eight students in the second year of the three‐year undergraduate programme in general nursing were interviewed using an un‐structured, open‐ended and face‐to‐face interview approach. Data analysis was approached through thematic analysis.

Results.  Four themes emerged: The organization: caring in context, Barriers and breaking the barriers, Theory and practice, Only a student. The imposed physical, psychological, social and emotional barriers of isolation dramatically alter the caring experience. Balancing the care of isolated patients to meet their individual needs while preventing the spread of infection has significance for students. Applying infection control theory to the care of patients in source isolation is vital for students’ personal and professional development. Perceptions of supernumerary status influence students’ experiences of caring for these patients.

Relevance to clinical practice.  Designating equipment for the sole use of isolated patients assists students in maintaining infection control standards. Balancing the art and science of caring for patients in source isolation is important to reduce barriers to the student–patient relationship and to promote delivery of holistic care. Staff nurses should consider using available opportunities to impart recommended isolation practices to students thereby linking the theory of infection control to patient care. Providing structured, continuing education for all grades of staff would acknowledge the interdependence of all healthcare workers in controlling hospital‐acquired infection.
Negotiation of parental roles within family‐centred care: a review of the research
Authors: Corlett Jo , Twycross Alison
Published: August 2006

Aims and objectives.  To review research published in the past 15 years about how children's nurses’ negotiate with parents in relation to family‐centred care.

Background.  Family‐centred care is a basic tenet of children's nursing and requires a process of negotiation between health professionals and the family, which results in shared decision‐making about what the child's care will be and who will provide this. The literature highlights inconsistencies in the degree to which nurses are willing to negotiate with parents and allow them to participate in decisions regarding care of their child. There is need to explore further the extent to which nurses communicate and negotiate shared care with children and their parents.

Conclusions.  Three themes emerged from this review of the literature relating to whether role negotiation occurred in practice, parental expectations of participation in their child's care and issues relating to power and control. Parents wanted to be involved in their child's care but found that nurses’ lack of communication and limited negotiation meant that this did not always occur. Nurses appeared to have clear ideas about what nursing care parents could be involved with and did not routinely negotiate with parents in this context.

Relevance to clinical practice.  For family‐centred care to be a reality nurses need to negotiate and communicate with children and their families effectively. Parents need to be able to negotiate with health staff what this participation will involve and to negotiate new roles for themselves in sharing care of their sick child. Parents should be involved in the decision‐making process. However, research suggests that a lack of effective communication, professional expectations and issues of power and control often inhibit open and mutual negotiation between families and nurses.
The health beliefs of hospital staff and the reporting of needlestick injury
Authors: Tabak Nili , Shiaabana Amal Musaa , ShaSha Shaul
Published: August 2006

Aim.  The aim of this study is to examine the connection between the health beliefs of hospital staff (doctors, nurses and auxiliary staff) and their failure to report needlestick injuries.

Background.  Needlestick injury to hospital staff is quite frequent and can result in infections and disease, but staff frequently do not report the injury despite their awareness of the risk of blood‐borne pathogens.

Methods.  Five questionnaires were constructed based on three existing research tools and were tested for validity and reliability. Two hundred and forty questionnaires were distributed to eight randomly chosen departments of a single Israeli hospital. Seventy‐six percent of the questionnaires were anonymously completed and returned.

Results.  Nurses had the highest rate of needlestick injury, followed by auxiliary staff and doctors. Auxiliary staff showed the highest rate of compliance with the duty to report such injuries, while doctors showed the lowest. Perceived severity of contractable disease, the perceived efficacy of reporting injuries and overall motivation to maintain health were the best predictors of reporting compliance. Non‐compliers emphasized the negative aspects of reporting the injuries, primarily that it took up too much time.

Conclusions.  The solution to non‐compliance with the duty to report must be a targeted investment in training and education.

Relevance to clinical practice.  Finding the reasons for compliance and non‐compliance with the duty to report needlestick injuries will help in designing educational programmes for hospital staff and in determining a strategy for improving health behaviour.
Family centred care: a review of qualitative studies
Authors: Shields Linda , Pratt Jan , Hunter Judith
Published: August 2006

Aim.  To review systematically qualitative studies, which were found during a literature search for a Cochrane systematic review of the use of family centred care in children's hospitals.

Background.  Family centred care has become a cornerstone of paediatric practice, however, its effectiveness is not known. No single definition exists, rather a list of elements that constitute family centred care. However, it is recognized to involve the parents in care planning for a child in health services. A new definition is presented here.

Methods.  The papers were found in wide range of databases, by hand searching and by contacting the authors where necessary, using terms given in detail in the protocol in the Cochrane Library, in 2004. Qualitative studies could not be used for statistical analysis, but are still important to the review and so are described separately in this paper.

Results.  Negotiation between staff and families, perceptions held by both parents and staff roles influenced the delivery of family centred care. A sub‐theme of cost of family centred care to families and staffs was discovered and this included both financial and emotional costs.

Conclusion.  Further research is needed to generate evidence about family centred care in situations arising from modern models of care in which family centred care is thought to be an inherent part, but which leave families with the care of sick children with little or no support.

Relevance to clinical practice.  Family centred care is said to be used widely in practice. More research is needed to ensure that is it being implemented correctly.
How do children's nurses make clinical decisions? Two preliminary studies
Authors: Twycross Alison , Powls Lucy
Published: August 2006

Aims and objectives.  To gain an understanding of how children's nurses make clinical decisions.

Background.  Several studies have explored how nurses make clinical decisions and the factors that may affect the decision‐making strategies used. However, the results of these studies are contradictory. Further, little is known about children's nurses’ decision‐making strategies.

Design.  The think aloud technique.

Methods.  Nurses (n = 12) from three surgical wards and nurses (n = 15) from three medical wards in a Scottish children's hospital were presented with clinical scenarios and asked to think aloud. The verbal protocols were analysed to provide an indication of how children's nurses made decisions. Whether there were any differences in decision‐making between experienced and less experienced nurses and between graduates and non‐graduates was also explored.

Results.  Analysis of verbal protocols obtained using the think aloud technique suggested that all the nurses in the sample used a hypothetico‐deductive (analytical) model of decision‐making. Further, all participants appeared to use backward reasoning strategies regardless of their level of expertise. This is a characteristic of non‐expert decision‐making. Experienced and less experienced nurses collected similar additional information before planning nursing interventions, supporting the conjecture that they were functioning at a non‐expert level in relation to decision‐making. No differences were seen in the information collected by graduate and non‐graduate nurses.

Conclusions.  The decision‐making strategies of children's nurses need exploring further and further research is needed to identify factors that may affect decision‐making strategies. Several strategies to support nurses’ clinical decision‐making have been proposed but need testing to ascertain their effectiveness.

Relevance to clinical practice.  In clinical practice nurses make numerous decisions throughout the course of a shift. Sub‐optimal decision‐making strategies may adversely affect the quality of nursing care provided. It is imperative, therefore, to ascertain how nurses make clinical decisions and the factors that may influence the decision‐making strategies used.
The culture of a trauma team in relation to human factors
Authors: Cole Elaine , Crichton Nicola
Published: August 2006

Aim.  The aim of this ethnographic study was to explore the culture of a trauma team in relation to human factors.

Background.  Traumatic injury is the leading cause of death in the first four decades of life in the western world. Evidence suggests that the initial assessment and resuscitation of trauma victims is most successfully carried out by an organized trauma team. Most trauma teams use Advanced Trauma Life Support principles which focus on rapid assessment and management of the patient's injuries. Similarly, most trauma education focuses on Advanced Trauma Life Support principles, concentrating firmly on the patient's physical status. Nevertheless, contemporary literature about emergency teams suggests that human factors, such as communication and interprofessional relationships, can affect the team's performance regardless of how clinically skilled the team members are.

Method.  Focused ethnography was used to explore the culture of a trauma team in one teaching hospital. Six periods of observation were undertaken followed by 11 semi‐structured interviews with purposively chosen key personnel. Data from transcripts of the observation field notes and interviews were analysed using open coding, followed by formation of categories resulting in the emergence of six central categories.

Results.  Findings suggest that leadership, role competence, conflict, communication, the environment and the status of the patient all influence the culture of the trauma team. Interpretation of these categories suggests that trauma team education should include human factor considerations such as leadership skills, team management, interprofessional teamwork, conflict resolution and communication strategies.

Relevance for clinical practice.  The findings suggest that support systems for role development of junior team leaders should be formalized. The proven airline industry techniques of Crew Resource Management, focusing on teamwork and effective communication, could be implemented into continuing professional development for trauma teams to engender collaboration and interprofessional practice.
The dispersal characteristics of the invasive plant Mimulus guttatus and the ecological significance of increased occurrence of high‐flow events
Authors: TRUSCOTT A‐M. , SOULSBY C. , PALMER S. C. F. , NEWELL L. , HULME P. E.
Published: August 2006

Increased occurrence of high‐flow events as a result of climate change may affect the dispersal success of an invasive plant species Mimulus guttatus and may result in range expansion. Predicted changes in climate point to a continuation of the recent observed trends in increased precipitation and high‐flow events in Northern Europe.

The study focused on the dispersal characteristics of M. guttatus, and especially the roles of vegetative fragmentation with increasing water velocities, subsequent fragment survival, regeneration and colonization, as well as the buoyancy, survival and germination success of seeds.

M. guttatus was found to fragment readily under velocities typical of high flow conditions and even small fragments had high survival, regeneration and colonization capacity.

Large numbers of small (< 0.02 mg) seeds are produced; however, seeds have a short buoyancy period so the timing and magnitude of high‐flow events is crucial in determining potential dispersal distances. Seeds germinate readily both in water and on sand with an average 33% germination within 9 days.

The dual strategy of dispersal by vegetative fragments and seeds, together with the opportunity of dispersing the two types of propagules during different periods of the year, facilitates local dominance by M. guttatus as well as long‐distance colonization. As a result, the rate of spread of M. guttatus into inundation communities along rivers is likely to increase with more frequent high‐flow events, especially if these coincide with the growing season. Thus, predicting the response of riparian invasive species to environmental change requires not only an understanding of the role of climate in plant demography but also the impact of changes in hydrology on rates of spread.
An unexpected recent ancestor of unisexual Ambystoma
Authors: ROBERTSON ALEXANDER V. , RAMSDEN CADHLA , NIEDZWIECKI JOHN , FU JINZHONG , BOGART JAMES P.
Published: August 2006

Previous research has shown that members of the unisexual hybrid complex of the genus Ambystoma possess a mitochondrial genome that is unrelated to their nuclear parental species, but the origin of this mitochondrion has remained unclear. We used a 744‐bp fragment of the mitochondrial gene cytochrome b within a comparative phylogenetic framework to infer the maternal ancestor of this unisexual lineage. By examining a broader range of species than has previously been compared, we were able to uncover a recent maternal ancestor to this complex. Unexpectedly, Ambystoma barbouri, a species whose nuclear DNA has not been identified in the unisexuals, was found to be the recent maternal ancestor of the individuals examined through the discovery of a shared mtDNA haplotype between the unisexuals and A. barbouri. Based on a combination of sequence data and glacial patterning, we estimate that the unisexual lineage probably originated less than 25 000 years ago. In addition, all unisexuals examined showed extremely similar mtDNA sequences and the resultant phylogeny was consistent with a single origin for this lineage. These results confirm previous suggestions that the unisexual Ambystoma complex was formed from a hybridization event in which the nuclear DNA of the original maternal species was subsequently lost.
Worldwide phylogeography of the blacktip shark (Carcharhinus limbatus) inferred from mitochondrial DNA reveals isolation of western Atlantic populations coupled with recent Pacific dispersal
Authors: KEENEY D. B. , HEIST E. J.
Published: August 2006

Although many coastal shark species have widespread distributions, the genetic relatedness of worldwide populations has been examined for few species. The blacktip shark, (Carcharhinus limbatus), inhabits tropical and subtropical coastal waters throughout the world. In this study, we examined the genetic relationships of blacktip shark populations (n = 364 sharks) throughout the majority of the species’ range using the entire mitochondrial control region (1067–1070 nucleotides). Two geographically distinct maternal lineages (western Atlantic, Gulf of Mexico, and Caribbean Sea clades, and eastern Atlantic, Indian, and Pacific Ocean clades) were identified and shallow population structure was detected throughout their geographic ranges. These findings indicate that a major population subdivision exists across the Atlantic Ocean, but not the Pacific Ocean. The historical dispersal of this widespread, coastal species may have been interrupted by the rise of the Isthmus of Panama. This scenario implies historical dispersal across the Pacific Ocean (supported by the recovery of the same common haplotype from the Philippines, Hawaii, and the Gulf of California reflecting recent/contemporary dispersal abilities) and an oceanic barrier to recent migration across the Atlantic. Genetic structure within the eastern Atlantic/Indo‐Pacific (ΦST = 0.612, P < 0.001) supports maternal philopatry throughout this area, expanding previous western Atlantic findings. Eastern Atlantic/Indo‐Pacific C. limbatus control region haplotypes were paraphyletic to Carcharhinus tilstoni haplotypes in our maximum‐parsimony analysis. The greater divergence of western Atlantic C. limbatus than C. tilstoni from eastern Atlantic/Indo‐Pacific C. limbatus reflects the taxonomic uncertainty of western Atlantic C. limbatus.
Blind population genetics survey of tropical rainforest trees
Authors: DUMINIL JÉRÔME , CARON HENRI , SCOTTI IVAN , CAZAL SAINT‐OMER , PETIT RÉMY J.
Published: August 2006

Rainforest tree species can be difficult to identify outside of their period of reproduction. Vascular tissues from Carapa spp. individuals were collected during a short field trip in French Guiana and analysed in the laboratory with nuclear and chloroplast markers. Using a Bayesian approach, > 90% of the samples could be assigned to one of two distinct clusters corresponding to previously described species, making it possible to estimate the genetic structure of each species and to identify cases of introgression. We argue that this blind procedure represents a first‐choice rather than a fallback option whenever related taxa are investigated.
Ménage à trois on Macquarie Island: hybridization among three species of fur seal (Arctocephalusspp.) following historical population extinction
Authors: LANCASTER M. L. , GEMMELL N. J. , NEGRO S. , GOLDSWORTHY S. , SUNNUCKS P.
Published: August 2006

Human‐induced changes to natural systems can cause major disturbances to fundamental ecological and population processes and result in local extinctions and secondary contacts between formerly isolated species. Extensive fur seal harvesting during the nineteenth century on Macquarie Island (subantarctic) resulted in extinction of the original population. Recolonization by three species has been slow and complex, characterized by the establishment of breeding groups of Antarctic and subantarctic fur seals (Arctocephalus gazellaandArctocephalus tropicalis) and presumed nonbreeding (itinerant) male New Zealand fur seals (Arctocephalus forsteri). One thousand and seven pups from eight annual cohorts (1992–2003) were analysed using mitochondrial control region data (RFLP) and 10 microsatellite loci to estimate species composition and hybridization. Antarctic fur seals predominated, but hybridization occurred between all three species (17–30% of all pups). Involvement of New Zealand fur seals was unexpected as females are absent and males are not observed to hold territories during the breeding season. The proportion of hybrids in the population has fallen over time, apparently owing to substantial influxes of pure Antarctic and subantarctic individuals and non‐random mating. Over 50% of New Zealand hybrids and 43% of Antarctic‐subantarctic hybrids were not F1, which indicates some degree of hybrid reproductive success, and this may be underestimated: simulations showed that hybrids become virtually undetectable by the third generation of backcrossing. While human impacts seem to have driven novel hybridization in this population, the present ‘time slices’ analysis suggests some biological resistance to complete homogenization.
Analysis of spatial genetic structure in an expandingPinus halepensispopulation reveals development of fine‐scale genetic clustering over time
Authors: TROUPIN D. , NATHAN R. , VENDRAMIN G. G.
Published: August 2006

We analysed the change of spatial genetic structure (SGS) of reproductive individuals over time in an expandingPinus halepensispopulation. To our knowledge, this is the first empirical study to analyse the temporal component of SGS by following the dynamics of successive cohorts of the same population over time, rather than analysing different age cohorts at a single time. SGS is influenced by various factors including restricted gene dispersal, microenvironmental selection, mating patterns and the spatial pattern of reproductive individuals. Several factors that affect SGS are expected to vary over time and as adult density increases. Using air photo analysis, tree‐ring dating and molecular marker analysis we reconstructed the spread of reproductive individuals over 30 years beginning from five initial individuals. In the early stages, genotypes were distributed randomly in space. Over time and with increasing density, fine‐scale (< 20 m) SGS developed and the magnitude of genetic clustering increased. The SGS was strongly affected by the initial spatial distribution and genetic variation of the founding individuals. The development of SGS may be explained by fine‐scale environmental heterogeneity and possibly microenvironmental selection. Inbreeding and variation in reproductive success may have enhanced SGS magnitude over time.