Search

Objective: To review and analyse the evidence for the cholesterol-lowering effect of ezetimibe in adult patients with hypercholesterolaemia who are not at low-density lipoprotein cholesterol (LDL-C) goal on statin monotherapy.Research Design: Systematic review and meta-analysis.Methods: MEDLINE and EMBASE were searched to identify ezetimibe randomised controlled trials (RCTs) published between January 1993 and December 2005. The meta-analysis combined data from RCTs, with a minimum treatment duration of 6 weeks, that compared treatment with ezetimibe 10 mg/day or placebo added to current statin therapy. The difference between treatments was analysed for four co-primary outcomes: mean percentage change from baseline in total cholesterol (TC), LDL-C, and high-density lipoprotein cholesterol (HDL-C), and number of patients achieving LDL-C treatment goal. Meta-analysis results are presented for a modified version of the inverse variance random effects model.Results: Five RCTs involving a total of 5039 patients were included in the meta-analysis. The weighted mean difference (WMD) between treatments significantly favoured the ezetimibe/statin combination over placebo/statin for TC (-16.1% (-17.3, -14.8); p < 0.0001), LDL-C (-23.6% (-25.6, -21.7); p < 0.0001) and HDL-C (1.7% (0.9, 2.5); p < 0.0001). The relative risk of reaching the LDL-C treatment goal was significantly higher for patients on ezetimibe/statin relative to those on placebo/statin (3.4 (2.0, 5.6); p < 0.0001). In pre-defined sub-group analyses of studies in patients with coronary heart disease, the WMD between treatments remained significantly in favour of ezetimibe/statin (p < 0.0001) for TC and LDL-C but was no longer significant for HDL-C. Elevations in creatine kinase, alanine aminotransferase or aspartate aminotransferase that were considered as an adverse effect did not differ significantly between treatments.Conclusions: The meta-analysis we performed included only five studies and was restricted to analysis of the changes in cholesterol levels relative to baseline. However, the results suggest that ezetimibe co-administered with ongoing statin therapy provides significant additional lipid-lowering in patients not at LDL-C goal on statin therapy alone, allowing more patients to reach their LDL-C goal. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the effectiveness of triclosan/copolymer and fluoride dentifrices in improving plaque control and gingival health. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, MEDLINE (1986 to March 2003) and EMBASE (1986 to March 2003). Personal files and the reference lists of all articles were checked for further studies. SELECTION CRITERIA: Trials were selected if they met the following criteria: random allocation of participants; participants were adults with plaque and gingivitis; unsupervised use of dentifrices for at least 6 months; and primary outcomes - plaque and gingivitis after 6 months. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted information. For each plaque and gingivitis index, the mean differences for each study were pooled as weighted mean differences (WMDs) with the appropriate 95% confidence intervals (CIs) using the random effect models. MAIN RESULTS: Sixteen trials provided data for the meta-analysis. The triclosan/copolymer dentifrice significantly improved plaque control compared with a fluoride dentifrice, with a WMD of -0.48 (95% CI: -0.64 to -0.32) for the Quigley-Hein index and WMD of -0.15 (95% CI: -0.20 to -0.09) for the plaque severity index. When compared with a fluoride dentifrice, the triclosan/copolymer dentifrice significantly reduced gingivitis with WMDs -0.26 (95% CI: -0.34 to -0.18) and -0.12 (95% CI: -0.17 to -0.08) for the Loe and Silness index and gingivitis severity index, respectively. [ABSTRACT FROM AUTHOR]

The current work reviews literature on the nature of stalking. Despite its nebulous nature and differing legal and clinical definitions of stalking, researchers and practitioners are referring to the same phenomenon. Stalking is chronic, consisting of a number of nuisance behaviors that appear consistent over countries and samples. Different categorizations of stalkers and their victims exist, but ex-partner stalkers are a distinctive category with respect to their prevalence, violence risk, and attrition rate. Different samples and definitions and false victimization reports obscure reliable lifetime prevalence estimates, but these appear to be around 12%-16% among women and 4%-7% among men. Stalking has deleterious effects on victims but some of the effects may be the result of stalking's exacerbating of existing vulnerabilities. Future research should focus on subgroups of stalkers and their victims, on cross-cultural investigations, and on the co-occurrence of stalking with other crimes. [ABSTRACT FROM AUTHOR]

This article aims to clarify two issues relating to stalking: how potential victims perceive the crime and the prevalence of stalking and stalking-related acts among the British female population. Three hundred forty-eight women were invited to classify which of a range of intrusive behaviors were exemplars of stalking. They were then asked to indicate whether they had firsthand experience of any of these behaviors and, if so, to describe the worst episode. Of the sample, 24% reported at least one incident of stalking. The sample held clear ideas on what they felt did and did not constitute stalking behaviors. Cluster analyses provided subtypes of stalking behaviors as perceived by respondents and subtypes of actual stalking as experienced by the sample. The findings suggest that a final legislative definition of stalking may not be necessary and that the high prevalence rate requires serious academic and legal attention. [ABSTRACT FROM AUTHOR]

Examines the accumulation of novel Delta[sup 6]-unsaturated fatty acids in transgenic tobacco lines expressing the borage Delta[sup 6]-fatty acid desaturase. Presence of the gamma-linolenic acid and octadecatetraenoic acid in a range of seed and non-seed tissues; Distribution of the fatty acids among the various lipid classes of the tobacco leaf.

This study, prepared by the author during her nurse training, examines the main problems encountered by 14 sufferers from multiple sclerosis living in the community, and the difficulties of those involved in their home care. [ABSTRACT FROM AUTHOR]

Br J Clin Pharmacol 1980 Aug;10(2):121-6 1 beta-Adrenoceptor blockade, plasma labetalol concentrations and anti- hypertensive actions were investigated at 2 hourly intervals during the interdose period of chronic oral therapy in six hypertensive patients. 2 beta-adrenoceptor blockade varied during the inter-dose period and was maximal 2 and 4 h after the oral dose (P > 0.05). 3 Systolic pressure rose during the interdose period (P > 0.05). A significant correlation was found between the degree of beta-adrenoceptor blockade and the change in systolic pressure at 2 h after the oral dose. 4 Efficacy of labetalol as a beta-adrenoceptor antagonist and anti- hypertensive drug was assessed 2 h after an oral dose during chronic eight hourly dosage in sixteen hypertensive patients. Pharmacokinetics of labetalol were studied in the same patients. 5 Peak plasma labetalol concentration occurred 2 h after the oral dose and subsequently the plasma concentration declined monoexponentially. 6 The steady state concentration (CSS) of labetalol was correlated significantly with the daily oral dose in mg kg-1, the mid point labetalol concentration (Cmax+Cmin) divided by 2 and the isoprenaline dose ratio-1 at 2 h after the oral dose. 7 No correlation was found between the antihypertensive effect and the CSS ng ml-1 labetalol or between the isoprenaline dose ratio-1 and the CSS labetalol ng ml-1. [ABSTRACT FROM AUTHOR]

Peatland ecosystems are of global conservation and environmental importance storing globally significant amounts of ancient carbon, regulating regional temperatures and hydrological regimes, and supporting unique biodiversity. Livestock grazing, land-use change, drainage, nutrient and acid deposition, and wildfire threaten the composition and function of many peatlands including those in the uplands of the United Kingdom. Presently, little is known about either the short- or long-term effects of wildfires within these systems in the UK. Our study aimed to evaluate how plant communities respond to wildfires across a range of vegetation communities, soil types, and burn severities. We evaluated wildfire burn severity using the ground-based Composite Burn Index adapted for treeless peatlands. Using paired burned-unburned plots, we quantified differences in the abundance of plant families and functional groups, vegetation diversity, and community composition. Multivariate differences in composition between burned and unburned areas were used as an index of community resilience to fire. Plots in heathland communities with shallow organic soils burned at the highest severities and had the greatest reductions in plant diversity and richness. There were significant declines in plot-scale species richness and diversity with increasing burn severity. Graminoids were resilient to fire whilst Ericaceae tended to increase with higher severity. Bryophyte composition was substantially altered-pleurocarpous species declined and acrocarpous species increased with greater burn severity. Community resilience was related to ground layer burn severity with higher burn severity driving greater changes in communities. Wildfire effects on temperate peatlands are a function of fire weather and site environmental and ecological characteristics. Management policy should ensure that the risk of severe wildfires is mitigated to protect ecosystem function and biodiversity. This will require system-specific fire management prescriptions across the gradient of peatland soil and vegetation types., Competing Interests: Outwith this study, the authors associated with this paper have received funding or in‐kind support from the following organisations: Scottish Natural Heritage, the Royal Society for the Protection of Birds, the Game and Wildlife Conservation Trust, the Heather Trust, Natural England, the National Trust for Scotland, as well as private and public landowners and managers., (© 2023 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Globally, forest-savanna mosaic landscapes are of significant conservation importance but have been widely impacted by human land-use. We studied how restoration, through cessation of long-term cattle grazing impacts (i) forest regeneration; (ii) forest understory structure and composition; and (iii) populations and diversity of large mammals and nocturnal birds, within naturally patchy gallery forests in the Beni Savannas of Bolivia. Comparing grazed and restored sites, we assessed the abundance and composition of tree functional types at different life stages (seedlings, saplings and adults), with focus on the region's key palm species Attalea princeps (motacú). Additionally, we surveyed habitat structure and composition in the shrub and ground-layer, and monitored occurrence and encounter rates of large mammals and nocturnal birds along dusk and evening transects. We found evidence of lower recruitment of motacú palms on the grazed site and lower potential for natural motacú regeneration. Principal Components Analysis revealed forests on grazed sites had simpler, more open shrub-layers and altered ground-layer structure and composition including increased bare ground. Mammal species richness was greater on the restored site, and there were more declining, globally threatened and site-unique species. Species richness was similar for nocturnal birds within forests on both the grazed and restored site, but nearly all species tended to be encountered more frequently on the restored site. Our results suggest cattle negatively impact forest regeneration and alter the structure and composition of the shrub and ground layer with potential consequences for the diversity and abundance of wildlife. Our study represents one of only a handful completed in the Beni region of Bolivia to date. The Beni is currently under pressure from widespread, largely unregulated cattle ranching. Our results thus provide vital evidence to support development of restoration and conservation policy, and its integration with rangeland management in this threatened and critically understudied region., Competing Interests: The authors have declared that no competing interests exist.

Obstructive sleep apnea (OSA) is a multisystem breathing disorder associated with increased morbidity and mortality. Clinical and operative assessment tools improve surgical approaches to treat airway obstruction. The primary sites of anatomic obstruction are at the levels of the nasal, palatal, and hypopharyngeal airway. The literature suggests a relationship between reduced neuromuscular tone and the age-related increase in OSA prevalence for normal-weight adults. Pharyngeal soft tissue collapse due to reduced airway pressure is defined as the critical closing pressure. Respiratory biochemistry homeostasis is an additional factor in maintaining airway patency., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: To establish the existence and directions of any associations between measures of body mass index (BMI) with caries levels using individual measures of each as derived from national surveys in England., Methods: The BMIs of five-year-old children calculated from the 2017 National Child Measurement Programme and caries measures from the 2016-17 Public Health England (PHE) National dental epidemiology survey were securely linked at a child level. Comparison at individual level of caries levels and BMI z scores was done using multivariable regression., Results: Records for 67,033 children were linked and allocated a deprivation quintile. An association between BMI Z score categories and caries levels was established. Caries prevalence was higher among overweight (24.4%) and very overweight (27.6%) children compared with those of average BMI (22.5%). Odds ratios were statistically significant at 1.08 and 1.14 for prevalence among overweight and very overweight children. Children of low BMI were found to have higher caries severity (1.2 d₃mft) and extent (4.4 d₃mft among those with any caries) compared to children of healthy BMI (0.7 d₃mft, 3.3 d₃mft) with statistically significant Incidence Rate Ratio of 1.24. Underweight children were more likely to have caries experience and more severe attack compared with children of healthy weight. Deprivation and ethnicity were confounding factors., Conclusions: There is some association between child BMI status and caries levels whereby caries prevalence among children of higher BMI is increased. The associations are over and above those of deprivation, ethnicity and water fluoridation individually, but these factors impact on the strength of the link between BMI and caries., (Copyright© 2020 Dennis Barber Ltd.)

Large amounts of carbon are stored in northern peatlands. There is concern that greater wildfire severity following projected increases in summer drought will lead to higher post-fire carbon losses. We measured soil carbon dynamics in a Calluna heathland and a raised peat bog after experimentally manipulating fire severity. A gradient of fire severity was achieved by simulating drought in 2 × 2 m plots. Ecosystem respiration (ER), net ecosystem exchange (NEE), methane (CH 4 ) flux and concentration of dissolved organic carbon ([DOC], measured at the raised bog only) were measured for up to two years after burning. The response of these carbon fluxes to increased fire severity in drought plots was similar to plots burnt under ambient conditions associated with traditional managed burning. Averaged across all burnt plots, burning altered mean NEE from a net carbon sink at the heathland (-0.33 μmol CO 2 m -2 s -1 in unburnt plots) to a carbon source (0.50 μmol m -2 s -1 in burnt plots) and at the raised bog (-0.38 and 0.16 μmol m -2 s -1 , respectively). Burning also increased CH 4 flux at the raised bog (from 1.16 to 25.3 nmol m -2 s -1 in the summer, when it accounted for 79% of the CO 2 -equivalent emission). Burning had no significant effect on soil water [DOC]., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Calluna vulgaris-dominated habitats are valued for ecosystem services such as carbon storage and for their conservation importance. Climate and environmental change are altering their fire regimes. In particular, more frequent summer droughts will result in higher severity wildfires. This could alter the plant community composition of Calluna habitats and thereby influence ecosystem function. To study the effect of fire severity on community composition we used rain-out shelters to simulate drought prior to experimental burns at two Calluna-dominated sites, a raised bog and a heathland. We analysed species abundance in plots surveyed ca. 16 months after fire in relation to burn severity (indicated by fire-induced soil heating). We found that fire severity was an important control on community composition at both sites. Higher fire severity increased the abundance of ericoids, graminoids and acrocarpous mosses, and decreased the abundance of pleurocarpous mosses compared to lower severity fires. At the raised bog, the keystone species Sphagnum capillifolium and Eriophorum vaginatum showed no difference in regeneration with fire severity. Species and plant functional type beta-diversity increased following fire, and was similar in higher compared to lower severity burns. Our results further our understanding of the response of Calluna-dominated habitats to projected changes in fire regimes, and can assist land managers using prescribed fires in selecting burning conditions to achieve management objectives., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To assess the role of factors posited to affect population caries levels across England., Basic Research Design: Multivariable regression analysis assessing four potential determinants of caries severity and prevalence: deprivation, exposure to fluoridated water, ethnicity and geographic region Participants: Random sample of 121,875 five-year-old children in England in the 2014/15 academic year., Main Outcome Measures: Decayed, missing and filled teeth, with decay measured at the dentinal level, (d₃mft), presented as prevalence (dmft⟩0) and extent of decay among children who have any (d₃mft if d₃mft>0)., Independent Variables: Parental reported ethnicity from school records, index of multiple deprivation (IMD) scores, region and exposure to water fluoridation calculated utilising home postcodes., Results: The data support wider literature displaying associations between caries and deprivation across a social gradient. The important, new findings are deprivation, some ethnic groups and lack of exposure to water fluoridation are all associated with increased prevalence and severity of caries when considered together and independently. New evidence supports the impact of water fluoridation on health inequalities in that the greatest impact of exposure to fluoridated water was seen in the most deprived children and those from an Asian / Asian British ethnic group., Conclusions: Five-year-old children who were from the most deprived areas, not exposed to fluoridated water, of an Eastern European ethnic group and living in the North West demonstrated the highest prevalence and severity of caries in the survey under scrutiny. This is of public health importance, providing evidence for population groups to target with health improvement activities., (Copyright© 2018 Dennis Barber Ltd.)

Moorland habitats dominated by the dwarf shrub Calluna vulgaris provide important ecosystem services. Drought is projected to intensify throughout their range, potentially leading to increased fire severity as moisture is a key control on severity. We studied the effect of low fuel moisture content (FMC) on fire severity by using 2×2m rain-out shelters prior to completing 19 experimental fires in two sites in Scotland (UK): a dry heath with thin organic soils and a raised bog with deep, saturated peat, both dominated by Calluna vulgaris. Reduced FMC of the moss and litter (M/L) layer at both sites, and the soil moisture of the dry heath, increased fire-induced consumption of the M/L layer and soil heating at both sites. Increase in fire severity was greater at the dry heath than at the raised bog, e.g. average maximum temperatures at the soil surface increased from 31°C to 189°C at the dry heath, but only from 10°C to 15°C at the raised bog. Substantial M/L layer consumption was observed when its FMC was below 150%. This led to larger seasonal and daily soil temperature fluctuation, particularly at the dry heath during warm months. The results suggest that low FMC following predicted changes in climate are likely to increase wildfire severity and that the impact on vegetation composition and carbon stores may be greater at heathlands than at peatlands. Managed burning aiming to minimise fire severity (e.g. ignition of the M/L layer and exposure to lethal temperatures of ericoid seeds) should be carried out when the FMC of the M/L layer is above 150% and the FMC of the soil is above 200-300%., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Variation in the structure of ground fuels, i.e. the moss and litter (M/L) layer, may be an important control on fire severity in heather moorlands and thus influence vegetation regeneration and soil carbon dynamics. We completed experimental fires in a Calluna vulgaris-dominated heathland to study the role of the M/L layer in determining (i) fire-induced temperature pulses into the soil and (ii) post-fire soil thermal dynamics. Manually removing the M/L layer before burning increased fire-induced soil heating, both at the soil surface and 2 cm below. Burnt plots where the M/L layer was removed simulated the fuel structure after high severity fires where ground fuels are consumed but the soil does not ignite. Where the M/L layer was manually removed, either before or after the fire, post-fire soil thermal dynamics showed larger diurnal and seasonal variation, as well as similar patterns to those observed after wildfires, compared to burnt plots where the M/L layer was not manipulated. We used soil temperatures to explore potential changes in post-fire soil respiration. Simulated high fire severity (where the M/L layer was manually removed) increased estimates of soil respiration in warm months. With projected fire regimes shifting towards higher severity fires, our results can help land managers develop strategies to balance ecosystem services in Calluna-dominated habitats., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective To explore possible reasons for the reduction in population caries levels among 5-year-old children in England since 2008.Design An ecological study to explore possible reasons for the apparent reduction in dental caries, which included changes in survey methods, deprivation levels and ethnic mix of the population, impact of community level oral health improvement interventions, reductions in sugar intake, and increases in the availability of fluoride.Setting Data were drawn from three consecutive epidemiological surveys undertaken in 2007/8 and 2011/12 (NHS Dental Epidemiology programme for England), and 2014/15 (Public Health England Dental Public Health Epidemiology Programme). Evidence about the possible reasons for the observed reduction in caries levels was drawn from a range of national sources.Main outcomes measures Severity and prevalence of caries at dentinal level as measured by visual means alone among children aged five years.Results Reasons relating to changes in methods used in the survey, deprivation and ethnicity were rejected, along with community level interventions, as reasons for whole population level change. The factor relating to reduced sugar intake was neither rejected nor sustained. Reasons relating to increased fluoride availability, in particular that for increased concentration in children's toothpastes, was sustained.Conclusions The reduction in caries levels among 5-year-olds has most likely been brought about by the wider availability of children's toothpaste containing at least 1,000 ppm fluoride, along with other factors.

The review of 'Recognizing faces' by Hadyn Ellis, published in the British Journal of Psychology in 1975, marked the genesis of a distinct field of research. This seminal review sprang from a broader programme of research on face recognition conducted at the University of Aberdeen, whose influence continues to be felt in what has become an internationally important research area. We discuss the background to the Aberdeen research, summarize some of its achievements, and offer reasons why it proved so successful. These reasons include the synergy between theory and practice-based studies, the value of combining different perspectives and sources of evidence, sound techniques that led to easily reproducible findings, and the emphasis on testing even the most 'common sense' assumptions., (© 2017 The British Psychological Society.)

Objective: We report the findings from and comment on the surveys of the oral health of 5-year-old children undertaken in Scotland (2013-14), Wales (2014-15) and England (2014-15). This was the fourteenth survey in Scotland since 1988. In England and Wales it is the third survey since 2007 when changes were required in consent arrangements., Method: Representative samples were drawn within Health Boards across Scotland and local authorities across England and Wales. Consent was sought via opt-out parental consent in Scotland and opt-in parental consent in England and Wales. Children examined were those aged five in England and those in Primary 1 (school year aged 5 to 6) in Scotland and Wales. Examinations were conducted in schools by trained and calibrated examiners. Caries was visually diagnosed at the dentinal threshold., Results: There is a continuing decline in d₃mft in all three countries. d₃mft was 1.27 (opt-out consent) for Scotland, 0.84 for England (opt-in consent) and 1.29 for Wales (opt-in consent). Tooth decay levels remain higher in more deprived areas across Great Britain, with clear inequalities gradients demonstrated across all geographies. Attempts to measure changes in dental health inequalities across the three countries show no conclusive trends., Conclusion: Inter-country comparisons provide further oral health intelligence despite differences in approach and timing. The third surveys in England and Wales using the new consent arrangements have enabled trend analysis. Dental health inequalities gradients were shown across all geographies and all of the indicators of inequality., (Copyright© 2017 Dennis Barber Ltd.)

Aims: This study assessed the cost-effectiveness of ezetimibe with statin therapy vs statin monotherapy from a US payer perspective, assuming the impending patent expiration of ezetimibe., Methods: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses. The base-case scenario was used to evaluate the cost-effectiveness of adding ezetimibe 10 mg to statin in patients aged 35-74 years with a history of coronary heart disease (CHD) and/or stroke, and with low-density lipoprotein cholesterol (LDL-C) levels ≥70 mg/dL over a lifetime horizon, assuming a 90% price reduction of ezetimibe after 1 year to take into account the impending patent expiration in the second quarter of 2017. Sub-group analyses included patients with LDL-C levels ≥100 mg/dL and patients with diabetes with LDL-C levels ≥70 mg/dL., Results: The lifetime discounted incremental cost-effectiveness ratio (ICER) for ezetimibe added to statin was $9,149 per quality-adjusted life year (QALY) for the base-case scenario. For patients with LDL-C levels ≥100 mg/dL, the ICER was $839/QALY; for those with diabetes and LDL-C levels ≥70 mg/dL, it was $560/QALY. One-way sensitivity analyses showed that the model was sensitive to changes in cost of ezetimibe, rate reduction of non-fatal CHD, and utility weight for non-fatal CHD in the base-case and sub-group analyses., Limitations: Indirect costs or treatment discontinuation estimation were not included., Conclusions: Compared with statin monotherapy, ezetimibe with statin therapy was cost-effective for secondary prevention of CHD and stroke and for primary prevention of these conditions in patients whose LDL-C levels are ≥100 mg/dL and in patients with diabetes, taking into account a 90% cost reduction for ezetimibe.

Abiotic conditions, biotic factors, and disturbances can act as filters that control community structure and composition. Understanding the relative importance of these drivers would allow us to understand and predict the causes and consequences of changes in community structure. We used long-term data (1989-2002) from the sagebrush steppe in the state of Washington, USA, to ask three questions: (1) What are the key drivers of community-level metrics of community structure? (2) Do community-level metrics and functional groups differ in magnitude or direction of response to drivers of community structure? (3) What is the relative importance of drivers of community structure? The vegetation in 2002 was expressed as seven response variables: three community-level metrics (species richness, total cover, compositional change from 1989 to 2002) and the relative abundances of four functional groups. We used a multi-model inference framework to identify a set of top models for each response metric beginning from a global model that included two abiotic drivers, six disturbances, a biotic driver (initial plant community), and interactions between the disturbance and biotic drivers. We also used a permutational relative variable importance metric to rank the influence of drivers. Moisture availability was the most important driver of species richness and of native forb cover. Fire was the most important driver of shrub cover and training area usage was important for compositional change, but disturbances, including grazing, were of secondary importance for most other variables. Biotic drivers, as represented by the initial plant communities, were the most important driver for total cover and for the relative covers of exotics and native grasses. Our results indicate that the relative importance of drivers is dependent on the choice of metric, and that drivers such as disturbance and initial plant community can interact., (© 2016 by the Ecological Society of America.)

Objective: To summarise what is currently known about the oral health of older adults in England and Wales., Basic Research Design: Summary of the main findings from a recent review of oral health surveys and demographic and health data relating to older people in the UK (West Midlands, North West, Bolton and Kirklees, East London and the City of London and Wales). Their findings were compared, where possible to estimates from the 2009 Adult Dental Health Survey., Findings: A higher proportion of older adults in England and Wales have untreated caries and signs of severe caries than the general adult population. The majority of dentate residents in the care homes surveyed had untreated caries. Despite the poorer oral health of residents in care homes, managers of such services report difficulty in accessing routine and emergency dental care., Conclusions: Existing epidemiological data in England and Wales show that older people in residential and nursing care homes have poorer oral health than the general adult population and inequitable access to dental services. Greater comparability and utility would be gained from regional oral health surveys if standards were agreed for this age group with regard to sampling, consent, questionnaires and clinical measures., (Copyright© 2016 Dennis Barber Ltd)

Fire is widely used as a traditional habitat management tool in Scotland, but wildfires pose a significant and growing threat. The financial costs of fighting wildfires are significant and severe wildfires can have substantial environmental impacts. Due to the intermittent occurrence of severe fire seasons, Scotland, and the UK as a whole, remain somewhat unprepared. Scotland currently lacks any form of Fire Danger Rating system that could inform managers and the Fire and Rescue Services (FRS) of periods when there is a risk of increased of fire activity. We aimed evaluate the potential to use outputs from the Canadian Fire Weather Index system (FWI system) to forecast periods of increased fire risk and the potential for ignitions to turn into large wildfires. We collated four and a half years of wildfire data from the Scottish FRS and examined patterns in wildfire occurrence within different regions, seasons, between urban and rural locations and according to FWI system outputs. We used a variety of techniques, including Mahalanobis distances, percentile analysis and Thiel-Sen regression, to scope the best performing FWI system codes and indices. Logistic regression showed significant differences in fire activity between regions, seasons and between urban and rural locations. The Fine Fuel Moisture Code and the Initial Spread Index did a tolerable job of modelling the probability of fire occurrence but further research on fuel moisture dynamics may provide substantial improvements. Overall our results suggest it would be prudent to ready resources and avoid managed burning when FFMC > 75 and/or ISI > 2., Competing Interests: G. Matt Davies is an Academic Editor for PeerJ.

Fire has been used for centuries to generate and manage some of the UK's cultural landscapes. Despite its complex role in the ecology of UK peatlands and moorlands, there has been a trend of simplifying the narrative around burning to present it as an only ecologically damaging practice. That fire modifies peatland characteristics at a range of scales is clearly understood. Whether these changes are perceived as positive or negative depends upon how trade-offs are made between ecosystem services and the spatial and temporal scales of concern. Here we explore the complex interactions and trade-offs in peatland fire management, evaluating the benefits and costs of managed fire as they are currently understood. We highlight the need for (i) distinguishing between the impacts of fires occurring with differing severity and frequency, and (ii) improved characterization of ecosystem health that incorporates the response and recovery of peatlands to fire. We also explore how recent research has been contextualized within both scientific publications and the wider media and how this can influence non-specialist perceptions. We emphasize the need for an informed, unbiased debate on fire as an ecological management tool that is separated from other aspects of moorland management and from political and economic opinions.This article is part of the themed issue 'The interaction of fire and mankind'., (© 2016 The Authors.)

Unlabelled: Dental epidemiological surveys of children often focus on caries levels of five-year-olds as they are accessible and amenable to examination. Standardised surveys of this age group have been successfully carried out in the UK for many years. If improvements to caries level at age five are to be made then it is important to know when caries develops in the preceding years and what the likely causes are. This paper reports on the feasibility, utility and impact of a standardised survey of three-year-old children which took place in England., Method: Standardised examinations were carried out on consented three-year-olds attending child care sites which had been randomly sampled using a method described in a national protocol. Feasibility was assessed by compliance results, utility from examples of use of the data and impact by a count of media responses at the time of publication., Results: Data from 53,814 examinations provided caries level estimates for 88% of lower tier local authorities, this number representing 8% of the population of this age cohort. Of the children for whom parental consent was provided, 8% refused to be examined at school and 9% were absent. The arising information was used in a variety of ways by local authorities and health planners. The media response was strong with coverage by TV, radio, printed press and online reporting., Conclusion: This national survey of the oral health of three year olds was feasible but more labour intensive than surveys of school age children and the information derived has good utility and impact.

Pseudoreplication is defined as the use of inferential statistics to test for treatment effects where treatments are not replicated and/or replicates are not statistically independent. It is a genuine but controversial issue in ecology particularly in the case of costly landscape-scale manipulations, behavioral studies where ethics or other concerns may limit sample sizes, ad hoc monitoring data, and the analysis of natural experiments where chance events occur at a single site. Here key publications on the topic are reviewed to illustrate the debate that exists about the conceptual validity of pseudoreplication. A survey of ecologists and case studies of experimental design and publication issues are used to explore the extent of the problem, ecologists' solutions, reviewers' attitudes, and the fate of submitted manuscripts. Scientists working across a range of ecological disciplines regularly come across the problem of pseudoreplication and build solutions into their designs and analyses. These include carefully defining hypotheses and the population of interest, acknowledging the limits of statistical inference and using statistical approaches including nesting and random effects. Many ecologists face considerable challenges getting their work published if accusations of pseudoreplication are made - even if the problem has been dealt with. Many reviewers reject papers for pseudoreplication, and this occurs more often if they haven't experienced the issue themselves. The concept of pseudoreplication is being applied too dogmatically and often leads to rejection during review. There is insufficient consideration of the associated philosophical issues and potential statistical solutions. By stopping the publication of ecological studies, reviewers are slowing the pace of ecological research and limiting the scope of management case studies, natural events studies, and valuable data available to form evidence-based solutions. Recommendations for fair and consistent treatment of pseudoreplication during writing and review are given for authors, reviewers, and editors.

Aim: The optimal management of residual pituitary adenoma after resection is not clearly defined, with some authors proposing early radiosurgery or radiotherapy for patients with evidence of residual tumor on postoperative imaging and others recommending observation alone. This retrospective study seeks to determine the most appropriate treatment for patients with evidence of residual tumor on postoperative MRI., Methods: Forty-one consecutive patients who underwent transsphenoidal resection of pituitary adenomas between 2002 and 2005 and were followed radiographically and clinically for a mean of 4.4 years were analyzed., Results: Despite an official interpretation by a board-certified neuroradiologist suggesting the presence of residual tumor postoperatively in twenty-four out of forty-one patients, only four patients (16.7%) required additional intervention during the follow-up period. None of the patients received perioperative radiotherapy., Conclusion: This suggests that aggressive management of radiographically suspected residual tumor may not be indicated and that observation with serial imaging may be sufficient in the management of patients with residual tumor.