From individual vital rates to population dynamics: An integral projection model for European native oysters in a marine protected area

Following an 85% decline in global oyster populations, there has been a recent resurgence in interest in the restoration of the European native oyster Ostrea edulis. Motivations for restoration from environmental stakeholders most often include recovering lost habitats and associated biodiversity and supporting ecosystem function. In coastal communities, another important justification is recovery of traditional and low‐impact fisheries but this has received less attention. Many restoration projects across Europe focus on the translocation of adult stocks, under the assumption that the limit to population growth and recovery is adult growth and survival. This may not necessarily be the case, especially where knowledge of large extant adult populations exists as in the Blackwater, Crouch, Roach and Colne Marine Conservation Zone in Essex, UK. Identifying what limits population growth for restoration and recovery is an important conservation tool. Here, the first size‐dependent survival, growth and fecundity data for free‐living O. edulis from a novel field experiment are used to parameterize an Integral Projection Model that examines the sensitivity of a flat oyster population to variation in individual vital rates and to potential harvesting – an original objective of a coastal community‐led restoration project. Given the high adult fecundity in this species, population recovery is most sensitive to changes in recruitment success; however, elasticity (proportional sensitivity of the population) is more evenly spread across other parameters when recruitment is already high. Based on locally agreed management objectives, recovery to double the current stock biomass should take 16–66 years (mean = 30 years) without active intervention. At that point, harvest rates could be sustained below 5% of the harvestable adult size whilst ensuring λs remains above 1

From substance to process: A meta-ethnographic review of how healthcare professionals and patients understand placebos and their effects in primary care.

Research suggests that a 'placebo' can improve conditions common in primary care including pain, depression and irritable bowel syndrome. However, disagreement persists over the definition and clinical relevance of placebo treatments. We conducted a meta-ethnographic, mixed-research systematic review to explore how healthcare professionals and patients understand placebos and their effects in primary care. We conducted systematic literature searches of five databases - augmented by reference chaining, key author searches and expert opinion - related to views on placebos, placebo effects and placebo use in primary care. From a total of 34 eligible quantitative, qualitative and mixed-methods articles reporting findings from 28 studies, 21 were related to healthcare professionals' views, 11 were related to patients' views and two were related to both groups. In the studies under review, healthcare professionals reported using placebos at markedly different frequencies. This was highly influenced by how placebos were defined in the studies. Both healthcare professionals and patients predominantly defined placebos as material substances such as 'inert' pills, despite this definition being inconsistent with current scientific thinking. However, healthcare professionals also, but less prevalently, defined placebos in a different way: as contextual processes. This better concurs with modern placebo definitions, which focus on context, ritual, meaning and enactivism. However, given the enduring ubiquity of substance definitions, for both healthcare professionals and patients, we question the practical, clinical validity of stretching the term 'placebo' towards its modern iteration. To produce 'placebo effects', therefore, primary healthcare professionals may be better off abandoning placebo terminology altogether

Acupressure to Reduce Treatment-Related Symptoms for Children With Cancer and Recipients of Hematopoietic Stem Cell Transplant: Protocol for a Randomized Controlled Trial.

BackgroundWe describe the study design and protocol of a pragmatic randomized controlled trial (RCT) Acupressure for Children in Treatment for a Childhood Cancer (ACT-CC).ObjectiveTo describe the feasibility and effectiveness of an acupressure intervention to decrease treatment-related symptoms in children in treatment for cancer or recipients of a chemotherapy-based hematopoietic stem cell transplant (HSCT).DesignTwo-armed RCTs with enrollment of 5 to 30 study days.SettingTwo pediatric teaching hospitals.PatientsEighty-five children receiving cancer treatment or a chemotherapy-based HSCT each with 1 parent or caregiver.InterventionPatients are randomized 1:1 to receive either usual care plus daily professional acupressure and caregiver delivered acupressure versus usual care alone for symptom management. Participants receive up to 20 professional treatments.Main outcomeA composite nausea/vomiting measure for the child.Secondary outcomesChild's nausea, vomiting, pain, fatigue, depression, anxiety, and positive affect.Parent outcomesDepression, anxiety, posttraumatic stress symptoms, caregiver self-efficacy, and positive affect. Feasibility of delivering the semistandardized intervention will be described. Linear mixed models will be used to compare outcomes between arms in children and parents, allowing for variability in diagnosis, treatment, and age.DiscussionTrial results could help childhood cancer and HSCT treatment centers decide about the regular inclusion of trained acupressure providers to support symptom management

Perceptions and practice of personal protective behaviors to prevent COVID-19 transmission in the G7 nations

Introduction: To combat the transmission of COVID-19, countries have endorsed a series of non-pharmaceutical measures. We evaluated the practice and perceptions of personal protective measures and social distancing across the G7 countries. Methods: Data were collected during 19–21 March 2020, from 7005 of Kantar’s online panelists aged >16 years across the G7 countries: Canada, France, Great Britain, Germany, Italy, Japan, and the United States. Data were post-stratified and weighted to match population distributions of the respective countries. Descriptive and multivariable analyses were conducted in late March 2020. Results: Males (vs females) and those less educated (vs college graduates) were less likely to practice personal protective measures and social distancing. Younger adults were also less likely to practice social distancing (vs adults >65 years old). Respondents who expressed concern about the impact of COVID-19 on their health, income or education had higher odds of practicing personal protective measures (AOR=2.81, 1.74, and 1.54, respectively) and social distancing (AOR=3.18, 1.68, and 1.89, respectively) compared to those who did not. Those who perceived precautionary measures as highly effective were also more likely to practice personal protective measures (AOR=2.05) and social distancing (AOR=3.99) compared to those who perceived them as ineffective. Conclusions: Concerns about COVID-19 and perceived effectiveness of precautionary measures strongly predict practice of protective measures, regardless of the types of behaviors. Population-wide interventions should focus on ensuring increased adherence and tailoring communications to groups that are less likely to practice protective behaviors

Mulberry extract to modULate Blood glucosE Responses in noRmoglYcaemic adults (MULBERRY): study protocol for a randomized controlled trial

Background: worldwide sugar consumption has tripled during the last fifty years. High sugar intake is associated with weight gain and increased incidence of diabetes and has been linked with increased cardiovascular mortality. Reducing the health impact of dietary sugar and poor quality carbohydrate intake is a public health priority. IminoNorm®, a proprietary mulberry leaf extract (ME), may reduce blood glucose responses following dietary sugar and carbohydrate intake by reducing absorption of glucose from the gut. Previous research has shown that ME can reduce blood glucose and improve insulin responses in healthy subjects and also in subjects with raised fasting blood glucose levels. Mulberry leaf has an excellent safety profile. This pilot study will test a novel, safe, water soluble product in normoglycaemic adults in the UK to determine if it can reduce glucose absorption without increasing plasma insulin concentration.Methods/design: the trial will be a double-blind, individually randomised, four-arm single-dose crossover design to test the effect of three doses of ME in order to determine efficacy, dose response relationship and gastrointestinal side effects with respect to placebo. A total of 40 subjects will participate in this study and attend for four visits receiving each of the four interventions in random order.Discussion: we aim to test the evidence that mulberry leaf extract can reduce blood glucose without a disproportionate increase in blood insulin responses in healthy individuals in a high-quality research study based in the UK. It is hoped that this will lead to further randomised controlled trials and an effective dietary supplement to lower blood glucose concentration

Sea bed disturbance increases flat oyster recruitment for low to moderate stock densities

1. It has long been suggested by commercial fishing interests that the sea bed benefits from being trawled or disturbed. Evidence to support increased benthic food web productivity in areas disturbed by trawling has suggested that this is the case, and that some mobile consumers can benefit from this increased productivity. 2. The same hypothesis has been put forward for shellfish recruitment, that disturbance of the sea bed, e.g. ‘harrowing’, increases the exposure of suitable settlement substrates for shellfish larvae. This is an approach often taken in shellfish mariculture in private fisheries, and has led to calls for support of expanding such activities into publicly managed areas to promote shellfish recovery and restoration. 3. Increased seabed disturbance, however, may not align with conservation policy or societal objectives for natural recovery of the seabed landscape. Furthermore, evidence for increased shellfish recruitment from seabed disturbance is mixed, and many attempts to elucidate whether relationships exist receive criticism for operating at small spatial and temporal scales. 4. An analysis is presented from 3 years of data (2016–2018) from a stock survey of a private European flat oyster, Ostrea edulis, fishery operating in the Blackwater estuary, Essex, UK. Using data for adult and recruit oyster abundance and distribution in 2018, with ‘harrowing’ effort from 2016–2018, it is asked whether oyster recruitment was related to disturbance effort. 5.It was found that oyster recruitment is positively related to increased seabed disturbance, but only up to intermediate adult oyster abundance equivalent to 60 oysters/100 m dredge, beyond which harrowing results in recruitment declines. This has implications for approaches to oyster fishery recovery, but also for restoration projects seeking evidence-led guidance on which ways may be appropriate to kick-start natural recovery in historical oyster areas that are habitat limited

Personal Finance: An Interdisciplinary Profession

This commentary recommends that financial counseling and planning research, education, and practice be framed as an interdisciplinary profession called personal finance. Authors summarize the history of the profession and key theories providing the conceptual foundation. In order for the emerging profession of personal finance to achieve significant visibility and gain maturity, professionals must reach consensus on definining collective scholarship. Readers are encouraged to engage in the dialogue and comment on the call to action by contacting the lead author

Experimental estimation of ladder dredge efficiency for capture of European flat oysters over mixed sediment

Fishing gear-based landings or survey methods are often used to make assessments of species stock abundance. In order to convert catch into abundance values, estimates or assumptions are made on the catch efficiency of the gear-based method. This is the case in areas where flat oysters, Ostrea edulis, are surveyed for fisheries and conservation objectives in a range of projects across Europe. Flat oyster dredge efficiency assumptions vary widely from 5–30% in published studies and uncertainty in what is an appropriate efficiency estimate has led some survey teams to switch to Catch-per-unit-effort (CPUE), where CPUE is also of concern should catch efficiency change with shellfish density, ground type or some other unmeasured variable such as shellfish distribution. We undertook an experimental approach to estimate dredge efficiency in a standard ladder dredge used to harvest and survey adult flat oysters in the UK and Ireland. The dredge efficiency trials assessed how efficiency was influenced by oyster density (between 1 and 2.2 oysters m2), distribution (clumped vs uniform) and ground types across a gradient of more hard to more soft surface sediments. Dredge efficiency was significantly affected by oyster distribution, but also density and ground hardness as well as their interactions. While a median value between 7 and 10% seems an appropriate universal ladder dredge efficiency to adopt, ground type and distribution had such an effect that local conditions may effect this considerably. Catch efficiency was negatively density-dependent, this makes CPUE methods challenging where oyster densities are likely to vary. Practitioners, regulators and researchers conducting surveys can improve CPUE approaches through standard techniques and knowledge of how catch efficiency varies as we have presented here

Comparison of urinary 6‐β‐cortisol and the erythromycin breath test as measures of hepatic P450IIIA (CYP3A) activity

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110077/1/cptclpt1992140.pd

Massage for Children Undergoing Hematopoietic Cell Transplantation: A Qualitative Report

Background. No in-depth qualitative research exists about the effects of therapeutic massage with children hospitalized to undergo hematopoietic cell transplantation (HCT). The objective of this study is to describe parent caregivers' experience of the effects of massage/acupressure for their children undergoing HCT. Methods. We conducted a qualitative analysis of open-ended interviews with 15 parents of children in the intervention arm of a massage/acupressure trial. Children received both practitioner and parent-provided massage/acupressure. Results. Parents reported that their child experienced relief from pain and nausea, relaxation, and greater ease falling asleep. They also reported increased caregiver competence and closeness with their child as a result of learning and performing massage/acupressure. Parents supported a semistandardized massage protocol. Conclusion. Massage/acupressure may support symptom relief and promote relaxation and sleep among pediatric HCT patients if administered with attention to individual patients' needs and hospital routines and may relieve stress among parents, improve caregiver competence, and enhance the sense of connection between parent and child