bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate Variability in Regions of Amphibian Declines
Authors: Alexander Michael A. , Eischeid Jon K.
Published: March 2003

Abstract: We explored the relationship between amphibian declines and climate variations in Colorado (U.S.A.), Puerto Rico, Costa Rica–Panama, and Queensland (Australia) through two sources of data: output from the National Center for Environmental Prediction “reanalysis system” and area‐averaged station data. The reanalysis system merges observations from airplanes, land stations, satellites, ships, and weather balloons with output from a weather‐forecast model to create global fields of atmospheric variables. Station data consisted of temperature and precipitation measured with thermometers and rain gauges at fixed locations. Temperatures were near normal in Colorado when the amphibian declines occurred in the 1970s, whereas in Central America temperatures were warmer than normal, especially during the dry season. The station data from Puerto Rico and Australia indicated that temperatures were above normal during the period of amphibian declines, but reanalysis did not show such a clear temperature signal. Although declines occurred while the temperature and precipitation anomalies in some of the regions were large and of extended duration, the anomalies were not beyond the range of normal variability. Thus, unusual climate, as measured by regional estimates of temperature and precipitation, is unlikely to be the direct cause of amphibian declines, but it may have indirectly contributed to them. Previous researchers have noted that the declines appear to have propagated from northwest to southeast from Costa Rica to Panama and from southeast to northwest in Queensland, Australia. Wind has the potential to transport pathogens that cause amphibian mortality. The mean direction of the near‐surface winds tended to parallel the path of amphibian declines from July–October in Central America and from May–July in Australia. The wind direction was highly variable, however, and the propagation rate of amphibian declines was much slower than the mean wind speed. In addition, the most likely pathogen is a chytrid fungus that does not produce desiccation‐resistant spores. Thus, if wind is involved in the propagation of amphibian declines, it is through a complex set of processes.
Frogs and a Cloud‐Forest Edge in Ecuador
Authors: C. Eduardo Toral , Feinsinger Peter , Crump Martha L.
Published: March 2003

Abstract: Edge effects on tropical faunas may differ between highland and lowland sites and may therefore require different conservation strategies. In northwestern Ecuador, we examined the frog fauna on both sides of a boundary between wet Andean forest and agricultural lands, asking the following questions: ( 1 ) What is the nature of the response of frogs to edge? ( 2 ) Does the response change with land use? ( 3 ) What conservation measures are suggested by the first two questions? We set up 12 study plots along 16 km of convoluted boundary in one watershed. Each plot contained an agricultural parcel bordering a rectangle extending into the forest. In the dry season of 1996, following local tradition each agricultural parcel was cleared of second‐growth vegetation and then burned, planted, cultivated, and ( in six cases ) harvested 1 year later. Half the parcels were planted in pasture grasses; the others were planted with corn and beans. We randomly assigned each treatment to two sites within each of three blocks. At each site, parallel to the boundary we set up eight all transects, four on the forest side of the boundary and four on the agricultural side. We censused frogs in plots with visual‐encounter surveys along all transects in four different seasons from just after planting to just before crop harvest. Regardless of land use or survey date, frog‐capture frequencies changed abruptly at the forest‐agriculture boundary and then remained constant regardless of distance into the forest or into the cultivated parcels. Forest transects provided 95% of the 2111 captures; all but 5 captures were of Eleutherodactylus spp. ( Leptodactylidae). Eleutherodactylus leoni dominated the forest frog fauna but was rare throughout agricultural parcels. The second most common species, E. w‐nigrum, displayed the opposite pattern. The stepwise nature of these responses differs from results of studies in tropical lowlands and suggests that edge effects that might penetrate from highland agriculture into cloud forest may be of far less conservation concern than the absolute loss of habitat as the agricultural boundary creeps upslope. This suggestion should be viewed with caution because the scope of our study included only one watershed, two idiosyncratic land‐use treatments, and a unique vertebrate taxon.
Importance of Farmland Habitats for Conservation of Plant Species
Authors: Freemark Kathryn E. , Boutin Céline , Keddy Cathy J.
Published: March 2003

Abstract: Little attention has been paid, particularly in North America, to the importance of the mosaic of farmland habitats for the conservation of native plant species. We examined patterns in plant species richness, composition, and abundance at the scale of site, habitat (sites of a given habitat type pooled), and landscape for 10 farmland habitats (crop, hay field, pasture, old field, herbaceous fencerow, woody fencerow, roadside, ditch, plantation, woodlot) at 121 sites in eastern Ontario, Canada. At the site level, woodlots (3–79 ha) had the highest richness of overall (average 57.6 species), woody (23.4), and herbaceous species (25.0). Crop, herbaceous fencerow, and plantation habitats had few native species per site. Introduced species comprised>50% of herbs per site in seven habitats. Across habitats, 305 species were observed; 227 species were herbaceous, 70% of which were native and 31% of which were weeds. Wooded fencerows had the highest species richness in total (153) and for herbs (107). Woodlots had the most woody species (56). Percent native species was generally lower and percent weeds higher at the site level than at the habitat level. All habitats had unique species; woodlots had the highest number of unique species (  74). Results of the multivariate analysis for abundant herbs revealed that woodlots and plantations were different, as were crop and ditch habitats. The results of our landscape‐level study show that plant species richness and composition varied substantially among the five landscapes studied, ranging from a row‐crop monoculture landscape to a diverse mosaic of crop and noncrop habitat landscape. The row‐crop monoculture landscape had 11% of total, 4% of native, 27% of introduced, and 27% of the weed species found in the landscape with a greater diversity of crop and noncrop habitats. The richness of introduced and weed species was asymptotic with the addition of ditch, hayfield, and pasture in the landscape, and native species richness increased steeply, particularly with the addition of marsh, wooded fencerow, and woodlot. Our results emphasize the importance of maintaining a diverse mosaic of habitats and of noncrop habitats in farmland for conserving herbaceous and woody native plants.
Presence and Abundance of Red‐Listed Plant Species in Swedish Forests
Authors: Gustafsson Lena
Published: March 2003

Abstract: This study was performed to obtain information on the presence and abundance of red‐listed vascular plants, bryophytes, and lichens of forests in an objective and systematic way and on a large scale. Species were searched for in line transects in three areas in southern Sweden, representing a total of 1350 km  2. I investigated 135 ha of production forests and, for comparison, 35 so‐called “woodland key habitats” (WKHs) covering 63 ha. It is estimated that there are 70,000 WKHs in Sweden presumed to be important sites for red‐listed species. I found 22% of the forest vascular plants, bryophytes, and lichens on the national red list, indicating that most such species are very rare. The red‐listed bryophytes and lichens were considerably more common than the vascular plants. Due to a relatively high abundance of a few red‐listed species, the average number of records for the three species groups together was 0.9–2.4/ha in the production forest. Extrapolated to the whole hemiboreal region of Sweden, there could be several million occurrences of red‐listed plant species within the managed forests. The red‐listed species were to a high degree associated with deciduous trees and dead wood and occurred mainly in mature forests. Woodland key habitats had more red‐listed species, more species in high categories of threat, and significantly more records per hectare than production forests. Because WKHs constitute only 1% of the productive forest land in Sweden, they cannot alone safeguard the future of red‐listed species. The great importance of managed forests, which make up more than 95% of the productive forest land in Sweden, must be acknowledged. Combined conservation planning is recommended, with attention being given to both WKHs and production forests.
Bird Species Associated with Riparian Woodland in Fragmented, Temperate‐Deciduous Forest
Authors: Groom Jeremiah D. , Grubb Thomas C.
Published: March 2003

Abstract: Forest area is known to be correlated with bird‐species diversity. Most researchers of riparian forest avifauna have used riparian woodland width as an index of forest area. We conducted point counts at 135 locations along Big and Little Darby creeks in Ohio and used Landsat Thematic Mapper data to determine woodland area and width surrounding each point‐count station. Probability of detection was positively correlated with area for 11 bird species and negatively correlated with area for 8 species. Thus, along Big and Little Darby creeks, woodland area appeared to better predict bird‐species presence than woodland width. The proposed Little Darby National Wildlife Refuge located within the study area includes restoration of riparian forest habitat along the two creeks. If the riparian habitat zones are not sufficient in area, already common species, rather than declining Neotropical migrants, may be the only species to benefit from restoration efforts.
Biophysical Factors, Land Use, and Species Viability in and around Nature Reserves
Authors: Hansen Andrew J. , Rotella Jay J.
Published: March 2003

Abstract: Many nature reserves are located in landscapes with extreme biophysical conditions. We examined the effects of interactions between biophysical factors and land use on bird population viability inside and outside of Yellowstone National Park. Our hypotheses were as follows: (1) biophysical factors constrain bird species richness and bird reproduction at higher elevations; (2) nature reserves are located at higher elevations, whereas private lands and more intense land use occur mostly at lower elevations with more mild climates and fertile soils; and (3) intense land use at lower elevations favors nest predators and brood parasites and thereby reduces reproductive output for some bird species. We used simulation models to evaluate whether favorable habitats outside reserves are population source areas and whether intense land use can convert these habitats to population sinks and reduce population viability within reserves. Bird species richness and abundance were high in small hotspots in productive, low‐elevation habitats. Length of breeding season—and opportunity for renesting—was greatest at the lowest elevations for both American Robins (   Turdus migratorius) and Yellow Warblers (   Dendroica petechia). Nature reserves were higher in elevation than private lands, so hotspots for bird richness and abundance occurred primarily on or near private lands, where rural residential development was concentrated. Brown‐headed Cowbirds (   Molothrus ater) were significantly more abundant near rural homes, but nests of American Robins were not parasitized and their nest success did not differ with home density. Nests of Yellow Warblers were commonly parasitized by cowbirds, and their nest success was significantly lower near rural homes. Estimated intrinsic population growth ( λ) for American Robins suggested that low‐elevation hotspots were population source areas for this species. Estimated λ for the Yellow Warbler suggested that the entire study area was a population sink, likely due to the effects of intense land use at lower elevations and climate constraints at higher elevations. Removing the effect of land use from the simulations revealed that high‐elevation hotspots were population sinks, whereas low‐elevation hotspots were source areas. Our results are consistent with the possibility that bird‐population source areas outside nature reserves can be converted to population sinks by intense human use, thereby reducing the viability of subpopulations within reserves.
Avifaunal Collapse in West African Forest Fragments
Authors: Beier Paul , Van Drielen Maryann , Kankam Bright O.
Published: March 2003

Abstract: Despite the fact that West African tropical forests are the most fragmented in Africa, there has been no published research on biodiversity in these fragments. To determine how forest birds respond to five factors—patch size, patch isolation, canopy density, abundance of large trees, and proximity to forest edge—in these forests, we surveyed 60 species of forest birds on 121 transects (2.5 ha each) in 35 forest fragments in the semideciduous forest zone of Ghana. Species richness per transect increased with patch size over the entire range of patch sizes observed (3–33,000 ha). The diversity of forest birds (22 species) on a single transect in a large forest patch was similar to the cumulative diversity (25 species) on all 17 transects in 13 small patches. Twenty‐two of 60 species were area sensitive, 15 of which were never found in small patches. These results suggest that only large forests will conserve many species of West African forest birds. Nine species were edge sensitive, 7 of which were also area sensitive. However, forest structure near patch edges was not consistent with bird responses to canopy and tree density, suggesting that mechanisms other than microclimate or structural changes ( perhaps predation or nest parasitism) underlie the response of most species that are sensitive to both edge and area. Regression of critical patch size (the smallest patch size in which a species was detected) on logarithm of body mass (an index of home range size) for 22 area‐sensitive species suggests that area‐sensitive species are unlikely to occur in patches smaller than several home‐range areas. Canopy density influenced 13 species (11 positively, 2 negatively), and abundance of large trees influenced 8 species (3 positively, 5 negatively). Forest birds did not respond to isolation (distance from a patch to a large forest) for isolation distances of 1–25 km, suggesting that island biogeographic mechanisms had less influence on birds than other potential mechanisms of area sensitivity. Although small patches contributed little to the conservation of forest birds—species found in small patches were well represented in large patches—small patches are probably important for supporting generalist bird species that provide ecological services in the agricultural matrix and serving as nuclei for future ecosystem recovery.
The Biogeography of Faunal Place Names in the United States
Authors: Cox John J. , Maehr David S. , Larkin Jeffery L.
Published: March 2003

Abstract: The names of native wildlife species are attached to thousands of landmarks throughout the United States. We used a U.S. Geological Survey online database to assess the abundance, distribution, density, and historical range fidelity of 24 faunal place names within the continental United States and Alaska. Our search generated over 35,000 faunal place names distributed across 49 states, with overall highest densities in mountainous regions. The distribution of place names corroborates the familiar pattern of range constriction characteristic of many species during the past century. Place names of range‐limited species demonstrated strong fidelity to historical ranges. The spatial patterns of faunal place names are important indicators of a species' historical distribution. Furthermore, these place names reflect culturally important connections between humans and native fauna. Prudent analysis of place names may provide important biogeographical information for maintaining or restoring species and habitat components, although its utility will likely be limited to large, charismatic species.
Temporal Extrapolation of PVA Results in Relation to the IUCN Red List Criterion E
Authors: Kindvall Oskar , Gärdenfors Ulf
Published: March 2003

Abstract: The World Conservation Union (  IUCN  ) Red List threat categories of critically endangered, endangered and vulnerable are defined by a set of five criteria ( A–E ). Criterion E is quantitatively defined by three specified threshold extinction risks (  50%, 20%, and 10%  ), each associated with a particular time frame. For a population viability analysis (  PVA) to be useful for assessing a species' threat category, the results must have been expressed as the full extinction probability function over time or at least for the three specified time frames. Often this is not the case, and extrapolations from different kinds of PVA results (  e.g., mean time to extinction ) are often necessary. By means of analytic models, we investigated the possibilities of extrapolation. Based on our results, we suggest that extrapolation is not advisable due to the huge errors that can occur. The extinction probability function is the best kind of summary statistic to use when applying criterion E, but even then the threat categorization may be ambiguous. If the extinction risk is low in the near future but increases rapidly later on, a species may be classified as vulnerable even though it is expected to become extinct within 100 years. To avoid this, we suggest that the guidelines to the IUCN Red List criteria include three reference lines that allow for interpretation of the PVA results in the context of the three threat categories within the entire period of 100 years. If the estimated extinction probability function overshoots one of these functions, the species should be classified accordingly.
An Evolutionary Approach to Understanding the Biology of Invasions: Local Adaptation and General‐Purpose Genotypes in the Weed Verbascum thapsus
Authors: Parker Ingrid M. , Rodriguez Joseph , Loik Michael E.
Published: March 2003

Abstract: The role of evolution in the invasion of non‐native species has important implications for conservation, weed science, risk assessment, and policy. In this paper we first discuss why an evolutionary perspective can be helpful and outline a range of potentially useful approaches from population biology and ecological genetics. As a case study, we then ask how adaptation and genetic structure may promote or constrain the expansion of an invasive weed, Verbascum thapsus, into high elevations in the Sierra Nevada of California. We used growth‐chamber and common‐garden experiments to assay a range of morphological and physiological traits that could influence plant fitness at high elevation. There was a significant relationship between elevation and leaf size and reflectance above 800 m, although we found no relationship between elevation and most other traits (  growth rate in warm or cool temperatures, freezing tolerance when grown in warm or cool temperatures, leaf number, rosette morphology, plant height  ). We did see marked genetic differentiation among populations, possibly reflecting founder effects and a history of genetic drift. When we partitioned the phenotypic variance, there was almost no variation among maternal families within populations, limiting the potential for selection to act. The majority of the variance for all traits was among individuals within families, suggesting that environmental conditions strongly influenced the phenotype. Overall, the increasing success of V. thapsus at high elevations appears to conform more to Baker's concept of a general‐purpose genotype than to invasion by rapid adaptation.
Women's Experiences of Birth in St. Petersburg, Russian Federation, Following a Maternal and Child Health Intervention Program
Authors: Chalmers Beverley , Muggah Henry , Samarskaya Mida F. , Tkatchenko Elena
Published: March 2003

Background:

An educational program for professionals in maternal and child health care in St. Petersburg, Russian Federation, was conducted between 1994 and 1997.

Methods:

The program was designed to provide 12 workshops in evidence‐based antenatal and intrapartum care, and appropriate preparation of parents for pregnancy, birth, and parenthood for health care professionals in the city.

Results:

Observations on the quality of maternity care service provided for women at the start and after the completion of the intervention program are reported. Significant changes occurred in maternity care practices during the period in which training programs were offered in St. Petersburg. In particular, more family centered care services were introduced, and breastfeeding practices improved. Significant reductions in maternal and perinatal mortality occurred.

Conclusions:

Most maternity hospitals showed a reduction in the use of interventions in delivery over the period of study, although one or two showed tendencies to follow in their Western counterparts' footsteps, including the emergence of a high cesarean delivery rate. This is not yet a cause for concern, but is worth future monitoring by local authorities. (BIRTH 25:2 June 1998)
Postpartum Early Hospital Discharge and Follow‐up Practices in Canada and the United States
Authors: Britton John R.
Published: March 2003

Background:
Although official guidelines and recent legislation have addressed early postpartum hospital discharge and follow‐up, little is known about the practices of obstetricians in Canada and the United States on this issue.
Methods:
Questionnaires were mailed to two separate random samples of 2000 Fellows of the American College of Obstetricians and Gynecologists (ACOG) in the United States and all Canadian Fellows. Practices and perceptions were compared with those recommended in the literature, recent legislation, and guidelines of ACOG and American Academy of Pediatrics (AAP).
Results:
In contrast to concerns expressed in the medical literature and official AAP/ACOG guidelines, many physicians considered potential psychosocial and demographic risk factors relatively unimportant in making early discharge decisions, preferring to emphasize aspects of the patient's medical condition, hospital course, and social support. Although the official guidelines encourage follow‐up for all patients discharged early, additional visits are routinely advised by only 39 percent of obstetricians after vaginal delivery and by 68 percent after cesarean section. After vaginal delivery 39 percent of obstetricians used telephone follow‐up and 37 percent after cesarean delivery. Moreover, although the official guidelines recommend follow‐up within 48 hours of discharge, only one‐half of the obstetricians surveyed advised follow‐up at this time. In contrast to the guidelines, most obstetricians defined early discharge as that occuring within 24 hours after vaginal delivery and 72 hours after cesarean delivery; most defined optimal lengths of stay within the 48‐hour (after vaginal delivery) and 96‐hour (after cesarean delivery) periods considered short by the guidelines.
Conclusions:
Current postpartum early discharge and follow‐up practices emphasize the physical health of the mother and place little emphasis on social risk. They appear to be influenced by perceptions of the appropriateness of the length of stay and are not in agreement with professional guidelines. (BIRTH 25:3 September 1998)
Perineal Outcomes in a Home Birth Setting
Authors: Aikins Murphy Patricia , Feinland Julie Baker ,   Patricia Aikins Murphy is an Associate Research Scientist in the Department of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons in New York. Julie Baker Feinland is with Hampshire Obstetrical and Gynecological Associates, Inc., of Northampton, Massachusetts.
Published: March 2003

Background:
Perineal lacerations are a source of significant discomfort to many women. This descriptive study examined perineal outcomes in a home birth population, and provides a preliminary description of factors associated with perineal laceration and episiotomy.
Methods:
Data were drawn from a prospective cohort study of 1404 intended home births in nurse‐midwifery practices. Analyses focused on a subgroup of 1068 women in 28 midwifery practices who delivered at home with a midwife in attendance. Perineal trauma included both episiotomy and lacerations. Minor abrasions and superficial lacerations that did not require suturing were included with the intact perineum group. Associations between perineal trauma and study variables were examined in the pooled dataset and for multiparous and nulliparous women separately.
Results:
In this sample 69.6 percent of the women had an intact perineum, 15 (1.4%) had an episiotomy, 28.9 percent had first‐ or second‐degree lacerations, and 7 women (0.7%) had third‐ or fourth‐degree lacerations. Logistic regression analyses showed that in multiparas, low socioeconomic status and higher parity were associated with intact perineum, whereas older age (≥ 40 yr), previous episiotomy, weight gain of over 40 pounds, prolonged second stage, and the use of oils or lubricants were associated with perineal trauma. Among nulliparas, low socioeconomic status, kneeling or hands‐and‐knees position at delivery, and manual support of the perineum at delivery were associated with intact perineum, whereas perineal massage during delivery was associated with perineal trauma.
Conclusions:
The results of this study suggest that it is possible for midwives to achieve a high rate of intact perineums and a low rate of episiotomy in a select setting and with a select population. (BIRTH 25:4 December 1998)
Effects of Female Relative Support In Labor: A Randomized Controlled Trial
Authors: Madi Banyana Cecilia , Sandall Jane , Bennett Ruth , MacLeod Christina
Published: March 2003

Background: This study was a randomized controlled trial of primigravidas in Botswana to determine the effectiveness of the presence of a female relative as a labor companion on labor outcomes. Methods: One hundred and nine primigravidas in uncomplicated spontaneous labor were randomly distributed into a control group who labored without family members present, and an experimental group who had a female relative with them during labor. Results: Significantly more mothers in the experimental group had a spontaneous vaginal delivery (91% vs 71%), less intrapartum analgesia (53% vs 73%), less oxytocin (13% vs 30%), fewer amniotomies to augment labor (30% vs 54%), fewer vacuum extractions (4% vs 16%), and fewer cesarean sections (6% vs 13%) than in the control group. These differences were all significant at p < 0.05. Epidural analgesia was not used in the hospital at the time of the study. The only analgesics used were intramuscular pethidine or hyoscine N‐butylbromide (Buscopan). Conclusions: The presence in labor of a female relative was shown to be associated with fewer interventions and a higher frequency of normal delivery compared with the outcomes of those without family member support. The presence of a female relative as a labor companion is a low‐cost, preventative intervention that is consistent with the traditional cultural practices in Botswana. In the light of this and previous studies, all women giving birth in a hospital should be offered the choice of a female relative as a companion to give support during labor.
Low‐Birthweight Prevention Programs: The Enigma of Failure
Authors: Stevens‐Simon Catherine , Orleans Miriam
Published: March 2003

Background:
Low birthweight is the primary cause of neonatal morbidity and mortality in the United States. The purpose of our study was to identify factors associated with the effectiveness and apparent ineffectiveness of comprehensive, multicomponent, prenatal care programs for preventing low birthweight.
Methods:
We reviewed obstetric, pediatric, and public health program evaluations, research reports, and commentaries, published in the English language literature, over the last four decades that pertained to the efficacy of prenatal care for preventing low birthweight.
Results:
The heterogeneous nature of the services delivered and the lack of consistency in the definition of variables made it impossible to use rigorous, quantitative techniques to summarize this evaluation of the literature. Two general limitations of research design that emerged from our reviews were the focus on clusters of commonly associated risk factors, which has blurred the causal pathways linking specific risk factors to low birthweight, and the failure to examine process variables. These two methodologic problems have led investigators to erroneous conclusions that overstate the significance of negative intervention outcomes. The success and failure of low‐birthweight prevention programs has rarely been examined in relation to evidence that the intervention actually modified the targeted risk factors.
Conclusions:
Few rigorous evaluations of well‐designed programs have been conducted. Without an improvement in intervention designs and evaluation studies, recommendations to support or curtail the funding of comprehensive, multicomponent prenatal care services are inappropriate. Rigorously obtained evidence of the costs and benefits of approaches to the prevention of low birthweight are sorely needed.
Declining Trends in Cesarean Deliveries, Ohio 1989–1996: An Analysis by Indications
Authors: Koroukian Siran M. , Rimm Alfred A.
Published: March 2003

Background:
Similar to trends observed nationwide, the rates of cesarean deliveries declined in Ohio during the late 1980s and the early 1990s. This study examined the trends in cesarean deliveries in Ohio from 1989 through 1996, in the presence or absence of indications, and in relation to the use of obstetric procedures. Methods:Birth certificate data for all singleton, liveborn infants in Ohio (n =1,204,859) were used to analyze temporal trends in cesarean sections. Results:The rates of primary and repeat cesarean deliveries declined, respectively, from 15.7 to 12.4 percent and from 83 to 63.3 percent during the 8‐year study period. Significant declines in repeat cesarean deliveries were observed both in the presence and absence of documented medical conditions that could present a potential indication for the procedure. The rates of repeat cesareans remained comparable among women with and without documented indications for cesarean section (64% and 61%, respectively). In addition, 45 and 30 percent of repeat cesareans in 1989 and 1996, respectively, were performed in the absence of any documented indications, or on an elective basis. The declines in cesarean delivery rates during the 8‐year study period occurred simultaneously with an increase in the use of electronic fetal monitoring, induction, and stimulation of labor. Conclusions:The findings suggest that a sizable proportion of repeat cesarean deliveries in 1996 may be unnecessary, even though a marked decline in the procedure has occurred between 1989 and 1996.
Japanese Couples' Childbirth Experiences in Michigan: Implications for Care
Authors: Yeo SeonAe , Fetters Michael , Maeda Yukio
Published: March 2003

Background:
Subtle cultural differences in the childbirth experience for expatriate Japanese couples living in southeast Michigan can sometimes cause conflicts between them and American health caregivers. The purpose of this study was to examine Japanese couples' perceptions and experiences of prenatal care and childbirth in a region of the United States, and to explore the implications for providing culturally competent care.
Methods:
In this qualitative study, in‐depth interviews of 11 Japanese couples (n= 22) were conducted at an outpatient primary care clinic in southeast Michigan by a team of researchers fluent in the Japanese language and knowledgeable about the culture. Participants also completed a short questionnaire.Results:The major themes that emerged comprised perceptions related to a language barrier, ultrasonography, prenatal vitamin supplementation, episiotomy, epidural anesthesia, and practitioner‐patient relationship. Throughout these six themes it was evident that Japanese health care professionals had difficulty accepting health care that was different from the care provided in their home country.Conclusion:The most striking finding of this study was the difficulty for health caregivers to provide culturally competent care. Although the program has strongly invested in health professionals and support staff who were fluent in Japanese and knowledgeable about Japanese culture, conflicts still occurred.
Assessing Effective Care in Normal Labor: The Bologna Score
Authors: Chalmers Beverley , Porter Richard
Published: March 2003

The intention of the “Bologna score” is to quantify, both in an individual labor and in a wider population, the extent to which labors have been managed as if they are normal as opposed to complicated. In this way it may be possible to assess both attitudes and practices within a maternity service toward the effective care of normal labor. A scoring system for normal labor was proposed at the World Health Organization (Regional Office for Europe) Task Force Meeting on Monitoring and Evaluation of Perinatal Care, held in Bologna in January 2000. This paper describes conceptual development of the scale. Recommendations for future evaluation of the Bologna score's validity and potential include field testing globally, comparison with the Apgar score, and evaluation of the relative weight contributed by each of the five measures comprising the Bologna score.
Waiting For Something to Happen: Hospitalization with Placenta Previa
Authors: Katz Anne
Published: March 2003

Background: Placenta previa occurs in approximately 1 of every 200 pregnancies. No research examining women's experiences of this condition has been published. The objective of this study was to describe the experience of women hospitalized with placenta previa. Methods: A descriptive study was conducted using a convenience sample of 10 pregnant women who had been hospitalized with placenta previa. Women were recruited from a tertiary care hospital and participated in two semistructured interviews during the pregnancy and one after the baby's birth while in hospital. They were admitted to hospital from 28 weeks' gestation and remained in hospital until delivery, generally at 36 weeks' gestation. Transcripts of the interviews were analyzed using content analysis to describe their experience. Results: Six themes were identified from the descriptions of the experience as related by the participants. They encompassed the experience from the first symptoms to feelings about the experience after the baby was born. Conclusions: Women with placenta previa experience significant stressors while in hospital. Health caregivers should be aware of the loss of control and isolation these women feel and be mindful of the potential for sequelae in the postpartum period.
Eating Disorders and Childbearing: Concealment and Consequences
Authors: Mitchell‐Gieleghem Anne , Mittelstaedt Mary E. , Bulik Cynthia M.
Published: March 2003

ABSTRACT: The reported incidence of eating disorders has increased markedly during the past 30 years. Numerous studies have linked a spectrum of eating disorders to serious medical complications resulting in hospitalization and death. The prevalence of such disorders occurs primarily in women of adolescent and childbearing age. This article reviews the published literature alerting the practitioner to the indicators of a condition that is seldom disclosed bythe client or detected by the caregiver. Predisposing factors, behavioral theories, and reproductive outcomes are discussed to provide clear evidence of the link between eating disorders and poor pregnancy outcome. Recommendations are offered for early recognition ofa repeatedly concealed disease and for management of eating disorders during the childbearing cycle. (BIRTH 29:3 September 2002)
Differences Among Helicobacter pylori Strains Isolated from Three Different Populations and Demonstrated by Restriction Enzyme Analysis of an Internal Fragment of the Conserved Gene hpaA
Authors: Evans Dolores G. , Queiroz Dulciene M.M. , Mendes Edilberto N. , Svennerholm Ann‐Marie , Evans, Jr. Doyle J.
Published: March 2003

Background. Our goal was to test the idea that Helicobacter pylori genotypes vary from one population to another.

Methods. Analysis of Sau3A and Hinf I restriction fragment–length polymorphism (RFLP) in a 375‐bp polymerase chain reaction amplicon of hpaA was used to compare 31 H. pylori isolates from a relatively small and genetically homogeneous population (Goteborg, Sweden) with those of large, genetically heterogeneous populations located in two different countries (50 isolates from Houston, TX, and 69 isolates from Minas Gerais, a state in the southeastern region of Brazil).

Results. Five different Sau3A and three different Hinf I restriction patterns were found; different combinations of these comprise 10 different RFLP types, I through X. The RFLP types found in the United States and Brazil collections were very similar, except for two Brazil isolates belonging to type VIII and five Brazil isolates belonging to type X, neither type found in the United States. The overall profile of H. pylori isolates from Sweden was remarkably different, with 18 of 31 (58%) having a new Sau3A restriction pattern, termed gS; 10 of these 18 isolates had Hinf I restriction pattern E (RFLP type VIII), and 8 had Hinf I restriction pattern F (RFLP type IX). No isolates from Sweden belonged to RFLP type III or type X.

Conclusions. RFLP typing of a 375‐bp polymerase chain reaction–amplified DNA fragment of H. pylori hpaA revealed that H. pylori genotypes can and do vary from one population to another. We conclude that the unique RFLP profile shown by the group of H. pylori isolates from Goteborg is the result of a cohort effect in this relatively small, stable, genetically homogeneous population. Also, the overall similarity between RFLP profiles of the H. pylori isolates from Texas and Minas Gerais coincides with the fact that although geographically distanced, these populations are similar in being large, dynamic, and genetically heterogeneous.
Comparison of Seven and Fourteen Days of Lansoprazole, Clarithromycin, and Amoxicillin Therapy for Eradication of Helicobacter pylori: A Report from India
Authors: Bhasin Deepak Kumar , Sharma Brijesh Chander , Ray Pallab , Pathak Chander Mohan , Singh Kartar
Published: March 2003

Background. In developed countries, a 1‐week regimen of combined proton pump inhibitors and two antibiotics is considered adequate for Helicobacter pylori eradication. However, there is a paucity of reports from developing countries on treatment duration of less than 14 days. We compared efficacy of 7 and 14 days of lansoprazole (L), clarithromycin (C), and amoxicillin (A) combinations for eradication of H. pylori.

Patients and Methods. Forty‐six consecutive patients who presented with upper gastrointestinal symptoms and tested positive for H. pylori infection were included in the study. In every patient, after performance of upper gastrointestinal endoscopy, antral biopsies were obtained. H. pylori infection was diagnosed by positive rapid urease test and identification of organisms on antral histology. Patients were randomly selected to receive lansoprazole, 30 mg once daily, plus clarithromycin, 250 mg twice daily, plus amoxicillin, 500 mg three times daily for 2 weeks (
group 1;
n = 24;
age, 36 ± 12
years; 18
men)
or 1
week (
group 2;
n = 22;
age, 45 ± 15
years; 12
men). One month after completion of treatment, repeat upper gastrointestinal endoscopy was performed. H. pylori eradication was defined as absence of organism on histopathological examination of both antrum and body of stomach and negative rapid urease test.

Results. Eradication rate was higher in group 1 (23 of 24; 96%) as compared to group 2 (12 of 22; 54%; p < .05). One patient in group 1 had diarrhea, and one patient in group two had skin rash and itching.

Conclusions. Fourteen‐day therapy with lansoprazole, clarithromycin, and amoxicillin is highly effective in eradication of H. pylori. Reducing duration of therapy to 7 days significantly lowers eradication rates.
Solubility, Absorption, and Anti–Helicobacter pylori Activity of Bismuth Subnitrate and Colloidal Bismuth Subcitrate: In Vitro Data Do Not Predict In Vivo Efficacy
Authors: Phillips Rosemary H. , Whitehead Mark W. , Lacey Sandra , Champion Miranda , Thompson Richard P.H. , Powell Jonathan J.
Published: March 2003

Objectives. The aim of this study was to compare the dissolution, bioavailability, and anti–Helicobacter pylori activity of bismuth subnitrate and colloidal bismuth subcitrate. This could, first, provide insights into the mechanism of action of bismuth and, second, help to develop optimal therapeutic strategies.

Methods. Solubility and aquated size of bismuth species were determined in human gastric juice, while absorption into blood and urinary excretion of bismuth was determined in volunteers. Activity against H. pylori was determined in vitro in the presence and absence of antibiotics, while H. pylori eradication was compared in vivo.

Results. Bismuth from colloidal bismuth subcitrate was at least 10% soluble and ultrafilterable and was absorbed in volunteers (>0.5%), whereas that from bismuth subnitrate was insoluble and not absorbed (<0.01%). Colloidal bismuth subcitrate was active against H. pylori (mean inhibitory concentration, ≤12.5 μg/ml), while bismuth subnitrate was inactive (>400 μg/ml); neither was synergistic with antibiotics. With in vivo triple therapy, bismuth subnitrate was as effective as colloidal bismuth subcitrate in eradicating H. pylori (74% and 70% eradicated, respectively).

Conclusions. Colloidal bismuth subcitrate, unlike bismuth subnitrate, is partially soluble, absorbed in humans, and directly toxic to H. pylori in vitro. Surprisingly, however, these preparations had similar efficacy in vivo against H. pylori within triple therapy, suggesting that bismuth compounds may also exhibit indirect antimicrobial effects. We propose that this is an effect on the gastric mucus layer. Nonabsorbable bismuth compounds should be preferentially considered in bismuth‐based therapies against H. pylori, as they would minimize toxicity while maintaining efficacy.
New Approaches for Validation of Lethal Phenotypes and Genetic Reversion in Helicobacter pylori
Authors: McDaniel Timothy K. , DeWalt Kevin C. , Salama Nina R. , Falkow Stanley
Published: March 2003

Background.

Because of limited genetic tools for use in Helicobacter pylori, tests routinely applied in other bacteria for demonstrating a gene’s role in viability and other phenotypes have not been applied to this organism. In a mutational study of putative response regulator genes, we aimed to develop such tools for H. pylori.

Materials and Methods.

We attempted to mutate five response regulator genes by allelic exchange insertional mutagenesis. For genes that yielded no viable mutants, a second copy of the gene was inserted into the chromosome via a suicide vector, and it was seen if providing the second copy would permit the gene’s disruption. For genes that yielded mutants with selectable phenotypes, a strategy was developed for reversion whereby an intact copy of the gene is introduced to the organism by transformation with PCR products. Following this procedure, revertants were selected by phenotypic tests then tested for genetic reversion.

Results.

After failure to attain transformants upon attempted mutation of genes HP0166 and HP1365, we inserted a second copy of each gene within the H. pylori chromosome. In each case the second copy relieved the block of transformation. Mutation of genes HP0703 and HP1021 gave non‐motile and small‐colony phenotypes, respectively. Following transformation with PCR products containing intact copies of the genes, both phenotype and genotype had reverted following phenotypic selections.

Conclusions.

The methods used in this study provide new approaches for confirming suspected genotype/phenotype associations and should be widely applicable in the study of H. pylori.
CagA Status in Dyspeptic Patients With and Without Peptic Ulcer Disease in Turkey: Association With Histopathologic Findings
Authors: Demırtürk Levent , Özel A. Melih , Yazgan Yusuf , Solmazgül Emrullah , Yildirim Şükrü , Gültepe Mustafa , Gürbüz A. Kemal
Published: March 2003

Background.

CagA seropositivity is closely associated with that of vacuolating cytotoxin (VacA). Helicobacter pylori strains positive for both VacA and CagA were reported to be strongly associated with peptic ulcer disease. Different results reporting that cagA gene is not associated with more serious diseases, lowers the importance of CagA protein as a marker. In this study, CagA seropositivity is examined in Turkish peptic ulcer and nonulcer dyspepsia patients; histopathologic scores of CagA (+) and CagA (−) groups were compared.

Materials and Methods.

Sixty consecutive patients (one gastric ulcer, 13 duodenal ulcer and 46 nonulcer dyspepsia) (mean age 40.9 ± 14.7; 33 women, 27 men) with dyspeptic complaints who underwent upper gastrointestinal (GI) endoscopy were included. Biopsies from the antrum and corpus were used for histopathologic examination and for rapid urease test. H. pylori‐negative patients comprised the control group. Histopathologic findings were graded using a previously described grading system (for inflammation, activity, atrophy, intestinal metaplasia and H. pylori, grades from 0 to 3 were used to quantify the findings). In H. pylori‐positive patients, antibodies against CagA protein were determined using an ELISA method.

Results.

H. pylori was (+) in 46 patients. One duodenal ulcer and 13 nonulcer dyspepsia patients were negative for H. pylori. CagA positivity is significantly higher in peptic ulcer patients [12/12] than in nonulcer dyspepsia patients [25/33]. While inflammation, activity and atrophy scores were significantly higher in CagA positive patients, intestinal metaplasia and H. pylori load scores were not. Although the histopathologic scores in controls were lower than CagA (−) group, statistical significance was observed only in inflammation and intestinal metaplasia scores.

Conclusion.

Development of more prominent gastritis and severe atrophy in CagA (+) patients is an indicator of the importance of CagA rather than H. pylori load. Therefore, we suggest that nonulcer dyspepsia patients should also be tested for CagA status along with the tests for H. pylori status; and a positive CagA testing should be considered as an indication for eradication treatment. If CagA is negative, further assesment should be performed to decide whether or not to treat the patient.