Comparison of rural and urban attitudes to the conservation of Asian elephants in Sri Lanka: empirical evidence

There has been little study of economic and general attitudes towards the conservation of the Asian elephant. This paper reports and analyses results from surveys conducted in Sri Lanka of attitudes of urban dwellers and farmers towards nature conservation in general and the elephant conservation in particular. The analyses are based on urban and a rural sample. Contingent valuation techniques are used as survey instruments. Multivariate logit regression analysis is used to analyse the respondents' attitudes towards conservation of elephants. It is found that, although some variations occurred between the samples, the majority of the respondents (both rural and urban) have positive attitudes towards nature conservation in general. However, marked differences in attitudes toward elephant conservation are evident between these two samples: the majority of urban respondents were in favour of elephant conservation; rural respondents expressed a mixture of positive and negative attitudes. Overall, considerable unrecorded and as yet unutilised economic support for conservation of wild elephants exists in Sri Lanka. (C) 2002 Elsevier Science Ltd. All rights reserved.

Comparison of the Retinomax autorefractor with hand-held retinoscopy in 1-year-old infants

This study aimed to determine the accuracy (and usability) of the Retinomax, a hand-held autorefractor, compared to measurements taken from hand-held retinoscopy (HHR) in a sample of normal 1-year-old children. The study was a method comparison set at four Community Child Health Clinics. Infants (n = 2079) of approximately 1 year of age were identified from birth/immunization records and their caregivers were contacted by mail. A total of 327 infants ranging in age from 46 weeks to 81 weeks (mean 61 weeks) participated in the study. The children underwent a full ophthalmic examination. Under cycloplegia, refraction was measured in each eye by streak retinoscopy (HHR) and then re-measured using the Retinomax autorefractor. Sphere, cylinder, axis of cylinder and spherical equivalent measurements were recorded for HHR and Retinomax instruments, and compared. Across the range of refractive errors measured, there was generally close agreement between the two examination methods, although the Retinomax consistently read around 0.3 D less hyperopic than HHR. Significantly more girls (72 infants, 47.7%), struggled during examination with the Retinomax than boys (52 infants, 29.5%) (P < 0.001). Agreement deteriorated between the two instruments if the patient struggled during the examination (P < 0.001). In general, the Retinomax would appear to be a useful screening instrument in early childhood. However, patient cooperation affects the accuracy of results and is an important con-sideration in determining whether this screening instrument should be adopted for measuring refractive errors in early infancy.

An Australian comparison of specialist care of acute myocardial infarction

Objective. To determine whether patients hospitalized with acute myocardial infarction (AMI) in an Australian setting receive better pharmacological care if managed by cardiologists than by non-cardiologists. Design. Retrospective chart review of patients hospitalized between 1 January 1997 and 30 June 1998, undertaken by abstractors blind to study objectives. Setting. One tertiary and two community hospitals in south-east Queensland, Australia, in which all patients admitted with AMI were cared for by cardiologists and general physicians, respectively. Study participants. Two cohorts of consecutive patients satisfying diagnostic criteria for AMI: 184 in the tertiary hospital and 207 in the community hospitals. Main outcome measures. Frequency of use, in highly eligible patients, of thrombolysis, P-blockers, aspirin, angiotensin-converting enzyme (ACE) inhibitors, lipid-lowering agents, nitrates, and calcium antagonists. Cohorts were compared for differences in prognostic factors or illness severity. Results. In community hospital patients, there was greater use of thrombolysis [100% versus 83% in the tertiary hospital; difference 17%, 95% confidence interval (CI) 11-26%; P < 0.001] and of ACE inhibitors (84% versus 66%; difference 18%, 95% CI 3-34%; P = 0.02), and lower median length of stay (6.0 days versus 7.0 days; P = 0.001) compared with tertiary hospital patients. Frequency of use of other drugs, and adjusted rates of death and re-infarction were the same for both cohorts. Conclusions. With respect to pharmacological management of patients hospitalized with AMI, cardiologists and general physicians appear to provide care of similar quality and achieve equivalent outcomes. Further studies are required to confirm the generalizability of these results to Australian practice as a whole.

A comparison of the efficacy and safety of olanzapine versus haloperidol during transition from intramuscular to oral therapy

Background: Acutely agitated patients with schizophrenia who receive intramuscular (IM) medications typically are switched to oral (PO) antipsychotic maintenance therapy Objective: The goal of this study was to assess the efficacy and safety of olanzapine versus those of haloperidol during transition from IM to PO therapy We used additional data from a previously reported trial to test the hypothesis that the reduction in agitation achieved by IM olanzapine 10 mg or IM haloperidol 7.5 mg would be maintained following transition to 4 days of PO olanzapine or PO haloperidol (5-20 mg/d for both). We also hypothesized that olanzapine would maintain its more favorable extrapyramidal symptom (EPS) safety profile. Methods: This was a multinational (hospitals in 13 countries), double-blind, randomized, controlled trial. Acutely agitated inpatients with schizophrenia were treated with 1 to 3 IM injections of olanzapine 10 mg or haloperidol 7.5 mg over 24 hours and were entered into a 4-day PO treatment period with the same medication (5-20 mg/d for both). The primary efficacy measurement was reduction in agitation, as measured by the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) score. Adverse events and scores on EPS rating scales were assessed. Results: A total of 311 patients (204 men, 107 women; mean [SD] age, 38.2 [11.6] years) were enrolled (131, 126, and 54 patients in the olanzapine, haloperidol, and placebo groups, respectively). In all, 93.1% (122/131) of olanzapine-treated patients and 92.1% (116/126) of haloperidol-treated patients completed the IM period and entered the PO period; 85.5% (112/131) of olanzapine-treated patients and 84.1% (106/126) of haloperidol-treated patients completed the PO period. IM olanzapine and IM haloperidol effectively reduced agitation over 24 hours (mean [SD] PANSS-EC change, -7.1 [4.8] vs -6.7 [4.3], respectively). Reductions in agitation were sustained throughout the PO period with both study drugs (mean [SD] change from PO period baseline, -0.6 [4.8] vs -1.3 [4.4], respectively). During PO treatment, haloperidol-treated patients spontaneously reported significantly more acute dystonia than olanzapine-treated patients (4.3% [5/116] vs 0% [0/122], respectively; P = 0.026) and akathisia (5.2% [6/116] vs 0% [0/122], respectively; P = 0.013). Significantly more haloperidol-treated patients than olanzapine-treated patients met categorical criteria for treatment-emergent akathisia (18.5% [17/92] vs 6.5% [7/107], respectively; P = 0.015). Conclusions: In the acutely agitated patients with schizophrenia in this study, both IM olanzapine 10 mg and IM haloperidol 7.5 mg effectively reduced agitation over 24 hours. This alleviation of agitation was sustained following transition from IM therapy to 4 days of PO treatment (5-20 mg/d for both). During the 4 days of PO treatment, olanzapine-treated patients did not spontaneously report any incidences of acute dystonia, and olanzapine had a superior EPS safety profile to that of haloperidol. The combination of IM and PO olanzapine may help improve the treatment of acutely agitated patients with schizophrenia. Copyright (C) 2003 Excerpta Medica, Inc.

Provitamin A carotenoid content of different cultivars of edible pandanus fruit

As part of an overall study to identify vitamin A-rich foods, a study was carried out in the Federated States of Micronesia (FSM) to provide information on production, acquisition, consumption and cultural acceptability of edible pandanus cultivars, Pandanus teetorius, and to identify their carotenoid content. Samples of five pandanus cultivars were collected and analyzed for alpha- and beta-carotene by HPLC. The results showed that the two cultivars with yellow fruit coloration contained low levels of carotenoids, while the orange fruits, which were also well liked as a food in the community, contained higher levels at maxima of 190 mug/100 g and 393 mug/100 g for alpha- and beta-carotene, respectively. Common patterns of intake when the fruit is available show that pandanus can provide a large proportion of estimated requirements of retinol equivalents. Local people were generally unaware that pandanus had health benefits, although the food was very popular. Nevertheless, key informants report that production had greatly decreased in recent years. To reverse this trend, those acceptable cultivars high in carotenoid content should be promoted both for their general enjoyment and their health benefits. (C) 2003 Elsevier Science Ltd. All rights reserved.

Comparison of bioassay and high performance liquid chromatographic assay of artesunate and dihydroartemisinin in plasma

The study was a comparison of bioassay and HPLC analysis of artesunate (ARTS) and dihydroartemisinin (DHA) in plasma. ARTS and DHA in plasma samples from patients treated with ARTS were quantified by HPLC and expressed as DHA. DHA-equivalents in the same plasma samples were measured using a standardised parasite culture technique. DHA concentrations estimated by both methods were highly correlated (bioassay = 0.96 x HPLC + 11.0; r(2) = 0.92). At high concentrations ( > 12 000 nmol/l) bioassay sometimes overestimated DHA. Bioassay of active drug in plasma correlates well with specific chemical analysis by HPLC. ARTS and DHA appear to account for the total antimalarial activity in plasma after ARTS administration. (C) 2003 Elsevier Science B.V. All rights reserved.

The effect of the reduction of carbon content on the toughness of high chromium white irons in the as-cast state

Three high chromium white cast irons were examined in the as-cast state to determine the effect of the carbon content on the fracture toughness. The plane strain fracture toughness K-Ic and the fracture strength were measured for each alloy. X-ray mapping was used to identify the phases on the fracture surfaces. Scanning electron fractography and optical microscopy were used to determine the volume fraction of each phase on the fracture surfaces. It was found that most fracture occurred in the eutectic carbides, but that for the alloys with a reduced volume fraction of eutectic carbides, a small amount of crack propagation occurred in the austenitic dendrites. This change in crack path correlated with an increase in fracture toughness. The Ritchie-Knott-Rice model of brittle fracture was applied. It was found to sensibly predict the critical length for fracture for each alloy. Deep etching was employed to examine the distribution of eutectic carbides. It was found that the eutectic carbides formed a continuous network in each case. (C) 2004 Kluwer Academic Publishers.

Food choice in Siganus fuscescens: influence of macrophyte nutrient content and availability

Using multiple-choice feeding experiments, the selection of six species of macrophytes by the herbivorous rabbitfish Siganus fuscescens was examined. The rabbitfish showed distinct food choice in the laboratory; however, selection of macrophytes by S. fuscescens was not related to their absolute nutrient content (nitrogen, carbon, energy and ash free dry mass). Nutrient assimilation estimates showed that the macrophytes which were most preferred were those that S. fuscescens assimilated best. In S. fuscescens, the macrophytes that were preferred passed through the gut significantly faster than the less preferred species. Gut transit time had a significant effect on the absolute value of a food item in terms of net nutrient gain per unit time. This study showed that food value could be inferred from the absolute nutrient content of the macrophytes. Thus both the ability to assimilate nutrients as well as the absolute nutrient content of macrophytes must be quantified when assessing food value. (C) 2004 The Fisheries society of the British Isles.

Utilising survey data to inform public policy: Comparison of the cost-effectiveness of treatment of ten mental disorders

Background Mental health survey data are now being used proactively to decide how the burden of disease might best be reduced. Aims To study the cost-effectiveness of current and optimal treatments for mental disorders and the proportion of burden avertable by each. Method Data for three affective, four anxiety and two alcohol use disorders and for schizophrenia were compared in terms of cost, burden averted and efficiency of current and optimal treatment. We then calculated the burden unavertable given current knowledge. The unit of health gain was a reduction in the years lived with disability (YLDs). Results Summing across all disorders, current treatment averted 13% of the burden, at an average cost of AUS$30 000 per YLD gained. Optimal treatment at current coverage could avert 20% of the burden, at an average cost of AUS$18 000 per YLD gained. Optimal treatment at optimal coverage could avert 28% of the burden, at AUS$16 000 per YLD gained. Sixty per cent of the burden of mental disorders was deemed to be unavertable. Conclusions The efficiency of treatment varied more than tenfold across disorders. Although coverage of some of the more efficient treatments should be extended, other factors justify continued use of less-efficient treatments for some disorders. Declaration of interest None. Funding detailed in Acknowledgements.

Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients

There has been little investigation into whether or not differences exist in the nature of physical impairment associated with neck pain of whiplash and insidious origin. This study examined the neck flexor synergy during performance of the cranio-cervical flexion test, a test targeting the action of the deep neck flexors. Seventy-five volunteer subjects participated in this study and were equally divided between Group 1, asymptomatic control subjects, Group 2, subjects with insidious onset neck pain and Group 3, subjects with neck pain following a whiplash injury. The cranio-cervical flexion test was performed in five progressive stages of increasing cranio-cervical flexion range. Subjects' performance was guided by feedback from a pressure sensor inserted behind the neck which monitored the slight flattening of the cervical lordosis which occurs with the contraction of longus colli. Myoelectric signals (EMG) were detected from the muscles during performance of the test. The results indicated that both the insidious onset neck pain and whiplash groups had higher measures of EMG signal amplitude (normalized root mean square) in the sternocleidomastoid during each stage of the test compared to the control subjects (all P