Potential methodological influences on the determination of particle retention efficiency by suspension feeders: Mytilus edulis and Ciona intestinalis

The retention efficiency (RE) of suspension-feeding bivalve molluscs depends on particle size and is generally assumed to decline below a maximum retention of particles larger than 3 to 7 µm. Previous suggestions that the RE spectrum of mussels Mytilus edulis can exhibit variability, possibly as a result of physiological regulation, have been attributed to artifacts associated with the indirect method. The possibility that variable physical properties of seston particles and/or miscalculations can result in inaccurate RE measurements was examined using 3 methodologies (static, flow-through and a new approach based on the static method) and 3 particle sources (natural seston, algal cell monocultures and clay). Measurements obtained with the static method varied depending on the selected sampling interval. However, this artifact can be removed using frequent sampling and a regression analysis approach. Accurate RE measurements can be obtained with the flow-through method when feeding behaviour is flow independent. For all particle suspensions and methods, mussels from the study site in Lysefjord, Norway, had a maximum RE for particles >8–11 µm (1 to 5 September 2015). The RE for smaller particles declined gradually, with 50–60% retention of 4 µm particles and 30–40% retention of 2 µm particles. Differences in the RE size spectra of mussels and tunicates Ciona intestinalis, collected and measured at the same site, further indicated that RE was not influenced by potentially confounding methodological factors. Assumptions regarding the RE spectrum of bivalves have contributed to many conclusions on their ecosystem interactions. The reliability of clearance rate measurements obtained using the indirect method can only be assured if the effective retention of tracer particles is confirmed and not assumed.publishedVersio

Do Children Who Move Home and School Frequently Have Poorer Educational Outcomes in Their Early Years at School? An Anonymised Cohort Study

Frequent mobility has been linked to poorer educational attainment. We investigated the association between moving home and moving school frequently and the early childhood formal educational achievement. We carried out a cohort analysis of 121,422 children with anonymised linked records. Our exposure measures were: 1) the number of residential moves registered with a health care provider, and 2) number of school moves. Our outcome was the formal educational assessment at age 6–7. Binary regression modeling was used to examine residential moves within the three time periods: 0 – ,1 year; 1 – ,4 years and 4 – ,6 years. School moves were examined from age 4 to age 6. We adjusted for demographics, residential moves at different times, school moves and birth related variables. Children who moved home frequently were more likely not to achieve in formal assessments compared with children not moving. Adjusted odds ratios were significant for 3 or more moves within the time period 1 –,4 years and for any number of residential moves within the time period 4– ,6 years. There was a dose response relationship, with increased odds ratios with increased frequency of residential moves (2 or more moves at 4–,6 years, adjusted odds ratio 1.16 (1.03, 1.29). The most marked effect was seen with frequent school moves where 2 or more moves resulted in an adjusted odds ratio of 2.33 (1.82, 2.98). This is the first study to examine the relationship between residential and school moves in early childhood and the effect on educational attainment. Children experiencing frequent mobility may be disadvantaged and should be closely monitored. Additional educational support services should be afforded to children, particularly those who frequently change school, in order to help them achieve the expected educational standards

Risk Factors for Extended Duration of Acute Diarrhea in Young Children

Objective and Background: We sought to identify predictors of extended duration of diarrhea in young children, which contributes substantially to the nearly 1 1/2 million annual diarrheal deaths globally. Methods: We followed 6-35 month old Nepalese children enrolled in the placebo-arm of a randomized controlled trial with 391 episodes of acute diarrhea from the day they were diagnosed until cessation of the episode. Using multiple logistic regression analysis, we identified independent risk factors for having diarrhea for more than 7 days after diagnosis. Results: Infants had a 17 (95% CI 3.5, 83)-fold and toddlers (12 to 23 month olds) a 9.9 (95% CI 2.1, 47)-fold higher odds of having such illness duration compared to the older children. Not being breastfed was associated with a 9.3 (95% CI 2.4, 35.7)-fold increase in the odds for this outcome. The odds also increased with increasing stool frequency. Furthermore, having diarrhea in the monsoon season also increased the risk of prolonged illness. Conclusion: We found that high stool frequency, not being breastfed, young age and acquiring diarrhea in the rainy season were risk factors for prolonged diarrhea. In populations such as ours, breastfeeding may be the most important modifiable risk factor for extended duration of diarrhea

Latitudinally distinct stocks of Atlantic cod face fundamentally different biophysical challenges under on-going climate change

The reproductive success of marine ectotherms is especially vulnerable in warming oceans due to alterations in adult physiology, as well as embryonic and larval survival prospects. These vital responses may, however, differ considerably across the species' geographical distribution. Here we investigated the life history, focusing on reproductive ecology, of three spatially distant populations (stocks) of Atlantic cod (Gadus morhua, Gadidae) (50–80° N), in the Irish/Celtic Seas-English Channel Complex, North and Barents Seas, under past and projected climate. First, experimental tracking of spawning behaviour evidenced that the ovulation cycle is highly distressed at ≥9.6 (±0.25)°C (Tup). This knife-edge threshold resulted in erratic spawning frequencies, whereas vitellogenin sequestration remained unaffected, indicating endocrine rather than aerobic scope constraints. Cod in the Celtic Sea-English Channel are, therefore, expected to show critical stock depensation over the next decades as spawning grounds warm above Tup, with Irish Sea cod subsequently at risk. Second, in the relatively cooler North Sea, the northward retraction of Calanus finmarchicus (Calanidae) and Para-Pseudocalanus spp. (Clausocalanidae) (1958–2017) limit cod larvae feeding opportunities, particularly in the southernmost subarea. However, the contrasting increase in Calanus helgolandicus (Calanidae) does not counteract this negative effect, likely because cod larvae hatch ahead of its abundance peaks. Overfishing again comes as a twin effect. Third, in the still relatively cold Barents Sea, the sustainably harvested cod benefit from improved food conditions in the recent ice-free polar region but at the energetic cost of lengthier and faster spawning migrations. Consequently, under climate change local stocks are stressed by different mechanistic factors of varying management severity

Host Suitability of a Gregarious Parasitoid on Beetle Hosts: Flexibility between Fitness of Adult and Offspring

Behavioral tactics play a crucial role in the evolution of species and are likely to be found in host-parasitoid interactions where host quality may differ between host developmental stages. We investigated foraging decisions, parasitism and related fitness in a gregarious ectoparasitoid, Sclerodermus harmandi in relation to two distinct host developmental stages: larvae and pupae. Two colonies of parasitoids were reared on larvae of Monochamus alternatus and Saperda populnea (Cerambycidae: Lamiinae). Paired-choice and non-choice experiments were used to evaluate the preference and performance of S. harmandi on larvae and pupae of the two species. Foraging decisions and offspring fitness-related consequences of S. harmandi led to the selection of the most profitable host stage for parasitoid development. Adult females from the two colonies oviposited more quickly on pupae as compared to larvae of M. alternatus. Subsequently, their offspring development time was faster and they gained higher body weight on the pupal hosts. This study demonstrates optimal foraging of intraspecific détente that can occur during host-parasitoid interactions, of which the quality of the parasitism (highest fitness benefit and profitability) is related to the host developmental stage utilized. We conclude that S. harmandi is able to perfectly discriminate among host species or stages in a manner that maximizes its offspring fitness. The results indicated that foraging potential of adults may not be driven by its maternal effects, also induced flexibly with encountering prior host quality

Long-term follow-up of disability pensioners having musculoskeletal disorders

<p>Abstract</p> <p>Background</p> <p>Previously we have conducted a randomised controlled trial (RCT) to evaluate the effect of a brief cognitive behavioural program with a vocational approach aiming to return disability pensioners with back pain to work, as compared to no intervention. One year after the intervention, 10 participants (22%) who received the program and 5 (11%) in the control group reported to have entered a return to work process. The aims of this study were to evaluate long-term effects of the intervention, and compare this effect to 2 reference populations not participating in the original trial.</p> <p>Methods</p> <p>Three groups of disability pensioners were investigated: 1) Disability pensioners having back pain (n = 89) previously participating in the RCT (randomized to either a brief cognitive behavioural intervention or to a control group), 2) 342 disability pensioners having back pain, but refusing to participate in the study and 3) 449 disability pensioners having other musculoskeletal disorders than back pain. Primary outcome was return to work, defined as a reduction in payment of disability pension.</p> <p>Results</p> <p>Only 2 of 89 (2.3%) participants from the RCT had reduced disability pension at 3-years follow-up, both from the control group. None of the participants that had been in a process of returning to work after 1 year had actually gained employment at 3-years follow-up. In the 2 groups not participating in the previous RCT, only 4 (1.2%) and 8 (1.6%) had returned to work after 3 years respectively.</p> <p>Conclusion</p> <p>The number of pensioners who returned to work was negligible in all groups regardless of having participated in a cognitive behavioural intervention or not.</p

Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Chronic kidney disease (CKD) and end-stage renal disease (ESRD) represent worldwide health problems with an epidemic extent. Therefore, attention must be given to the optimisation of patient care, as gaps in the care of CKD and ESRD patients are well documented. As part of a multidisciplinary patient care strategy, clinical pharmacy services have led to improvements in patient care. The purpose of this study was to summarise the available evidence regarding the role and impact of clinical pharmacy services for these patient populations.</p> <p>Methods</p> <p>A literature search was conducted using the <it>Medline</it>, <it>Embase </it>and <it>International Pharmaceutical Abstracts </it>databases to identify relevant studies on the impact of clinical pharmacists on CKD and ESRD patients, regarding disease-oriented and patient-oriented outcomes, and clinical pharmacist interventions on drug-related problems.</p> <p>Results</p> <p>Among a total of 21 studies, only four (19%) were controlled trials. The majority of studies were descriptive (67%) and before-after studies (14%). Interventions comprised general clinical pharmacy services with a focus on detecting, resolving and preventing drug-related problems, clinical pharmacy services with a focus on disease management, or clinical pharmacy services with a focus on patient education in order to increase medication knowledge. Anaemia was the most common comorbidity managed by clinical pharmacists, and their involvement led to significant improvement in investigated disease-oriented outcomes, for example, haemoglobin levels. Only four of the studies (including three controlled trials) presented data on patient-oriented outcomes, for example, quality of life and length of hospitalisation. Studies investigating the number and type of clinical pharmacist interventions and physician acceptance rates reported a mean acceptance rate of 79%. The most common reported drug-related problems were incorrect dosing, the need for additional pharmacotherapy, and medical record discrepancies.</p> <p>Conclusions</p> <p>Few high-quality trials addressing the benefit and impact of clinical pharmacy services in CKD and ESRD patients have been published. However, all available studies reported some positive impact resulting from clinical pharmacist involvement, including various investigated outcome measures that could be improved. Additional randomised controlled trials investigating patient-oriented outcomes are needed to further determine the role of clinical pharmacists and the benefits of clinical pharmacy services to CKD and ESRD patients.</p

Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia

<p>Abstract</p> <p>Background</p> <p>Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms.</p> <p>Methods</p> <p>Qualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies.</p> <p>Results</p> <p>Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection.</p> <p>Conclusions</p> <p>Patient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals.</p

Social Media Use for Health-Related Purposes By People with Rheumatic and Musculoskeletal Diseases - Results of a Global Survey

Background/Purpose: In Malaysia around one in ten older people are diagnosed with osteoarthritis (OA), with the knee being one of the most commonly affected areas. This can lead to functional limitations, impaired activities of daily living and reduced quality-of-life. Our systematic review of the literature concludes that a programme integrating exercise, education and active coping strategies, known as Enabling Self-management and Coping with Arthritic Pain using Exercise (ESCAPE-pain) provides the best evidence for implementation. Thus, this study aims to evaluate the feasibility of the ESCAPE-pain programme among patients with knee OA in the Malaysian healthcare context. Methods: A pragmatic, feasibility randomised controlled trial (RCT) was conducted recruiting patients with knee osteoarthritis from two hospitals in Malaysia. Participants were randomised to receive ESCAPE-pain intervention plus usual care (n=36) (intervention group) or usual care only (n=36) (control group). Outcomes were measured for physical function (TUG), knee injury and osteoarthritis outcome scores (KOOS), mental wellbeing (Short-WEMWBS), exercise health beliefs and self-efficacy (ExBeliefs) and fear of falling (Short-FES-I) at baseline, six-week and after 12-week of intervention. Results: There were no significant differences in baseline characteristics between the groups (p>0.05). Recruitment rate showed 90.5% (72/105) and retention rate at 12-week was 87.5% (63/72). Attendance to intervention programme at ≥10 of 12 sessions was high (82.4%). Using modified intention-to-treat analysis, repeated measures ANOVA showed no significant changes (p>0.05) for TUG or KOOS between intervention and control groups. However, better outcomes (p<0.05) were reported after 12 weeks for health beliefs, mental wellbeing, and fear of falling among patients in intervention group. Satisfaction survey among participants revealed that the ESCAPE-pain programme is easy to follow, straightforward and tolerable for future implementation. Conclusion: The findings of this study indicate that the ESCAPE-pain programme is feasible for patients with knee OA in Malaysia. As a feasibility study, this is not powered to detect significant differences on primary KOOS outcomes, nonetheless participants reported positive views towards exercise with significant improvements in belief in performing activities, mental wellbeing and reduced fear of falling