bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nordic guidelines for neuraxial blocks in disturbed haemostasis from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Authors: BREIVIK H. , BANG U. , JALONEN J. , VIGFÚSSON G. , ALAHUHTA S. , LAGERKRANSER M. 
Published: October 2009

Background: Central neuraxial blocks (CNBs) for surgery and analgesia are an important part of anaesthesia practice in the Nordic countries. More active thromboprophylaxis with potent antihaemostatic drugs has increased the risk of bleeding into the spinal canal. National guidelines for minimizing this risk in patients who benefit from such blocks vary in their recommendations for safe practice.Methods: The Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) appointed a task force of experts to establish a Nordic consensus on recommendations for best clinical practice in providing effective and safe CNBs in patients with an increased risk of bleeding. We performed a literature search and expert evaluation of evidence for (1) the possible benefits of CNBs on the outcome of anaesthesia and surgery, for (2) risks of spinal bleeding from hereditary and acquired bleeding disorders and antihaemostatic drugs used in surgical patients for thromboprophylaxis, for (3) risk evaluation in published case reports, and for (4) recommendations in published national guidelines. Proposals from the taskforce were available for feedback on the SSAI web‐page during the summer of 2008.Results: Neuraxial blocks can improve comfort and reduce morbidity (strong evidence) and mortality (moderate evidence) after surgical procedures. Haemostatic disorders, antihaemostatic drugs, anatomical abnormalities of the spine and spinal blood vessels, elderly patients, and renal and hepatic impairment are risk factors for spinal bleeding (strong evidence). Published national guidelines are mainly based on experts' opinions (weak evidence). The task force reached a consensus on Nordic guidelines, mainly based on our experts' opinions, but we acknowledge different practices in heparinization during vascular surgery and peri‐operative administration of non‐steroidal anti‐inflammatory drugs during neuraxial blocks.Conclusions: Experts from the five Nordic countries offer consensus recommendations for safe clinical practice of neuraxial blocks and how to minimize the risks of serious complications from spinal bleeding. A brief version of the recommendations is available on http://www.ssai.info.
The effects of birthweight and breastfeeding on asthma among children aged 1–5 years
Authors: Xu Xiaohui , Dailey Amy B , Freeman Natalie C , Curbow Barbara A , Talbott Evelyn O 
Published: October 2009

Aim:  Asthma is a major cause of morbidity and mortality among children and has steadily increased in prevalence. The combined effect of birthweight and breastfeeding on childhood asthma remains unclear.Methods:  In this study, we analysed a nationally representative sample of children aged 1–5 years from the National Health and Nutrition Examination Survey 1999–2002. Logistic regression was performed to examine the hypothesis whether birthweight and breastfeeding are independently associated with the prevalence of asthma after accounting for the complex sampling design. In addition, we sought to describe the relationship between birthweight and childhood asthma and to assess the potentially combined effect between birthweight and breastfeeding on asthma among children aged 1–5 years after considering the possible effects of social and environmental factors.Results:  We found that birthweight (measured continuously) was inversely and linearly associated with the prevalence of childhood asthma (odds ratio (OR) = 0.80 per 1 kg increase in birthweight, 95% confidence interval (CI): 0.65–0.98). Using a categorical variable, low birthweight (LBW) was positively associated with childhood asthma (OR = 1.28, 95% CI: 0.81–2.68). Furthermore, we detected an interaction between birthweight and breastfeeding on childhood asthma. Breastfeeding had a strong protective effect on asthma among children with high birthweight (OR = 0.14, 95% CI: 0.04–0.43) while it had no significant effect on asthma among children with normal birthweight or LBW.Conclusions:  The mechanisms underlying these relationships remain uncertain and warrant further explanation.
Children in out‐of‐home care: Does routine health screening improve outcomes?
Authors: Nathanson Dania , Lee Gillian , Tzioumi Dimitra 
Published: October 2009

Aim:  Children in out‐of‐home care have high and frequently unidentified health needs. The Child Protection Unit at Sydney Children's Hospital offers comprehensive health screening to children in care. Recommendations for remediation are made, but follow‐up in the clinic is not offered. Current research has failed to establish whether health screening results in health benefits for the children screened. The aim of this study was to assess the impact of the health screening clinic on children's health outcomes by tracking the first 100 children screened, determining how many of the health recommendations made for each child had been implemented and, if possible, what the health outcome had been.Methods:  Research questionnaires were sent to the Department of Social Services caseworkers of the first 100 children screened.Results:  Adherence to health recommendations was high; however, it was not possible to quantify the degree of health benefit to the children screened. A number of systemic problems were identified, which are likely to hinder the accessibility of health care for children in care.Conclusions:  Comprehensive health screening of children in care is likely to benefit a child's health, although this could not be determined. Agencies responsible for placing children in care need systems in place to ensure better inter‐agency collaboration between the health system and community services. This should help improve health outcomes.
Herbivore feeding preferences in captive and wild populations
Authors: RAFFERTY CHRISTINE M. , LAMONT BYRON B. , HANLEY MICK E. 
Published: October 2009

AbstractInvestigations into the mechanisms underpinning plant selection by herbivores have often yielded conflicting results. Such inconsistency might stem from whether selection experiments are conducted with captive or wild populations, and upon the different measures of plant selection used to determine herbivore preference. Here we compared the feeding preferences of captive and wild kangaroos (Macropus fuliginosus) using a standard set of plant species (14 Hakea spp., Proteaceae) and several measures of herbivore selection to examine how environment influenced relative consumption. Three indices of herbivore consumption were measured: number of plants (NP), total shoot volume per plant (TV) and percentage available shoot volume (PV) consumed. NP and TV were closely correlated in the wild and captive populations and consistently correlated with six morphological and chemical plant attributes examined, the most notable being a strong negative correlation with shoot phenolic content. This uniformity suggests that plant selection by captive kangaroos is broadly consistent with that observed in field trials, and consequently that for macropods, at least, captive trials offer a valid way to determine the relative acceptability of different plant species. However, the fact that our third measure of herbivore selection PV was weakly correlated in captive and wild populations and showed no relationship with shoot phenolic content highlights the importance of which measure of plant selection is applied. We suggest that, while NP and TV are potentially confounded by plant size and availability, they offer the clearest insight into plant selection from the point of view of the herbivore, while PV is more suitable for plant‐centred studies.
Does disturbance, competition or resource limitation underlie Hieracium lepidulum invasion in New Zealand? Mechanisms of establishment and persistence, and functional differentiation among invasive and native species
Authors: RADFORD IAN J. , DICKINSON KATHARINE J. M. , LORD JANICE M. 
Published: October 2009

AbstractThe processes underlying plant invasions have been the subject of much ecological research. Understanding mechanisms of plant invasions are difficult to elucidate from observations, yet are crucial for ecological management of invasions. Hieracium lepidulum, an asteraceous invader in New Zealand, is a species for which several explanatory mechanisms can be raised. Alternative mechanisms, including competitive dominance, disturbance of resident vegetation allowing competitive release or nutrient resource limitation reducing competition with the invader are raised to explain invasion. We tested these hypotheses in two field experiments which manipulated competitive, disturbance and nutrient environments in pre‐invasion and post‐invasion vegetation. H. lepidulum and resident responses to environmental treatments were measured to allow interpretation of underlying mechanisms of establishment and persistence. We found that H. lepidulum differed in functional response profile from native species. We also found that other exotic invaders at the sites were functionally different to H. lepidulum in their responses. These data support the hypothesis that different invaders use different invasion mechanisms from one another. These data also suggest that functional differentiation between invaders and native resident vegetation may be an important contributing factor allowing invasion. H. lepidulum appeared to have little direct competitive effect on post‐invasion vegetation, suggesting that competition was not a dominant mechanism maintaining its persistence. There was weak support for disturbance allowing initial establishment of H. lepidulum in pre‐invasion vegetation, but disturbance did not lead to invader dominance. Strong support for nutrient limitation of resident species was provided by the rapid competitive responses with added nutrients despite presence of H. lepidulum. Rapid competitive suppression of H. lepidulum once nutrient limitation was alleviated suggests that nutrient limitation may be an important process allowing the invader to dominate. Possible roles of historical site degradation and/or invader‐induced soil chemical/microbial changes in nutrient availability are discussed.
Consequences of southern cassowary (Casuarius casuarius, L.) gut passage and deposition pattern on the germination of rainforest seeds
Authors: BRADFORD MATT G. , WESTCOTT DAVID A. 
Published: October 2009

AbstractIn Australia's tropical rainforests the endangered southern cassowary,Casuarius casuarius, L., is the largest native frugivore and many plant species, because of the size of their fruits or seeds, are thought to be largely dependent on cassowaries for their dispersal. In this study we asked whether the contribution of cassowaries to plant recruitment extends beyond removing seeds from the vicinity of the parent. To do this we conducted germination trials involving 17 rainforest plant species to test whether cassowary consumption and seed deposition pattern alter germination probability or time to germination. Twenty‐four per cent of species showed changed germination probabilities, with one species showing no germination without cassowary consumption, and 35% showed changed time to germination. However these differences did not translate into any significant effects when considered across all species. We examined gut scarification, fruit pulp removal (de‐inhibition) and deposition in faecal material as mechanisms for changing germination success; each contributed to the changed success of individual species. There was a negative effect of seed clumping on five species. We conclude that cassowary consumption can modify germination performance in a minority of rainforest plants and that the effect is generally positive. Although the effect on large seeded species was small it is most likely to be important as the cassowary is the only animal in Australia able to internally process large numbers of these seeds.
The contribution of mistletoes to nutrient returns: Evidence for a critical role in nutrient cycling
Authors: MARCH WENDY A. , WATSON DAVID M. 
Published: October 2009

AbstractBoth nutrient cycling and nutrient relationships between mistletoe and host have been widely studied; yet it is unclear whether high nutrient concentrations commonly found in mistletoes affect rates of nutrient cycling. To address this question, we assessed 13 elements in the leaf litter of a temperate eucalypt forest in southern New South Wales, comparing concentrations from trees (Eucalyptus blakelyi, E. dwyeri, and E. dealbata) with and without the hemiparasitic mistletoe Amyema miquelii. Results were in accord with previous research on fresh leaves showing that concentrations of many elements were higher in the mistletoe than the host. This was not the case for all elements; most notably for N, where concentrations were significantly lower in the mistletoe. However, the return of all elements increased with mistletoe infection because of the combined effect of enrichment in mistletoe tissues and high rates of mistletoe litterfall. Annual returns of N and P in leaf litter increased by a factor of 1.65 and 3 respectively, with the greatest increase being for K by a factor of 43 in spring. These increased element returns were not significantly influenced by any changes in host leaf litter quality, as mistletoe infection was not found to affect host element concentrations. Mistletoe infection also altered the spatial and temporal distribution of element returns because of the patchy occurrence of mistletoes and extended period of mistletoe litterfall compared with the host. These findings provide a mechanistic explanation for the role of mistletoes as a keystone resource and, together with comparable results from root‐parasitic plants in boreal tundra and cool‐temperate grasslands, suggest that enhancing nutrient return rates may be a generalized property of parasitic plants.
Spread and impact of introduced conifers in South America: Lessons from other southern hemisphere regions
Authors: SIMBERLOFF DANIEL , NUÑEZ MARTIN A. , LEDGARD NICHOLAS J. , PAUCHARD ANIBAL , RICHARDSON DAVID M. , SARASOLA MAURO , VAN WILGEN BRIAN W. , ZALBA SERGIO M. , ZENNI RAFAEL D. , BUSTAMANTE RAMIRO , PEÑA EDUARDO , ZILLER SILVIA R. 
Published: October 2009

AbstractThe history of conifers introduced earlier elsewhere in the southern hemisphere suggests that recent invasions in Argentina, Brazil, Chile and Uruguay are likely to increase in number and size. In South Africa, New Zealand and Australia, early ornamental introductions and small forestry plantations did not lead to large‐scale invasions, while subsequent large plantations were followed with a lag of about 20–30 years by troublesome invasions. Large‐scale conifer plantation forestry in South America began about 50–80 years later than in South Africa, Australia and New Zealand, while reports of invasions in South America lagged behind those in the latter nations by a century. Impacts of invading non‐native conifers outside South America are varied and include replacement of grassland and shrubland by conifer forest, alteration of fire and hydrological regimes, modification of soil nutrients, and changes in aboveground and belowground biotic communities. Several of these effects have already been detected in various parts of South America undergoing conifer invasion. The sheer amount of area planted in conifers is already very large in Chile and growing rapidly in Argentina and Brazil. This mass of reproductive trees, in turn, produces an enormous propagule pressure that may accelerate ongoing invasions and spark new ones at an increasing rate. Regulations to control conifer invasions, including measures to mitigate spread, were belatedly implemented in New Zealand and South Africa, as well as in certain Australian states, inspired by observations on invasions in those nations. Regulations in South America are weaker and piecemeal, but the existing research base on conifer invasions elsewhere could be useful in fashioning effective regulations in South America. Pressure from foreign customers in South Africa has led most companies there to seek certification through the Forestry Stewardship Council; a similar programme operates in Australia. Such an approach may be promising in South America.
Sacral nerve stimulation for the treatment of faecal incontinence following low anterior resection for rectal cancer
Authors: de Miguel M. , Oteiza F. , Ciga M. A. , Armendáriz P. , Marzo J. , Ortiz H. 
Published: October 2009

AbstractAim  The aim of this study was to assess the effectiveness of sacral nerve stimulation (SNS) in the management of faecal incontinence following neoadjuvant therapy and low anterior resection (LAR) for rectal cancer.Method  In a prospective single‐centre study, 15 patients (12 men, median age 72 years) were enrolled between 2005 and 2008. All had severe incontinence after total mesorectal excision, and 14 had received preoperative full‐course chemoradiotherapy. The patients were followed up for a median of 50 (range: 24–144) months. There was no recurrence (local or distal). Incontinence was evaluated using the Cleveland Clinic Florida Fecal Incontinence (CCF‐FI) scoring system. Quality of life (QoL) was evaluated using the Fecal Incontinence Quality of Life (FIQL) questionnaire. SNS was performed in three stages.Results  During percutaneous nerve evaluation (PNE), a good response was observed in seven patients, all of whom received a permanent implant. The median follow up was 12 (range: 1–44) months. The mean CCF‐FI score was reduced from 19.2 [standard deviation (SD) 1.2] to 6.2 (SD 1.7) (P < 0.01). The mean number of days per week with an incontinent episode decreased from 7 (SD 0) to 0.2 (SD 0.3) (P < 0.01), and the mean number of defaecations per week decreased from 42.5 (SD 13.7) to 13.2 (SD 7.4) (P < 0.01). In the five patients with a permanent implant who were followed up for longer than 6 months, all FIQL scores improved. An increase in the mean resting and squeeze pressures was seen in four patients with a permanent implant.Conclusions  SNS is a treatment option for faecal incontinence after LAR for rectal cancer.
Treatment of slow‐transit constipation with sacral nerve modulation
Authors: Naldini G. , Martellucci J. , Moraldi L. , Balestri R. , Rossi M. 
Published: October 2009

AbstractAim  Constipation is common and a selection of the best treatment is difficult, especially for slow‐transit constipation (STC). The aim of the study was to assess the effect of sacral nerve modulation (SNM) on STC.Method  A retrospective analysis of patients with STC, treated with SNM was undertaken. All were evaluated by cinedefecography, colon transit‐time, Cleveland Clinic Constipation Score (CCS), SF‐36 Quality of Life (QoL) and a bowel diary. Initially, all patients underwent a temporary implant for 4 weeks. The criteria of success were disappearance of necessity for laxatives or enema requirement, and improvement in QoL.Results  Fifteen patients with STC were treated from March 2003 to May 2006. Nine (60%) underwent permanent implantation. After SNM, the mean improvement of Wexner Constipation Score (CCS) and QoL was 10 and 6.2 respectively. There were no complications. The mean follow‐up period was 42 months.Conclusion  Sacral nerve modulation seems to be a useful option for STC.
The role of reprogramming in sacral nerve modulation for faecal incontinence
Authors: Govaert B. , Rietveld M. P. , van Gemert W. G. , Baeten C. G. 
Published: October 2009

AbstractAim  After implantation of a sacral nerve modulation (SNM) device for faecal incontinence (FI), patients are subjected to a rigid follow‐up schedule. If symptoms recur, it may be necessary to reprogramme the stimulation parameters of the device. The aims of this study was to assess the need for reprogramming in patients with an SNM implant for FI.Method  All patients who received a permanent SNM implant for FI from January 2000 to February 2008 were included in this study. Patients were subjected to a rigid follow‐up schedule at 1, 3, 6 and 12 months, and yearly thereafter. Stimulator settings of the SNM device and changes made at every visit were collected and added to the database, and the number of patients in whom the stimulation parameter settings needed reprogramming was determined.Results  A total of 155 patients (11 men) were analysed. The mean age (± standard deviation) of the patients was 57.7 ± 11.9 years. Median follow‐up was 28.1 (range: 1.0–93.6) months. The mean voltage increased significantly from 1.8 V at 1 month to 2.0 V at 3 months. Thirty‐nine (25.2%) patients required no reprogramming of their SNM implant during any of their follow‐up visits; however, 51 (32.9%) patients required reprogramming at 1–25% of their visits, 42 (27.1%) patients at 26–50% of their visits, 14 (9.0%) patients at 51–75% of their visits and nine (5.8%) patients at 76–100% of their visits.Conclusion  Physicians and patients need to be aware of the fact that reprogramming of the SNM stimulator needs to be carried out at least once during follow‐up in the majority of patients. Trained physicians or specialist nurses are imperative to ensure effective follow‐up and appropriate SNM reprogramming.
The ‘Iranian Diaspora’ and the New Media: From Political Action to Humanitarian Help
Authors: Ghorashi Halleh , Boersma Kees 
Published: October 2009

ABSTRACTThis article looks at the shifting position of the ‘Iranian diaspora’ in relation to Iran as it is influenced by online and offline transnational networks. In the 1980s the exilic identity of a large part of the Iranian diaspora was the core factor in establishing an extended, yet exclusive form of transnational network. Since then, the patterns of identity within this community have shifted towards a more inclusive network as a result of those transnational connections, leading to more extensive and intense connections and activities between the Iranian diaspora and Iranians in Iran. The main concern of the article is to examine how the narratives of identity are constructed and transformed within Iranian (charity) networks and to identify the factors that contribute to this transformation. The authors use the transnational lens to view diasporic positioning as linked to development issues. New technological sources help diaspora groups, in this case Iranians, to build virtual embedded ties that transcend nation states and borders. Yet, the study also shows that these transnational connections can still be challenged by the nation state, as has been the case with recent developments in Iran.
The Paradoxes of Community‐based Participation in Dar es Salaam
Authors: Dill Brian 
Published: October 2009

ABSTRACTThe current discourse and practice of international development rest on the assumption that community‐based participation is an essential component of efforts to facilitate change across the global South. Such participation is thought not only to ensure efficiency and sustainability, but also to accelerate broader structural transformation by empowering individuals to exercise agency in relation to development. This article seeks to contribute to critical participation studies by analysing the broader processes and structures that shape participatory opportunities in Dar es Salaam, Tanzania. The author argues that by promoting community‐based organizations (CBOs), national and transnational development actors have produced and legitimated a system of popular participation that, in contrast to their claims, disempowers local citizens. Paradoxically, these CBOs have further contributed to the exclusion of the majority of community actors.