A Tale of Two Sylamores: Understanding Relationships Among Land Use, Nutrients, and Aquatic Communities Across a Subsidy-Stress Gradient

Agricultural land use is known to degrade aquatic systems with high inputs of nutrients, sediments, and pesticides. Increased nutrients can lead to increased algal growth and thus possible hypoxic conditions in slow moving water, while increased sediment loads have been shown to obstruct light and reduce substrate stability. These conditions negatively impact primary producers, macroinvertebrates, and fish. However, small-scale changes in land use can subsidize an aquatic ecosystem instead, where an increase in nutrients allows nutrient-limited biota to flourish, and minor increases in sedimentation may help support populations of collector-filterers. The stimulation in performance caused by small disturbances is part of the subsidy-stress gradient, where increasing perturbation subsidizes an ecosystem until a certain threshold is reached, at which a decline in performance and increased variability starts to occur. The North and South Sylamore watersheds in north Arkansas provide a useful template to investigate the subsidy-stress gradient in relation to land use. North Sylamore flows through the Ozark National Forest and has a heavily forested catchment, while South Sylamore flows through mostly private land, some of which is pasture (23%). Physicochemical, macroinvertebrate, and fish data were collected from multiple sites within each watershed to determine if South Sylamore is exhibiting a response to pasture/agriculture characteristic of a subsidy-stress gradient. Sites within South Sylamore had significantly higher nitrate levels, larger macroinvertebrate populations dominated by collector-filterers, and greater abundance of algivorous fish, suggesting South Sylamore may be subsidized by the surrounding pastoral lands. However, South Sylamore also had a significantly lower proportional abundance of sensitive macroinvertebrate taxa and more unique tolerant fish taxa, suggesting South Sylamore is experiencing stress as well. Habitat quality of South Sylamore could be improved by restoration of trees within the riparian zone. Monitoring aquatic systems for subsidy-stress responses can inform restoration/management decisions and guide intervention prior to watersheds and aquatic communities becoming overly stressed

Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement

Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self-esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short-term hypothalamic-pituitary-adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children