bluuebunny/crossref_metadata_2025 huggingface dataset:
A functional comparison of the hyolingual complex in pygmy and dwarf sperm whales (Kogia breviceps and K. sima), and bottlenose dolphins (Tursiops truncatus)
Authors: Bloodworth Brian E. , Marshall Christopher D.
Published: June 2007

The function of the hyolingual complex in three odontocete species was investigated to compare adaptations of divergent feeding strategies, suction and ram feeding. Pygmy and dwarf sperm whales, members of the genus Kogia (or kogiids), are known to be strong suction feeders. We tested the hypotheses that kogiids would have a larger, more robust hyolingual complex, and that hyolingual muscles would have a greater maximum theoretical muscle tension compared with ram‐based feeders such as bottlenose dolphins (Tursiops truncatus). A robustness index and surface area was calculated for bony hyoid elements in kogiids and bottlenose dolphins. The anatomy, muscle architecture, pinnation, two‐dimensional angle of attachment and maximum theoretical muscle tension were measured in each hyolingual muscle. A functional model incorporating vector analyses of hyolingual musculature was created for kogiids and bottlenose dolphins to assess differences in function of their hyolingual complexes. Kogiid hyoid surface areas were significantly greater (P = 0.01) than in bottlenose dolphins. Most maximum theoretical muscle tensions of hyolingual complexes were not significantly different within or between species. The data suggest that associated orofacial and tongue morphology, particularly the relationship of hyoid shape and tongue retractor muscles, greatly influences suction capability in odontocetes. Kogiids demonstrated adaptations that occlude lateral gape, including a novel vertical ridge on each side of the mandible, and a shortened mandible that is capable of a large gape, and gape angle. These adaptations presumably assist in maintaining negative intraoral pressure generated by the depression and retraction of the relatively short and wide kogiid tongue. The tongues of kogiids should be capable of generating greater intraoral volume changes compared with the long, narrow tongue of bottlenose dolphins.
A Movement from Right to Left in Argentine Nationalism? The Alianza Libertadora Nacionalista and Tacuara as Stages of Militancy
Authors: GOEBEL MICHAEL
Published: June 2007

This article contributes to debates about fascist influences among Argentina’s guerrilla groups of the 1970s. From the overall perspective of developments in Argentine nationalism, it traces back the history of the far‐right Alianza Libertadora Nacionalista and Tacuara and assesses their significance as the nuclei from which later guerrillas came. Based on police reports and periodical publications from the period in question (c.1937–c.1973), it makes some generalisations about the collective biographies of militants. While not contradicting the widely held view that originally fascist groupings played a role in the emergence of Argentine guerrillas, the article introduces some nuances into this argument. Particular emphasis is given to the role of Peronism and the Cuban Revolution as facilitators of changes in Argentine nationalism.
Transnational lives, transnational marriages: a review of the evidence from migrant communities in Europe
Authors: BECK‐GERNSHEIM ELISABETH
Published: June 2007

Abstract
Whom do migrants marry? This question has become a popular topic of research, and existing studies identify a common trend: most of the non‐European, non‐Christian migrants in Europe marry someone from their country of origin. The motivations for such practices are to be found in the characteristics of transnational spaces and in the social structures that emerge in such spaces. Based on a review of research from several European countries, three such constellations are discussed: first, the obligations to kin, especially when migration regulations become more restrictive, and marriage becomes the last route by which to migrate to Europe. Second, new forms of global inequality, between the metropolitan centre and countries of the global periphery, give migrants in Europe improved status and standing in their society of origin and therefore excellent opportunities on the marriage market there. Third, gender relations have started to shift in both host society and migrant families. Men and women alike are trying to rebalance power relations within marriage and to shift them in their favour. In this process marriage to a partner from the country of family origin may promise strategic benefits. The article ends with suggestions for future research.
Cornish identities and migration: a multi‐scalar approach
Authors: DEACON BERNARD , SCHWARTZ SHARRON
Published: June 2007

Abstract
In this article we argue that theories of transnationalism have value in exploring the historical context of migration and that historical contexts help to shape such theoretical conceptualizations. Historians of migration have now begun to engage more directly with the literature of transnationalism, focusing on the networks that linked settler and home communities. Here we add to this by examining a nineteenth‐century migrant community from a British region through the lens of transnationalism, applying the concept to the case of the Cornish, whose economic specialization produced culturally distinct Cornish communities on the mining frontiers of North America, Australia and South Africa. In doing so, we bring together the issues of scale and time. We review the multiple levels of the Cornish transnational space of the late nineteenth century, which exhibited aspects of both core transnationalism and translocalism. This waned, but in the later twentieth century, a renewed interest in a transnational Cornish identity re‐emerged, articulating with changing identity claims in Cornwall itself. To capture better the experience of the Cornish over these two very different phases of transnationalism we identify another subset of transnationalism ‐ that of transregionalism.
A home far away? Religious identity and transnational relations in the Iranian diaspora
Authors: MCAULIFFE CAMERON
Published: June 2007

Abstract
In this article, I address the influence of religious identity on the discourses of national belonging that traditionally dominate transnational discussions. Many of the children of the Iranian diaspora live in a state of exile from contemporary theocratic Iran. Living at a temporal and physical distance from the homeland has resulted in differential long‐distance imaginings mediated by the diasporic context. Through the reflections of the children of Iranian migrants on the desire to ‘return’, a picture is painted of differing transnational trajectories divided along religious lines within the Iranian diaspora. For many of the second generation from a Muslim background their centrality in the discourses of national belonging, typified through the conflated ‘Muslim Iranian’ of media representations, feeds a desire for return. In contrast, for many second‐generation Baha ‘is their positionality as a minority, in both the homeland and the diaspora, combines with an eschatological problematizing of national belonging, to lead them away from Iran. In this article I draw on discussions about email communication in the diaspora(s) carried out as a part of research with the Iranian communities of London, Sydney and Vancouver.
Meanings of being a female co‐worker to a person developing burnout
Authors: Ericson‐Lidman Eva , Norberg Astrid , Strandberg Gunilla
Published: June 2007

Burnout is dramatically increasing in many industrialised countries. Burnout is mainly studied from the perspective of the burnout person although it has been confirmed to affect co‐workers as well. This study aimed to illuminate meanings of being a female co‐worker to a person developing burnout. Fifteen interviews with nursing and medical staff were performed, tape‐recorded and transcribed verbatim and a phenomenological‐hermeneutic method was used to interpret the text. One meaning of being a female co‐worker is struggling, on the one hand to understand and help the person developing burnout and on the other hand to manage their work and survive oneself. This means to be torn between helping the workmate and managing their work. Co‐workers are filled with contradictory feelings, from deep concern to aversion and when the workmate finally goes on sick leave, co‐workers’ feelings of shortcomings and failure emerge, along with troubled conscience. This study reveals a picture of the difficulties of being a female co‐worker to a person developing burnout that it is crucial to be aware of.
Work satisfaction, career preferences and unpaid household work among recently graduated health‐care professionals – a gender perspective
Authors: Enberg Birgit , Stenlund Hans , Sundelin Gunnevi , Öhman Ann
Published: June 2007

Aim:  This study investigated perceptions of recently graduated health‐care professionals towards healthcare work, preferences for future careers, work organisation and management. In addition, it scrutinised the impact of unpaid household work on work satisfaction using a gender theoretical analysis.

Method:  A questionnaire was distributed to 1035 nurses, occupational therapists and physiotherapists who graduated in the semester of spring 1999 in Sweden. The response rate was 81% and the respondents represent 3338 graduates. When estimating proportions and means, sampling weights reflecting the sampling design were used.

Results:  Among both men and women, there was a high satisfaction with work in general, but a great dissatisfaction with work management and organisation. Multiple logistic regression analyses revealed a significant association between dissatisfaction with the work organisation and age groups and type of employment among the women. Younger women were more dissatisfied than older, and public employees were more dissatisfied than private employees. The women in the study did more unpaid household work than the men did. The data suggest that this can be of importance for the dissatisfaction at work, although this was not statistically significant. Working conditions and career preferences differ between the three professions as well as among men and women in the same profession. Geriatrics was not a preferred area for future work, although it is an area with predicted increasing personnel needs in the future. The results are discussed in relation to future needs for health‐care personnel, gender and organisation theory.

Conclusions:  Because of the predicted scarcity of health‐care personnel in Sweden, it is of importance that healthcare organisations address the issues of work satisfaction as well as possible competence drain. Gender equality in terms of working conditions is another important aspect that needs to be highlighted.
Psychometric properties of the Swedish version of the Resilience Scale
Authors: Lundman Berit , Strandberg Gunilla , Eisemann Martin , Gustafson Yngve , Brulin Christine
Published: June 2007

The aim of this study was to investigate resilience in relation to age and gender, and to elucidate the underlying structure of the Swedish version of the Resilience Scale (RS). The RS, originally created by Wagnild and Young is a 25 items scale of Lickert type with possible scores ranges from 25 to 175, the higher the score, the stronger resilience. A standardized procedure was used for translation. The analysis was based on 1719 participants, 1248 women and 471 men, from eight different samples, aged from 19 to 103 years. We found that the participants estimated their resilience as relatively high. There was a significant relationship between age and resilience, for every year RS score increased with 0.134 units. There was no relation between gender and resilience. From a factor analyses five factors emerged, equanimity, meaningfulness, perseverance, existential aloneness and self‐reliance reflecting the five dimensions described by Wagnild and Young.

We concluded that the resilience is related to age, the older, the stronger resilience. Five underlying dimensions was identified, which can be seen as reflection of the theoretical assumptions behind the RS scale. The RS scale seems applicable to a Swedish population.
Psychometric properties of the Swedish Diabetes Empowerment Scale
Authors: Leksell Janeth , Funnell Martha , Sandberg Gun , Smide Bibbi , Wiklund Gunnel , Wikblad Karin
Published: June 2007

Objective:  This study was conducted to determine the psychometric properties of the Swedish version of the Diabetes Empowerment Scale (Swe‐DES‐23).

Research design and methods:  A convenience sample of 195 patients with type 1 and type 2 diabetes completed the Swe‐DES‐23 questionnaire. To establish discriminant validity, Swe‐DES subscales were compared with the Semantic Differential in Diabetes scale (SDD) and a general health scale (EVGFP). Construct validity was tested using factor analyses. To determine unidimensionality of the subscales, inter‐item correlations were calculated. Internal consistency was tested by the use of the Crohnbach‐α coefficient.

Results:  The factor analysis resulted in four factors (empowerment subscales) with eigenvalues >1.0, explaining 60% of the variance. The four empowerment subscales: goal achievement, self‐awareness, stress management and readiness to change showed Crohnbach‐α values ranging from 0.68 to 0.91. Patients with good self‐reported health and low burden of diabetes scored significantly higher on almost all empowerment subscales. Only weak correlations were found between metabolic control and the empowerment subscales.

Conclusions:  The SWE‐DES‐23 scale had acceptable validity and reliability and, thus, could be a suitable tool in evaluating empowerment‐based education programmes. Further testing is needed to shorten the questionnaire.
A patient‐oriented perspective in existential issues: a theoretical argument for applying Peplau's interpersonal relation model in healthcare science and practice
Authors: Nyström Maria
Published: June 2007

Since Hildegard Peplau's interpersonal relation model for psychodynamic nursing, in the 1950s, many theories about humanity have been expanded in the discipline of nursing. For this purpose Rosemarie Rizzo Parse, for example, synthesized principles and concepts from Martha Rogers with existential phenomenology, when she introduced the idea of a simultaneity paradigm as unique for the discipline of nursing in opposition to Peplau's psychodynamic model. The aim of this paper is to discuss borrowed theories in relation to the efforts to find a unique theoretical foundation for healthcare science and practice. It is suggested that Parse's division in a totality vs. a simultaneity paradigm is an artificial distinction. The discussion is concluded with reflections about Peplau's interpersonal relation model, a patient‐oriented perspective and psychodynamic theory, as example of a theory, which may help to further understand patients’ existential situation.
Thirty‐eight single nucleotide polymorphism markers for high‐throughput genotyping of chum salmon
Authors: ELFSTROM CARITA M. , SMITH CHRISTIAN T. , SEEB LISA W.
Published: June 2007

We characterize 38 single nucleotide polymorphism genotyping assays for chum salmon (Oncorhynchus keta), an important species for both commercial and subsistence fisheries in western Alaska. These assays are based on the 5′‐nuclease reaction and thus facilitate high‐throughput genotyping with minimal optimization time. Minor allele frequency differences (Δq) among collections were between 0.01 and 0.50 resulting in per locus FST estimates of 0.00–0.08 with an average of 0.03.
Microsatellite markers for the invasive plant species white sweetclover (Melilotus alba) and yellow sweetclover (Melilotus officinalis)
Authors: WINTON L. M. , KROHN A. L. , CONN J. S
Published: June 2007

We describe specific primers that amplify nine microsatellite DNA loci from Melilotus alba and Melilotus officinalis, both invasive plant species (Fabaceae) throughout North America. Allelic diversity was slightly lower for M. alba than for M. officinalis, as was expected heterozygosity. For both species, heterozygote deficit was observed at several loci. Genotypic diversity was very high for both species; the 29 plant samples of each species all had different multilocus genotypes. These markers will be used to determine the origins of the sweetclover invasion in Alaska and to compare patterns of diversity between subarctic and lower latitude populations.
Development of EST‐SSRs in the Mediterranean blue mussel, Mytilus galloproviancialis
Authors: YU HONG , LI QI
Published: June 2007

Eight polymorphic microsatellite repeat markers were identified from Mytilus galloproviancialis, expressed sequence tags (EST) deposited in public sequence database. Number of alleles per locus ranged from two to 10, and the observed and expected heterozygosities ranged from 0.029 to 0.872 and from 0.031 to 0.811, respectively. Three additional Mytiloida species assessed for cross‐species amplification revealed four loci could give positive amplifications. EST‐derived simple sequence repeats provide robust, informative and potentially transferable polymorphic markers suitable for population genetic, parentage, and mapping studies of M. galloproviancialis.
Changes in the management of British forests between 1945 and 2000 and possible future trends
Authors: MASON W. L.
Published: June 2007

The last half‐century has been an era of historically unprecedented expansion in British forests, which now cover over 12% of the land surface. In the immediate post‐War period, the forest composition was evenly divided between conifers and broadleaves. However, several decades of extensive afforestation in parts of the uplands have resulted in conifers comprising over 60% of the forest area and Sitka Spruce Picea sitchensis becoming the commonest species in British forests. Towards the end of the last century, forestry policies began to give prominence to sustainable forest management so that greater emphasis is now being given to aspects such as the restoration and enhancement of native woodlands and the diversification of plantation forests. Because of their age structure, at least 70% of both conifer and broadleaved high forest stands are now entering a closed‐canopy stage where the trees compete with each other for light, moisture and nutrients. This is different from the situation in the late 1940s when the appreciable area of young stands in both new woodlands or felled areas would have provided a more open woodland habitat. The prevailing silvicultural system used for many years in all high forest types has been ‘patch clear felling’ but this can be detrimental to visual amenity and cause a sudden change in forest microclimate. There is now increasing interest in the use of continuous cover forestry, which seeks to promote irregular stand structures with intimate species mixtures as a means of avoiding some of the negative impacts of clear felling. Timber production in British forests is increasingly concentrated in the conifer forests and the amount of broadleaved timber harvested has declined sharply in recent years. This decline is another consequence of the lack of active broadleaved management that has been reported in recent ecological surveys. The possible advent of a new woodfuel market may be an opportunity to renew the viability of under‐managed woodlands. The next decades are likely to see a greater range of silvicultural systems being practised in British woodlands and the development of more mixed woodland, which may also ensure greater resilience against climate change. Amongst the challenges for the future are the need to obtain a better understanding of the interactions between stand management, resulting forest habitat and the impacts on biodiversity so that foresters and other stakeholders can better predict the outcome from different silvicultural regimes.
Factors affecting the survival of founding individuals in translocated New Zealand Saddlebacks Philesturnus carunculatus
Authors: TAYLOR SABRINA S. , JAMIESON IAN G.
Published: June 2007

Successful founders of new populations may represent a non‐random sample of potential founding individuals. Using a recent Saddleback Philesturnus carunculatus translocation as a natural experiment, we related morphology, parasite load and genetic variation of translocated individuals to subsequent survivorship to assess the traits of successful founders. We also included capture location and holding time in our models to account for variables particular to translocations. Generalized linear model results suggest that, in addition to capture location, poor body condition (males) and the presence of ectoparasites (females) significantly reduced survivorship. Despite recent claims in the literature, we found no evidence that genetic variation was associated with survivorship or parasite load.
Interactive effects of food and age on breeding in the Montagu's Harrier Circus pygargus
Authors: ARROYO BEATRIZ E. , BRETAGNOLLE VINCENT , LEROUX ALAIN
Published: June 2007

We evaluated the direct and interactive effects of food and age on reproduction in the Montagu's Harrier Circus pygargus, to test whether variation in food supply was likely to affect age‐specific breeding probability or success. Younger females were more frequently non‐breeders than older females. When breeding, older females laid earlier, produced larger clutches, failed less often and had higher number of fledglings than younger females. Probability of breeding was higher, laying was earlier, and clutch size and number of fledglings per pair increased with increasing food abundance. A significant interaction between food and age was observed in both breeding probability and breeding performance: older females were more likely to breed than younger females when food abundance was low, and younger females performed less well in good food conditions than older females. Overall, differences between age groups were most marked in extreme food conditions, regardless of the quality of the conditions.
Experimental and Numerical Investigation of Mechanical and Thermal Residual Strains in Adhesively Bonded Joints
Authors: Jumbo F. , Ruiz P. D. , Yu Y. , Swallowe G. M. , Ashcroft I. A. , Huntley J. M.
Published: June 2007

Abstract:  This paper describes an investigation of residual and mechanical strains in aluminium/aluminium (Al/Al) and aluminium/carbon fibre‐reinforced polymer (Al/CFRP) adhesively bonded double‐lap joints. Residual strains were measured inside the adherends by means of neutron diffraction (ND) and modelled using finite element analysis (FEA). In the Al/Al joints the measured residual strains were negligible, showing good agreement with FE predicted results. However, considerable strains developed in the Al/CFRP joint because of differential thermal contraction of the two materials during joint manufacture. Although considerable scatter was seen in the ND results, the measured and predicted trends showed similar behaviour and were of comparable magnitude. The paper also reports measurements of internal strains in an Al/CFRP joint under tensile load using ND and of surface strains using moiré interferometry (MI). In general, good agreement was observed between FE predictions, surface strains measured with MI and internal strains measured with ND for the loaded Al/CFRP joint.
An Experimental Study on Wrinkling Behaviours and Characteristics of Gossamer Space Structures
Authors: Wang C. , Du X. , Wan Z.
Published: June 2007

Abstract:  Ultra‐large and ultra‐lightweight gossamer space structures have received wide attention because of their small packaging volume and low cost. Wrinkle is the common deformation outcome and the main failure mode of such structures. The experimental test is essential for the wrinkling analysis, as contact test cannot be used to accurately determine wrinkling behaviour because of lightweight and flexibility. A novel non‐contact dot‐printing photogrammetry (DPP) based on the technology of the printed‐dot targets is presented to measure wrinkling characteristics. The characteristics of wrinkle development of gossamer space structures are obtained by incorporating the DPP method and a tension wrinkling (TW) test. Results reveal that wrinkle formation is the predominant form of bifurcation when the membrane is undergoing in‐plane displacement. Over‐contraction deformation is the special characteristic of the wrinkles, which reflects the degree of wrinkling and region in the wrinkled membrane. The development of wrinkling can be divided into five characteristic phases, and the occurrence of the wrinkles is followed by an abrupt jump variation. DPP measurement and TW test are the effective ways to obtain accurately the wrinkling behaviours and characteristics in small‐scale gossamer structures. Finite element results based on nonlinear post‐wrinkling analysis are used to validate the experimental test. The numerical predictions agree well with the experimental results.
Stress Intensity Factor Gauging by Digital Image Correlation: Application in Cyclic Fatigue
Authors: Hamam R. , Hild F. , Roux S.
Published: June 2007

Abstract: A fatigue crack in steel (CCT geometry) is studied via digital image correlation. The measurement of the stress intensity factor (SIF) change during one cycle is performed using a decomposition of the displacement field onto a tailored set of elastic fields. The same analysis is performed using two different routes, namely, the first one consists in computing the displacement field using a general correlation technique providing the displacement field projected onto finite element shape functions, and then analysing this displacement field in terms of the selected mechanically relevant fields. The second strategy, called integrated approach, directly estimates the amplitude of these elastic fields from the correlation of successive images. Both procedures give consistent results, and offer very good performances in the evaluation of the crack tip position (uncertainty of about 20 μm for a 14.5‐mm crack), SIFs (uncertainty <1 MPa) and opening properties.
Women's Preconceptional Health and Use of Health Services: Implications for Preconception Care
Authors: Hillemeier Marianne M. , Weisman Carol S. , Chase Gary A. , Dyer Anne‐Marie , Shaffer Michele L.
Published: June 2007

Objective. To improve understanding of women's use of health care before pregnancy, by analyzing how the health status and health risks of pre‐ and interconceptional women are associated with health services use.

Data Source. Data are from a cross‐sectional random‐digit dial telephone survey of a representative sample of 2002 women ages 18–45 years from the Central Pennsylvania Women's Health Study (CePAWHS). A subsample of 1,325 respondents with current reproductive capacity, classified by reproductive life stage (preconceptional or interconceptional), was analyzed.

Study Design. Bivariate and multiple logistic regression analyses were conducted to determine how health needs (including indices of health status and health risks related to adverse pregnancy outcomes) are associated with five indicators of health services use (receipt of a regular physical exam, obstetrician–gynecologist [ob/gyn] visit, receipt of a set of recommended screening services, receipt of health counseling services on general health topics, and receipt of pregnancy‐related counseling), controlling for predisposing and enabling variables.

Principal Findings. Only half of women at risk of pregnancy report receiving counseling about pregnancy planning in the past year. One‐third of women surveyed did not receive routine physical examinations and screening services, and over half received little or no health counseling. Multivariate analyses showed that all the measures of health needs except for negative health behavior were related to some type of health services use. Psychosocial stress was associated with having a recent ob/gyn visit, with receiving general health counseling, and with receiving pregnancy planning counseling. Cardiovascular risk was positively associated with receiving general health counseling and a regular physical exam, but negatively associated with seeing an ob/gyn. Positive health behaviors were associated with receiving screening services and with receiving general health counseling. Preconceptional reproductive life stage was positively associated with receiving a regular physical exam and negatively associated with having an ob/gyn visit.

Conclusions. Pre‐ and interconceptional women with specific health care needs may not receive appropriate health care before pregnancy. Improving pregnancy experiences and outcomes requires more comprehensive preconception health care and more preventive care before the first pregnancy.
Twin‐to‐twin transfusion syndrome: Is the future getting brighter?
Authors: WALKER Susan P. , COLE Stephen A. , EDWARDS Andrew G. ,   Victorian Fetal Therapy Service
Published: June 2007

The twin‐to‐twin transfusion syndrome (TTTS) continues to pose a major challenge in the area of fetal therapy. Untreated, the mortality and morbidity are extremely high, and the fact that there are two structurally normal fetuses at risk makes the case for effective in utero therapy even more compelling. Advances in therapeutic procedures, in particular the development of selective laser photocoagulation of intertwin vascular anastomoses, have improved outcomes, both in terms of survival and survival free of disability. This review examines the pathophysiology, diagnosis, surveillance, contemporary therapies, expected outcomes and ongoing challenges in TTTS.
Getting an evidence‐based post‐partum haemorrhage policy into practice
Authors: CAMERON Carolyn A. , ROBERTS Christine L. , BELL Jane , FISCHER Wendy
Published: June 2007

Background:  Post‐partum haemorrhage (PPH) is a potentially life‐threatening complication of childbirth occurring in up to 10% of births. The NSW Department of Health (DoH) issued a new evidence‐based policy (Framework for Prevention, Early Recognition and Management of Post‐partum Haemorrhage) in November 2002. Feedback from maternity units indicated that there were deficiencies in the skills and experience is needed to develop the written protocols and local plans of action required by the Framework.

Methods:  All 96 hospitals in NSW that provide care for childbirth were surveyed. A senior midwife completed a semistructured telephone interview.

Results:  Ninety four per cent of hospitals had PPH policies. Among hospitals that provided a copy of their policy, 83% were dated after the release of the DoH's Framework, but 22% contained an incorrect definition of PPH. Only 71% of respondents in small rural and urban district hospitals recalled receiving a copy of the Framework. There was considerable variation in the frequency of postnatal observations. Key factors that impede local policy development were resources, entrenched practices and centralised policy development. Enabling factors were effective relationships, the DoH policy directive (Framework), education and organisational issues/time.

Conclusions:  Greater assistance is needed to ensure that hospitals have the capacity to develop a policy applicable to local needs. Maternity hospitals throughout the state provide different levels of care and NSW DoH policy directives should not be ‘one size fits all’ documents. Earlier recognition of PPH may be facilitated by routine post‐partum monitoring of all women and should be consistent throughout the state, regardless of hospital level.
Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: The role of risk factors and threshold value for the 50‐g glucose challenge test
Authors: TAN Peng Chiong , LING Liza Ping , OMAR Siti Zawiah
Published: June 2007

Background:  The best method of screening for gestational diabetes (GDM) remains unsettled. The 50‐g glucose challenge test (GCT) is used in a two‐stage screening process but its best threshold value can vary according to population.

Aims:  To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one‐hour venous plasma glucose with the GCT.

Method:  In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT ≥ 7.2 mmol/L underwent the 75‐g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria.

Result:  Thirty‐five per cent had GCT ≥ 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was ≥ 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT ≥ 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM.

Conclusions:  Risk factors were not independent predictors of GDM in women with GCT ≥ 7.2 mmol/L. GCT threshold value ≥ 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.
The ADIPS pilot National Diabetes in Pregnancy Audit Project
Authors: SIMMONS David , CHEUNG N. Wah , McINTYRE H. David , FLACK Jeff R. , LAGSTROM Janet , BOND Dianne , JOHNSON Elizabeth , WOLMARANS Louise , WEIN Peter , SINHA Ashim K. ,   ADIPS National Diabetes in Pregnancy Audit Project Team
Published: June 2007

Background:  Limited resources are available to compare outcomes of pregnancies complicated by diabetes across different centres.

Aims:  To compare the use of paper, stand alone and networked electronic processes for a sustainable, systematic international audit of diabetes in pregnancy care.

Methods:  Development of diabetes in pregnancy minimum dataset using nominal group technique, email user survey of difficulties with audit tools and collation of audit data from nine pilot sites across Australia and New Zealand.

Results:  Seventy‐nine defined data items were collected: 33 were for all women, nine for those with gestational diabetes (GDM) and 37 for women with pregestational diabetes. After the pilot, four new fields were requested and 18 fields had queries regarding utility or definition. A range of obstacles hampered the implementation of the audit including Medical Records Committee processes, other medical/non‐medical staff not initially involved, temporary staff, multiple clinical records used by different parts of the health service, difficulty obtaining the postnatal test results and time constraints. Implementation of electronic audits in both the networked and the stand‐alone settings had additional problems relating to the need to nest within pre‐existing systems. Among the 496 women (45 type 1; 43 type 2; 399 GDM) across the nine centres, there were substantial differences in key quality and outcome indicators between sites.

Conclusions:  We conclude that an international, multicentre audit and benchmarking program is feasible and sustainable, but can be hampered by pre‐existing processes, particularly in the initial introduction of electronic methods.
Social influences for smoking in pregnancy in south western Sydney antenatal clinic attendees
Authors: MOHSIN Mohammed , FORERO Roberto , BERTHELSEN Angela , BAUMAN Adrian , JALALUDIN Bin , GYANESHWAR Rajanishwar
Published: June 2007

This study examined the needs of and barriers to smoking cessation of 677 women who attended antenatal clinics in south‐west Sydney. More than a quarter (26.3%) of the mothers reported smoking at their first antenatal visit. Smokers were more likely to be teenagers, single mothers and less likely to have formal education or employment. They were less aware of the potential health risks of smoking in pregnancy (SIP). High levels of SIP remain a public health problem, and effective interventions are needed.
Reduction in protein S activity during normal pregnancy
Authors: KURASAWA Gotaro , KOTANI Kazuhiko , ITO Yuji , SAIGA Kyoko , IIJIMA Kenji
Published: June 2007

We investigated the serial changes in blood protein S (PS) and related proteins in 11 normal pregnant women. The PS activity decreased significantly in the third trimester and reached minimum levels (23.3%) one hour after delivery. Although the PS activity was reduced markedly below the normal limits, all the women delivered safely. The mechanisms that cause the reduction in PS activity and the clinically dangerous conditions involving PS activity during pregnancy warrant further investigation.
A randomised trial of two regimens of vaginal misoprostol to manage termination of pregnancy of up to 16 weeks
Authors: KHAZARDOOST Soghra , HANTOUSHZADEH Sedigheh , MADANI Marjan Moezi
Published: June 2007

Objective:  The purpose of this study was to compare the efficacy and side‐effects of two regimens of vaginal misoprostol for pregnancy termination of up to 16 weeks.

Methods:  A randomised clinical trial of medical pregnancy termination of up to 16 weeks was conducted. A hundred pregnant women requesting legal termination of pregnancy were randomised into two groups to receive either 200 µg (50 women) or 400 µg (50 women) – vaginal misoprostol every six hours up to four doses. Outcome of abortion and side‐effects were assessed.

Results:  The groups were similar in maternal age, gestational age, parity and indication for pregnancy termination. There were no statistically significant differences between the two groups in abortion (P = 0.084) and mean induction to abortion time (P = 0.35). However, the side‐effects in the 400 µg group were significantly higher than in the 200 µg group (P = 0.000).

Conclusion:  In pregnancy termination of up to 16 weeks, 200 µg vaginal misoprostol every six hours up to four doses was as effective as 400 µg, but side‐effects were more common in 400 µg regimen.
Letrozole and desogestrel‐only contraceptive pill for the treatment of stage IV endometriosis
Authors: REMORGIDA Valentino , ABBAMONTE Luiza Helena , RAGNI Nicola , FULCHERI Ezio , FERRERO Simone
Published: June 2007

Background:  It has recently been suggested that aromatase inhibitors may effectively reduce pain symptoms related to the presence of endometriosis both in postmenopausal women and in subjects of reproductive age.

Aims:  This study aims to evaluate the effectiveness of a combination of letrozole and desogestrel in the treatment of pain symptoms related to the presence of endometriosis.

Methods:  This open‐label prospective study included 12 women with endometriosis‐related pain symptoms that were refractory to previous medical and surgical treatments. All women had previous laparoscopy documenting stage IV endometriosis. The treatment protocol included the daily oral administration of letrozole 2.5 mg (Femara®), desogestrel 75 µg (Cerazette®), elemental calcium 1000 mg and vitamin D 880 I.U. The scheduled treatment period was six months.

Results:  None of the women included in the study completed the six‐month treatment because all patients developed ovarian cysts; the median length of treatment was 84 days (range, 56–112). At interruption of treatment, all women reported significant improvements in dysmenorrhoea and dyspareunia. Pain symptoms quickly recurred at three‐month follow up. There were no severe adverse effects of treatment; no significant change in the mineral bone density was observed during treatment.

Conclusions:  The combination of letrozole and desogestrel induces a relief of pain symptoms in women with endometriosis but it causes the development of ovarian cysts. Pain symptoms quickly recur after the completion of treatment.
Simultaneous use of a levonorgestrel intrauterine system and an etonogestrel subdermal implant for debilitating adolescent endometriosis
Authors: AL‐JEFOUT Moamar , PALMER John , FRASER Ian S.
Published: June 2007

Adolescent familial endometriosis may cause severe and persistent symptoms that are disruptive to lifestyle. Treatment may be difficult in many cases. We describe the novel and successful first use of a simultaneous combination of a levonorgestrel intrauterine system and an etonogestrel subdermal implant in a teenager with severe pain symptoms as a result of laparoscopically confirmed endometriosis, which was refractory to other treatments.
Surveillance of HIV Exposure and Postexposure Prophylaxis Among Health Care Workers in Greece
Authors: Konte Vasileia , Nikolopoulos Georgios , Raftopoulos Vasilios , Pylli Magda , Tsiara Chrissa , Makri Efraxia , Paraskeva Dimitra
Published: June 2007

ABSTRACT
Objective: Many developed countries have implemented surveillance systems for monitoring occupational exposure to HIV. The aim of the present study was to analyze surveillance data on HIV postexposure prophylaxis (PEP) for health care workers (HCWs) in Greece.

Design: All data reported to the Hellenic Centre for Disease Control and Prevention between January 1996 and June 2005 were analyzed.

Sample and measurement: 188 reported occupational exposures to HIV were analyzed, retrospectively.

Results: Most exposures were in the physicians (37.8%), followed by the nursing personnel (18.6%). Nearly 38% of the HCWs were males and the predominant type of biological material involved in the exposure was blood (74.5%). Two drugs were used for PEP in 23.4% of the HCWs, and 3 drugs in 66.5% of the reported cases.

Conclusions: Greek guidelines provide guidance for treating HCWs after occupational exposure to HIV. In our study, antiretroviral treatment, a three‐drug regimen in the majority of the cases, was prescribed after evaluation of specially appointed physicians. The surveillance system of occupational exposure to HIV in HCWs should be further developed and enhanced in order to monitor and evaluate the risk factors surrounding the incidents.
Development of a Family Dynamic Environment Scale for Korean Adolescents
Authors: Kim Hyun‐Sil , Kim Hun‐Soo
Published: June 2007

ABSTRACT
The objective of this study was to develop a short and reliable Family Dynamic Environment Scale (FDES) that would better serve the needs of mental health professionals in detecting the potential for delinquent behavior in Korean adolescents related to a dysfunctional family dynamic environment. Semi‐structured interviews with 30 adolescents were initially conducted to generate a set of items, after which, 44 participants were included in method test–retest reliability test. Finally, 544 participants recruited by proportional stratified random sampling were included in a factor analysis. The original version of the FDES had 60 items in 7 categories; the final version included 42 items grouped into 5 factors. Both test–retest reliability and Cronbach's α coefficient were high for the final version of the scale. As a result of factor analysis, five factors were extracted: family psychological climate, parent–child relationship, paternal parenting attitude, family cohesion, and maternal parenting attitude. These contributed 50.3% of the variance in the item scores. All 42 items loaded above .35 on their respective factors. The Cronbach's α coefficients for internal consistency were .95 for the total 42 items and .92, .81, .82, .78, and .71, respectively, for each of the 5 factors.
Nursing the Community, a Look Back at the 1984 Dialogue Between Virginia A. Henderson and Sherry L. Shamansky
Authors: Abrams Sarah E.
Published: June 2007

ABSTRACT
Dr. Sherry L. Shamansky, one of the founding editors of Public Health Nursing, interviewed renowned 20th‐century leader, Virginia Avenal Henderson (1897–1996), then research associate emeritus at Yale University School of Nursing, about the nursing of “aggregates.” Their discussion, originally published in Public Health Nursing, in 1984 (Vol. 1, No. 4), highlights Henderson's views about the scope of nursing, health care organization and funding, and perceived tension between direct care of the sick in the community and preventive activities directed toward communities or populations at risk. Readers familiar with Henderson's influential definition of nursing may find her responses to interview questions helpful in understanding her view of the opportunities and challenges faced by public or community health nurses of the time.
Radiation of the Rat Brain Suppresses Seizure‐Induced Neurogenesis and Transiently Enhances Excitability during Kindling Acquisition
Authors: Raedt Robrecht , Boon Paul , Persson Asa , Alborn Ann‐Marie , Boterberg Tom , Van Dycke Annelies , Linder Birgit , De Smedt Tim , Wadman Wytse J. , Ben‐Menachem Elinor , Eriksson Peter S.
Published: June 2007

Summary:  Purpose: Adult hippocampal neurogenesis is enhanced in several models for temporal lobe epilepsy (TLE). In this study, we used low‐dose whole brain radiation to suppress hippocampal neurogenesis and then studied the effect of this treatment on epileptogenesis in a kindling model for TLE.

Methods: Half of the rats were exposed to a radiation dose of 8 Gy one day before the initiation of a rapid kindling protocol. Afterdischarge threshold (ADT), afterdischarge duration (ADD), clinical seizure severity, and inflammation were compared between groups. On the first and third day after radiation, rats were injected with 5′‐bromo‐2′‐deoxyuridine (BrdU) to evaluate neurogenesis. Seven and 21 days after radiation, numbers of doublecortin (DCX) positive neuroblasts in subgranular zone and granule cell layer were compared between groups.

Results: We showed that radiation significantly suppressed neurogenesis and neuroblast production during kindling acquisition. Radiation prevented an increase in ADT that became significantly lower in radiated rats. On the third and fourth kindling acquisition day radiated rats developed more severe seizures more rapidly, which resulted in a significantly higher mean severity score on these days. Differences in ADD could not be demonstrated.

Discussion: Our results demonstrate that brain radiation with a relatively low dose effectively suppressed the generation of new granule cells and transiently enhanced excitability during kindling acquisition. Although seizure‐induced neurogenesis was lower in the radiated rats we could not detect a strong effect on the final establishment of the permanent fully kindled state, which argues against a prominent role of seizure‐induced neurogenesis in epileptogenesis.
Presurgical Behavioral Medicine Evaluation (PBME) for Implantable Devices for Pain Management: A 1‐Year Prospective Study
Authors: Heckler David R. , Gatchel Robert J. , Lou Leland , Whitworth Tony , Bernstein Dana , Stowell Anna W.
Published: June 2007

Abstract:  To reduce poor surgical outcomes, presurgical psychological evaluations are used to better predict prognosis. The current study investigated the utility of a revised Presurgical Behavioral Medicine Evaluation (PBME) algorithm, developed specifically for patients who were candidates for implantable devices. Patients were categorized into a Green, Yellow I, Yellow II, or Red prognosis group, with Green having the best, and Red having the worst, prognosis for good surgical outcomes. Variables, including gender, disability payment status, and involvement in pending litigation, were found to be significantly different among the groups in a sample of 95 consecutive patients. Analysis of data at the initial evaluation indicated that patients within the Red group endorsed significantly more physical/functional limitations, depressive symptomatology, and psychosocial distress than the Green group. In a 12‐month follow‐up analysis, significant differences among the four groups on various psychosocial measures were found. In addition, post‐hoc tests revealed specific significant differences among the groups. A repeated measures analysis of the initial evaluation, 6‐month, and 12‐month follow‐up data revealed that these measures were also significantly affected by the prognostic group. Lastly, nonparametric analysis indicated that there were significant differences among the groups on total risk factor scores as determined by the PBME algorithm.