bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of plant size, leaf herbivory, local competition and fruit production on survival, growth and future reproduction of a neotropical herb
Authors: Horvitz Carol C. , Schemske Douglas W. 
Published: March 2003

Summary1 The effects of natural variation in herbivory, local competition, plant size, and fruit production on next year’s growth, survival and inflorescence production of individuals in natural populations of Calathea ovandensis were estimated during 5 years.2 For each year, we estimated path coefficients (by standardized multiple regression analysis) for the direct effects of predictor variables on demographic rates. Separate analyses were performed for each life‐history stage: seedlings, juveniles, pre‐reproductives and reproductives, for a total of 55 analyses. Emergent patterns for stages were evaluated (Fisher’s combined probability test) by combining years. To determine significance of effects in single years, we calculated table‐wide probabilities for each stage across multiple years (Bonferroni sequential test). Emergent patterns for years were also evaluated (Fisher’s combined probability test) by combining stages.3 Survival of seedlings was positively affected by plant size and negatively affected by local competition. Survival of juveniles was positively affected by plant size, but not by other factors. Survival of large stages was not generally affected by any of the factors.4 Relative growth rates of all stages were negatively affected by plant size; larger plants grew more slowly than smaller plants. Additionally, growth rate of juveniles was negatively affected by local competition, whereas growth rate of reproductives was positively affected by reproduction.5 Next year’s inflorescence production was positively affected by plant size for both pre‐reproductive and reproductive stages. For reproductives, it was additionally positively affected by current fruit production.6 Analysis of differences among years showed that herbivory negatively affected both survival and growth in 1985, but not in other years, whereas local competition negatively affected survival in 1983 and growth in 1984.7 Effects of biotic interactions varied among stages and through time. The large effects of competition on seedlings and juveniles was as expected, but the small effect of herbivory on small plants was surprising as was the striking temporal variation in its effect and its impact on large plants.
Are trade‐offs in allocation pattern and root morphology related to species abundance? A congeneric comparison between rare and common species in the south‐western Australian flora
Authors: Poot Pieter , Lambers Hans 
Published: March 2003

Summary

Many narrowly endemic species are restricted to distinctive edaphic environments. The adaptations that make these species successful in their restricted habitat may incur a cost, and decrease their success in more common habitats. We compared growth, biomass allocation and root morphology of two narrowly endemic Hakea species (Proteaceae) of Mediterranean south‐western Australia with those of five more widespread congeners, in a glasshouse study. The rare Hakea species occur in endangered winter‐wet shrublands that grow on skeletal (0–20 cm deep) soils overlying massive ironstone rock, whereas their common congeners occur nearby on deeper wetland and non‐wetland soils.
The ironstone endemics differed consistently from their widespread congeners in some important root characteristics. During early development they allocated relatively more biomass to their roots, and had a higher specific root length due to a lower average root diameter and a lower root mass density. Therefore, when compared at the same plant mass, the ironstone endemics had a considerably greater total root length.
The ironstone endemics also favoured root growth in deeper layers of the substrate: they invested up to 64% of their root mass in the bottom 10 cm of 40‐cm‐deep pots, vs. 35% for common species. Only in the ironstone endemics did the extension of the main root axis continue at the same rate after reaching the bottom of the pot.
We suggest that the observed differences are the consequence of evolutionary trade‐offs, and represent specializations of the endemic species to increase the chances of getting access to water before the onset of severe summer drought in these habitats. However, while adaptive in a shallow‐soil habitat, these traits may reduce success on deeper soils by compromising both below‐ground and above‐ground competitive abilities.
Overlapping resource use in three Great Basin species: implications for community invasibility and vegetation dynamics
Authors: Booth Mary S. , Caldwell Martyn M. , Stark John M. 
Published: March 2003

Summary

In the Great Basin of the western United States of America, the invasive annual grass Bromus tectorum has extensively replaced native shrub and bunchgrass communities, but the native bunchgrass Elymus elymoides has been reported to suppress Bromus. Curlew Valley, a site in Northern Utah, provides a model community to test the effects of particular species on invasion by examining competitive relationships among Elymus, Bromus and the native shrub Artemisia tridentata.
The site contains Bromus/Elymus, Elymus/Artemisia and monodominant Elymus stands. Transect data indicate that Elymus suppresses Bromus disproportionately relative to its above‐ground cover. Artemisia seedlings recruit in Elymus stands but rarely in the presence of Bromus. This relationship might be explained by competition between the two grasses involving a different resource or occurring in a different season to that between each grass and Artemisia.
Time reflectometry data collected in monodominant patches indicated that in spring, soil moisture use by Bromus is rapid, whereas depletion under Elymus and Artemisia is more moderate. Artemisia seedlings may therefore encounter a similar moisture environment in monodominant or mixed perennial stands. However, efficient autumn soil moisture use by Elymus may help suppress Bromus.
In competition plots, target Artemisia grown with Bromus were stunted relative to those grown with Elymus, despite equivalent above‐ground biomass of the two grasses. Competition for nitrogen in spring and autumn, assessed with 15N tracer, appears to be secondary to moisture availability in determining competitive outcomes.
Elymus physiology and function appear to play an important role in determining the composition of communities in Curlew Valley, by maintaining zones free of Bromus where Artemisia can recruit.
Evidence‐based medicine: the need for a new definition
Authors: Buetow S. , Kenealy T. 
Published: March 2003

AbstractEvidence is defined by its ability to establish or support conclusions. Evidence‐based medicine (EBM) equates evidence with scientific evidence and views factors such as clinical expertise as important in moving from evidence to action. In contrast, we suggest that EBM should acknowledge multiple dimensions of evidence including scientific evidence, theoretic evidence, practical evidence, expert evidence, judicial evidence and ethics‐based evidence. What EBM loses by not acknowledging these dimensions as evidence is the ability, among other things, to make and defend judgements based on understandings that complement science and are no less important than those science can offer. We argue for a new definition of EBM that, without forced accommodation or unacceptable compromise, acknowledges dimensions of evidence produced within and outside science.
Understanding patients’ views of a surgical outpatient clinic
Authors: Frcs Alison Waghorn , Frcp Martin McKee 
Published: March 2003

AbstractFor many people, the outpatient clinic is the first point of contact with a hospital. As clinical management moves from the in‐patient setting, it is taking on a much greater importance. Yet there are still many gaps in our knowledge about how those who interact with it, whether as staff or patients, view it. This study sought to describe patients’ perceptions and to explore some of the socio‐demographic characteristics associated with these differing perceptions. The study took place in a district general hospital in southern England. A questionnaire seeking the experiences and views of patients was developed. After piloting, it was administered to patients attending surgical outpatient clinics. The results were supplemented by those of a study of times that the same patients waited to be seen and the duration of their consultations. We found that 288 patients attended the clinics of four consultant general surgeons in a week chosen to be typical of those throughout the year and, of these, 188 (76%) returned questionnaires. As far as could be ascertained, responders did not differ from non‐responders. New patients only were asked about the time they had waited for an appointment and 32% felt that this had been excessive. Young patients were more likely to feel that the wait had been too long. Patients were more likely to overestimate the time that they waited than to underestimate it and 27% thought the time spent with the doctor had been too short. The perception of inadequate time was greatest among those attending clinics where the actual time available was least. Of the patients, 30% had questions they would have liked to have asked but did not, 32% of patients would definitely have liked a leaflet explaining their treatment, 44% of patients were very satisfied with how they were treated by the doctor and 3% were dissatisfied. Non‐white patients tended to be less satisfied with both the overall attendance and the length of consultation, although the actual times spent with doctors were the same for both groups. Seventy‐eight per cent of patients had no preference for being seen by a male or female doctor. Those expressing a preference tended to prefer a doctor of their own sex. We found that while many patients are satisfied with the outpatient experience, there are several issues that require attention. Patient’s perceptions are often as important as more objective measures in determining whether an attendance is considered satisfactory.
Depth of understanding and excellence of practice: the question of wholeness and problem‐based learning
Authors: Margetson D. B. 
Published: March 2003

AbstractThe paper evaluates the importance of conceptions underlying practices in medicine and in medical education. It uses a study of anaesthetists’ approaches to practice, and of lectures in problem‐based learning, to illustrate the influence of a conception of ‘applying knowledge in, or to, practice’ and of its apparently serious limitations reflected in practice. A brief background to the pervasiveness of the conception is given, together with discussion of an alternative, and arguably better, conception and its realization in rigorous problem‐based learning in contrast to transitional, semi‐problem‐based learning.
Continuous training as a key to increase the accuracy of administrative data
Authors: Lorenzoni Luca , Cas Roberto Da , Aparo Ugo Luigi 
Published: March 2003

AbstractThe aim of this study was to evaluate the impact of a program of training, education and awareness on the accuracy of the data collected from hospital discharge abstracts. Four random samples of hospital discharge abstracts relating to four different periods were studied. The evaluation of the impact of systematic training and education activities was performed by checking the quality of abstracting information from the medical records. The analysis was carried out at the Istituto Dermopatico dell'Immacolata, a research hospital (335 beds) in Rome, Italy, which specializes in dermatology, plastic and vascular surgery. Error rates in discharge abstracts were subdivided into six categories: selection of the wrong principal diagnosis (type A); low specificity of the principal diagnosis (type B); incomplete reporting of secondary diagnoses (type C); selection of the wrong principal procedure (type D); low specificity of the principal procedure (type E); incomplete reporting of procedures (type F). A specific rate for errors modifying classification in diagnosis related groups (DRG) was then estimated and the effect of re‐abstracting on the case‐mix index evaluated. Error types A, B, C, E and F dropped from 8.5% to 2%, 15.8 to 4.9, 31.8 to 13.1, 4.1 to 0.3 and 22 to 2.6%, respectively. Error type D was 0.7 both in the first (the baseline) and fourth periods of analysis. All differences in error types were statistically significant. In 1999 8.3% of cases were assigned to a different DRG after re‐abstracting as compared with 24.3% in the third quarter of 1994, 23.8% in the first quarter of 1995 and 5.5% in September–October 1997. Continuous training and feedback of information to departments have shown to be successful in improving the quality of abstracting information at patient level from the medical record. These positive results were facilitated by the introduction of a prospective payment system to finance inpatient hospital activity. The effort to increase administrative data quality at hospital level facilitates the use of those data sets for internal quality management activities.
What issues are raised by evaluating problem‐based undergraduate medical curricula? Making healthy connections across the literature
Authors: Maudsley Gillian 
Published: March 2003

AbstractThere have been various waves and ripples of undergraduate medical curricular reform over recent decades. Such programme‐wide innovation can attract exceptional suspicion and scrutiny about its worth, fuelled by adverse reactions to change. It also raises expectations of what programme evaluation can reveal about the experience, achievements and ‘added value’ of the medical students or doctors. Problem‐based undergraduate medical curricula are expected, for example, to fulfil elusive ‘true’ (outcome) descriptors of educational quality. The aim here was to explore the rationale, approach and challenges for undergraduate medical programme evaluation, particularly for problem‐based curricula. The main focus was on internal, formative evaluation: Why undertake educational evaluation? What is the evaluative context of problem‐based learning? What philosophy has guided programme evaluation of innovative undergraduate medical curricula? What can educational, health care and other evaluation frameworks offer? What can be learned from examples of published accounts of problem‐based undergraduate medical programme evaluation? Where to from here? Ideally, evaluators of medical education should be explicit about their rationale, highlight local curricular context and special features, balance process‐measures with outcome‐measures (including unplanned outcomes), and be eclectic in methods. ‘Healthier links’ with the health care evaluation and educational evaluation literature could be beneficial. It remains to be seen, however, whether the medical educational changes that the General Medical Council's Tomorrow's Doctors triggered in the United Kingdom will stimulate important advances in educational evaluation.
Family physicians’ and general practitioners’ approaches to drug management of diabetic hypertension in primary care
Authors: PhD Khalid A.J. Al Khaja , PhD Reginald P. Sequeira , FAMS Vijay S. Mathur MD D.Phil , MBBCh. Awatif H.H. Damanhori , FRCS Abdul Wahab M. Abdul Wahab 
Published: March 2003

Abstract Rationale, aims and objectives To compare the pharmacotherapeutic approaches
to diabetic hypertension of family physicians (FPs) and general practitioners (GPs).
Methods A retrospective prescription‐based study was conducted in 15 out of
a total of 20 health centres, involving 115 primary care physicians – 77 FPs
and 38 GPs, representing 74% of the primary care physicians of Bahrain. Prescriptions
were collected during May and June 2000 to comprise a study population of 1266 diabetic‐hypertensive
patients. Results As monotherapy, angiotensin‐converting enzyme (ACE) inhibitors
(37.9%) and β‐blockers (38.3%) were the most commonly prescribed
classes of antihypertensives by FPs and GPs, respectively. Calcium channel blockers
(CCBs) were ranked third by both categories of physicians. For two‐drug combinations,
a β‐blocker and an ACE inhibitor was the combination of choice for both physician
categories. Patients managed by the FPs were more likely to receive a β‐blocker–CCB
combination (17.4 vs. 14.9%) or a diuretic–ACE inhibitor combination
(16.7 vs. 11.4%) and less likely to receive a β‐blocker–diuretic
combination (11.8 vs. 16.7%) than those managed by the GPs. The proportion
of patients receiving antihypertensive combinations was 40.6 and 38.5% for
FPs and GPs, respectively. While the GPs prescribed CCB as a monotherapy to the elderly
most often, the FPs choice was a β‐blocker. Diuretics were less preferred by
both FPs and GPs. β‐Blocker–ACE inhibitor was again the most preferred
combination of both FPs and GPs. FPs prescribed CCB–β‐blocker combinations
more often than GPs (P = 0.01), whereas CCB–ACE inhibitor combinations
were less preferred (P = 0.09). A trend towards excessive use of short‐acting
nifedipine as monotherapy for elderly patients, both by FPs and by GPs, was noticed.
Glibenclamide, alone or in combination with metformin, was the foremost antidiabetic
drug prescribed by FPs and GPs. Middle‐aged (45–64 years) patients seen by
GPs were more likely to receive glibenclamide than those treated by FPs (P
= 0.001) and less likely to receive gliclazide (P = 0.01). Combinations of a β‐blocker with either glibenclamide or insulin were prescribed considerably more often by GPs. Conclusions Within the same practice setting, a substantial difference was observed between FPs and GPs in terms of preference for different classes of drugs in the management of diabetic hypertension. The compliance of both FPs and GPs was suboptimal; overall, the compliance of the FPs was closer to the recommended guidelines, however. Educational programmes should specifically address these inadequacies in order to improve the quality of health care.
Impact of group structure and process on multidisciplinary evidence‐based guideline development: an observational study
Authors: Pagliari Claudia , Grimshaw Jeremy 
Published: March 2003

AbstractRationale, aims and objectives This paper presents selected results from
a study investigating the impact of small group processes on the development of clinical
practice guidelines by multidisciplinary panels. Observations of one panel developing
a guideline for primary care over several months are reported here. Methods Non‐participant
observation with content analy‐sis of transcripts aided by field notes. Results Bales’s
interaction process analysis was used to categorize interactions in terms of their
task‐oriented or socioemotional qualities. This revealed a well‐functioning, task‐oriented
group characterized by predominantly positive social behaviours. However, a breakdown
of dialogue by speaker indicated a marked effect of professional role and status
on the level of contribution to group discussions. This, and marked changes in panel
composition across meetings, has implications for the multidisciplinarity of decision‐making
in such groups and hence for the acceptance and implementation of their outputs.
Conclusions These findings are likely to generalize to other health care settings in view of the growing emphasis on multidisciplinary decision‐making and the clear status hierarchies inherent within the medical and allied fields.
On the buzzword approach to policy formation
Authors: Loughlin Michael 
Published: March 2003

AbstractThis article draws attention to an absurd feature of contemporary political life that significantly affects health service policy and calls for an urgent explanation. Policies are formed by a process that privileges rhetoric over reality, producing policies that are ‘operationalized’ first and only ‘conceptualized’ at a later date. Two influential articles on clinical governance illustrate this phenomenon perfectly. Lack of clarity about its true meaning and nature is a key feature of clinical governance. The lack of clarity allows policy‐makers to shift responsibility for the problems of the health service onto the workforce, who are required to interpret the deliberately vague and platitudinous statements of management in order to implement the policy. But management, through the creation of monitoring agencies, reserves the right to determine whether the policy has been correctly interpreted, thus retaining power without responsibility. Government and senior management have abandoned the communicative function of language, eschewing reasoned debate (as characterized by the use of evidence and structured argument), instead employing language exclusively for the purposes of control and manipulation. Those of us still concerned that the future of our essential services should be determined by open and reasonable debate need to discuss urgently how to explain and respond to this appalling situation.
In vitro inhibition of epithelial cell invasion by Aeromonashydrophila Vibrio species by fish Aeromonas hydrophila major adhesin
Authors: Fang  , Ling  , Tan  , Ge  , Sin  
Published: March 2003

AbstractA virulent strain of Aeromonas hydrophila (PPD 134/91) was obtained from the Primary Production Department, Singapore. Its major adhesin was isolated and purified by potassium thiocyanate extraction and Bio‐Gel P‐100 gel filtration. The ability of the protein in peak 1, termed major adhesin, to inhibit bacteria from adhering to and invading host cells was studied in vitro using epithelioma papillosum cells of carp (EPC). Results showed that a concentration of 10 μg ml–1 of this major adhesin could competitively inhibit 28% of A. hydrophila PPD 134/91 from invading EPC cells in vitro. When the concentration was increased to 40 μg ml–1, the major adhesin significantly cross‐inhibited nine other virulent or weakly virulent strains of A. hydrophila. In addition, the major adhesin significantly inhibited not only another bacterial strain from the same family, Aeromonas sobria, but also strains of Vibrio spp. tested. Therefore, we suggest that the major adhesin of this virulent A. hydrophila strain has the potential to be used as a vaccine against the heterogeneous Aeromonas and Vibrio species.
Analysis of exotoxins produced by atypical isolates of Aeromonas salmonicida, by enzymatic and serological methods
Authors: Gudmundsdóttir B K , Hvanndal Í , Björnsdóttir B , Wagner U 
Published: March 2003

AbstractIn this study, exotoxins produced by 62 Aeromonas salmonicida strains and the bacterium Haemophilus piscium were analysed. Enzymatic assays, zymograms and serological detection were used to monitor secretion by bacterial strains of the previously described exotoxins P1, GCAT and AsaP1 and also the extracellular P2 metallo‐gelatinase and a serine caseinase, which is different from the P1 protease and has not yet been characterized. Based on the results, the strains were divided into five groups. One comprised the type strains for A. salmonicida ssp. masoucida, H. piscium and 36% of the atypical isolates, and another, a type strain for A. salmonicida ssp. smithia together with 14% of the atypical isolates. A second type strain of A. salmonicida ssp. smithia was grouped with 8% of the atypical isolates. The largest group contained the type strains for A. salmonicida ssp. achromogenes and 38% of the atypical isolates. The type strains for A. salmonicida ssp. salmonicida were in the last group with all the four typical strains and 4% of the atypical isolates. The combination of zymogram and serological detection used is recommended as the most reliable method for characterizing A. salmonicida strains according to their exotoxin secretion.