Intern Self-Care: An Exploratory Study Into Strategy Use and Effectiveness

In this exploratory study, 363 interns were surveyed to assess the frequency of use and effectiveness of self-care strategies used during the internship year. Among the most frequently used strategies were family and friend social support, active problem solving, and humor. The most effective strategies were family and friend social support, seeking pleasurable experiences, and humor. A strong positive relationship was found between total scores for Frequency and Effectiveness subscales, and women reported significantly more use and effectiveness of strategies. Recommendations and resources are provided for interns and internship sites that seek to further understand and encourage intern self-care

Scenarios in Social-Ecological Systems: Co-Producing Futures in Arctic Alaska

Scenarios are used to think ahead in rapidly changing, complex, and competitive environments, and make crucial decisions in absence of complete information about the future. Currently, at many regional scales of governance, there is a growing need for legitimate tools that enable the actors (e.g., governments, corporations, organized interests) at local-scales to address pressing concerns in the midst of uncertainty. This is particularly true of areas experiencing rapidly changing environments (e.g., drought, floods, diminishing sea ice, erosion) and complex social problems (e.g., remote communities, resource extraction, threatened cultures). Scenario exercises produce neither forecasts of what is to come nor are they visions of what participants would like to happen. Rather, they produce pertinent evidence-based information related to questions of “what would happen if...” and thus provide the possibility of strategic decision- making to plan research that promotes community resilience.Financial support by the National Science Foundation (ArcSEES Program #1263850) is gratefully acknowledged

Cardiac index monitoring by pulse contour analysis and thermodilution after pediatric cardiac surgery

ObjectivesTo validate a new device (PiCCO system; Pulsion Medical Systems, Munich, Germany), we compared cardiac index derived from transpulmonary thermodilution and from pulse contour analysis in pediatric patients after surgery for congenital heart disease. We performed a prospective clinical study in a pediatric cardiac intensive care unit of a university hospital.MethodsTwenty-four patients who had had cardiac surgery for congenital heart disease (median age 4.2 years, range 1.4-15.2 years) were investigated in the first 24 hours after admission to the intensive care unit. A 3F thermodilution catheter was inserted in the femoral artery. Intracardiac shunts were excluded by echocardiography intraoperatively or postoperatively. Cardiac index derived from pulse contour analysis was documented in each patient 1, 4, 8, 12, 16, 20, and 24 hours after admission to the intensive care unit. Subsequently, a set of three measurements of thermodilution cardiac indices derived by injections into a central venous line was performed and calculated by the PiCCO system.ResultsThe mean bias between cardiac indices derived by thermodilution and those derived by pulse contour analysis over all data points was 0.05 (SD 0.4) L · min · m−2 (95% confidence interval 0.01-0.10). A strong correlation between thermodilution and contour analysis cardiac indices was calculated (Pearson correlation coefficient r = 0.93; coefficient of determination r2 = 0.86).ConclusionsPulse contour analysis is a suitable method to monitor cardiac index over a wide range of indices after surgery for congenital heart disease in pediatric patients. Pulse contour analysis allows online monitoring of cardiac index. The PiCCO device can be recalibrated with the integrated transpulmonary thermodilution within a short time frame

Sea-Ice Distribution in the Bering and Chukchi Seas: Information from Historical Whaleships’ Logbooks and Journals

Satellite data have revealed dramatic losses of Northern Hemisphere sea ice since the end of the 1970s. To place these changes in a longer-term context, we draw on daily observations taken from logbooks and journals of whaling vessels cruising in the Bering and Chukchi seas to investigate sea-ice conditions in this region of the Arctic between 1850 and 1910. We compare these observations to sea-ice data from 1972 to 1982, which predate the majority of the recent changes and cover a period recognized as a relative maximum in recent Bering Sea ice extent. Records from May indicate that end-of-winter sea-ice extent in the Bering Sea during the mid 19th century closely resembled that in the 1972 – 82 data. However, the historical data reveal that sea ice was more extensive during summer, with the greatest difference occurring in July. This pattern indicates a later and more rapid seasonal retreat. These conclusions highlight the value of historical data, which we have far from exhausted in this study.Des données satellitaires révèlent que l’hémisphère nord a enregistré des pertes dramatiques de glaces de mer depuis la fin des années 1970. Afin de mettre ces changements dans un plus long contexte, nous nous appuyons sur les observations quotidiennes tirées de journaux et de carnets de bord de baleiniers ayant parcouru la mer de Béring et la mer des Tchouktches dans le but d’étudier les glaces de mer de cette région de l’Arctique entre les années 1850 et 1910. Nous comparons ces observations aux données sur les glaces de mer recueillies de 1972 à 1982 – soit avant que la plupart des récents changements n’aient été enregistrés – ce qui couvre une période reconnue comme un maximum relatif en matière d’étendue récente des glaces dans la mer de Béring. Les données enregistrées en mai laissent entrevoir que l’étendue des glaces de mer en fin d’hiver dans la mer de Béring au milieu du XIXe siècle ressemblait beaucoup à l’étendue des glaces dont témoignent les données prélevées entre 1972 et 1982. Cependant, les données historiques révèlent que les glaces de mer étaient plus considérables au cours de l’été, la plus grande différence se manifestant au mois de juillet. Cette tendance indique donc un retrait saisonnier plus tardif et plus rapide. Les conclusions mettent en évidence l’importance des données historiques, que nous sommes loin d’avoir épuisées dans le cadre de cette étude

A fixed-dose randomized controlled trial of olanzapine for psychosis in Parkinson disease

Background: Psychosis is a common and debilitating side effect of long-term dopaminergic treatment of Parkinson disease (PD). While clozapine is an effective treatment, the need for blood monitoring has limited its first-line use.  Objective: Since olanzapine shows similar receptor affinity to clozapine, we hypothesized that it might be an effective alternative to clozapine for treatment of drug-induced psychosis (DIP) in PD, and that lower doses than usual might make it tolerable. Methods: In 1998-2003 we conducted a four-week, double-blind, placebo-controlled, parallel group, fixed-dose trial of olanzapine (0, 2.5mg, or 5mg) in 23 PD patients with DIP while allowing for clinically realistic dose adjustments of dopaminomimetic mid-study. The primary outcome measures were Brief Psychiatric Rating Scale (BPRS) ratings scored from videotaped interviews after study termination by an observer blinded to dose assignment and to interview timing, and CGI (Clinical Global Impression). The Unified Parkinson’s Disease Rating Scale motor subscale (UPDRS) was the primary measure of tolerability. Results: Intention-to-treat analysis found no significant differences among treatment groups in study completion or serious adverse events. However, a disproportionate number of olanzapine vs. placebo subjects reported mild side effects (p<0.04), many citing motor worsening. Fourteen patients completed the study (seven on placebo, two on 2.5mg olanzapine, five on 5mg olanzapine). In study completers, analysis by repeated measures ANOVA revealed no significant difference between olanzapine and placebo groups in BPRS psychosis reduction (p=0.536), parkinsonism (p=0.608), or any other measured parameters (CGI, MMSE, Beck Depression Inventory, Hamilton Depression score, PDQ‑39, Schwab-England ADL assessment, and sleep scores). Conclusion: This study adds to other evidence that olanzapine is ineffective in treating medication-induced psychosis in Parkinson disease

A study of formation processes of supercooled water and frazil ice in a coastal polynya

第4回極域科学シンポジウム横断セッション：[IA] 「急変する北極気候システム及びその全球的な影響の総合的解明」―GRENE北極気候変動研究事業研究成果報告2013―11月12日（火） 国立極地研究所 ２階大会議

Sea-ice production over the Laptev Sea shelf inferred from historical summer-to-winter hydrographic observations of 1960s-1990s

The winter net sea-ice production (NSIP) over the Laptev Sea shelf is inferred from continuous summer-to-winter historical salinity records of 1960s–1990s. While the NSIP strongly depends on the assumed salinity of newly formed ice, the NSIP quasi-decadal variability can be linked to the wind-driven circulation anomalies in the Laptev Sea region. The increased wind-driven advection of ice away from the Laptev Sea coast when the Arctic Oscillation (AO) is positive implies enhanced coastal polynya sea-ice production and brine release in the shelf water. When the AO is negative, the NSIP and seasonal salinity amplitude tends to weaken. These results are in reasonable agreement with sea-ice observations and modeling

Instantaneous sea ice drift speed from TanDEM-X interferometry

The drift of sea ice is an important geophysical process with widespread implications for the ocean energy budget and ecosystems. Drifting sea ice can also threaten marine operations and present a hazard for ocean vessels and installations. Here, we evaluate single-pass along-track synthetic aperture radar (SAR) interferometry (S-ATI) as a tool to assess ice drift while discussing possible applications and inherent limitations. Initial validation shows that TanDEM-X phase-derived drift speed corresponds well with drift products from a ground-based radar at Utqiaġvik, Alaska. Joint analysis of TanDEM-X and Sentinel-1 data covering the Fram Strait demonstrates that S-ATI can help quantify the opening/closing rate of leads with possible applications for navigation. S-ATI enables an instantaneous assessment of ice drift and dynamic processes that are otherwise difficult to observe. For instance, by evaluating sea ice drift through the Vilkitsky Strait, Russia, we identified short-lived transient convergence patterns. We conclude that S-ATI enables the identification and analysis of potentially important dynamic processes (e.g., drift, rafting, and ridging). However, current limitations of S-ATI are significant (e.g., data availability and they presently only provide the cross-track vector component of the ice drift field) but may be significantly reduced with future SAR systems.</p