Can different patient satisfaction survey methods yield consistent results? Comparison of three surveys.

OBJECTIVE: To examine the consistency of survey estimates of patient satisfaction with interpersonal aspects of hospital experience. DESIGN: Interview and postal surveys, evidence from three independent population surveys being compared. SETTING: Scotland and Lothian. SUBJECTS: Randomly selected members of the general adult population who had received hospital care in the past 12 months. MAIN OUTCOME MEASURES: Percentages of respondents dissatisfied with aspects of patient care. RESULTS: For items covering respect for privacy, treatment with dignity, sensitivity to feelings, treatment as an individual, and clear explanation of care there was good agreement among the surveys despite differences in wording. But for items to do with being encouraged and given time to ask questions and being listened to by doctors there was substantial disagreement. CONCLUSIONS: Evidence regarding levels of patient dissatisfaction from national or local surveys should be calibrated against evidence from other surveys to improve reliability. Some important aspects of patient satisfaction seem to have been reliably estimated by surveys of all Scottish NHS users commissioned by the management executive, but certain questions may have underestimated the extent of dissatisfaction, possibly as a result of choice of wording.     

Can we predict nutrient limitation in streams and rivers?

1. Anthropogenic impacts on the biogeochemical cycles of nitrogen (N) and phosphorus (P) affect natural ecosystems worldwide. Modelling is required to predict where and when these key nutrients limit primary production in freshwaters. 2. We reviewed 382 nutrient‐enrichment experiments to examine which factors promote limitation of microphytobenthos biomass by N or P in streams and rivers. Using regression models, we examined whether the response of microphytobenthos biomass to N and P additions could be predicted by the absolute N and P concentrations in the water, the water N:P ratio or a combination of the two. 3. The absolute N concentration in the water was the best predictor of the magnitude of the response of microphytobenthos biomass to N additions. In comparison, the N:P ratio was the best predictor of whether or not N was limiting. However, predictions were uncertain except at extreme N:P ratios <1 : 1 and >100 : 1. 4. The absolute P concentration in the water was the best predictor of the magnitude of the response of microphytobenthos biomass to P additions. Neither the absolute nor the relative N and P concentrations predicted whether or not P was limiting. 5. The absolute and the relative N and P water concentrations contribute significant and complementary insights into the responses of microphytobenthos biomass to nutrient enrichment in running waters. However, ability to predict nutrient limitation from these concentrations is constrained by substantial error in the models. In the future, the prediction ability of models of nutrient limitation might be improved by focussing on regional scales and accounting for additional factors such as light and disturbance.     

Can soil Chytridiomycota survive and grow in different osmotic potentials?

Twenty isolates from soil in the orders Spizellomycetales, Blastocladiales and Chytridiales (Chytridiomycota) grew on complex solid media supplemented with 10 g l⁻¹ sodium chloride. In a synthetic liquid medium, 4.4 g l⁻¹ sodium chloride strongly inhibited growth in three of the five isolates, possibly because of the effect of the ions or osmolarity of the solution. The maximum concentration for growth in synthetic liquid medium with different osmotic potentials using polyethylene glycol (PEG) varied considerably amongst the isolates. Three patterns of growth with increasing concentrations of PEG were evident among isolates within the genus Rhizophydium. Up to the concentration where growth ceased, the dry weight of each isolate either decreased, remained constant, or in one case, increased. Most of the fungi survived when incubated at room temperature for 7 d in complex liquid media supplemented with 35 g l⁻¹ sodium chloride or 300 g l⁻¹ PEG. These data indicate that soil Chytridiomycota can survive various osmotic potentials that may occur during the wetting and drying phases in soils.     

Can traits predict species' vulnerability? A test with farmland passerines in two continents

Species' traits have been used both to explain and, increasingly, to predict species' vulnerability. Trait-based comparative analyses allow mechanisms causing vulnerability to be inferred and, ideally, conservation effort to be focused efficiently and effectively. However, empirical evidence of the predictive ability of trait-based approaches is largely wanting. I tested the predictive power of trait-based analyses on geographically replicated datasets of farmland bird population trends. I related the traits of farmland passerines with their long-term trends in abundance (an assessment of their response to agricultural intensification) in eight regions in two continents. These analyses successfully identified explanatory relationships in the regions, specifically: species faring badly tended to be medium-sized, had relatively short incubation and fledging periods, were longer distant migrants, had small relative brain sizes and were farmland specialists. Despite this, the models had poor ability to predict species' vulnerability in one region from trait-population trend relationships from a different region. In many cases, the explained variation was low (median R(2) = 8%). The low predictive ability of trait-based analyses must therefore be considered if such trait-based models are used to inform conservation priorities.     

Can shifts in metabolic scaling predict coevolution between diet quality and body size?

Larger species tend to feed on abundant resources, which nonetheless have lower quality or degradability, the so‐called Jarman‐Bell principle. The “eat more” hypothesis posits that larger animals compensate for lower quality diets through higher consumption rates. If so, evolutionary shifts in metabolic scaling should affect the scope for this compensation, but whether this has happened is unknown. Here, we investigated this issue using termites, major tropical detritivores that feed along a humification gradient ranging from dead plant tissue to mineral soil. Metabolic scaling is shallower in termites with pounding mandibles adapted to soil‐like substrates than in termites with grinding mandibles adapted to fibrous plant tissue. Accordingly, we predicted that only larger species of the former group should have more humified, lower quality diets, given their higher scope to compensate for such a diet. Using literature data on 65 termite species, we show that diet humification does increase with body size in termites with pounding mandibles, but is weakly related to size in termites with grinding mandibles. Our findings suggest that evolution of metabolic scaling may shape the strength of the Jarman‐Bell principle.     

Can body mass index predict percent body fat and changes in percent body fat with weight loss in bariatric surgery patients?

The primary objective of this study was to assess the validity of body mass index (BMI) in predicting percent body fat and changes in percent body fat with weight loss in bariatric surgery patients. Twenty-two bariatric patients (17 female, five male) began the study designed to include 12 months of testing, including data collection within 1 week presurgery and 1 month, 3 months, 6 months, and 1 year postsurgery. Five female subjects were lost to the study between 6 months and 12 months postsurgery, resulting in 17 subjects (12 female, five male) completing the 12 months of testing. Variables measured in the study included height, weight, percent fat (% fat) by hydrostatic weighing, lean mass, fat mass, and basal metabolic rate. Regression analyses predicting % fat from BMI yielded the following results: presurgery r = 0.173, p = 0.479, standard error of estimate (SEE) = 3.86; 1 month r = 0.468, p = 0.043, SEE = 4.70; 3 months r = 0.553, p = 0.014, SEE = 6.2; 6 months r = 0.611, p = 0.005, SEE = 5.88; 12 months r = 0.596, p = 0.007, SEE = 7.13. Regression analyses predicting change in % fat from change in BMI produced the following results: presurgery to 1 month r = -0.134, p = 0.583, SEE = 2.44%; 1-3 months r = 0.265, p = 0.272, SEE = 2.36%; 3-6 months r = 0.206, p = 0.398, SEE = 3.75%; 6-12 months r = 0.784, p = 0.000, SEE = 3.20. Although some analyses resulted in significant correlation coefficients (p < 0.05), the relatively large SEE values would preclude the use of BMI in predicting % fat or change in % fat with weight loss in bariatric surgery patients.     

Can indicator species predict restoration outcomes early in the monitoring process? a case study with peatlands

Success in ecological restoration is rarely assessed rigorously due to insufficient planning for post-restoration monitoring programs, limited funding and, especially, lack of scientifically validated evaluation criteria and protocols. In this article, we propose the use of the Indicator Value Index technique (IndVal), which statistically determines the association of species to one or several particular site types, to obtain indicators of success at the early stages of the recovery process in restoration projects. Peat bogs extracted by the vacuum method, subsequently restored by a moss-transfer technique and regularly monitored for ~10 years were used as a model system to test this approach. We first identified 34 restored sectors of ~10 ha from 4 to 11 years old in twelve eastern-Canadian bogs. These sectors were then classified according to their degree of success in recovering a typical sphagnum moss carpet (restoration goal). Then, we retrospectively reviewed vegetation communities recorded at the third year after restoration to identify indicator species of different categories of restoration success, using the IndVal methodology. By identifying early indicator species, our method provides a tool that guides intervention soon after restoration if a site is not on a desired successional trajectory. Typical bog species, namely the bryophytes S. rubellum and Mylia anomala and the tree Picea mariana, were indicative of successful restoration; while bare peat, lichens and one species of ericaceous shrubs (Empetrum nigrum), which cope better under drier conditions, indicated sites where restoration failed. A surprising finding was that the moss Polytrichum strictum, which is known to facilitate the colonization of sphagnum in disturbed peatlands, is an early indicator of unsuccessful restoration. This finding made us question the nursing role of P. strictum at a cover threshold above ca. 30%, when P. strictum could be outcompeting sphagnum and become dominant. We conclude that the IndVal method is an effective tool to identify early indicators of restoration success when combined with a thoughtful examination of species frequency and cover within each site type.     

Can micro-imaging based analysis methods quantify structural integrity of rat vertebrae with and without metastatic involvement?

This study compares the ability of μCT image-based registration, 2D structural rigidity analyses and multimodal continuum-level finite element (FE) modeling in evaluating the mechanical stability of healthy, osteolytic, and mixed osteolytic/osteoblastic metastatically involved rat vertebrae. μMR and μCT images (loaded and unloaded) were acquired of lumbar spinal motion segments from 15rnu/rnu rats (five per group). Strains were calculated based on image registration of the loaded and unloaded μCT images and via analysis of FE models created from the μCT and μMR data. Predicted yield load was also calculated through 2D structural rigidity analysis of the axial unloaded μCT slices. Measures from the three techniques were compared to experimental yield loads. The ability of these methods to predict experimental yield loads were evaluated and image registration and FE calculated strains were directly compared. Quantitatively for all samples, only limited weak correlations were found between the image-based measures and experimental yield load. In comparison to the experimental yield load, we observed a trend toward a weak negative correlation with median strain calculated using the image-based strain measurement algorithm (r=-0.405, p=0.067), weak significant correlations (p<0.05) with FE based median and 10th percentile strain values (r=-0.454, -0.637, respectively), and a trend toward a weak significant correlation with FE based mean strain (r=-0.366, p=0.09). Individual group analyses, however, yielded more and stronger correlations with experimental results. Considering the image-based strain measurement algorithm we observed moderate significant correlations with experimental yield load (p<0.05) in the osteolytic group for mean and median strain values (r=-0.840, -0.832, respectively), and in the healthy group for median strain values (r=-0.809). Considering the rigidity-based predicted yield load, we observed a strong significant correlation with the experimental yield load in the mixed osteolytic/osteoblastic group (r=0.946) and trend toward a moderate correlation with the experimental yield load in the osteolytic group (r=0.788). Qualitatively, strain patterns in the vertebral bodies generated using image registration and FEA were well matched, yet quantitatively a significant correlation was found only between mean strains in the healthy group (r=0.934). Large structural differences in metastatic vertebrae and the complexity of motion segment loading may have led to varied modes of failure. Improvements in load characterization, material properties assignments and resolution are necessary to yield a more generalized ability for image-based registration, structural rigidity and FE methods to accurately represent stability in healthy and pathologic scenarios.     

Can macaroni penguins keep up with climate- and fishing-induced changes in krill?

Macaroni penguins have evolved to cope with the highly variable conditions of the Southern Ocean. However, changes in prey supply and patchiness potentially associated with changes in climate and krill fishing activity may be occurring too rapidly for the penguins to adapt. We use a stochastic dynamic programming model to examine how changes in both the mean and patchiness of krill supply may affect the foraging decisions, and therefore breeding success, of female macaroni penguins at South Georgia. We predict that rapid changes in the mean supply of prey will have more of an effect on the condition of the female and chick than changes in prey patchiness, and that changes in foraging behavior compensate for changes in prey up to a threshold point, beyond which breeding success is likely impacted. In particular, we predict that the location of the threshold is affected by whether or not the penguins are adapted to the prey environment in which they are foraging, with the female and chick receiving on average 20% less of their daily energetic requirement if the female is not foraging optimally.     

Middle phalanx skeletal morphology in the hand: Can it predict flexor tendon size and attachments?

Specific sites on the palmar diaphysis of the manual middle phalanges provide attachment for the flexor digitorum superficialis (FDS) tendon. It has been assumed in the literature that lateral palmar fossae on these bones reflect locations for these attachments and offer evidence for relative size of the flexor tendon. This assumption has led to predictions about relative FDS muscle force potential from sizes of fossae on fossil hominin middle phalanges. Inferences about locomotor capabilities of fossil hominins in turn have been drawn from the predicted force potential of the flexor muscle. The study reported here provides a critical first step in evaluating hypotheses about behavioral implications of middle phalangeal morphology in fossil hominins, by testing the hypothesis that the lateral fossae reflect the size of the FDS tendon and the location of the terminal FDS tendon attachments on the middle phalanx. The middle phalangeal region was dissected in 43 individuals from 16 primate genera, including humans. Qualitative observations were made of tendon attachment locations relative to the lateral fossae. Length measurements of the fossae were tested as predictors of FDS tendon cross-sectional area and of FDS attachment tendon lengths. Our results lead to the conclusion that the hypothesis must be rejected, and that future attention should focus on functional implications of the palmar median bar associated with the lateral fossae.     

Can we use plant traits and soil characteristics to predict leaf damage in savanna woody species?

Although several hypotheses aim to explain insect herbivory on plants, the relative importance of plant traits, environment, and organizational scale (i.e., individual or community) to herbivory damage level is not well understood. We used an approach based on a local scale, divided into individual and community levels, to test if plant traits, soil characteristics, and plant density explain leaf damage. We sampled 983 individuals in 49 plots distributed over dense and open savanna formations in Emas National Park. In order to explain plant damage, we performed a multi-model inference analysis of four plant traits associated with plant damage, five soil characteristics, and plant density. We did not find any support to plant vigor or plant stress hypotheses at individual plant level. However, the resource concentration hypothesis and plant stress hypothesis explained leaf damage at the community level. We found that increased availability of calcium (Ca) in soils reduced plant damage at the community level. Because soil Ca concentration is a major constraint to plant development in the Brazilian savanna, we postulated that its increasing availability permits plants to invest more in defense strategies. We demonstrate that plant density, Ca soil concentration, and leaf size can be used to predict the plant damage suffered by woody species in savannas at community level.     

Quantitative characterization of repolarization alternans in terms of amplitude and location: What information from different methods?

The qualitative definition of repolarization alternans (RA) as an every-other-beat alternation of the repolarization amplitude allows several possible quantitative characterizations of RA. In the absence of a standardization, any correct comparison among quantitative outputs by different automatic methods requires knowledge of the differences in the RA parameterization at the basis of their algorithms. Thus, aim of the present study was to investigate the kind of information provided by five methods, namely the fast Fourier spectral method (FFTSM), the complex demodulation method (CDM), the modified moving average method (MMAM), the Laplacian likelihood ratio method (LLRM) and the heart-rate adaptive match filter method (AMFM) when characterizing RA in terms of its amplitude and location. Eight synthetic ECG recordings affected by stationary RA with uniform and triangular profiles localized along the ST segment, over the T wave, at the end of the T wave and all along the JT segment, respectively, were considered. Results indicate that quantitative RA characterization is method dependent. More specifically, the FFTSM and the LLRM provide a measure that matches the root mean square of the RA profile over the JT segment. Instead, the CDM and the AMFM compute RA amplitude as the mean value of the RA profile over the JT segment. Eventually, the MMAM provides the maximum amplitude difference between consecutive beats along repolarization. RA location is homogeneously among methods, since they all provide the time instant in correspondence of which the center of mass of the alternation occurs.     

What works in the field? A comparison of different interviewing methods in ethnobotany with special reference to the use of photographs

Ethnobotanists use a variety of interview techniques to collect ethnobotanical data. Drawing upon the results from a quantitative ethnobotanical study in five Yuracaré and Trinitario communities in the Bolivian Amazon, the pros and cons of the following methods are evaluated: (1) interviews in situ during transects, walk-in-the-woods, and homegarden sampling; and (2) interviews ex situ with fresh plant material, voucher specimens, or plant photographs as reference tools. Although the systematic use of plant photographs for ethnobotanical interviews is poorly documented in literature, the results show that indigenoùs participants in our study recognize significantly more plant species from photographs than from voucher specimens. It is argued that, especially in remote and isolated study sites, photographs might be advantageous over voucher specimens.     

Can glutamine and growth hormone promote protein anabolism in children with cystic fibrosis?

To determine whether recombinant human growth hormone (rhGH), glutamine (GLN) or a combination of both agents can enhance protein synthesis in cystic fibrosis (CF) patients, six 9.6 +/- 0.5-year-old prepubertal children (4 M, 2 F) with CF and stable lung disease with undernutrition (weight/height <50th percentile) or delayed growth (height <5th percentile) received stable isotope infusions, in the postabsorptive state and on 4 separate study days: (a) at baseline, and after a 4-week treatment with either, (b) oral GLN (0.7 g/kg/day), (c) rhGH (0.3 mg/kg/week, SC), or (d) both GLN and rhGH. Four-hour infusions of (13)C-leucine were used to assess leucine appearance rate (Ra, an index of protein breakdown), oxidation (Ox), and non-oxidative leucine disposal (NOLD, an index of protein synthesis). Results are expressed as changes (%) from baseline:We conclude that in children with CF: (1) due to high inter-subject variability, oral glutamine does not significantly enhance protein gain; (2) rhGH has significant anabolic effects which are mediated by stimulation of protein synthesis, and (3) glutamine does not enhance the effect of rhGH.     

Do factors describing forest naturalness predict the occurrence and abundance of middle spotted woodpecker in different forest landscapes?

Conservation biologists often use some specialized species as surrogates for communicating conservation needs, e.g. to signal states and changes in ecosystem. This requires a detailed knowledge of a species’ habitat demands and relationship between its occurrence and abundance, and certain environmental conditions. This paper explores the relationship between the occurrence and abundance of middle spotted woodpecker (Leiopicus medius) and structural, compositional, and functional elements of forest naturalness in three different forest landscapes in Poland, which encompass a wide spectrum of species’ habitats. Neither compositional nor functional elements of forest naturalness seemed to affect species’ distribution. In all studied areas, environmental variables related to the structural elements of forest naturalness, e.g. the share of old and uneven-aged stands, number of large living trees, positively influenced the occurrence and abundance of middle spotted woodpecker. Mature, unevenly structured forests might occur as a result of sustainable forest management, aimed at preserving the continuity of old stands and the maintenance of diverse age and species’ structure, providing suitable habitat condition for the species. Therefore, both presence and abundance of middle spotted woodpeckers can serve as indicators of wildlife-friendly forest management in deciduous forests.     

Can we predict carbon stocks in tropical ecosystems from tree diversity? Comparing species and functional diversity in a plantation and a natural forest

? Linking tree diversity to carbon storage can provide further motivation to conserve tropical forests and to design carbon-enriched plantations. Here, we examine the role of tree diversity and functional traits in determining carbon storage in a mixed-species plantation and in a natural tropical forest in Panama. ? We used species richness, functional trait diversity, species dominance and functional trait dominance to predict tree carbon storage across these two forests. Then we compared the species ranking based on wood density, maximum diameter, maximum height, and leaf mass per area (LMA) between sites to reveal how these values changed between different forests. ? Increased species richness, a higher proportion of nitrogen fixers and species with low LMA increased carbon storage in the mixed-species plantation, while a higher proportion of large trees and species with high LMA increased tree carbon storage in the natural forest. Furthermore, we found that tree species varied greatly in their absolute and relative values between study sites. ? Different results in different forests mean that we cannot easily predict carbon storage capacity in natural forests using data from experimental plantations. Managers should be cautious when applying functional traits measured in natural populations in the design of carbon-enriched plantations.     

Can network metrics predict vulnerability and species roles in bird‐dispersed plant communities? Not without behaviour

Network metrics are widely used to infer the roles of mutualistic animals in plant communities and to predict the effect of species' loss. However, their empirical validation is scarce. Here we parameterized a joint species model of frugivory and seed dispersal with bird movement and foraging data from tropical and temperate communities. With this model, we investigate the effect of frugivore loss on seed rain, and compare our predictions to those of standard coextinction models and network metrics. Topological coextinction models underestimated species loss after the removal of highly linked frugivores with unique foraging behaviours. Network metrics informed about changes in seed rain quantity after frugivore loss. However, changes in seed rain composition were only predicted by partner diversity. Nestedness, closeness, and d’ specialisation could not anticipate the effects of rearrangements in plant–frugivore communities following species loss. Accounting for behavioural differences among mutualists is critical to improve predictions from network models.     

Steady-state measurements of ΔpH and Δψ in Rhodospirillum rubrum chromatophores by two different methods. Comparison with phosphorylation potential

The pH gradient, ΔpH, and the membrane potential, Δψ, formed during light-induced electron transport in Rhodospirillum rubrum chromatophores were measured by two independent methods: (a) using specific electrodes to monitor light-dependent uptake of NH₄Cl and SCN^? at chromatophore concentrations of about 0.1 mg bacteriochlorophyll/ml and (b) using 9-aminoacridine and 8-anilinonaphthalenesulfonic acid as fluorescent probes for ΔpH and Δψ, respectively, at chromatophore concentrations of about 0.01 mg bacteriochlorophyll/ml. The light intensity was measured and set at a level which saturated the highest bacteriochlorophyll concentration used. The steady-state values obtained with each method under phosphorylating conditions were compared with the phosphorylation potential maintained by the chromatophores under identical conditions. The results indicate that under all conditions employed the ratio $\text{H}{}^{\mathrm{+}}\text{ATP}$ is greater than 2, and varies between 2.4 and 3.4 depending on the method used for estimation of the electrochemical proton gradient.