bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimally managing under imperfect detection: a method for plant invasions
Authors: Regan Tracey J. , Chadès Iadine , Possingham Hugh P. 
Published: November 2010

Summary1. Failing to account for uncertainty in the detection of invasive plants may lead to inefficient management strategies and wasted resources. Smart strategies to manage plant invasions requires consideration of the economic costs and benefits, and plant life‐history characteristics as well as imperfect detection.2. We develop a partially observable Markov decision process (POMDP) to provide optimal management actions when we are uncertain about the presence of invasive plants. The optimal strategy depends on the probability of being in a particular state. We ask the question, ‘When is it preferable to use a less efficient, less costly action to a more efficient, more costly action?’ We apply the POMDP to branched broomrape Orobanche ramosa, a parasitic plant species at the centre of a national eradication campaign in South Australia.3. The optimal strategy depends on the ability to detect the invasive species and the location of the infested site. For high detection rates, if the site is a satellite infestation, management should employ the more efficient, more costly action (i.e. soil fumigation) the year the weed is detected followed by monitoring. When the detection probability is low, then it is optimal to employ the less efficient, low cost action (i.e. host denial) in the years the species is not detected. For sites in the centre of the infestation, management should employ the less costly, less efficient action. While the optimal strategy is insensitive to colonization, the likelihood of local eradication diminishes as colonization probability increases, highlighting the importance of limiting colonization if eradication is to be achieved.4. Synthesis and applications. Providing decision support for managing ecological systems is a key role of applied research. Formulating this support within a decision theory context provides a framework for good decision‐making. The POMDP model is a novel decision support tool for optimal sequential decision making when invasive plants are difficult to detect. The model can determine the best management action to employ based on the location of the infestation and can inform when to switch to alternative management actions that buffer against imperfect detection.
Cognitive presence in asynchronous online learning: a comparison of four discussion strategies
Authors: Darabi A. , Arrastia M.C. , Nelson D.W. , Cornille T. , Liang X. 
Published: November 2010

AbstractSome scholars argue that students do not achieve higher level learning, or cognitive presence, in online courses. Online discussion has been proposed to bridge this gap between online and face‐to‐face learning environments. However, the literature indicates that the conventional approach to online discussion – asking probing questions – does not necessarily advance the discussion through the phases of cognitive presence: triggering events, exploration, integration and resolution, which are crucial for deep knowledge construction. Using mixed methods, we examined the contribution of four scenario‐based online discussion strategies – structured, scaffolded, debate and role play – to the learners' cognitive presence, the outcome of the discussion. Learners' discussion postings within each strategy were segmented and categorized according to the four phases. The discussion strategies, each using the same authentic scenario, were then compared in terms of the number of segments representing these phases. We found that the structured strategy, while highly associated with triggering events, produced no discussion pertaining to the resolution phase. The scaffolded strategy, on the other hand, showed a strong association with the resolution phase. The debate and role‐play strategies were highly associated with exploration and integration phases. We concluded that discussion strategies requiring learners to take a perspective in an authentic scenario facilitate cognitive presence, and thus critical thinking and higher levels of learning. We suggest a heuristic for sequencing a series of discussion forums and recommend areas for further related research.
Bayesian sensitivity models for missing covariates in the analysis of survival data
Authors: Hemming Karla , Hutton Jane Luise 
Published: November 2010

AbstractRationale  This paper presents a Bayesian approach using WinBUGS for analysing survival data in which observations have missing information on some covariates. Modelling the joint density of the survival time and the covariates allows for the missing covariate data to be missing at random (MAR), as opposed to the more restrictive assumptions imposed by a complete case analysis.Methods  Here, the survival times are modelled by the accelerated failure time model and the joint covariate density is factorized as a series of conditional densities, each modelled by logistic regression. We propose a class of models to examine MAR assumption by using Bayesian informative priors or auxiliary data.Results  In the example considered, the complete case analysis underestimates the proportion of severely impaired cases. Furthermore, models evaluating sensitivity to the MAR assumption suggest that median life expectancies could be increased. Gains in precision are small in the application considered, possibly a reflection of extra uncertainty because of the inclusion of all cases, including those of unknown severity.Conclusions  Through simple Bayesian models, more realistic assumptions concerning the nature of the missing data can be made. Implementation in WinBUGS means that this model is accessible to practicing statisticians.
Bringing together values‐based and evidence‐based medicine: UK Department of Health Initiatives in the ‘Personalization’ of Care
Authors: Fulford K. W. M. (Bill) 
Published: November 2010

AbstractRationale  Person‐centred medicine depends on combining best research evidence with the unique values (including the preferences, concerns, needs and wishes) of individual patients and their families.Aims and objectives  The paper gives a brief introduction to values‐based practice as a new approach to incorporating patients' values into clinical decision making alongside best research evidence as derived from evidence‐based practice.Method  The role of values‐based practice as a partner to evidence‐based practice is illustrated through a series of policy, training and service development initiatives in mental health from the UK Department of Health in London.Results  These initiatives have supported person‐centred developments in key areas of mental health practice including, (1) the use of involuntary treatment; and (2) a shared approach of assessment. Early moves are underway to extend values‐based practice to other areas of health care beyond mental health.Conclusion  Values‐based practice offers a new approach to incorporating patients' unique values into clinical decision making that is complementary to evidence‐based practice as a resource for person‐centred medicine.
European Federation of Associations of Families of People with Mental Illness initiatives on person‐centred care
Authors: Steffen Sigrid 
Published: November 2010

AbstractRationale  European Federation of Associations of Families of People with Mental Illness is working towards the goal of shifting the emphasis of care for people with metal illness from the treatment of the symptoms to a more holistic approach of treating the whole person – in other words ‘person‐centred care’. It is also working with the Geneva conference on person‐centred medicine and various interested groupings and organizations to ensure that the role of the family is fully recognized and supported.Method  By engaging primarily with the medical community in bringing to fruition certain initiatives which European Federation of Associations of Families of People with Mental Illness considers as important to the success of person‐centred care.Results  To date, no formal reviews have taken place and feedback from the initiatives has been informal and anecdotal.Conclusion  Early reports from the various initiatives are positive. But they also indicate that there is still much work to be done in order for the concept to become a reality across the majority of European countries.
Concentrations of Total Proteins and Albumins, and AST, AP, CK and GGT Activities in the Blood Serum Boer and Saanen Goats During Puerperium
Authors: Djuricic D , Dobranic T , Grizelj J , Gracner D , Harapin I , Stanin D , Folnozic I , Getz I , Cvitkovic D , Samardzija M 
Published: November 2010

ContentsThe metabolism of proteins in the blood serum in Boer and Saanen goats was investigated during puerperium. Twenty Boer goats (10 primiparous and 10 pluriparous) and 10 Saanen goats (five primiparous and five pluriparous) between 2 and 5 years of age were used in this research. Blood for analysis was taken every fourth day from day 3 until day 40 post‐partum. Blood samples were collected by jugular puncture. In the obtained blood serum, the concentration of total proteins (PT) and albumin (ALB), and the activity of enzymes aspartate aminotransferase (AST) [the Enzyme Commission number (EC number) 2. 6. 1. 1.], gamma‐glutamyltransferase (GGT) (EC 2. 3. 2. 2.), creatine kinase (CK) (EC 2. 7. 3. 2.) and alkaline phosphatase (AP) (EC 3. 1. 3. 1.) were determined by spectrophotometry. These parameters were in physiological ranges in Boer goats and in Saanen goats, without significant differences according to number of kids per doe. According to the research results of the blood serum in goats during puerperium, there were no significant differences in the concentration of ALB. Boer goats had significant higher (p < 0.05) concentration of PT and enzyme activity of AP, CK and GGT. Saanen goats had only enzyme activity of AST significantly higher (p < 0.05). Enzyme activity of alkaline phosphatase was significant higher (p < 0.05) in pluriparous goats in both breeds than in primiparous. The obtained results may represent a contribution to a better understanding of protein metabolism during puerperium in dairy and meat goats and for diagnostic purposes.
GP Clinic: Promoting access to primary health care for mental health service clients
Authors: Perkins David , Hamilton Meg , Saurman Emily , Luland Teresa , Alpren Charles , Lyle David 
Published: November 2010

AbstractObjective:  To evaluate an innovative rural service offering comprehensive primary health care for mental health service clients. Design:  A formative evaluation using mixed methods. Setting:  A rural NSW community. Participants:  Fifteen health care providers and 120 adult clients. Intervention:  A monthly clinic held in a general practice to provide primary health care for clients of the community mental health team. Main outcome measures:  Client utilisation and clinic activity data. Provider views of service effectiveness, possible improvements and sustainability. Results:  The GP Clinic has operated successfully for 2.5 years without access block. Some 52% of clients had no physical illness and 82% were referred to other health and community services. In total, 40% continued to attend the clinic while 32% went on to consult a GP independently. Client access to care improved as did collaboration between the community mental health team and primary care providers. Conclusion:  The GP Clinic is a straightforward and flexible service model that could be used more widely.
Taking a history: The learnings that national health science forgot
Authors: Rahman Ashequr , Chesters Janice , Savige Gayle , Deacon Nicholas 
Published: November 2010

AbstractObjective:  This paper provides evidence for the importance of taking an effective history and considering regional differences before formulating national health policies. Design:  Qualitative study; the data collection technique included manual searches of rare book collections, a search of the Victorian Public Record Office and Australian Archives files and a local media appeal for information about iodine and iodine supplementation in Gippsland and other regions of Australia. Setting:  Regional Victoria and Australia as a whole. Participants:  A total of 17 community members from the Gippsland region provided information on taking iodine tablets between the late 1940s and the late 1960s. Main outcome measures:  Information from the community members who took iodine tablets, archival material, published papers in journals on iodine deficiency disorder in Gippsland, government reports and meeting minutes regarding distribution of iodine supplementation in Gippsland. Results:  Taking an effective history is vital to planning national health interventions. It might not be adequate to just search electronic databases. A thorough search of archival and hard copy material and consultation with members of the population can help find key historical data that can inform better health policy action. Conclusion:  There is strong historical evidence of dietary iodine deficiency in the Gippsland region and in a number of other regions across Australia. Government and health authorities should undertake regular iodine status monitoring in these regions. Considering regional difference is important when making national health policy.
Starting rural, staying rural: How can we strengthen the pathway from rural upbringing to rural practice?
Authors: Strasser Roger , Hogenbirk John C. , Lewenberg Michael , Story Margot , Kevat Ajay 
Published: November 2010

AbstractObjective:  To determine if selecting rural background students into the Monash Bachelor of Medicine and Bachelor of Surgery (MBBS) program affects vocational training location and intended practice location after training. Design:  Retrospective cohort mail survey. Setting:  Australia. Participants:  Rural‐background students at Monash 1992–1994 (n = 24/40) and 1995–1999 (n = 59/120) and urban background students (n = 36/93 and 104/300, respectively). Overall study population: 62% female, average age of 28 years; 79% Australian‐born; and 60% married/partnered.Interventions:  Rural or urban background, rural undergraduate exposure. Main outcome measures:  Intent towards rural medical practice, vocational training location and subsequent practice location. Results:  There was a positive and significant (P ≤ 0.05) association between rural background and rural practice intent when respondents began (10‐times higher than urban graduates) and completed (three times higher) their MBBS course. Rural practice intent increased fourfold in urban background graduates. There was a positive and significant association between rural background and preferred place of practice in 5–10 years in a Rural, Remote and Metropolitan Area (RRMA) 3–7 community (three times higher). There was a positive, but non‐significant association between rural background and RRMA 3–7 community as their current location and first place of practice once vocationally qualified.Conclusions:  Interest in rural practice is not fully reflected in location during or after vocational training. The beneficial effects of rural undergraduate exposure might be lost if internship and vocational training programs provide insufficient rural clinical experiences and curriculum content. Continuation of the rural pathway might be needed to maintain rural practice intent.
CAPSULE ENDOSCOPY FOR OBSCURE GASTROINTESTINAL BLEEDING IN THE TROPICS: REPORT FROM INDIA
Authors: Ghoshal Uday C , Lakshmi Chandrasekharan P , Kumar Sunil , Das Kshaunish , Misra Asha , Rai Praveer , Mohindra Samir , Saraswat Vivek A , Kumar Ashok , Choudhuri Gourdas 
Published: November 2010

Background:  Capsule endoscopy (CE) is useful in patients with obscure gastrointestinal bleeding (OGIB). Experience in CE in OGIB in the tropics is limited.Methods:  Eighty‐six patients with OGIB were evaluated clinically and using CE (Given Imaging, Yoqneam, Israel) 89 times (twice in three patients) during a 64‐month period. Images were downloaded and examined by a single investigator using software (Rapid Reader; Given Imaging, Yoqneam, Israel). Patients received specific treatment and were followed up. Intraoperative findings, response to specific treatment and outcome on follow up (10.3 ± 14.1 months) were considered to confirm CE findings.Results:  Of 86 patients (aged 54.5 ± 16.3 years, 63 males), 64 and 22 had OGIB‐overt and OGIB‐occult, respectively. Lesions were equally detected in OGIB‐overt and OGIB‐occult patients (48/64, 75% vs 18/22, 81.8%, P = ns). Lesions were detected in 64 of 86 (74.4%) patients [vascular malformations with or without fresh bleeding in 24 (37.5%), tumors in 12 (18.8%), strictures in 15 (23.4%), ulcers in five (7.8%), hookworm in five (7.8%), and more than one lesion in three patients (4.7%)]. Endoscopic insertion of the capsule was required in four patients, and in six it was retained, although none developed intestinal obstruction (surgical removal in two). The sensitivity, specificity, positive and negative predictive values of CE to detect the lesion(s) were 92.9%, 68.2%, 84.8%, and 83.3%, respectively.Conclusion:  CE is safe and is equally effective in detecting lesion(s) in occult and overt OGIB. Worm infestation and small bowel tuberculosis are unique and important causes of OGIB in the tropics.
UNILATERAL VERSUS BILATERAL DRAINAGE USING SELF‐EXPANDABLE METALLIC STENT FOR UNRESECTABLE HILAR BILIARY OBSTRUCTION
Authors: Iwano Hirotoshi , Ryozawa Shomei , Ishigaki Noriko , Taba Kumiko , Senyo Manabu , Yoshida Kanako , Sakaida Isao 
Published: November 2010

Background:  There is no consensus on the choice of either unilateral or bilateral drainage in stent placement for patients with unresectable hilar biliary obstruction. The aim of the present study was to clarify which drainage method is superior.Methods:  We retrospectively reviewed 82 patients with hilar biliary obstruction who underwent metallic stenting. These patients were divided into a unilateral drainage group (Uni group) and a bilateral drainage group (Bi group).Results:  There was no significant difference between the groups in median survival time, median stent patency period, and median complication‐free survival time. The most frequent complication was stent obstruction, followed by cholangitis. Liver abscess was found at a higher frequency in the Bi group (17.6%) than in the Uni group (1.5%) (P = 0.0266). There was no significant difference between the groups in the occurrence of two or more complications (P = 0.247), life‐threatening severe complications (P = 0.0577), and stent obstruction by sludge (P = 0.0912).Conclusion:  When compared with bilateral biliary drainage, unilateral biliary drainage is associated with a lower incidence of liver abscess as well as a comparable outcome of stent patency time and complication‐free survival. We therefore propose that hilar biliary obstruction can be treated first by unilateral drainage with a metallic stent and by bilateral drainage only in patients who develop cholangitis in the contralateral biliary tree.
DISCRIMINATION BETWEEN SCLEROSING CHOLANGITIS‐ASSOCIATED AUTOIMMUNE PANCREATITIS AND PRIMARY SCLEROSING CHOLANGITIS, CANCER USING INTRADUCTAL ULTRASONOGRAPHY
Authors: Kubota Kensuke , Kato Shingo , Uchiyama Takashi , Watanabe Seitaro , Nozaki Yuich , Fujita Koji , Yoneda Masato , Inamori Masahiko , Shimamura Takeshi , Abe Yasunobu , Kirikoshi Hiroyuki , Kobayashi Noritoshi , Saito Satoru , Nakajima Atsushi 
Published: November 2010

Background and Aim:  Differentiation of sclerosing cholangitis‐associated autoimmune pancreatitis (SC‐AIP), primary sclerosing cholangitis (PSC) and cancer of the hilar part of the bile duct (CHB) has been challenging. The aim of the present study was to evaluate characteristic intraductal ultrasonography (IDUS) features that could be used to discriminate SC‐AIP from PSC and CHB.Methods:  Six patients with SC‐AIP, 10 patients with PSC and 12 patients with CHB were identified. We reviewed the following bile duct features observed using IDUS to determine their usefulness for differentiating SC‐AIP from PSC and CHB: presence of symmetrical wall thickness, wall thickness, presence of homogeneous internal foci and presence of lateral mucosal lesions continuous to the hilar.Results:  IDUS results (SC‐AIP, PSC, CHB) were as follows: wall thickness (mm), 3.7 ± 0.9, 2.6 ± 0.9, 2.8 ± 0.0.6; presence of symmetrical wall thickness, 100% (6/6), 20% (2/10), 8.3% (1/12); presence of homogeneous internal foci, 100% (6/6), 10% (1/10), 8.3% (1/12); and presence of lateral mucosal lesions continuous to the hilar, 83.3% (5/6), 40%(4/10), 25% (3/12). Symmetrical wall thickness of the bile duct, homogeneous internal foci and lateral mucosal lesions continuous to the hilar were detected significantly more often among the patients with SC‐PSC than among the patients with PSC or CHB (P < 0.05).Conclusions:  IDUS findings, such as symmetrical wall thickness, presence of homogeneous internal foci and presence of lateral mucosal lesions continuous to the hilar can facilitate the differential diagnosis of SC‐AIP from PSC and CHB.
MAGNIFYING ENDOSCOPIC FINDINGS OF THE SURFACE STRUCTURE OF NON‐CANCEROUS MUCOSA SURROUNDING DIFFERENTIATED AND UNDIFFERENTIATED GASTRIC CARCINOMA
Authors: Kawamura Masashi , Abe Shu , Oikawa Keisuke , Terai Shiho , Saito Masahiro , Shibuya Daisuke , Kato Katsuaki , Inomata Yoshifumi , Ohara Shuichi , Shimosegawa Tooru 
Published: November 2010

Background:  Several reports have described the usefulness of magnifying endoscopy in observing the surface structure in gastric neoplasia. The aim of the present study was to evaluate the characteristics of the surface structure of non‐cancerous mucosa surrounding gastric cancer.Methods:  Sixty Japanese patients with early gastric cancer were enrolled in this study. We observed the non‐cancerous gastric mucosa surrounding gastric carcinoma by magnifying endoscopy and classified the magnified view into four patterns: (A) dotted; (B) short‐linear; (C) striped; and (D) granular, according to Sakaki's classification.Results:  All patients were diagnosed as having Helicobacter pylori infection, and histological evaluation revealed 46 types of differentiated and 14 types of undifferentiated‐type gastric carcinomas. There were significant differences in the gender, age and endoscopic‐atrophic‐border scale between patients with these two types. In all, the surface structure at 240 points (4 points each in 60 patients) of non‐cancerous mucosa was observed by magnifying endoscopy. The prevalences of the surface patterns of the mucosa surrounding differentiated carcinoma were: A, 1.1%; B, 8.1%; C, 28.3%; D, 62.5%, and those of the mucosa surrounding undifferentiated carcinoma were: A, 8.9%; B, 73.2%; C, 14.3%; D, 3.6%. There were significant differences in the surface structure of the non‐cancerous mucosa surrounding differentiated and undifferentiated gastric carcinoma.Conclusion:  The microsurface structure of the gastric mucosa surrounding gastric cancer lesions differed between patients with differentiated and undifferentiated gastric cancer. These findings are expected to be useful for the early detection of gastric carcinoma lesions or for the determination of extensions of carcinoma lesions.