bluuebunny/crossref_metadata_2025 huggingface dataset:
Does birthweight predict adolescent adiponectin levels?
Authors: Kim Chul Sik , Park Jong Suk , Park Jina , Nam Ji Sun , Kang Eun Seok , Ahn Chul Woo , Cha Bong Soo , Lim Sung Kil , Kim Kyung Rae , Lee Hyun Chul , Huh Kap Bum , Kim Dae Jung
Published: January 2006

Objective Low birthweight is associated with insulin resistance later in life, and adiponectin is known to play an important role in insulin resistance. We have investigated whether birthweight has a relationship with adiponectin levels in adolescence.

Patients An at‐home questionnaire survey was completed by 660 middle‐school students (aged 12–15 years) in Seoul, Korea, and 152 participants were selected randomly based on their birthweight.

Measurements Subjects were separated into three groups according to birthweight. We recorded the birthweight and measured anthropometric factors including blood pressure, lipid profile, homeostasis model assessment of insulin resistance (HOMA‐IR) and β‐cell function (HOMA‐β), and adiponectin levels of the subjects. These parameters were compared among the groups. The relationship between birthweight and physiological characteristics in adolescence was examined.

Results Systolic blood pressure, lipid profiles and fasting plasma glucose were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C‐peptide and HOMA‐IR were higher in the low birthweight tertile. After adjustment for confounding factors, birthweight was inversely related to diastolic blood pressure, insulin, C‐peptide and HOMA‐IR. Adiponectin level had a significant relationship with current body mass index (BMI) (r = –0·291; P < 0·001) but not with birthweight (r = 0·117; P = 0·166).

Conclusions Although birthweight is closely related to insulin resistance during adolescence, adiponectin levels during adolescence had no significant relationship with birthweight. This result implies that low birthweight may not permanently affect adiponectin levels, but current body size is more closely associated with a decreased adiponectin level. However, the limited importance of birthweight as a determining factor on the adiponectin level later in life needs to be further evaluated.
Tissue levels of adiponectin, tumour necrosis factor‐alpha, soluble intercellular adhesion molecule‐1 and heart‐type fatty acid‐binding protein in human coronary atherosclerotic plaques
Authors: Karaduman Mehmet , Sengul Ali , Oktenli Cagatay , Pekel Aysel , Yesilova Zeki , Musabak Ugur , Sanisoglu S. Yavuz , Gunay Celalettin , Baysan Oben , Kocar Ismail H. , Tatar Harun , Ozata Metin
Published: January 2006

Background  There is little information available about any link between the levels of adiponectin, intercellular adhesion molecule‐1 (ICAM‐1), tumour necrosis factor‐α (TNF‐α) and heart‐type fatty acid‐binding protein (H‐FABP) in coronary atherosclerotic plaque specimens.

Aim  To analyse tissue levels of adiponectin, ICAM‐1, TNF‐α and H‐FABP in the plaques obtained from coronary artery bypass grafting (CABG) and to evaluate whether there is any relationship between these variables and other characteristics.

Patients and methods  Coronary artery specimens from 37 consecutive patients (28 men and nine women) at time of CABG procedure and preprocedural blood samples were obtained. Tissue concentrations of adiponectin, ICAM‐1, TNF‐α and H‐FABP in the atherosclerotic plaques were measured.

Results  Blood glucose and tissue levels of TNF‐α and ICAM‐1 were negatively correlated with tissue levels of adiponectin, whereas TNF‐α was positively correlated with ICAM‐1 in atherosclerotic plaques. In addition, there was a positive correlation between blood glucose and tissue levels of both TNF‐α and ICAM‐1. TNF‐α and ICAM‐1 levels in atherosclerotic plaques appear to progressively increase whereas adiponectin levels progressively decrease with smoking status. Atherosclerotic tissue levels of these substances are also altered in diabetes.

Conclusions  The data are in accord with those in prior publications on the detection and quantification of various inflammatory cytokines in atherosclerotic plaques. Our results indicate that diabetic state and smoking, in addition to other physiopathological mechanisms, may create a chronic inflammatory situation in the atherosclerotic process.
The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV
Authors: Reuter H , Burgess L J , Schneider J , Van Vuuren W , Doubell A F
Published: January 2006

Aims : To establish the influence of human immunodeficiency virus (HIV) infection on the histopathological features of patients presenting with tuberculous pericarditis.

Methods and results : A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large pericardial effusions had open pericardial biopsies under general anaesthesia and were included in the study. Patients underwent pericardiocentesis, followed by daily intermittent catheter drainage; a comprehensive diagnostic work‐up (including histopathology of the pericardial tissue) was also performed. Histological tuberculous pericarditis was diagnosed according to predetermined criteria. Tuberculous pericarditis was identified in 25 patients, five of whom were HIV+. The presence of granulomatous inflammation (with or without necrosis) and/or Ziehl–Neelsen positivity yielded the best test results (sensitivity 64%, specificity 100% and diagnostic efficiency 75%).

Conclusions : Co‐infection with HIV impacts on the histopathological features of pericardial tuberculosis and leads to a decrease in the sensitivity of the test. In areas which have a high prevalence of tuberculosis, the combination of a sensitive test such as adenosine deaminase, chest X‐ray and clinical features has a higher diagnostic efficiency than pericardial biopsy in diagnosing tuberculous pericarditis.
Dental findings of a child with Wolf–Hirschhorn syndrome
Authors: JOHNSTON N. J. , FRANKLIN D. L.
Published: January 2006

The case presented is that of a 5‐year‐old female with Wolf–Hirschhorn syndrome. Dental findings were severe hypodontia, late dental development, taurodontism of the primary molars, microdontia, and spacing. Hypodontia has previously been reported and therefore this case adds to the evidence that hypodontia may be a common feature of this syndrome. It also suggests that other dental anomalies could occur in children with Wolf–Hirschhorn syndrome.
Sotos syndrome with hypodontia
Authors: CALLANAN A. P. , ANAND P. , SHEEHY E. C.
Published: January 2006

Sotos syndrome, or cerebral gigantism, is a rare genetic condition characterized by tall stature, gigantism, dolichocephaly, advanced bone age and learning disability. The purpose of this case report is to highlight the dental management of a 10‐year‐old boy with Sotos syndrome who presented with hypodontia and dental caries.
Is there life after Buckley's Formocresol? Part I – A narrative review of alternative interventions and materials
Authors: SRINIVASAN V. , PATCHETT C. L. , WATERHOUSE P. J.
Published: January 2006

Objectives. (1) To present a narrative review of the currently available alternative interventions and materials to formocresol pulpotomy for the management of extensive caries in the primary molar, and (2) to produce a clinical protocol for pulp therapy techniques in the extensively carious primary molar.

Introduction. The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. Since Buckley's Formocresol contains 19% formaldehyde in its full strength and, therefore, 1% in a 20% dilution, a safer alternative should be identified.

Methods. A narrative review of the published literature for primary molar pulp therapy techniques was undertaken following an extensive and appropriate literature search. A specialist group of paediatric dentists was formed to arrive at a consensus and establish an evidence‐based protocol for the management of extensively carious primary molar teeth. Part I of this paper explores the currently available alternative interventions and materials to formocresol in the form of a narrative review. The second part of the paper will present the formation of a specialist group to arrive at a consensus and establish an evidence‐based protocol for the management of the extensively carious primary molar.

Conclusions. After consideration of a review of extensively searched literature, a protocol and key points document have been developed to assist clinicians in their treatment planning. Further long‐term studies with the highest level of evidence (i.e. randomized controlled trials) are required to enable us to identify acceptable alternatives which can replace formocresol.
A survey of specialist paediatric dental services in Sweden: results from 2003, and trends since 1983
Authors: KLINGBERG G. , DAHLLÖF G. , ERLANDSSON A.‐L. , GRINDEFJORD M. , HALLSTRÖM‐STALIN U. , KOCH G. , LUNDIN S.‐Å.
Published: January 2006

The child population in Sweden has changed dramatically during the last 20 years. Changes have also occurred within the Public Dental Service (PDS), regarding the provision of dental care to children and adolescents. All these changes may affect the referral pattern and provision of specialist dental care for children and adolescents.

Objectives.  The primary aim of this study was to survey the services provided by specialists in paediatric dentistry in Sweden during 2003. A secondary aim was to compare the results with previous surveys.

Methods.  A Web‐based survey was sent to all 34 specialist paediatric dentistry clinics and was answered by all clinics. Data were compared with results from the surveys performed in 1983, 1989, and 1996.

Results.  The number of paediatric dentists had been relatively constant over the last 20 years, whereas the number of children referred to paediatric dentists had increased by 28% since 1983. It was estimated that 1·3% of all children in Sweden are treated at a specialist paediatric dental clinic in 2003. Dental treatment need in combination with behaviour management problems (BMP) was the main reason for referral and occurred in 37% of all referrals. The proportion of medically compromised children/children with disabilities had increased from 6% in 1983 to 22% in 2003. The number of patients treated using sedation and general anaesthesia had increased since 1983, and particularly since 1996.

Conclusions.  Despite improvements in dental health among children and adolescents in Sweden during the last 20 years, an increasing number of children are referred for specialist paediatric dental treatment. There is an urgent need to increase the number of specialist paediatric dentists in Sweden in order to ensure the continuation of high quality of dental care for children and adolescents.
The immediate and long‐term outcome of enhanced external counterpulsation in treatment of chronic stable refractory angina
Authors: LOH P. H. , LOUIS A. A. , WINDRAM J. , RIGBY A. S. , COOK J. , HURREN S. , NIKOLAY N. P. , CAPLIN J. , CLELAND J. G. F.
Published: January 2006

Background.  Treatment of angina recalcitrant to conventional pharmacological therapy and revascularization remains problematic. Safe, effective and affordable treatments with high patient acceptability are desirable. Enhanced external counterpulsation (EECP) may fulfil these criteria better than many other proposed interventions.

Objective.  To examine the immediate and long‐term effect of EECP in treatment of chronic stable refractory angina.

Design.  Prospective observational study of consecutive patients treated with EECP and follow‐up for 1 year.

Setting.  Teaching hospital.

Main outcome measures.  Canadian Cardiovascular Society (CCS) angina grading, weekly angina frequency and glyceryl trinitrate (GTN) use.

Results.  Sixty‐one patients were treated with EECP and 58 completed a course of treatment. Further analysis is confined to those who completed EECP. About 52% of patients suffered from CCS III and IV angina prior to EECP. Immediately post‐EECP, angina improved by at least one CCS class in 86% and by two classes in 59%. At 1‐year follow‐up, sustained improvement in CCS was observed in 78% of the patients. The median weekly angina frequency and GTN use were significantly reduced immediately after EECP [7 (4–14) vs. 1 (0–4) episodes per week and 7 (2–16) vs. 0 (0–2) times per week respectively, P < 0.0001; data in median (interquartile range)]. The reduction was sustained at 1‐year follow‐up. In 48 patients, their mean exercise time improved significantly after EECP [301 ± 130 s vs. 379 ± 147 s, P < 0.0001]. Major adverse treatment‐related events were rare.

Conclusion.  This study shows that for patients who fail to respond to conventional measures, a high proportion gain symptomatic benefit from EECP.
Supplementary prescribing: relationships between nurses and psychiatrists on hospital psychiatric wards
Authors: JONES A.
Published: January 2006

The purpose of this study was to explore some of the issues for the implementation of supplementary prescribing for acute hospital care. The study design was the use of focus group methodology. In total, 19 nurses and 7 psychiatrists joined 1 of 6 focus groups held on the psychiatric unit. The data were analyzed using a modified grounded theory technique. In the study to be reported here, nurses and psychiatrists described the potential for different ways of working to emerge on acute psychiatric wards. Two major themes were identified: supplementary prescribing bringing about different ways of influencing decisions and controlling professional work; nurses and psychiatrists developing different types of relationships. Findings suggest an overall positive acceptance for supplementary prescribing, but for greater attention to be placed on the nature of relationships between nurses and psychiatrists. Implications for practice include the impact on new roles for nurses and psychiatrists and how this new form of relationship can best serve patients.
In search of the True Self: a clinical journey through the vale of Soul‐making
Authors: WILKIN P.
Published: January 2006

Once a person accepts any form of mainstream mental health care, she is faced with the paradox of disabling caring. Every time an emotionally distressed individual is professionally rescued, she forfeits a golden opportunity to discover and utilize her own healing potential. Yet within a mental health service that is heavily medicalized and investing more and more in time‐limited therapies, can it ever be otherwise? Drawing on the developmental theory of Donald Winnicott, together with the poet John Keats’ concept of ‘Soul‐making’, this case study provides an account of therapy delivered from outside the parameters of a health–illness model of caring. It acknowledges human suffering as a natural and inevitable part of life and, whilst acknowledging the value of therapeutic companionship, proclaims the mentally distressed person as best placed to navigate her own recovery.
Pharmacological management of akathisia in combination with psychological interventions by a mental health nurse consultant
Authors: JONES M. , BENNETT J. , GRAY R. , ARYA P. , LUCAS B.
Published: January 2006

The article describes the management of akathisia by a mental health nurse (MHN) prescriber, working in partnership with the patient. A single‐case design was used to evaluate this. It highlights three features: first, MHN can safely prescribe psychiatric medication in combination with concordance therapy. Second, the value base underpinning prescribing practice is partnership, honesty and choice for the patient. Finally, the pharmacological mechanism of antipsychotic medication, which contributes towards akathisia, requires further analysis.
Greek psychiatric care reform: new perspectives and challenges for community mental health nursing
Authors: BELLALI Th , KALAFATI M.
Published: January 2006

The purpose of this article is twofold: (1) to explore the main issues of psychiatric care reform in Greece and outline the operating way of the new residential structures of psychiatric care and rehabilitation; and (2) to focus on the implementation of mental health nursing roles in the primary care services such as supervisor‐therapist, liaison, coordinator‐crisis interventionist and counsellor‐trainer within the context of a multidisciplinary therapeutic team. Given that multiple professionals are involved in mental health care in primary care, issues of role are likely to be crucial to the effective implementation of new workers. Moreover, there is existing evidence of ambiguity in the roles of different mental health professionals in primary care, relating to the problems they manage and the treatments they provide. The authors believe that more emphasis needs to be given to the mental health nursing specialty in Greece, because the large majority of patients requiring mental health care should have the possibility of taking better quality of care as the psychiatric structures at community are continuously developing.
The development of an evaluation questionnaire for the Newcastle Crisis Assessment and Home Treatment Service: finding a way to include the voices of service users
Authors: HOPKINS C. , NIEMIEC S.
Published: January 2006

The views of users of services have traditionally been sought through the use of ‘patient satisfaction’ surveys. Because such surveys are often devised by service providers there are concerns that their use as evaluation tools may be flawed due to issues of power and passivity, and that they do not represent active involvement by service users in the feedback loop. The Newcastle Crisis Assessment and Treatment Service offers treatment at home to people in mental health crisis who would otherwise be admitted to hospital. This article reports on the process of inviting previous users of a home treatment service to give their views about what was most important to them about receiving the service. A participatory research approach combining a two‐stage modified Delphi study and semi‐structured interviews conducted by service user interviewers were employed to gather rich data to inform the construction of a service evaluation questionnaire. The questionnaire is now in routine use for every person who is in receipt of treatment at home. The feedback obtained from the questionnaire will be used to shape and refine the service provided by the team. As a ‘live’ document through use and feedback, the questionnaire will continue to evolve in order to retain its sensitivity and relevance.
Further thoughts on the process of restraint
Authors: WINSHIP G.
Published: January 2006

The physical restraint of a disturbed person is a subject constant of psychiatry and is a challenge that particularly faces nurses working in acute inpatient settings. While other approaches to psychiatric treatment have been discarded (e.g. punishment, blood letting, trepanation, deep insulin therapy and so on) or evolved into new treatments (the use of medication), the act of physical restraint has remained largely unmodified. Given the ubiquity of physical restraint in psychiatry, particularly as a nursing procedure, the absence of a sustained body of research is notable. This essay examines some of the historical underpinnings of the use of restraint in psychiatry brought into sharp focus by the David Bennett Inquiry Report (2003) and the National Institute of Clinical Effective (NICE) guidelines (2005) on the management of violence.
Patterns of latex allergen recognition in children sensitized to natural rubber latex
Authors: Pamies Rafael , Oliver Fernando , Raulf‐Heimsoth Monika , Rihs Hans‐Peter , Barber Domingo , Boquete Manuel , Nieto Antonio , Mazón Angel
Published: January 2006

Single recombinant latex allergens permit the study of the pattern of sensitization to individual allergens. We aimed to quantify the IgE‐response to individual latex allergens in children sensitized to latex. The study group included 31 latex‐sensitized children: 26 operated at least twice, 20 of them with spina bifida; two children with one operation and three atopic non‐operated children. IgE antibodies to rHev b 1, rHev b 3, rHev b 5, rHev b 6.01, rHev b 7.02 and rHev b 8, coupled to ImmunoCAPs, were measured in each serum. IgE responses to rHev b 1, rHev b 5 and rHev b 6.01 were found in 17 children each, and their mean ± s.d. levels were 5 ± 7.4, 16.8 ± 14 and 10 ± 18 kU/l, respectively. IgE responses to rHev b 3 (4 ± 5.4 kU/l) were found in eight children. Two children had IgE to rHev b 7 (1.7 and 3.2 kU/l), and none to rHev b 8. Four sera were negative to all tested recombinant allergens. We divided the patients in three groups: sensitized only to rHev b 1, sensitized only to rHev b 5 and/or rHev b 6.01, and sensitized to both rHev b 1 and to rHev b 5 and/or rHev b 6.01. The three groups had the same profile of clinical features. Hev b 5 induces the quantitatively higher IgE responses in children with multiple surgeries sensitized to latex. Responses to Hev b 6.01 equal those of Hev b 1.
Current cat ownership may be associated with the lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis in schoolchildren in Himeji, Japan
Authors: Kurosaka Fumitake , Nakatani Yuji , Terada Tadayuki , Tanaka Akira , Ikeuchi Haruki , Hayakawa Akira , Konohana Atsuo , Oota Kenji , Nishio Hisahide
Published: January 2006

The aim of the study was to clarify the relationship between current pet ownership, passive smoking, and allergic diseases among the Japanese children. From 1995 to 2001, we distributed the Japanese edition of the questionnaire of the American Thoracic Society and the Division of Lung Diseases (ATS‐DLD) to survey allergic diseases among 35,552 6‐yr‐old children at primary school in the city of Himeji, Japan. We analyzed the data by multiple logistic regression and calculated adjusted odds ratios for environmental factors, including passive smoking and pet (dog and/or cat) ownership. There were no significant relationships between the prevalence of asthma and current pet ownership and passive smoking. However, current cat ownership was related to a significantly lower prevalence of atopic dermatitis [adjusted odds ratio (aOR) 0.79, 95% confidence interval (CI) 0.67–0.93], allergic rhinitis (aOR: 0.71, 95% CI 0.57–0.89) and Japanese cedar pollinosis (aOR 0.57, 95% CI 0.44–0.75). Strikingly, passive smoking was also related to a significantly lower prevalence of allergic rhinitis (aOR 0.83, 95% CI 0.77–0.89) and Japanese cedar pollinosis (aOR 0.81, 95% CI 0.74–0.88). Current cat ownership was associated with a lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis. In addition, passive smoking was also associated with a lower prevalence of allergic rhinitis and Japanese cedar pollinosis.
Amino acid variants in Surfactant protein D are not associated with bronchial asthma
Authors: Krueger Marcus , Puthothu Beena , Gropp Eva , Heinze Jessica , Braun Sandra , Heinzmann Andrea
Published: January 2006

Surfactant protein D (SFTPD) belongs to the family of collectins and is part of the innate immune system. Thereby it plays an important role in the defense of various pathogens. Besides it is involved in the development of acute and chronic inflammation of the lung. Levels of SFTPD are elevated in serum and alveolar lavage of asthmatic patients. As SFTPD binds and neutralizes common allergens like house dust mites it is especially important in allergic asthma. Three common amino acid variants have been identified in SFTPD and association of the first variant has been described to severe infection with respiratory syncytial virus. Furthermore the functional impact of all three amino acid variants has been demonstrated. Due to its function SFTPD represents an ideal candidate gene for bronchial asthma and we were interested whether the polymorphisms were in association with asthma in children. The three polymorphisms leading to amino acid exchanges (Met11Thr, Ala160Thr, and Ser270 Thr) were typed by restriction fragment length polymorphisms in 322 asthmatic children and 270 controls. Association analyses were performed by Armitage's trend test. In addition haplotypes were calculated by FASTEHPLUS and FAMHAP. None of the polymorphisms was in association with bronchial asthma. Haplotype analyses revealed four major haplotypes all of which were evenly distributed between the populations. We conclude from our data that functional amino acid variants in SFTPD do not play a major role in the genetic pre‐disposition to bronchial asthma in children.
Medications with anticoagulant properties increase the likelihood of a negative colonoscopy in faecal occult blood test population screening
Authors: Clarke P. , Jack F. , Carey F. A. , Steele R. J. C.
Published: January 2006

Objective  The aim of this study was to evaluate the effect of medication with anticoagulant properties on the false positive rate in a population‐based faecal occult blood test (FOBt) colorectal screening programme.

Methods  Eight hundred and forty‐six consecutive individuals found to be FOBt‐positive in the Scottish arm of the national colorectal cancer screening pilot were studied. All were aged between 50 and 69 years and underwent colonoscopy. Before the procedure the participants' current medication was recorded, and correlated with the colonoscopic findings.

Results  Of 846 participants, 301 (35.6%) were taking regular anticoagulant medication at the time of FOB testing. Of these, 143 (47.5%) had colorectal neoplasia found on colonoscopy, whereas of those not taking anticoagulant medication, 308 (56.5%) were found to have neoplasia. This 9% difference was statistically significant (P = 0.012).

Conclusion  These results indicate that in a population screened for colorectal neoplasia by FOB testing, anticoagulant medication being taken at the time of testing is associated with an increased likelihood of a negative colonoscopy.
Rectal cancer treatment of the elderly
Authors: Endreseth B. H. , Romundstad P. , Myrvold H. E. , Bjerkeset T. , Wibe A. ,   The Norwegian Rectal Cancer Group
Published: January 2006

Objective  Life expectancy and incidence of rectal cancer have been increasing. The purpose of this study was to evaluate rectal cancer treatment among very old patients.

Methods  This prospective national cohort study includes all 4875 rectal cancer patients in Norway aged over 65 years treated between November 1993 and December 2001. Patients aged 65–74, 75–79, 80–84 and over 85 years were compared for patient‐, tumour‐ and treatment‐characteristics and relative survival. Two thousand eight hundred and forty patients treated for cure with major surgery and TME technique were further evaluated for postoperative mortality, five‐year local recurrence, distant metastasis and disease‐free survival.

Results  There were more palliative surgery and local procedures and less surgery for cure (47%vs 77%, P < 0.001) for patients over 85 years compared to younger patients. Five‐year relative survival was 36% for patients aged over 85 years compared to 49% for patients 80–84 years and 60% for patients 65–74 years. Among patients treated for cure with major surgery the rate of anterior resection decreased by age (67%vs 46%, P < 0.001). Postoperative mortality increased from 3% to 8% (P < 0.001). There were no significant differences in the rates of five‐year local recurrence, distant metastasis or relative survival.

Conclusion  Although a slight increase in postoperative mortality, major rectal cancer surgery can be performed in very old patients. These patients had similar rates of local recurrence, distant metastasis and relative survival as younger patients.
Ileostomy rod – is it a bridge too far?
Authors: Speirs M. , Leung E. , Hughes D. , Robertson I. , Donnelly L. , Mackenzie I. , Macdonald A.
Published: January 2006

Objective  Defunctioning loop ileostomies are used commonly to protect low colorectal anastomoses and thereby reducing the serious complications of leakage. However, they are associated with specific complications such as retraction. Traditionally, a supporting rod is placed as a bridge to support both limbs of the stoma in the hope of reducing the incidence of stomal retraction. There is little evidence in the published literature to support this practice. The aim of this study was to determine whether using an ileostomy rod would reduce the incidence of stomal retraction.

Method  A prospective, randomised controlled trial was performed in 60 consecutive patients who required a defunctioning loop ileostomy. Patients were allocated to either a ‘bridge’ or ‘bridge‐less’ protocol. All the patients were assessed by dedicated stoma nurses for at least 3 months and until their stomas were closed. Their postoperative symptoms, including stoma activity and retraction rate, were recorded.

Results  Between May 2001 and June 2004, 57 patients completed the study (28 bridge; 29 bridge‐less). There were no significant differences in the retraction rate between the groups. No clinical anastomotic leakage was recorded and none of the patients required early closure.

Conclusions  If a loop ileostomy is constructed properly, stomal retraction is uncommon and routine use of a bridge is unnecessary.
Conservation Payments under Risk: A Stochastic Dominance Approach
Authors: Benítez Pablo C. , Kuosmanen Timo , Olschewski Roland , van Kooten G. Cornelis
Published: January 2006

Conservation payments can be used to preserve forest and agroforest systems. To explain landowners' land‐use decisions and determine appropriate conservation payments, it is necessary to focus on revenue risk. Marginal conditional stochastic dominance rules are used to derive conditions for determining the conservation payments required to guarantee that the environmentally preferred land use dominates. An empirical application to shaded coffee protection in the biologically important Chocó region of West Ecuador shows that conservation payments required for preserving shaded coffee areas are much higher than those calculated under risk‐neutral assumptions. Further, the extant distribution of land has strong impacts on the required payments.
State Trading Enterprises in a Differentiated Product Environment: The Case of Global Malting Barley Markets
Authors: Dong Fengxia , Marsh Thomas L. , Stiegert Kyle W.
Published: January 2006

This study tested if the exclusive procuring and pricing policies of two state trading enterprises (STEs) in international malting barley markets could be used in a strategic trade context. The research provided four key findings. First, the global malting barley market operated in a quantity‐setting oligopolistic structure during the study years. Second, both STEs and other exporting countries were in Cournot competition and thus made available strategic trade possibilities. Third, initial commodity payments were too high to generate a rent‐shifting outcome. Fourth, product differentiation was confirmed, which may have dampened the desire/ability of STEs to pursue a rent‐shifting objective.
Drainwater Management for Salinity Mitigation in Irrigated Agriculture
Authors: Schwabe Kurt A. , Kan Iddo , Knapp Keith C.
Published: January 2006

Salinity and drainage management options include source control, reuse, and evaporation ponds. This article identifies efficient strategies to maintain hydrologic balance in closed drainage basins and evaluates their impact on regional agricultural profits. Theoretical analysis suggests that economic efficiency requires acknowledgment of the nonseparability between water use and land value. Empirically, our solution involves a modest amount of source control, a substantial amount of reuse, and the elimination of evaporation ponds often associated with large environmental damages, while maintaining grower income. Various policy instruments and options are introduced and discussed, including a system of drainwater charges, marketable permits, and land retirement.
Valuing a Change in a Fishing Site without Collecting Characteristics Data on All Fishing Sites: A Complete but Minimal Model
Authors: Morey Edward R. , Breffle William S.
Published: January 2006

Resource economists are often asked to value a proposed change at one, and only one, recreational site; the model we develop and estimate is applicable for those cases. The application is valuing the elimination of fish consumption advisories on a large bay on Lake Michigan. The model is minimal but complete: complete in that the choice set is not restricted, minimal in that only two conditional indirect utility functions are estimated. It is utility‐theoretic and one does not have to collect characteristic data on all of the other fishing sites in the region. Data include the number of trips each individual currently takes to Green Bay, answers to “would you prefer to fish Green Bay under conditions A or B?” and how often each angler says they would fish Green Bay under different sets of conditions.
Integrating Agronomic Principles into Production Function Specification: A Dichotomy of Growth Inputs and Facilitating Inputs
Authors: Zhengfei Guan , Oude Lansink Alfons , van Ittersum Martin , Wossink Ada
Published: January 2006

This article presents a general conceptual framework for integrating agronomic principles into economic production analysis. We categorize inputs in crop production into growth inputs and facilitating inputs. Based on this dichotomy we specify an asymmetric production function. The robustness of the asymmetric framework is tested using crop‐level panel data on potato production in the Netherlands. The test results do not reject the proposed framework, and the asymmetric specification better represents the underlying production technology.
Gaming in a 3D multiuser virtual environment: engaging students in Science lessons
Authors: Lim Cher P. , Nonis Darren , Hedberg John
Published: January 2006

Based on the exploratory study of a 3D multiuser virtual environment (3D MUVE), known as Quest Atlantis (QA), in a series of Primary Four (10‐ to 11‐year‐olds) Science lessons at Orchard Primary School in Singapore, this paper examines the issues of learning engagement and describes the socio‐cultural context of QA's implementation. The students and teacher were observed during the lessons, interviewed after, and the completed quests were analysed to determine the level of engagement achieved. A pre‐ and posttest on the Science concepts covered was also administered. A seven‐level taxonomy of engagement was used to provide the study with a more holistic perspective of engagement, together with the attempt to concretise the element of engagement into observable traits. Although there was a significant improvement of the posttest over the pretest, the level of engagement of the students was low (between 3 and 4). The lack of engagement might be a result of the distractions in the 3D MUVE, the students’ difficulty with language used in the QA, their lack of computer competency for QA tasks, and/or their inability to complete the quests’ section on reflections. The biggest challenges to the integration of QA into the Science curriculum were the interdependent issues of time (or lack of it) and ‘buy‐in’ by the school and parents.
Disabilities Information Flow: a disabilities information management system
Authors: Ling Bin , Allison Colin , Nicholl J Ross , Moodley Luke , Roberts Dave
Published: January 2006

The Disabilities Information Flow (DIF) project at the University of St Andrews has sought to provide a means of efficiently managing all student disabilities information within the institution and provide appropriate role‐based service interfaces for all staff who need to routinely interact with this information. This paper describes the software engineering processes used for the context analysis, design and implementation of the DIF.
Rethinking the nature of online work in asynchronous learning networks
Authors: Van Aalst Jan
Published: January 2006

Research on asynchronous learning networks (ALNs) has indicated that there are problems with both the quantity and quality of online interactions that can undermine the aim of inquiry. The goal of this paper is to offer a new way of thinking about these problems in the context of knowledge building, a specific form of collaborative inquiry supported by an ALN. Drawing from interviews with teachers following two teacher education courses that introduced teachers to knowledge building, it is argued that we need to rethink the role and purpose of online work in ALNs—as building a communal learning resource. A framework for doing this is proposed in terms of three notions: collaboration, learning how to learn and idea improvement. The framework is expected to contribute to the literature on knowledge building by providing a new way to distinguish knowledge building from other forms of collaborative inquiry.
PRESELI DOLERITE BLUESTONES: AXE‐HEADS, STONEHENGE MONOLITHS, AND OUTCROP SOURCES
Authors: WILLIAMS‐THORPE OLWEN , JONES M.C. , POTTS P.J. , WEBB P.C.
Published: January 2006

Summary.  Chemical compositions and magnetic susceptibility data were compared for 12 dolerite bluestone implements including axes, axe‐hammers and battle‐axes, 11 Stonehenge monoliths (chemical data only), and potential source outcrops in Preseli, South Wales. Most of the studied artefacts are of spotted dolerite, a small number being unspotted dolerite. Bivariate graphs, discriminant analysis and t‐tests were used singly and in combination to show, respectively, that the implements found at sites in England are mainly similar to Stonehenge monoliths, while the implements found in Wales have a variety of compositions and are much less similar to Stonehenge monoliths. The dichotomy between English and Welsh dolerite bluestone implements could be explained by exploitation of different Preseli outcrops or erratic assemblages derived from them. A small number of spotted dolerite implements have previously been shown to have chemical compositions atypical of and marginal to Preseli, suggesting the possibility of a source of spotted dolerite outside Preseli. Previously published analytical data in combination with the new implement/outcrop comparisons presented in this paper support derivation of the majority of analysed Stonehenge monoliths at one particular outcrop within the group of four identified by Thorpe et al. 15 years ago. Analysis of all the extant bluestone monoliths at Stonehenge (now possible using non‐destructive methods) would allow progress in identifying monolith outcrop sources, and in understanding the links with the bluestone axe trade.
REDEFINING THE NORTHERN BRITISH IRON AGE
Authors: HARDING D.W.
Published: January 2006

Summary.  Unlike Southern Britain, the Iron Age in Northern Britain spans two millennia from the introduction of iron technology to the Norse settlements. Northern Britain is divided into a series of geographical and archaeological regions, including for the pre‐Roman Earlier Iron Age the whole of aceramic and non‐coin‐using northern England. Despite a wealth of settlement evidence, the Earlier Iron Age lacks diagnostic material assemblages, even in the ceramic Atlantic regions, where radiocarbon dating is now confirming the origins of Atlantic Roundhouses in the mid‐first millennium BC. External connections may have been long‐distance, reflecting a complex variety of selective connections. For the Later Iron Age, interpretation based upon historical sources has inhibited a proper archaeological evaluation of the ‘Picts’ and of the traditional view of Dalriadic settlement in Argyll, both of which are now under review.
Bishops, priests and penance in late Saxon England
Authors: Cubitt Catherine
Published: January 2006

This article examines the textual and manuscript evidence for the practice of penance in late Saxon England. It also examines the significance for pastoral care of the linguistic evidence for specialized vernacular terms for penance: ‘scrift’ for ‘confessor’, ‘dædbote’ and compounds of ‘hreow’ for ‘penance’ and ‘remorse’. The linguistic and textual evidence suggests that penance was a regular part of lay piety. The manuscript evidence, on the other hand, supports recent contentions that penitentials were used by bishops and should be linked to canon law. However, the manuscript evidence cannot be properly understood unless the scant survival rate of humble priestly handbooks is taken into account. Moreover, bishops in this period were deeply involved in furthering pastoral care and their interests and concerns should not be divorced from a pastoral and local context. In conclusion, the article will argue that penitential practices were firmly rooted in the Anglo‐Saxon church's ministry for the laity.
Canon law and the practice of penance: Burchard of Worms's penitential
Authors: Körntgen Ludger
Published: January 2006

This article investigates the characteristics and function of Book 19 of Burchard's Decretum. It demonstrates how the penitential questionnaire, usually considered the most original part of this text, was the result of Burchard's systematic expansion upon his main source, Regino of Prüm. It argues that Book 19 was not a conventional penitential, to be used to support the administration of penance by priests, but rather that it was meant to be both an exemplary penitential and a summary of the preceding eighteen books. Burchard thus sought to ensure there was no contradiction between his collection of canon law and his penitential.
Developing a Mental Health Guide for Families and Carers of People with Intellectual Disabilities
Authors: Gratsa Anastasia , Spiller Mary Jane , Holt Geraldine , Joyce Theresa , Hardy Steven , Bouras Nick
Published: January 2006

Background  Although there is already information available about caring for someone with a mental health problem, there is very little written for families and carers of people with intellectual disabilities.

Materials and methods  This paper describes the development of a Guide as such a resource. The consultation stage involved interviews and focus groups with families, service users and paid carers (n = 20) to highlight their needs and preferred format. Additional carers (n = 12) completed structured questionnaires to evaluate the Guide.

Results  The initial consultation showed that an easily accessible and user‐friendly information resource was needed. The evaluation showed that family carers were satisfied with the Guide, finding it easy to read and covering most of the information required. However, they did highlight areas that needed further detail.

Conclusions  The involvement of carers in the development of such resources is essential, emphasizing the benefit of carers’ knowledge and experience to professionals.
The use of transglutaminase in dairy products
Authors: ÖZRENK ELVAN
Published: January 2006

Modification of proteins by enzymes such as transglutaminase (TG) has recently become of great interest to food scientists. TG (EC 2.3.2.13) catalyses the post‐translational modification of proteins by transamidation of available glutamine residues by the formation of covalent cross‐links between glutamine and lysine residues in proteins. It is suggested that TG is a useful tool for the production of dairy products. In this review, properties of TG and its possible use in the manufacture of dairy products are discussed. Aspects covered include reactions catalysed by the enzyme and properties of modified proteins of selected milk proteins and products.
Influence of added lyophilized butter serum on the heat stability of unconcentrated and concentrated bovine milk
Authors: HUPPERTZ THOM , FOX PATRICK F
Published: January 2006

The influence of added lyophilized butter serum on the heat stability of milk was investigated. The addition of lyophilized serum from salted butter to unconcentrated skimmed milk (SM) reduced the heat coagulation time (HCT) at, and increased the pH of, the maximum in the pH–HCT profile and caused disappearance of the minimum. NaCl had similar effects on the heat stability of SM as lyophilized salted butter serum, whereas lyophilized serum from unsalted butter had little effect. The addition of lyophilized salted butter serum to concentrated skimmed milk (CSM) also shifted the pH of maximum heat stability to a higher value and, at certain concentrations, increased the maximum HCT; similar effects were obtained on addition of NaCl, but lyophilized serum from unsalted butter had little effect. These results suggest that the effects of lyophilized serum from salted butter on the heat stability of SM or CSM are due primarily to the presence of a high level of NaCl in this serum.
Is food availability limiting African Penguins Spheniscus demersus at Boulders? A comparison of foraging effort at mainland and island colonies
Authors: PETERSEN SAMANTHA L. , RYAN PETER G. , GREMILLET DAVID
Published: January 2006

The African Penguin Spheniscus demersus (Vulnerable) formed three new colonies during the 1980s, two on the South African mainland (Stony Point and Boulders) and one on Robben Island. One of the mainland colonies, at Boulders, Simon's Town, is in a suburban area, resulting in conflict with humans. Growth of the Boulders colony was initially rapid, largely through immigration, but has since slowed, possibly as a result of density‐dependent effects either on land (where there has been active management to limit the spread of the colony) or at sea. We test the latter hypothesis by comparing the foraging effort of Penguins feeding small chicks at island and mainland sites, and relate this to the foraging area available to birds. Three‐dimensional foraging paths of African Penguins were reconstructed using GPS and time–depth loggers. There were no intercolony differences in the rate at which birds dived during the day (33 dives/h), in diving depths (mean 17 m, max. 69 m) or in travelling speeds. The maximum speed recorded was 2.85 m/s, with birds travelling faster when commuting (average 1.18 m/s) than when foraging (0.93 m/s) or resting at sea (0.66 m/s during the day, 0.41 m/s at night). There were strong correlations between foraging trip duration, foraging range and total distance travelled. Foraging effort was correlated with chick age at Robben Island, but not at Boulders. Contrary to Ashmole's hypothesis, birds from Boulders (c. 1000 pairs) travelled further (46–53 km) and foraged for longer (13.2 h) than did birds from Robben Island (c. 7000 pairs) and Dassen Island (c. 21 000 pairs) (33 km, 10.3 h). The mean foraging range also differed significantly between mainland (18–20 km) and island colonies (9 km). The area available to central‐place‐foraging seabirds breeding on the mainland is typically less than that for seabirds breeding on islands, but the greater foraging range of Boulders birds results in an absolute foraging area roughly twice that of island colonies, and the area per pair is an order of magnitude greater for the relatively small Boulders colony. Ashmole's hypothesis assumes relatively uniform prey availability among colonies, but our results suggest this does not apply in this case. The greater foraging effort of Boulders birds probably reflects reduced prey availability in False Bay, and thus the recent slowing in growth at the colony may be the result of differential immigration rather than management actions to limit the spatial growth of the colony.