bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoproterozoic cap carbonates: a critical appraisal of existing models and the plumeworld hypothesis
Authors: Shields Graham A.
Published: July 2005

Evidence for glaciation during the mid‐late Neoproterozoic is widespread on Earth, reflecting three or more ice ages between 730 Ma and 580 Ma. Of these, the late Neoproterozoic Marinoan glaciation of approximately 635 Ma stands out because of its ubiquitous association with a characteristic, microcrystalline cap dolostone that drapes glacially influenced rock units worldwide. The Marinoan glaciation is also peculiar in that evidence for low altitude glaciation at equatorial latitudes is compelling. Three models have been proposed linking abrupt deglaciation with this global carbonate precipitation event: (i) overturn of an anoxic deep ocean; (ii) catastrophically accelerated rates of chemical weathering because of supergreenhouse conditions following global glaciation (Snowball Earth Hypothesis); and (iii) massive release of carbonate alkalinity from destabilized methane clathrates. All three models invoke extreme alkalinity fluxes into seawater during deglaciation but none explains how such alkalinity excess from point sources could be distributed homogeneously around the globe. In addition, none explains the consistent sequence of precipitation events observed within cap carbonate successions, specifically: (i) the global blanketing of carbonate powder in shallow marine environments during deglaciation; (ii) widespread and disruptive precipitation of dolomite cement; followed by (iii) localized barite precipitation and seafloor cementation by aragonite. The conceptual model presented here proposes that low latitude deglaciation was so massive and abrupt that the resultant meltwater plume could extend worldwide, physically separating the surface and deep ocean reservoirs for ≥103 years. It is proposed that cap dolostones formed primarily by microbially mediated precipitation of carbonate whitings during algal blooms within this low salinity plumeworld rather than by abiotic precipitation from normal salinity seawater. Many of the disruption features that are characteristic of cap dolostones can be explained by microbially mediated, early diagenetic dolomitization and cementation. The re‐initiation of whole ocean circulation degassed CO2 into the atmosphere in areas of upwelling, triggering localized, abiotic CaCO3 precipitation in the form of aragonite fans that overlie cap dolostones in NW Canada and Namibia. The highly oxygenated shallow marine environments of the glacial and post‐glacial Neoproterozoic world provided consistently favourable conditions for the evolutionary development of animals and other oxygenophiles.
Molecular epidemiology of drug resistance markers of Plasmodium falciparum malaria in Thailand
Authors: Congpuong K. , Na Bangchang K. , Mungthin M. , Bualombai P. , Wernsdorfer W. H.
Published: July 2005

To determine differences in the distribution of drug resistance mutations in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multi‐drug resistance 1 (pfmdr1) genes of P. falciparum isolates in Thailand, a study was conducted using polymerase chain reaction‐restriction fragment length polymorphism to detect mutations in P. falciparum isolates obtained from three areas with different levels of in vivo mefloquine (MQ) resistance. All isolates carried mutant allele T76 of the pfcrt gene and wild‐type allele D1246 of the pfmdr1 gene except for one isolate, which showed the wild‐type K76 allele. This isolate was obtained from Chanthaburi Province, an area with high MQ resistance. Relatively low rates of the mutant alleles D1042 and Y86 of the pfmdr1 gene were found among Thai isolates of P. falciparum. However, a statistically significant difference in the distribution was noted. Most of the mutant isolates were found among isolates from areas with moderate or low MQ resistance. Only one isolate with mixed mutant and wild‐type N1042 and D1042 and two mutants of Y86 were found among the isolates from areas with high MQ resistance. The findings provide limited support for the hypothesis that mutant alleles of pfmdr1 may be associated with increased sensitivity to MQ.
Team communication in the operating room
Authors: Davies J. M.
Published: July 2005

Good communication is vital for safe patient care and good team functioning, not only in the Operating Room but also in all areas of healthcare, as well as in other safety critical industries. Examples from aviation demonstrate both the failures and the successes that can arise from poor and excellentcommunication. There are six components of effective teamwork: situational awareness, problem identification, decision making, workload distribution, time management and conflict resolution. Practising these, and self‐evaluation of team communication, should help to improve team function and contribute to making patient care safer.
Does ICU length of stay influence quality of life?
Authors: Stricker K. H. , Cavegn R. , Takala J. , Rothen H. U.
Published: July 2005

Background:  Patients with prolonged stay in the intensive care unit (ICU) use a disproportionate share of resources. However, it is not known if such treatment results in impaired quality of life (QOL) as compared to patients with a short length of stay (LOS) when taking into account the initial severity of illness.

Methods:  Prospective, observational case–control study in a university hospital surgical and trauma adult ICU. All patients admitted to the ICU during a 1‐year period were included. Patients with a cumulative LOS in the ICU > 7 days, surviving up to 1 year after ICU admission and consenting were identified (group L, n = 75) and matched to individuals with a shorter stay (group S). Matching criteria were diagnostic group and severity of illness. Health‐related quality of life (HRQOL) was assessed 1 year after admission using the short‐form 36 (SF‐36) and was compared between groups and to the general population. Further, overall QOL was estimated using a visual analogue scale (VAS) and willingness to consent to future intensive care, and was compared between groups L and S.

Results:  Based on ANCOVA, a significant difference between groups L and S was noted for two out of eight scales: role physical (P = 0.033) and vitality (P = 0.041). No differences were found for the physical component summary (P = 0.065), the mental component summary (P = 0.267) or the VAS (P = 0.316). Further, there was no difference in expectation to consent to future intensive care (P = 0.149). As compared to the general population, we found similar scores for the mental component summary and for three of eight scales in group L and five of eight scales in group S.

Conclusions:  When taking into account severity of illness, HRQOL 1 year after intensive care is comparable between patients with a short and a long LOS in the ICU. Thus, prolonged stay in the ICU per se must not be taken as an indicator of future poorer HRQOL. However, as compared to the general population, significant differences, mostly in physical aspects of QOL, were found for both groups of patients.
Postpartum neurologic symptoms following single‐shot spinal block for labour analgesia
Authors: Viitanen H. , Porthan L. , Viitanen M. , Heula A‐L. , Heikkilä M.
Published: July 2005

Background:  As part of a quality assurance program, we investigated the incidence of postpartum neurologic symptoms in multiparous parturients receiving spinal block for labour analgesia, now in routine use in our labour ward.

Methods:  Two hundred and twenty‐nine consecutive multiparous parturients presenting for vaginal delivery and requesting spinal analgesia were asked to participate in this prospective study. All parturients received our standard intrathecal analgesia (ITA): 2.5 mg bupivacaine (1 ml) + 25 µg fentanyl (0.5 ml) using a 27‐gauge Quincke‐type needle. The patients filled in a questionnaire on the first day after delivery and again upon discharge. Complaints typical of neurologic sequelae were noted and a neurologic examination was performed, if necessary. All patients with postdural puncture headache (PDPH) and transient neurologic symptoms (TNSs) were interviewed by telephone 2 weeks after discharge to determine the course of the symptoms.

Results:  Two hundred and twelve parturients were included in the study. Eighteen (8.5%) parturients complained of PDPH, the severity of which was mild in eight (4%), moderate in seven (3%), and severe in three (1%) patients, respectively. Fifteen (7%) mothers were treated with analgesics or bedrest only. Three (1%) patients were given an epidural blood patch. The paramedian approach was associated with the development of PDPH (P = 0.04). Transient neurologic symptoms were experienced by nine (4.2%) mothers, lasting 1–3 days, mostly presenting as bilateral pain in the buttocks or thighs. One parturient suffered from paraesthesia of the left foot lasting for 3 days. Forty (19%) mothers complained of non‐postural headache and 28 (13%) of new‐onset backpain. Three mothers (1%) would not want to receive a further spinal block.

Conclusion:  Transient neurologic symptoms (TNSs) after spinal block occurred infrequently. The incidence of PDPH was higher than in the obstetric population in general and calls for re‐evaluation of our spinal block methods. Despite the occurrence of neurologic sequelae, patient acceptability was high.
Identification and characterization of errors and incidents in a medical intensive care unit
Authors: Graf J. , Von Den Driesch A. , Koch K.‐C. , Janssens U.
Published: July 2005

Background:  To assess the frequency, type, consequences, and associations of errors and incidents in a medical intensive care unit (ICU).

Methods:  Two‐hundred and sixteen consecutive patients with predominantly cardiovascular and pulmonary disorders admitted between December 2002 and February 2003 were enrolled. Demographic data, SAPS II, and TISS‐28 were obtained for all patients. Prior to patient enrolment all staff members (physicians, nurses, physiotherapists) were repeatedly encouraged to make use of the Incident Report Form (IRF) and detailed descriptions on how, why and when to use the IRF were provided.

Results:  During the observation period of 64 days, 50 errors involving 32 patients (15%) were reported. Patients subjected to errors were more severely ill (SAPS II 42 ± 25 vs. 32 ± 18, P < 0.05), had a higher hospital mortality (38% vs. 9%), and a longer ICU stay (11 ± 18 vs. 3 ± 5 days, P < 0.05). Gender, age and TISS‐28 were equally distributed. Each day of ICU stay increased the risk by 8% (odds ratio 1.078, 95% confidence interval 1.034–1.125, P < 0.001), and by 2.3% per SAPS II point (odds ratio 1.023, 95% confidence interval 1.006–1.040, P < 0.001). The majority of errors and incidents were judged as ‘human failures’ (73%), and 46 errors and incidents (92%) as ‘avoidable’.

Conclusions:  The identification and characterization of errors and incidents combined with contextual information is feasible and may provide sufficient background information for areas of quality improvement. Areas with a high frequency of errors and incidents need to undergo process evaluation to avoid future occurrence.
Dopamine or norepinephrine infusion during thoracic epidural anesthesia? Differences in hemodynamic effects and plasma catecholamine levels
Authors: Lundberg J. F. , Martner J. , Raner C. , Winsö O. , Biber B.
Published: July 2005

Background:  During thoracic epidural anesthesia, an intravenous dopamine infusion augments the systemic pressure response and modifies plasma catecholamine levels. If such an altered response occurs when norepinephrine is infused is not clear. Therefore, dopamine and norepinephrine induced circulatory and catecholamine responses were studied before and during thoracic epidural anesthesia.

Methods:  Nine chloralose‐anesthetized dogs were equipped with thoracic epidural catheters. Dopamine (5, 10, and 20 µg kg−1 min−1), and norepinephrine (0.1, 0.25, and 0.5 µg kg−1 min−1) were infused before and during epidural anesthesia, while cardiovascular performance and plasma catecholamine changes were studied.

Results:  Thoracic epidural anesthesia decreased arterial pressure, and cardiac contractility. The systemic pressure response induced by dopamine was augmented during epidural anesthesia. Norepinephrine did not increase arterial pressure and myocardial contractility as markedly as dopamine, and cardiac output was not altered. Thoracic epidural anesthesia attenuated the plasma norepinephrine level. Plasma dopamine levels were augmented by the dopamine infusion during epidural anesthesia, while plasma norepinephrine levels were attenuated. In contrast, norepinephrine augmented the plasma norepinephrine levels during epidural anesthesia. In general, plasma norepinephrine levels were three to six times higher during a norepinephrine infusion compared to a dopamine infusion.

Conclusion:  The cardiovascular response to a graded dopamine infusion is augmented during thoracic epidural anesthesia, while norepinephrine‐induced effects are unaltered. The modified plasma catecholamine levels may contribute to the hemodynamic differences between dopamine and norepinephrine infusions during thoracic epidural anesthesia.
Training trauma teams in the Nordic countries: An overview and present status
Authors: Wisborg T. , Castren M. , Lippert A. , Valsson F. , Wallin C. J. ,   on behalf of the Working Scandinavian Group (WISE)
Published: July 2005

Background:  During the last decade there has been an increased interest in the organisation and quality of trauma care in the Nordic countries. Still, most patients are initially cared for at hospitals with low caseloads of severe trauma. More than 200 hospitals offer initial care to trauma patients. Training of trauma teams using simulators or simulated patients has evolved in the same period, as one important factor to overcome lack of practical training. This overview describes the present state of trauma team training in the Nordic countries.

Methods:  Members of a Nordic working group on the use of simulation in medicine reviewed present literature on training with simulation and described the present use of team training in their own countries during winter 2004.

Results:  There is an increasing amount of evidence indicating that training of teams with simulation reduces treatment errors and improves performance. The training activities do not need to be complex, but skilled debriefing seems necessary. Few Nordic hospitals train their trauma teams. The training activities vary considerably between and within countries.

Conclusion:  There is considerable evidence supporting an increased use of experience gained in other high‐risk domains where training in communication, leadership and decision‐making is the focus for safety and improvement efforts. There is a need for more widespread training of trauma teams. The different training activities actually undertaken should be scientifically evaluated.
Comparison of perioperative spirometric data following spinal or general anaesthesia in normal‐weight and overweight gynaecological patients
Authors: Von Ungern‐Sternberg B. S. , Regli A. , Reber A. , Schneider M. C.
Published: July 2005

Background:  There is limited data comparing the impact of spinal anaesthesia (SA) and general anaesthesia (GA) on perioperative lung function. Here we assessed the differences of these two anaesthetic techniques on perioperative lung volumes in normal‐weight (BMI < 25) and overweight (BMI 25–30) patients using spirometry.

Methods:  We prospectively studied 84 consenting patients having operations in the vaginal region receiving either GA (n = 41) or SA (n = 43). Both groups (GA and SA) were further divided into two subgroups each (normal‐weight vs. overweight). We measured vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), midexpiratory (MEF25‐75) and peak expiratory flow rates (PEFR) at the preoperative assessment (baseline), after premedication, after effective SA, and 20 min, 1 h, 2 h and 3 h after the operation (last measurement after patient mobilization).

Results:  Premedication was associated with a small but significant decrease in lung volumes in direct correlation with BMI (−5%). Spinal anaesthesia resulted in a significant reduction in lung volumes in overweight as opposed to normal‐weight patients. Postoperatively, lung volumes were significantly more reduced following GA than SA as indicated by differences in mean VC (SD) of −12 (6)% vs. −6 (5)% 20 min after the end of the operation in the normal‐weight and −18 (5)% vs. −10 (5)% in the overweight patients. There was a significant impact of BMI on postoperative respiratory function, which was significantly more important in the GA group than in the SA group, and recovery of lung volumes was more rapid in the normal‐weight patients than in the overweight patients, particularly in the SA group.

Conclusion:  In gynaecological patients undergoing vaginal surgery, the impact of anaesthesia on postoperative lung function as assessed by spirometry was significantly less after SA than GA, particularly in overweight patients.
Impact of gender on treatment and outcome of ICU patients
Authors: Reinikainen M. , Niskanen M. , Uusaro A. , Ruokonen E.
Published: July 2005

Background:  Gender modifies immunologic responses caused by severe trauma or critical illness. The aim of this study was to investigate the impact of gender on hospital mortality, length of intensive care unit (ICU) stay, and intensity of care of patients treated in ICUs.

Methods:  Data on 24,341 ICU patients were collected from a national database. We measured severity of illness with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and intensity of care with Therapeutic Intervention Scoring System (TISS) scores. We used logistic regression analysis to test the independent effect of gender on hospital mortality. We compared the lengths of ICU stay and the intensity of care of men and women.

Results:  Male gender was associated with increased hospital mortality among postoperative ICU patients [adjusted odds ratio 1.33 (95% confidence interval 1.12–1.58, P = 0.001)] but not among medical patients [adjusted odds ratio 1.02 (95% confidence interval 0.92–1.13, P = 0.74)]. Male gender was associated with an increased risk of death particularly in the oldest age group (75 years or older) and among the patients with relatively low APACHE II scores (<16). Mean length of ICU stay was 3.2 days for men and 2.6 days for women (P < 0.001). Male patients comprised 61.7% of the study population but consumed 66.0% of days in intensive care.

Conclusion:  Male gender contributes to poor outcome in postoperative ICU patients. Approximately two‐thirds of ICU resources are consumed by male patients.
Is ECG‐guidance a helpful method to correctly position a central venous catheter during prehospital emergency care?
Authors: David J. S. , Tazarourte K. , Perfus J. P. , Savary D.
Published: July 2005

Background:  Insertion of a central venous catheter (CVC) in an emergency situation is challenging and may be potentially associated with more complications. Because CVC positioning by ECG‐guidance may help to decrease the frequency of a malpositioned catheter, we decided to prospectively evaluate the usefulness of positioning a CVC by ECG‐guidance during prehospital emergency care.

Methods:  Prospective observational study during which all patients requiring CVC placement during prehospital care were included. We compared two periods of 1 year during which CVCs were inserted without and then with the help of ECG‐guidance.

Results:  Eighty successive patients were included. We observed a significant reduction of incorrectly positioned CVCs with ECG‐guidance (13% vs. 38%, P < 0.05) and a decreased number of chest X‐rays needed to verify the position of the CVC (40 vs. 54, P < 0.05).

Conclusion:  ECG‐guidance is a safe and feasible technique which significantly improved the rate of CVCs correctly positioned during prehospital emergency care.
The future role of the anaesthesiologist in pain management
Authors: Breivik H.
Published: July 2005

Background:  Relieving pain during and after surgery and trauma has always been a basic duty of anaesthesiologists. With their skills and expertise in regional analgesia and pharmacological analgesia, anaesthesiologists have improved management of severe cancer pain. Will there be a place for anaesthesiologists in multidisciplinary pain clinics managing chronic non‐cancer pain patients in the future?

Methods:  This is a personal review of the development of pain management as a growing part of the responsibilities of anaesthesiologists during the past three decades and the importance of continued involvement of anaesthesiologists in this interesting and challenging aspect of clinical medicine.

Results and conclusions:  Optimal management of pain during and after surgery is a prerequisite for successful short‐ and long‐term rehabilitation after surgery. After surgery, reducing dynamic pain with prolonged optimal epidural analgesia and regional blocks facilitates mobilization and reduces chronic pain. The expertise of well‐trained anaesthesiologists in skilfully using regional analgesia and pharmacological pain relief continues to be in demand in palliative care. Some interventional techniques are useful in relieving chronic non‐cancer pain in selected patients. Well‐trained anaesthesiologist‐pain clinicians can perform interventional treatments safely. No doubt, anaesthesiologists will continue to have important roles in pain management in the future.
Single‐shot spinal block for labour analgesia in multiparous parturients*
Authors: Viitanen H. , Viitanen M. , Heikkilä M.
Published: July 2005

Background:  Intrathecal analgesia (ITA) is effective in late, rapidly progressing labour. In 1998, our hospital implemented the use of single‐shot spinal block for pain relief in multiparous parturients. As part of a quality assurance programme, we assessed the analgesic efficacy, obstetric and neonatal outcomes and maternal satisfaction after this form of analgesia now in routine use in our labour ward.

Methods:  Two hundred and twenty‐nine consecutive multiparous parturients presenting for vaginal delivery and requesting analgesia were asked to participate in this prospective study. All parturients received our standard ITA: 2.5 mg bupivacaine (1 ml) + 25 µg fentanyl (0.5 ml) inserted via the L2−3 or L3−4 interspace. Routine monitoring included maternal vital signs, uterine contraction and fetal heart rate tracing. Pain scores (visual analogue scale (VAS) 0–10), sensory levels, motor block, side‐effects and maternal satisfaction were recorded. Satisfactory analgesia was defined as a decrease in pain scores to three or less within 20 min after injection. The number of parturients requesting additional analgesia and the duration of spinal block (time from injection until request for additional medication after satisfactory analgesia had worn off) were recorded.

Results:  Two hundred and nine parturients were included in the study. Satisfactory analgesia was achieved in 153 (73%) parturients. Fifty‐five (26%) women requested additional analgesia: 38 (18%) because of unsatisfactory analgesia and 17 (8%) because analgesia ended before delivery. The duration of spinal block was 101 ± 34 min. Pruritus occurred in 64%, fetal bradycardia in 7% and hypotension in 2% of deliveries. Pain relief was rated excellent by 65%, moderate by 20% and inadequate by 14% of the parturients. One hundred and sixty‐nine (81%) women stated that they would like to have spinal analgesia again for pain relief during delivery.

Conclusion:  The majority of multiparous parturients found ITA adequate for pain relief during delivery. However, modifications are required in terms of improved timing, reliability and duration of analgesia.
Life‐history and ecological correlates of decline and extinction in the endemic Australian frog fauna
Authors: MURRAY BRAD R. , HOSE GRANT C.
Published: July 2005

Abstract Frog populations are rapidly disappearing throughout the world. An important issue for ecologists to resolve is why some frog species are more susceptible to decline than others. Here, we performed a comparative study of the endemic Australian frog fauna to determine whether the life history and ecology of declining species have predisposed them to extinction. Decline was consistently found to be correlated with geographical range size across contemporary species and in analyses based on phylogenetically independent contrasts (PICs). Species with narrow geographical ranges have been disproportionately more susceptible to decline. Across species, decline was also correlated with large body size and a high proportion of the geographical range overlapping with the distribution of cane toads and landscape stress (e.g. land clearing). We show that with the exception of range size, however, correlates of decline across species are underpinned by a small number of evolutionary events. Hence, the suite of traits that correlate with decline in the cross‐species analysis is only relevant to a small number of clades. We also found that clutch size, testes mass, ova size and distributional overlap with feral pigs were not significantly related to decline. In the ongoing search for life‐history and ecological correlates of decline and extinction, our results highlight the importance of performing analyses across contemporary species and using PICs.
Dispersal and population structure of the rufous bettong,Aepyprymnus rufescens(Marsupialia: Potoroidae)
Authors: POPE L. C. , BLAIR D. , JOHNSON C. N.
Published: July 2005

Abstract Many species of herbivorous mammals declined to extinction following European settlement of inland Australia. The rufous bettong,Aepyprymnus rufescens(a macropodoid marsupial), is ecologically similar to many of these species. We used analysis of microsatellite markers to determine dispersal patterns and mating system characteristics in a cluster of local populations ofA. rufescens, with the aim of gaining a better understanding of regional population dynamics in such species. Particularly, we asked whether the rufous bettong showed source‐sink dynamics, as Morton (1990) hypothesized that many mammals may have been made vulnerable to extinction through such processes. We compared populations separated by distances of up to 12 km, and detected significant genetic differentiation among local populations (FST = 0.016). Females displayed greater genetic structuring than males, suggesting that females dispersed over shorter distances or less frequently than males. Geographic distance was weakly related to genetic distance between populations suggesting some gene flow at this scale, and paternity assignment indicated that dispersal can occur over distances of up to 6.5 km. Our study populations varied widely in density, but density did not explain the pattern of genetic differentiation observed. These findings of significant structure among populations, some influence of distance on genetic divergence and that density explains little of the divergence among populations, suggested that source‐sink dynamics did not play a large role among these populations. Variance in male mating success was low (maximum assigned paternity for an individual male was 14% of offspring). While data on multiple maternity were limited, roughly half of repeat maternity was assigned to the same male, suggesting that the mating system of the rufous bettong is not purely promiscuous.
Do wild dogs exclude foxes? Evidence for competition from dietary and spatial overlaps
Authors: MITCHELL BRUCE D. , BANKS PETER B.
Published: July 2005

Abstract  The management of wild canids (wild dogs/dingoes and foxes) presents a conservation dilemma for land managers across Australia. These canids are predators of wildlife and domestic stock but dingoes are considered native and anecdotal reports suggest that they may suppress foxes such that dingo/dog conservation may have a net benefit to wildlife. This study examines dietary and spatial interactions between wild dogs and foxes in the Greater Blue Mountains region of NSW to address the possibility of suppression through competitive exclusion by dogs on foxes. Predator diets were compared using faecal analysis as well as an analysis of 19 dietary studies from similar forest habitats in eastern Australia. Spatial relationships were examined using data from an extensive canid control programme. Diets of wild dogs and foxes showed a high degree of overlap in species taken, indicating potential for competition. But there was also evidence of resource partitioning with the size and arboreality of mammalian prey differing between the two predators. Wild dogs and foxes responded to different landscape‐scale variation in the physical environment, but there was no clear evidence of large‐scale differences in their distribution. At the fine scale there was a negative association between these predators that indicated possible temporal avoidance or localized habitat shifts. Therefore, there is evidence for dietary competition and fine‐scale exclusion, but no support for landscape‐scale exclusion of foxes by wild dogs in the Blue Mountains.
Effect of season of burning and removal of herbaceous cover on seedling emergence in a eucalypt savanna of north‐eastern Australia
Authors: WILLIAMS PAUL R. , CONGDON ROBERT A. , GRICE ANTHONY C. , CLARKE PETER J.
Published: July 2005

Abstract  Seedling emergence in a eucalypt savanna of north‐eastern Australia was documented over a 12‐month period, between May 1999 and May 2000. Seedling emergence for grasses, forbs and subshrubs was found to mainly occur in a brief pulse at the start of the wet season following fire or the removal of grass biomass. Only a minor number of tree and shrub seedlings were detected overall. Burning, or cutting away the grass layer in unburnt savanna, in both the early (i.e. May) and the late (i.e. October) dry seasons significantly increased seedling emergence over undisturbed savanna that had been unburnt for 3 years. Removing the grass layer in unburnt savanna, during either the early or the late dry season, triggered similar seedling densities to savanna burnt in the early dry season. Late dry season fires promoted the greatest seedling density. We attribute this to the higher intensity, late dry season fires releasing a greater proportion of seed from dormancy, coupled with the higher density of soil seed reserves present in the late dry season.
Microsite heterogeneity in litterfall risk to seedlings
Authors: GILLMAN LEN N. , OGDEN JOHN
Published: July 2005

Abstract  Litterfall is an important cause of damage and mortality to seedlings in many forest ecosystems. This study is the first to investigate the contribution of variable risk of litterfall damage to microsite heterogeneity. Two hundred artificial seedlings were ‘planted’ in the ground at 2‐m intervals along transects in each of two New Zealand forests, and all plant species with foliage directly above each artificial seedling were recorded. Additional artificial seedlings were planted on the ground underneath treeferns and on their trunks (epiphytically). The artificial seedlings were monitored monthly for damage over 2 years. Three overtopping species that cause litterfall damage, along with one species that impedes litterfall, produced different microsites with a hierarchy of litterfall damage risk to seedlings (2–30% per year). This risk differed significantly among microsites (P < 0.0005). Seedlings differ in resilience to litterfall and, therefore, microsites with different litterfall risks provided the potential for regeneration niche differentiation. More seedlings were damaged beneath Cyathea dealbata (Cyatheaceae), which drops whole fronds, than on its trunks. The reverse was found for Dicksonia fibrosa (Dicksoniaceae), which retains dead fronds as a ‘skirt’. We suggest that shedding whole fronds, or producing a skirt of fronds, are alternative ‘strategies’ that can reduce competition from terrestrial and epiphytic seedlings, respectively.
Two fine‐resolution Pliocene charcoal records and their bearing on pre‐human fire frequency in south‐western Australia
Authors: DODSON JOHN R. , ROBINSON MICHAEL , TARDY CLAUDINE
Published: July 2005

Abstract  Yallalie is a probable meteor impact crater and in the Upper Pliocene contained a substantial lake. Two Mid‐Pliocene finely laminated sediment records from Palaeolake Yallalie, from about 3 million years ago, provide evidence of fire and fire frequency in the sclerophyll woodland and heaths of south‐western Australia in the absence of humans. Fine charcoal was observed in all samples examined, and was deposited at a rate of about 0.3–0.8 cm2 cm−2 year−1 in Palaeolake Yallalie. This evidence suggests the occurrence of annual fires occurring every year in the slightly warmer and wetter climate compared with today. The near coastal western location and the prevailing westerly winds probably carry charcoal from the near region or lake catchment scale. The data indicate that local fires occurred at a variety of time intervals between 3 and 13 years, with a typical average of 6–10 years. The results are comparable with those of Atahan et al. (2004) for the same site but from a period of about 200 000 years later in the Mid‐Pliocene. Thus, the records which differ in age by some hundreds of thousands of years have all recorded fire frequencies that are longer than for the historical period and this may have important implications for the long‐term survival of the integrity of the high biodiversity plant communities of the region.
Update on anti‐emetics for chemotherapy‐induced emesis
Authors: Olver I. N.
Published: July 2005

Abstract

The need to control chemotherapy‐induced emesis has stimulated research into anti‐emetics. Emesis is not only unpleasant, but negatively impacts on global quality of life. The development of two new classes of drugs has been responsible for the major advances in anti‐emesis. The 5 hydroxytryptamine3 (5HT3) antagonists in combination with dexamethasone significantly improved the control of acute post chemotherapy emesis, but delayed emesis which can last for several days was still problematic, yet its incidence was underestimated by clinicians. Both the control of acute and delayed emesis was improved when the neurokinin1 (NK1) receptor antagonists were added to 5HT3 antagonists and steroids. The complete control of delayed emesis was improved by 21% with little toxicity. The triple drug combination has become the standard of care for preventing the emesis associated with cytotoxic drugs of high emetic potential. (Intern Med J 2005; 35: 478−481)
Asthma 3+ Visit Plan: a qualitative evaluation
Authors: Douglass J. A. , Goeman D. P. , Yu E. A. , Abramson M. J.
Published: July 2005

Abstract

Introduction:  The Asthma 3+ Visit Plan is a Commonwealth primary care initiative to improve care for patients with moderate or severe asthma through visits to general practitioners (GP).

Aims:  To assess the use of, and barriers to, completing the Asthma 3+ Visit Plan in recurrent emergency department attendees; asthma knowledge, symptoms and quality of life were assessed before and after undertaking the plan.

Methods:  The design was a predominantly qualitative study. Consenting individuals who presented for emergency treatment for asthma were interviewed before and after completing the Asthma 3+ Visit Plan with their GP. Asthma knowledge, symptom control, quality of life and demographic information were collected and participants underwent in‐depth interviews for qualitative analysis. The setting was a tertiary teaching hospital and two suburban hospitals. The participants were 20 recurrent emergency attendees with asthma.

Results:  Individuals who completed the Asthma 3+ Visit Plan had significant improvements in asthma‐related quality of life and asthma knowledge. Qualitative interviews revealed that recurrent emergency attendees for asthma viewed the Asthma 3+ Visit Plan favourably. A good relationship with the GP appeared integral to the success of the Asthma 3+ Visit Plan and patient recall was an important factor in plan completion. Cost was also a barrier to patients completing the plan.

Conclusion:  Our findings support the Asthma 3+ Visit Plan as a discharge strategy for recurrent emergency attendees with asthma. (Intern Med J 2005; 35: 457–462)
Part II. General practitioner–specialist referral process
Authors: Piterman L. , Koritsas S.
Published: July 2005

Abstract

This is the second of two articles that explore the general practitioner (GP)–specialist relationship. In this article, we explore the nature of the referral process, beginning with referrals frequently made by GPs in Australia and reasons for referral to specialists. In Australia, GPs commonly refer patients to specialists, particularly orthopaedic surgeons, ophthalmologists, surgeons and gynaecologists for a variety of reasons, including diagnosis or investigation, treatment and reassurance (reassurance for themselves as well as reassurance for the patient). GPs will choose a specialist after considering a variety of factors, such as the specialist's medical skill, their previous experience with the specialist, the quality of communication between them, office location and patient preferences. The referral is generally made by telephone or by letter, the latter of which is known to vary significantly in content and quality. The specialist, GP and patient expectations of the referral and the consultation process are also described. Specialists expect the GP to provide information about the problem to be addressed and adequate patient history, GPs expect a clear response regarding diagnosis and management as well as justification for the course of action, and patients expect clear communication and explanation of the diagnosis, treatment and follow‐up requirements. When these expectations remain unmet, GPs, specialists and patients end up dissatisfied with the referral process. (Intern Med J 2005; 35: 491–496)
Recombinant factor VIIa as an adjunctive therapy for patients requiring large volume transfusion: a pharmacoeconomic evaluation
Authors: Loudon B. , Smith M. P.
Published: July 2005

Abstract

Background:  Acute haemorrhage requiring large volume transfusion presents a costly and unpredictable risk to transfusion services. Recombinant factor VIIa (rFVIIa) (NovoSeven, Novo Nordisk, Bagsvaard, Denmark) may provide an important adjunctive haemostatic strategy for the management of patients requiring large volume blood transfusions.

Aims:  To review blood transfusion over a 12‐month period and assess the major costs associated with haemorrhage management. A pharmoeconomic evaluation of rFVIIa intervention for large volume transfusion was conducted to identify the most cost‐effective strategy for using this haemostatic product.

Methods:  Audit and analysis of all patients admitted to Christchurch Public Hospital requiring >5 units of red blood cells (RBC) during a single transfusion episode. Patients were stratified into groups dependent on RBC units received and further stratified with regard to ward category. Cumulative costs were derived to compare standard treatment with an hypothesized rFVIIa intervention for each transfusion group. Sensitivity analyses were performed by varying parameters and comparing to original outcomes.

Results:  Comparison of costs between the standard and hypothetical model indicated no statistically significant differences between groups (P < 0.05). Univariate and multivariate sensitivity analyses indicate that intervention with rFVIIa after transfusion of 14 RBC units may be cost‐effective due to conservation of blood components and reduction in duration of intensive area stay.

Conclusion:  Intervention with rFVIIa for haemorrhage control is most cost‐effective relatively early in the RBC transfusion period. Our hypothetical model indicates the optimal time point is when 14 RBC units have been transfused. (Intern Med J 2005; 35: 463–467)
Differences in stroke care practices between regional and metropolitan hospitals
Authors: Read S. J. , Levy J.
Published: July 2005

Abstract

Background: A recent audit of stroke care in major Australian metropolitan teaching hospitals showed considerable variation in care practices and uptake of evidence‐based therapies. We could find no published data on stroke care practices in regional Australia.

Aim: To compare acute stroke care practices at four regional hospitals with a metropolitan teaching hospital with a stroke unit.

Methods: The hospital medical records of 30 consecutive patients at each hospital (total 150 patients), with a discharge diagnosis of stroke, were retrospectively audited to identify differences in stroke care practices, including the use of investigations, acute interventions, and secondary prevention strategies, between the regional and metropolitan, and between smaller (less than 150 stroke admissions annually) and larger (more than 250 admissions annually) hospitals.

Results: Patients treated at regional or smaller hospitals were less likely to have a computed tomography head scan within 24 h of admission, carotid duplex, echocardiography, estimations of lipids and glucose, a swallow assessment, involvement of allied health professionals or be prescribed prophylaxis against deep vein thrombosis, compared to patients treated at metropolitan or larger hospitals.

Conclusions: Significant differences in stroke care practices exist between regional/smaller and metropolitan/larger hospitals. Strategies designed to minimize variation in care practices, such as evidence‐based care pathways, should be explored. (Intern Med J 2005; 35: 447–450)
Weekly docetaxel as second line treatment after mitozantrone for androgen‐independent prostate cancer
Authors: Joshua A. M. , Nordman I. , Venkataswaran R. , Clarke S. , Stockler M. R. , Boyer M. J.
Published: July 2005

Abstract

Background: Two recent phase III trials have shown an improvement in survival with the use of docetaxel in metastatic androgen‐independent prostate cancer (AIPC) compared to mitozantrone. However no phase II trials have clearly defined the level of activity of docetaxel after mitozantrone.

Aims: We sought to define the activity and toxicity of weekly docetaxel as second line chemotherapy after mitozantrone in men with AIPC.

Methods: Twenty men were treated with docetaxel 40 mg/m2 weekly for 3 of every 4 weeks until progression or prohibitive toxicity. End‐points included prostate specific antigen response, common toxicity criteria, time to progression and overall survival.

Results: Nine patients (45%) had a 50% or greater reduction in PSA maintained for at least 1 month. Weekly docetaxel was well tolerated with few major ­toxicities: two patients had Grade 3 diarrhoea (10%) and six had grade 2−4 haematologic toxicities (30%). The median time to progression was 5 months (range 0−13) and median survival was 13 months (range 1−24) from starting docetaxel. The median survival from starting mitozantrone was 19 months. Men who had responded to mitozantrone were no more likely to respond to docetaxel (P = 0.2 Fischer's exact test).

Conclusions: Weekly docetaxel is a safe and active second‐line treatment after mitozantrone for androgen‐resistant prostate cancer, with similar levels of activity to the first‐line setting. (Intern Med J 2005; 35: 468−472)
Costs (Historical versus Current) versus Exit Values
Authors: STERLING ROBERT R.
Published: July 2005

The three alternative methods of accounting are sharply distinguished, the questions regarding those methods are segregated, a criterion ‐ relevance–that will discriminate the methods is identified, and that criterion is applied to the alternatives. The relevance criterion is applied initially in the context of a simple case and subsequently in the context of more complex cases. The exit value system is supported because the exit value of an owned asset is demonstrably relevant to exchange decisions and because it fares no worse than other systems when other criteria suchas additivity, are considered.
Dividends, Distortion and Double Taxation
Authors: PARTINGTON G. H. , CHENHALL R. H.
Published: July 2005

It is often claimed the double taxation inherent in the classical system of corporate taxation imposes an extra tax burden on corporate income and causes undesirable distortions in economic behaviour. In anticipation of suggestions for reform, consequent upon a major inquiry into the Australian financial system, this paper questions several of the traditional criticisms of the classical tax system and suggests that the supposed extra tax burden may not exist.
Duration and Fisher's Rate of Return over Cost
Authors: HIRST MARK , MA RONALD
Published: July 2005

This paper seeks to explain why the net present value profiles of investment projects may intersect with changes in the interest rate. Previous explanations have pointed to differences in the timing of the projects' cash flows. However, the timing of a project's cash flows has not been defined in the literature and the relative timing of projects' cash flows typically is illustrated by a simplistic example. We make use of the projects' durations to specify timing differences and provide a more explicit analysis of the role of timing differences in the intersection of present value profiles of projects.
Market Prices v. Cost Indexation in Accounting for Steel Inventories
Authors: WOLNIZER P. W.
Published: July 2005

Professional accounting prescriptions in the U.S.A., U.K. and Australia suggest cost indexation as a method of approximating the replacement cost of inventories. The behaviour of prices quoted by over ninety steel producing companies in the U.S.A. for ten product groups (thirty‐eight product grades) over the period 1968–77 is examined to determine the appropriateness of using aggregative revaluation procedures within the context of financial statement preparation. The evidence adduced suggests that the use of price indexes to obtain the replacement cost of inventories may distort the financial statements of companies whose inventories do not tally with the regimen of the index. Further, the investigation shows that the problems arising from the use of replacement cost do not arise with the use of selling prices. Reliable selling price data are readily available for a wide range of steel inventories on an up‐to‐date basis, in both domestic and international markets. Not only can selling price data for steel inventories be obtained with reasonable ease compared with the complexities of index‐based valuation procedures, but they are more precise measures.
Theory, Pragmatism and Conservatism in Reflecting the Effects of Warrants on Diluted EPS
Authors: BARLEV BENZION
Published: July 2005

The American, British and Canadian professional accounting bodies have prescribed methods for calculating earnings per share which are materially different. The aim of this paper is to determine which of the three methods is most compatible with finance theory with particular reference to the effects of dilution. Only the Canadian method can be shown to be theoreticaly sound.
One Type of Security in Retrospect
Authors: SMITH R. G. E.
Published: July 2005

The case for capitalizing large firms solely with ordinary shares (common stock) is extended by rebutting the arguments of Williams and Finlay (1983) that common stock is obsolete. An account of the historical origins of the supporting elements of the one‐security plan is provided. Of the arguments and evidence to be presented, some will be recapitulations of points made earlier and some will be additional.
Garner ν. Murray–A Re‐appraisal
Authors: ASHTON R. K.
Published: July 2005

The decision in Garner v. Murray was a departure from what had been accepted partnership practice. In the elementary accounting texts the decision in the case is widely quoted although, surprisingly, the legal merits of the case have not been examined in the literature. It is to this question that this paper is directed. The analysis shows that the main points in the case were incorrectly decided and would have provided grounds for an appeal. The final part of the paper examines the implications of the analysis for the problems identified by Houghton (1981).