bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONGESTIVE CARDIAC FAILURE: URBAN AND RURAL PERSPECTIVES IN VICTORIA
Authors: Ansari Mohammad Z. , Henderson Toni , Ackland Michael , Cicuttini Flavia , Sundararajan Vijaya 
Published: January 2004

ABSTRACTObjective:  Effective and timely care for congestive cardiac failure (CCF) should reduce the risks of hospitalisation. The purpose of this study is to describe variations in rates of hospital admissions for CCF in Victoria as an indicator of the adequacy of primary care services. Detailed analyses identify trends in hospitalisations, urban/rural differentials and variations by the Primary Care Partnerships (PCP). Setting:  Acute care hospitals in Victoria. Design:  Routine analyses of age and sex standardised admission rates of CCF in Victoria using the Victorian Admitted Episodes Dataset from 1993–1994 to 2000–2001. Subjects:  All patients admitted to acute care hospitals in Victoria with the principal diagnosis of CCF between 1993–1994 and 2000–2001. Results:  There were 8359 admissions for CCF in Victoria with an average of 7.37 bed days in 2000–2001. There was a significantly higher admission rate for CCF in rural areas compared to metropolitan in 2000/2001 –(2.53/1000 (2.44–2.62) and 1.80/1000 (1.75–1.85)) – respectively. Small area analyses identified 17 PCP (14 of which were rural) with significantly higher admission rate ratios of CCF compared to Victoria. Conclusion:  Small area analyses of CCF have identified significant gaps in the management of CCF in the community. This may be a reflection of deficit in primary care availability, accessibility, or appropriateness. Detailed studies may be needed to determine the relative importance of these factors in Victoria for targeting specific interventions at the PCP level. What does this study add?:  Congestive cardiac failure is a major public health problem. In Australia, there is a lack of studies identifying long‐term hospitalisation trends of CCF, as well as small area analyses, especially in regard to rural and urban variations. This study has identified significant variations over an eight year period in admission rates of CCF in rural and urban Victoria. Small area analyses (e.g. at the level of primary care partnerships) have identified rural communities with significantly higher admission rates of CCF compared to the Victorian average. For the first time in Australia, this study has provided a new approach for generating evidence on quality of primary care services in rural and urban areas, and offers opportunities for targeting public health and health services interventions that can decrease access barriers, improve the adequacy of primary care, and reduce demand on the hospital system in Victoria.
TAKING PRIMARY CARE CONTINUING PROFESSIONAL EDUCATION TO RURAL AREAS: LESSONS FROM THE UNITED ARAB EMIRATES
Authors: Revel Tony , Yussuf Hussein 
Published: January 2004

ABSTRACTObjective:  To assess the impact of a practice based multidisciplinary educational program. Design:  A descriptive account of experiences in introducing a new program of continuing professional development. Setting:  Rural primary health care centres in the United Arab Emirates. Subjects:  All staff working in the rural health centres. Results:  The educational intervention proved popular and appeared to effect a behavioural change. Teamwork in the health centres showed a marked improvement. Conclusion:  A practice‐based, multidisciplinary educational program using case‐based learning proved to be effective when introduced to rural health centres of a developing country with multiracial health care professionals. What is already known?:  Academic detailing and case‐based learning have proven to be some of the more effective methods of continuing professional development when used in a Western culture. The same principles of education proved effective when delivering practice based education to multi‐racial, multi‐disciplinary staff in a developing country. The benefits of the program were seen to extend beyond the educational components.
RURAL DOCTORS AND RURAL BACKGROUNDS: HOW STRONG IS THE EVIDENCE? A SYSTEMATIC REVIEW
Authors: Laven Gillian , Wilkinson David 
Published: January 2004

ABSTRACTObjective:  We sought to summarise the evidence for an association between rural background and rural practice by systematically reviewing the national and international published reports. Design:  A systematic review. Setting:  A search of the national and international published reports from 1973 to October 2001. Subject:  The search criteria included observational studies of a case‐control or cohort design making a clear and quantitative comparison between current rural and urban doctors, this resulted in the identification of 141 studies for potential inclusion. Results:  We systematically reviewed 12 studies. Rural background was associated with rural practice in 10 of the 12 studies, in which it was reported, with most odds ratios (OR) approximately 2–2.5. Rural schooling was associated with rural practice in all 5 studies that reported on it, with most OR approximately 2.0. Having a rural partner was associated with rural practice in 3 of the 4 studies reporting on it, with OR approximately 3.0. Rural undergraduate training was associated with rural practice in 4 of 5 studies, with most OR approximately 2.0. Rural postgraduate training was associated with rural practice in 1 of 2 studies, with rural doctors reporting rural training about 2.5 times more often. Conclusions:  There is consistent evidence that the likelihood of working in rural practice is approximately twice greater among doctors with a rural background. There is a smaller body of evidence in support of the other rural factors studied, and the strength of association is similar to that for rural background. What is already known on this subject?:  It is widely perceived that doctors with a rural background are more likely to return to work in rural areas and major policy initiatives in Australia rely on this assumption. It is recognised that other factors such as location of primary and secondary education, rural medical training and spouse or partner background may also be influential. In order to determine the strength of the evidence for an association between rural background and rural practice we did a systematic review of the published reports. What does this study add?:   This systematic review provides good evidence that doctors with a rural background are about twice as likely to work as rural doctors, compared with those with an urban background. Rural background seems to be an important factor that can be employed in policy and practice, however, the problem of increasing the number of rural doctors is multifactorial and so is the solution.
ROLE OF MULTI‐PURPOSE SERVICE PROGRAMS PROVIDING RESIDENTIAL AGED CARE IN RURAL AUSTRALIA: A DISCUSSION PAPER
Authors: Neumayer Bob , Chapman Janet , Whiteford Gail 
Published: January 2004

ABSTRACTObjective:  To determine if multi‐purpose service (MPS) Programs deliver improved residential aged care as opposed to traditional rural hospitals. Design:  A variation on comparative–experimentalist: type 4. In this design 2 groups providing different service models of rural health services are compared. Setting:  Six MPS Programs and three traditional hospitals in rural New South Wales. Subjects:  Key stakeholders – area representatives, health service managers, MPS managers, doctors, staff, MPS or hospital committee members and consumer groups including residents. Main outcome measure:  To analyse the ability of MPS Programs to deliver quality residential aged care as opposed to using traditional hospitals for such services. Results:  Multi‐purpose service programs provided better residential environments and greater flexibility of service provision. There were few apparent differences between the two service models in regard to organisational culture and training. Conclusions:  The findings of this evaluation suggest that in the provision of residential aged care in rural communities, MPS Programs demonstrated better standards of care than traditional hospital based services. What is already known on the subject:  The development of multi‐purpose service programs to replace the older traditional rural hospitals is a relatively new practice in Australia. With the introduction of MPS programs there has been little evaluative research to demonstrate their effectiveness in health service delivery and the provision of residential aged care. Multi‐purpose service programs aim to integrate and coordinate acute, aged and community rural health services under one structure and so it is imperative that evaluative studies such as this one takes place. What does this study add?:  The findings of this study demonstrate that the MPS model provides a better solution than hospitals to the problem of providing residential aged care in rural communities. With Australia looking to further develop MPS Programs in rural areas, it is hoped quality aged care services will be enhanced allowing older adults to remain in the communities of their choice.
FARM‐RELATED INJURY PRESENTING TO AN AUSTRALIAN BASE HOSPITAL
Authors: Franklin Richard C. , Davies John N. 
Published: January 2004

ABSTRACTObjective:  Data concerning farm‐related injuries were collected from the Emergency Department at Tamworth Base Hospital over a 12‐month period from 1 September 1997. Aim of study:  The aim of the study was to collect information at a local level to establish baselines with a view to developing prevention strategies. All people who presented with a farm injury or illness to the emergency department participated in the study. Results:  During this period there were 384 injuries, of which nearly three‐quarters were males (72.2%). Four injuries were fatal. The average rate of injury per 100 farms per annum in the service area of the Hospital was 30 per 100 farms (range 9–80 per 100 farms, per annum). Half (54.1%) of the people injured were employed at the time of the injury. Horses (21.1%) and motorcycles (15.8%) were the two most common injury agents. Conclusion:  The information gained can be used to direct injury prevention at a local level and may be also used at the national level as a guide when grouped with other similar studies of different commodity groups.
CAPP2: A RANDOMIZED CONTROLLED TRIAL (RCT) OF ASPIRIN & RESISTANT STARCH IN HEREDITARY NON POLYPOSIS COLORECTAL CANCER
Authors: Macrae F , Ives P , Leggett B , Scott R , Burn J 
Published: January 2004

There is consistent level III evidence for aspirin in the chemoprevention of colorectal cancer, but no RCT proof. Animal, in vitro and ecological studies suggest protection with Resistant Starch (RS). HNPCC gene carriers have 50–80% lifetime risk of developing colorectal cancer, and on Finnish experience a 5% per annum incidence of adenomas at colonoscopic surveillance. CAPP2 is a RCT of aspirin and/or RS in 1200 phenotypically or genotypically affected members of families with HNPCC, over a 4‐year period, giving 90% probability of detecting a 50% reduction in adenomas at P < 0.05 significance.Recruitment from 27 centres operating worldwide is 391 subjects (at 24/04/01) with Australia contributing 41. Three hundredand twenty‐one subjects are on treatment and 68 have withdrawn from the trial. Recruitment has been principally through familial cancer clinics in association with DNA Diagnostic Laboratories in VIC, QLD and more recently NSW. Recruitment in VIC is enhanced by a population‐based study of mismatch repair gene carriers identified through a study of colorectal cancer presenting under 45 years. Ethical pathways enabling the participation in CAPP2 through registries of HNPCC families in sites remote from the CAPP2 centre in Melbourne have been established in Australia.Reported side‐effects have been weight gain, flatulence and mild to acute constipation. One patient has withdrawn due to bleeding peptic disease in Europe. Overall, compliance to the RS prescription has been good worldwide. Only four Australian participants have found the starch difficult and have withdrawn. No strokes have been reported.Preliminary analysis of the colonoscopy findings in gene carriers who have previously been on annual surveillance has identified an unexpectedly high rate of adenomas at their entry colonoscopy. This information on findings on surveillance in HNPCC may allow a downward estimate of the sample size required for the study.Experience to date confirms the feasibility of this multicentre international RCT. Australian centres managing families with HNPCC are invited to contact the trial centre in Melbourne.
AMELIORATION OF MURINE TNBS COLITIS USING PREBIOTICS
Authors: Amansec SG , Connor SJ , Cardillo R , Cuan N , Grimm MC , Conway P 
Published: January 2004

An understanding of the pathogenesis of inflammatory bowel disease has been enhanced by the development of animal models mimicking these diseases. In one such model, chronic transmural intestinal inflammation is induced in mice by rectal administration of 2,4,6 trinitrobenzenesulfonic acid (TNBS). A T helper (Th)1 T‐cell response predominates, immunologically similar to Crohn's disease. This well‐characterised model offers potential for analysing novel therapies, including those that modulate the intestinal flora. Prebiotics are nondigestible foods such as resistant starches that benefit the host by selectively stimulating growth of ‘beneficial’ bacteria in the colon. They act as powerful substrates for bacterial fermentation and inhibit the growth of a number of pathogens. This study aimed to develop and characterise the TNBS model of colitis, and to use it to analyse the prophylactic effects of prebiotics.Specific pathogen‐free 8‐week‐old‐male BALB/c mice were administered 2.5 mg TNBS in 45% ethanol per rectum. Mice were fed a resistant starch diet (30% Culture‐Pro 958 N), or control diet, for 2 weeks prior to induction of colitis through to sacrifice. Mice were monitored daily for hydration status, stress, diarrhoea and weight loss and sacrificed on days 5, 7, 9, and 14. The colons were assessed macroscopically and histologically (grade 0–6). Stool counts of the putative ‘beneficial’ bacterial groups, lactobacilli and bifidobacteria, were performed on days 3, 7 and 14.In the control group, all mice developed diarrhoea and significant weight loss. Transmural colonic inflammation was seen, with thickening, hyperaemia and ulceration macroscopically and histological scores of grade 5–6. Weight loss was significantly reduced in mice fed 30% Culture‐Pro 958 N (P < 0.05). Lactobacilli and bifidobacteria were significantly more prevalent in the stools of resistant starch‐fed mice (P < 0.005). Histological scores at day 7 were reduced from grade 5 in control diet mice, to grade 1–2 in resistant starch‐fed mice.This study provides the novel observation that the clinical and histological severity of TNBS colitis is ameliorated by prophylactic use of prebiotics, in the form of a resistant starch diet. These findings confirm the importance of the bacterial flora to development of colonic inflammation in this mouse model of IBD and they offer insights into pathogenesis of human Crohn's disease. The results highlight promise for the potential use of similar non‐toxic therapies in human Crohn's disease.
ANTIBODIES TO SACCHAROMYCES CEREVISIAE and ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES IN INFLAMMATORY BOWEL DISEASE: ASSESSMENT and RELEVANCE IN AN AUSTRALIAN POPULATION USING TWO DIFFERENT ASCA ASSAY KITS
Authors: Moore MM , Fabricatorian D , Selby WS , Morrow AW 
Published: January 2004

A number of North American and European studies have elucidated a relationship between antibodies to the yeast Saccharomyces cerevisiae (ASCA) and Crohn's disease (CD).Aims  (1) To ascertain whether this relationship is relevant to Australian patients; (2) To compare the results with two different commercial ASCA kits; (3) To examine the usefulness of this test in combination with perinuclear antineutrophil cytoplasmic autoantibodies (pANCA) for distinguishing Crohn's disease from ulcerative colitis (UC).Methods  Serum samples were obtained from 28 patients with CD, 27 patients with UC and 22 non‐IBD patients presenting for investigation of other gastroenterological illnesses. ASCA IgG and IgA were determined by enzyme immunoassay using the two test kits. pANCA was detected by indirect immunofluorescence.Results  Using the Medizym test kit, the presence of either IgG or IgA ASCA was 50% sensitive and 93% specific for CD. The QUANTA Lite kit yielded a higher sensitivity of 79% but specificity of 74%. The sensitivity of pANCA for UC was 48% but was 100% specific. Used in combination, ASCA+ve/pANCA–ve was only 50% sensitive but 100% specific for CD using the Medizym kit compared with 79% sensitivity and 93% specificity using QUANTA Lite. The combination of ASCA–ve/pANCA+ve was 41% sensitive and 100% specific for ulcerative colitis using the Medizym kit compared with 30% sensitive and 100% specific using QUANTA Lite.Conclusions  At least 50% of Australian patients with CD have ASCA detectable in serum, confirming the results of overseas studies. Sensitivity was greater with the QUANTA Lite kit whereas the Medizym kit was slightly more specific. ASCA may aid in the diagnosis of CD. When used in combination with pANCA it may also help distinguish CD from UC in difficult cases.
A longitudinal study of gender‐related cognition and behaviour
Authors: Campbell Anne , Shirley Louisa , Candy Julia 
Published: January 2004

Abstract Gender schema theory proposes that children's acquisition of gender labels and gender stereotypes informs gender‐congruent behaviour. Most previous studies have been cross‐sectional and do not address the temporal relationship between knowledge and behaviour. We report the results of a longitudinal study of gender knowledge and sex‐typed behaviour across three domains in children tested at 24 and 36 months (N = 56). Although both knowledge and sex‐typed behaviour increased significantly between 2 and 3 years, there was no systematic pattern of cross‐lagged correlations between the two, although some concurrent relationships were present at 24 months. Future longitudinal work might profitably focus on younger children using reliable pre‐verbal measures of gender knowledge and employing a shorter lag between measurement times.
The Rise of Experimentalism in German Collective Bargaining
Authors: Behrens Martin , Jacoby Wade 
Published: January 2004

AbstractThis paper addresses the debate on union strategies by analysing industrial relations change in three of Germany's most internationalized sectors: chemicals, metalworking and construction. It characterizes two logics of change in German industrial relations: a battlefield logic and an experimentalist logic. It demonstrates historical trends towards centralization of wage bargaining in each sector before looking at recent pressures for decentralization and flexibility. In chemi‐cals, the social partners control decentralization. In metalworking increasing flexibility is characterized by a mismatch between the national‐level union and the district‐level employers. Finally, the construction union seeks to replace the centralized bargaining system with a state minimum wage.
Political Myth and Germany 1945–1949
Authors: Flanagan Clare 
Published: January 2004

AbstractPolitical scientists point to a shift in myth reception after 1945. This is most vividly reflected in the German context. In the years of the Allied occupation, the necessary exposure of Third Reich political mythology coincided with the introduction into German debate of the mythmaking of the Cold War. The result was a uniquely diverse collection of narratives of political elucidation, historical explanation and propaganda. All the various categories for classification as myth are demonstrated: myths of the self, of the other, myths of the nation, the state, leadership, myths of past, present or future determination. And subsequent general theories of political myth as broadly defined forms of community identification, as unifying historical messages, or as expressions of past or planned aggression, are similarly illustrated. Also significantly validated in this context is the affinity of myth theory and theology. This article confirms the usefulness of myth analysis in assessing responses to value structures, delimiting political control, and refining our awareness of the constituents of political ‘reality’; yet it also exposes the inadequacy, in the political domain, of any one definition of myth theory, and highlights our ongoing complicity in political mythmaking, specifically in the case of Germany.
What about the workers? The expansion of higher education and the transformation of academic work
Authors: Bryson Colin 
Published: January 2004

ABSTRACTThis article assesses the impact of the profound changes that have taken place in the higher education sector on academic staff in the UK. The perceptions of staff about their work and employment are examined through evidence provided by a recent large‐scale survey. The discussion draws on a labour process perspective. The article finds that the views of staff are far from homogeneous and not universally pessimistic. However, in general the morale and satisfaction of many teaching staff have been eroded by work intensification and that of research staff by the considerable insecurity created by casualised employment. Nonetheless resistance and resilience continues despite the commodifying pressures, and ‘traditional’ values remain strong.
Value‐Enhancing Capital Budgeting and Firm‐specific Stock Return Variation
Authors: Durnev Art , Morck Randall , Yeung Bernard 
Published: January 2004

ABSTRACTWe document a robust cross‐sectional positive association across industries between a measure of the economic efficiency of corporate investment and the magnitude of firm‐specific variation in stock returns. This finding is interesting for two reasons, neither of which is a priori obvious. First, it adds further support to the view that firm‐specific return variation gauges the extent to which information about the firm is quickly and accurately reflected in share prices. Second, it can be interpreted as evidence that more informative stock prices facilitate more efficient corporate investment.
The Statistical and Economic Role of Jumps in Continuous‐Time Interest Rate Models
Authors: Johannes Michael 
Published: January 2004

ABSTRACTThis paper analyzes the role of jumps in continuous‐time short rate models. I first develop a test to detect jump‐induced misspecification and, using Treasury bill rates, find evidence for the presence of jumps. Second, I specify and estimate a nonparametric jump‐diffusion model. Results indicate that jumps play an important statistical role. Estimates of jump times and sizes indicate that unexpected news about the macroeconomy generates the jumps. Finally, I investigate the pricing implications of jumps. Jumps generally have a minor impact on yields, but they are important for pricing interest rate options.