bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stand development moderates effects of ungulate exclusion on foliar traits in the forests of New Zealand
Authors: Mason Norman W. H. , Peltzer Duane A. , Richardson Sarah J. , Bellingham Peter J. , Allen Robert B. 
Published: August 2010

Summary 1. Ungulate herbivores may greatly alter the functional composition of plant communities through their selection of leaves with high nutrient concentrations and low structural or chemical defences. These impacts may have broader implications for ecosystem functions via changing rates of litter decomposition and the relative abundance of foliar traits. However, it is unlikely that ungulate impacts will be consistent across different vegetation types and different environmental conditions. 2. We compared shifts in abundance‐weighted trait means and functional diversity indices in 88 pairs of plots fenced to exclude ungulate herbivores (exclosures) and adjacent control plots for eight foliar traits related to ungulate palatability in forest ecosystems. The stem density and basal area per species were both used to weight trait means and functional diversity indices, since these are proportional to recruitment and litter production, respectively. We also regressed exclosure effects on environmental and stand development variables to test whether context influenced the impact of ungulate exclusion. 3. There was a consistent, significant trend across seven of the eight leaf traits examined for increased palatability inside exclosure plots relative to control plots when trait means were weighted by the number of stems per species, but not when weighted by basal area. This suggests that ungulate exclosure consistently increased recruitment of palatable species, but is unlikely to have yet affected mean litter quality. Exclosure effects were linked to stand development variables, with effects being greatest in disturbed stands (where total basal area decreased and the number of stems increased), and least in stands undergoing competitive thinning. 4. Synthesis. The consistency of exclosure effects indicates that ungulate impacts on plant communities in New Zealand’s indigenous forest may be reversible at zero deer density, while their dependence on stand development suggests that the ungulate control impacts may be greatest in seral shrubland or forest communities.
The shared influence of phylogeny and ecology on the reproductive patterns of Myrteae (Myrtaceae)
Authors: Staggemeier Vanessa Graziele , Diniz‐Filho José Alexandre Felizola , Morellato Leonor Patrícia Cerdeira 
Published: August 2010

Summary1. Many factors shape plant reproductive patterns including climate, competition or attraction of pollinators and seed dispersers, flower and fruit morphologies and phylogenetic relationships. South American Myrtaceae (Myrteae) were chosen to evaluate hypotheses on how abiotic and biotic factors, morphology and phylogeny influence plant reproductive phenology.2. We examined whether Myrteae reproductive patterns are seasonal and related to climate; whether aggregated or segregated flowering and fruiting occur among species sharing pollinators or seed dispersers; the relationship between phenological and morphological traits, time of reproduction and Myrteae phylogenetic history; and the shared influence of ecological (environmental) and phylogenetic factors on Myrteae reproductive patterns.3. We observed flowering and fruiting of 34 Myrteae species during 30 months in an Atlantic rain forest (south‐eastern Brazil). We employed circular statistics to test for seasonality and multiple regressions to relate climate and phenology. Competition and facilitation hypotheses were tested using null models. We quantified the phylogenetic signal on phenology and morphology of Myrteae species using phylogenetic eigenvector regression (PVR) analyses, and used PVR and partial regressions to quantify the influences of ecology and phylogeny on phenology.4. Myrteae flowered seasonally, whereas fruiting was not seasonal. Environmental factors (day‐length and temperature) and associations with biotic vectors through facilitation hypothesis explained the aggregated blossom. Fruit maturation time affected the species’ flowering sequence. Plants with longer fruit maturation times flowered at the end of the appropriate season, explaining the continuous fruit availability despite the seasonal flowering. The random fruiting pattern explained the regular presence of seed dispersers. Myrteae phenology was phylogenetically structured, even when phenophases were not seasonal, i.e., closer related species fruited under more similar environmental conditions, suggesting that the reproductive phenological niche was inherited along the course of evolution. We detected a shared influence of ecology and phylogeny on Myrteae phenological responses, and the ecological component explained better phenological variation than phylogeny.5. Synthesis. We provided a new perspective on plant phenology based on phylogeny and ecology and demonstrated the importance of considering their shared influence in phenological studies. Our analyses can be employed for the most representative families of highly diverse ecosystems to improve our understanding of evolutionary patterns and general trends in phenology.
Improving the quality of drug error reporting
Authors: Armitage Gerry , Newell Robert , Wright John 
Published: August 2010

AbstractBackground  Drug errors are a common and persistent problem in health care and are also associated with serious adverse events. Reporting has become the cornerstone of learning from errors, but is not without its imperfections.Aim  The aim of this study is to improve reporting and learning from drug errors through investigating the contributory factors in drug errors and quality of reporting in an acute hospital.Methods  A retrospective, random sample of 991 drug error reports from 1999 to 2003 were subjected to quantitative and qualitative analysis. This was followed by 40 qualitative interviews with a volunteer, multi‐disciplinary sample of health professionals. The combined analysis has been used to develop a knowledge base for improved drug error reporting.Results  The quality of reports varied considerably, and 27% of reports lacked any contributory factors. Documentary analysis revealed a focus on individuals, sometimes culminating in blame without obvious justification. Doctors submitted few reports, and there were notable differences in reporting according to clinical location. Communication difficulties commonly featured in causation, and high workload and interruptions were predominant contributory factors in the interview data. Interviewees viewed causation as multifactorial, including cognitive and psychosocial factors. Organizational orientation to error was predominantly perceived by interviewees as individual rather than systems‐based. Staff felt obliged to report but rarely received feedback.Implications and conclusion  Drug errors are multifactorial in causation. Current reporting schemes lack a theoretical basis, and are unlikely to capture the information required to ensure learning about causation. Health professionals have reporting fatigue and some remain concerned that reporting promotes individual blame rather than an examination of systems factors. Reporting can be strengthened by human error theory, redesigned to capture a range of contributory factors, facilitate learning and foster supportive actions. It can also be feasible in routine practice. Such an approach should be examined through multi‐centred evaluation.
Consensus on ‘core/essential’ and ‘ideal world’ criteria of a pre‐discharge occupational therapy home assessment
Authors: Barras Sarah , Grimmer‐Somers Karen , May Esther 
Published: August 2010

AbstractRationale, aims and objectives  There are no standard criteria for an occupational therapy (OT) home assessment for patients about to be discharged from an acute rehabilitation facility. This has implications for benchmarking, quality improvement and research. The aim of this paper is to establish ‘core/essential’ and ‘ideal world’ elements of OT home assessments for patients about to be discharged from acute rehabilitation settings.Methods  A piloted open‐ended questionnaire initiated a Delphi study involving knowledgeable OTs working in Australian public and private acute rehabilitation settings. ‘Core/essential’ and ‘ideal world’ elements of OT home assessments were confirmed when 70% agreement was reached.Results  Of 242 facilities in two Australian states, 110 were invited to participate, and 81 OTs from 84 facilities did so. Four Delphi rounds were required to reach consensus on 30 ‘core/essential’ and 25 ‘ideal world’ elements.Conclusion  Standard use of ‘core/essential’ pre‐discharge home assessment elements should improve standards of care and the quality of discharge planning. OTs should consider including ‘ideal world’ criteria in pre‐discharge assessments to optimize recently ill patients' community independence.
Cancer patients' perception of information exchange between hospital‐based doctors and their general practitioners
Authors: Spiegel Wolfgang , Zidek Thomas , Karlic Heidrun , Maier Manfred , Vutuc Christian , Isak Karin , Micksche Michael 
Published: August 2010

AbstractRationale, aims and objectives  The quality of communication between health care professionals is a key issue determining health outcomes in cancer care. This study aims to find out what importance cancer patients in Austria attach to information exchange between hospital‐based doctors and their general practitioners (GPs) and how patients perceive this flow of information.Methods  In this cross‐sectional study, cancer patients seeking help at a community‐based organization in the voluntary sector (Viennese Cancer League) were polled with a 16‐item questionnaire. Contingency tables were evaluated by means of the chi‐squared and Mantel–Haenszel test.Results  The mean age of the 252 respondents – 92.6% of those polled (272) – was 51.9 years (SD ± 13.6). 87.5% [female (f): 92.1%, male (m): 80.2%] considered the exchange of information between the hospital‐based specialists and their GP ‘very important’ or ‘important’; 12.5% (f: 8.0%, m: 19.8%) ‘not so important’ or ‘not at all important’; 28.1% (f: 26.0%, m: 31.2%) of patients considered the flow of information as ‘very good’ or ‘fairly good’, but 50.9% (f: 58.7, m: 40.0%) as ‘rather poor’ or ‘poor’. Some 34.8% of patients thought that their cancer disease was first suspected by a hospital‐based specialist; 42.1% thought that it was first suspected by a doctor outside the hospital. Even when patients were counselled elsewhere they gave high importance to the provision of appropriate information to their GP.Conclusions  Cancer patients in Austria attach high importance to the provision of appropriate information to their GP by hospitals and perceive this exchange of information as insufficient, a finding that could well be prevalent in other European health systems.
A comparison of the scientific quality of publicly and privately funded randomized controlled drug trials
Authors: Jones Richard , Younie Stuart , Macallister Andrew , Thornton Jim 
Published: August 2010

AbstractBackground  There is disagreement but few objective data on the relative quality of publicly or privately funded research. Cochrane reviews of randomized trials provide a good comparison opportunity because there is widespread agreement on how trial quality should be assessed and the Cochrane reviewers routinely do this.Aims  To compare the quality of publicly or privately funded randomized controlled trials.Methods  A total of 105 trials included in two Cochrane reviews were studied. Their quality assessments were abstracted from the relevant review and information about their funding source was collected from the original trial publications.Main results  Funding information was obtained for 87 trials. Of these, trials funded by pharmaceutical companies were larger (median sample size 126 vs. 45, P < 0.001), more likely to have avoided ascertainment bias 11/14 vs. 15/41 (P = 0.05). Non‐significant trends in avoiding entry bias 19/19 vs. 35/37 and performance bias 13/22 vs. 14/48 also favoured the commercial trials. Commercial trials also had higher recorded attrition rates (median 6% vs. 1%, P = 0.007), but this difference was entirely caused by more non‐commercial trials reporting a zero attrition rate.Discussion  The apparently lower attrition rate in the non‐commercial trials should be interpreted with caution. Zero attrition in clinical trials with follow‐up of many months is somewhat implausible.Main conclusion  Commercially funded randomized trials tend to be of higher methodological quality than government‐funded ones.
The importance of organizational climate and implementation strategy at the introduction of a new working tool in primary health care
Authors: Carlfjord S. , Andersson A. , Nilsen P. , Bendtsen P. , Lindberg M. 
Published: August 2010

AbstractRationale, aims and objectives The transmission of research findings into routine care is a slow and unpredictable process. Important factors predicting receptivity for innovations within organizations have been identified, but there is a need for further research in this area. The aim of this study was to describe contextual factors and evaluate if organizational climate and implementation strategy influenced outcome, when a computer‐based concept for lifestyle intervention was introduced in primary health care (PHC).Method The study was conducted using a prospective intervention design. The computer‐based concept was implemented at six PHC units. Contextual factors in terms of size, leadership, organizational climate and political environment at the units included in the study were assessed before implementation. Organizational climate was measured using the Creative Climate Questionnaire (CCQ). Two different implementation strategies were used: one explicit strategy, based on Rogers’ theories about the innovation‐decision process, and one implicit strategy. After 6 months, implementation outcome in terms of the proportion of patients who had been referred to the test, was measured.Results The CCQ questionnaire response rates among staff ranged from 67% to 91% at the six units. Organizational climate differed substantially between the units. Managers scored higher on CCQ than staff at the same unit. A combination of high CCQ scores and explicit implementation strategy was associated with a positive implementation outcome.Conclusions Organizational climate varies substantially between different PHC units. High CCQ scores in combination with an explicit implementation strategy predict a positive implementation outcome when a new working tool is introduced in PHC.
Relationship between pre‐discharge occupational therapy home assessment and prevalence of post‐discharge falls
Authors: Johnston Kylie , Barras Sarah , Grimmer‐Somers Karen 
Published: August 2010

AbstractRationale, aims and objective Pre‐discharge occupational therapy home assessments are common practice, and considered important for falls prevention in older people. This prospective, observational cohort study describes the association between pre‐discharge home assessment and falls in the first month post‐discharge from a rehabilitation hospital.Methods 342 inpatients were recruited and followed up 1 month post‐discharge. Patients were classified into diagnostic groups (cardiac, orthopaedic trauma, spinal, peripheral joint surgery, neurological and deconditioned). Age, gender, falls risk [Falls Risk Assessment Scoring System (FRASS)], functional independence scores (FIM™) and receipt (or not) of a home assessment were recorded. Patients completed a diary to document post‐discharge falls. Logistic regression analysis tested the effect on falling of receiving a home assessment, age, gender, diagnostic group, FRASS and FIM™.Results Considering all subjects, not receiving a home assessment increased the risk of falling 1 month post‐discharge [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4–4.7,P = 0.003]. Neurological and orthopaedic trauma patients had significantly elevated risks of falling [OR (95% CI), respectively, 12.5 (4.7–33.2), 3.4 (1.4–8.4)] relative to the orthopaedic joint group. For all diagnostic groups except neurological, falls risk was mitigated by a home assessment. In non‐neurological patients, adjusting for the effect of diagnostic group, FRASS and FIM™ scores indicated a significant association between not receiving a home assessment and falling (OR 4.2, 95% CI 2.1–8.2,P < 0.001).Conclusions Pre‐discharge occupational therapy home assessments are sound post‐discharge falls‐prevention strategies in non‐neurological patients. The decision to conduct a home assessment should consider diagnosis, falls risk and functional independence.
Analysis of dyadic data: a guideline applied to erectile dysfunction
Authors: Cappelleri Joseph C. , Stecher Vera J. 
Published: August 2010

AbstractRationale  Research on relationships often does not refer to a single person but rather to two persons. Nonetheless, such data has been often analysed by examining individuals in isolation, which falls short of capturing their truly interpersonal and non‐independent nature.Aims and objectives  This paper highlights and illustrates some analytic tools for such dyadic data that are essential for theories about dyadic relationships to be tested adequately.Methods  The methodology is applied to clinical trial data from male patients treated for their erectile dysfunction and data from their partners with respect to treatment satisfaction. Multi‐level modelling was used to analyse the data.Results  The approaches outlined allow researchers to assess both individual effects and companion effects (e.g. of baseline intercourse satisfaction on subsequent treatment satisfaction), role of participant (e.g. patient or partner) or treatment condition (e.g. test or placebo) on outcome (e.g. treatment satisfaction), and differences on individual and companion effects when couples differ on important variables (e.g. differences on the individual and companion effects of baseline intercourse satisfaction on treatment satisfaction when couples differ with respect to treatment condition).Conclusion  Researchers are encouraged to consider implementing dyadic data analysis in their own work.
Optimal two‐stage breast cancer screening for countries with intermediate or low incidence of breast cancer
Authors: Kuo Shou‐Jen , Chen Tony Hsiu‐Hsi , Yen Amy Ming‐Fang , Chen Dar‐Ren , Chen Li‐Sheng 
Published: August 2010

AbstractObjectives  This study is to identify an optimal cut‐off for two‐stage breast cancer screening making allowance for variation of the baseline incidence rate and utility values between sensitivity and specificity.Methods  We used data from a two‐stage breast cancer screening of Taiwanese women aged 50–69 years for whom risk stratification was based on a composite risk score (conventional risk factors); subjects with a risk score greater than the cut‐off score were screened using mammography. The Bayesian posterior risk for breast cancer was computed by incorporation of the baseline incidence rate and the risk score. Bayes' maximum utility decision rule was then developed to determine the optimal screening cut‐off.Results  With a risk score of −9 applied to the current two‐stage breast cancer screening programme, we could detect one breast cancer case for every 1406 women. Given different predetermined risks, the selected cut‐offs were −9 for 1:1200, −8 for 1:800, −4 for 1:600, −1 for 1:400 and 3 for 1:200 for women aged 50–59 years. When the regret utility ratio of positive predictive value to negative predictive value was set at 1:10, the specificity and sensitivity were 58.5% and 70.4%, respectively, and the optimal cut‐off was −5.5. When the ratio was set at 10:1, the sensitivity and specificity were 75.5% and 57.1%, respectively, and the optimal cut‐off value was −7.5.Conclusions  This study demonstrates that Bayes' maximum utility decision rule can be used to determine optimal cut‐off values for two‐stage breast cancer screening in countries or areas with lower or intermediate incidence of breast cancer.
Effect of feedback in promoting adherence to an exercise programme: a randomized controlled trial
Authors: Shakudo Masaaki , Takegami Misa , Shibata Ai , Kuzumaki Miki , Higashi Takahiro , Hayashino Yasuaki , Suzukamo Yoshimi , Morita Satoshi , Katsuki Michio , Fukuhara Shunichi 
Published: August 2010

AbstractObjective  We investigated whether providing participants in an exercise programme with regular feedback on their exercise progress affected their adherence to the programme regimen.Method  We conducted a randomized controlled trial. Adult men and women with borderline hypertension and a body mass index ≥ 25.0 were randomized to two intervention groups (groups A and B) and one control group (group C) and were prescribed regular aerobic exercise. During the 12‐week study period, group A was provided with both feedback information on their exercise progress and a health letter, while group B was provided with the health letter only. The main outcome measure was exercise performance, per cent achievement of target exercise level (%) defined as the number of weeks during which the exercise target was reached divided by the number of weeks in the programme. Results were compared using the Kruskal–Wallis test.Results  A total of 105 study subjects were randomized into three groups (A, n = 37; B, n = 37 and C, n = 31). Per cent achievement of target exercise level during the 12‐week period was highest in group A (26.5%), followed by groups B (22.9%) and C (17.4%) (P = 0.36). Subjects who received regular feedback during the exercise programme tended to have higher exercise performance.Conclusions  In improving adherence to exercise intervention, the provision of regular feedback to participants in an exercise programme may be an effective intervention.
Initiation of antipsychotic treatment by general practitioners. A case–control study
Authors: Boonstra Geartsje , Grobbee Diederick E. , Hak Eelko , Kahn René S. , Burger Huibert 
Published: August 2010

AbstractRationale, aims and objectives  Antipsychotics are approved treatment for severe conditions and have serious side effects. Antipsychotics are often prescribed off‐label. Although a substantial proportion of antipsychotics are prescribed in primary care, it is largely unknown what motivates the general practitioner (GP) to initiate antipsychotic treatment. Therefore, we sought to examine the relation between pre‐defined, licensed as well as off‐label, reasons for antipsychotic treatment and the initiation of this treatment by the GP as well as report registration and incidence of antipsychotic treatment in general practice.Methods  In a case–control study, 723 patients selected from an electronic database and with a new antipsychotic prescription were compared with 3615 controls receiving any other new prescription. Using logistic regression, six pre‐defined categories of International Classification of Primary Care (ICPC) codes (‘psychosis’, ‘depression and anxiety’, ‘sleeping disorders’, ‘acute stress and surmenage’, ‘dementia’ and ‘somatic indications’) were associated with initiating antipsychotic treatment.Results  All, including off‐label, categories were significantly related to initiating antipsychotic treatment. The incidence of initiating antipsychotic therapy was 1.28 per 1000 persons per year (95% confidence interval: 1.09, 1.48). GPs registered an ICPC code in 50% and prescribed typical antipsychotics in 90% of the cases. Prescription of atypical antipsychotics increased almost threefold over the study period.Conclusions  The results suggest that GPs prescribe antipsychotics off‐label. Despite serious side effects and relatively infrequent occurrence in Dutch general practices, GPs seem imprecise in underpinning and registrating the initiation of antipsychotic treatment. GPs increasingly prescribe atypical antipsychotics although the prescription of typical antipsychotics still dominates.