Prevalence and Management of Anaemia in Renal Transplant Recipients: Data from Ten European Centres.

Background: Although it is a known predictor of mortality, there is a relative lack of recent information about anaemia in kidney transplant recipients. Thus, we now report data about the prevalence and management of post-transplant anaemia (PTA) in Europe 5 years after the TRansplant European Survey on Anemia Management (TRESAM) study. Methods: In a cross-sectional study enrolling the largest number of patients to date, data were obtained from 5,834 patients followed at 10 outpatient transplant clinics in four European countries using the American Society of Transplantation anaemia guideline. Results: More than one third (42%) of the patients were anaemic. The haemoglobin (Hb) concentration was significantly correlated with the estimated glomerular filtration rate (eGFR) (r = 0.4, p < 0.001). In multivariate analysis, eGFR, serum ferritin, age, gender, time since transplantation and centres were independently and significantly associated with Hb. Only 24% of the patients who had a Hb concentration <110 g/l were treated with an erythropoiesis-stimulating agent. The prevalence of anaemia and also the use of erythropoiesis-stimulating agents were significantly different across the different centres, suggesting substantial practice variations. Conclusions: PTA is still common and under-treated. The prevalence and management of PTA have not changed substantially since the TRESAM survey.

Primary science teacher confidence revisited: ten years on

Background

The mental health needs of people with a learning disability detained in police custody

Few research studies examine the prevalence or mental health needs of people with a Learning Disability (LD) detained in police custody. This paper describes the population of detainees with an LD who presented to an inner city inter-agency police liaison service during a three-year period. Two forensically trained Community Mental Health Nurses (CMHNs) screened all custody record forms (n=9014) for evidence of a mental health problem or LD. The CMHNs interviewed positively screened detainees (n=1089) using a battery of measures designed to assess mental health status, risk-related behaviour and alcohol or drug abuse. Almost one-in-ten of those interviewed (95/1089) were judged to have a possible or definite LD. Fifty-two per cent were cases on the General Health Questionnaire (GHQ) whilst 61% attained 'above threshold' Brief Psychiatric Rating Scale (BPRS) scores. The majority (63%) had a history of causing harm to others while 56 per cent had a history of self-harm. More than half (56%) regularly consumed harmful levels of alcohol while one-in-four (27%) reported abusing drugs. Higher than expected numbers of detainees have a learning disability and most have complex mental health needs. A police liaison service offers a way of identifying people with LD and connecting them with appropriate health and social care agencies.

Insights into torpor and behavioural thermoregulation of the endangered Juliana's golden mole

The cryptic, subterranean ways of golden moles (Chrysochloridae) hamper studies of their biology in the field. Ten species appear on the IUCN red list, but the dearth of information available for most inhibits effective conservation planning. New techniques are consequently required to further our understanding and facilitate informed conservation management decisions. We studied the endangered Juliana's golden mole Neamblysomus julianae and aimed to evaluate the feasibility of using implantable temperature sensing transmitters to remotely acquire physiological and behavioural data. We also aimed to assess potential body temperature (T-b) fluctuations in relation to ambient soil temperature (T-a) in order to assess the potential use of torpor. Hourly observations revealed that T-b was remarkably changeable, ranging from 27 to 33 degrees C. In several instances T-b declined during periods of low T-a. Such 'shallow torpor' may result in a daily energy saving of c. 20%. Behavioural thermoregulation was used during periods of high T-a by selecting cooler microclimates, while passive heating was used to raise T-b early morning when T-a was increasing. In contrast to anecdotal reports of nocturnal patterns of activity, our results suggest that activity is flexible, being primarily dependent on T-a. These results exemplify how behavioural patterns and microclimatic conditions can be examined in this and other subterranean mammal species, the results of which can be used in the urgently required conservation planning of endangered Chrysochlorid species.

Die Ungewissheit der Natur. Zur Dichtung Michael Donhausers und Hans-Ulrich Treichels

This article analyses the idea and role of nature in the poetics of two contemporary German poets, Donhauser and Treichel.