Short-beaked common dolphins Delphinus delphis in the eastern North Atlantic (ENA) are subject to mortality due to entanglement in various types of fishing gear. However, for this region, there is no ...population-level information available on trends in abundance, (incidental) mortality rates or even the actual distributional range. Working under the assumption that only 1 population exists in ENA waters, the current study presents basic life history data and investigates whether biological information obtained from postmortem data is, in itself, useful for managing this population. Life history parameters were estimated by analysing postmortem data obtained over a 16 yr period by UK, Irish, French, Galician (northwest Spain) and Portuguese stranding and bycatch observer programmes. An annual pregnancy rate of 26%, a calving interval of 3.79 yr, an average age attained at sexual maturity of 8.22 yr and an average length at sexual maturity of 188 cm were determined. With respect to the findings based solely on mortality data, significance testing failed to detect differences that could be construed as evidence of the population exhibiting what might be density-dependent compensatory responses. The low annual pregnancy rate reported throughout the sampling period may suggest either that the level of anthropogenic mortality did not cause a substantial population level decline, or a prey base declining at approximately the same rate as the dolphin population. However, this approach alone does not facilitate an assessment of the current state of the D. delphis population in the ENA. Population abundance estimates, trends in abundance and knowledge of factors that affect the dynamics of the population, such as annual mortality rates in fisheries, temporal variations in prey abundance and effects of contaminants on reproductive activity, are required not only to set management objectives, but also to give context to cross-sectional life history information.
Management continuity is especially important in chronic or complex clinical diseases that require management from several providers who could potentially work at cross purposes. Continuity is ...achieved when services are delivered in a complementary and timely manner. Shared management plans or care protocols facilitate management continuity, providing a sense of predictability and security in future care for both patients and providers.
Rationale: There is a need for a brief, validated patient self-report instrument to assess the extent to which patients with chronic illness receive care that aligns with the Chronic Care ...Model-measuring care that is patient-centered, proactive, planned and includes collaborative goal setting; problem-solving and follow-up support. Sample: A total of 283 adults reporting one or more chronic illness from a large integrated health care delivery system were studied. Methods: Participants completed the 20-item Patient Assessment of Chronic Illness Care (PACIC) as well as measures of demographic factors, a patient activation scale, and subscales from a primary care assessment instrument so that we could evaluate measurement performance, construct, and concurrent validity of the PACIC. Results: The PACIC consists of 5 scales and an overall summary score, each having good internal consistency for brief scales. As predicted, the PACIC was only slightly correlated with age and gender, and unrelated to education. Contrary to prediction, it was only slightly correlated (r = 0.13) with number of chronic conditions. The PACIC demonstrated moderate test-retest reliability (r = 0.58 during the course of 3 months) and was correlated moderately, as predicted (r = 0.32-0.60, median = 0.50, P < 0.001) to measures of primary care and patient activation. Discussion: The PACIC appears to be a practical instrument that is reliable and has face, construct, and concurrent validity. The resulting questionnaire is in the public domain, and recommendations for its use in research and quality improvement are outlined.
Research into adverse events (AEs) has highlighted the need to improve patient safety. AEs are unintended injuries or complications resulting in death, disability or prolonged hospital stay that ...arise from health care management. We estimated the incidence of AEs among patients in Canadian acute care hospitals.
We randomly selected 1 teaching, 1 large community and 2 small community hospitals in each of 5 provinces (British Columbia, Alberta, Ontario, Quebec and Nova Scotia) and reviewed a random sample of charts for nonpsychiatric, nonobstetric adult patients in each hospital for the fiscal year 2000. Trained reviewers screened all eligible charts, and physicians reviewed the positively screened charts to identify AEs and determine their preventability.
At least 1 screening criterion was identified in 1527 (40.8%) of 3745 charts. The physician reviewers identified AEs in 255 of the charts. After adjustment for the sampling strategy, the AE rate was 7.5 per 100 hospital admissions (95% confidence interval CI 5.7- 9.3). Among the patients with AEs, events judged to be preventable occurred in 36.9% (95% CI 32.0%-41.8%) and death in 20.8% (95% CI 7.8%-33.8%). Physician reviewers estimated that 1521 additional hospital days were associated with AEs. Although men and women experienced equal rates of AEs, patients who had AEs were significantly older than those who did not (mean age and standard deviation 64.9 16.7 v. 62.0 18.4 years; p = 0.016).
The overall incidence rate of AEs of 7.5% in our study suggests that, of the almost 2.5 million annual hospital admissions in Canada similar to the type studied, about 185 000 are associated with an AE and close to 70 000 of these are potentially preventable.
ABSTRACT
This study investigated the main factors contributing to boron toxicity in plants. Growth was rapidly inhibited by internal B concentrations in the range 1–5 m m across a range of plant ...types that included monocot, dicot and algal species. In contrast, mature cells were able to withstand up to 60 m m B for several days. In wheat, rapid inhibition of root growth occurred if high B was applied to the root tip, but not if high B was applied to mature sections of the root. In leaves, there were gradations in B concentrations that correlated with visible symptoms of toxicity. However, there was no evidence to support the hypothesis that toxicity in leaves is due to osmotic stress induced by the accumulation of B. Analysis of the sensitivity to B of a range of metabolic processes including photosynthesis, respiration and protein synthesis leads to the conclusion that growth is not restricted by effects of B on energy supply and not directly by inhibition of protein synthesis. At higher B concentrations, many cellular activities were found to be partially inhibited and the toxicity to mature tissues was therefore considered not to arise from the disruption of a single process, but from the accumulated retardation of many cellular processes, exacerbated in light by photo‐oxidative stress.
This book examines the role of war in shaping the African state, society, and economy. Richard J. Reid helps students understand different patterns of military organization through Africa's history; ...the evolution of weaponry, tactics, and strategy; and the increasing prevalence of warfare and militarism in African political and economic systems. He traces shifts in the culture and practice of war from the first millennium into the era of the external slave trades, and then into the nineteenth century, when a military revolution unfolded across much of Africa. The repercussions of that revolution, as well as the impact of colonial rule, continue to this day. The frequency of coups d'états and civil war in Africa's recent past is interpreted in terms of the continent's deeper past.
Many plants are known to reduce the toxic effects of high soil boron (B) by reducing uptake of B, but no mechanism for limiting uptake has previously been identified. The B-tolerant cultivar of ...barley (Hordeum vulgare L.), Sahara, was shown to be able to maintain root B concentrations up to 50% lower than in the B-sensitive cultivar, Schooner. This translated into xylem concentrations that were approximately 64% lower and leaf concentrations 73% lower in the tolerant cultivar. In both cultivars, B accumulation was rapid and reached a steady-state concentration in roots within 3 h. In Schooner, this concentration was similar to the external medium, whereas in Sahara, the root concentration was maintained at a lower concentration. For this to occur, B must be actively extruded from the root in Sahara, and this is presumed to be the basis for B tolerance in barley. The extrusion mechanism was inhibited by sodium azide but not by treatment at low temperature. Several anion channel inhibitors were also effective in limiting extrusion, but it was not clear whether they acted directly or via metabolic inhibition. The ability of Sahara to maintain lower root B concentrations was constitutive and occurred across a wide range of B concentrations. This ability was lost at high pH, and both Schooner and Sahara then had similar root B concentrations. A predictive model that is consistent with the empirical results and explains the tolerance mechanism based on the presence of a borate anion efflux transporter in Sahara is presented.
Background Functional status limitations may be associated with both an increased risk of death and a decreased likelihood of influenza vaccination, and so may confound the association of influenza ...vaccination and risk of all cause mortality in seniors. Methods We conducted a nested case–control study of persons ≥65 years of age that included 252 cases who died during an influenza season and 576 age-matched controls. We identified functional limitations by medical record review, and compared the effect of adjustment for those factors with that of adjustment for disease covariates defined by diagnosis codes, using methods reported by previous influenza vaccine effectiveness studies, on the association of influenza vaccination and risk of death. Results Functional limitations, such as requiring assistance for bathing, were highly prevalent in cases, even in the subgroup defined as free of comorbidity by diagnosis code criteria, and were associated with a decreased likelihood of vaccination among controls. Adjustment for functional limitations resulted in an estimate of the relative risk of death in vaccinated persons compared with unvaccinated persons that was closer to the null odds ratio (OR), 0.71; 95% confidence interval (95% CI), 0.47–1.06 than the unadjusted estimate (OR, 0.59; 95% CI, 0.41–0.83). In contrast, adjustment for diagnosis code covariates moved the estimate further from the null (OR, 0.45; 95% CI, 0.30–0.68). Conclusions Functional limitations appear to be important confounders of the association of vaccination and risk of death, while adjustment for diagnosis code covariates did not control for a healthy vaccinee bias. Further research is needed on methods to reduce the influence of bias in observational studies of influenza vaccine effectiveness.
ABSTRACT
Phosphate uptake in the freshwater charophyte plant Chara corallina was found to be strongly dependent on the presence of Na in the external medium. Based on the reciprocal stimulations of ...32Pi uptake by Na and 22Na uptake by Pi, the logical mechanism for Pi uptake appears to be a nNa/Pi symport with a half‐maximal stimulation (Km) for Na of approximately 300 μM and a Km for Pi of approximately 10 μM. Comparison of the stimulations of 32Pi and 22Na influxes at pH 6 gives a stoichiometry of Na : Pi of 5·68. The reduction in Pi influx with increasing pH is consistent with the transported species being the monovalent H2PO4−. In voltage‐clamp experiments, currents elicited by Pi in the presence of Na were equivalent to an influx of positive charge which exceeded the measured influxes of 32P by a factor of 6·26. Intracellular perfusion was used to examine the dependence of Pi influx on ATP and Na. In perfused cells, Pi influx was low when ATP was absent from the internal medium or Na was absent from the external medium. Addition of ATP alone had little effect whereas addition of Na alone increased the 32Pi influx slightly. Addition of both ATP and Na together restored Pi influx to rates comparable to those of intact cells. It is suggested that the ATP is required for membrane hyperpolarization which in turn drives the highly electrogenic flux of Pi with up to 6 Na. However, consideration of the electrochemical potential differences for Na and Pi at pH less than 6 shows that nNa/Pi would not be feasible. It is suggested that at low pH, H+ may substitute for Na.
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