bluuebunny/crossref_metadata_2025 huggingface dataset:
Kidney fat and marrow fat indices of the sika deer population at Mount Goyo, northern Japan
Authors: Takatsuki Seiki
Published: March 2003

Fat deposits are effective indicators of the nutritional status of wild populations of ungulates. Three fat indices (kidney fat, femur marrow fat and mandible marrow fat) of sika deer (Cervus nippon) at Mount Goyo, northern Japan, were compared. The kidney fat index (KFI) was suitable for good and intermediate nutritional status, but could not precisely reflect poor conditions. Bone marrow fat indices (MFI) were not good indicators because samples with high MFI values did not distinguish between samples whose KFI values were different, and samples collected in non‐winter seasons did not cover the range of poor conditions. It is therefore recommended to use both the KFI and the femur‐MFI complementarily.
Life history elasticity and the population‐level effect of p‐nonylphenol on Daphnia galeata
Authors: Tanaka Yoshinari , Nakanishi Junko
Published: March 2003

In order to evaluate population‐level effects of p‐nonylphenol on a cladoceran zooplankton (Daphnia galeata), the chronic effects on survival and reproduction were estimated with partial life table tests, which examined responses in life history characters until 3 weeks after birth. The observed responses in survival and reproduction were converted to reductions of the intrinsic rate of natural increase r. The population level EC50, which is defined as the exposure concentration that reduces r by 50%, was estimated as 16.1 μg l−1. In order to examine the extent to which the population‐level effect in terms of r is influenced by extra mortality in nature, which is induced by predation, starvation, etc., sensitivity (elasticity) measures of the intrinsic rate of natural increase to reductions in age‐specific survival and reproduction were calculated under hypothetical predation schemes. The sensitivities of the intrinsic rate to changes in survival and reproduction invariably decline rapidly after the onset of reproduction irrespective of predation schemes. This implies that partial life cycle tests until 21 days after birth can provide reliable estimates of the population‐level effects.
Effects of body size and predators on intracohort competition in wild and domesticated juvenile salmon in a stream
Authors: Reinhardt Ulrich G. , Yamamoto Toshiaki , Nakano Shigeru
Published: March 2003

Competition between masu salmon (Oncorhynchus masou) of wild and aquaculture origin was investigated. Fry were individually marked and released in stream enclosures with and without a piscivorous predator. The aim was to assess the effects of predators and salmon body size on survival and growth of the two types of fish under natural conditions. The presence of predaceous Japanese huchen (Hucho perryi) resulted in lower mean growth rates of surviving fry. Relatively large fish survived and grew better than relatively small fish in the absence of predators, but not in their presence. This probably indicates an indirect effect of predation risk on within‐cohort competitive behavior among salmon juveniles, with larger fish forced to give up their position as superior competitors. Domesticated fish survived in larger numbers and grew much faster than wild fish, irrespective of predator presence. Comparison with similar field studies revealed a pattern that the pre‐experimental environment influenced the outcome of competition between wild and domesticated juvenile salmon. Domesticated fish were superior competitors even in the absence of an initial size advantage, which commonly gives a further advantage to hatchery‐raised fish in natural streams. Therefore, caution dictates to avoid the release or escape of such fish into the wild.
Ant defence system: A mechanism organizing individual responses into efficient collective behavior
Authors: Sakata Hiroshi , Katayama Noboru
Published: March 2003

A colony of social insects is an excellent model for investigating the organization of responses of subunits (i.e. colony members) with limited skills into sophisticated collective behavior. The defence system of Lasius niger ant colonies is well organized in a context‐dependent way. The proportion of fighting ants to fleeing ants changes gradually according to the importance of the area being defended, and was higher where ants tended honeydew‐rich aphids and on trails for foraging with heavy traffic, than where ants were walking alone or on trails with light traffic. Although there were intrinsic differences in aggressiveness between individual ants, the differences in aggressive responses between defended areas was not due to the presence of highly aggressive or timid individuals in each area. Instead, it was due to a change in aggressiveness of individuals in response to external conditions. The cue that altered individual aggressiveness was the presence of surrounding nest‐mates, rather than the presence of aphids. We concluded that the defence system of this ant species consists of three processes: (i) a recruiting system that allocates more workers to more valuable resources; (ii) individual ants following a simple decision rule to become more aggressive in response to increased numbers of nest‐mates nearby (hence aggressive behavior reflecting the importance of each area to the colony); and (iii) variability in individual responses causing a gradual change in the proportion of fighting ants responding to a threat.
Habitat use and diversity of waterbirds in a coastal lagoon around Lake Biwa, Japan
Authors: Hattori Akihisa , Mae Satoshi
Published: March 2003

We investigated habitat use and diversity of waterbirds at one of the coastal and satellite lagoons around Lake Biwa, which is a registered wetland of the Ramsar Convention in Japan. To evaluate the importance for waterbirds of a lagoon around the freshwater lake, we conducted 26 censuses over 1 year on seven blocks with different landscape elements in a small lagoon. A total of 25 species were found and most of them (72%) belonged to a guild in which birds forage without diving. Species density (per ha) and diversity was high in blocks where Zizania latifolia Turcz and Phragmites australis L. reed beds existed. Not all of the waterbird species were feeding all the time, but were often resting in their preferred blocks, suggesting that they use the lagoon as both a refuge and a feeding site. Habitats with a structural reed bed community and shallow waters (<1 m depth) may be crucial determinants of high waterbird diversity in this small lagoon around which many people live.
Overlapping territory of a benthophagous fish, Goniistius zonatus (Teleostei: Cheilodactylidae)
Authors: Matsumoto Kazunori
Published: March 2003

Overlapping territories of a benthophagous morwong, Goniistius zonatus, were studied at two temperate water locations (Morode and Arakashi) in southern Japan. At both locations, total length (TL) of the fish inhabiting the study areas ranged from 12 cm to 34 cm, but fish 20–25 cm TL were not found in the Arakashi study area. At Morode, individuals maintained territories against conspecifics of similar size, and the territories broadly overlapped among three size classes (small < 20 cm ≤ medium <25 cm ≤ large). At Arakashi, large‐sized fish chased individuals of both the same‐ and medium‐sized individuals from their territories, resulting in territory overlap only between large and small size classes. The territories were apparently maintained for feeding, as the main activity of the fish within the territories was foraging and no reproductive behavior was observed at either location. All fish foraged on similar substrates in the daytime. At Morode, however, the diet composition differed among different size classes, whereas at Arakashi, fish of all sizes fed on quite similar foods. A comparison between the two populations indicates that the territory overlap among the three size classes at Morode may have resulted from food‐resource partitioning.
Species‐specific foraging behavior of birds in a riparian forest
Authors: Murakami Masashi , Nakano Shigeru
Published: March 2003

In riparian forest, insectivorous birds are largely dependent on aquatic preys. However, the contribution made by aquatic preys to bird diets varies considerably among bird species. In the present study, bird foraging behaviors were observed in order to examine the relationship between bird foraging method and the variation in the contribution of aquatic preys. The great tit, the black‐faced bunting, and the wren are largely dependent on aquatic preys by capturing them on the ground. Sallyers, the brown flycatcher, the pale‐legged willow warbler, and the narcissus flycatcher are also largely dependent on aquatic preys and capture them mostly during flight. The narcissus flycatcher frequently utilises aquatic invertebrates dwelling on the ground. The leaf and branch gleaner, the crowned willow warbler, does not depend on aquatic prey as much. Although both the pygmy woodpecker and nuthatch are branch and trunk gleaners, the nuthatch utilises aquatic preys frequently by capturing them on the ground as well as during flight, but the pygmy woodpecker does not depend on aquatic preys. The marsh tit also does not depend on aquatic preys but carefully searches terrestrial prey that hide in the vegetation. The differential dependence on aquatic preys among species can lead to the heterogeneous distribution of birds within a riparian forest, suggesting that the indirect effect of aquatic preys on a forest ecosystem via birds can vary within a forest–stream ecotone.
Stochasticity of species assemblage of canopy trees and understorey plants in a temperate secondary forest created by major disturbances
Authors: Hiura Tsutom
Published: March 2003

Detrended canonical correspondence analysis (DCCA) was applied to explore the species assemblage of plants in a temperate secondary forest that was created by major disturbances. The DCCA showed vague relationships between species dominance and environmental factors for canopy tree species even when rare species were excluded from the analysis. For the highest dominant species of the understorey, the scores of the first axis, which correlated with the species richness of overstorey trees, decreased. This fact showed that the assemblage of canopy trees affects, through the differences in leaf phenology or leaf characteristics of canopy trees, the life history of dominant understorey plants. The study’s results suggest that competition colonization might be more important for canopy trees during the developing stage of the forest if the disturbance occurs on a large scale, and that colonization from the local species pool determines species assemblage on a landscape scale.
Oscillations and chaos generated by competition for interactively essential resources
Authors: Huisman Jef , Weissing Franz J.
Published: March 2003

Recent theory shows that: (i) competition between multiple species for multiple resources may generate oscillations and chaotic fluctuations in species abundances; and (ii) these non‐equilibrium dynamics may favor a high biodiversity. These findings were based on Liebig’s Law of the Minimum, which assumes that each species is limited by only one resource at a time. In reality, however, resources can have interactive effects on growth. Here, we investigate whether competition for interactively essential resources may generate oscillations and chaos as well. Our results show that competition for interactively essential resources may, indeed, exhibit dynamics of similar complexity. This illustrates the wide potential for non‐equilibrium dynamics generated by multispecies competition, and suggests that competitive chaos may occur on a wide variety of different resource types.
Sensitivity of ecosystem functioning to changes in trophic structure, functional group composition and species diversity in belowground food webs
Authors: Setälä Heikki
Published: March 2003

The objective of the present paper, using decomposer food webs as a tool, is to explore the levels of the ecological hierarchy (trophic groups, feeding guilds, species populations) at which reduction in complexity brings about significant changes in ecosystem performance. A review is given of various mini‐ecosystem studies that have recently been conducted at the University of Jyväskylä. It is hypothesized that the typical features of soils as a habitat, and the peculiarities of belowground food webs, such as the commonness of indirect interactions (mediated through abiotic resources) among the biota, together with the high frequency of polyphagy/omnivory among soil organisms, produce a diversity‐ecosystem functioning relationship that is likely to differ from those of aquatic and aboveground food webs. Experiments showed that alterations in ‘trophic levels’ were reflected in significant changes in decomposition processes, which, in turn, had substantial impact on primary production. Similarly, heterogeneity within ‘trophic levels’ was shown to be associated with increased growth of birch and pine seedlings. In contrast, species diversity within a feeding guild had little or no influence on ecosystem‐level processes. However, the species‐specific properties of individual taxa were shown to be more influential in affecting plant growth than species number per se. For example, the presence of an omnivorous enchytraeid species in the mini‐ecosystems was observed to consistently be associated with high biomass production of tree seedlings. It is concluded that the so‐called trophic dynamic models based on direct feeding interactions are of limited value in predicting the outcomes of interactions taking place belowground.
Floral sexual dimorphism and flower choice by pollinators in a nectarless monoecious vine Akebia quinata (Lardizabalaceae)
Authors: Kawagoe Tetsuhiro , Suzuki Nobuhiko
Published: March 2003

We investigated the pollination system and movement patterns of pollinators among flowers of the nectarless, monoecious vine Akebia quinata
in natural populations and experimental floral arrays. Female flowers did not offer any rewards for pollinators and were larger than male flowers. Pollinators of A. quinata
, such as small solitary bees and hoverflies, clearly discriminated between male and female flowers. Hoverflies always visited male flowers and rarely visited female flowers. In contrast, solitary bees tended to visit female flowers first when entering the array, but then switched to male flowers within the same foraging bout. This tendency disappeared when the sepal size of female flowers was experimentally reduced to the size of male flowers. Thus, observed non‐randomness in flower choice by solitary bees may be caused by female > male sexual dimorphism and may increase the chance of cross‐pollination and lower the probability of geitonogamous pollination in a single visit to a plant. Therefore, floral sexual dimorphism in A. quinata is considered to be an adaptation for deceptive pollination associated with discriminating pollinators.
Different bird strategies and their responses to habitat changes in an agricultural landscape
Authors: Tworek Stanisław
Published: March 2003

Breeding bird communities were investigated in habitat islands in the agricultural landscape of southern Poland in 1995–1998. Using the following species‐specific characteristics of birds – type and location of nest, type of food, place and way of foraging, type of migration, clutch size, incubation period, fledging period and number of broods per year – five typical bird strategies were delimited: ‘terrestrial’, ‘predators’, ‘hole‐nesters’, ‘vagrants’ and ‘arboreal’. Stepwise multiple regression and canonical correlation analyses were used to examine relationships between ecological parameters for bird strategies and habitat variables describing sample plots. Bird densities, domination, species abundance and turnover rates depended on the area and structure of a habitat island and to a lesser extent on isolation and surrounding land use. Terrestrial birds tend to occupy large, open habitats, often wetlands, predators also need extensive areas of forest for nesting and open habitats for foraging, hole‐nesters demand areas with old tree stands or other places where they can hide their nests, many close to human settlements, vagrants prefer dampish habitats with rich herb and shrub layers and arboreal birds appear to be characteristic of forest edges. Results from this study show that responses of birds to habitat changes differ depending on their strategies. Some life styles benefit from habitat fragmentation, while for others it is a principal threat. The methodology used in this study can be a model for species that share distributional, ecological or life‐history features and may enable more effective conservation of bird species.
A common allometric equation for predicting stem weight of mangroves growing in secondary forests
Authors: Komiyama Akira , Jintana Vipak , Sangtiean Tanuwong , Kato Shogo
Published: March 2003

The allometric relationship for stem weightWs is usually expressed as a function of stem diameter and height, similar to the variabled.b.h.2H, which equals the squared diameter at breast height multiplied by tree height. However, this relationship often differs between tree species, and this segregation of the relationship by species forces the researcher to do a tremendous amount of field work to determine a series of allometric equations for all tree species in the forest. In this study, we examined the segregation in thed.b.h.2H–Ws allometric relationship for five mangrove species. We examined the overall stem shape and the specific gravity of stem relating to the allometric relationships. The difference in the specific gravity was found to be the main cause of the segregation in thed.b.h.2H–Ws relationship. By taking into consideration the specific gravity of stem, we established a common equation for the five mangrove species.
Effect of heterotrophic nanoflagellates on the loss of virus‐like particles in pond water
Authors: Manage Pathmalal M. , Kawabata Zen’ichiro , Nakano Shin‐ichi , Nishibe Yuichiro
Published: March 2003

A decrease in the abundance of virus‐like particles (VLP) by heterotrophic nanoflagellates (HNF) was examined using size‐fractionated water samples taken from a hypereutrophic pond in December 1999, and in March and July 2000. We recorded a considerable decrease in the abundance of VLP in the 5.0 µm filtrate relative to the 0.2–0.8 µm filtrates. Decrease rates of VLP were reduced in a parallel 5.0 µm filtrate treated with cycloheximide. The loss rates of VLP in 5.0 µm filtrate varied in each experiment, and a high rate of loss was found when the growth rate of HNF was high. These results suggested that HNF consumed the VLP and that HNF is an important factor for decreasing viral abundance in freshwater environments.
Tree mortality of five major species on Hokkaido Island, northern Japan
Authors: Umeki Kiyoshi
Published: March 2003

The mortality rates of five major tree species (Abies sachalinensis,Acer mono,Magnolia obovata,Quercus crispula,Tilia japonica) on Hokkaido Island, northern Japan were modeled using logistic regressions based on the long‐term observation of 8929 individuals in 65 permanent plots. Individual size, recent growth, one‐sided and two‐sided interactions with neighbors, climatic and topographic factors were used as independent variables in the logistic regressions, and relevant variables were selected using the stepwise method. For all species analyzed, the final models significantly explained tree mortality rates. The regression analyses indicated that individual size and/or recent growth had effects on tree mortality. A significant effect of one‐sided interaction on tree mortality was detected for three species, and a significant effect of two‐sided interaction was detected for two species. The interactions with neighbors were not necessarily competitive. For all species analyzed, climatic and topographic factors affected tree mortality. The mortality models obtained can be used for forest dynamics simulations. One ecological question was examined using these models. Species that can grow fast in forest stands with smaller basal areas tended to have high mortality rates in forest stands with larger basal areas. Some ecological characteristics of the analyzed species are described based on the results of the regressions.
Influence of shade timing on an Equisetum arvense L. population
Authors: Sakamaki Yoshiaki , Ino Yoshio
Published: March 2003

Equisetum arvense L. is a perennial pteridophyte that grows in open sites. In Tokyo, the plant has photosynthetic shoots from late March to November. However, in some populations, these shoots are lost before summer because of shading by taller plants. To investigate the contribution of shoots that remain on the plant for a certain duration, in terms of the maintenance of the E. arvense population, tubers were cultivated under different light conditions and the dry weight of growth, photosynthetic rates and respiration rates were measured. Individual growth was simulated on the basis of matter production and its partitioning. Biomass at the start of the next growing season (the initial size) was seriously decreased by shading before July. However, shading after July had little effect on the initial size of the next season plants. Thus, E. arvense can maintain its population if its shoots are retained until summer.
Austro‐oriental genus Parabaliothrips Priesner (Thysanoptera: Thripidae), with a new Australian species forming male aggregations
Authors: Gillespie Peter S , Mound Laurence A , Wang Chin‐Ling
Published: March 2003

A second Australian species of Parabaliothrips Priesner is described, P.
newmani, forming male aggregations on the leaf buds of Moreton Bay fig, Ficus
macrophylla (Moraceae). The genus, predominantly south‐east Asian, is redefined
and a key provided to the five described species. Members of this genus feed on leaves
across a wide range of plant families, although each species is host specific. The
host plant of the previously known Australian species, P. setifer Karny, is
newly recognised as Leucopogon lanceolatus (Epacridaceae), and different south‐east Asian species are associated with species of Betulaceae, Hamamelidaceae and Fagaceae.
Intravenous regional anaesthesia in the treatment of paediatric forearm fractures in the emergency department
Authors: Ojala Rob , Kelly Anne‐Maree
Published: March 2003

Objective: To describe our experience using local anaesthetic‐assisted manipulation and plaster with prilocaine as a method of facilitating fracture reduction in paediatric patients; in particular, issues of efficacy and safety.

Methods: Retrospective explicit chart review was performed on all paediatric patients presenting with distal forearm fractures for a 6 month period between 1 January and 31 July 1996. Data collected included: (i) the success of the procedure (defined by clinical and radiological parameters); (ii) age and gender of the patient; (iii) use of adjuvant medications; and (iv) occurrence of complications.

Results: In the study period, 156 paediatric patients presented with distal forearm fractures. Of these, 78 patients required manipulation. Fifty‐three patients were treated with a local anaesthetic‐assisted manipulation and plaster, while 25 patients were admitted for a reduction under general anaesthesia. Successful fracture reduction using local anaesthetic‐assisted manipulation and plaster was achieved in 96.3% of the cases in which this method was used. With respect to safety, no adverse respiratory/haemodynamic sequelae or problems with prilocaine toxicity were found. Adjuvant medication was used frequently (49%); however, the reasons for use could not be determined in this study.

Conclusions: This study suggests that local anaesthetic‐assisted manipulation and plaster using prilocaine has a high success rate and a good safety record. This should be confirmed by study of a larger population. Factors to be taken into account when considering the use of this procedure are: (i) patient and parental preference; (ii) age of the patient; (iii) experience of the available staff; (iv) availability of personnel resources; (v) impact on patient flow in the emergency department; and (vi) anticipated delay in therapy if admission for treatment under general anaesthesia is chosen.
Nasal septal haematomas: A case series and literature review
Authors: Elcock Mark
Published: March 2003

Abstract

Nasal septal haematomas are a rhinological emergency that occur as a rare complication of direct nasal trauma. This case report presents a series of five cases identified from the 838 cases of nasal trauma seen at the Gold Coast Hospital, Queensland, during 1996. The main presenting complaints were headache, nasal pain, nasal swelling, epistaxis, fever and, most commonly, nasal congestion. On physical examination the external nose was swollen, deformed and tender. Nasal speculum examination revealed either unilateral or bilateral red/ blue discolouration with deformity or swelling of the anterior nasal septum. If complicated by a nasal septal abscess, this swelling was fluctuant and tender. A high index of suspicion of the presence of nasal septal haematoma is required in all cases of nasal trauma because prompt recognition is vital. Management is relatively simple and is usually undertaken in the emergency department. Aspiration or drainage of the haematoma/ abscess is performed under a local anaesthetic followed by bilateral nasal packing. Paediatric cases should have a general anaesthetic. Suitable antibiotic cover is required, along with close specialist ear, nose and throat follow up. Early diagnosis and intervention is paramount in preventing cosmetic deformity or other more life‐threatening sequelae.
Adrenoleukodystrophy presenting with Addisonian crisis
Authors: Raftos John
Published: March 2003

Abstract

The case of a young boy who presented with Addisonian crisis as a manifestation of adrenoleukodystrophy (ALD) is presented. Adrenoleukodystrophy is an uncommon X‐linked genetic disease that may present with acute adrenocortical insufficiency. The pathogenesis, clinical presentation and management of adrenoleukodystrophy are presented.
Venom as a source of useful biologically active molecules
Authors: Bailey Paul , Wilce Jacqueline
Published: March 2003

In the specialty area of venomology, emergency physicians traditionally have been most interested in the description of a variety of envenomation syndromes and, subsequent to this, the most appropriate investigative and therapeutic strategies to employ when envenomation is present. Taking an alternative viewpoint, in this paper we have reviewed a selection of interesting areas of biomedical research in which venom components are being investigated for their potential as novel therapeutic agents, pesticides and ion‐channel probes. In addition, we describe the molecular imaging tools of X‐ray crystallography and nuclear magnetic resonance spectroscopy, key techniques in the development of rationally designed therapeutic agents. See Commentary, page 5.
Warfarin toxicity in the emergency department: Recommendations for management
Authors: Cruickshank Jaycen , Ragg Michael , Eddey David
Published: March 2003

Objective:

To examine patients who presented to a hospital emergency department with evidence of warfarin toxicity, and to review the available published literature to determine what guidelines are available for management of this problem.

Method:

A retrospective analysis of all adult patients who presented to The Geelong Hospital Emergency Department between 1 January 1996 and 30 June 1998 with international normalized ratio > 6 due to warfarin toxicity.

Results:

A total of 84 patients with international normalized ratio > 6 were included in the study. The average age was 68.3 years. Fifty‐three per cent were women. The international normalized ratio was between 6 and 10 in 33 patients (39%), and greater than 10 in 51 patients (61%). Major bleeding occurred in 16.7% of patients, minor bleeding in 17.8%. Sixty‐five per cent had no bleeding. Seven patients died, four of those with bleeding. Patients with an international normalized ratio > 10 were more likely to receive fresh frozen plasma (77.6%vs 28.6%; P < 0.001) and in greater amounts (3.0 units vs 0.8 units; P < 0.001) than those with an international normalized ratio of 6–10. There were also more episodes of major bleeding, although not significant. Patients with major bleeding were older (mean 75.4 years vs 67.5 years; P = 0.04), more likely to be admitted (P = 0.046), were more often given fresh frozen plasma (P = 0.003) and in greater amounts (3.28 units vs 2.0 units; P = 0.02).

Conclusion:

Warfarin toxicity is a common problem, and variation in management is not surprising considering the lack of consensus in the literature on this topic. Current recommendations are summarized and a simple flowchart for management of this problem is provided.
Major Incident Medical Management and Support (MIMMS): A practical, multiple casualty, disaster‐site training course for all Australian health care personnel
Authors: Sammut John , Cato Denys , Homer Tony
Published: March 2003

Major Incident Medical Management and Support is a 3‐day major incident training course designed specifically for doctors, nurses and ambulance personnel. It teaches a systematic, ‘all hazards’ approach to the principles of pre‐hospital, multiple‐casualty incident medical management. This article explores the origins and development of the course in Australia, it outlines the nature and content of the course, details the demographic profile of those who have successfully completed the course to date and, finally, looks at the future directions of the course in Australia. See Commentary, page 143.
Emergency Medical Services Fellowship in the United States of America
Authors: Zalstein Salomon
Published: March 2003

Travelling outside Australia to undertake further training in an area of subspecialty interest is both interesting and beneficial to the advancement of the individual and our specialty. In the United States of America, such formal training following completion of specialist qualification in emergency medicine is referred to as ‘Fellowship’ training. While other authors have discussed the general areas of overseas work and emergency medicine Fellowships, this paper specifically addresses the area of prehospital care, known in the United States as ‘emergency medical services’. Although there are significant differences in prehospital care between the United States and Australia, a great deal of what can be learned from undertaking a Fellowship in prehospital care in the United States is locally applicable. A typical curriculum is outlined, and the steps in selecting and arranging such a programme are discussed. Some potential pitfalls are also mentioned. Given the paucity of formal training in prehospital care in this country, such fellowship programmes are an excellent means of obtaining a very solid understanding of this important aspect of emergency medicine.
Fatal pneumococcal Waterhouse–Friderichsen syndrome
Authors: Doherty Steven
Published: March 2003

There have only been six deaths reported in the English literature due to disseminated intravascular coagulation and Waterhouse–Friderichsen syndrome complicating pneumococcemia in otherwise healthy persons with normal spleens. Four of these deaths occurred in children and two in adults. A case of fulminant pneumococcemia complicated by disseminated intravascular coagulation and Waterhouse–Friderichsen syndrome in an otherwise healthy adult with a normal spleen is presented. The case is typical of the course of fulminant pneumococcal sepsis and highlights some of the difficulties experienced by rural general practitioners and rural retrieval services. Mechanisms by which Pneumococcus can elicit fulminant sepsis are discussed, although there is no explanation as to why this may occur in the setting of normal splenic function.
Factors influencing prehospital and emergency department analgesia administration to patients with femoral neck fractures
Authors: Vassiliadis John , Hitos Kerry , Hill Celine T
Published: March 2003

Objectives:To assess the analgesia practices of ambulance personnel and emergency department staff treating patients with fractured neck of femur.

Methods:This is a retrospective analysis of 176 patients with an admission diagnosis of fractured neck of femur, who presented to a major western Sydney teaching hospital, between January and November 1999.

Results:One hundred and twenty‐eight patients met the inclusion criteria. The median age was 82, there were more female than male subjects. Ambulance officers made a clinical diagnosis of fractured neck of femur in 68% of cases. In 49% of cases no analgesia was given. Patients were given a higher triage category and pain relief faster if they had been given analgesia by ambulance officers,P = 0.0018 andP = 0.002, respectively. The median time to analgesia was 2 h 48 min.

Conclusions:Only a modest proportion of patients with fractured neck of femur received prehospital analgesia and delays to analgesia in the emergency department are considerable. Strategies to address the delivery of appropriate analgesia to this group of patients should be developed.
Benchmarking in emergency health systems
Authors: Kennedy Marcus P , Allen Jacqueline , Allen Greg
Published: March 2003

This paper discusses the role of benchmarking as a component of quality management. It describes the historical background of benchmarking, its competitive origin and the requirement in today's health environment for a more collaborative approach. The classical ‘functional and generic’ types of benchmarking are discussed with a suggestion to adopt a different terminology that describes the purpose and practicalities of benchmarking.

Benchmarking is not without risks. The consequence of inappropriate focus and the need for a balanced overview of process is explored. The competition that is intrinsic to benchmarking is questioned and the negative impact it may have on improvement strategies in poorly performing organizations is recognized. The difficulty in achieving cross‐organizational validity in benchmarking is emphasized, as is the need to scrutinize benchmarking measures. The cost effectiveness of benchmarking projects is questioned and the concept of ‘best value, best practice’ in an environment of fixed resources is examined.
Focused assessment with sonography for trauma patients by clinicians: Initial experience and results
Authors: Vassiliadis John , Edwards Robert , Larcos George , Hitos Kerry
Published: March 2003

Objectives: To describe the establishment of a service to provide bedside focused assessment sonography in trauma and to evaluate the service to date.

Setting: Emergency department of an urban trauma centre.

Methods: A prospective study of trauma patients who received a focused assessment sonography in trauma examination performed by a clinician managing the trauma in the emergency department. Accuracy was determined by comparing the scan interpretation with abdomino‐pelvic computerized tomography, laparotomy or postmortem examination.

Results: The study period ran from 1 January 2000 to 11 September 2001 inclusive (20 months). One hundred and forty patients were included, with a final diagnosis established by computerized tomography (n = 124) and/or laparotomy (n = 18). There were 26 true‐positives, 101 true‐negatives, two false‐positives and 11 false‐negatives. Ten of the false‐negative studies were performed by clinicians who had not reached accreditation. The sensitivity of focused assessment sonography in trauma was 70%, specificity 98% and diagnostic accuracy 91%.

Conclusions: We have described the implementation of a clinician‐based focused assessment sonography in trauma service within the emergency department with the support of radiology/ultrasound and trauma service. Processes for credentialling, quality assurance and training need to be in place. Significant issues exist with the length of time it takes clinicians to reach accreditation, in order that a critical mass of clinicians exists to provide a consistent service. The credentialling process should mandate a minimum number of supervised examinations.
Emergency ultrasound credentialling for focused assessment sonography in trauma and abdominal aortic aneurysm: A practical approach for Australasia
Authors: Jones Peter G , Peak Stephen , McClelland Andy , Holden Andrew , Higginson Ian , Gamble Greg
Published: March 2003

Objective:  Focused assessment with sonography for trauma and emergency ultrasound for abdominal aortic aneurysm are now practiced widely by non‐radiologists in emergency departments worldwide. Various credentialling programs have been proposed for novice sonographers; however, their feasibility has been questioned. We adopted the Australasian College for Emergency Medicine (ACEM) credentialling process for emergency ultrasound to determine whether it is feasible for emergency physicians in the Australasian environment.

Methods:  Three full‐time emergency medicine specialists and a post‐Fellowship Examination trainee at Auckland Hospital undertook the credentialling process.

Results:  All four participants had sufficient scans to complete the process after 16 months. Accuracy for focused assessment with sonography for trauma, 90% (95% CI 83–95%), and abdominal aortic aneurysm, 99% (95% CI 90–100%), is similar to that previously reported.

Conclusion:  The ACEM credentialling process for focused assessment with sonography for trauma and abdominal aortic aneurysm is practical and achievable for emergency medicine specialists working in the Emergency Department at Auckland Hospital. Further studies are necessary to determine whether this holds true for other major trauma centres in Australasia.
Paediatric emergency department design: Does it affect staff, patient and community satisfaction?
Authors: Judkins Simon
Published: March 2003

Objectives: To assess the change in perception of the standard of paediatric care following the opening of a dedicated paediatric emergency area in an established tertiary hospital emergency department on patients and families, hospital staff and the general practitioners of the local community.

Methods: A questionnaire was circulated to the relevant parties prior to and 6 months after the opening of the paediatric department. The surveys were circulated to the families/custodians of the paediatric attendees, general practitioners who refer paediatric patients and the medical and nursing staff both within the emergency department and the inpatient paediatric ward. The questions related to the physical environment, perceived level of care and the overall satisfaction with treatment.

Results: The most striking change was in the patient family group who showed an increase in their level of satisfaction with the physical environment and their overall care. The general practitioner group showed only a slight improvement, while the inpatient staff showed no notable changes. The emergency department staff developed a higher level of confidence and satisfaction when dealing with this population group.

Conclusion: The change in the physical environment in which we treat our paediatric emergencies seemed to enhance the level of satisfaction of our attendees. Staff appear to be more confident when dealing with these patients in a dedicated paediatric area. The effect has not yet flowed on to the inpatient staff and general practitioners, perhaps reflecting a small exposure of these individuals to the survey subject matter.
Perineal rectosigmoidectomy: An effective approach for the repair of complete rectal prolapse
Authors: Chiu KM , AhChong AK , Yip AWC
Published: March 2003

The results of five consecutive perineal rectosigmoidectomies were reviewed to evaluate the role of this approach for complete rectal prolapse. There were two male and three female patients, with a median age of 75 years (range 45–82 years). On average, 23.6 cm (range 15–35 cm) of sigmoid colon and rectum was resected. There was no operation‐related mortality. One patient developed postoperative chest infection and another acute retention of urine. No recurrence of the prolapse was detected during a median follow‐up period of 25 months (range 6–42 months). Perineal rectosigmoidectomy is an effective and the least invasive procedure for complete rectal prolapse. It is the preferred approach for patients who have had multiple previous abdominal operations and for the frail elderly patient in whom, particularly, constipation is a major associated feature.
Annual Scientific Meeting of The College of Surgeons of Hong Kong: A 5‐year audit
Authors: Lee Dwh , Chan Acw , Lai Pbs , Fung Tmk , Chung Scs
Published: March 2003

Objective: To examine the quality of surgical research in Hong Kong by auditing the results of abstracts submitted for annual scientific meetings held by The College of Surgeons of Hong Kong.

Materials and Methods: From 1993 to 1998, all abstracts submitted for the meetings were evaluated and classified according to the hierarchy of evidence. The institutions of the presenting authors were recorded. Ovid MEDLINE search was then conducted to determine whether the abstracts were subsequently published in an indexed medical journal.

Results: In total, 165 abstracts were submitted for the meeting in a 5‐year period. Randomized controlled trials constituted 12% of this research. Participation from community surgeons showed an encouraging trend from 17% in 1993 to 63% in 1998. In the first 4 years, 38% of abstracts were of publishable quality. More than half of the prospective randomized controlled trials were selected for presentation and subsequently published. Those abstracts selected for presentation have a higher chance of being published subsequently (P < 0.03).

Conclusions: The randomized controlled trial remains a powerful research tool but is scarce in Hong Kong surgical research.
Mesenteric cystic lymphangioma presented with small bowel volvulus
Authors: Poon Michael Chi‐Ming , Lee Danny Wai‐Hung , Wong Pik‐Kei , Chan Angus Chi‐Wai
Published: March 2003

A 62‐year‐old man presented with small bowel obstruction due to volvulus that was caused by mesenteric cystic lymphangioma. Preoperative diagnosis of this rare benign pathology of the lymphatic system is almost impossible. Complete surgical removal is the treatment of choice.
Combined transoral and transnasal power‐assisted endoscopic adenoidectomy by a StraightShot® microdebrider and Endoscrub® device
Authors: Ku Peter Ka‐Ming , Pak Martin Wai , Hasselt Charles Andrew van
Published: March 2003

Objective:

To describe a combined transoral and transnasal approach power‐assisted endoscopic adenoidectomy by StraightShot® microdebrider and Endoscrub® device in children.

Method:

Transoral power‐assisted endoscopic adenoidectomy using a 45°‐curved cutting visor of a StraightShot® microdebrider (Medtronic Xomed, Jacksonville, FL, USA) is performed with an Endoscrub, irrigation device (Medtronic Xomed) attached to the rigid endoscope. The oscillating mode (1500 r.p.m.) of the microdebrider is selected. The dissection begins at the inferior pole of the adenoids and swifted upwards to the roof of the nasopharynx. Transnasal dissection of the choanal extension of the adenoids is achieved using a straight‐cutting visor with the aid of a 0° rigid endoscope.

Results:

The technique was performed in 11 consecutive patients (six male and five female) in a 6‐month period. The mean age of the patients was 6.9 years (range, 3–9 years). The main indication for surgery was obstructive sleep apnoea with huge obstructive adenoids and with choanal extension. The mean operative time was 4.8 min (range, 2–11 min). The mean blood loss was 12.8 mL (range, 4–16 mL). No intraoperative or postoperative complications were recorded.

Conclusion:

The described technique for dissection of adenoids in children is safe and is recommended for patients with large adenoids and with choanal extension.

Chinese Abstract

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Some issues and options for the conservation of native biodiversity in rural New Zealand
Authors: Norton By David A. , Miller Craig J.
Published: March 2003

SummaryFor the 70% of New Zealand under private ownership, native biodiversity conservation has to occur within a landscape that must also provide a productive return to land owners. Recent New Zealand legislation, especially the Resource Management Act 1991, promotes sustainable management on private land by allowing for the economic and cultural well‐being of local communities while providing for the protection of natural resources including native biodiversity. We suggest that, to effectively conserve native biodiversity in rural landscapes, we need to consider four key issues: (i) what might be realistic goals for native biodiversity conservation; (ii) how might we better arrange different land uses to meet both native biodiversity and production goals; (iii) what is the optimum arrangement of native biodiversity; and (iv) how native biodiversity conservation can improve productive returns to land managers. Options to enhance native biodiversity conservation include a variety of incentives (e.g. management agreements, financial incentives and regulatory systems) and onsite management options (e.g. remnant management, restoration plantings, weed and pest control, use of native species for commercial and amenity purposes, use of exotic species to facilitate native biodiversity). The importance of taking a landscape‐based rather than a paddock‐based approach to management is emphasized.
Eradication of Feral Cats (Felis catus) from Gabo Island, south‐east Victoria
Authors: Twyford By Keith L. , Humphrey Peter G. , Nunn Ross P. , Willoughby Lawson
Published: March 2003

Summary Concerns about the effects of predation by Feral Cats (Felis catus) on native fauna, particularly breeding seabirds, precipitated a decision in 1987 to control and eventually eradicate cats from Gabo Island. The size of the population prior to control was at least 30 animals. A control programme, undertaken between 1987 and 1991, centred on shooting, trapping and an extensive 1080 poison‐baiting programme. Trapping and shooting were ineffectual. Poisoning was the most successful and effective technique for the rapid and widespread reduction in the Feral Cat population on Gabo Island. The effectiveness of dead 1‐day‐old chickens as a poison carrier was demonstrated. Effective poison baiting was attributed to bait selection and strategic timing of baiting to periods when prey was at low levels. Outcomes from the trapping programme and post‐control monitoring strongly suggested that the cat population had been reduced to only two or three animals, possibly of the same sex. Monitoring between 1992 and 1998 failed to record any evidence of cats, indicating that the cats remaining after poison baiting had been unable to sustain a viable population. On the basis of the available evidence, Feral Cats appear to have been successfully eradicated from Gabo Island.