Devolving authority for health care in Canada's provinces: 2. Backgrounds,resources and activities of board members

OBJECTIVE: To obtain information from the members of the boards of devolved health care authorities and evaluate their orientations in meeting the expectations of provincial governments, local providers and community members. DESIGN: Mail survey, conducted in cooperation with the devolved authorities, in the summer of 1995. SETTING: Three provinces (Alberta, Saskatchewan and Prince Edward Island) with established boards and 2 (British Columbia and Nova Scotia) with immature boards. PARTICIPANTS: All 791 members of boards of devolved authorities in the 5 provinces, of whom 514 (65%) responded. OUTCOME MEASURES: Sociodemographic background, training, experience and activities of board members as well as their use of information. RESULTS: There were systematic differences between established and immature boards in regard to training, information use and actual and desired activities. Members spent 35 hours per month, on average, on work for their board. Members were largely middle-aged, well educated and well off. Only 36% were employed full time. Nine out of 10 had previous experience on boards, more often in health care than in social services. They were least pleased with their training in setting priorities and assessing health care needs and most pleased with their training in participating effectively in meetings and understanding their roles and responsibilities. The information for decision-making most available to them was information on service costs (68% said it was available "most of the time" or "always") and utilization (64%); the least available information was that on key informants'' opinions (47%), service benefits (37%) and citizens'' preferences (28%). Board activity was dominated by setting priorities and assessing needs, secondarily occupied with ensuring the effectiveness and efficiency of services and allocating funds, and least concerned with delivering services and raising revenue. The match between activities desired by members and actual activities was significantly poorer for members of immature boards than for those of established boards. CONCLUSIONS: The responses concerning these structural variables suggest that board members are most likely to meet the expectations of provincial governments. Fewer appear well equipped to accommodate the views of their providers and even fewer to incorporate the perspectives of their community.     

Reports by anaesthetists to procurators-fiscal: analysis of "anaesthetic deaths" over 10 years in four Scottish teaching hospitals.

Review of 489 "anaesthetic deaths" reported to procurators-fiscal over 10 years disclosed only 30 that were thought to justify such reporting. Most of the remainder occurred in patients so desperately ill at the time of operation that death was expected. Postmortem examinations ordered by the Crown authorities in nearly all cases were probably largely unrewarding and mostly unnecessary. The results suggest that the present regulation on reporting should be revised to focus more attention on the few deaths that occur in patients who have no apparent contraindication to anaesthesia or operation.     

"Whistleblowing": a health issue.

OBJECTIVE--To examine the response of organizations to "whistleblowing" and the effects on individual whistleblowers. DESIGN--Questionnaire survey of whistleblowers who contacted Whistleblowers Australia after its publicity campaign. SETTING--Australia. SUBJECTS--25 men and 10 women from various occupations who had exposed corruption or danger to the public, or both, from a few months to over 20 years before. RESULTS--All subjects in this non-random sample had suffered adverse consequences. For 29 victimization had started immediately after their first, internal, complaint. Only 17 approached the media. Victimization at work was extensive: dismissal (eight subjects), demotion (10), and resignation or early retirement because of ill health related to victimization (10) were common. Only 10 had a full time job. Long term relationships broke up in seven cases, and 60 of the 77 children of 30 subjects were adversely affected. Twenty nine subjects had a mean of 5.3 stress related symptoms initially, with a mean of 3.6 still present. Fifteen were prescribed long term treatment with drugs which they had not been prescribed before. Seventeen had considered suicide. Income had been reduced by three quarters or more for 14 subjects. Total financial loss was estimated in hundreds of thousands of Australian dollars in 17. Whistleblowers received little or no help from statutory authorities and only a modest amount from workmates. In most cases the corruption and malpractice continued unchanged. CONCLUSION--Although whistleblowing is important in protecting society, the typical organisational response causes severe and longlasting health, financial, and personal problems for whistleblowers and their families.     

用铀子系法测定河套人和萨拉乌苏文化的年代

用铀子系法中的~(230)Th增长法测定了河套人与萨拉乌苏文化的年代。并用~(231)Pa增长法对所测年代的可靠性作了检验。 根据测得数据,萨拉乌苏组的沉积时代不早于晚更新世中期,其上部不超过三万年,下部为距今3—5万年左右。 考虑到人化石及旧石器的出土层位,河套人与萨拉乌苏文化的年代应为距今3.7—5万年左右。     

Recuperation after muscular fatigue by "diverting activities"

"Diverting activity" is defined as any physical or mental activity performed between or simultaneously with bouts of exhaustive, local muscular work. In the present experiments bouts of exhaustive work consisting of rhythmic lifting of weights were performed with the elbow flexors or with the flexors of the middle finger. Pauses of 2 min duration spent in complete rest or while performing diverting activities alternated between the bouts of work. As diverting activities were used: Physical activity, dynamic or static, performed with big or small muscle groups (other than the fatigued group), or mental activity (problem solving). It was found that the amount of work that could be performed after a pause with diverting activity was always larger than the amount of work performed after a passive pause. The beneficial effect was seen also when the blood flow to the exhausted muscles was interrupted by pneumatic cuffs. Determination of the blood flow in the exhausted muscles by means of Xe-133 clearance showed no systematic blood flow increases caused by the diverting activity. It is concluded that recuperation after local muscle fatigue is influenced by a central nervous factor (Setchenov phenomenon) that is largely independent of the local blood flow.     

超级杂交稻两优培九及其亲本的光氧化特性

通过比较超级杂交稻两优培九和其亲本的光能利用与活性氧代谢的差异,为培育耐光氧化的杂交稻提供选亲配组的生理依据．使用TPS-光合仪和FMS2荧光仪(Hansateeh,UK)分别测定了人工光氧化处理后水稻叶片的光合速率与叶绿素荧光,同时测定了叶绿素、蛋白质和丙二醛的含量。以及超氧化物歧化酶和过氧化物酶的活性．结果表明,两优培九的光合速率低于母本2．4％,高于父本23％;光氧化处理8d后,与母本相比。两优培九的叶绿素、蛋白质、原初光化学效率、超氧化物歧化酶和过氧化物酶分别高于母本33％、15％、30％、32％和100％;光化学猝灭系数和丙二醛分别低于母本9％和50％。与父本相比,则差异不大．超级杂交稻两优培九在光氧化条件下光能利用率较高,在耐光氧化特性上具有超亲的光合生理特性．     

Genetic evidence of "American" and "European" type symbiotic algae of Paramecium bursaria Ehrenberg

Paramecium bursaria is composed of a "host" ciliate and a "symbiont" green alga. Based upon physiology, DNA hybridization and virus infection, two types of symbionts, called "American" type and "European" type, have been reported to date. Here, we determined the 18S rDNA and internal transcribed spacer 2 (ITS2) regions for both "American" and "European" types. Sequence features clearly separated into two lineages; NC64A (USA), Syngen 2-3 (USA), Cs2 (Chinese), MRBG1 (Australian), and Japanese strains belong to the "American", whereas PB-SW1 (German) and CCAP 1660/11 (British) strains belong to the "European". In "American" 18S rDNA, three introns were inserted in the same positions as for previously described Japanese symbionts. In "European" 18S rDNA, a single intron occurred in a different position than in the "American". Between the types, sequence differences were seven or eight nucleotides (0.39 %) in the 18S rDNA exon, and more than 48 nucleotides (19.2 %) in ITS2 regions. We subsequently sequenced the host 18S rDNA. As a result, two groups: Cs2, MRBG1, and Japanese strains, and PB-SW1 and CCAP 1660/11 strains, were separated (with 23 substitutions and 4 insertions or deletions between the groups). The congruent separations between hosts and symbionts may imply that the type of symbiont depends on the host type.     

Effects of sequential pollination on the success of "fast" and "slow" pollen donors in Hibiscus moscheutos (Malvaceae)

Competition among pollen grains for the chance to fertilize ovules typically involves two stages: arrival times on stigmas and/or the growth of pollen tubes through styles. In a previous study of Hibiscus moscheutos, we found that individual pollen donors often differed in pollen tube competitive ability. Here we determined whether short delays in pollen arrival time altered the average success of "fast" and "slow" pollen donors when both types of pollen experienced the same delays. Hand-pollination experiments were carried out using four pairs of pollen donors that differed in competitive ability. We allowed delays of 15 or 30 min between the first and second pollen donor and then determined seed paternity using allozyme markers. The second donor typically sired fewer seeds than pollen that arrived earlier, but, contrary to expectation, "faster" pollen did not always sire significantly more seeds than "slower" pollen when each was applied after delays of the same duration. In two of the four pairs of donors, differences that were seen following simultaneous pollinations disappeared when each type of pollen was applied following identical delays of 15 or 30 min. This unexpected response suggests that the dynamics of pollen tube competition are more complex than anticipated.     

Comparative genome analysis of "Candidatus Phytoplasma australiense" (subgroup tuf-Australia I; rp-A) and "Ca. Phytoplasma asteris" Strains OY-M and AY-WB

The chromosome sequence of "Candidatus Phytoplasma australiense" (subgroup tuf-Australia I; rp-A), associated with dieback in papaya, Australian grapevine yellows in grapevine, and several other important plant diseases, was determined. The circular chromosome is represented by 879,324 nucleotides, a GC content of 27%, and 839 protein-coding genes. Five hundred two of these protein-coding genes were functionally assigned, while 337 genes were hypothetical proteins with unknown function. Potential mobile units (PMUs) containing clusters of DNA repeats comprised 12.1% of the genome. These PMUs encoded genes involved in DNA replication, repair, and recombination; nucleotide transport and metabolism; translation; and ribosomal structure. Elements with similarities to phage integrases found in these mobile units were difficult to classify, as they were similar to both insertion sequences and bacteriophages. Comparative analysis of "Ca. Phytoplasma australiense" with "Ca. Phytoplasma asteris" strains OY-M and AY-WB showed that the gene order was more conserved between the closely related "Ca. Phytoplasma asteris" strains than to "Ca. Phytoplasma australiense." Differences observed between "Ca. Phytoplasma australiense" and "Ca. Phytoplasma asteris" strains included the chromosome size (18,693 bp larger than OY-M), a larger number of genes with assigned function, and hypothetical proteins with unknown function.     

Rapid detection of the "highly virulent" group B Streptococcus ST-17 clone

Group B streptococcus (GBS) is a leading cause of neonatal morbidity and mortality. Multilocus sequence typing (MLST) revealed that the sequence type ST-17 defines a "highly virulent" serotype III clone strongly associated with neonatal invasive infections. Our aim was to identify a target sequence enabling rapid, simple, and specific detection of this clone by a real-time PCR assay. Conventional methods for DNA manipulation and gene analyses were used to characterize the gbs2018 gene variant specific for ST-17 clone and to design ST-17- and GBS-specific primers. Conventional and real-time PCR assays were developed to detect GBS and ST-17 clones in bacterial cultures and directly on clinical samples. One hundred and fifty-six French GBS strains from various geographical areas in France isolated between 1990 and 2005 were screened by PCR with ST-17-specific primers. Forty strains were positive, and all were validated by MLST as ST-17. A representative sampling of 49 ST-17-PCR-negative strains was confirmed by MLST as non-ST-17. Real-time PCR was further used to directly test 85 vaginal samples. Among these, 13 were GBS-positive, and one was identified as ST-17. The association between strain invasiveness and ST-17 lineage in neonates with late onset disease was highly significant: 78% (P<0.0001) of strains isolated were ST-17. In conclusion, an ST-17-specific gbs2018 allele was identified and used to develop a sensitive and specific rapid-screening molecular assay for identifying ST-17 "highly virulent" GBS. Using this technique, accurate identification of women and neonates colonized by ST-17 can be readily achieved within less than 2 h.     

One-pot synthesis of chitosan-g-(PEO-PLLA-PEO) via "click" chemistry and "SET-NRC" reaction

For the development of biocompatible and degradable biomaterials, a kind of well-defined graft copolymer consisting of chitosan back-bone and amphiphilic PEO-PLLA-PEO branch chains was synthesized by Cu(0) catalyzed one-pot strategy combining "click" chemistry and single electron transfer-nitroxide radical coupling (SET-NRC) reaction. First, the precursors of 6-azide-N-phthaloyl-chitosan, TEMPO-PEO-alkyne and mPEO-PLLA-Br were designed and produced. Then, the one-pot coupling reactions between these precursors were performed in the presence of nanosized Cu and PMDETA. The efficiencies of the coupling reactions were greater than 90% determined by the FTIR and ESR spectra. The structure of graft copolymer with 43% of the grafting ratio was confirmed by the spectral analysis. This work provided a route to prepare chitosan graft copolymer.     

Twin concordance for a binary trait. II. Nested analysis of ever-smoking and ex-smoking traits and unnested analysis of a "committed-smoking" trait

Twin concordance rates for a binary trait can provide information about causes of trait variation. However, if trait prevalence varies with age (or birth cohort) or between the sexes, trait concordance rates will be artificially inflated because of the matching within pairs of twins. Our previous paper showed how to minimize the effects of such confounding by using logistic regression to model trait prevalence as a function of age and sex and that the binary correlation coefficient was useful as a measure of concordance that can be adjusted for trait prevalence. This method is extended here to allow for nested analyses and is applied to the smoking habits of a sample of 3,807 pairs of adult twins. For monozygotic (MZ) twins, the correlation coefficients for the binary trait of "ever-smoking" (males: .50 +/- .04; females: .60 +/- .02) were significantly greater than for dizygotic (DZ) twins (males: .37 +/- .05; females: .31 +/- .04; unlike-sex pairs: .21 +/- .03). For "giving-up smoking," given that both twins were previously smokers, the correlations for MZ twins (males: .37 +/- .07; females: .29 +/- .05) were also greater than for DZ twins (males: .11 +/- .09; females: .26 +/- .08; unlike-sex pairs: .13 +/- .06), although the difference was not statistically significant for females. Current smokers who had been smoking for at least 10 years were arbitrarily defined as "committed-smokers." The binary trait of "committed-smoking" was more strongly correlated in MZ twins (males: .41 +/- .06; females: .41 +/- .04) than in DZ twins (males: .22 +/- .08; females: .18 +/- .05; unlike-sex pairs: .16 +/- .05). These observations suggest that as well as depending on socially determined environmental factors, smoking behavior is influenced by genetic factors and/or by environmental factors unique to the MZ twin environment, which are of particular importance as determinants of "committed-smoking." There is a need for further research to investigate the personal characteristics of "committed-smokers" and to seek intervention strategies that are more suited to the needs of individual smokers.     

Studies on "stiffness of extremities disease" in the yak (Bos mutus)

Wild yak (Bos mutus) are affected by a disorder known colloquially as "stiffness of extremities disease," characterized by emaciation, lameness, stiffness in the gait, enlargement of the costochondral junctions, and abnormal curvature in the long bones. Results from preliminary epidemiologic and clinical observations suggested that this was a local, nutritional and metabolic disease associated with some mineral deficiency. Our objective was to determine the possible relationship between this disease and phosphorus (P) deficiency. We found that P concentrations in forage samples from affected areas were significantly lower than were those from unaffected areas, and the mean calcium:P ratio in the affected forage was 14:1. Phosphorus concentrations of blood, bone, teeth, and hair from affected yak were also significantly lower than were those from reference yak. Serum P levels of affected animals were much lower than were those of reference yak, whereas serum alkaline phosphatase levels were significantly higher than were those from reference yak. The P deficiency disease could be cured with supplement of disodium hydrogen phosphate (Na(2)HPO(4)). We conclude that the disease is mainly caused by P deficiency in forage.     

锌胁迫对“不知火”和“椪柑”的生理指标及锌分布的影响

采用砂基培养法,研究了0、0.05和0.5 mg·L^-1Zn²⁺（0.05 mg·L^-1为对照,0.5 mg·L^-1为锌过量,0 mg·L^-1为锌缺乏）处理下“不知火”和“椪柑”叶片的一些生理指标及不同部位锌含量的变化。结果表明：1）缺锌处理的“不知火”叶绿体色素含量和叶面积均显著低于其对照和锌过量处理;锌过量处理的“椪柑”叶绿体色素含量和叶面积均显著低于对照。2) 3个锌浓度处理间,“不知火”叶片POD、“椪柑”叶片CAT活性无显著性差异,“不知火”叶片CAT、SOD活性随着锌浓度的升高而升高,锌缺乏处理下“椪柑”叶片POD、CAT、SOD活性均显著地高于“不知火”,而锌过量时“不知火”叶片SOD活性显著高于“椪柑”;锌胁迫下“不知火”和“椪柑”叶片MDA含量均显著高于对照,锌过量时“椪柑”叶片MDA含量显著高于“不知火”。3）2品种柑橘不同部位的锌含量随着锌处理浓度的升高而升高,在相同浓度的锌处理下“椪柑”叶锌含量显著高于其他部位及“不知火”叶锌含量,“不知火”上部叶锌含量显著高于其下部叶。     

"Timers" and "scanners" among orientation detectors in cat visual cortex

Experiments were carried out on immobilized cats to determine whether, among visual cortical neurons, besides the "scanners" described by the writers previously, which are responsible for a dynamic shift of preferred orientation, there exist also "timer" cells, which do not change the temporal parameters of their responses during rotation of a flashing stimulus. The existence of such cells is postulated on the basis of the previous hypothesis on the spatiotemporal principle of orientational coding. Of 76 neurons tested 27, i.e., 36%, were classed as "timers." They differed significantly from the "scanners" (64%) by the following properties: shorter latent periods, shorter time to the peak and duration of responses, more rapid rise of discharge frequently in the volley. The "timers" had less sharp orientational tuning and a low ratio between values of responses to presentation of preferred and worst stimuli (on account of a considerable increase in responses to unpreferred orientations). The set of preferred orientations of the "timers" was found to be highly selective and additional relative to the corresponding distribution for "scanners."The difference in frequency-temporal properties of responses and orientational tuning of the "timers" and "scanners" and their possible mutually complementary role in orientational coding at the visual cortical level are discussed.Institute of Higher Nervous Activity and Neurophysiology, Academy of Sciences of the USSR, Moscow. Translated from Neirofiziologiya, Vol. 17, No. 1, pp. 35–43, January–February, 1985.     

"U"字缝合止血法对前置胎盘剖宫产患者术中出血量的影响

目的:探讨"U"字缝合止血法对前置胎盘剖宫产患者术中出血量的影响。方法:将2015年9月至2017年9月在西北妇女院儿童医院行前置胎盘剖宫产术的产妇96例作为研究对象,将其随机分组为两组,每组各48例患者。两组均给予常规止血处理,对照组采用"8"字缝合止血法,观察组为"U"字缝合止血法,比较两组手术指标及止血效果。结果:观察组手术时间、止血时间、术中出血量均显著少(短)于对照组(P0.05),凝血酶时间(TT)、血浆凝血酶还原时间(PT)、D-二聚体(D-D)、血小板(PLT)以及活化部分凝血活化酶时间(APTT)水平均明显低于对照组(P0.05),血红蛋白(HGB)、纤维蛋白原(FIB)水平均显著高于对照组(P0.05);止血有效率[97.92%(47/48)]显著高于对照组[85.42%(41/48)](P0.05),患者下床活动时间、住院治疗时间均显著短于对照组(P0.05)。结论:在前置胎盘剖宫产术中,实施"U"字缝合止血法可快速止血,且操作简单,确保降低出血量,降低对患者的损害,保证产妇健康和安全。     

"Timer" and "scanner" neurons in the cat visual cortex with low stimulus-background contrast

The response pattern and orientation detection of "timer" and "scanner" neurons were investigated in awake, immobilized cats with reduced contrast (2.3 and 10.0) between the light stimulus and the background. These two divisions had already been made [3, 5] at a high contrast level of 100. During this action, all scanners were found to retain their properties: they did not change into timers. The number of timers, however, dropped to 40% of their original total. The relationship between the properties of neurons belonging to these groups remained as it was during maximum contrast: with timers, response began and peaked earlier; it was also of higher frequency and briefer, while its capacity for orientation detection was far inferior to that of scanners. The neurons leaving the timer group following a reduction in contrast manifested a pattern somewhere between timer and scanner cells, resembling the latter in a number of parameters. Findings confirmed the deduction that both timer and scanner neurons are present and operate consistently under a wide range of conductions in the cat visual cortex; the former fulfill the functions of synchronizers and the latter of directional filters which are rearranged in time [5].Institute of Higher Nervous Activity and Neurophysiology, Academy of Sciences of the USSR, Moscow. Translated from Neirofiziologiya, Vol. 18, No. 6, pp. 805–812, November–December, 1986.     

Community attitudes to the European bison <Emphasis Type="Italic">Bison bonasus</Emphasis> in areas where its reintroduction is planned and in areas with existing populations in northeastern Poland

The main aim of the study was to assess the attitudes of communities in northeastern Poland to the European bison Bison bonasus. Four forest complexes were analyzed: two sites to which animals will be reintroduced in the near future (Augustowska and Romincka forests) and two sites where European bison subpopulations already exist (Knyszyńska and Borecka forests). We also analyzed the factors affecting these attitudes. The survey was based on direct interviews with respondents, and answers were transformed onto a 7-point Likert scale. The results showed that respondents living in areas where reintroduction is planned had more negative attitudes than those living in the vicinity of forest complexes where European bison already lives. The difference was probably a result of myths about the E. bison and crop damage by wildlife. We conclude that proper management of the European bison may lead to higher societal acceptance levels, especially among farmers. Moreover, management and acceptance of the wisent could also influence attitudes to state forests. Negative attitudes to the E. bison can be minimized by workshops that can clarify underlying issues and increase trust towards conservation authorities. The workshops should be aimed at farmers with larger farms and more towards women than men.     

Genealogy of wine grape cultivars: "Pinot" is related to "Syrah"

Since the domestication of wild grapes ca 6000 years ago, numerous cultivars have been generated by spontaneous or deliberate crosses, and up to 10 000 are still in existence today. Just as in human paternity analysis, DNA typing can reveal unexpected parentage of grape cultivars. In this study, we have analysed 89 grape cultivars with 60 microsatellite markers in order to accurately calculate the identity-by-descent (IBD) and relatedness (r) coefficients among six putatively related cultivars from France ("Pinot", "Syrah" and "Dureza") and northern Italy ("Teroldego", "Lagrein" and "Marzemino"). Using a recently developed likelihood-based approach to analyse kinship in grapes, we provide the first evidence of a genetic link between grapes across the Alps: "Dureza" and "Teroldego" turn out to be full-siblings (FS). For the first time in grapevine genetics we were able to detect FS without knowing one of the parents and identify unexpected second-degree relatives. We reconstructed the most likely pedigree that revealed a third-degree relationship between the worldwide-cultivated "Pinot" from Burgundy and "Syrah" from the Rhone Valley. Our finding was totally unsuspected by classical ampelography and it challenges the commonly assumed independent origins of these grape cultivars. Our results and this new approach in grape genetics will (a) help grape breeders to avoid choosing closely related varieties for new crosses, (b) provide pedigrees of cultivars in order to detect inheritance of disease-resistance genes and (c) open the way for future discoveries of first- and second-degree relationships between grape cultivars in order to better understand viticultural migrations.     

"Mind the trap": mindfulness practice reduces cognitive rigidity

Two experiments examined the relation between mindfulness practice and cognitive rigidity by using a variation of the Einstellung water jar task. Participants were required to use three hypothetical jars to obtain a specific amount of water. Initial problems were solvable by the same complex formula, but in later problems ("critical" or "trap" problems) solving was possible by an additional much simpler formula. A rigidity score was compiled through perseverance of the complex formula. In Experiment 1, experienced mindfulness meditators received significantly lower rigidity scores than non-meditators who had registered for their first meditation retreat. Similar results were obtained in randomized controlled Experiment 2 comparing non-meditators who underwent an eight meeting mindfulness program with a waiting list group. The authors conclude that mindfulness meditation reduces cognitive rigidity via the tendency to be "blinded" by experience. Results are discussed in light of the benefits of mindfulness practice regarding a reduced tendency to overlook novel and adaptive ways of responding due to past experience, both in and out of the clinical setting.