bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of structural characteristics between old‐growth and postfire second‐growth hemlock–hardwood forests in Adirondack Park, New York, U. S. A.
Authors: Ziegler Susy Svatek 
Published: March 2003

Abstract1 This study compares the structural characteristics of 12 old‐growth and six postfire second‐growth hemlock–northern hardwood stands in north central Adirondack Park, New York, in order to test the null hypothesis that there are no differences in species composition, size structure, age structure and attributes such as dead wood and canopy gaps between old‐growth stands and this type of second‐growth forest.2 The second‐growth forests of this study regenerated following widespread logging‐related fires in either 1903 or 1908; the old growth and second growth have similar environmental settings.3 Estimates of stand ages, derived from an increment core of the oldest tree in each stand, range from 88 to 390 years.4 Structural attributes are related to stand age (i.e. stage of development). In comparison with the second‐growth forests of this study, older stands are characterized as (a) a larger average diameter of canopy trees; (b) a greater basal area of trees; (c) a lower density of canopy trees and of all trees ≥ 10 cm d.b.h.; (d) a higher density of eastern hemlock (Tsuga canadensis(L.) Carrière) trees; (e) a higher density of large trees (≥ 50 cm d.b.h.); (f) larger canopy gaps; and (g) a greater volume of coarse woody debris (both logs ≥ 20 cm d.b.h. and snags ≥ 10 cm d.b.h.).5 Despite differences between old growth and second growth, especially in species composition, it appears from observations of the 18 stands that second‐growth forests are developing some structural characteristics of old growth.6 Structural attributes of the old‐growth forests are similar to characteristics of the same forest type in geographically distant areas in eastern USA.
Bird species numbers in an archipelago of reeds at Lake Velence, Hungary
Authors: Báldi András , Kisbenedek Tibor 
Published: March 2003

Abstract1 Bird species numbers were studied on 109 reed islands at Lake Velence, Hungary, in the 1993 and 1994 breeding seasons. The aim was to describe and account for the abundance and distribution patterns of the bird species.2 It was expected that an exponential model would fit the calculated species–area curves. However, for the 1993 data, both the power function (LogS ~ LogArea) and the exponential (S ~ LogArea) models did so, while the power function, exponential and linear (S ~ A) models fitted the curves for the 1994 data.3 The results showed that the pattern was not random: a collection of small islands held more species than a few large islands with the same total area.4 The relative species richness of small islands is a result of the preference of most common passerine bird species for the edges of reed islands. Most individuals were found in the first 5 m of the reedbed, and no edge avoidance was detected on a local spatial scale. Large, rarer species (e.g. Great White Egret), however, were found to be dependent on large reed islands.5 Comparison of results with two other studies on bird communities of reed islands revealed that the type of landscape matrix (e.g. deep water, shallow water or agricultural lands) among reed patches significantly influences bird communities. Deep water was dominated by grebes and coot, shallow water by reed‐nesting passerines, and farmed areas by reed‐ and bush‐nesting passerines.
Endemism in the Australian flora
Authors: Crisp M. D. , Laffan S. , Linder H. P. , Monro A. 
Published: March 2003

AimTo detect centres of vascular plant endemism at a continental scale by analysis of specimen‐based distributional data and to relate any pattern to environmental factors and history.LocationAustralia.MethodsPresence of 8468 seed plant species‐level taxa throughout continental Australia and Tasmania was mapped on a 1° grid to visualize the pattern of species richness. This sample comprises half the known flora. Three indices of endemism were calculated but we preferred one that is unrelated to species richness, so that these two concepts could be distinguished in practice. Centres of endemism were detected by simple mapping and by spatial autocorrelation analysis (SAC). Linear regression was used to examine the relationship of the patterns of species richness and endemism to latitude, topography and climate.ResultsBoth species richness and endemism vary greatly across the continent but in most cases the same centres were high in both richness and endemism. Twelve distinct centres were identified. The major centres of both diversity and endemism are south‐west western Australia, the Border Ranges between New South Wales and Queensland, the Wet Tropics near Cairns, Tasmania and the Iron‐McIlwraith Range of eastern Cape York Peninsula. The last centre appears to be more significant than recognized by past authors. Whether this is a true Australian centre of endemism, or is largely an outlier of the flora of Papua New Guinea, is explored. Another centre, in the Adelaide–Kangaroo Island region, has been overlooked altogether by previous authors. Regression analysis did not find a simple climatic explanation of the observed patterns. There was a suggestion that topographic variation within the 1° cells may be positively correlated with endemism, which is consistent with mountainous regions functioning as refugia. One clear result is that all the major centres of endemism are near‐coastal. A likely explanation is that Pleistocene expansions of the central desert have been a powerful limitation on the viability of refugia for narrowly endemic species. All the centres of endemism lie outside the estimated limits of the expanded arid zone at the last glacial maximum (18,000 yr BP). In particular, the ‘Central Australian Mountain Ranges centre of plant diversity and endemism’ ofBoden & Given (1995)is detected as a strong centre of species richness, but not at all as a centre of endemism. This is despite good sampling of this region.Main conclusionsEndemism can be distinguished from species richness by using an appropriate index and mapping of such indices can detect centres of endemism. This study demonstrates the value of specimen based distributional data, such as is held in state herbaria and museums.
High incidence of adverse reactions to egg challenge on first known exposure in young atopic dermatitis children: predictive value of skin prick test and radioallergosorbent test to egg proteins
Authors: Monti G. , Muratore M. C. , Peltran A. , Bonfante G. , Silvestro L. , Oggero R. , Mussa G. C. 
Published: March 2003

SummaryBackground Egg skin prick test (SPT) and/or radioallergosorbent test (RAST) positivity has been described in infants and children with a food allergy, or in infants at high risk of atopy who have never eaten eggs. Clinical reactions are also observed when some of these children or infants eat eggs for the first time.Objective and method A prospective study was made of 107 atopic dermatitis (AD) children (66 boys, 41 girls) aged 1–19 months (median 5 months) who had never ingested egg, to compare the outcome of a first oral egg challenge and the results of albumen and yolk SPTs and RASTs.Results The egg challenge (conducted at age 12–24 months: mean 16 months, median 15 months) was positive in 72/107 children (67.3%). The reactions were immediate or early (first 6 h) in 56/72 (77.8%). The most severe (all within the first 6 h) were one case of anaphylactic shock (1.4%), three cases of laryngeal oedema (4.1%) and one serious attack of asthma (1.4%). The skin weal diameter at and above which reactions always occurred was 5 mm for both albumen and yolk. They were, however, also observed in the complete absence of a weal. The outcome of the challenge was always positive when the specific IgEs (sIgE) for albumen and yolk were > 99 KU/L and ≥ 17.5 KU/L, respectively. Here, too, reactions were noted even when sIgE levels were < 0.35 KU/L.Conclusion AD children who have never eaten eggs may be sensitized and display reactions at the first ingestion. The percentage of reactions in this series was by no means negligible. These findings were observed in children with mild as well as moderate–severe AD when first examined. SPT for albumen and yolk diameter ≥ 5 mm, and sIgE for albumen > 99 KU/L and for yolk ≥ 17.5 KU/L were 100% specific in predicting the outcome of the challenge. It may thus be concluded that children with AD whose SPT and/or RAST for albumen and/or yolk are equal to or higher than these cut‐off values should not be subjected to the oral challenge when consideration is given to the introduction of egg in their diet. Even when these cut‐offs are not reached, however, clinical reactions to the challenge cannot be ruled out a priori, and it should be preferably performed in a protected environment, such as a hospital.
Allergy after ingestion or inhalation of cereals involves similar allergens in different ages
Authors: Armentia A. , Rodríguez R. , Callejo A. , Martín‐Esteban M. , Martín‐Santos J.‐M. , Salcedo G. , Pascual C. , Sánchez‐Monge R. , Pardo M. 
Published: March 2003

SummaryBackground Cereals are among the major foods that account for food hypersensitivity reactions. Salt‐soluble proteins appear to be the most important allergens contributing to the asthmatic response. In contrast, very limited information is available regarding cereal allergens responsible for allergic reactions after ingestion of cereal proteins.Objective The aim of this study was to evaluate the allergenic reactivity of ingested and inhaled cereal allergens in different ages, in order to investigate if the response to different allergens would depend on the sensitization route.Methods We included 66 patients in three groups. Group 1: 40 children aged 3 to 6 months who suffered from diarrhoea, vomiting, eczema or weight loss after the introduction of cereal formula in their diet and in which a possibility of coeliac disease was discarded. Group 2: 18 adults with food allergy due to cereals tested by prick tests, specific IgE and food challenge. Group 3: eight patients previously diagnosed as having baker's asthma. Sera pool samples were collected from each group of patients and IgE immunoblotting was performed.Results We found an important sensitization to cereal in the 40 children. The most important allergens were wheat followed by barley and rye. Among the adults with cereal allergy, sensitization to other allergens was common, especially to Lolium perenne (rye grass) pollen. Immunoblotting showed similar allergenic detection in the three groups.Conclusion Clinically significant reactivity to cereal may be observed in early life. Inhalation and ingestion routes causing cereal allergy seem to involve similar allergens. The diet control was more effective in children. The possibility of cereal allergy after the introduction of cereal formula during the lactation period should not be underestimated.
Prevalence and severity of allergic rhinitis in house dust mite‐allergic patients with bronchial asthma or atopic dermatitis
Authors: Terreehorst I. , Oosting A. J. , Tempels‐Pavlica Z. , De Monchy J. G. R. , Bruijnzeel‐Koomen C. A. F. M. , Hak E. , Van Wijk R. Gerth 
Published: March 2003

SummaryBackground Allergic rhinitis, asthma and atopic dermatitis are closely associated. Although population‐based studies report a high prevalence of rhinitis among asthma patients, less is known of the association between rhinitis and atopic dermatitis and the severity of concomitant rhinitis.Objectives We aimed to determine the prevalence and severity of allergic rhinitis among asthmatics and patients with atopic dermatitis and assessed whether age and comorbidity influence the severity of rhinitis signs and symptoms.Methods Three hundred and twenty‐five patients recruited for a multicentre trial to study the effect of encasings of mattresses, pillows and duvets on signs and symptoms of allergic rhinitis and/or asthma and/or atopic dermatitis recorded visual analogue scores (VAS) and daily symptom scores and underwent nasal challenge tests with house dust mite (HDM).Results Based on history and clinical symptoms 92% of the 164 asthmatic patients and 85% of the 86 patients with atopic dermatitis could be diagnosed as having rhinitis. Inclusion of a positive provocation to HDM did not result in a substantial lower prevalence of rhinitis. Subjects reported moderate symptoms, with mean rhinitis VAS scores ranging from 40.0 to 55.0. Presence of atopic dermatitis was associated with lower rhinitis VAS and symptoms scores, whereas in multivariate analysis the presence of asthma was positively associated with nasal responsiveness to HDM.Conclusion The prevalence of nasal symptoms in patients with bronchial asthma or atopic dermatitis and sensitized to house dust mites is high. Although the majority of patients experience mild to moderate symptoms, the presence of nasal disease needs to be examined in all patients with atopic disorders.
What can patients do to improve health care?
Authors: Wensing Michel , Grol Richard 
Published: March 2003

ObjectiveTo give an overview of the value of different interventions for increasing the role of individual patients in improving the quality of care provision.Search strategyMedline searches and manual searches in medical journals covering the period from 1980 until June 1997.Inclusion criteriaStudies reporting descriptions and evaluations of seven types of interventions that aim to help integrate the needs and preferences of individual patients into health care provision.Data extractionThe following information was extracted: assumptions underlying the interventions; resources needed for development and implementation; and acceptability to clinicians.Main resultsSeveral interventions for increasing patients' roles in health care could be successful in clinical practice, such as feeding forward patient data to clinicians, interactive patient education and feedback to health care providers about patients' evaluations of care. The available research focuses on feedback methods. Insights into the benefits and limitations of the use of the different interventions for improving care are limited.ConclusionThe active role that patients' views play in the contact with a care provider is often neglected. Promising interventions for the empowerment of individual patients require further development and evaluation.
The effects of an `explicit' values clarification exercise in a woman's decision aid regarding postmenopausal hormone therapy
Authors: O'Connor Annette M. , Wells George A. , Tugwell Peter , Laupacis Andreas , Elmslie Tom , Drake Elizabeth 
Published: March 2003

Objective To evaluate the incremental effect of a graphic weigh‐scale values clarification exercise to explicitly consider the personal importance of the benefits versus the risks in a woman's decision aid regarding postmenopausal hormone therapy.Design Randomized controlled trial.Intervention Decision aid including information on options, benefits and risks, and their probabilities either followed by: (1) a graphic weigh‐scale values clarification exercise to explicitly consider the personal importance of each benefit and risk; or (2) a summary of the main benefits and risks to implicitly consider benefits versus the risks.Sample Two‐hundred and one women aged 50–69 years from Ottawa, Canada, who had never used hormone therapy.Outcome Perceived clarity of values, a sub‐scale of the decisional conflict scale; congruence between personal values of benefits and risks (measured on 0–10 importance rating scale) and choices (accept, decline, unsure regarding preventive hormone therapy [HRT]) using discriminant function analysis.Results There were no statistically significant differences between interventions in perceived clarity of values and overall congruence between values and choices. Amongst those choosing HRT, there was a trend in those exposed to the graphic weigh‐scale exercise to have better congruence between values and choices compared to implicit values clarification (P = 0.06).Conclusion The use of the graphic weigh‐scale exercise in a decision aid conveys no overall short‐term benefit. Further study is needed to specifically determine effects in those changing the status quo and on the quality of patient‐practitioner communication and persistence with decisions.
Developing consumer‐led maternity services: a survey of women’s views in a local healthcare setting
Authors: Emslie Margaret J. , Campbell Marion K. , Walker Kim A. , Robertson Susan , Campbell Anne 
Published: March 2003

Objective This paper describes a prospective study of women’s views and experiences of maternity services. The aim was to examine the way women make choices and decisions about maternity care and the factors which influence decision making, with a view to developing services which best meet the needs of the population. Patient choice issues reviewed included: choice of place of birth, choice of lead professional and choices in labour management. Design, setting and participants A cohort of women attending maternity booking clinics, within the catchment area of Peterhead Maternity Unit (PMU) in north‐east Scotland, were surveyed by means of postal questionnaires at three stages during their contact with maternity services. A subset of women also took part in in‐depth interviews. Results Not all women were given information about all the available options for place of birth and many women were unclear of the differences between them. Factors influencing choice of place of birth can change, with the medical aspects of maternity care becoming more important as the pregnancy progresses. Women rated the importance of seeing the same staff at antenatal visits highly, but were less concerned with their ability to choose which professional to see. More importance was attached to being able to choose a particular midwife rather than a particular obstetrician. Women’s choices with regard to labour management were largely met. Insufficient information, however, was provided about choices in pain relief. Conclusions The survey revealed the importance of locally based research, involving all stakeholders, in developing services which best meet the needs of a population.
Citizens’ expectations and likely use of a NHS Walk‐in Centre: results of a survey and qualitative methods of research
Authors: Chapple Alison , Sibbald Bonnie , Rogers Anne , Roland Martin 
Published: March 2003

Objectives To find out which groups of people would use a National Health Service walk‐in centre that would offer mainly health care advice, staffed by nurses. To understand the circumstances in which people would use a walk‐in centre and to ascertain to what extent it would meet patients’ expressed health‐care needs. Design A postal survey of 2400 people plus 27 semi‐structured interviews and one focus group. Setting and participants The study was conducted in Wakefield, Yorkshire UK, and included both white and ethnic minority groups. Results Most people reported that they would use a walk‐in centre. It would be more attractive to young as compared with older people, ethnic minority as compared with white people, people who are dissatisfied with access to NHS services and people with urgent health‐care problems. People want a wide range of services, including diagnosis, treatment, prevention, and general information. People also want access to both doctors and nurses, to male as well as female practitioners, to counsellors and interpreters. The type of service planned for this walk‐in centre will meet some of the expressed needs. However, patients’ expectations of the walk‐in centre exceed planned provision in a number of key respects. Conclusion Walk‐in centres without GPs and with limited services will disappoint the public. It is important that walk‐in centres are evaluated and attention paid to ‘local voices’ before additional money is allocated for such centres elsewhere.
A measure of informed choice
Authors: Marteau Theresa M. , Dormandy Elizabeth , Michie Susan 
Published: March 2003

Objective To develop a measure of informed choice.Conceptualization and measurement The measure is based on the following definition of an informed choice: one that is based on relevant knowledge, consistent with the decision‐maker’s values and behaviourally implemented. The measure comprises an eight‐item scale of knowledge, a four‐item scale assessing attitudes towards undergoing the screening test and a record of test uptake.Participants Sixty‐six women awaiting their first antenatal clinic appointments.Measure development In women offered a screening test in pregnancy, the internal reliability of both the knowledge and the attitude scales was acceptable (alpha coefficients 0.82 and 0.83, respectively). Of the 42 women completing both scales, 18 were classified as having made an informed choice, and 24 were classified as having made an uninformed choice.Conclusion The results of this preliminary study provide some evidence to support the feasibility of conceptualizing and measuring informed choices regarding screening using a brief measure assessing knowledge and attitudes. The validity and utility of this approach awaits further studies, involving larger numbers of participants, offered different screening tests.
Using disease risk estimates to guide risk factor interventions: field test of a patient workbook for self‐assessing coronary risk
Authors: Paterson J. Michael , Llewellyn‐Thomas Hilary A. , Naylor C. David 
Published: March 2003

Objective To assess the feasibility and acceptability of a patient workbook for self‐assessing coronary risk. Design Pilot study, with post‐study physician and patient interviews. Setting and subjects Twenty southern Ontario family doctors and 40 patients for whom they would have used the workbook under normal practice conditions. Interventions The study involved convening two sequential groups of family physicians: the first (n=10) attended focus group meetings to help develop the workbook (using algorithms from the Framingham Heart Study); the second (n=20) used the workbook in practice with 40 patients. Follow‐up interviews were by interviewer‐administered questionnaire. Main outcome measures Physicians' and patients' opinions of the workbook's format, content, helpfulness, feasibility, and potential for broad application, as well as patients' perceived 10‐year risk of a coronary event measured before and after using the workbook. Results It took an average of 18 minutes of physician time to use the workbook: roughly 7 minutes to introduce it to patients, and about 11 minutes to discuss the results. Assessments of the workbook were generally favourable. Most patients were able to complete it on their own (78%), felt they had learned something (80%) and were willing to recommend it to someone else (98%). Similarly, 19 of 20 physicians found it helpful and would use it in practice with an average of 18% of their patients (range: 1–80%). The workbook helped to correct misperceptions patients had about their personal risk of a coronary event over the next 10 years (pre‐workbook (mean (SD) %): 35.2 (16.9) vs. post‐workbook: 17.3 (13.5), P < 0.0001; estimate according to algorithm: 10.6 (7.6)). Conclusions Given a simple tool, patients can and will assess their own risk of CHD. Such tools could help inform otherwise healthy individuals that their risk is increased, allowing them to make more informed decisions about their behaviours and treatment.