Global Scale Variation in the Salinity Sensitivity of Riverine Macroinvertebrates: Eastern Australia, France, Israel and South Africa

Salinity is a key abiotic property of inland waters; it has a major influence on biotic communities and is affected by many natural and anthropogenic processes. Salinity of inland waters tends to increase with aridity, and biota of inland waters may have evolved greater salt tolerance in more arid regions. Here we compare the sensitivity of stream macroinvertebrate species to salinity from a relatively wet region in France (Lorraine and Brittany) to that in three relatively arid regions eastern Australia (Victoria, Queensland and Tasmania), South Africa (south-east of the Eastern Cape Province) and Israel using the identical experimental method in all locations. The species whose salinity tolerance was tested, were somewhat more salt tolerant in eastern Australia and South Africa than France, with those in Israel being intermediate. However, by far the greatest source of variation in species sensitivity was between taxonomic groups (Order and Class) and not between the regions. We used a bayesian statistical model to estimate the species sensitivity distributions (SSDs) for salinity in eastern Australia and France adjusting for the assemblages of species in these regions. The assemblage in France was slightly more salinity sensitive than that in eastern Australia. We therefore suggest that regional salinity sensitivity is therefore likely to depend most on the taxonomic composition of respective macroinvertebrate assemblages. On this basis it would be possible to screen rivers globally for risk from salinisation

The Iowa Homemaker vol.18, no.2

Special Invitation for One by Jane Helser, page 2 Whether Dress or Mate – Investigate by Dorothy Goeppinger, page 3 A Petition to Play by Ruth Sawin, page 4 Hold Your Horses by Berniece Williams, page 5 Fashion Maypole by Barbara Field, page 6 “Veishea-timing” by Beth Cummings, page 8 Learn All to Do All by Alvina Iverson, page 9 Fifty Grads Go to Work by Faithe Danielson, page 10 Throwing Bouquets by Winnifred Cannon, page 11 What’s New in Home Economics edited by Marjorie Pettinger, page 12 Behind Bright Jackets edited by Winnifred Cannon, page 14 Pie for All by Evelyn Burchard, page 15 “You Can’t Print That!” by Beth Johnson, page 16 Homemaking in the Hills by Carolyn Roller, page 17 Dear Someone, by Helen Greene, page 18 Picnic Precautions by Ida Halpin, page 20 Browned With Precision by Anne Halder Allen, page 21 From Carving to Kitchens by Ruth Dahlberg, page 22 Busy Summering by Betty Burbank and Henrietta Dunlop, page 23 Bowls With a Past by Jean Metcalf, page 2

How community pharmacists could improve their role as providers of medicines information

The role of the specialist pharmacist is increasingly recognised within the palliative care team. In Glasgow, in partnership with the local NHS board, Macmillan Cancer Support has funded four part-time Macmillan pharmacist facilitator posts

Investigating the medicines and pharmacy information needs of older palliative care patients and their carers receiving care from community pharmacies

• The pharmacist is increasingly recognised as the expert on medication by the multidisciplinary palliative care team. However, patients and their carers may be unaware of the pharmacist as a source of information about medication and may have limited knowledge of the services provided by community pharmacists. • Focus Groups interviews were conducted with a sample of patients and carers over the age of 55yrs. It was found that: (i) Patient information leaflets and the internet are commonly consulted for medicines information, but there is a preference for face to face interactions; (ii) there appears to be a lack of pro-active dissemination of information on the prescription dispensing process and limited knowledge of broader pharmacy services, which is often gained in an ad-hoc manner or as part of a critical event and unlikely to be integrated within any anticipatory care package. • Older palliative care patients and their carers have particular medicine and pharmacy information needs. The study outlines the type and nature of information required to support Community Pharmacists to better serve the needs of this client group

Improved Eating Behaviour and Nutrient Intake in Noncompliant Patients with Phenylketonuria after Reintroducing a Protein Substitute: Observations from a Multicentre Study

Noncompliance is widespread in adults with PKU and is associated with adverse metabolic, nutritional and cognitive abnormalities. Returning to the PKU diet is important for this at-risk population, yet for many this is challenging to achieve. Strategies that ease the return to the PKU diet, while offering nutritional and cognitive advantages, are needed. Twelve PKU adults (33.7 ± 2.6 years), who had been noncompliant for 4.5 years (range: 1 to 11 years), took 33 g of a low-volume, nutrient-enriched, protein substitute daily for 28 days. Outcomes of eating behaviour, nutrient intake and mood were assessed at entry (baseline, days 1–3) and after the intervention period (days 29–31). At baseline, intakes of natural protein and estimated phenylalanine were high (66.4 g and 3318.5 mg, respectively) and intakes of calcium, magnesium, iron, zinc, iodine and vitamin D were below country-specific recommendations. With use of the experimental protein substitute, natural protein and estimated phenylalanine intake declined (p = 0.043 for both). Fat and saturated fat intakes also decreased (p = 0.019 and p = 0.041, respectively), while energy and carbohydrate intake remained unchanged. Micronutrient intake increased (p ≤ 0.05 for all aforementioned) to levels well within reference nutrient intake recommendations. Blood vitamin B12 and vitamin D increased by 19.8% and 10.4%, respectively. Reductions in anxiety and confusion were also observed during the course of the study yet should be handled as preliminary data. This study demonstrates that reintroducing a low-volume, nutrient-enriched protein substitute delivers favourable nutritional and possible mood benefits in noncompliant PKU patients, yet longer-term studies are needed to further confirm this. This preliminary knowledge should be used in the design of new strategies to better facilitate patients’ return to the PKU diet, with the approach described here as a foundation

Assessment and Treatment of Hepatitis C Virus Infection Among People Who Inject Drugs in the Opioid Substitution Setting: ETHOS Study

Vertical rainfall profile retrieval based on reflectivity data collected by spaceborne rain radars can be improved through the techniques that exploit an estimation of the sea surface Normalised Radar Cross Section (NRCS) as an additional information. However, errors that can currently be made in predicting the sea surface NRCS may significantly affect their performance. Therefore, in this paper we first address the problem to evaluate the NCRS of the sea surface perturbed by rain, when observed at nadir. For this purpose, the dominant effect of ring waves generated by rainfall is considered. The joint effect of wind is also considered. The proposed model is based on the Full Wave Model (FWM) theory. Some comparisons are made with an alternative, less flexible model based on the Integral Equation Model (IEM) theory, and partial comparisons are also made with experimental data, which authorize to consider the proposed model well grounded and exploitable for application. then, we show that the model can be usefully exploited to improve rainfall rate vertical profile retrieval over the sea surface, inthe case of nadir looking, single frequency radars

The effect of social functioning and living arrangement on treatment intent, specialist assessment and treatment uptake for hepatitis C virus infection among people who inject drugs: the ETHOS study

Background: The objective was to assess social functioning and its association with treatment intent, specialist assessment and treatment uptake for hepatitis C virus (HCV) infection among people with a history of injecting drug use. Methods: ETHOS is a prospective observational cohort evaluating the provision of HCV assessment and treatment among people with chronic HCV and a history of injecting drug use, recruited from nine community health centres and opioid substitution treatment clinics (NSW, Australia). Social functioning was assessed using a short form of the Opioid Treatment Index social functioning scale. Those classified in the highest quartile (score >6) were considered having lower social functioning. Analyses were performed using logistic regression. Results: Among 415 participants (mean age 41 years, 71% male), 24% were considered having lower social functioning, 70% had early HCV treatment intent (intention to be treated in the next 12 months), 53% were assessed by a specialist and 27% initiated treatment. Lower social functioning was independently associated with unemployment, unstable housing, recent injecting drug use and moderate to extremely severe symptoms of depression, anxiety and stress. Lower social functioning was independently associated with reduced early HCV treatment intent (aOR 0.51, 95% CI 0.30-0.84) and lower specialist assessment (aOR 0.48, 95% CI 0.29-0.79), but not HCV treatment uptake (aOR 0.76, 95% CI 0.40-1.43). Living with someone was independently associated with HCV treatment uptake (with someone and children: aOR 2.28, 95% CI 1.01-5.14; with someone and no children: aOR 2.36, 95% CI 1.30-4.31), but not early HCV treatment intent or specialist assessment. Conclusions: This study highlights the need for the development and implementation of strategies targeting people who inject drugs with lower social functioning to enhance HCV treatment intent and specialist assessment. Further, strategies to enhance social support may play a role in increasing HCV treatment uptake.This work was supported by the National Health and Medical Research Council (NHMRC, 568985) and New South Wales Health. The Centre for Social Research in Health is supported by a grant from the Australian Government Department of Health and Ageing. This publication was funded by the Australian Government Department of Health and Ageing. GD and PH are supported through NHMRC Practitioner Fellowships. JG is supported through a NHMRC Career Development Fellowship

Assessment and delivery of treatment for hepatitis C virus infection in an opioid substitution treatment clinic with integrated peer-based support in Newcastle, Australia

Background: Among people who inject drugs (PWID), the prevalence of hepatitis C virus (HCV) infection is high; however HCV treatment uptake remains low. New models of care are needed to address the growing burden of HCV-related disease in PWID and to understand the barriers to assessment and treatment of HCV. This study evaluated assessment and treatment for HCV infection among PWID attending an opioid substitution treatment (OST) clinic with an integrated peer support worker model. Methods: Clients with a history of IDU and chronic HCV infection, attending the Newcastle Pharmacotherapy Service, Newcastle Australia, were recruited as part of a multisite prospective observational study (the ETHOS Cohort). Additional chart review was conducted for clients not enrolled in the ETHOS Cohort. A peer support worker was introduced to complement and extend services offered by the clinical team. Client contacts and assessments with a nurse and/or peer worker were evaluated, including those who commenced HCV treatment. Results: A total of 1447 clients attended the OST service during February 2009 and June 2014. Of these, 378 (26%) were assessed by a nurse and 242 (17%) by a clinician. HCV treatment was commenced by 20 (5%) participants and 15 (75%) achieved a sustained virological response (SVR). During May 2009 and July 2011, 332 nurse contacts and 726 peer worker contacts were evaluated. The nurse-led contacts were related to HCV treatment (50%) and review of pathology tests (34%), whereas peer worker contacts included discussion about HCV treatment (75%), education, counselling and/or support (53%) and general discussion about HCV infection (59%). Conclusion: These data demonstrate that peer support workers facilitate broader discussion about HCV treatment, education and/or support, allowing nurses to focus on HCV-related assessment and treatment. HCV treatment uptake was very low in this cohort, but SVR was high. The integration of peer support workers in treatment programs within OST clinics may address barriers to HCV care, but further studies are needed to assess their impact on assessment and treatment outcomes