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The infection biology of Branchotenthes octohamatus (Monogenea: Hexabothriidae) from the gills of the southern fiddler ray, Trygonorrhina fasciata (Rhinobatidae), was studied using the fluorescent dye, 5(6)-carboxyfluorescein diacetate N-succinimidyl ester (CFSE). This is the first use of this technique on a monogenean species with unciliated larvae and the first for any monogenean larva infecting an elasmobranch host. CFSE-labelled post-larvae were recovered from gills of T. fasciata within 30 min of exposure to the host, providing strong evidence that larvae invade host gills directly and do not migrate after initial attachment elsewhere. The rapidity with which larvae settled suggests that the mode of infection may deliver larvae directly to the gills via the host's inhalant respiratory current. The specificity of B. octohamatus was investigated by exposing a sympatric rhinobatid host species, the western shovelnose ray, Aptychotrema vincentiana, to B. octohamatus larvae newly emerged from eggs laid by adult parasites from gills of T. fasciata. Experimental exposure of A. vincentiana to freshly hatched B. octohamatus larvae resulted in a persistent infection, indicating that B. octohamatus may not be strictly host specific. Post-larval development charted on these experimentally infected A. vincentiana specimens was slow. Parasites appeared to be sexually mature at 91 days at 21–25°C. Branchotenthes octohamatus larvae bear only 4 pairs of hooklets on the haptor whereas all other hexabothriid larvae described so far have 5 hooklet pairs. Ontogenetic changes to the haptor revealed that it is probably hooklet pair III that is lost from B. octohamatus prior to larval development. [ABSTRACT FROM PUBLISHER]

Empruthotrema tasmaniensis sp. nov. is described from the nasal fossae of the southern eagle ray, Myliobatis australis Macleay (Myliobatidae), from the east coast of Tasmania. Empruthotrema tasmaniensis is distinguished from others in the genus by the presence of an accessory piece associated with the male copulatory organ; no other species of Empruthotrema Johnston and Tiegs, 1922 has an accessory piece. Merizocotyle urolophi sp. nov. is described from the nasal fossae of the sparsely spotted stingaree, Urolophus paucimaculatus Dixon ( Urolophidae), and is distinguished from other members of the genus by 12 marginal loculi on the haptor; this is the only species of Merizocotyle Cerfontaine, 1894 that has this configuration. Squalotrema llewellyni Kearn and Green, 1983, described previously from Squalus acanthias Linnaeus (Squalidae) from the English Channel, is recorded from the same host species caught off the east coast of Tasmania. We found Triloculotrema japanica Kearn, 1993, which was described originally in the nasal fossae of the Japanese topeshark, Hemitriakis japanica (Muller and Henle) (Triakidae), off Minabe, Japan, in the nasal fossae of Mustelus antarcticus (Gunther) (Triakidae) caught off the east coast of Tasmania. Merizocotyle australensis (Beverley-Burton and Williams, 1989) Chisholm, Wheeler and Beverley-Burton, 1995, found in the nasal fossae of Himantura uarnak collected from Darwin, represents a new host and locality record. Empruthotrema and Merizocotyle are revised fully and additional information is provided for Squalotrema Kearn and Green, 1983 and Triloculotrema Kearn, 1993. A key is given to the Merizocotylinae Johnston and Tiegs, 1922 and illustrations are provided of all important taxonomic characters. We postulate how the different types of haptors found in Empruthotrema and Merizocotyle may have been derived and discuss the taxonomy of Merizocotyle which is still in a poor state. [ABSTRACT FROM AUTHOR]

Presents results of a survey on the quality of training in general surgery in Great Britain. Total number of trainees surveyed; Percentage of trainees saying they should be operating under supervision; Satisfaction of trainees with the quality or quantity of their training.

Laparoscopic adrenalectomy (LA) has been shown to reduce hospital stay and morbidity when compared to open adrenalectomy (OA). It is uncertain if the laparoscopic resection of large (≥6 cm) potentially malignant adrenal tumours is appropriate due to concern over incomplete resection and local recurrence. The aim of the present study was to compare the outcomes of LA for tumours ≥6 cm with those < 6 cm. Details of all patients referred with adrenal tumours between January 1999 and January 2006 had been recorded prospectively on a database. LA was performed using a lateral transabdominal approach. Contraindications to LA were local invasion requiring en bloc resection of adjacent organs or the requirement of additional open procedures. 103 patients were referred for adrenal resection. Three with metastatic adrenal carcinoma and two with severe cardiorespiratory disease were deemed unsuitable for operation. One hundred and eleven adrenalectomies were performed: 101 LAs and 10 OAs. Thirty-nine LA were for tumours ≥6 cm while nine OA were for tumours ≥6 cm. There were no significant differences between the median total anaesthetic time, postoperative complications or postoperative stay for patients undergoing LA for tumours ≥6 cm versus tumours <6 cm. Of the six conversions, five were performed for adrenal tumours ≥6 cm [local invasion ( n = 3), adhesions ( n = 1), primary renal carcinoma ( n = 1)]. All tumours in the LA group were resected with clear margins and at a median follow up of 50 months (range 38–74 months). There has been no evidence of local recurrence. In the absence of local invasion, the outcomes of laparoscopic adrenalectomy for patients with tumours ≥6 cm were comparable to those with tumours <6 cm. This has helped confirm a policy of initial laparoscopic resection for all noninvasive adrenal tumours can be applied safely. [ABSTRACT FROM AUTHOR]

Nursing leaders in ambulatory care need to objectively quantify patient intensity to balance patient care needs and nursing resources. In this three-part series, current literature on acuity/intensity tools will be reviewed, and the development of an Ambulatory Intensity System (AIS) to objectively quantify nursing care will be described. In this article, the ongoing implementation of the system, its incorporation into the organization's established computerized appointment system, reliability measures, and related performance improvement activities will be discussed. [ABSTRACT FROM AUTHOR]

Nursing leaders in ambulatory care need to objectively quantify patient intensity to balance patient care needs and nursing resources. In this three-part series the current literature on acuity/intensity tools will be reviewed, and the development of an Ambulatory Intensity System (AIS) to objectively quantify the nursing care will be described. [ABSTRACT FROM AUTHOR]

Epidermal cilia of the oncomiracidium of Neoheterocotyle rhinobatidis (Monogenea, Monopisthocotylea, Monocotylidae) have long cross-striated vertical rootlets that are not extensions of the basal bodies as are the vertical rootlets in all catenulid and rhabditophoran turbellarians examined to date. Instead, they originate in the basal part of the horizontal rootlet a short distance from the basal bodies. In Monocotyle spiremae (Monocotylidae), the vertical rootlets are less distinct, with no apparent cross-striation, but they also originate from the basal part of the horizontal rootlets. Epidermal cilia of the oncomiracidium of Zeuxapta seriolae (Monogenea, Polyopisthocotylea, Axinidae) lack vertical rootlets like all other neodermatans examined, but bundles of fibres extend from the basal bodies a short distance into the cytoplasm of the epidermal cells. Monopisthocotylean Monogenea would be intermediate between rhabditophorans and the other neodermatans (in having weakly developed vertical tootles), if these structures were homologous in the two groups. However, in view of the different origin Hf vertical rootlets in turbellarians and monopisthocolylean oncomiracidia, it is suggested that they are not homologous, and vertical rootlets in the Monopisthocotylea are therefore named ‘false vertical rootlets’. [ABSTRACT FROM AUTHOR]

Interviews with 103 middle-class wives on their family building experiences and use of birth control techniques show this highly educated group to be effective family planners in comparison with other social groups. The wives developed clear ideas early in marriage about family size, timing and spacing, formulated with reference to sets of beliefs about the transmission of cultural advantage from parents to children, and their social responsibility in relation to world population levels. Ideas about the spacing of children and desired family size appear to be influenced by the women’s orientation towards returning to employment, but their relatively late age of terminating full-time education has had remarkably little effect on the timing of either marriage or the first child’s birth. Female contraceptive methods were most popular with this sample, and their relative effectiveness as family planners may be explained by their preference for the more reliable techniques and high level of motivation to use them efficiently. Variations in patterns of contraceptive usage noted between this and other studies are probably a function of age differences in the groups of women surveyed. [ABSTRACT FROM PUBLISHER]