bluuebunny/crossref_metadata_2025 huggingface dataset:
Retirement at the Turn of the Twentieth Century: A Canadian Perspective
Authors: Dillon Lisa , Gratton Brian , Moen Jon
Published: February 2010

Abstract:

In late-nineteenth-century North America, privately financed retirement emerged as a recognized phenomenon. While scholars acknowledge these origins, the prevalence of retirement remains intensely debated. The 1901 Canadian census explicitly required the enumerator to ask respondents if they had retired. The question makes it possible to correct estimates of labour force participation that are biased upward by the known tendency of men to report their lifelong occupation, even if they had retired. It also permits a separate consideration of this life stage well before formal retirement under public and private pension systems. An analysis of older men's responses from a 5 per cent sample of the 1901 Canadian census demonstrates that retirement was much more extensive than can be calculated from occupational reporting. While most older men reported an occupation and did not report retirement, over a fifth of those in their seventies and eighties reported an occupation but appear to have retired from it. Such a dual report was linked to greater age, being a farmer, urban status, and residence in Ontario. It was also associated with not owning property and a dependent status within households.
Stereotactic electroencephalography with temporal grid and mesial temporal depth electrode coverage: does technique of depth electrode placement affect outcome?
Authors: Van Gompel Jamie J. , Meyer Fredric B. , Marsh W. Richard , Lee Kendall H. , Worrell Gregory A.
Published: February 2010

Object

Intracranial monitoring for temporal lobe seizure localization to differentiate neocortical from mesial temporal onset seizures requires both neocortical subdural grids and hippocampal depth electrode implantation. There are 2 basic techniques for hippocampal depth electrode implantation. This first technique uses a stereotactically guided 8-contact depth electrode directed along the long axis of the hippocampus to the amygdala via an occipital bur hole. The second technique involves direct placement of 2 or 3 4-contact depth electrodes perpendicular to the temporal lobe through the middle temporal gyrus and overlying subdural grid. The purpose of this study was to determine whether one technique was superior to the other by examining monitoring success and complications.

Methods

Between 1997 and 2005, 41 patients underwent invasive seizure monitoring with both temporal subdural grids and depth electrodes placed in 2 ways. Patients in Group A underwent the first technique, and patients in Group B underwent the second technique.

Results

Group A consisted of 26 patients and Group B 15 patients. There were no statistically significant differences between Groups A and B regarding demographics, monitoring duration, seizure localization, or outcome (Engel classification). There was a statistically significant difference at the point in time at which these techniques were used: Group A represented more patients earlier in the series than Group B (p < 0.05). The complication rate attributable to the grids and depth electrodes was 0% in each group. It was more likely that the depth electrodes were placed through the grid if there was a prior resection and the patient was undergoing a new evaluation (p < 0.05). Furthermore, Group A procedures took significantly longer than Group B procedures.

Conclusions

In this patient series, there was no difference in efficacy of monitoring, complications, or outcome between hippocampal depth electrodes placed laterally through temporal grids or using an occipital bur hole stereotactic approach. Placement of the depth electrodes perpendicularly through the grids and middle temporal gyrus is technically more practical because multiple head positions and redraping are unnecessary, resulting in shorter operative times with comparable results.
The 2009 devaluation of radiosurgery and its impact on the neurosurgery–radiation oncology partnership
Authors: Heilbrun M. Peter , Adler John R.
Published: February 2010

Neurosurgeons, radiation oncologists, and, increasingly, other surgical specialists recognize that radiosurgery is an important tool for managing selected disorders throughout the body. The partnership between neurosurgeons and radiation oncologists has resulted in collaborative studies that have established the clinical benefits of radiosurgery. Today, however, a range of political and financial issues is straining this relationship and thereby undermining the practice of radiosurgery.

Neurosurgeons and radiation oncologists recently restricted the definition of radiosurgery to include only cranial- and spine-focused radiation treatments. Meanwhile, organized radiation oncology decided unilaterally that radiosurgery administered to other parts of the body would be termed stereotactic body radiation therapy. Finally, neurosurgical and radiation oncology coding experts developed new Current Procedural Terminology codes for cranial vault and spine radiosurgery, which were approved for use by the Relative Value Scale Update Committee as of 2009.

The authors suggest that the neurosurgery strategy—which included 1) reasserting that all of the tasks of a radiosurgery procedure remain bundled, and 2) agreeing to limit the definition of radiosurgery to cranial vault and spine—has failed neurosurgeons who perform radiosurgery, and it may jeopardize patient access to this procedure in the future.

The authors propose that all of the involved medical specialties recognize that the application of image-guided, focused radiation therapy throughout the body requires a partnership between radiation and surgical disciplines. They also urge surgeons to reexamine their coding methods, and they maintain that Current Procedural Terminology codes should be consistent across all of the different specialties involved in these procedures. Finally, surgeons should consider appropriate training in medical physics and radiobiology to perform the tasks involved in these specific procedures; ultimately all parties should receive equivalent reimbursement for similar assigned tasks, whether performed individually or jointly.
Rational Exploration of N‐Heterocyclic Carbene (NHC) Palladacycle Diversity: A Highly Active and Versatile Precatalyst for Suzuki–Miyaura Coupling Reactions of Deactivated Aryl and Alkyl Substrates
Authors: Peh Guang‐Rong , Kantchev Eric Assen B. , Er Jun‐Cheng , Ying Jackie Y.
Published: February 2010

As less attention has been focussed on the design of highly efficient palladium precatalysts to ensure the smooth formation of the active catalyst for metal‐mediated cross coupling reactions, we herein demonstrate that combining the bulky N‐heterocyclic carbene (NHC) 1,3‐bis(2,6‐diisopropylphenyl)imidazol‐2‐ylidene (IPr) with cyclopalladated acetanilide as the optimal palladium precatalyst leads to superior catalytic activity compared with the state‐of‐the‐art NHC–Pd catalysts. The complex was discovered through the evaluation of a small, rationally designed library of NHC–palladacycles prepared by a novel, practical and atom‐economic method, the direct reaction of IPr⋅HCl with palladacycle acetate dimers.
Transition‐Metal‐Free Formal Sonogashira Coupling and α‐Carbonyl Arylation Reactions
Authors: Prüger Birgit , Hofmeister Gretchen E. , Jacobsen Christian Borch , Alberg David G. , Nielsen Martin , Jørgensen Karl Anker
Published: February 2010

Transition‐metal‐free formal Sonogashira coupling and α‐carbonyl arylation reactions have been developed. These transformations are based on the nucleophilic aromatic substitution (SNAr) of β‐carbonyl sulfones to electron‐deficient aryl fluorides, producing a key intermediate that, depending on the reaction conditions, gives the aromatic alkynes or α‐aryl carbonyl compounds. The development of these reactions is presented and, based on investigations under basic and acidic conditions, mechanisms have been proposed. To develop the formal Sonogashira coupling further, a milder, two‐step protocol is also disclosed that expands the reaction concept. The scope of these reactions is demonstrated for the synthesis of Sonogashira and α‐carbonyl arylated products from a range of electron‐deficient aryl fluorides with a variety of functional groups and aryl‐, heteroaryl‐, alkyl‐, and alkoxy‐substituted sulfone nucleophiles. These transition‐metal‐free reactions complement the metal‐catalyzed versions in terms of substitution patterns, simplicity, and reaction conditions.
Expression patterns of hormones, signaling molecules, and transcription factors during adenohypophysis development in the chick embryo
Authors: Parkinson Nicole , Collins Michelle M. , Dufresne Lynn , Ryan Aimee K.
Published: February 2010

The chick embryo is an ideal model to study pituitary cell‐type differentiation. Previous studies describing the temporal appearance of differentiated pituitary cell types in the chick embryo are contradictory. To resolve these controversies, we used RT‐PCR to define the temporal onset and in situ hybridization and immunohistochemistry to define the spatial localization of hormone expression within the pituitary. RT‐PCR detected low levels of Fshβ (gonadotropes) and Pomc (corticotropes, melanotropes) mRNA at E4 and Gh (somatotropes), Prl (lactotropes), and Tshβ (thyrotropes) mRNA at E8. For all hormones, sufficient accumulation of mRNA and/or protein to permit detection by in situ hybridization or immunohistochemistry was observed ∼3 days later and in all cases corresponded to a notable increase in RT‐PCR product. We also describe the expression patterns of signaling (Bmp2, Bmp4, Fgf8, Fgf10, Shh) and transcription factors (Pitx1, Pitx2, cLim3) known to be important for pituitary organogenesis in other model organisms. Developmental Dynamics 239:1197–1210, 2010. © 2010 Wiley‐Liss, Inc.
Raman spectroscopy in lipid analysis
Authors: Baeten Vincent
Published: February 2010

In the last decade, Raman spectroscopy has gained in maturity as a valuable technique for lipid analysis. The technique is non‐destructive, does not need sample presentation thereby allowing use in in situ and on‐line analysis, and is relatively cost effective. Recent studies have demonstrated the potential of Raman spectroscopy for determining and quantifying different parameters and properties of lipids, and for following oxidative deterioration.
In vivo proton MR spectroscopy findings specific for adenylosuccinate lyase deficiency
Authors: Henneke M. , Dreha‐Kulaczewski S. , Brockmann K. , van der Graaf M. , Willemsen M. A. A. P. , Engelke U. , Dechent P. , Heerschap A. , Helms G. , Wevers R. A. , Gärtner J.
Published: February 2010

Adenylosuccinate lyase (ADSL) deficiency is an inherited metabolic disorder affecting predominantly the central nervous system. The disease is characterized by the accumulation of succinylaminoimidazolecarboxamide riboside and succinyladenosine (S‐Ado) in tissue and body fluids. Three children presented with muscular hypotonia, psychomotor delay, behavioral abnormalities, and white matter changes on brain MRI. Two of them were affected by seizures. Screening for inborn errors of metabolism including in vitro high resolution proton MRS revealed an ADSL deficiency that was confirmed genetically in all cases. All patients were studied by in vivo proton MRS. In vitro high resolution proton MRS of patient cerebrospinal fluid showed singlet resonances at 8.27 and 8.29 ppm that correspond to accumulated S‐Ado. In vivo proton MRS measurements also revealed a prominent signal at 8.3 ppm in gray and white matter brain regions of all patients. The resonance was undetectable in healthy human brain. In vivo proton MRS provides a conclusive finding in ADSL deficiency and represents a reliable noninvasive diagnostic tool for this neurometabolic disorder. Copyright © 2010 John Wiley & Sons, Ltd.
Only fat infiltrated muscles in resting lower leg of FSHD patients show disturbed energy metabolism
Authors: Kan H. E. , Klomp D. W. J. , Wohlgemuth M. , van Loosbroek‐Wagemans I. , van Engelen B. G. M. , Padberg G. W. , Heerschap A.
Published: February 2010

Facioscapulohumeral muscular dystrophy (FSHD) is characterized by asymmetric dysfunctioning of individual muscles. Currently, it is unknown why specific muscles are affected before others and more particularly what pathophysiology is causing this differential progression. The aim of our study was to use a combination of 31P magnetic resonance spectroscopic imaging (MRSI) and T1‐weighted MRI to uncover metabolic differences in fat infiltrated and not fat infiltrated muscles in patients with FSHD. T1‐weighted images and 3D 31P MRSI were obtained from the calf muscles of nine patients with diagnosed FSHD and nine healthy age and sex matched volunteers. Muscles of patients were classified as fat infiltrated (PFM) and non fat‐infiltrated (PNM) based on visual assessment of the MR images. Ratios of phosphocreatine (PCr), phosphodiesters (PDE) and inorganic phosphate (Pi) over ATP and tissue pH were compared between PFM and PNM and the same muscles in healthy volunteers. Of all patients, seven showed moderate to severe fatty infiltration in one or more muscles. In these muscles, decreases in PCr/ATP and increases in tissue pH were observed compared to the same muscles in healthy volunteers. Interestingly, these differences were absent in the PNM group. Our data show that differences in metabolite ratios and tissue pH in skeletal muscle between healthy volunteers and patients with FSHD appear to be specific for fat infiltrated muscles. Normal appearing muscles on T1 weighted images of patients showed normal phosphoryl metabolism, which suggests that in FSHD disease progression is truly muscle specific. Copyright © 2010 John Wiley & Sons, Ltd.
Quantized Auger recombination and carrier multiplication in semiconductor nanoparticles and carbon nanotubes
Authors: Taguchi Seiji , Ueda Akihiro , Tayagaki Takeshi , Matsuda Kazunari , Kanemitsu Yoshihiko
Published: February 2010

We studied carrier recombination dynamics in CdSe nanocrystals, CdSe nanorods, Mn‐doped CdS nanocrystals, and carbon nanotubes using femtosecond pump‐probe spectroscopy. Auger recombination in nanocrystals and nanorods occurs due to three‐carrier collisions, while that in carbon nanotubes occurs due to two‐exciton collisions. We found that the Auger coefficient depends strongly on the nanocrystal size. In Mn‐doped CdS nanocrystals, we observed that the decay time is almost independent of the excitation intensity. This indicates that the Auger recombination process is controlled by doping of Mn ions into CdS nanocrystals. (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Ambipolar characteristics of microcrystalline silicon thin‐film transistors
Authors: Chan Kah‐Yoong , Gordijn Aad , Stiebig Helmut , Knipp Dietmar
Published: February 2010

Hydrogenated microcrystalline silicon (μc‐Si:H) has recently attracted significant attention as a promising candidate for thin‐film transistors (TFTs) in large‐area electronics due to high electron and hole charge carrier mobilities. We report on top‐gate ambipolar TFTs based on μc‐Si:H prepared by plasma‐enhanced chemical vapor deposition at temperatures below 200 °C. Electrons and holes are directly injected into the μc‐Si:H channel via chromium drain and source contacts. The TFTs exhibit electron and hole charge carrier mobilities of 30‐50 cm2/Vs and 10‐15 cm2/Vs, respectively. In this work, the electrical characteristics of the top‐gate ambipolar μc‐Si:H TFTs are described by a simple analytical model that takes the ambipolar transport into account. The analytical expressions are used to model the transfer curves, the potential and the net surface charge along the channel of the TFTs. The electrical model provides insights into the electronic transport of ambipolar μc‐Si:H TFTs (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Primary care approach to dysphonia
Authors: Turley Richard , Cohen Seth
Published: February 2010

Objective

To understand how primary care physicians manage patients with dysphonia and the barriers they face when evaluating patients for voice problems.

Study Design

Cross‐sectional survey.

Setting

Primary care community.

Subjects and Methods

A total of 933 internal and family medicine physicians were randomly selected from a database of physicians in a referral basin of a tertiary care medical center and mailed a questionnaire. Questions concerned physician comfort level in recognizing an abnormal voice, their view of the quality of life impact of dysphonia, frequency of evaluating patients for voice problems, barriers to the evaluation of voice problems, reasons for referral, and common treatments prior to referral.

Results

A total of 271 physicians responded, for a response rate of 29.0 percent. Of those who responded, 36.5 percent routinely evaluate their patients for voice problems. Reasons for not evaluating patients for voice problems were patients not complaining about hoarseness, more pressing issues, not feeling comfortable assessing patients for voice problems, and time constraints. Chronic voice changes and not being able to understand patients' speech were the most common reasons for referral. Reflux and allergy treatment were common treatment modalities prior to referral. A total of 67.5 percent of respondents were interested in learning more about voice problems.

Conclusion

Primary care physicians face limitations with respect to evaluating patients for voice problems. Otolaryngologists must continue outreach efforts and collaboration with primary care colleagues in order to enhance the screening for voice problems.
Chester Himes's The End of a Primitive: Exile, Exhaustion, Dissolution
Authors: BELAS OLIVER
Published: February 2010

The focus of this article is The End of a Primitive, the novel that marks Chester Himes's transition from a writer of protest to one of crime fiction. Drawing on archival research carried out in the United States, I advance two arguments. Firstly, the story told in the autobiographical Primitive is, in part, that behind Himes's leaving America for Paris in 1953. The novel, I argue, inaugurates a writing of exile that is continued in Himes's crime fiction, a writing through which, because of his literal and figurative distance from America, Himes came to feel more strongly his sense of national – that is, American – identity. Secondly, in Primitive Himes presents the reader with a formal breakdown of sorts, one that “clears the way” for the crime fiction (which, my archival research shows, Himes had begun writing before Primitive was finished). This breakdown – of the protest novel conceived in generic terms – also predicts the trajectory of Himes's hard-boiled crime novels. By signalling the generic exhaustion of protest fiction through the failure of “good” form, Primitive, as the end point of Himes's more generic protest writing, also anticipates the movement of the crime stories towards formal or generic dissolution, an indication, I suggest, of Himes's late belief that literature was in general an ineffective catalyst of social–political change.
Acute health sector reform: an analysis of the Australian Senate's proposals
Authors: Braithwaite Jeffrey , Hindle Don
Published: February 2010

Jeffrey Braithwaite is Senior Lecturer and Director, Graduate Management Programs and Don Hindle isVisiting Professor in the Faculty of Medicine, University of New South Wales.
Health promotion-who, us? Developing health promoting emergency departments
Authors: Bensberg Monica , Kennedy Marcus
Published: February 2010

This paper describes the initiation of Victoria's Health Promoting Emergency Departments (HPEDs) Program,involving seven of Melbourne's Emergency Departments (EDs). The Program aims to integrate health promotion intothe function of EDs, to complement the clinical and curative emergency care that they already provide. A developmentphase identified the means of achieving this and involved establishing a multi-disciplinary Steering Committee andengaging health promotion specialists to record the opportunities for health promotion within the ED context.A literature review, and consultations with ED staff (focus groups and surveys) and other stakeholders were conducted.A concept paper was published and the development phase findings were documented, including recommendations onthe future of the Program.
Outcomes measurement for asthma following acute presentation to an emergency department
Authors: Masters Geoff , Hall Sonj E , Phillips Martin , Boldy Duncan
Published: February 2010

The Asthma Management Plan (AMP) was developed by the Thoracic Society of Australia and New Zealand in 1989to provide a more uniform approach to asthma care, aimed at reducing mortality, morbidity and emergencypresentations. The AMP is often supplemented with Asthma Clinical Pathways (CPs) within the emergencydepartment and hospital setting.This study was designed to evaluate the impact of these two instruments on asthma outcomes one month afterpresentation to the emergency department. The AMP and CP were both found to have had positive influences onasthma management. However, the study illustrates that there continue to be problems with asthma management,which would be improved by a more consistent use of these instruments.
Increasing the efficiency and flexibility of capital funding for public and private hospitals
Authors: Bridges John F P , Sperling Perry
Published: February 2010

This paper outlines the recent history of capital funding in the health sector in Australia. It focuses on the trends incapital expenditures and the roles of the public and private sectors. The demand for future capital funding willdepend upon a number of factors, including the state of the current capital stock and uncertain future impacts oftechnology and changes in patient demands. Because of these uncertainties, capital funding for the future must beflexible to meet any changes in operations and demand. The paper highlights the possible use of joint ventures betweenvarious public and private organisations, based on the principles of competition and cooperation.
Public hospitals: who's looking after you? The difficulties in encouraging patients to use their private health insurance in public hospitals
Authors: Sullivan Natalie , Redpath Rebecca , O'Donnell Anthony
Published: February 2010

Private health insurance PHI) is an important part of the Australian health system. During the introduction of the recent PHI reforms it was argued that, without the reforms, the public hospital system would undoubtedly collapse under the increased demand for public health services. The increase in PHI coverage might also have been expected to result in an increase in the revenue earned by public hospitals as a result of treating privately insured patients. However, the decline in numbers of privately insured patients using their PHI in public hospitals has continued, with adverse impacts on public hospital budgets in some states. This article addresses the complex interactions between various policy instruments and their impact on public hospitals, and reports the results of a study conducted at the Austin & Repatriation Medical Centre (A&RMC) which examined the reasons for privately insured patients electing not to use their insurance in public hospitals, and methods by which they might be overcome.
The Australian Health Care Agreements - a teaching hospital perspective
Authors: Davison Julia
Published: February 2010

The Australian Health Care Agreements (AHCAs) are important for patients, health care professionals and hospital CEOs alike. The current agreements have not been fully effective in promoting necessary reforms, and this paper suggests priority areas for attention in the next round. Five areas for targeted reform are suggested. These are pharmaceuticals, workforce planning, continuum of care across settings, education and research, and safety and quality. It is time to give some radical thought to the role and scope of the AHCAs. Healthcare policy reform needs to be across the continuum of care.
Health insurance: managing risk in the private sector
Authors: Schneider Russell
Published: February 2010

How does Australia, in both its private and public sectors, provide the health care that Australians want and need at prices they can afford to pay? If this is to be sustainable in the private sector health funds need to be given a capacity to manage their risk exposure. Provided insurers continue to insure sick people, costs will be driven not so much by the age profile of the insured population (though it will have some effect) as by technology and its capacity to supply and create the demands of the aged (not ageing per se). Handling these costs is the real challenge for the future.
Report review: Not for service: experiences of injustice and despair in mental health care in Australia
Authors: Summers Michael , McKenzie Peter
Published: February 2010

IT IS ONLY BY EXAMINING the impact of public
policies on the lives of people that we can begin
to assess the success or failure of those policies.
With this as a starting point, Not for service
presents an extensive (just over 1000 pages) and
balanced picture of the impact of policies on the
lives of people with mental illness and their
families and friends. The authors take care to state
that their research is not a rigorous examination
of the extent to which the National Standards for
Mental Health Services have been implemented,
but do observe that the ?volume and consistency
of the information demonstrate the gaps and
difficulties governments have had in meeting
these standards? (p 14). The report is lengthy, but
is well laid out and ?easy? to read, although the
content will leave any reader feeling uneasy about
the current state of our mental health system.
There is also a shorter (96 page) summary report
available.
Managing acute behavioural disturbance in an emergency department using a behavioural assessment room
Authors: Cowling Susan A , McKeon Margaret A , Weiland Tracey J
Published: February 2010

This study was conducted to evaluate a behavioural
assessment room (BAR) as a strategy in the
management of people exhibiting acute behavioural
disturbance in the St Vincent?s Hospital,
Melbourne Emergency Department (ED). The
study involved a retrospective audit of the data
documented for BAR use over a 12-month period
and a structured questionnaire of clinical and nonclinical
emergency department staff.
Patients managed in the BAR presented with
various behaviours; 58% were substance
induced. The median duration of stay in the room
was 20 minutes, during which assessment and
containment or ?behavioural resuscitation? proceeded.
98.5% of questionnaire respondents
believed that the BAR created a safer environment
for all ED patients, staff and others.
Australian Health Review call for papers
Authors: Leggat Sandra G
Published: February 2010

Models of care:
do they make the difference?
Australian Health Review invites contributions for the
models of care section of the journal. This is a regular
section and we welcome ongoing article submissions.
Health care is delivered in countless ways for
those who have debilitating illnesses or conditions.
Stakeholders boast that it is the particular
?model of care? that makes the positive difference
to patients and clients ? but, it has been difficult
to ascertain the true impact of models of care on
patient/client or system outcomes. To assist in
clarifying this important area for health service
management and policy decision making, we are
looking for articles on case studies or research
projects that suggest either positive or negative
outcomes for specific models of care.
Australian Health Review is looking to publish
feature articles, research papers, case studies and
commentaries related to your experience with
specific models of care. We are particularly interested
in papers that measure the model's effectiveness
at a system, organisation and/or client
level. Australian and New Zealand submissions
are welcome, as well as international initiatives
with lessons for Australia and New Zealand.
Submissions can be short commentaries of
1000 to 2000 words, or more comprehensive
reviews of 2000 to 4000 words. Please consult
the AHR Guidelines for Authors for information
on formatting and submission.
Editorial Acknowledgement of Reviewers 27/09/2006 – 30/9/2007
Authors: Leggat Sandra G
Published: February 2010

We called on many professionals around the world to assist us in our peer review of papers for Australian
Health Review.
Workforce development: planning what you need starts with knowing what you have
Authors: Page Sue , Willey Katie
Published: February 2010

Health workforce planning and research occurs
at both national and state/territory levels, but
identifying current workforce availability and
future workforce need is more problematic at a
regional level. We report on the practical
approach to workforce development taken by
North Coast Area Health Service (NCAHS) in
NSW, Australia.
The NCAHS plan considers the impact of workforce
ageing, changes in casemix and volume
predicted by population demographics, staff level
guidelines associated with service enhancements,
and changes in service delivery models
driven by the need for economic efficiencies,
greater investment in disease prevention and
medical technological advancements. Finally, the
paper addresses how workforce development
plans can assist sustainable service delivery
through targeted strategies in recruitment, retention and retraining.
Redesigning models of patient care delivery and organisation: building collegial generosity in response to workplace challenges
Authors: Mary Chiarella E
Published: February 2010

This case study describes the New South Wales
Nursing and Midwifery Office (NaMO) Models of
Care Project, a project designed to identify,
encourage and disseminate innovations in nursing
care organisation and delivery. The project is a 4-
year action research project, using a range of
interactive engagements including workshops,
seminars, questionnaires and websites to achieve
the goals. This case study briefly describes the
main stimuli for review and redesign of models of
care identified through analysis of the clinicians?
presentations, and explores the range of
responses to the workplace challenges.
Self-assessment of medico-legal risk by doctors: the Know Your Risk Version 1 – Short Form
Authors: Johnson Maree , Murphy Brooke , Payne Sheryn , Chang Sungwon
Published: February 2010

An instrument to measure medico-legal risk-management
behaviours among medical practitioners
was developed and tested. A cross-sectional survey
was posted to 962 UNITED Medical Protection
members receiving premium support. A final
sample of 757 currently working medical practitioners
responded, including general practitioners
(21.9%), surgeons (29.9%), obstetricians and
gynaecologists (12.7%), and others (35.5%).
The Know Your Risk Version 1 ? Short Form and
other tools developed by this team are available for
use by group practices, hospital administrators and
practitioners. These tools have the potential to
assist regulators and insurers to identify, monitor or
screen individual medico-legal risk behaviours.
Standardising practices through form design and education improves insulin management
Authors: McIver Fiona B , Mitchell Charles A , Finn Carmel P , Kamp Maarten C
Published: February 2010

Diabetes is common in hospitalised patients and
insulin is frequently required for management.
Insulin is a high-risk drug, accounting for about
15% of reported medication-related incidents.
Despite its complexity, insulin management in
hospitals is often undertaken by junior and nonspecialist
staff. Improving insulin management
requires addressing safe prescribing and administration
as well as quality use of insulin. Common
errors in insulin use are well documented and can
be addressed through form design and enhancing
decision support. We undertook to improve insulin
management using a locally proven improvement
methodology. New forms were developed for intravenous
and subcutaneous insulin and blood
glucose management. Audited pilot studies in
four hospitals confirmed improved insulin management
without adversely impacting on overall
diabetes management as assessed using
Glucometrics. Subsequently, the forms have been
introduced to 70% of Queensland public hospitals
with roll-out to remaining hospitals continuing.
Large-scale standardisation of insulin management is feasible.
Is there a role for podiatric surgeons in public hospitals? An audit of surgery to the great toe joint in Victoria, 1999–2003
Authors: Ribonson Priscilla , Gilheany Mark F
Published: February 2010

This project aimed to describe and compare the frequencies of procedures performed by podiatric surgeons and orthopaedic surgeons for elective surgery to the great toe joint, an area of identified clinical need. The objective was to determine whether podiatric surgeons in the Australian context possess a surgical skill set which can be utilised in the public health sector. The Medicare Benefits Schedule (Medicare Australia) was reviewed to identify all codes relating to great toe joint surgery and frequency data were obtained for the period July 1999 to June 2003. A separate audit of the activity of Victorian podiatric surgeons was conducted.

During the 4 years in Victoria, the number of procedures performed on this joint by 152 orthopaedic surgeons was 5882. Two podiatric surgeons in Victoria performed 1260 operations on this joint over this period (17.6% of great toe joint surgery on average each year in the private sector). Utilising orthopaedic workforce figures and on a per-surgeon basis, during this period the podiatric surgeons performed this type of surgery between 2 and 16 times more often than the orthopaedic surgeons, and consideration should be given to using these skills in the public sector to address the growing demand.
Designing a funding system for rehabilitation services Part 2 achieving efficiency and quality of care
Authors: Duckett Stephen , Gray Len , Howe Anna
Published: February 2010

This paper examines the objectives of a funding policy for rehabilitation services.A casemix funding system comprises two sets of instruments: a classification systemand a payment system. Attention is given to identifying which policy objectives arebest pursued through each of these instruments. The paper then analyses the effectof various instruments on creating incentives for efficiency and quality, and assessespolicy options with regard to their capacity for dealing with the heterogeneity ofrehabilitation patients and controlling various forms of gaming. In conclusion, thepaper canvasses four major areas warranting consideration in advancing policy: theuse of a blended payment system; dealing with functional gain; the developmentof an information base; and the focus on designated rehabilitation units.
Using endoscopic procedures forAN-DRG assignment:Australia leads the way
Authors: Antioch Kathryn M , Zhang Xichuan
Published: February 2010

The study reported in this article sought to develop Australian National Diagnosis Related Groups (AN-DRGs) using endoscopic procedures in Major Diagnostic Category (MDC) 6 (Digestive System) and MDC 7 (Hepatobiliary System and Pancreas) through statistical analysis of the Australian Casemix Clinical Committee's recommendations. Five ANOVA were undertaken on final recommendations for gastroscopy and colonoscopy in MDC 6. The Reduction in Variance (RIV) for the AN-DRGs in version 3 relative to version 2 increased by up to 14.6%, representing RIV of between 25.28% to 32.30%. For all ANOVAs, F>100, alpha < .0001, Coefficient of Variation (CV) was generally lower in version 3 by between 0.4% to 22.9%, except for AN-DRGs for other gastroscopy for major gastro-intestinal disease, which increased by 8.7%. Two ANOVA for Endoscopic Retrograde Cholangio-pancreatography Procedures (ERCP) recommendations resulted in RIV of up to 18.67%, F>100, alpha <- .0001 and CV up to 0.8091. MDC 6, in AN-DRG versions 3 and 3.1, has 11 AN-DRGs following the surgical hierarchy involving gastroscopy and colonoscopy. Patients assigned will not have an operating room procedure; they will have anon-operating room procedure that is either a complex therapeutic or other(diagnostic or therapeutic) procedure. Similar AN-DRGs are in MDC 7 for ERCP. Version 3.1 has expanded the definition of Common Bile Duct Exploration (CDE) to include ERCP. There is no separate AN-DRG for laparoscopy cholecystectomy.
Is there equity in emergency medical care? Waiting times and walk-outs in South Western Sydney hospital emergency departments
Authors: Mohsin Mohammed , Bauman Adrian , Ieraci Sue
Published: February 2010

This study explores the association between selected socioeconomic characteristics ofemergency patients with waiting times in emergency departments and walk-outs (thosewho did not wait for treatment) in South Western Sydney Area Health Servicehospital emergency departments. Bivariate and multivariate analyses indicated thatwaiting times to see a doctor and walk-out rates varied by age, sex, country of birth,insurance status, socioeconomic status, severity of patient illness and day of arrival.Patients who were female, from a non-English-speaking background, self-referred,uninsured and those from lower socioeconomic status showed significantly longerwaiting times than others. Patients who left emergency departments without treatmentshowed higher waiting times from arrival to triage than other groups. This appliedacross socioeconomic categories. These findings indicate that prolonged waiting timesfor triage, which occur at the busiest periods, may be one of the main indicators forpatients leaving emergency departments without treatment. The study alsodemonstrates variability in waiting times, which could possibly be partly addressedby more standardised triage policies, but may be influenced by other non-clinicalfactors, which require further investigation.
Would employment-based health savings accounts help Medicare
Authors: Hindle Don , McAuley Ian
Published: February 2010

The health systems of Australia and New Zealand are built on common foundations which largely reflect the social and institutional underpinnings of the British health sector. Both countries initially relied upon a combination of privately-funded services for those who could afford them and charitable support for those who were less well off. They introduced formalised regulation and licensing of health professionals and government-funded and delivered public health services. Senior medical staff divided their time between fee-earning private practice and pro bono work in the charitable/voluntary sector, and so on.
Listening, Mediation, Event: Anthropological and Sociological Perspectives
Authors: Born Georgina
Published: February 2010

This paper outlines an approach to listening drawn from the anthropology and sociology of music, arguing that there is a pressing need for comparative empirical studies of listening. I suggest that the terms of the discussion should shift from listening to the broader category of musical experience, in this way allowing questions of the encultured, affective, corporeal and located nature of musical experience to arise in a stronger way than hitherto. I propose a focus on the relations between musical object and listening subject, where this entails analysis of the social and historical conditions that bear on listening, and of the changing types of subjectivity brought to music. The point is that neither these conditions, nor the forms of music's mediation, nor the relations between musical object and subject can be fully known in advance. I sketch three perspectives from anthropology and sociology that indicate the kinds of insight offered by empirical research which takes listening-as-musical-experience, and the situated, relational analysis of musical subjects and objects, as its focus.
DnaK from Bifidobacterium animalis subsp. lactis is a surface-exposed human plasminogen receptor upregulated in response to bile salts
Authors: Candela Marco , Centanni Manuela , Fiori Jessica , Biagi Elena , Turroni Silvia , Orrico Catia , Bergmann Simone , Hammerschmidt Sven , Brigidi Patrizia
Published: February 2010

Bifidobacteriumanimalissubsp.lactislives in the gastrointestinal tract of most mammals, including humans. Recently, for the probiotic strainB. animalissubsp.lactisBI07, a dose-dependent plasminogen-binding activity was demonstrated and five putative plasminogen-binding proteins were identified. Here we investigated the role of surface DnaK as aB. animalissubsp.lactisBI07 plasminogen receptor. DnaK was visualized on the bacterial cell surface by transmission electron microscopy. The His-tagged recombinant DnaK protein showed a high affinity for human plasminogen, with an equilibrium dissociation constant in the nanomolar range. The capability to tolerate physiological concentrations of bile salts is a crucial feature for an intestinal symbiont micro-organism. By proteome analysis we demonstrated that the long-term exposure ofB. animalissubsp.lactisBI07 to bile salts results in the upregulation of important surface plasminogen receptors such as DnaK and enolase. Moreover, adaptation ofB. animalissubsp.lactisBI07 to physiological concentrations of bile salts significantly increased its capacity to interact with the host plasminogen system. By enhancing the bacterial capacity to interact with the host plasminogen, the gut bile environment may facilitate the colonization of the human host byB. animalissubsp.lactisBI07.
Monitoring the Neotropical brown stink bug Euschistus heros (F.) (Hemiptera: Pentatomidae) with pheromone‐baited traps in soybean fields
Authors: Borges M. , Moraes M. C. B. , Peixoto M. F. , Pires C. S. S. , Sujii E. R. , Laumann R. A.
Published: February 2010

The effectiveness of the synthetic sex pheromone of the Neotropical brown stink bug, Euschistus heros, was evaluated both in laboratory and in field assays. Lures loaded with 1 mg of methyl 2,6,10‐trimethyltridecanoate (TMTD) continuously attracted female bugs for more than 30 days to pheromone‐baited traps in field trials. The pheromone‐baited traps were effective in field tests even at low bug population densities, as compared with the usual monitoring technique, shake cloth sampling. Traps around borders or in the centre of soybean fields caught similar numbers of bugs. Trap captures showed a positive relationship with field populations, as monitored with the shake cloth technique, during the reproductive phase of the soybean crop, i.e. from the R1–R5 developmental stage (pod formation to pod fill). The physiological state of the trapped migrating insects was determined. The first insects arriving in the field had fewer eggs in the reproductive tract compared to later arrivals. Some cross‐attraction was also observed, with Piezodorus guildinii and Edessa meditabunda also being caught in pheromone‐baited traps, suggesting that these insects respond to the sex pheromone or to the defensive compounds released by E. heros captured in traps. In brief, the results showed that traps baited with 1 mg of the sex pheromone efficiently caught bugs, that the lures lasted for more than 1 month under field conditions and that placement of traps around the borders of the crop area was as effective as placement inside the crop area. Border‐placed traps were effective at a density of one trap every 200 m.
Corrosion Behavior of As‐Received and Previously Cast Type III Gold Alloy
Authors: Ayad Mohamed F. , Ayad Ghada M.
Published: February 2010

Purpose: The rationale for using gold alloys is based largely upon their alleged ability to resist corrosion, but little information is available to determine the corrosion behavior of recast alloys. This study characterized the elemental composition of as‐received and recast type III gold alloy and examined the in vitro corrosion behavior in two media using a potentiodynamic polarization technique.

Materials and Methods: Seventy‐eight disk‐shaped specimens were prepared from a type III gold alloy under three casting protocols according to the proportion of as‐received and recast gold alloy (n = 26). (1) Group as received (100% as‐received metal), (2) group 50% to 50% (50% wt. new metal, 50% wt. once recast metal), and (3) group recast (100% once recast metal). The surface structures of 20 specimens from each group were examined under scanning electron microscopy, and their elemental compositions were determined using X‐ray energy‐dispersive spectroscopy. Further, the potentiodynamic cyclic polarization between −1000 and +1000 mV (SCE) were performed for six specimens from each casting protocol in 0.09% NaCl solution (n = 3) and Fusayama artificial saliva (n = 3) at 37°C. Zero‐current potential and corrosion current density were determined. The data were analyzed with 1‐way ANOVA and the Ryan–Einot–Gabriel–Welsch multiple‐range test t (α= 0.05).

Results: Elemental composition was significantly different among the casting groups (p < 0.001). The mean weight percentage values were 72.4 to 75.7% Au, 4.5 to 7.0% Pd, 10.7 to 11.1% Ag, 7.8 to 8.4% Cu, and 1.0 to 1.4% Zn. The mean values for Zero‐current potential and corrosion current density for all casting protocols were not significant (p > 0.05); however, the difference between the electrolytes was significant (p < 0.001). Fusayama artificial saliva seemed to offer the most corrosive environment.

Conclusions: Type III gold alloy in any casting protocol retained passivity under electrochemical conditions similar to the oral environment. Moreover, high‐gold type III alloys from reputable manufacturers and recasting protocol tested should produce acceptable corrosion‐resistant castings.
Analysis of complement receptor Type 1 expression on red blood cells in negative phenotypes of the Knops blood group system, according to CR1 gene allotype polymorphisms
Authors: Pham Bach‐Nga , Kisserli Aymric , Donvito Béatrice , Duret Valérie , Reveil Brigitte , Tabary Thierry , Le Pennec Pierre‐Yves , Peyrard Thierry , Rouger Philippe , Cohen Jacques H.M.
Published: February 2010

BACKGROUND: The KN blood group system, which consists of nine antigen specificities, is located on complement receptor Type 1 (CR1/CD35). CR1, a complement regulatory protein, acts as a vehicle for immune complex clearance. CR1 exhibits a red blood cell (RBC) density polymorphism. CR1 sites on RBCs in normal individuals range from 150 to 1200 molecules per cell. CR1 density polymorphism is regulated by HindIII restriction fragment length polymorphism and Q981H and P1786R polymorphisms in Caucasians. Yet, the role of the different polymorphisms in determining the CR1 density on RBCs remains unknown. The “null” serologic KN phenotype, known as Helgeson phenotype, was reported to be related with a very low CR1 density, less than 150 molecules per cell.

STUDY DESIGN AND METHODS: The aim of this work was to investigate whether the KN‐negative phenotype displayed by 60 individuals was related to the CR1 density by performing the phenotypic and genetic analysis of CR1 and to investigate the molecular background associated with the KN system.

RESULTS: We showed that the Helgeson‐like phenotype had a prevalence of 12% in this population. The overall genotype/phenotype concordance was 90%. Among individuals with a KN‐negative phenotype, the prevalences of Kn(a–), McC(a–), Sl1‐negative, Sl3‐negative, and KCAM‐negative deduced phenotype were 37, 12, 29, 7, and 24%, respectively.

CONCLUSION: From our data, we suggest that the definition of the Helgeson phenotype must be revised, since the latter may be due not only to a very low CR1 density on RBCs, but also to the absence of expression of a high‐prevalence KN antigen.