bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the quality of The National Pain Database for pain management services in the United Kingdom
Authors: Hall G. C. , Bryant T. N. , Merrett L. K. , Price C. 
Published: October 2008

SummaryData on specialist pain management is scarce. We evaluated PainDB, a database which aggregates this information from UK pain clinics. PainDB entries for 1120 patients (2648 consultations) were compared to records at 30 pain clinics. Staff were surveyed about normal practice at 28 sites. First consultations (17 135) on the aggregated PainDB were analysed for 2003 for omissions. Those consultations included on PainDB (54.6%) showed good concurrence with written notes (88.1%), with no pattern for the missing visits. Questionnaire responses were often absent from notes (56%) and diagnosis was most frequently omitted from PainDB (12.4–18.4%). Clinic staff overestimated completeness. Despite commitment, PainDB is currently unsuitable for research or audit. As routine hospital data should provide information on activity, specific questions on severity and outcome could be answered by short‐term recording of predefined variables.
A survey of the use of ultrasound guidance in internal jugular venous cannulation*
Authors: McGrattan T. , Duffty J. , Green J. S. , O’Donnell N. 
Published: October 2008

SummaryIt has been that suggested the use of two dimensional (2D) ultrasound to facilitate placement of central venous cannulae in the internal jugular vein improves patient safety and reduces complications. Since the introduction of the National Institute for Clinical Excellence Technology Appraisal Guideline Number 49 in 2002, promoting the use of ultrasound in placement of internal jugular venous cannulae, utilisation of ultrasound has increased throughout the United Kingdom. We report the findings of a postal survey of 2000 senior anaesthetists in the United Kingdom which enquired about their use of ultrasound for internal jugular vein cannulae placement. Only 27% use 2D ultrasound as their first choice technique, although 35% use it as their first choice when teaching. There was no significant difference in practice between those working within a sub specialty in anaesthesia. There continues to be discrepancies between the application of the guideline and how senior anaesthetists both site and teach the placement of internal jugular vein central venous cannulae.
Unplanned extubation in a paediatric intensive care unit: impact of a quality improvement programme
Authors: Da Silva P. S. L. , De Aguiar V. E. , Neto H. M. , De Carvalho W. B. 
Published: October 2008

SummaryUnplanned tracheal extubation is an important quality issue in current medical practice as it is a common occurrence in paediatric intensive care units. We have assessed the effectiveness of a continuous quality improvement programme in reducing the incidence of unplanned extubation over a 5‐year period. After a 2‐year baseline period, we developed action plans to address the issues identified. Following implementation of the programme, the overall incidence of unplanned extubation decreased from 2.9 unplanned extubations per 100 intubated patient days in the first year to 0.6 in the last year (p = 0.0001). This reduction was the result of a decrease in unplanned extubation in children younger than 2 years of age. Although mortality was similar to that of children who did not experience an unplanned extubation, those with an unplanned extubation had a significantly longer duration of mechanical ventilation, longer stay in the intensive care unit, and longer hospital stay. We found that the implementation of a continuous quality improvement programme is effective in reducing the overall incidence of unplanned extubations.
Emergency cricothyroidotomy: a randomised crossover study of four methods
Authors: Dimitriadis J. C. , Paoloni R. 
Published: October 2008

SummaryEmergency physicians and registrars performed emergency cricothyroidotomy on an artificial airway model using a standard surgical approach and three common commercial products, participants had received no refresher training. The order in which the methods were used was randomised to minimise any learning effect. Three methods (standard surgical, Minitrach II, and Quicktrach) were universally successful in obtaining ventilation within 150 s, whilst the Melker kit had a 26% failure rate and significantly longer median time to ventilation (126 s vs≤48 s for other methods, p < 0.001). Despite success in using the surgical method, the Quicktrach and Minitrach II were rated as first or second preference by the majority of operators (78% and 70% respectively). Without refresher training emergency physicians and registrars successfully performed emergency cricothyroidotomy using the standard surgical method, Quicktrach and Minitrach II kits however the use of the Melker kit under these conditions resulted in significant delays or failure to establish an airway.
Assessment of a new disposable introducer for spinal needles
Authors: Erskine R. J. 
Published: October 2008

SummaryThe compatibility between spinal needles and their introducers varies between manufacturers and can significantly influence the usable length of the spinal needle available resulting in failure to locate CSF in larger patients. The usable length of 90‐mm pencil point spinal needles from four manufacturers ranged from 68 to 79 mm when the needle was used in combination with its introducer. A new purpose‐built introducer needle is described which, when used with a 25 g or finer spinal needle, maximises the usable length of the needle. Using this new introducer the usable needle length of a 90‐mm Whitacre needle was increased by a further 7 to 86 mm resulting in only a 4 mm loss of total needle length. The new introducer was well received by users.
Increased temperature sensitivity of net DOC production from ombrotrophic peat due to water table draw‐down
Authors: CLARK J. M. , ASHLEY D. , WAGNER M. , CHAPMAN P. J. , LANE S. N. , EVANS C. D. , HEATHWAITE A. L. 
Published: October 2008

AbstractThe production and release of dissolved organic carbon (DOC) from peat soils is thought to be sensitive to changes in climate, specifically changes in temperature and rainfall. However, little is known about the actual rates of net DOC production in response to temperature and water table draw‐down, particularly in comparison to carbon dioxide (CO2) fluxes. To explore these relationships, we carried out a laboratory experiment on intact peat soil cores under controlled temperature and water table conditions to determine the impact and interaction of each of these climatic factors on net DOC production. We found a significant interaction (P< 0.001) between temperature, water table draw‐down and net DOC production across the whole soil core (0 to −55 cm depth). This corresponded to an increase in theQ10(i.e. rise in the rate of net DOC production over a 10 °C range) from 1.84 under high water tables and anaerobic conditions to 3.53 under water table draw‐down and aerobic conditions between −10 and − 40 cm depth. However, increases in net DOC production were only seen after water tables recovered to the surface as secondary changes in soil water chemistry driven by sulphur redox reactions decreased DOC solubility, and therefore DOC concentrations, during periods of water table draw‐down. Furthermore, net microbial consumption of DOC was also apparent at − 1 cm depth and was an additional cause of declining DOC concentrations during dry periods. Therefore, although increased temperature and decreased rainfall could have a significant effect on net DOC release from peatlands, these climatic effects could be masked by other factors controlling the biological consumption of DOC in addition to soil water chemistry and DOC solubility. These findings highlight both the sensitivity of DOC release from ombrotrophic peat to episodic changes in water table draw‐down, and the need to disentangle complex and interacting controls on DOC dynamics to fully understand the impact of environmental change on this system.
Tree age, disturbance history, and carbon stocks and fluxes in subalpine Rocky Mountain forests
Authors: BRADFORD J. B. , BIRDSEY R. A. , JOYCE L. A. , RYAN M. G. 
Published: October 2008

AbstractForest carbon stocks and fluxes vary with forest age, and relationships with forest age are often used to estimate fluxes for regional or national carbon inventories. Two methods are commonly used to estimate forest age: observed tree age or time since a known disturbance. To clarify the relationships between tree age, time since disturbance and forest carbon storage and cycling, we examined stands of known disturbance history in three landscapes of the southern Rocky Mountains. Our objectives were to assess the similarity between carbon stocks and fluxes for these three landscapes that differed in climate and disturbance history, characterize the relationship between observed tree age and time since disturbance and quantify the predictive capability of tree age or time since disturbance on carbon stocks and fluxes. Carbon pools and fluxes were remarkably similar across the three landscapes, despite differences in elevation, climate, species composition, disturbance history, and forest age. Observed tree age was a poor predictor of time since disturbance. Maximum tree age overestimated time since disturbance for young forests and underestimated it for older forests. Carbon pools and fluxes were related to both tree age and disturbance history, but the relationships differed between these two predictors and were generally less variable for pools than for fluxes. Using tree age in a relationship developed with time since disturbance orvice versaincreases errors in estimates of carbon stocks or fluxes. Little change in most carbon stocks and fluxes occurs after the first 100 years following stand‐replacing disturbance, simplifying landscape scale estimates. We conclude that subalpine forests in the Central Rocky Mountains can be treated as a single forest type for the purpose of assessment and modeling of carbon, and that the critical period for change in carbon is < 100 years.
The experiences of prenatal depression among Taiwanese women
Authors: Tseng Ying‐Fen , Hsu Chen‐Mei , Liu Yu‐Hsiang , Chen Chung‐Hey 
Published: October 2008

AbstractTitle.  The experiences of prenatal depression among Taiwanese women. Aim.  This paper is a report of a study to describe Taiwanese women’s experiences of prenatal depression.Background.  Despite its long‐term adverse effects for both mother and child, prenatal depression has received less scholarly attention than postpartum depression. Studies to date have proposed structured measures for quantifying prenatal depression, but the characteristics of this phenomenon have not been qualitatively analysed.Method.  A convenience sample of 12 Taiwanese pregnant women scoring above 15 on the Edinburgh Perinatal Depression Scale participated in in‐depth interviews during 2005. The interviews were transcribed verbatim and analysed using content analysis.Findings.  Unbalanced commitment to motherhood was the primary theme of the life experiences of prenatal depression in these Taiwanese women, which summarized their feelings of engagement and ambivalence towards their experiences of transition to motherhood. Five recurring sub‐themes were identified: multiple conflicting roles, lack of social support, dissatisfaction with body image, future uncertainty and emotional instability.Conclusion.  Prenatal depression is a painful growth experience represented by silent and unbalanced commitment during the maternal role transition. Our findings may help healthcare professionals to understand the vulnerable experiences of pregnant women and devise preventive intervention strategies, such as prenatal education for both parents and comprehensive screening for prenatal depression in at‐risk pregnant women, so that they are better prepared for the transition to motherhood.
The use of physical restraint in institutional care of older people in Finland: nurses’ individual, communal and alternative modes of action
Authors: Saarnio Reetta , Isola Arja , Laukkala Helena 
Published: October 2008

Aims and objectives.  The aim of the study was to map nursing staff’s individual, communal and alternative modes of action in situations where they used physical restraint of older people in Finland.Background.  The use of physical restraint in institutional care of older people involves modes of action that are linked to the personalities and modes of operation of individual nurses or to communal modes of operation mutually agreed on in the workplace. Nurse’s individual modes of operation are linked to consideration towards older people when using physical restraint. Communal modes of operation include joint discussion among nurses, decision‐making and written guidelines concerning the use of physical restraint.Design.  A quantitative survey.Methods.  The data were collected from nurses (n = 1148) working in healthcare centre wards, municipal and private nursing homes in Finland using a structured questionnaire (response rate 78%).Results.  Older nurses and those with the longest working experience were most active in using individual modes of operation in situations where physical restraint was applied. Nurses’ participation in continuing education in care of older people increased the use of both individual and alternative modes of action. The alternative modes of action were one that understands the older person and one that focuses on negotiation. The use of physical restraint was often discussed in the workplace during information sessions or during work, but only 33% had written guidelines on the use of physical restraint.Conclusions.  Education can be used to increase nurses’ ability to use alternative modes of action and thus decrease the use of physical restraint in institutional care of older people. Nursing management has a key role in making sure that units caring for older people receive written guidelines on the use of physical restraint.Relevance to clinical practice.  Locums especially need more education to avoid the use of physical restraint.
Pedigree reconstruction in wild cichlid fish populations
Authors: KOCH MARTIN , HADFIELD JARROD D. , SEFC KRISTINA M. , STURMBAUER CHRISTIAN 
Published: October 2008

AbstractIt is common practice to use microsatellites to detect parents and their offspring in wild and captive populations, in order to reconstruct a pedigree. However, correct inference is often constrained by a number of factors, including the absence of demographic data and ignorance regarding the completeness of parental sampling. Here we present a new Bayesian estimator that simultaneously estimates the pedigree and the size of the unsampled population. The method is robust to genotyping error, and can estimate pedigrees in the absence of demographic data. Using a large‐scale microsatellite assay in four wild cichlid fish populations of Lake Tanganyika (1000 individuals in total), we assess the performance of the Bayesian estimator against the most popular assignment program, Cervus. We found small but significant pedigrees in each of the tested populations using the Bayesian procedure, but Cervus had very high type I error rates when the size of the unsampled population was assumed to be lower than what it was. The need of pedigree relationships to infer adaptive processes in natural populations places strong constraints on sampling design and identification of multigenerational pedigrees in natural populations.
Avian haematozoan parasites and their associations with mosquitoes across Southwest Pacific Islands
Authors: ISHTIAQ F. , GUILLAUMOT L. , CLEGG S. M. , PHILLIMORE A. B. , BLACK R. A. , OWENS I. P. F. , MUNDY N. I. , SHELDON B. C. 
Published: October 2008

AbstractThe degree to which haematozoan parasites can exploit a range of vectors and hosts has both ecological and evolutionary implications for their transmission and biogeography. Here we explore the extent to which closely related mosquito species share the same or closely related haematozoan parasites, and examine the overlap in parasite lineages with those isolated from avian hosts,Zosteropsspecies, sampled across the same study sites. Mosquito samples were collected and analysed (14 species,n = 804) from four islands in Vanuatu and the main island of New Caledonia. Using polymerase chain reaction, 15.5% (14/90) of pooled mosquito (thoracic) samples showed positive amplifications. Subsequent phylogenetic analysis of the cytochromebgene identified four genetically distinctPlasmodiumand twoHaemoproteuslineages from these samples, five of which were identical to parasite lineages (n = 21) retrieved from the avian hosts. We found that threePlasmodiumlineages differing by a maximum of 0.9% sequence divergence were recovered from different species and genera of mosquitoes and twoHaemoproteuslineages differing by 4.6% sequence divergence were carried by 10 distantly related (11–21% divergent) mosquito species. These data suggest a lack of both cospeciation and invertebrate host conservatism. Without experimental demonstration of the transmission cycle, it is not possible to establish whether these mosquitoes are the biological vectors of isolated parasite lineages, reflecting a limitation of a purely polymerase chain reaction‐based approach. Nonetheless, our results raise the possibility of a new transmission pathway and highlight extensive invertebrate host shifts in an insular mosquito–parasite system.
Pronounced reproductive skew in a natural population of green swordtails,Xiphophorus helleri
Authors: TATARENKOV ANDREY , HEALEY CHRISTIANE I. M. , GRETHER GREGORY F. , AVISE JOHN C. 
Published: October 2008

AbstractFor many species in nature, a sire's progeny may be distributed among a few or many dams. This poses logistical challenges — typically much greater across males than across females — for assessing means and variances in mating success (number of mates) and reproductive success (number of progeny). Here we overcome these difficulties by exhaustively analyzing a population of green swordtail fish (Xiphophorus helleri) for genetic paternity (and maternity) using a suite of highly polymorphic microsatellite loci. Genetic analyses of 1476 progeny from 69 pregnant females and 158 candidate sires revealed pronounced skews in male reproductive success both within and among broods. These skews were statistically significant, greater than in females, and correlated in males but not in females with mating success. We also compare the standardized variances in swordtail reproductive success to the few such available estimates for other taxa, notably several mammal species with varied mating systems and degrees of sexual dimorphism. The comparison showed that the opportunity for selection on maleX. helleriis among the highest yet reported in fishes, and it is intermediate compared to estimates available for mammals. This study is one of a few exhaustive genetic assessments of joint‐sex parentage in a natural fish population, and results are relevant to the operation of sexual selection in this sexually dimorphic, high‐fecundity species.
Transcriptomic variation and plasticity in rufous‐collared sparrows (Zonotrichia capensis) along an altitudinal gradient
Authors: CHEVIRON ZACHARY A. , WHITEHEAD ANDREW , BRUMFIELD ROBB T. 
Published: October 2008

AbstractAs modern genomic tools are developed for ecologically compelling models, field manipulation experiments will become important for establishing the role of functional genomic variation in physiological acclimation and evolutionary adaptation along environmental clines. High‐altitude habitats expose individuals to hypoxic and thermal stress, necessitating physiological acclimation, which may result in evolutionary adaptation. We assayed skeletal muscle transcriptomic profiles of rufous‐collared sparrows (Zonotrichia capensis) distributed along an altitudinal gradient on the Pacific slope of the Peruvian Andes. Nearly 200 unique transcripts were differentially expressed between high‐altitude [4100 m above sea level (a.s.l.)] and low‐altitude (2000 m a.s.l.) populations in their native habitats. Gene ontology and network analyses revealed that these transcripts are primarily involved in oxidative phosphorylation, protein biosynthesis, signal transduction and oxidative stress response pathways. To assess the plasticity in gene expression differences between populations, we performed a ‘common garden’ experiment in which high‐ and low‐altitude individuals were transferred to a common low‐altitude site (~150 m). None of the genes that were differentially expressed between populations at the native altitudes remained significantly different between populations in the common garden. The role of gene expression variation in adaptation and acclimation to environmental stress is largely unexplored in natural populations of birds. These results demonstrate substantial plasticity in the biochemical pathways that underpin cold and hypoxia compensation in Z. capensis, which may mechanistically contribute to enabling the broad altitudinal distribution of the species.
Reduced introgression of the Y chromosome between subspecies of the European rabbit (Oryctolagus cuniculus) in the Iberian Peninsula
Authors: GERALDES A. , CARNEIRO M. , DELIBES‐MATEOS M. , VILLAFUERTE R. , NACHMAN M. W. , FERRAND N. 
Published: October 2008

AbstractThe role of the Y chromosome in speciation is unclear. Hybrid zones provide natural arenas for studying speciation, as differential introgression of markers may reveal selection acting against incompatibilities. Two subspecies of the European rabbit (Oryctolagus cuniculus) form a hybrid zone in the Iberian Peninsula. Previous work on mitochondrial DNA (mtDNA), Y‐ and X‐linked loci revealed the existence of two divergent lineages in the rabbit genome and that these lineages are largely subspecies‐specific for mtDNA and two X‐linked loci. Here we investigated the geographic distribution of the two Y chromosome lineages by genotyping two diagnostic single nucleotide polymorphisms in a sample of 353 male rabbits representing both subspecies, and found that Y chromosome lineages are also largely subspecies‐specific. We then sequenced three autosomal loci and discovered considerable variation in levels of differentiation at these loci. Finally, we compared estimates of population differentiation between rabbit subspecies at 26 markers and found a surprising bimodal distribution of FST values. The vast majority of loci showed little or no differentiation between rabbit subspecies while a few loci, including the SRY gene, showed little or no introgression across the hybrid zone. Estimates of population differentiation for the Y chromosome were surprisingly high given that there is male‐biased dispersal in rabbits. Taken together, these data indicate that there is a clear dichotomy in the rabbit genome and that some loci remain highly differentiated despite extensive gene flow following secondary contact.