Underwater Central California: A Guide to Saving Your Ocean Heritage

Describes the state of the wildlife and habitats inside the three national marine sanctuaries that stretch along the coast of central California, and identifies key threats to the future of California's coast

Weekly variability of hydrography and transport of northwestern inflows into the northern North Sea

Quantifying the variability of North Sea inflows and understanding the temporal variability of their physical properties are essential for understanding, modelling and managing the ecosystems of the North Sea. The Joint North Sea Information System (JONSIS) line hydrographic section crosses the path of the main inflows of Atlantic water into the northwestern North Sea. We use observations from an autonomous underwater glider to observe the inflows at high spatial and temporal resolutions. The glider completed 10 partial sections of the JONSIS line in October and November of 2013. Key water masses of the inflow are identified; their spatial distribution varies greatly from section to section. This is not apparent from long-running ship surveys of the JONSIS line, which are generally several months apart. In particular, the distribution of water of most recent Atlantic origin varies as summer stratification decays throughout autumn: at the start of the deployment it is present as a thin layer beneath the thermocline; at the end of the deployment, it occupies the full depth of the water column. Thermohaline flow, i.e. that which is driven by horizontal density gradients, is focused into three or four jets (approximately 10 km wide). Jets as narrow as these have not previously been observed in the region. We also observe baroclinic eddies. The thermohaline transport of the inflows is compared with the absolute transport that is derived by referencing geostrophic shear to the glider's dive-average current. Thermohaline transport (approximately 0.2 Sv) is consistently smaller than absolute transport (approximately 0.5 Sv). The week-to-week variability in hydrography and flow structure identified in this study is relevant to on-going efforts to define a background state against which the nature of anthropogenic changes can be assessed, and future modelling efforts should represent the spatial and temporal variability that we have identified

Normothermic versus hypothermic cardiopulmonary bypass in children undergoing open heart surgery (thermic-2):study protocol for a randomized controlled trial

BACKGROUND: During open heart surgery, patients are connected to a heart-lung bypass machine that pumps blood around the body (“perfusion”) while the heart is stopped. Typically the blood is cooled during this procedure (“hypothermia”) and warmed to normal body temperature once the operation has been completed. The main rationale for “whole body cooling” is to protect organs such as the brain, kidneys, lungs, and heart from injury during bypass by reducing the body’s metabolic rate and decreasing oxygen consumption. However, hypothermic perfusion also has disadvantages that can contribute toward an extended postoperative hospital stay. Research in adults and small randomized controlled trials in children suggest some benefits to keeping the blood at normal body temperature throughout surgery (“normothermia”). However, the two techniques have not been extensively compared in children. OBJECTIVE: The Thermic-2 study will test the hypothesis that the whole body inflammatory response to the nonphysiological bypass and its detrimental effects on different organ functions may be attenuated by maintaining the body at 35°C-37°C (normothermic) rather than 28°C (hypothermic) during pediatric complex open heart surgery. METHODS: This is a single-center, randomized controlled trial comparing the effectiveness and acceptability of normothermic versus hypothermic bypass in 141 children with congenital heart disease undergoing open heart surgery. Children having scheduled surgery to repair a heart defect not requiring deep hypothermic circulatory arrest represent the target study population. The co-primary clinical outcomes are duration of inotropic support, intubation time, and postoperative hospital stay. Secondary outcomes are in-hospital mortality and morbidity, blood loss and transfusion requirements, pre- and post-operative echocardiographic findings, routine blood gas and blood test results, renal function, cerebral function, regional oxygen saturation of blood in the cerebral cortex, assessment of genomic expression changes in cardiac tissue biopsies, and neuropsychological development. RESULTS: A total of 141 patients have been successfully randomized over 2 years and 10 months and are now being followed-up for 1 year. Results will be published in 2015. CONCLUSIONS: We believe this to be the first large pragmatic study comparing clinical outcomes during normothermic versus hypothermic bypass in complex open heart surgery in children. It is expected that this work will provide important information to improve strategies of cardiopulmonary bypass perfusion and therefore decrease the inevitable organ damage that occurs during nonphysiological body perfusion. TRIAL REGISTRATION: ISRCTN Registry: ISRCTN93129502, http://www.isrctn.com/ISRCTN93129502 (Archived by WebCitation at http://www.webcitation.org/6Yf5VSyyG)

An investigation into the relationship between nutritional status, dietary intake, symptoms and health-related quality of life in children and young people with juvenile idiopathic arthritis: a systematic review and meta-analysis

Background: The association between diet, symptoms and health related quality of life in children and young people with Juvenile idiopathic arthritis (JIA) is not clearly understood. The objectives of this systematic review and meta-analysis were to explore the evidence for a relationship between nutritional status, dietary intake, arthritis symptoms, disease activity and health-related quality of life in children and young people with JIA considering both observational and interventional studies separately. Method: The databases PubMed, CINAHL, PsycINFO, Web of Science and Cochrane were searched in October 2019, updated in September 2020 and October 2021. Searches were restricted to English language, human and age (2–18 years old). Studies were included if they measured the effect of dietary supplements, vitamins or minerals, or diet in general, on quality of life and/ or arthritis symptom management. Two researchers independently screened titles and abstracts. Full texts were sourced for relevant articles. PRISMA guidelines were used for extracting data. For variables (vitamin D and disease activity), a random-effects meta-analysis model was performed. Two authors using a standardized data extraction form, extracted data independently. Results: 11,793 papers were identified through database searching, 26 studies met our inclusion criteria with 1621 participants. Overall studies quality were fair to good. Results from controlled trial and case control studies with total 146 JIA patients, found that Ɯ-3 PUFA improved the mean active joint count (p p p p = 0.029). Conclusions: We were only able to include small studies, of lower design hierarchy, mainly pilot studies. We found some evidence of lower height and weight across studies in JIA, but were unable to confirm an association between diet, symptoms and health-related quality of life in children and young people with JIA. Well-designed, carefully measured and controlled interventional studies of dietary patterns in combination with important contributing factors such as medication and lifestyle behaviours, including physical activity, are required to determine the impact of diet in improving symptoms and growth patterns in children and young people with JIA, with an aim to improve the quality of their life. Trial registration: PROSPERO [CRD42019145587]

Parks Canada’s adaptation framework and workshop approach: Lessons learned across a diverse series of adaptation workshops

In 2017, the Canadian Parks Council Climate Change Working Group, a team of federal, provincial, and territorial representatives, developed a Climate Change Adaptation Framework for Parks and Protected Areas, guiding practitioners through a simple, effective five-step adaptation process. This framework was adapted by Parks Canada into a two-day adaptation workshop approach, with 11 workshops subsequently held from September 2017 to May 2019 at Parks Canada sites in the Yukon, Quebec, Manitoba, Alberta, Nova Scotia, British Columbia, Newfoundland, and Ontario. Lessons learned from each workshop have been integrated into the approach, with the development of tools and guidance for each phase of the process, and a shareable, visual “placemat” that describes each step of the framework, acting as a map for those navigating the process

Occupational Therapy on College Campuses: Facilitating Student Success Through Occupation

Purpose: To explore how occupational therapy services fit into a supported education model on college campuses. Rationale: College students present with many strengths and challenges in college settings. There are limited services for young adults to succeed in college and students with various diagnoses face challenges in the areas of time management, organization, academic skills, and in social areas of college (Orentlicher, & Olson, 2010; Rogers, Kash-MacDonald, Bruker, & Maru, 2010). Higher education is a role emerging area for occupational therapists, and there are some pioneering occupational therapists who have discovered multiple ways to provide services to students who are challenged by aspects of college life. Objectives: Describe the history and current practice of supported education and its fit within the domain of OT. Describe a variety of OT supported education programmes Identify aspects of the supported education programmes that participants could apply to their college or practice setting Format: This workshop will begin by describing the history and models of supported education. The presenters will define six examples of OT programmes on college campuses. Finally, the presenters will encourage participants to share ideas and identify aspects of the various programs that they could apply to their college or practice setting

Sources and pathways of glacial meltwater in the Bellingshausen Sea, Antarctica

Meltwater content and pathways determine the impact of Antarctica's melting ice shelves on ocean circulation and climate. Using ocean glider observations, we quantify meltwater distribution and transport within the Bellingshausen Sea's Belgica Trough. Meltwater is present at different densities and with different turbidities: both are indicative of a layer's ice shelf of origin. To investigate how ice-shelf origin separates meltwater into different export pathways, we compare these observations with high-resolution tracer-release model simulations. Meltwater filaments branch off the Antarctic Coastal Current into the southwestern trough. Meltwater also enters the Belgica Trough in the northwest via an extended western pathway, hence the greater observed southward (0.50 mSv) than northward (0.17 mSv) meltwater transport. Together, the observations and simulations reveal meltwater retention within a cyclonic in-trough gyre, which has the potential to promote climactically important feedbacks on circulation and future melting

Challenges and solutions to recruitment of neonates and children having cardiac surgery into a study using a novel sampling device

OBJECTIVE: To narratively describe the challenges and solutions required in delivering a non-commercial study of children undergoing cardiac surgery using a novel subcutaneous hormone collection device. RESULTS: The challenges faced by the research team are divided into those of conducting healthcare research in children and those specific to this study. Many of the issues of conducting healthcare research in children can and have been overcome by structural and institutional culture change–normalising and embedding research as part of good clinical care. The issues specific to insertion and maintenance of the novel collection device can be overcome by education and support of the clinical teams. The increased incentives and resources of commercial research may have overcome many of these

Firearm Safety, Gun Violence and Chicago Families: Voices of Child Health in Chicago Report

Chicago has seen continuing firearm violence, with over 2,000 shooting victims so far in 2021. The epidemic of firearm violence impacts children across the state, as it remains the number one cause of death in children and youth across Illinois. In some of our previous reports, Chicago parents identified gun violence as their top social concern for kids in the city, and in recent years, they reported it was the main social problem getting worse the fastest for Chicago youth. In this month's Voices of Child Health in Chicago Report, we focus on the importance of firearm safety and parents' concerns about gun violence in the city. We asked 1,505 Chicago parents from all 77 community areas in the city about their experiences with firearm safety as well as other gun violence prevention and concern-related questions.