bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvements in outcomes for chronic obstructive pulmonary disease (COPD) attributable to a hospital‐based respiratory rehabilitation programme
Authors: Young P. , Dewse M. , Fergusson W. , Kolbe J.
Published: March 2008

Aim: To determine whether the benefits of pulmonary rehabilitation, demonstrated in selected subjects in randomised controlled studies, can be achieved by a hospital‐based respiratory rehabilitation programme conducted as part of routine clinical management.

Methods: Design: A prospective longitudinal study of patients with severe chronic obstructive pulmonary disease (COPD) enrolled in a hospital based, non‐medically supervised, outpatient, respiratory rehabilitation programme was undertaken.

The rehabilitation programme was of pragmatic design and content, supervised by respiratory physiotherapists and comprised seven two hour sessions over one month for groups of six to eight patients. It included education on disease management, practical instruction in coping skills, as well as a progressive aerobic exercise programme for specific muscle training related to functional activities.

Subjects were assessed prior to the programme but after optimisation of pharmacologic therapy, at the completion of the programme and at three months and six months post‐programme. Principal outcome parameters were exercise capacity (as assessed by a six minute walk distance [MWD] test), degree of perceived breathlessness and quality of life (QOL) (assessed by the Chronic Respiratory Disease Questionnaire [CRDQ]).

Results: Fifty‐one subjects with severe COPD (Fev1=0.9±0.4 1) completed the programme. There was a significant improvement in exercise capacity (a six MWD test improved from 375±126 m at baseline to 440±109 m at three months, p<0.005). There were significant improvements in QOL (in the total CRDQ score as well as in the domains of dyspnoea, fatigue and mastery). There was a reduction in the level of perceived dyspnoea (modified Borg Scale). Most improvements were maintained for three and six months following completion of the programme. Compared with the six months preceding the programme there was a reduction in hospital admissions and reduction in courses of oral steroids.

Conclusions: An outpatient, hospital‐based respiratory rehabilitation programme pragmatically adapted for clinical utility produces substantial and clinically significant improvements in exercise tolerance and QOL, similar in type and magnitude to those obtained in controlled clinical trials. There was an associated reduction in COPD‐related morbidity. Such gains were mostly maintained for six months after completion of the programme. Thus respiratory rehabilitation must be regarded as an essential component of a comprehensive clinical programme for the management of COPD.
Is health‐related quality of life among older, chronically ill patients associated with unplanned readmission to hospital?
Authors: Pearson S. , Stewart S. , Rubenach S.
Published: March 2008

Background: Assessment of health‐related quality of life (HRQL) is being used increasingly to assess the impact of treatment.

Aims: To determine if HRQL, assessed shortly after acute hospitalisation, is associated with readmission to hospital.

Methods: In a prospective, longitudinal study, 163 chronically ill, medical and surgical patients (mean age 67.0±16.3 years) discharged to home following acute hospitalisation were studied. HRQL was assessed at one month post‐hospital discharge using the MOS 36‐Item Short‐Form Health Survey (SF‐36). Patients were followed‐up for six months thereafter to determine subsequent incidence of unplanned readmission.

Results: HRQL as measured by the eight health dimensions of the SF‐36, for the entire cohort, was lower relative to age and gender matched norms for the local population (p<0.01). During study follow‐up, 47 (35%) patients had an unplanned readmission and one patient died. Patients who had an unplanned readmission demonstrated both significantly lower physical (32.2±9.8 vs 38.6±10.1: p<0.001) and mental (45.1±12.7 vs 49.9±12.3: p=0.03) health component scores in comparison to the remainder of the cohort. On multivariate analysis, independent correlates of unplanned readmission were: 1) presence of formal home assistance (OR 6.4: p<0.01), 2) ≥five prescribed medications (OR 2.4: p=0.04), 3)≥two admissions in the six months before follow‐up (OR 4.3: p<0.01) and 4) an SF‐36 physical component score of ≤40 (OR 2.2: p=0.05).

Conclusions: In this cohort of predominantly older and chronically ill patients recently discharged from acute hospital care, relatively lower SF‐36 physical health component scores were independently associated with an increased risk of subsequent unplanned readmission.
Correlation of cytogenetics, BCR‐ABL PCR studies and fluorescence in situ hybridisation (FISH) in adult acute lymphoblastic leukaemia
Authors: Campbell L. J. , Martinow A. , Michael P. M. , White J. S. , Rayeroux K. C. , Januszewicz E. H.
Published: March 2008

Background: Philadelphia positive (Ph+) acute lymphoblastic leukaemia (ALL) accounts for 11–29% of adult ALL. Reverse transcriptase polymerase chain reaction (RT‐PCR) for the BCR‐ABL fusion mRNA has identified patients with the fusion mRNA without cytogenetic evidence of the 9;22 translocation. The reason for discrepancies between cytogenetic and molecular diagnoses is unclear.

Aim: Our aim was to study cases of ALL with discordant cytogenetic and RT‐PCR results and identify any reasons for such discrepancies.

Methods: Laboratory records were scanned for cases of ALL tested by both RT‐PCR and cytogenetics and positive by either for the 9;22 translocation. Fluorescence in situ hybridisation (FISH) was used to study discordant results where a specimen was available.

Results: We identified 15 patients with ALL who had both cytogenetic and RT‐PCR studies for BCR‐ABL. Seven had discordant results; five patients had positive RT‐PCR studies with normal (four/five) or abnormal but Ph negative cytogenetics (one/five), and two were Ph+ but RT‐PCR negative. FISH, using Vysis LSI bcr/abl translocation probes, showed fused signals in 12% interphase cells but not in metaphase cells in one specimen with normal cytogenetics, and 6% interphase cells in the Ph negative patient with abnormal cytogenetics. This second patient subsequently relapsed with a minor Ph+ cell line derived from the Ph negative line.

Conclusions: These results confirmed the need for both cytogenetics and RT‐PCR to identify Ph+ ALL. FISH did not show sub‐microscopic rearrangements of BCR‐ABL in normal metaphases. Failure to identify the Philadelphia chromosome cytogenetically appeared due rather to Ph+ cells failing to divide.
The effect of a respiratory home nurse intervention in patients with chronic obstructive pulmonary disease (COPD)
Authors: Smith B. J. , Appleton S. L. , Bennett P. W. , Roberts G. C. , Fante P. Del , Adam R. , Trott C. M. , Allan D. P. , Southcott A. M. , Ruffin R. E.
Published: March 2008

Background: Chronic obstructive pulmomary disease (COPD) is associated with substantial mortality, morbidity, and costs to the health care system. With the increasing interest in outreach care programmes it is important to evaluate their impact upon patients and health services, for conditions such as COPD.

Aim: To determine the effectiveness of an outreach respiratory nurse in a shared care approach, with collaboration between general practitioners and hospital services, in the management of patients with severe COPD.

Methods: Patients with severe COPD attending The Queen Elizabeth Hospital, Adelaide participated in a randomised controlled trial of a home based nursing intervention (HBNI) over 12 months with outcome measures including mortality rate, hospital service utilisation, FEV1 and health related quality of life (HRQL) using a modified Dartmouth Primary Care Co‐operative Quality of Life questionnaire.

Results: There were 48 subjects in each study arm, with no differences in mortality rate (eight deaths in the HBNI group and seven in the control group), hospital admissions, length of stay, number of outpatient and Emergency Service visits. The study had inadequate follow‐up of FEV1 and HRQL within the control group. Within the HBNI group, a small improvement in HRQL (in three of ten indices measured) was demonstrated, despite a deterioration in FEV1 (11% reduction, p=0.04) compared to baseline. Quality of life of HBNI subjects' carers did not change.

Conclusion: An increased level of care given by an outreach respiratory nurse in a shared care approach for patients with severe COPD produced small improvements in HRQL but did not result in the prevention of deaths or reduced health care utilisation.
Comparison of an age adjusted warfarin loading protocol with empirical dosing and Fennerty's protocol
Authors: Roberts G. W. , Druskeit T. , Jorgensen L. E. , Wing L. M. H. , Gallus A. S. , Miller C. , Cosh D. , Eaton V. S.
Published: March 2008

Aim: A warfarin loading protocol adjusting doses for age was compared to both Fennerty's protocol (Fenn) and empirical dosing (Emp).

Methods: Patients beginning warfarin were randomised to receive doses according to either the age adjusted (Age) protocol or Fenn. Data were retrospectively collected for patients who had begun warfarin in the previous six months to represent empirical dosing. The study was performed on inpatients being commenced on warfarin for the first time at two teaching hospitals.

Main outcome measures: Endpoints were time to reach a stable, therapeutic International Normalised Ratio (INR) between 2–3, the number of patients experiencing an INR ≥4 in the first week and the number of patients who had a dose held in the first week.

Results: Thirty‐five patients were assessed in the Age group, 28 in the Fenn group, and 123 patients for the Emp group. Patients using the Age protocol achieved a stable, therapeutic INR more rapidly than either the Fenn (p=0.003, log rank test) or Emp (p<0.001) group. The Age group had a lower proportion of patients experiencing an INR ≥4 in the first week (p<0.05) as well as a lower proportion having doses held in the first week (p<0.01). There were no differences between Emp and Fenn for any of the endpoints.

Conclusion: Adjustment of warfarin loading doses for age exhibits clear superiority over the use of Fenn or Emp. This becomes increasingly important as the average age of patients being warfarinised increases, with the recognition that atrial fibrillation requires anticoagulation. Fenn consistently overdosed elderly patients, especially those aged 80 years and older.
Male systemic sclerosis and occupational silica exposure—a population‐based study
Authors: Englert H. , Small‐McMahon J. , Davis K. , O'Connor H. , Chambers P. , Brooks P.
Published: March 2008

Background: The continuing uncertainty about the silica‐systemic sclerosis relationship led to the investigation of its role as a disease determinant in a large population‐based study of systemic sclerosis.

Aims: To compare the frequency, socioeconomic and educational status, age‐specific prevalence and duration of occupational silica exposure in males with and without systemic sclerosis. To assess the temporal relationship between exposure and disease onset. To estimate disease latency. To compare disease characteristics between silica‐exposed and non‐silica‐exposed male cases.

Methods: The study was case‐control in design. The exposure variable was occupational silica exposure as assessed by an occupational health officer blinded to case/control status and the outcome variable was systemic sclerosis. The employed instrument comprised either a standardised telephone questionnaire (interviewed cases and controls) or medical records (deceased or living‐status‐unknown cases).

Results: Sixty of 160 cases (37.5%) and 11 of 83 (13.3%) controls had occupational silica exposure (OR=3.93; 1.84‐8.54). Comparison of data between 64 interviewed cases and all controls demonstrated initial occupational silica exposure occurring before age 40, comparable educational status but significantly different cumulative socioeconomic status with cases being over‐represented in semi‐skilled and unskilled occupations. Cross‐sectional ‘current’ occupational data underestimated cumulative silica exposure by more than 50%. Silica exposure uniformly preceded onset of second disease symptoms and disease diagnosis. In most, it also preceded onset of first disease symptoms. Disease latency approximated two decades. No disease features distinguished silica‐associated systemic sclerosis from idiopathic systemic sclerosis. The duration of silica exposure in the interviewed silica‐exposed cases did not significantly exceed that of silica‐exposed controls.

Conclusions: Male systemic sclerosis displays socioeconomic dependence. Silica is a disease determinant in male systemic sclerosis, with disease features including a long latency and clinical characteristics indistinguishable from idiopathic disease. Cross‐sectional ‘current’ occupational data underestimate cumulative occupational silica exposure.
The effect of acute hyperglycaemia on brachial artery flow mediated dilatation in normal volunteers
Authors: Bagg W. , Whalley G. A. , Sathu A. , Gamble G. , Sharpe N. , Braatvedt G. D.
Published: March 2008

Abstract Background: Endothelial function is known to be abnormal in patients with diabetes and acute hyperglycaemia may play an aetiological role.

Aims: The aim of this randomised controlled study was to determine if acute systemic hyperglycaemia impairs endothelial function in normal subjects.

Methods: Endothelial function was assessed by the change in brachial artery diameter in response to forearm ischaemia using B‐mode ultrasound in ten healthy subjects (eight male) aged 19–35 years. Brachial artery blood flow velocity and diameter were measured before and after five minutes of forearm ischaemia. Measurements were performed in the supine position after an overnight fast, before and after 60 minute infusions of 0.9% saline or 10% dextrose. Measurements were made on two separate occasions at least 24 hours apart, and subjects were randomised to saline first or dextrose first. The largest diameter measured after ischaemia was divided by the resting arterial diameter to calculate percent dilatation of the artery from baseline, and is reported as flow‐mediated dilatation (FMD).

Results: Dextrose infusion resulted in a significant rise in mean (SD) serum glucose 5.2 (0.1) to 9.2 (0.3) mmol/L and insulin concentration 6.3 (1.4) to 20.6 (3.7) mU/L p<0.002. Brachial artery blood flow velocity and diameter increased significantly from baseline after ischaemia (p<0.002). Mean FMD (SEM) before and after infusion were not, however, significantly different (p=0.4) (pre‐saline 7.3 [1.0]%, post saline 5.2 [1.5]% and predextrose 8.1 [2.0]%, post dextrose 5.9 [1.7]%).

Conclusions: These data suggest that acute hyperglycaemia does not impair FMD in normal subjects.
The Anatomy and relations of evidence‐based medicine
Authors: McDonald I. G. , Daly J. M.
Published: March 2008

AbstractCurrent tensions between evidence‐based medicine (EBM) and some clinicians are counterproductive and unnecessary. The most contentious issues concern (a) the limitations of efficacy data from randomised trials as evidence; (b) differences in attitudes to medical diagnosis and clinical judgement; and (c) political concerns about the use of the concept of clinical evidence and guidelines to restrict physician autonomy. Health services research has evolved in response to a bureaucratic need to study health care, including clinical practice, in order to improve its effectiveness (defined mainly in terms of technological interventions), and to contain costs. Its perspective is from the top‐down representing the interests of bureaucracy and managed care, and articulates with political demands for professional account‐ability and cost‐containment. EBM has established its place as an important contributor to the methodological toolbox for health services research. There is a need for a corresponding coherent programme of clinical practice research which would locate EBM in the clinical environment beside quality assurance, the study of the appropriateness and effectiveness of interventions, and multidisciplinary research related to the art of medicine and supportive aspects of clinical care. EBM would then be seen as one organ in relation to many others making their contribution to the body of knowledge needed for clinical decisions and policy making. A ‘centre for the study of clinical practice' would be an appropriate structure to support such a comprehensive programme of clinical practice research in a tertiary hospital. The bottom‐up perspective of clinical practice research would complement the current top‐down perspective of most health services research, providing information to doctors, patients and administrators concerning local quality of care and health outcomes, information which could also be aggregated for guidance of health policy makers. It would also represent the voice of the clinician in policy debates. Such a programme, located in the practice environment, would also foster mutual understanding, respect and co‐operation between workers from different backgrounds.
The diagonal ear lobe crease (Frank's sign) is not associated with coronary artery disease or retinopathy in type 2 diabetes: the Fremantle Diabetes Study
Authors: Davis T. M. E. , Balme M. , Jackson D. , Stuccio G. , Bruce D. G.
Published: March 2008

Background: The diagonal ear lobe crease (ELC) has been suggested as a simple marker of vascular disease in the general population but there are few data from diabetic patients despite their increased risk of angiopathy.

Aim: To determine whether the ELC is a clinically useful sign of coronary artery disease (CAD) or retinopathy in type 2 diabetes.

Methods: One thousand and twenty‐two patients from the multi‐ethnic urban catchment area of Fremantle Hospital in Western Australia were studied. This sample represents 79% of the type 2 diabetic subjects recruited to the ongoing Fremantle Diabetes Study and 49% of all 2072 patients with type 2 diabetes identified through active case detection in a postcode‐defined region of 120,097 people. In addition to other comprehensive data relating to diabetes and its management, the presence of an ELC and evidence of both CAD and retinopathy were ascertained for each patient.

Results: The prevalence of ELC was 55%. Patients with an ELC were more likely to have CAD than those without an ELC (p=0.019), but the proportions with retinopathy were not significantly different (p=0.085). The sensitivity and specificity of ELC for detecting CAD were 60% and 48%, and for retinopathy 61% and 47% respectively. The patients with an ELC were significantly older, more likely to be male and had a higher systolic blood pressure than those without (p<0.02). After adjusting for known vascular risk factors, socioeconomic variables and ethnicity in a logistic regression model, an ELC was neither a significant independent predictor of CAD (p=0.45) nor of retinopathy (p=0.14).

Conclusions: The ELC is of little value as a sign of the presence of diabetic vascular complications.
Calcium intakes among Australian women: Geelong Osteoporosis Study
Authors: Pasco J. A. , Sanders K. M. , Henry M. J. , Nicholson G. C. , Seeman E. , Kotowicz M. A.
Published: March 2008

Background: Dietary calcium deficiency may be a risk factor for osteoporosis.

Aims: To estimate habitual calcium intakes and prevalence of calcium supplementation among free‐living Australian women and validate a calcium‐specific food‐frequency questionnaire.

Methods: Calcium intakes for 1045 randomly selected women (20–92 years) were estimated by questionnaire which was tested against estimates from four day weighed records kept by 32 randomly selected women.

Results: The mean difference between calcium estimates was not statistically significantly different from zero (mean difference=121 mg; standard deviation of differences=357 mg; p>0.05). There was moderate agreement (weighted κ=0.4) between methods in ranking subjects into tertiles of calcium intake. Mean dietary calcium intakes were 615 mg/day for 20–54 years, 646 mg/day for 55–92 years and 782 mg/day for lactating women. Seventy‐six per cent of women aged 20–54 years, 87% of older and 82% of lactating women had intakes below the recommended dietary intake (RDI). There was no association detected between calcium intake and age. Dairy foods provided 79.0% of dietary calcium intake. Calcium supplements were used by 6.6% and multivitamins by a further 4.3% of women. Supplementation was independent of dietary calcium intake and more likely used by postmenopausal women.

Conclusions: Our results suggest that 76% of women consume less than the RDI even when supplemental calcium is included. Furthermore, 14% have less than the minimal requirement of 300 mg/day and would, therefore, be in negative calcium balance and at risk of bone loss. Despite advertising campaigns promoting better nutrition and increased awareness of osteoporosis, many women are failing to achieve an adequate calcium intake.
Reply to Savulescu: Why we should maintain a prohibition on destructive research on human embryos
Authors: Tobin B.
Published: March 2008

Julian Savulescu argues that destructive experimentation on human embryos is ethically permissible. He attempts to refute objections to such experimentation, and offers an account of the status of the early human embryo according to which it is the kind of entity upon which it is perfectly permissible to experiment. However, his attempts to refute the objections to destructive experimentation on human embryos are unconvincing, and the consequences of his own view of the status of the embryo are counterintuitive.
Covariance‐based subdivision of the human striatum using T1‐weighted MRI
Authors: Cohen Michael X , Lombardo Michael V. , Blumenfeld Robert S.
Published: March 2008

The striatum plays a key role in many cognitive and emotional processes, and displays an intricate pattern of connectivity with cortical and subcortical structures. Invasive tracing work in rats and non‐human primates demonstrates that the striatum can be segregated into subregions based on similar clustering of input and output fibers. In contrast, the human striatum is typically segregated according to local anatomical landmarks without considering natural boundaries formed by functional/anatomical networks. Here, we used non‐invasive magnetic resonance (MR) imaging in young, healthy adults to define subregions of the human striatum based on volume correlations with other subcortical and cortical structures. We present three methods to delineate anatomical volumetric correlations based on gray matter content estimated from T1‐weighted MR images. We observed both consistencies with and divergences from invasive tracing work in animals, suggesting that magnetic resonance imaging (MRI)‐based covariance likely does not correspond to direct anatomical connections, although it might index other forms of connectivity or tissue type similarity. These novel approaches may be useful in understanding connectivity of other regions, and changes in connectivity in patient or ageing populations.
Metabolic diversity of heterotrophic bacterioplankton over winter and spring in the coastal Arctic Ocean
Authors: Sala Maria Montserrat , Terrado Ramon , Lovejoy Connie , Unrein Fernando , Pedrós‐Alió Carlos
Published: March 2008

Metabolic diversity of heterotrophic bacterioplankton was tracked from early winter through spring with Biolog Ecoplates under the seasonally ice covered arctic shelf in the Canadian Arctic (Franklin Bay, Beaufort Sea). Samples were taken every 6 days from December 2003 to May 2004 at the surface, the halocline where a temperature inversion occurs, and at 200 m, close to the bottom. Despite the low nutrient levels and low chlorophyll a, suggesting oligotrophy in the winter surface waters, the number of substrates used (NSU) was greater than in spring, when chlorophyll a concentrations increased. Denaturing gradient gel electrophorisis analysis also indicated that the winter and spring bacterial communities were phylogenetically distinct, with several new bands appearing in spring. In spring, the bacterial community would have access to the freshly produced organic carbon from the early phytoplankton bloom and the growth of rapidly growing specialist phenotypes would be favoured. In contrast, in winter bacterioplankton consumed more complex organic matter originated during the previous year's phytoplankton production. At the other depths we tested the NSU was similar to that for the winter surface, with no seasonal pattern. Instead, bacterioplankton metabolism seemed to be influenced by resuspension, advection, and sedimentation events that contributed organic matter that enhanced bacterial metabolism.
Salvage endoscopic submucosal dissection for residual or local recurrent intraepithelial neoplasia in the colorectum: a prospective analysis
Authors: Hurlstone D. P. , Shorthouse A. J. , Brown S. R. , Tiffin N. , Cross S. S.
Published: March 2008

Objective  A prospective technical feasibility study of cap assisted ESD for ‘curative intent’ in patients with residual or local neoplastic recurrence following EMR. Primary end points were second stage R0 resection rate, safety and recurrence.

Method  Salvage ESD was performed using the Olympus GIF‐XQ240 gastroscope and KD‐630L insulation tipped knife. Thirty‐day mortality, re‐admission rates, complications and histological resection status were collected prospectively up to 9 months following index resection.

Results  Thirty patients met eligibility criteria. Index R0 resection was achieved in 25/30 (83%) lesions. One patient underwent surgical excision with a second receiving a curative second stage dissection. Ninety‐six per cent (29/30) patients were discharged within 24 h of the procedure with a 0% 30‐day mortality and re‐admission rate. Bleeding occurred in 5/30 (16%) treated successfully with endoluminal haemostasis. There were no perforations. Overall ‘cure’ rates at short‐term follow‐up [median 6/12 (range; 3–18)] was 96%.

Conclusion  This novel application of ESD for first line ‘salvage’ therapy in treating residual or locally recurrent neoplastic disease may be a safe, minimally invasive and cost effective alternative to direct surgical resection in a select patient cohort.
Causes of frequency and nocturia after renal transplantation
Authors: Van der Weide Marian J.A. , Van Achterberg Theo , Smits Jeroen P.J.M. , Heesakkers John P.F.A. , Bemelmans Bart L.H. , Hilbrands Lukas B.
Published: March 2008

OBJECTIVE

To explore the role of bladder capacity, bladder pain, dysfunctional voiding, urgency, urinary tract infections (UTIs), and urinary output as potential causes of frequency and nocturia after renal transplantation.

PATIENTS AND METHODS

Data were gathered from 52 adult renal transplant patients (35 men and 17 women, mean age 49 years), using a written questionnaire, medical records, frequency/volume charts, and urinary cultures. The mean time between transplantation and data collection was 5 months. Structural equation modelling (SEM) was used for the simultaneous assessment of direct and indirect relationships between explanatory variables and voiding frequency.

RESULTS

Frequency and nocturia were found in 54% and 60% of the study population, respectively. Frequency was directly associated with a small bladder capacity, bladder pain, urgency, and a high daytime urine volume, and indirectly by UTIs (via urgency and bladder pain). Nocturia was associated with high nocturnal urine volume, small bladder capacity and dysfunctional voiding. A quarter of the patients had small bladders and another quarter had large bladders, the latter being associated with nocturnal polyuria.

CONCLUSIONS

The presence of frequency, especially when accompanied by bladder pain, might aid the physician to identify patients with small bladders. The presence of nocturia can be the result of a high nocturnal urine volume, which increases the risk of bladder enlargement. Because both abnormal bladder conditions can contribute to graft dysfunction, we recommend a urological follow‐up after renal transplantation, using frequency/volume charts.
THE COVERAGE PROBABILITY OF CONFIDENCE INTERVALS IN 2r FACTORIAL EXPERIMENTS AFTER PRELIMINARY HYPOTHESIS TESTING
Authors: Giri Khageswor , Kabaila Paul
Published: March 2008

We consider a 2r factorial experiment with at least two replicates. Our aim is to find a confidence interval for θ, a specified linear combination of the regression parameters (for the model written as a regression, with factor levels coded as −1 and 1). We suppose that preliminary hypothesis tests are carried out sequentially, beginning with the rth‐order interaction. After these preliminary hypothesis tests, a confidence interval for θ with nominal coverage 1 −α is constructed under the assumption that the selected model had been given to us a priori. We describe a new efficient Monte Carlo method, which employs conditioning for variance reduction, for estimating the minimum coverage probability of the resulting confidence interval. The application of this method is demonstrated in the context of a 23 factorial experiment with two replicates and a particular contrast θ of interest. The preliminary hypothesis tests consist of the following two‐step procedure. We first test the null hypothesis that the third‐order interaction is zero against the alternative hypothesis that it is non‐zero. If this null hypothesis is accepted, we assume that this interaction is zero and proceed to the second step; otherwise, we stop. In the second step, for each of the second‐order interactions we test the null hypothesis that the interaction is zero against the alternative hypothesis that it is non‐zero. If this null hypothesis is accepted, we assume that this interaction is zero. The resulting confidence interval, with nominal coverage probability 0.95, has a minimum coverage probability that is, to a good approximation, 0.464. This shows that this confidence interval is completely inadequate.
TREASURY NOTE AND BANK BILL RATES, THE RISK PREMIUM AND AUSTRALIAN MONETARY POLICY*
Authors: KARFAKIS COSTAS , PHIPPS ANTHONY
Published: March 2008

This paper examines a link in the Australian monetary transmission mechanism based on the risk structure of certain interest rates. Monthly data on the bank‐accepted bill and Treasury note rates reveal a significant reduction in both the mean and variance of the risk premium linking the two rates towards the end of 1989. The two interest rates cointegrate in each of the periods January 1984 to September 1989 and October 1989 to December 1995, though less significantly so in the earlier period, and formal tests indicate that the risk premium was stationary for each of the sub‐periods. Well defined error‐correction mechanisms suggest that the burden of adjustment to shocks to the money market was shared by the two interest rates. A stationary risk premium, combined with evidence that the Treasury note rate Granger‐caused the bank bill rate in both sub‐periods, indicates that the Reserve Bank has been able to influence the bill rate by targeting the note rate.
HONG KONG'S INDETERMINACY PUZZLE: INSTITUTIONALIST AND ECONOMETRIC APPROACHES*
Authors: SHAH PARTH J.
Published: March 2008

During the free‐issue regime (1974–1983), Hong Kong's money supply, price level and exchange rates were wholly governed by market forces. The system did not seem to have any nominal anchor. Theoretically its price level was indeterminate, engendering what is called an indeterminacy puzzle. The paper elaborates on the concept of price level indeterminacy and undertakes the question of empirical determination of the price level indeterminacy during the free‐issue regime. The empirical investigation employs two distinct approaches ‐ institutionalist and econometric. The results of the two approaches indicate the necessity of a broader approach to historical analyses. The paper also informs us about the relationship among money supply, price level and exchange rate in a regime of fiat money without a central bank.
THE POST‐KEYNESIAN ‘DEMAND FOR CREDIT’ MODEL*
Authors: HEWITSON GILLIAN
Published: March 2008

The post‐Keynesian ‘demand for credit’ model is a well‐cited piece of empirical evidence to support the contention that the money supply is endogenously rather than exogenously determined. In this paper, the model is critically examined and found to be problematic in several ways. Cointegration techniques are used to estimate a similar model using Australian data.
FINANCIAL DEREGULATION AND RELATIVE RISK OF AUSTRALIAN INDUSTRY*
Authors: BROOKS ROBERT D. , FAFF ROBERT W.
Published: March 2008

In the early 1980s the Australian economy underwent a period of rapid financial deregulation and liberalisation, the key symbol of this process being the floating of the exchange rate in December 1983. It has been suggested that one effect of such regulatory change is to alter the risk characteristics of economic units most directly impacted by the changes. In this vein, Brooks and Faff (1995) examined banking industry risk and found that deregulation coincided with a stabilising of the beta risk of banks. However, financial deregulation was expected to have widespread effects across the economy. Accordingly, in this paper we further test for possible effects by examining the level and stability of the beta risk of individual stocks and portfolios in other industries in both prederegulation and post‐deregulation periods. From a comparison of the two periods we find that the effects on beta levels vary across industries. However in general post‐deregulation betas have become stable across a large range of key industry classifications. This provides interesting insights into the effects of financial deregulation on relative risk and why different industries may have different experiences.
GEOGRAPHERS AND WORLD PEACE A PLEA FOR GEOPACIFICS
Authors: Taylor Griffith
Published: March 2008

Professor Taylor was elected Foundation President of the Institute of of Australian Geographers in 1958 and held office until 1961. A graduate of the universities of Sydney and Cambridge, he became successively Senior Geologist to the British Antarctic Expedition of 1910–3, Physiographer to the Australian Commonwealth Weather Service, the first MacCaughey Associate‐Professor of Geography in the University of of Sydney (1920–9), and Professor of Geography in the universities of Chicago (1929–35) and Toronto (1935–51). In 1951 he returned to Australia and in 1954 became the first, and only, geographer elected to the Fellowship of the Australian Academy of Science. Despite his eighty‐two years he is still intellectually and physically active, and continues to write with his accustomed éclat and zeal. This paper is an abridgement of his Presidential Address delivered to the Institute of Australian Geographers in Melbourne in January, 1960.
THE GEOMORPHIC IRRELEVANCE OF SOME DRAINAGE NET LAWS
Authors: Milton L. E.
Published: March 2008

New evidence, both theoretical and observational, is presented to show that Horton's Laws of Stream Numbers and Mean Stream Lengths represent the geomorphic application of abstract mathematical relationships. The laws follow automatically from the definition of order and must apply equally well to any branching system. The value of each of the coefficients Rb (bifurcation ratio) and Rl (ratio of mean stream lengths) is at least partly controlled by geomorphic factors, and an attempt has been made to describe the operation of these factors.
Changes in unemployment differentials in Sydney, 1947–76
Authors: VIPOND JOAN
Published: March 2008

This paper describes the historical development of spatial patterns of male and female unemployment rates within Sydney at each census year from 1947 to 1976, with two objectives: firstly to review the predictions of traditional urban theory that unemployment will be high in inner city areas because of the workforce characteristics of the residents; secondly, to assess the impact of the decentralisation of firms.
The Sydney business frontier 1856–92: a building stock approach
Authors: EDWARDS NORMAN
Published: March 2008

Through historical analysis of Sydney's emerging office zone, a description is offered of the part played by buildings as a factor in central area spatial change. As buildings are indispensible to the productivity of firms, it is reasoned that with changes in demand, firms have the option to shift to another building or to modify (or ultimately demolish and rebuild) the buildings occupied by them, or to do both. Accordingly, it is postulated that there are regular sequences of use and constructional change operating through buildings and that for firms of the same type these regularities are manifested over space. Such regularities within the expanding office zone are found to take the form of an outward wave of use and constructional change more or less as postulated.
Italian settlement in Sydney, 1920–78
Authors: BURNLEY I. H.
Published: March 2008

Italian settlement in Sydney has been distinguished by its poly‐nuclear pattern of concentration and also widespread dispersion. The classical invasion‐succession and concentric models of population movement have been less applicable to the process of settlement growth and change of the Italians for several reasons: first, the importance of chain migration and the resultant ‘urban village’ clusters and identifications; second, the possibility of owner occupancy of housing in ethnic concentrations through the conversion of the inner city rental market to an o wner occupier market of individual dwellings, so that concentrations could survive; and third, the tendency, despite substantial residential mobility within the first generation, for many longer‐established residents to stay behind in the concentrations—the reverse of the classical models. The decision to stay or move is in part a matter of choice, but language constraints have been influential. Many recent arrivals and younger persons have by‐passed the residential concentrations and their institutional structures because of better education and skills and because they could join relatives who had moved out, so that chain migration ultimately acted to disperse settlers after originally concentrating them.
The Tasman connection: aspects of Australian‐New Zealand relations
Authors: McCASKILL MURRAY
Published: March 2008

Although geographers frequently claim an interest in the study of spatial interactions there are few wide ranging studies of relationships between specific areas or countries. Australian and New Zealand geographers have treated their countries' inter‐relationships as marginal asides rather than as serious research themes. From a wide possible agenda the following aspects of trans‐Tasman relationships are examined: the interchange of plants and animals. New Zealand's nineteenth century peripheral relationship to a southeast Australian economic ‘core’, legislative borrowings concerning land and resources administration, population movements and trade connections. Since World War II growing cultural and political divergences have made the Tasman nations cautious about pursuing closer economic relationships.
Rural communities and small area forecasting: some examples from South Australia
Authors: SMAILES P. J. , HUGO G. J.
Published: March 2008

This paper demonstrates and evaluates two different but complementary methodologies of small area forecasting in a rural area some 80 km north of Adelaide. The first approach forecasts overall population trends using a sector‐by‐sector appraisal of the growth/decline prospects of each economic sector based on detailed field surveys carried out in 1968 and 1970. The second approach was to use the readily available 1971 census and corresponding vital statistics data to project the population of the study area using a simple cohort‐component projection methodology. Both approaches made forecasts of expected population levels by 1980, and in that year the authors conducted a resurvey of the same study area. The article demonstrates the need for, and results of, regular updating of the assumptions on which population forecasts are made, for the period 1968–1980 includedan unexpected revival of the farm economy as well as the onset of the international urban‐rural migration flow of the ‘population turnaround’. Neither of these trends had been foreseen in the initial forecasts; their effects are shown in the results of the 1980 resurvey, and the utility of the forecasting methodologies is discussed in the light of these findings.
Rubber smallholders in Peninsular Malaysia: problems and prospects
Authors: CHO GEORGE
Published: March 2008

After a discussion of farm size and average returns of rubber smallholders in Peninsular Malaysia interest is centred on the factors affecting production—land development, rubber replanting, alternative sources of household income and the role of the government in the local and international rubber market. Government attention to these factors should enhance returns to small rubber farmers.
Freedom of information and geographical practice
Authors: MERCER DAVID
Published: March 2008

Professional geographers are reliant for much of their research on information made available by government agencies and private corporations. The principal argument here is that much crucial information is either confidential, grossly distorted or totally suppressed. This means that geographers cannot always adequately perform one of their major professional responsibilities which is to comment critically on various developments taking place around them in the ‘real world’. The international freedom of information movement has developed and grown in response to the secrecy which characterises most liberal democracies around the world. Freedom of information legislation is discussed, together with a number of case studies illustrating the suppression and distortion of information. It is argued that the ‘openness’ of the ‘information environment’ within which geographers live and work has a significant impact on the kinds of research topics that are tackled.
A map of karst cave areas in Australia
Authors: JENNINGS J. N.
Published: March 2008

A dot map of karst cave areas in Australia is presented together with a similar one redrawn from the National Atlas of the United States of America. The limitations of the map are described. The geographical circumstances behind Australia's poverty in these resources and the risks to which they are exposed are outlined.
Economic processes and urban change: an analysis of contemporary patterns of residential restructuring
Authors: WILLIAMS PETER
Published: March 2008

This article examines questions of explanation in urban geography through consideration of the gentrification process. Particular attention is given to the problems of ‘structural’ analyses and the need to develop alternative political economy perspectives.
Australian aid: how far should the Jackson Review go?
Authors: PORTER DOUG
Published: March 2008

And don't forget to tell them about the Philippines context rather than the special features of my case.
Revolutionary and evolutionary change in human geography: a personal assessment
Authors: BROWETT JOHN
Published: March 2008

Many perspectives new to Anglo‐Saxon human geography have been introduced into the discipline over the last twenty years. These are reviewed in terms of the impacts upon mainstream human geography of the quantitative/spatial organisation /theoretical revolutions, and the reactions against these in turn by advocates of the behavioural, liberal/relevance, Marxist and post‐positivist perspectives. The review ends with a brief consideration of some contemporary approaches within human geography, particularly those seeking an understanding of the processes underpinning the relationships between agency and structure. By way of conclusion a personal assessment is given of the current standing of the discipline and the nature of the changes required of it in the 1980s.
The changing pattern of urban fertility in eastern Australia 1966–1976
Authors: WILSON M.G.A.
Published: March 2008

The article seeks to enhance understanding of post‐transitional demographic change by examining the working out at the local level of the macro‐scale societal processes underpinning the recent cyclic oscillation in Australian reproductive behaviour. Variations in urban marital and overall fertility between 1966 and 1971 and between 1971 and 1976 are described and analysed. In general, inter‐urban variability in both measures diminished greatly, as did the explanatory power of ecological differentials, suggesting widespread acceptance of the small family norm throughout the study‐area. While the process of convergence was continuous for marital fertility, structural changes contributed to later divergence of overall fertility levels, in accordance with Alonso's cyclical model of change. The current low level of residual inter‐urban variability suggests that little more may be gained from analyses of this type.
The origins of assisted British migrants to Queensland 1871–1892
Authors: CAMM J.C.R.
Published: March 2008

The aim of the present government is to encourage the introduction of emigrants from the mother country and failing this from the continent of Europe (The Queensland Treasurer, 1875).

This article examines the origins of British migrants to Queensland between 1871 and 1892, a period when the government assisted over 150,000 British migrants to the colony. At first most assisted migrants came from industrial‐urban areas and, except those from Ireland, had limited knowledge of rural life. In the 1880s the government canvassed the agricultural counties of eastern England to attract farm workers. Consequently, these areas became major source regions for assisted emigrants. Many assisted migrants, however, still had limited experience of rural life and on arrival in the colony preferred either to live in town or to move south. Despite these failures sufficient numbers of assisted British migrants remained to ensure the growth of the colony's agricultural economy.
Small may be inevitable*
Authors: WOOLMINGTON ERIC
Published: March 2008

Today's global culture system is experiencing a phase of accelerating change. This change is powered by technological innovation which produces social and economic turbulences in the system as unforeseen side‐effects of the changes wrought by technology. This turbulence takes many forms: the economic system must grow to avoid collapse; institutions grow bigger and more unwieldy; individuals become increasingly alienated. Therein lie the seeds of the system's disintegration, leading to the likely emergence of a subsequent culture system (or systems) of smaller dimensions, signs of which are already manifest.
A political economy approach to the allocation of health care resources: the case of remote areas of Queensland
Authors: HUMPHREYS J. S.
Published: March 2008

This article describes and accounts for the existing distribution of medical services in remote areas. In contrast to traditional geographical approaches which have sought to explain problems associated with service provision in remote areas in terms of high costs of overcoming vast distances and low population thresholds, it is argued that such geographical and economic factors alone are an insufficient basis for explanation. Rather, it is necessary to view this issue in the broader context of existing ideology that underpins the procedures relating to the allocation of society's scarce resources, and the role of political and bureaucratic processes that are responsible for health care inequities. The adoption of apolitical economy framework recognises the problem of resource allocation as essentially a political matter requiring an analysis of power relations.