Showing papers by "Flinders University published in 2000"

A quantitative analysis of fishing impacts on shelf-sea benthos

Abstract: 1. The effects of towed bottom-fishing gear on benthic communities is the subject of heated debate, but the generality of trawl effects with respect to gear and habitat types is poorly understood. To address this deficiency we undertook a meta-analysis of 39 published fishing impact studies. 2. Our analysis shows that inter-tidal dredging and scallop dredging have the greatest initial effects on benthic biota, while trawling has less effect. Fauna in stable gravel, mud and biogenic habitats are more adversely affected than those in less consolidated coarse sediments. 3. Recovery rate appears most rapid in these less physically stable habitats, which are generally inhabited by more opportunistic species. However, defined areas that are fished in excess of three times per year (as occurs in parts of the North Sea and Georges Bank) are likely to be maintained in a permanently altered state. 4. We conclude that intuition about how fishing ought to affect benthic communities is generally supported, but that there are substantial gaps in the available data, which urgently need to be filled. In particular, data on impacts and recovery of epifaunal structure-forming benthic communities are badly needed.

Endemic Melioidosis in Tropical Northern Australia: A 10-Year Prospective Study and Review of the Literature

Abstract: In a prospective study of melioidosis in northern Australia, 252 cases were found over 10 years. Of these, 46% were bacteremic, and 49 (19%) patients died. Despite administration of ceftazidime or carbapenems, mortality was 86% (43 of 50 patients) among those with septic shock. Pneumonia accounted for 127 presentations (50%) and genitourinary infections for 37 (15%), with 35 men (18%) having prostatic abscesses. Other presentations included skin abscesses (32 patients; 13%), osteomyelitis and/or septic arthritis (9; 4%), soft tissue abscesses (10; 4%), and encephalomyelitis (10; 4%). Risk factors included diabetes (37%), excessive alcohol intake (39%), chronic lung disease (27%), chronic renal disease (10%), and consumption of kava (8%). Only 1 death occurred among the 51 patients (20%) with no risk factors (relative risk, 0.08; 95% confidence interval, 0.01-0.58). Intensive therapy with ceftazidime or carbapenems, followed by at least 3 months of eradication therapy with trimethoprim-sulfamethoxazole, was associated with decreased mortality. Strategies are needed to decrease the high mortality with melioidosis septic shock. Preliminary data on granulocyte colony-stimulating factor therapy are very encouraging.

"Guess what I just heard!": Indirect aggression among teenage girls in Australia

Abstract: Traditionally males have been regarded as the more aggressive sex. However, recent research in several countries has challenged this notion by considering different forms of aggression. This paper provides an overview of a qualitative investigation of teenage girls' indirect forms of aggression (e.g,, exclusion from the group, spreading false stories), Focus groups and pair and individual interviews were used to collect data from adolescent girls and their teachers in two schools. The study provides some clear insights into the nature of teenage girls' indirect aggression. The predominant indirectly aggressive behaviors include talking about others and excluding peers from the group. Key explanations for these behaviors concern a desire to create excitement and a range of friendship and group processes centered on girls' needs for close personal relationships and to be a part of the peer group. The girls described the devastating effects of indirect aggression, particularly on girls with certain characteristics that predispose them to victimization. The girls were pessimistic about the potential of interventions, although peer mediation processes may be a way forward.

Neuroepithelial bodies of pulmonary airways serve as a reservoir of progenitor cells capable of epithelial regeneration.

Abstract: Remodeling of the conducting airway epithelium is a common finding in the chronically injured lung and has been associated with increased risk for developing lung cancer. Pulmonary neuroendocrine cells and clusters of these cells termed neuroepithelial bodies (NEBs) play a central role in each of these processes. We previously developed an adult mouse model of airway injury and repair in which epithelial regeneration after naphthalene-induced Clara cell ablation occurred preferentially at airway branch points and gave rise to nascent Clara cells. Continued repair was accompanied by NEB hyperplasia. We now provide the following evidence that the NEB microenvironment serves as a source of airway progenitor cells that contribute to focal regeneration of the airway epithelium: 1) nascent Clara cells and NEBs localize to the same spatial domain; 2) within NEB, both Clara cell secretory protein- and calcitonin gene-related peptide-immunopositive cells are proliferative; 3) the NEB microenvironment of both the steady-state and repairing lung includes cells that are dually immunopositive for Clara cell secretory protein and calcitonin gene-related peptide, which were previously identified only within the embryonic lung; and 4) NEBs harbor variant Clara cells deficient in cytochrome P450 2F2-immunoreactive protein. These data suggest that the NEB microenvironment is a reservoir of pollutant-resistant progenitor cells responsive to depletion of an abundant airway progenitor such as the Clara cell.

Terpinen-4-ol, the main component of the essential oil of Melaleuca alternifolia (tea tree oil), suppresses inflammatory mediator production by activated human monocytes.

Abstract: Objective and Design: To evaluate potential anti-inflammatory properties of tea tree oil, the essential oil steam distilled from the Australian native plant, Melaleuca alternifolia.¶Material and Methods: The ability of tea tree oil to reduce the production in vitro of tumour necrosis factor-α (TNFα), interleukin (IL)-1β, IL-8, IL-10 and prostaglandin E2 (PGE2) by lipopolysaccharide (LPS)-activated human peripheral blood monocytes was examined.¶Results: Tea tree oil emulsified by sonication in a glass tube into culture medium containing 10% fetal calf serum (FCS) was toxic for monocytes at a concentration of 0.016% v/v. However, the water soluble components of tea tree oil at concentrations equivalent to 0.125% significantly suppressed LPS-induced production of TNFα, IL-1β and IL-10 (by approximately 50%) and PGE2 (by approximately 30%) after 40 h. Gas chromatography/ mass spectrometry identified terpinen-4-ol (42%), α-terpineol (3%) and 1,8-cineole (2%, respectively, of tea tree oil) as the water soluble components of tea tree oil. When these components were examined individually, only terpinen-4-ol suppressed the production after 40 h of TNFα, IL-1β, IL-8, IL-10 and PGE2 by LPS-activated monocytes. Conclusion: The water-soluble components of tea tree oil can suppress pro-inflammatory mediator production by activated human monocytes.

Anatomy and physiology of the enteric nervous system.

Abstract: The enteric nervous system (ENS) is a quasi autonomous part of the nervous system and includes a number of neural circuits that control motor functions, local blood flow, mucosal transport and secretions, and modulates immune and endocrine functions. Although these functions operate in concert and are functionally interlinked, it is useful to consider the neural circuits involved in each separately.1 This short summary will concentrate mainly on the neural circuits involved in motor control.2 The enteric neural circuits are composed of enteric neurones arranged in networks of enteric ganglia connected by interganglionic strands. Most enteric neurones involved in motor functions are located in the myenteric plexus with some primary afferent neurones located in the submucous plexus. As in all nervous systems involved in sensory-motor control, the ENS comprises primary afferent neurones, sensitive to chemical and mechanical stimuli, interneurones and motorneurones that act on the different effector cells including smooth muscle, pacemaker cells, blood vessels, mucosal glands, and epithelia, and the distributed system of intestinal cells involved in immune responses and endocrine and paracrine functions. The digestive tract is unique among internal organs because it is exposed to a large variety of physicochemical stimuli from the external world in the form of ingested food. As a consequence, the intestine has developed a rich repertoire of coordinated movements of its muscular apparatus to ensure the appropriate mixing and propulsion of contents during digestion, absorption, and excretion. The oro-aboral transit of the intestinal contents can be regarded as a form of adaptive locomotion that occurs over a wide range of spatial and temporal domains.3 The movements of the intestine are the result of interaction of the neural apparatus and the muscular apparatus.4 The muscular apparatus is organised in muscle layers made up of large collections of smooth muscle cells …

Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters

Abstract: Purpose To evaluate the effect of the location of the corneoscleral tunnel incision as well as preoperative and intraoperative parameters on total and localized endothelial cell loss Setting Department of Ophthalmology, Humboldt-University of Berlin, Berlin, Germany Methods Fifty consecutive patients scheduled for routine cataract surgery were selected prospectively for this clinical trial Preoperatively, the axial length, anterior chamber depth, lens thickness, and astigmatism were measured Phacoemulsification time and relative energy as well as total surgical time were recorded With a specular microscope, endothelial cell counts were determined centrally, superiorly, and temporally preoperatively and 6 weeks and 6 and 12 months postoperatively Results After 12 months, the mean overall central endothelial cell loss in all eyes was 85% The mean endothelial cell loss was 119% in the lateral quadrant and 114% in the superior quadrant There were no significant differences between superior and temporal surgical approaches in intraoperative parameters of phacoemulsification time, relative intensity of phacoemulsification, and surgical time There were no significant differences in central endothelial cell loss or in the area localized in the quadrant of the positions of the corneal surgical site The only risk factors found significant for higher endothelial cell loss were shorter axial length and longer phacoemulsification time Conclusions The location of corneoscleral incisions for phacoemulsification can be chosen according to the preoperative astigmatism without inducing additional adverse effects on the corneal endothelium Shorter eyes have a significantly higher risk for greater endothelial cell loss

Ocean circulation off east Antarctica affects ecosystem structure and sea-ice extent

Abstract: Sea ice and oceanic boundaries have a dominant effect in structuring Antarctic marine ecosystems. Satellite imagery and historical data have identified the southern boundary of the Antarctic Circumpolar Current as a site of enhanced biological productivity. Meso-scale surveys off the Antarctic peninsula have related the abundances of Antarctic krill (Euphausia superba) and salps (Salpa thompsoni) to inter-annual variations in sea-ice extent. Here we have examined the ecosystem structure and oceanography spanning 3,500 km of the east Antarctic coastline, linking the scales of local surveys and global observations. Between 80 degrees and 150 degrees E there is a threefold variation in the extent of annual sea-ice cover, enabling us to examine the regional effects of sea ice and ocean circulation on biological productivity. Phytoplankton, primary productivity, Antarctic krill, whales and seabirds were concentrated where winter sea-ice extent is maximal, whereas salps were located where the sea-ice extent is minimal. We found enhanced biological activity south of the southern boundary of the Antarctic Circumpolar Current rather than in association with it. We propose that along this coastline ocean circulation determines both the sea-ice conditions and the level of biological productivity at all trophic levels.

The Effect of Exercise on Body Satisfaction and Self-Esteem as a Function of Gender and Age.

Abstract: The study investigated the relationship between amount of exercise and psychological well-being in a broadly based sample. A questionnaire assessing amount of exercise, reasons for exercise, body satisfaction, and self-esteem was completed by 252 participants between the ages of 16 and 60 years. Almost all participants (>95%) were White. Participants were divided into four groups on the basis of gender and age, resulting in 70 young women, 48 young men, 73 mature women, and 61 mature men. Significant negative relationships between amount of exercise and body satisfaction and self-esteem were found for young women, and positive relationships for the remainder of the sample. Women exercised more for reasons of weight control, tone, and mood enhancement than men. For the whole sample, the first two of these reasons were associated with lower body satisfaction, while exercising for health and fitness reasons was associated with increased self-esteem. It was concluded that reasons for exercising did not provide an adequate explanation for the obtained difference in correlations across gender and age.

Patient-oriented learning: a review of the role of the patient in the education of medical students

Abstract: Aim To explore the contribution patients can make to medical education from both theoretical and empirical perspectives, to describe a framework for reviewing and monitoring patient involvement in specific educational situations and to generate suggestions for further research. Methods Literature review. Results Direct contact with patients can be seen to play a crucial role in the development of clinical reasoning, communication skills, professional attitudes and empathy. It also motivates through promoting relevance and providing context. Few studies have explored this area, including effects on the patients themselves, although there are examples of good practice in promoting more active participation. Conclusion The Cambridge framework is a tool for evaluating the involvement of patients in the educational process, which could be used by curriculum planners and teachers to review and monitor the extent to which patients are actively involved. Areas for further research include looking at the ‘added value’ of using real, as opposed to simulated, patients; more work on outcomes for patients (other than satisfaction); the role of real patients in assessment; and the strengths and weaknesses of different models of patient involvement.

Globalization's Cultural Consequences

Abstract: Globalization has been associated with a range of cultural consequences. These can be analyzed in terms of three major theses, namely, homogenization, polarization, and hybridization. The homogenization thesis proclaims that global culture is becoming standardized around a Western or American pattern. While some evidence supports this view, the presence of cultural alternatives and resistance to Western norms suggests that polarization provides a more convincing picture of global cultural development. Global interconnection and interdependence do not necessarily mean cultural conformity. Culture, it seems, is harder to standardize than economic organization and technology. Yet the idea of polarization has its limits, too. The hybridization thesis argues that cultures borrow and incorporate elements from each other, creating hybrid, or syncretic, forms. Evidence to support this view comes mainly from popular music and religious life. The cultural consequences of globalization are therefore diverse and complex.

Endogenous BDNF is required for myelination and regeneration of injured sciatic nerve in rodents.

Abstract: Following a peripheral nerve injury, brain-derived neurotrophic factor (BDNF) and the p75 neurotrophin receptor are upregulated in Schwann cells of the Wallerian degenerating nerves. However, it is not known whether the endogenous BDNF is critical for the functions of Schwann cells and regeneration of injured nerve. Treatment with BDNF antibody was shown to retard the length of the regenerated nerve from injury site by 24%. Histological and ultrastructural examination showed that the number and density of myelinated axons in the distal side of the lesion in the antibody-treated mice was reduced by 83%. In the BDNF antibody-treated animals, there were only distorted and disorganized myelinated fibres in the injured nerve where abnormal Schwann cells and phagocytes were present. As a result of nerve degeneration in BDNF antibody-treated animals, subcellular organelles, such as mitochondria, disappeared or were disorganized and the laminal layers of the myelin sheath were loosened, separated or collapsed. Our in situ hybridization revealed that BDNF mRNA was expressed in Schwann cells in the distal segment of lesioned nerve and in the denervated muscle fibres. These results indicate that Schwann cells and muscle fibres may contribute to the sources of BDNF during regeneration and that the deprivation of endogenous BDNF results in an impairment in regeneration and myelination of regenerating axons. It is concluded that endogenous BDNF is required for peripheral nerve regeneration and remyelination after injury.

Home or Hospital for Stroke Rehabilitation? Results of a Randomized Controlled Trial: I: Health Outcomes at 6 Months

Abstract: Background and Purpose—We wished to examine the effectiveness of an early hospital discharge and home-based rehabilitation scheme for patients with acute stroke. Methods—This was a randomized, controlled trial comparing early hospital discharge and home-based rehabilitation with usual inpatient rehabilitation and follow-up care. The trial was carried out in 2 affiliated teaching hospitals in Adelaide, South Australia. Participants were 86 patients with acute stroke (mean age, 75 years) who were admitted to hospital and required rehabilitation. Forty-two patients received early hospital discharge and home-based rehabilitation (median duration, 5 weeks), and 44 patients continued with conventional rehabilitation care after randomization. The primary end point was self-reported general health status (SF-36) at 6 months after randomization. A variety of secondary outcome measures were also assessed. Results—Overall, clinical outcomes for patients did not differ significantly between the groups at 6 months aft...

Melioidosis: acute and chronic disease, relapse and re-activation

Abstract: In melioidosis-endemic regions the importance of re-activation of Burkholderia pseudomallei from latent foci remains unclear. This topic was assessed in a 10-year prospective study (1989-99) of melioidosis in the tropical north of the Northern Territory of Australia, together with other aspects of the nature of melioidosis. Incubation period from defined inoculating events was previously ascertained as 1-21 (mean 9) days. Of 252 total cases 244 (97%) were considered to be from recent acquisition of B. pseudomallei infection and 8 (3%) were considered to be re-activation from a latent focus. Acute illness occurred in 222 (88%) cases; 30 (12%) cases had chronic illness (symptomatic for > 2 months). Of the 207 patients surviving the initial illness, 27 (13%) had a confirmed relapse (mean time from initial diagnosis of 8 months), with 5 relapsing twice. Of these 32 relapses, 15 (3 fatal) were associated with poor adherence to the eradication therapy antibiotics and 10 (none fatal) were failures of eradication with doxycycline monotherapy. Following initial intensive therapy with ceftazidime or meropenem for at least 14 days, eradication therapy with trimethoprim-sulphamethoxazole monotherapy for at least 3 months had been more successful.

Genetic polymorphism of UDP-glucuronosyltransferase 2B7 (UGT2B7) at amino acid 268: ethnic diversity of alleles and potential clinical significance.

Abstract: UGT2B7 catalyses the glucuronidation of a diverse range of drugs, environmental chemicals and endogenous compounds. Hence, coding region polymorphisms of UGT2B7 are potentially of pharmacological, toxicological and physiological significance. Two variant UGT2B7 cDNAs encoding enzymes with either His

Inhibitory effects of muscarinic receptor autoantibodies on parasympathetic neurotransmission in Sjögren's syndrome

Abstract: Objective Sjogren's syndrome (SS) is an autoimmune disorder characterized by dry eyes and mouth (sicca syndrome) and lymphocytic infiltration of the lacrimal and salivary glands. Abnormalities of parasympathetic neurotransmission may contribute to the glandular dysfunction. In this study, we used a functional assay to investigate autoantibody-mediated effects on parasympathetic neurotransmission and smooth muscle contraction. Methods Serum and purified IgG were obtained from patients with primary and secondary SS and from control subjects. Contraction of isolated bladder strips in response to stimulation of M3-muscarinic receptors by a muscarinic receptor agonist, carbachol, or by endogenous acetylcholine released from postganglionic parasympathetic nerves was measured before and after the addition of patient serum or IgG. Results Sera from 5 of 9 patients with primary SS and from 6 of 6 patients with secondary SS inhibited carbachol-evoked bladder contraction by ∼50%. Sera from these patients also inhibited the action of neuronally released acetylcholine at M3-muscarinic receptors. Sera from 7 of 8 healthy individuals, from patients with rheumatoid arthritis without sicca symptoms, and from patients with systemic lupus erythematosus had no effect. The anti–muscarinic receptor activity was localized in the IgG fraction, since purified IgG from patients with SS also inhibited agonist- and nerve-evoked contractions. In this preliminary study, the autoantibodies seemed to be associated with the presence of bladder symptoms and other autonomic features. Conclusion Autoantibodies that act as antagonists at M3-muscarinic receptors on smooth muscle occur in a subset of patients with primary and secondary SS. Their presence in secondary SS was unexpected and provides new evidence for a common pathogenetic link between primary and secondary SS. These autoantibodies appear to contribute to sicca symptoms and may explain associated features of autonomic dysfunction in some patients.

Skin infections and infestations in Aboriginal communities in northern Australia

Abstract: The most important skin infections in Aboriginal communities in central and northern Australia are scabies and streptococcal pyoderma. Scabies is endemic in many remote Aboriginal communities, with prevalences in children up to 50%. The cycles of scabies transmission underlie much of the pyoderma. Up to 70% of children have skin sores, with group A streptococcus (GAS) the major pathogen. Group A streptococcus is responsible for the continuing outbreaks of post-streptococcal glomerulonephritis and acute rheumatic fever (ARF). The cycles of scabies transmission in dogs and humans do not appear to significantly overlap. Guidelines have been developed for community control of scabies and skin sores and successful community initiated coordinated programmes have occurred. The anthropophilic dermatophyte Trichophyton rubrum is ubiquitous in many communities, again reflecting living conditions. Other skin infections related to the tropical environment include melioidosis, nocardiosis, Chromobacterium violaceum and chromoblastomycosis. Sustainable and long-term improvements in scabies, skin sores and GAS-related disease and tinea require fundamental changes that address social and economic inequities and, in particular, living conditions and overcrowding.

Epidemiology of participation: an Australian community study

Abstract: STUDY OBJECTIVE To determine the levels of participation in social and civic community life in a metropolitan region, and to assess differential levels of participation according to demographic, socioeonomic and health status. To contribute to policy debates on community participation, social capital and health using these empirical data. DESIGN Cross sectional, postal, self completed survey on health and participation. SETTING Random sample of the population from the western suburbs of Adelaide, the capital city of South Australia, a population of approximately 210 000. PARTICIPANTS 2542 respondents from a sample of 4000 people aged 18 years and over who were registered on the electoral roll. MAIN RESULTS The response rate to the survey was 63.6% (n=2542). Six indices of participation, on range of social and civic activities, with a number of items in each, were created. Levels of participation were highest in the informal social activities index (46.7–83.7% for individual items), and lowest in the index of civic activities of a collective nature (2.4–5.9% for individual items). Low levels of involvement in social and civic activities were reported more frequently by people of low income and low education levels. CONCLUSIONS Levels of participation in social and civic community life in an urban setting are significantly influenced by individual socioeconomic status, health and other demographic characteristics. An understanding of the pattern of participation is important to inform social and health policy making. Increasing levels of participation will reduce social exclusion and is likely to improve the overall quality of community life.

The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice.

Abstract: Introduction In an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. This program is called the Parallel Rural Community Curriculum (PRCC). This paper is a discussion of the aims of the programme; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learnt from the evaluation of the first cohort of students’ experience of the course. Methods Independent external evaluators undertook a thematic analysis of a series of structured interviews of students and faculty involved in both the PRCC and the traditional curriculum. The mean examination results were determined and a rank order comparison of student academic performance was undertaken. Results The eight selected volunteer students reported greater access to patients and clinical learning opportunities than their mainstream counterparts and learned clinical decision making in the context of the whole patient, their family, and the available community resources. They identified patients with ‘core’ clinical conditions and had a longitudinal exposure to common diseases, whereas hospital-based peers had a cross-sectional exposure to highly filtered illness. The PRCC students’ academic performance improved in comparison with that of their tertiary hospital peers’ and in comparison to their own results in previous years. Conclusion The PRCC curriculum has cut across the traditional clinical discipline boundaries by teaching in an integrated way in rural general practice. It has affirmed the potential role of true generalist physicians in undergraduate medical education.

Measurement of Executive Function: Considerations for Detecting Adult Age Differences

Abstract: This review considers the validity and suitability of neuropsychological and other tests of executive function for the detection of adult age differences in executive function. Executive function is typically assessed using tests which have been found to be sensitive to frontal lobe dysfunction because theory links executive function with the frontal lobes. However, any age-related decline in executive function is expected to be mild, or sub-clinical, compared to the deficits shown among those with frontal lesions. Therefore, in order to detect the type of mild executive dysfunction expected among older adults we need to employ tests sensitive enough to detect any age-related deficit, yet which are not too stressful or tiring for older adults to perform. This review discusses some commonly used neuropsychological tests of executive function as well as tests devised to assess theoretical aspects of executive function. Indications are given throughout as to which tests appear to be most suitable for detecting age differences in executive function.

A Critical Appraisal of the Role of Dietary Long-Chain Polyunsaturated Fatty Acids on Neural Indices of Term Infants: A Randomized, Controlled Trial

Abstract: Objective. To determine whether dietary long-chain polyunsaturated fatty acids (LCPUFA), such as docosahexaenoic acid (DHA) and arachidonic acid, affect visual evoked potential (VEP) acuity of formula-fed infants, relative to breastfed infants. A secondary objective was to assess the effect of LCPUFA on Bayley9s mental developmental index (MDI) and psychomotor developmental index (PDI). Methods. Formula-fed infants were randomly allocated, in a double-blind manner, to either a placebo (no LCPUFA;n = 21), DHA supplemented (n = 23), or DHA+arachidonic acid supplemented formula (n = 24). Infants were fed their assigned formula from the first week of life until 1 year of age. A parallel reference group of breastfed infants was recruited and followed (n = 46). Infant VEP acuity was assessed at 16 and 34 weeks, and Bayley9s MDI and PDI were assessed at 1 and 2 years of age. Results. There were no differences among the randomized formula groups for VEP acuity at either 16 or 34 weeks of age. Breastfed infants had better VEP acuity at 34 weeks of age, but not at 16 weeks, compared with all formula-fed infants. Bayley9s MDI and PDI were similar in the 3 formula-fed groups at 1 and 2 years. Breastfed infants had higher MDI scores than formula-fed infants at 2 years of age even after adjusting for environmental variables. Conclusions. LCPUFA supplementation did not influence VEP acuity development in these well-nourished, formula-fed infants.

Transduction Sites of Vagal Mechanoreceptors in the Guinea Pig Esophagus

Abstract: Extrinsic afferent neurons play an essential role in both sensation and reflex control of visceral organs, but their specialized morphological peripheral endings have never been functionally identified. Extracellular recordings were made from fine nerve trunks running between the vagus nerve and esophagus of the guinea pig. Mechanoreceptors, which responded to esophageal distension, fired spontaneously, had low thresholds to circumferential stretch, and were slowly adapting. Calibrated von Frey hairs (0.12 mN) were used to probe the serosal surface at 100–200 sites, which were mapped on a video image of the live preparation. Each stretch-sensitive unit had one to three highly localized receptive fields (“hot spots”), which were marked with Indian ink applied on the tip of the von Frey hair. Recorded nerve trunks were then filled anterogradely, using biotinamide in an artificial intracellular solution. Receptive fields were consistently associated with intraganglionic laminar endings (IGLEs) in myenteric ganglia, but not with other filled neuronal structures. The average distance of receptive fields to IGLEs was 73 ± 14 μm (24 receptive fields, from 12 units; n = 5), compared to 374 ± 17 μm for 240 randomly generated sites ( n = 5; p < 0.001). After maintained probing on a single receptive field, spontaneous discharge of units was inhibited, as were responses to distension. During adapted discharge to maintained distension, interspike intervals were distributed in a narrow range. This indicates that multiple receptive fields interact to encode mechanical distortion in a graded manner. IGLEs are specialized transduction sites of mechanosensitive vagal afferent neurons in the guinea pig esophagus.

Home or hospital for stroke Rehabilitation? Results of a randomized controlled trial : II: cost minimization analysis at 6 months.

Abstract: Background and Purpose —The goal of the present study was to examine the resource and economic implications of an early hospital discharge and home-based rehabilitation scheme for patients with acute stroke. Methods —A cost minimization analysis in conjunction with a randomized controlled trial was carried out at 2 affiliated teaching hospitals in the southern metropolitan region of Adelaide, South Australia, between 1997 and 1998. Eighty-six hospitalized patients with acute stroke who required rehabilitation were randomized to receive both early hospital discharge and home-based rehabilitation, or conventional in-hospital rehabilitation and community care. Direct and indirect costs related to stroke rehabilitation were calculated, including hospital bed days, home-based intervention program, community services, and personal expenses during the 6 months after randomization. Results —The mean cost per patient was lower for patients randomized to the early hospital discharge and home-based rehabilitation ($8040) compared with those who received conventional care ($10 054). This cost saving was not statistically significant ( P =0.14). However, sensitivity analyses indicated that the cost of home-based rehabilitation was consistently lower than that of conventional care except when hospital costs were assumed to be 50% less than those used in the main analysis. Multiple regression analysis demonstrated that the cost of the home-based program was significantly related to a patient’s level of disability after adjustment for age, comorbidity, and the presence or absence of a caregiver. Conclusions —The early hospital discharge and home-based rehabilitation scheme was less costly than conventional hospital care for patients with stroke. Limitation of the provision of such services to patients with mild disability is likely to be most cost effective.

Negative Stereotyping of Obesity in Children: The Role of Controllability Beliefs

Abstract: This study investigated the extent of negative stereotyping of obesity (compared to negative stereotyping of height) in children and its relationship with the perception of obesity as controllable. Questionnaires measuring negative stereotyping and controllability beliefs about weight (and height) were completed by 96 children from Grades 4 to 6. Consistent negative stereotyping of obesity was found for both child and adult targets, regardless of the child's own gender, age, or weight, Likewise, children uniformly believed obesity to be largely under volitional control. The degree of controllability assigned to obesity was positively correlated with the extent of negative stereotyping. It was concluded that control beliefs may provide a vehicle for changing the strong negative attitudes displayed toward fat people.