Hvordan opplever personer som er utsatt for seksuelle overgrep i barndommen å bli møtt av hjelpetilbud - Hva oppleves som hjelpsomme og mindre hjelpsomme tilbud?

Foreliggende studie undersøker hva voksne utsatt for seksuelle overgrep som barn (SOB) i ettertid oppfatter som hjelpsomt og mindre hjelpsomt i møte med hjelpetilbud og hjelpere, og i tillegg hvordan de ideelt sett ønsker at utsatte for SOB skal bli møtt. Datainnsamlingen foregikk ved at besøkende ved fem støttesentre i Norge besvarte anonyme spørreskjemaer, bestående av åpne og lukkede spørsmål. Totalt 22 informanter oppfylte inklusjonskriteriet om å ha vært utsatt for seksuelle overgrep før fylte 18 år. Et mixed-metode design med fortolkende fenomenologisk analyse og deskriptiv statistikk ble benyttet. Studien viste at mest hjelpsomme erfaringer var god tilgjengelighet og tilrettelegging av hjelpetilbud og muligheten til å snakke åpent. En hjelpsom hjelper viste forståelse, ivaretakelse, trygghet, spurte direkte om overgrep og formidlet kunnskap om SOB. Minst hjelpsomme erfaringer var lang ventetid og vanskelig tilgjengelighet i hjelpetilbud og at hjelper hadde manglende kunnskap og uttrykte nedlatende og ikke-forstående adferd og utsagn relatert til SOB. Studien viser at økt kunnskap om SOB er viktig både for utsatte og deres hjelpere for at utsatte kan få den hjelp de trenger, og at de kan bli møtt av hjelpere som både har kunnskap om SOB og kan imøtekomme utsatte på respektfulle og lyttende måter. Nøkkelord: seksuelle overgrep mot barn, utsatte, hjelpsomme hjelpetilbud, mindre hjelpsomme hjelpetilbud, hjelpetilbud, SMISO, hjelpe

Identification of common horsetail (<i>Equisetum arvense</i> L.; Equisetaceae) using Thin Layer Chromatography versus DNA barcoding

The global herbal products market has grown in recent years, making regulation of these products paramount for public healthcare. For instance, the common horsetail (Equisetum arvense L.) is used in numerous herbal products, but it can be adulterated with closely related species, especially E. palustre L. that can produce toxic alkaloids. As morphology-based identification is often difficult or impossible, the identification of processed material can be aided by molecular techniques. In this study, we explore two molecular identification techniques as methods of testing the purity of these products: a Thin Layer Chromatography approach (TLC-test) included in the European Pharmacopoeia and a DNA barcoding approach, used in recent years to identify material in herbal products. We test the potential of these methods for distinguishing and identifying these species using material from herbarium collections and commercial herbal products. We find that both methods can discriminate between the two species and positively identify E. arvense. The TLC-test is more cost- and time-efficient, but DNA barcoding is more powerful in determining the identity of adulterant species. Our study shows that, although DNA barcoding presents certain advantages, other established laboratory methods can perform as well or even better in confirming species’ identity in herbal products

Less remineralized carbon in the intermediate-depth south Atlantic during Heinrich Stadial 1

Author Posting. © American Geophysical Union, 2019. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography and Paleoclimatology, 34(7), (2019): 1218-1233, doi:10.1029/2018PA003537.The last deglaciation (~20–10 kyr BP) was characterized by a major shift in Earth's climate state, when the global mean surface temperature rose ~4 °C and the concentration of atmospheric CO2 increased ~80 ppmv. Model simulations suggest that the initial 30 ppmv rise in atmospheric CO2 may have been driven by reduced efficiency of the biological pump or enhanced upwelling of carbon‐rich waters from the abyssal ocean. Here we evaluate these hypotheses using benthic foraminiferal B/Ca (a proxy for deep water [CO32−]) from a core collected at 1,100‐m water depth in the Southwest Atlantic. Our results imply that [CO32−] increased by 22 ± 2 μmol/kg early in Heinrich Stadial 1, or a decrease in ΣCO2 of approximately 40 μmol/kg, assuming there were no significant changes in alkalinity. Our data imply that remineralized phosphate declined by approximately 0.3 μmol/kg during Heinrich Stadial 1, equivalent to 40% of the modern remineralized signal at this location. Because tracer inversion results indicate remineralized phosphate at the core site reflects the integrated effect of export production in the sub‐Antarctic, our results imply that biological productivity in the Atlantic sector of the Southern Ocean was reduced early in the deglaciation, contributing to the initial rise in atmospheric CO2.We would like to thank Bärbel Hönisch at Lamont‐Doherty Earth Observatory of Columbia University for help with methods development and Sarah McCart for technical assistance with ICP‐MS analyses. We would also like to give special thanks to Anna lisa Mudahy, who was responsible for picking a substantial portion of the benthic foraminifera used in this study. We are grateful to the WHOI core lab for sample collection and archiving. This work was supported by NSF grant OCE‐1702231 to D. L.2020-01-2

Multi-Scale Kelvin-Helmholtz Instability Dynamics Observed by PMC Turbo on 12 July 2018: 2. DNS Modeling of KHI Dynamics and PMC Responses

Kjellstrand et al. (2021) describes the evolution and dynamics of a strong, large-scale Kelvin-Helmholtz instability (KHI) event observed in polar mesospheric clouds (PMCs) on 12 July 2018 by high-resolution imagers aboard the PMC Turbulence (PMC Turbo) stratospheric long-duration balloon experiment. The imaging provides evidence of KH billow interactions and instabilities that are strongly influenced by gravity waves at larger scales. Specific features include initially separated regions of KHI, secondary convective and KH instabilities of individual billows, and “tubes” and “knots” that arise where billow cores are mis-aligned or discontinuous along their axes. This study describes a direct numerical simulation of KH billow interactions in a periodic domain seeded with random initial noise that enables excitation of multiple KH billows exhibiting variable phase structures that capture multiple features of the observed KHI dynamics. Variable KH billow phases along their axes yield initial vortex tubes having diagonal alignments that link adjacent, but mis-aligned, billow cores. Weak initial vortex tubes and billow cores having nearly orthogonal alignments amplify, interact strongly, and drive intense vortex knots at these sites. These vortex tube & knot (T&K) dynamics excite “twist waves” that unravel the initial vortex tubes, and drive increasingly strong vortex interactions and a cascade of energy and enstrophy to successively smaller scales in the turbulence inertial range. The implications of T&K dynamics are much more rapid and intense breakdown and decay of the KH billows, and significantly enhanced energy dissipation rates, where these interactions occur

Atlantic circulation and ice sheet influences on upper South Atlantic temperatures during the last deglaciation

© The Author(s), 2019. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Umling, N. E., Oppo, D. W., Chen, P., Yu, J., Liu, Z., Yan, M., Gebbie, G., Lund, D. C., Pietro, K. R., Jin, Z. D., Huang, K., Costa, K. B., & Toledo, F. A. L. Atlantic circulation and ice sheet influences on upper South Atlantic temperatures during the last deglaciation. Paleoceanography and Paleoclimatology, 34(6), (2019): 990-1005, doi:10.1029/2019PA003558.Atlantic Meridional Overturning Circulation (AMOC) disruption during the last deglaciation is hypothesized to have caused large subsurface ocean temperature anomalies, but records from key regions are not available to test this hypothesis, and other possible drivers of warming have not been fully considered. Here, we present the first reliable evidence for subsurface warming in the South Atlantic during Heinrich Stadial 1, confirming the link between large‐scale heat redistribution and AMOC. Warming extends across the Bølling‐Allerød despite predicted cooling at this time, thus spanning intervals of both weak and strong AMOC indicating another forcing mechanism that may have been previously overlooked. Transient model simulations and quasi‐conservative water mass tracers suggest that reduced northward upper ocean heat transport was responsible for the early deglacial (Heinrich Stadial 1) accumulation of heat at our shallower (~1,100 m) site. In contrast, the results suggest that warming at our deeper site (~1,900 m) site was dominated by southward advection of North Atlantic middepth heat anomalies. During the Bølling‐Allerød, the demise of ice sheets resulted in oceanographic changes in the North Atlantic that reduced convective heat loss to the atmosphere, causing subsurface warming that overwhelmed the cooling expected from an AMOC reinvigoration. The data and simulations suggest that rising atmospheric CO2 did not contribute significantly to deglacial subsurface warming at our sites.We thank H. Abrams, G. Swarr, and J. Watson for technical assistance. This work was funded by the U.S. National Science Foundation grant OCE15‐558341, the Investment in Science Fund at the Woods Hole Oceanographic Institution, and an Australian Research Council Future Fellowship (FT140100993). The data are included in the supporting information and are available online (https://www.ncdc.noaa.gov/paleo/study/26530)

Land–atmosphere interactions in sub-polar and alpine climates in the CORDEX Flagship Pilot Study Land Use and Climate Across Scales (LUCAS) models – Part 2: The role of changing vegetation

International audienceAbstract. Land cover in sub-polar and alpine regions of northern and eastern Europe have already begun changing due to natural and anthropogenic changes such as afforestation. This will impact the regional climate and hydrology upon which societies in these regions are highly reliant. This study aims to identify the impacts of afforestation/reforestation (hereafter afforestation) on snow and the snow-albedo effect and highlight potential improvements for future model development. The study uses an ensemble of nine regional climate models for two different idealised experiments covering a 30-year period; one experiment replaces most land cover in Europe with forest, while the other experiment replaces all forested areas with grass. The ensemble consists of nine regional climate models composed of different combinations of five regional atmospheric models and six land surface models. Results show that afforestation reduces the snow-albedo sensitivity index and enhances snowmelt. While the direction of change is robustly modelled, there is still uncertainty in the magnitude of change. The greatest differences between models emerge in the snowmelt season. One regional climate model uses different land surface models which shows consistent changes between the three simulations during the accumulation period but differs in the snowmelt season. Together these results point to the need for further model development in representing both grass–snow and forest–snow interactions during the snowmelt season. Pathways to accomplishing this include (1) a more sophisticated representation of forest structure, (2) kilometre-scale simulations, and (3) more observational studies on vegetation–snow interactions in northern Europe

Management of Worsening Heart Failure With Reduced Ejection Fraction:<i>JACC </i>Focus Seminar 3/3

Despite worsening heart failure (HF) being extremely common, expensive, and associated with substantial risk of death, there remain no dedicated clinical practice guidelines for the specific management of these patients. The lack of a management guideline is despite a rapidly evolving evidence-base, as a number of recent clinical trials have demonstrated multiple therapies to be safe and efficacious in this high-risk population. Herein, we propose a framework for treating worsening HF with reduced ejection fraction with the sense of urgency it deserves. This includes treating congestion; managing precipitants; and establishing a foundation of rapid-sequence, simultaneous, and/or in-hospital initiation of quadruple medical therapy for HF with reduced ejection fraction, with the top priority being at least low doses of all 4 medications. Moreover, to maximally reduce residual clinical risk, we further propose consideration of upfront simultaneous use of vericiguat (ie, quintuple medical therapy) and administration of intravenous iron for those who are iron deficient.</p

Serum Biomarkers of Endothelial Dysfunction in Fabry Associated Cardiomyopathy

Background: Fabry disease (FD) is characterized by early development of vasculopathy and endothelial dysfunction. However, it is unclear whether these findings also play a pivotal role in cardiac manifestation. As Fabry cardiomyopathy (FC) is the leading cause of death in FD, we aimed to gather a better insight in pathological mechanisms of the disease.Methods: Serum samples were obtained from 17 healthy controls, 15 FD patients with and 7 without FC. FC was defined by LV wall thickening of &gt;12 mm in cardiac magnetic resonance imaging and serum level of proBNP, high sensitive Troponin T (hsT), and globotriaosylsphingosine (lyso-GB3) were obtained. A multiplex ELISA-Assay for 23 different angiogenesis markers was performed in pooled samples. Markers showing significant differences among groups were further analyzed in single samples using specific Elisa antibody assays. L-homoarginine (hArg), L-arginine, asymmetric (ADMA), and symmetric Dimethylarginine (SDMA) were quantified by liquid chromatography—mass spectrometry.Results: Angiostatin and matrix metalloproteinase 9 (MMP-9) were elevated in FD patients compared to controls independently of the presence of FC (angiostatin: 98 ± 25 vs. 75 ± 15 ng/mL; p = 0.001; MMP-9: 8.0 ± 3.4 vs. 5.0 ± 2.4 μg/mL; p = 0.002). SDMA concentrations were highest in patients with FC (0.90 ± 0.64 μmol/l) compared to patients without (0.57 ± 0.10 μmol/l; p = 0.027) and vs. controls (0.58 ± 0.12 μmol/l; p = 0.006) and was positively correlated with indexed LV-mass (r = 0.61; p = 0.003), hsT (r = 0.56, p = 0.008), and lyso-Gb3 (r = 0.53, p = 0.013). Accordingly, the ratio of L-homoarginine to SDMA (hArg/SDMA) was lowest in patients with FC (2.63 ± 1.78) compared to controls (4.16 ± 1.44; p = 0.005). For L-arginine, hArg and ADMA no significant differences among groups could be detected, although a trend toward higher ADMA and lower hArg levels could be observed in the FC group. Furthermore, a significant relationship between kidney and cardiac function could be revealed (p = 0.045).Conclusion: Elevated MMP-9 and angiostatin levels suggest an increased extracellular matrix turnover in FD patients. Furthermore, endothelial dysfunction may also be involved in FC, as SDMA and hArg/SDMA are altered in these patients

Land–atmosphere interactions in sub-polar and alpine climates in the CORDEX Flagship Pilot Study Land Use and Climate Across Scales (LUCAS) models – Part 2: The role of changing vegetation

Land cover in sub-polar and alpine regions of northern and eastern Europe have already begun changing due to natural and anthropogenic changes such as afforestation. This will impact the regional climate and hydrology upon which societies in these regions are highly reliant. This study aims to identify the impacts of afforestation/reforestation (hereafter afforestation) on snow and the snow-albedo effect and highlight potential improvements for future model development. The study uses an ensemble of nine regional climate models for two different idealised experiments covering a 30-year period; one experiment replaces most land cover in Europe with forest, while the other experiment replaces all forested areas with grass. The ensemble consists of nine regional climate models composed of different combinations of five regional atmospheric models and six land surface models. Results show that afforestation reduces the snow-albedo sensitivity index and enhances snowmelt. While the direction of change is robustly modelled, there is still uncertainty in the magnitude of change. The greatest differences between models emerge in the snowmelt season. One regional climate model uses different land surface models which shows consistent changes between the three simulations during the accumulation period but differs in the snowmelt season. Together these results point to the need for further model development in representing both grass–snow and forest–snow interactions during the snowmelt season. Pathways to accomplishing this include (1) a more sophisticated representation of forest structure, (2) kilometre-scale simulations, and (3) more observational studies on vegetation–snow interactions in northern Europe