Effects of Leaf Diversity on Tannin Concentration and Water Quality

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A Window for Climate Action

Recent student-led (Fridays for Future) and climate change activist-initiated (Extinction Rebellion) protests have effectively mobilized substantial resources and received extensive media coverage. However, potentially due to differences in these movements' tactics, it appears that Fridays for Future has had a more positive impact in bringing attention to the issue of climate change. The protests may have opened a policy window for climate change, presenting a momentary opportunity for substantial political action

The Unequal Pandemic

EPDF and EPUB available Open Access under CC-BY-NC- ND It has been claimed that we are ‘all in it together’ and that the COVID-19 virus ‘does not discriminate’. This accessible, yet authoritative book dispels this myth of COVID-19 as an ‘equal opportunity’ disease, by showing how the pandemic is a syndemic of disease and inequality. Drawing on international data and accounts, it argues that the pandemic is unequal in three ways: it has killed unequally, been experienced unequally and will impoverish unequally. These inequalities are a political choice: with governments effectively choosing who lives and who dies, we need to learn from COVID-19 quickly to prevent growing inequality and to reduce health inequalities in the future. COVID-19 is an unequal pandemic

Promoting Client Welfare and Preserving Autonomy: Ethical Treatment of Eating Disorders

Counselors often experience an ethical dilemma when mandating treatment for clients with eating disorders. In this article, the authors will briefly discuss the characteristics of eating disorders, the impact of cognitive impairment on the decision to mandate treatment, and the ethical principles of autonomy, beneficence, and nonmalificence that counselors must consider when work-ing with clients from this population. To address ethical concerns, the authors will apply Welfel’s (2010) ethical decision-making model to a case involving a client with Anorexia Nervosa

Novel functions of circulating Klotho

A significant portion of the key biological functions of αKlotho (αKL) and its cognate ligand Fibroblast growth factor-23 (FGF23) have been revealed through the study of rare diseases of mineral metabolism. These findings have far reaching implications for common disorders such as chronic kidney disease-mineral bone disorder (CKD-MBD). αKL’s predominant effect on mineral homeostasis is through its actions in the kidney as a co-receptor for FGF23, however emerging data has shed light on its capacity to act as a circulating factor through the cleavage of the transmembrane form of αKL (‘mKL’) to produce ‘cleaved KL’ or ‘cKL’. This review summarizes new findings from studies using extended delivery of cKL to mouse models with phenotypes reflecting those arising in CKD-MBD

Ocean circulation drifts in multi-millennial climate simulations: the role of salinity corrections and climate feedbacks

Low-resolution, complex general circulation models (GCMs) are valuable tools for studying the Earth system on multi-millennial timescales. However, slowly evolving salinity drifts can cause large shifts in climatic and oceanic regimes over thousands of years. We test two different schemes for neutralising unforced salinity drifts in the FAMOUS GCM: surface flux correction and volumetric flux correction. Although both methods successfully maintain a steady global mean salinity, local drifts and subsequent feedbacks promote cooling (≈ 4 °C over 6000 years) and freshening (≈ 2 psu over 6000 years) in the North Atlantic Ocean, and gradual warming (≈ 0.2 °C per millennium) and salinification (≈ 0.15 psu per millennium) in the North Pacific Ocean. Changes in the surface density in these regions affect the meridional overturning circulation (MOC), such that, after several millennia, the Atlantic MOC (AMOC) is in a collapsed state, and there is a strong, deep Pacific MOC (PMOC). Furthermore, the AMOC exhibits a period of metastability, which is only identifiable with run lengths in excess of 1500 years. We also compare simulations with two different land surface schemes, demonstrating that small biases in the surface climate may cause regional salinity drifts and significant shifts in the MOC (weakening of the AMOC and the initiation then invigoration of PMOC), even when the global hydrological cycle has been forcibly closed. Although there is no specific precursor to the simulated AMOC collapse, the northwest North Pacific and northeast North Atlantic are important areas that should be closely monitored for trends arising from such biases

Exploring the role of pain as an early predictor of category 2 pressure ulcers: a prospective cohort study

Objective To explore pressure area related pain as a predictor of category ≥2 pressure ulcer (PU) development. Design Multicentre prospective cohort study. Setting UK hospital and community settings. Participants inclusion Consenting acutely ill patients aged ≥18 years, defined as high risk (Braden bedfast/chairfast AND completely immobile/very limited mobility; pressure area related pain or; category 1 PU). Exclusion Patients too unwell, unable to report pain, 2 or more category ≥2 PUs. Follow-up Twice weekly for 30 days. Primary and secondary outcome measures Development and time to development of one or more category ≥2 PUs. Results Of 3819 screened, 1266 were eligible, 634 patients were recruited, 32 lost to follow-up, providing a 602 analysis population. 152 (25.2%) developed one or more category ≥2 PUs. 464 (77.1%) patients reported pressure area related pain on a healthy, altered or category 1 skin site of whom 130 (28.0%) developed a category ≥2 PU compared with 22 (15.9%) of those without pain. Full stepwise variable selection was used throughout the analyses. (1) Multivariable logistic regression model to assess 9 a priori factors: presence of category 1 PU (OR=3.25, 95% CI (2.17 to 4.86), p<0.0001), alterations to intact skin (OR=1.98, 95% CI (1.30 to 3.00), p=0.0014), pressure area related pain (OR=1.56, 95% CI (0.93 to 2.63), p=0.0931). (2) Multivariable logistic regression model to account for overdispersion: presence of category 1 PU (OR=3.20, 95% CI (2.11 to 4.85), p<0.0001), alterations to intact skin (OR=1.90, 95% CI (1.24 to 2.91), p=0.0032), pressure area related pain (OR=1.85, 95% CI (1.07 to 3.20), p=0.0271), pre-existing category 2 PU (OR=2.09, 95% CI (1.35 to 3.23), p=0.0009), presence of chronic wound (OR=1.66, 95% CI (1.06 to 2.62), p=0.0277), Braden activity (p=0.0476). (3) Accelerated failure time model: presence of category 1 PU (AF=2.32, 95% CI (1.73 to 3.12), p<0.0001), pressure area related pain (AF=2.28, 95% CI (1.59 to 3.27), p<0.0001). (4) 2-level random-intercept logistic regression model: skin status which comprised 2 levels (versus healthy skin); alterations to intact skin (OR=4.65, 95% CI (3.01 to 7.18), p<0.0001), presence of category 1 PU (OR=17.30, 95% CI (11.09 to 27.00), p<0.0001) and pressure area related pain (OR=2.25, 95% CI (1.53 to 3.29), p<0.0001). Conclusions This is the first study to assess pain as a predictor of category ≥2 PU development. In all 4 models, pain emerged as a risk factor associated with an increased probability of category ≥2 PU development

Anti-biofilm activity of a self-aggregating peptide against Streptococcus mutans

Streptococcus mutans is the primary agent of dental cavities, in large part due to its ability to adhere to teeth and create a molecular scaffold of glucan polysaccharides on the tooth surface. Disrupting the architecture of S. mutans biofilms could help undermine the establishment of biofilm communities that cause cavities and tooth decay. Here we present a synthetic peptide P1, derived from a tick antifreeze protein, which significantly reduces S. mutans biofilm formation. Incubating cells with this peptide decreased biofilm biomass by approximately 75% in both a crystal violet microplate assay and an in vitro tooth model using saliva-coated hydroxyapatite discs. Bacteria treated with peptide P1 formed irregular biofilms with disconnected aggregates of cells and exopolymeric matrix that readily detached from surfaces. Peptide P1 can bind directly to S. mutans cells but does not possess bactericidal activity. Anti-biofilm activity was correlated with peptide aggregation and β-sheet formation in solution, and alternative synthetic peptides of different lengths or charge distribution did not inhibit biofilms. This anti-biofilm peptide interferes with S. mutans biofilm formation and architecture, and may have future applications in preventing bacterial buildup on teeth

Developing sexual competence? Exploring strategies for the provision of effective sexualities and relationships education

School-based sexualities and relationships education (SRE) offers one of the most promising means of improving young people's sexual health through developing 'sexual competence'. In the absence of evidence on whether the term holds the same meanings for young people and adults (e.g. teachers, researchers, policy-makers), the paper explores 'adult' notions of sexual competence as construed in research data and alluded to in UK Government guidance on SRE, then draws on empirical research with young people on factors that affect the contexts, motivations and outcomes of sexual encounters, and therefore have implications for sexual competence. These data from young people also challenge more traditional approaches to sexualities education in highlighting disjunctions between the content of school-based input and their reported sexual experience. The paper concludes by considering the implications of these insights for developing a shared notion of what SRE is trying to achieve and suggestions for recognition in the content and approaches to SRE.</p