The international Classification of Impairments, Disabilities, and Handicaps (ICIDH): mental health aspects of its use in rehabilitation

This paper summarizes several issues related to the mental health aspects of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) and its use in the field of rehabilitation. Rehabilitation is characterized by multiple interventions, demanding extensive communication and coordination among different care providers. The ICIDH will be useful in the field of rehabilitation by providing a sound framework for consequences of diseases or disorders if clear descriptions and assessment guidelines of the categories are given. The development of dedicated assessment instruments linked to the ICIDH will be useful to many health workers to assess the needs of the patients, to evaluate services and to measure the outcomes of rehabilitation interventions, thus creating a common language for disablements.

On the geometrically exact low-order modelling of a flexible beam: formulation and numerical tests

This paper proposes a low-order geometrically exact flexible beam formulation based on the utilization of generic beam shape functions to approximate distributed kinematic properties of the deformed structure. The proposed nonlinear beam shapes approach is in contrast to the majority of geometrically nonlinear treatments in the literature in which element-based—and hence high-order—discretizations are adopted. The kinematic quantities approximated specifically pertain to shear and extensional gradients as well as local orientation parameters based on an arbitrary set of globally referenced attitude parameters. In developing the dynamic equations of motion, an Euler angle parametrization is selected as it is found to yield fast computational performance. The resulting dynamic formulation is closed using an example shape function set satisfying the single generic kinematic constraint. The formulation is demonstrated via its application to the modelling of a series of static and dynamic test cases of both simple and non-prismatic structures; the simulated results are verified using MSC Nastran and an element-based intrinsic beam formulation. Through these examples, it is shown that the nonlinear beam shapes approach is able to accurately capture the beam behaviour with a very minimal number of system states.

Slip-Shod or Safely Shod: The Bighorn Sheep as a Natural Model for Research

Over a million injuries caused by slipping of footwear are believed to require treatment by doctors every year in the United Kingdom and many domestic animals are injured by slipping. Recent research has revealed that surface roughness of solings and floors is an important determinant of grip on lubricated surfaces and it is also known that soling friction is affected by hardness. The bighorn sheep (Ovis canadensis) an animal species which has adapted to a slippery environment, was studied to elucidate optimum roughness and hardness and other features which influence grip. Four adult ewes were examined in the London Zoo. The cloven hooves of this species are very mobile and the cranial tips of the hooves are the first parts to make contact with the ground. A very small contact area ensures penetration of a film of water. Mean roughness of the contact area was found to be 53 microns Rtm and the mean hardness 63 Shore A. These characteristics appear to facilitate an excellent grip on wet slippery rock but not on smooth ice. Further studies of the feet of wild species could contribute to an understanding of the factors which determine the safety of solings and floors.

In vivo transplantation of fetal human gut-derived enteric neural crest cells

The prospect of using neural cell replacement for the treatment of severe enteric neuropathies has seen significant progress in the last decade. The ability to harvest and transplant enteric neural crest cells (ENCCs) that functionally integrate within recipient intestine has recently been confirmed by in vivo murine studies. Although similar cells can be harvested from human fetal and postnatal gut, no studies have as yet verified their functional viability upon in vivo transplantation. We sought to determine whether ENCCs harvested from human fetal bowel are capable of engraftment and functional integration within recipient intestine following in vivo transplantation into postnatal murine colon. Enteric neural crest cells selected and harvested from fetal human gut using the neurotrophin receptor p75^NTR were lentivirally labeled with either GFP or calcium-sensitive GCaMP and transplanted into the hindgut of Rag2^- /γc^- /C5^- -immunodeficient mice at postnatal day 21. Transplanted intestines were assessed immunohistochemically for engraftment and differentiation of donor cells. Functional viability and integration with host neuromusculature was assessed using calcium imaging. Transplanted human fetal gut-derived ENCC showed engraftment within the recipient postnatal colon in 8/15 mice (53.3%). At 4 weeks posttransplantation, donor cells had spread from the site of transplantation and extended projections over distances of 1.2 ± 0.6 mm (n = 5), and differentiated into enteric nervous system (ENS) appropriate neurons and glia. These cells formed branching networks located with the myenteric plexus. Calcium transients (change in intensity F/F0 = 1.25 ± 0.03; 15 cells) were recorded in transplanted cells upon stimulation of the recipient endogenous ENS demonstrating their viability and establishment of functional connections.

Clinical Significance of Pretransplant Donor-Specific Antibodies in the Setting of Negative Cell-Based Flow Cytometry Crossmatching in Kidney Transplant Recipients

Antibodies to donor-specific HLA antigens (donor-specific antibodies [DSA]) detected by single-antigen bead (SAB) analysis prior to kidney transplant have been associated with inferior graft outcomes. However, studies of pretransplant DSA, specifically in the setting of a negative flow cytometry crossmatch (FCXM) without desensitization therapy, are limited. Six hundred and sixty kidney and kidney-pancreas recipients with a negative pretransplant FCXM from September 2007 to August 2012 without desensitization therapy were analyzed with a median follow-up of 4.2 years. All patients underwent cell-based FCXM and SAB analysis on current and historic sera prior to transplantation. One hundred and sixty-two patients (24.5%) had DSA detected prior to transplant. One-year acute rejection rates were similar in DSA-positive versus DSA-negative patients (15.4% vs. 11.4%, respectively; p = 0.18) and were higher in those with DSA mean fluorescence intensity (MFI) greater than or equal to 3000 in multivariable analysis (p = 0.046). The estimated glomerular filtration rate (eGFR) at 3 and 4 years was lower in the DSA(+) versus the DSA(-) group (p = 0.050 at 3 years) without an impact on 5-year death-censored graft survival (89.0% vs. 90.6%, respectively; p = 0.53). Timing (current or historic) of DSA detection did not alter these findings. In conclusion, pretransplant DSA in the setting of a negative FCXM confers minimal immunologic risk in the intermediate term, does not necessitate desensitization therapy and should not represent a barrier to renal transplant.

APOL1 Polymorphisms in a Deceased Donor and Early Presentation of Collapsing Glomerulopathy and Focal Segmental Glomerulosclerosis in Two Recipients

Two common polymorphisms in APOL1 (G1 and G2) are conserved in persons of African ancestry, and the presence of two polymorphisms (commonly referred to as risk variants) has been identified as a risk factor for chronic kidney disease and focal seg-mental glomerulosclerosis. In kidney transplantation, deceased donors with two APOL1 risk variants carry an increased risk of renal allograft failure in the recipient. An emerging question is whether these data should influence deceased donor assessment or be used to refine prediction of allograft survival. We present the first detailed report of two cases of recipient glomerular disease in the first year following transplant from a deceased donor later defined as carrying two APOL1 risk variants. A possible "second hit" predisposing to renal disease in these recipients is discussed, one with active cytomegalovirus infection concurrent with collapsing glomerulopathy and renal failure and the other with chronic, slowly healing wound infection and focal segmental glomeru-losclerosis but stable renal function. In retrospect, awareness of the donor APOL1 risk alleles would not have influenced donor selection and ultimately did not influence posttransplant management. These case reports inform further discussion of the value of APOL1 testing for deceased donors.

Work hardening in an early return to work program for nurses with back injury

OBJECTIVES

Work assessment and work hardening were components of a comprehensive interdisciplinary program to prevent and manage back injury in nurses in a large tertiary care hospital. The effect of work hardening on morbidity and work status is described.

STUDY DESIGN

Nurses injured on 'target' wards who had time loss exceeding four working days received a work assessment. RESULTS determined work placement: work hardening. modified work or return to regular work. Pain, disability and lifting tolerance were monitored during work hardening and modified work; pain, disability, work endurance and work status were compared between initial and follow-up assessments.

RESULTS

Seven nurses received work hardening. All had increased lifting capacity; pain and disability scores decreased and, by 6 months follow-up, all were working full shifts at their regular jobs.

CONCLUSION

RESULTS support the concept of maintaining individuals with back injury in the workplace by providing early, on-site intervention that includes work hardening and modified work.

The role of tillage, fertiliser and forage species in sustaining dairying based on crops in southern Queensland 1. Winter-dominant forage systems

Field studies were conducted over 5 years on two dairy farms in southern Queensland to evaluate the impacts of zero-tillage, nitrogen (N) fertiliser and legumes on a winter-dominant forage system based on raingrown oats. Oats was able to be successfully established using zero-tillage methods, with no yield penalties and potential benefits in stubble retention over the summer fallow. N fertiliser, applied at above industry-standard rates (140 vs. 55 kg/ha.crop) in the first 3 years, increased forage N concentration significantly and had residual effects on soil nitrate-N at both sites. At one site, crop yield was increased by 10 kg DM/ha.kg fertiliser N applied above industry-standard rates. The difference between sites in fertiliser response reflected contrasting soil and fertiliser history. There was no evidence that modifications to oats cropping practices (zero-tillage and increased N fertiliser) increased surface soil organic carbon (0–10 cm) in the time frame of the present study. When oats was substituted with annual legumes, there were benefits in improved forage N content of the oat crop immediately following, but legume yield was significantly inferior to oats. In contrast, the perennial legume Medicago sativa was competitive in biomass production and forage quality with oats at both sites and increased soil nitrate-N levels following termination. However, its contribution to winter forage was low at 10% of total production, compared with 40% for oats, and soil water reserves were significantly reduced at one site, which had an impact on the following oat production. The study demonstrated that productive grazed oat crops can be grown using zero tillage and that increased N fertiliser is more consistent in its effect on N concentration than on forage yield. A lucerne ley provides a strategy for raising soil nitrate-N concentration and increasing overall forage productivity, although winter forage production is reduced.

The role of tillage, fertiliser and forage species in sustaining dairying based on crops in southern Queensland 2. Double-crop and summer sole-crop systems

Dairy farms located in the subtropical cereal belt of Australia rely on winter and summer cereal crops, rather than pastures, for their forage base. Crops are mostly established in tilled seedbeds and the system is vulnerable to fertility decline and water erosion, particularly over summer fallows. Field studies were conducted over 5 years on contrasting soil types, a Vertosol and Sodosol, in the 650-mm annual-rainfall zone to evaluate the benefits of a modified cropping program on forage productivity and the soil-resource base. Growing forage sorghum as a double-crop with oats increased total mean annual production over that of winter sole-crop systems by 40% and 100% on the Vertosol and Sodosol sites respectively. However, mean annual winter crop yield was halved and overall forage quality was lower. Ninety per cent of the variation in winter crop yield was attributable to fallow and in-crop rainfall. Replacing forage sorghum with the annual legume lablab reduced fertiliser nitrogen (N) requirements and increased forage N concentration, but reduced overall annual yield. Compared with sole-cropped oats, double-cropping reduced the risk of erosion by extending the duration of soil water deficits and increasing the time ground was under plant cover. When grown as a sole-crop, well fertilised forage sorghum achieved a mean annual cumulative yield of 9.64 and 6.05 t DM/ha on the Vertosol and Sodosol, respectively, being about twice that of sole-cropped oats. Forage sorghum established using zero-tillage practices and fertilised at 175 kg N/ha.crop achieved a significantly higher yield and forage N concentration than did the industry-standard forage sorghum (conventional tillage and 55 kg N/ha.crop) on the Vertosol but not on the Sodosol. On the Vertosol, mean annual yield increased from 5.65 to 9.64 t DM/ha (33 kg DM/kg N fertiliser applied above the base rate); the difference in the response between the two sites was attributed to soil type and fertiliser history. Changing both tillage practices and N-fertiliser rate had no affect on fallow water-storage efficiency but did improve fallow ground cover. When forage sorghum, grown as a sole crop, was replaced with lablab in 3 of the 5 years, overall forage N concentration increased significantly, and on the Vertosol, yield and soil nitrate-N reserves also increased significantly relative to industry-standard sorghum. All forage systems maintained or increased the concentration of soil nitrate-N (0–1.2-m soil layer) over the course of the study. Relative to sole-crop oats, alternative forage systems were generally beneficial to the concentration of surface-soil (0–0.1 m) organic carbon and systems that included sorghum showed most promise for increasing soil organic carbon concentration. We conclude that an emphasis on double- or summer sole-cropping rather than winter sole-cropping will advantage both farm productivity and the soil-resource base.

Identification of lotus rhizobia by direct DNA hybridization of crushed root nodules

Hybridization of crushed Lotus pedunculatus root nodules with P-labeled total genomic DNA probes was used to identify Rhizobium loti and Bradyrhizobium sp. (Lotus rhizobia). Probes always hybridized with homologous target DNA and frequently with DNAs of other strains from the same genus. Intergeneric hybridization did not occur. Results were comparable to those from colony hybridization.

Is the incidence of psychotic disorder in decline? Epidemiological evidence from two decades of research

BACKGROUND

It is unclear whether the incidence of first episode psychoses is in decline. We had the opportunity to determine whether incidence had changed over a 20-year period in a single setting, and test whether this could be explained by demographic or clinical changes.

METHODS

The entire population at-risk aged 16-54 in Nottingham over three time periods (1978-80, 1993-95 and 1997-99) were followed up. All participants presenting with an ICD-9/10 first episode psychosis were included. The remainder of the population at-risk formed the denominator. Standardized incidence rates were calculated at each time period with possible change over time assessed via Poisson regression. We studied six outcomes: substance-induced psychoses, schizophrenia, other non-affective psychoses, manic psychoses, depressive psychoses and all psychotic disorders combined.

RESULTS

Three hundred and forty-seven participants with a first episode psychosis during 1.2 million person-years of follow-up over three time periods were identified. The incidence of non-affective or affective psychoses had not changed over time following standardization for age, sex and ethnicity. We observed a linear increase in the incidence of substance-induced psychosis, per annum, over time (incidence rate ratios: 1.15; 95% CI 1.05-1.25). This could not be explained by longitudinal changes in the age, sex and ethnic structure of the population at-risk.

CONCLUSIONS

Our findings suggest psychotic disorders are not in decline, though there has been a change in the syndromal presentation of non-affective disorders, away from schizophrenia towards other non-affective psychoses. The incidence of substance-induced psychosis has increased, consistent with increases in substance toxicity over time, rather than changes in the prevalence or vulnerability to substance misuse. Increased clinical and popular awareness of substance misuse could also not be excluded.

A mesothelioma in a ferruginous hawk (Buteo regalis)

A malignant mesothelioma diagnosed post mortem in a ferruginous hawk (Buteo regalis) resembled similar tumours reported from poultry. It was papillomatous and composed of cuboidal cells. The tumour occupied much of the respiratory tract as well as extending into the left humerus, humero-scapular-coracoid joint and pectoral muscle.

No-tillage and nitrogen application affects the decomposition of 15N-labelled wheat straw and the levels of mineral nitrogen and organic carbon in a Vertisol

No-tillage (NT) practice, where straw is retained on the soil surface, is increasingly being used in cereal cropping systems in Australia and elsewhere. Compared to conventional tillage (CT), where straw is mixed with the ploughed soil, NT practice may reduce straw decomposition, increase nitrogen immobilisation and increase organic carbon in the soil. This study examined 15N-labelled wheat straw (stubble) decomposition in four treatments (NT v. CT, with N rates of 0 and 75 kg/ha.year) and assessed the tillage and fertiliser N effects on mineral N and organic C and N levels over a 10-year period in a field experiment. NT practice decreased the rate of straw decomposition while fertiliser N application increased it. However, there was no tillage practice × N interaction. The mean residence time of the straw N in soil was more than twice as long under the NT (1.2 years) as compared to the CT practice (0.5 years). In comparison, differences in mean residence time due to N fertiliser treatment were small. However, tillage had generally very little effect on either the amounts of mineral N at sowing or soil organic C (and N) over the study period. While application of N fertiliser increased mineral N, it had very little effect on organic C over a 10-year period. Relatively rapid decomposition of straw and short mean residence time of straw N in a Vertisol is likely to have very little long-term effect on N immobilisation and organic C level in an annual cereal cropping system in a subtropical, semiarid environment. Thus, changing the tillage practice from CT to NT may not necessitate additional N requirement unless use is made of additional stored water in the soil or mineral N loss due to increased leaching is compensated for in N supply to crops.

Surgical resection of a primary tracheal fibrosarcoma in a dog

A four-year-old, entire male Rottweiler was presented with a history of respiratory distress. A tracheal mass was diagnosed on thoracic radiographs and tracheoscopy. Surgical excision of three tracheal rings incorporating the tumour was performed. The mass was found to be a low-grade fibrosarcoma. Twenty-four months later, the owner reported that there was no recurrence of respiratory distress and the dog appeared to be doing well clinically. This case of primary tracheal fibrosarcoma suggests that this type of tumour should be listed in the differential diagnoses for tracheal neoplasia in dogs and that surgical treatment alone may be curative.

Sustaining productivity of a Vertosol at Warra, Queensland, with fertilisers, no-tillage or legumes. 9. Production and nitrogen benefits from mixed grass and legume pastures in rotation with wheat

Reduced supplies of nitrogen (N) in many soils of southern Queensland that were cropped exhaustively with cereals over many decades have been the focus of much research to avoid declines in profitability and sustainability of farming systems. A 45-month period of mixed grass (purple pigeon grass, Setaria incrassata Stapf; Rhodes grass, Chloris gayana Kunth.) and legume (lucerne, Medicago sativa L.; annual medics, M. scutellata L. Mill. and M. truncatula Gaertn.) pasture was one of several options that were compared at a fertility-depleted Vertosol at Warra, southern Queensland, to improve grain yields or increase grain protein concentration of subsequent wheat crops. Objectives of the study were to measure the productivity of a mixed grass and legume pasture grown over 45 months (cut and removed over 36 months) and its effects on yield and protein concentrations of the following wheat crops. Pasture production (DM t/ha) and aboveground plant N yield (kg/ha) for grass, legume (including a small amount of weeds) and total components of pasture responded linearly to total rainfall over the duration of each of 3 pastures sown in 1986, 1987 and 1988. Averaged over the 3 pastures, each 100 mm of rainfall resulted in 0.52 t/ha of grass, 0.44 t/ha of legume and 0.97 t/ha of total pasture DM, there being little variation between the 3 pastures. Aboveground plant N yield of the 3 pastures ranged from 17.2 to 20.5 kg/ha per 100 mm rainfall. Aboveground legume N in response to total rainfall was similar (10.6–13.2 kg/ha per 100 mm rainfall) across the 3 pastures in spite of very different populations of legumes and grasses at establishment. Aboveground grass N yield was 5.2–7.0 kg/ha per 100 mm rainfall. In most wheat crops following pasture, wheat yields were similar to that of unfertilised wheat except in 1990 and 1994, when grain yields were significantly higher but similar to that for continuous wheat fertilised with 75 kg N/ha. In contrast, grain protein concentrations of most wheat crops following pasture responded positively, being substantially higher than unfertilised wheat but similar to that of wheat fertilised with 75 kg N/ha. Grain protein averaged over all years of assay was increased by 25–40% compared with that of unfertilised wheat. Stored water supplies after pasture were <134 mm (<55% of plant available water capacity); for most assay crops water storages were 67–110 mm, an equivalent wet soil depth of only 0.3–0.45 m. Thus, the crop assays of pasture benefits were limited by low water supply to wheat crops. Moreover, the severity of common root rot in wheat crop was not reduced by pasture–wheat rotation.

Sustaining productivity of a Vertosol at Warra, Queensland, with fertilisers, no-tillage or legumes. 7. Yield, nitrogen and disease-break benefits from lucerne in a two-year lucerne - wheat rotation

Continuous cultivation and cereal cropping of southern Queensland soils previously supporting native vegetation have resulted in reduced soil nitrogen supply, and consequently decreased cereal grain yields and low grain protein. To enhance yields and protein concentrations of wheat, management practices involving N fertiliser application, with no-tillage and stubble retention, grain legumes, and legume leys were evaluated from 1987 to 1998 on a fertility-depleted Vertosol at Warra, southern Queensland. The objective of this study was to examine the effect of lucerne in a 2-year lucerne–wheat rotation for its nitrogen and disease-break benefits to subsequent grain yield and protein content of wheat as compared with continuous wheat cropping.Dry matter production and nitrogen yields of lucerne were closely correlated with the total rainfall for October–September as well as March–September rainfall. Each 100 mm of total rainfall resulted in 0.97 t/ha of dry matter and 26 kg/ha of nitrogen yield. For the March–September rainfall, the corresponding values were 1.26 t/ha of dry matter and 36 kg/ha of nitrogen yield. The latter values were 10% lower than those produced by annual medics during a similar period. Compared with wheat–wheat cropping, significant increases in total soil nitrogen were observed only in 1990, 1992 and 1994 but increases in soil mineralisable nitrogen were observed in most years following lucerne. Similarly, pre-plant nitrate nitrogen in the soil profile following lucerne was higher by 74 kg/ha (9–167 kg N/ha) than that of wheat–wheat without N fertiliser in all years except 1996. Consequently, higher wheat grain protein (7 out of 9 seasons) and grain yield (4 out of 9 seasons) were produced compared with continuous wheat. There was significant depression in grain yield in 2 (1993 and 1995) out of 9 seasons attributed to soil moisture depletion and/or low growing season rainfall. Consequently, the overall responses in yield were lower than those of 50 kg/ha of fertiliser nitrogen applied to wheat–wheat crops, 2-year medic–wheat or chickpea–wheat rotation, although grain protein concentrations were higher following lucerne.The incidence and severity of the soilborne disease, common root rot of wheat caused by Bipolaris sorokiniana, was generally higher in lucerne–wheat than in continuous wheat with no nitrogen fertiliser applications, since its severity was significantly correlated with plant available water at sowing. No significant incidence of crown rot or root lesion nematode was observed. Thus, productivity, which was mainly due to nitrogen accretion in this experiment, can be maintained where short duration lucerne leys are grown in rotations with wheat.

Sustaining productivity of a Vertosol at Warra, Queensland, with fertilisers, no-tillage or legumes. 8. Effect of duration of lucerne ley on soil nitrogen and water, wheat yield and protein

Soil nitrogen (N) supply in the Vertosols of southern Queensland, Australia has steadily declined as a result of long-term cereal cropping without N fertiliser application or rotations with legumes. Nitrogen-fixing legumes such as lucerne may enhance soil N supply and therefore could be used in lucerne–wheat rotations. However, lucerne leys in this subtropical environment can create a soil moisture deficit, which may persist for a number of seasons. Therefore, we evaluated the effect of varying the duration of a lucerne ley (for up to 4 years) on soil N increase, N supply to wheat, soil water changes, wheat yields and wheat protein on a fertility-depleted Vertosol in a field experiment between 1989 and 1996 at Warra (26°47′S, 150°53′E), southern Queensland. The experiment consisted of a wheat–wheat rotation, and 8 treatments of lucerne leys starting in 1989 (phase 1) or 1990 (phase 2) for 1, 2, 3 or 4 years duration, followed by wheat cropping. Lucerne DM yield and N yield increased with increasing duration of lucerne leys. Soil N increased over time following 2 years of lucerne but there was no further significant increase after 3 or 4 years of lucerne ley. Soil nitrate concentrations increased significantly with all lucerne leys and moved progressively downward in the soil profile from 1992 to 1995. Soil water, especially at 0.9–1.2 m depth, remained significantly lower for the next 3 years after the termination of the 4-year lucerne ley than under continuous wheat. No significant increase in wheat yields was observed from 1992 to 1995, irrespective of the lucerne ley. However, wheat grain protein concentrations were significantly higher under lucerne–wheat than under wheat–wheat rotations for 3–5 years. The lucerne yield and soil water and nitrate-N concentrations were satisfactorily simulated with the APSIM model. Although significant N accretion occurred in the soil following lucerne leys, in drier seasons, recharge of the drier soil profile following long duration lucerne occurred after 3 years. Consequently, 3- and 4-year lucerne–wheat rotations resulted in more variable wheat yields than wheat–wheat rotations in this region. The remaining challenge in using lucerne–wheat rotations is balancing the N accretion benefits with plant-available water deficits, which are most likely to occur in the highly variable rainfall conditions of this region.

Diagnostic pathology of selected diseases in wildlife

The prompt detection and effective management of infectious disease in wildlife rely greatly on field diagnosis. Although clinical work is sometimes of value, the cornerstone of diagnosis is pathological examination (gross necropsy with supporting laboratory investigations). The approach and rationale to gross post-mortem examination are common to all species, despite possible significant differences in technique. Likewise, the principles of sampling are usually comparable, with emphasis on standardisation, the correct use of equipment, and consistency in methods of storage and transportation of specimens. However, the type of sample taken and the laboratory tests required differ, depending upon the circumstances and possible diagnosis. Retention of material is always important. The principles of diagnostic pathology are discussed, with reference to selected diseases, namely: mycobacteriosis, Rift Valley fever, rabies, spongiform encephalopathies, morbillivirus and poxvirus infections, viral encephalitides, West Nile virus infection and chytridiomycosis. The importance of being able to perform certain investigations in the field, efficiently and safely, is emphasised.

Sustaining productivity of a Vertisol at Warra, Queensland, with fertilisers, no-tillage or legumes. 6. Production and nitrogen benefits from annual medic in rotation with wheat

Continuous cereal production in the summer-dominant rainfall region of north-eastern Australia has depleted native soil nitrogen fertility to a level where corrective strategies are required to sustain wheat grain yields and high protein levels for domestic and export markets. Annual medic pastures, along with other strategies, were evaluated from 1986 to 1998 on a Vertisol at Warra, southern Queensland, for their benefit to subsequent grain yield and protein content of wheat.Annual medic production and nitrogen yields were closely correlated with the growing season rainfall (March–September). Each 100 mm of growing season rainfall resulted in 1.39 t/ha of dry matter and 40 kg/ha of N yield. There were significant increases in soil mineralisable nitrogen following annual medic leys compared with continuous wheat in most years, but increases in total soil nitrogen were only observed in 1990, 1991 and 1992. However, pre-plant nitrate-nitrogen following an annual medic ley was always higher than that of continuous wheat without nitrogen fertiliser. This resulted in significant increases in wheat yield (6 of 9 seasons) and grain protein (in all seasons) compared with continuous wheat. The overall responses in yield and protein were similar to those of 50� kg/ha of fertiliser nitrogen applied to continuous wheat crops. A nitrogen harvest budget for the annual medic–wheat rotation over 11 years showed that it contributed 131 kg N/ha more than continuous wheat. Thus, using the seasonal conditions experienced from 1987 to 1998 as a reasonable representation of the rainfall range in the region, sustainable productivity can be maintained where annual medics are grown in short rotations with wheat.

Spontaneous neoplasms in captive African cane rats (Thryonomys swinderianus Temminck, 1827)

Despite the increasing importance of cane rat (Thryonomys swinderianus) farming in Africa, diseases of these animals in captivity are not well known. A survey of a colony in Gabon averaging 235 cane rats over a period of 36 months allowed the observation of several suspected tumors and the confirmation of three cases of neoplasms. Within a period of 8 months, a chondroma in an adult female, a hemangiosarcoma in a subadult male, and a chondrosarcoma in an elderly female were diagnosed. This incidence (1.3%) of neoplasms in the cane rat colony in such a short period is uncommon. Neoplasms in rodents might be induced by such factors as a high inbreeding coefficient, an oncogenic virus, or chemical agent intoxication. Although the etiology remains undetermined, these cases are described to provide baseline data on the pathology of this species in captivity.

A randomized controlled trial to prevent patient lift and transfer injuries of health care workers

STUDY DESIGN

Randomized controlled trial (RCT).

OBJECTIVES

To compare the effectiveness of training and equipment to reduce musculoskeletal injuries, increase comfort, and reduce physical demands on staff performing patient lifts and transfers at a large acute care hospital.

SUMMARY OF BACKGROUND DATA

Back injury to nursing staff during patient handling tasks is a major issue in health care. The value of mechanical assistive devices in reducing injuries to these workers is unclear.

METHODS

This three-armed RCT consisted of a "control arm," a "safe lifting" arm, and a "no strenuous lifting" arm. A medical, surgical, and rehabilitation ward were each randomly assigned to each arm. Both intervention arms received intensive training in back care, patient assessment, and handling techniques. Hence, the "safe lifting" arm used improved patient handling techniques using manual equipment, whereas the "no strenuous lifting" arm aimed to eliminate manual patient handling through use of additional mechanical and other assistive equipment.

RESULTS

Frequency of manual patient handling tasks was significantly decreased on the "no strenuous lifting" arm. Self-perceived work fatigue, back and shoulder pain, safety, and frequency and intensity of physical discomfort associated with patient handling tasks were improved on both intervention arms, but staff on the mechanical equipment arm showed greater improvements. Musculoskeletal injury rates were not significantly altered.

CONCLUSIONS

The "no strenuous lifting" program, which combined training with assured availability of mechanical and other assistive patient handling equipment, most effectively improved comfort with patient handling, decreased staff fatigue, and decreased physical demands. The fact that injury rates were not statistically significantly reduced may reflect the less sensitive nature of this indicator compared with the subjective indicators.

Cross-cultural implementation of a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) in Taiwan

BACKGROUND

There are no published reports of cross-cultural equivalence and interrater reliability at the level of individual symptom items assessed by a semi-structured clinical interview employing operationalised clinician ratings.

AIMS

To assess the cross-cultural clinical equivalence and reliability of a Chinese version of the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN).

METHOD

UK-US and Taiwanese groups of psychiatrists used Chinese and English transcripts of videotape interviews of Taiwanese patients to discuss cross-cultural issues and ratings of SCAN items. Item ratings were compared quantitatively individually and pooled by SCAN section.

RESULTS

Chinese equivalents were found for all SCAN items. No between-group differences were found for most individual items, but there were differences for some scaled items. Average agreement between the two groups was 69-100%.

CONCLUSIONS

Cross-cultural implementation based on SCAN in Taiwan appears valid.

Biomechanical analysis of peak and cumulative spinal loads during simulated patient-handling activities: a substudy of a randomized controlled trial to prevent lift and transfer injury of health care workers

Back injuries are a serious problem for nursing personnel who perform frequent patient-handling activities. Common prevention strategies include body mechanics education, technique training, and ergonomic interventions such as the introduction of assistive equipment. This investigation assessed and compared the effectiveness of two patient-handling approaches to reducing injury risk. One strategy involved using improved patient-handling technique with existing equipment, and the other approach aimed at eliminating manual patient handling through the use of additional mechanical and other assistive equipment. Both intervention arms received training in back care, patient assessment, and use of the equipment available on their particular wards. An analysis of compliance with interventions and the effects of patient-handling methods on both peak and cumulative spinal compression and shear during various tasks was conducted. Results showed greater compliance with interventions that incorporated new assistive patient-handling equipment, as opposed to those consisting of education and technique training alone. In several tasks, subjects who were untrained or non-compliant with interventions experienced significantly higher peak spinal loading. However, patient-handling tasks conducted with the aid of assistive equipment took substantially longer than those performed manually. This, along with variations in techniques, led to increases in cumulative spinal loading with the use of patient-handling equipment on some tasks. Thus, the use of mechanical assistive devices may not always be the best approach to reducing back injuries in all situations. No single intervention can be recommended; instead all patient-handling tasks should be examined separately to determine which methods maximize reductions in both peak and cumulative lumbar forces during a manoeuver.

Postmortem findings in captive cane rats (Thryonomys swinderianus) in Gabon

The causes of morbidity and mortality in a population of cane rats (Thryonomys swinderianus) on an experimental farm in Gabon were monitored for 21 months; 94 of 546 animals (17.2 per cent) died and were examined postmortem, and complementary laboratory examinations were carried out on 23 of the cases together with samples from 13 other animals kept elsewhere in similar conditions. Twenty-six (28 per cent) of the deaths occurred in preweaned kits, 40 (42 per cent) in subadults and 28 (30 per cent) in adults. The average monthly mortality was 2.5 per cent. Trauma was responsible for 29 of the deaths, 12 were due to septicaemia, 10 to primary respiratory lesions, five to digestive disorders, four to urinary lesions, three to reproductive problems and three to other causes; no diagnosis could be reached in 28 cases.

Invertebrate anesthesia

One hundred years ago (January 5th, 1901), an article in the Veterinary Record declared: The use of chloroform by practitioners is now common, and the amount of pain and suffering prevented is enormous. By its aid we are enabled to perform operations with success which without it were seldom satisfactory. A century later, in an age of sophisticated veterinary medicine, those words seem quaint, a relic of a bygone age. Our understanding of anesthesia of invertebrates in 2000 is very much at a comparable stage, however, and a great deal of research is needed to remedy this situation.

Necrobacillosis in free-living male European bison in Poland

In the Bialowieza Primeval Forest (Poland) a chronic disease of the external genital organs has been observed in free-living male European bison (Bison bonasus) since 1980. Investigations on this disease started in the late 1980s. The most striking findings are necrotic and ulcerative lesions of the prepuce and penis of bison aged from 6 mo to >10 yr. Histologic examination of tissue samples from the prepuce of six bison (9-mo- to 8-yr-old), and from the penis of two bison (3- and 8-yr-old), were characteristic of necrobacillosis. Masses of slender, Gram-negative, rod-like or filamentous bacteria occurred in necrotic tissue. At the periphery of necrotic tissue filamentous bacteria were often arranged in large clusters and strands that advanced towards healthy tissue. Immunolabeling and electron microscopy also suggest that these organisms are Fusobacterium sp.

Field anesthesia of free-living mountain gorillas (Gorilla gorilla beringei) from the Virunga Volcano region, Central Africa

Twenty-six anesthetic procedures involving 24 free-living mountain gorillas (Gorilla gorilla beringei) from Rwanda or the Democratic Republic of Congo were performed between February 1987 and October 1997. Sixteen procedures were performed to remove snares or to treat snare-related wounds, and four of the animals died without recovering consciousness because of their severe medical conditions. Ketamine was used for induction 19 times, tiletamine/zolazepam was used five times, and the agent was not recorded for two procedures. The mean (+/- SD) ketamine dosage for four animals of known weight was 7.1 +/- 0.9 mg/kg. All induction agents were delivered i.m. by remote injection, and mean induction times for ketamine and tiletamine/zolazepam were 5.5 +/- 2.6 min (n = 12) and 5.4 +/- 3.7 min (n = 5), respectively. Mean recovery times were significantly shorter with ketamine compared with tiletamine/zolazepam (42.0 +/- 24.9 min, n = 9 vs. 75.25 +/- 22.1 min, n = 4). Low hemoglobin oxygen saturation (mean = 86.7%) was recorded in three cases under ketamine anesthesia, and oxygen insufflation is therefore recommended to prevent hypoxemia. Gorillas induced with tiletamine/zolazepam had significantly higher respiratory rates compared with animals given ketamine. Successful anesthesia and recovery, in particular, depended on the assistance of local personnel.

Tumour-specific distribution of BRCA1 promoter region methylation supports a pathogenetic role in breast and ovarian cancer

The role of BRCA1 in sporadic breast and ovarian cancers remains elusive. Direct involvement of BRCA1 in the development of breast and ovarian cancer is suggested by the finding that the BRCA1 promoter region CpG island is methylated in a proportion of breast and ovarian cancers. The aim of this study was to compare the incidence of BRCA1 promoter region methylation in tumours in which loss of BRCA1 has been shown to play a role in pathogenesis (breast and ovarian carcinomas) with the incidence in tumours in which BRCA1 is unlikely to play a role in pathogenesis. Promoter region hypermethylation was significantly more common (P < 0.008) in breast and ovarian cancer (6/38 tumours methylated) than in colon cancer (0/35 tumours methylated) or in leukaemias (0/19 samples methylated). The restriction of BRCA1 promoter region hypermethylation to breast and ovarian cancer is consistent with a pathogenetic role of BRCA1 promoter methylation in these tumours. We suggest that the rarity of observed BRCA1 mutations in sporadic breast and ovarian cancer is due to the greater likelihood of BRCA1 inactivation by non-mutational mechanisms such as methylation.

A new peroxidase cDNA from white clover: its characterization and expression in root tissue challenged with homologous rhizobia, heterologous rhizobia, or Pseudomonas syringae

Temporal reverse transcription-polymerase chain reaction (RT-PCR) expression analyses were performed on Trprx2, a new white clover peroxidase, with roots challenged with homologous rhizobia, heterologous rhizobia, and a pathogen, Pseudomonas syringae. Low levels of Trprx2 expression were evident in all rhizobial treatments but in P.syringae-treated clover background expression was dramatically reduced within 1 h and was undetectable in treatments inoculated for more than 3 h. Spraying 4 mM salicylic acid onto seedlings increased Trprx2 expression. These data suggest a defensive role for Trprx2 in white clover and indicate active defense suppression by the pathogen.

Components of initial and residual disability after back injury in nurses

STUDY DESIGN

A pre- versus postintervention with concurrent control group design was used to investigate the effect of a workplace-based early intervention program on perception of disability in nurses with low back injury.

OBJECTIVES

This report examines changes over time in the components of the Oswestry Low Back Pain and Disability Questionnaire in two groups of back-injured nurses-those who received the early intervention program (study) and those who were not offered the program (control).

SUMMARY OF BACKGROUND DATA

Early intervention programs can decrease morbidity, time lost from work, and compensation costs. Although perception of disability decreases, some residual disability remains, the nature of which is not clear.

METHODS

The Oswestry Low Back Pain and Disability Questionnaire scores of 40 study nurses and 118 control nurses at time of injury and at 6 months after injury were examined. Analysis of variance was used to compare changes in mean overall scores over time. The proportion of nurses reporting disability on individual components of the Oswestry Low Back Pain and Disability Questionnaire at each time period was compared with the results of a chi-square test.

RESULTS

Overall Oswestry Low Back Pain and Disability Questionnaire scores were similar between study and control nurses at time of injury, but were significantly lower in study nurses at 6 months after injury. However, scores of individual Oswestry Low Back Pain and Disability Questionnaire components that related to job demands increased over time; this was most apparent in lifting, particularly in study nurses.

CONCLUSIONS

Although overall perception of disability decreased 6 months after injury, particularly in study nurses, disability in job-related activities persisted. Residual disability after back injury should be addressed in workplace-based prevention programs.

Emergency care of invertebrates

Invertebrates are of increasing importance to the veterinary profession, but little scientifically-based information exists on their emergency care. Therefore, basic principles--supportive care, including administration of fluids, and specific therapy (where available)--must be followed up on. Knowledge and understanding of the biology and natural history of these animals are essential if critical care is to prove successful.