Loss, resilience and recovery of kelp forests in a region of rapid ocean warming.

BACKGROUND AND AIMS: Changes in kelp abundances on regional scales have been highly variable over the past half-century owing to strong effects of local and regional drivers. Here, we assess patterns and dominant environmental variables causing spatial and interspecific variability in kelp persistence and resilience to change in Nova Scotia over the past 40 years. METHODS: We conducted a survey of macrophyte abundance at 251 sites spanning the Atlantic coast of Nova Scotia from 2019 to 2022. We use this dataset to describe spatial variability in kelp species abundances, compare species occurrences to surveys conducted in 1982 and assess changes in kelp abundance over the past 22 years. We then relate spatial and temporal patterns in abundance and resilience to environmental metrics. KEY RESULTS: Our results show losses of sea urchins and the cold-tolerant kelp species Alaria esculenta, Saccorhiza dermatodea and Agarum clathratum in Nova Scotia since 1982 in favour of the more warm-tolerant kelps Saccharina latissima and Laminaria digitata. Kelp abundances have increased slightly since 2000, and Saccharina latissima and L. digitata are widely abundant in the region today. The highest kelp cover occurs on wave-exposed shores and at sites where temperatures have remained below thresholds for growth (21 °C) and mortality (23 °C). Moreover, kelp has recovered from turf dominance following losses at some sites during a warm period from 2010 to 2012. CONCLUSIONS: Our results indicate that dramatic changes in kelp community composition and a loss of sea urchin herbivory as a dominant driver of change in the system have occurred in Nova Scotia over the past 40 years. However, a broad-scale shift to turf-dominance has not occurred, as predicted, and our results suggest that resilience and persistence are still a feature of kelp forests in the region despite rapid warming over the past several decades.

Quasiparticle mass enhancement and temperature dependence of the electronic structure of ferromagnetic SrRuO3 thin films.

We report high-resolution angle-resolved photoemission studies of epitaxial thin films of the correlated 4d transition metal oxide ferromagnet SrRuO(3). The Fermi surface in the ferromagnetic state consists of well-defined Landau quasiparticles exhibiting strong coupling to low-energy bosonic modes which contributes to the large effective masses observed by transport and thermodynamic measurements. Upon warming the material through its Curie temperature, we observe a substantial decrease in quasiparticle coherence but negligible changes in the ferromagnetic exchange splitting, suggesting that local moments play an important role in the ferromagnetism in SrRuO(3).

Infrared phonon spectroscopy of a compressively strained (001) SrTiO3 film grown on a (110) NdGaO3 substrate.

Polarized infrared reflectivity was measured between 5 and 300 K on a 17 nm thick, 1.1% compressively strained epitaxial (001) SrTiO(3) film and the orthorhombic (110) NdGaO(3) substrate upon which it was grown. A strong in-plane infrared anisotropy of the NdGaO(3) substrate was observed and polar modes with B(1u)-and a mixture of B(2u) + B(3u)-symmetry were seen. At low temperatures three new modes arose in the 90-130 cm( - 1) range, which we assigned to 4f Nd electronic transitions. The in-plane SrTiO(3) film phonons showed strong stiffening compared to the phonon frequencies of bulk unstrained SrTiO(3), particularly the soft mode, and the in-plane phonon peaks were found to split. No anomalies were detected as a function of temperature in either the infrared response or lattice parameters of the compressively strained SrTiO(3) film, providing an absence of evidence for the out-of-plane ferroelectric phase transition predicted by theory.

Ferroelectricity in strain-free SrTiO3 thin films.

Biaxial strain is known to induce ferroelectricity in thin films of nominally nonferroelectric materials such as SrTiO3. By a direct comparison of the strained and strain-free SrTiO3 films using dielectric, ferroelectric, Raman, nonlinear optical and nanoscale piezoelectric property measurements, we conclude that all SrTiO3 films and bulk crystals are relaxor ferroelectrics, and the role of strain is to stabilize longer-range correlation of preexisting nanopolar regions, likely originating from minute amounts of unintentional Sr deficiency in nominally stoichiometric samples. These findings highlight the sensitive role of stoichiometry when exploring strain and epitaxy-induced electronic phenomena in oxide films, heterostructures, and interfaces.

Standardizing contact investigation protocols.

SETTING: The State of Alabama Department of Public Health Division of Tuberculosis Control. OBJECTIVE: To standardize contact investigation protocols and implement an intervention to increase TB field worker adherence to the protocols with the goal of promoting efficiency and effectiveness in contact investigations. DESIGN: A process evaluation of existing data collection and management systems and protocols was performed. Standardized protocols and an intervention to increase TB field worker adherence to the protocols were created and pilot tested. These were then implemented and formative evaluation data were collected. RESULTS: The process evaluation revealed considerable variance among field workers with regard to protocols and definitions of variables related to contact investigations. Protocols were standardized and an intervention targeted at TB field workers was developed. The intervention consisted of a training workshop and the development of a computer-based contact investigation module. This was successfully implemented throughout the state. CONCLUSIONS: To perform effective contact investigations and conduct studies to improve the effectiveness of these investigations, TB control programs must pay careful attention to precisely defining variables and concepts related to the contact investigation. Furthermore, protocols must be standardized and resources devoted to training of TB field workers to ensure adherence to protocols.

Changes in deposition of phytoplankton constituents in a Ca2+ polluted lake.

Systematic reductions in the deposition rate of organic C, N, P, and chlorophyll (Chl) are documented for Ca2+ polluted, culturally eutrophic, Onondaga Lake, NY, based on analyses of weekly sediment trap collections over the May-October interval for 10 years of the 1980-1992 period. Inputs of both nutrient-rich domestic waste and industrial salt waste (including Ca2+) decreased over this period. Constituent ratios of the collected sediment indicate phytoplankton biomass was the dominant source of the deposited organic C, N, and Chl. Substantial decreases in downward fluxes of these constituents occurred starting in 1987: 37, 42, 25, and 54%, on average, for organic C, N, P, and Chl, respectively. These reductions were driven primarily by the decreases in the lake's salinity and Ca2+ concentration, that resulted from the closure of a soda ash manufacturing facility (1986), rather than decreases in water column P concentrations from reductions in domestic waste loading. Three different mechanisms for the decreased deposition, related to the reductions in salinity and Ca2+ concentration, are considered: (i) decrease in coating of phytoplankton with CaCO3 precipitate, (ii) increased grazing of phytoplankton by large cladocerans, and (iii) decreases in coagulation of phytoplankton. The greater loss of phytoplankton biomass through deposition, driven by salt waste inputs from the industry, exacerbated the lake's problem of high primary production. This response is consistent with ecological theory for nutrient saturated phytoplankton growth but has not previously been demonstrated on a whole-lake basis.

An interdisciplinary training program in nutrition sciences and cancer.

To address the shortage of health care professionals trained in the nutritional aspects of cancer prevention, the University of Alabama at Birmingham in 1988 initiated the Cancer Prevention and Control Training Program (CPCTP), with R25 grant support from the NIH/NCI. The CPCTP has enrolled 11 predoctoral and 12 postdoctoral trainees, of whom 18 have completed training and five remain in the program. The curriculum and other program elements are described, and the trainees' academic achievements and ultimate careers are reported. The CPCTP has become a significant resource for training cancer nutrition professionals.

Cancer Prevention and Control Training Program at the University of Alabama at Birmingham.

The pre- and postdoctoral Cancer Prevention and Control Training Program (CPCTP) at the University of Alabama at Birmingham (UAB) has attracted high-quality trainees from all over the United States. The trainees have pursued courses of study in epidemiology, nutrition sciences, health behavior, environmental health sciences, biostatistics, or public health nutrition; and research projects in cessation of tobacco use, cancer screening, cancer epidemiology, diet modification, nutrient-cancer relationships, statistical modeling of carcinogenesis, medical-nutrition education, and obesity, in precise alignment with NCI cancer control objectives. Both courses and research projects have been interdisciplinary, taking advantage of the strong interdepartmental collaborative atmosphere at UAB. Former trainees have been successfully placed in academic, administrative, and practice positions in which they can strategically apply their cancer prevention and control expertise.

Advance directives in cardiac and pulmonary rehabilitation patients.

PURPOSE: Advance directives have been available in parts of the United States for more than 20 years, but research shows that only a small percentage of adults (5-25%) have some form of written advance directive. The purose of this study was to examine the presence of advance directives among persons entering cardiac and pulmonary rehabilitation, and identify characteristics of persons most likely to have advance directives. METHODS: The sample consisted of 336 cardiac patients and 181 pulmonary patients who enrolled in the University of Alabama at Birmingham's Cardiopulmonary Rehabilitation Program between January 1996 and December 1999. As part of the initial program assessment, patients were asked two questions: (1) Do you have a living will? (2) Do you have any advance directives? For the purposes of this study, the two questions were combined to examine the presence of either a living will or other type of advance directive. RESULTS: Results indicate that 25% of both subgroups (cardiac and pulmonary patients) report having written advance directives. Logistic regression analysis indicates that among cardiac patients whites and older persons were more likely to have advance directives. Among pulmonary patients, females and whites were more likely to have advance directives. CONCLUSIONS: These results indicate that only a minority of cardiopulmonary rehabilitation patients have advance directives upon entry into the program, and that the prevalence differs among gender, racial, and age groups. Cardiac and pulmonary rehabilitation programs may be valuable sites for educating patients about advance directives and efforts by rehabilitation personnel may increase the prevalence of advance directives among patients.

Asthma self-management: do patient education programs always have an impact?

BACKGROUND: During the past 15 years, programs to improve self-management practices in adults with asthma have reported improvement in functional status and reduction of inappropriate use of health care services. However, these programs usually represent an ideal approach, applying multiple patient education methods. Consequently, when these programs are found to be efficacious, it is important to replicate the programs as well as to evaluate less complex methods that may be more appropriate for nonacademic health care settings. METHODS: We compared the following 3 standardized self-management treatments in a randomized, controlled trial: (1) a replication of the self-management program developed at a university medical center that was previously shown to be efficacious; (2) a modified version of this program including only the core elements; and (3) a usual-care program. Outcome measures included medication and inhaler regimen adherence, asthma symptoms, respiratory illness, functional status, and use of health care resources. RESULTS: All 3 groups improved on measures of respiratory illnesses, use of health care services, and functional status. Patients in both education groups did no better than the usual-care group. CONCLUSIONS: The results are inconsistent with the results of the first asthma self-management study at this institution and with those of efficacy studies of similar programs. Two factors, selection of the patient population and historical changes in asthma treatment, most likely contributed to the lack of impact of the self-management programs. As a result of the improved standards for usual care due to both factors, the opportunity to effect patient outcomes was substantially reduced.

The outcome of research training during surgical residency.

BACKGROUND/PURPOSE: The exposure to research during residency is currently an integral part of most academic surgical training programs. In this study, graduates of two surgical programs were surveyed to characterize their research experience and to determine the effects on their careers. METHODS: Between 1975 and 1990, 86 and 61 residents completed general surgical training programs at UCLA Medical Center and at Harbor-UCLA Medical Center, respectively. An anonymous survey was sent to each graduate regarding his research experience and current practice. RESULTS: Of the graduates who spent 2 years in research, 47% now hold academic positions, compared with 23% for those who spent less than 2 years (P = .18). When the graduates were segregated according to their desire to enter the laboratory, 49% of graduates who requested research time hold academic positions, whereas only 13% of those who would not request research are in academic positions (P = .01). CONCLUSIONS: Residents who strongly desire a period of research during surgical residency are also more productive in the laboratory. This information should be considered in selecting residents for research training in the current era of academic budget restriction and managed health care.

An inhibitor of the microsomal triglyceride transfer protein inhibits apoB secretion from HepG2 cells.

The microsomal triglyceride (TG) transfer protein (MTP) is a heterodimeric lipid transfer protein that catalyzes the transport of triglyceride, cholesteryl ester, and phosphatidylcholine between membranes. Previous studies showing that the proximal cause of abetalipoproteinemia is an absence of MTP indicate that MTP function is required for the assembly of the apolipoprotein B (apoB) containing plasma lipoproteins, i.e., very low density lipoproteins and chylomicrons. However, the precise role of MTP in lipoprotein assembly is not known. In this study, the role of MTP in lipoprotein assembly is investigated using an inhibitor of MTP-mediated lipid transport, 2-[1-(3, 3-diphenylpropyl)-4-piperidinyl]-2,3-dihydro-1H-isoindol-1-o ne (BMS-200150). The similarity of the IC50 for inhibition of bovine MTP-mediated TG transfer (0.6 microM) to the Kd for binding of BMS-200150 to bovine MTP (1.3 microM) strongly supports that the inhibition of TG transfer is the result of a direct effect of the compound on MTP. BMS-200150 also inhibits the transfer of phosphatidylcholine, however to a lesser extent (30% at a concentration that almost completely inhibits TG and cholesteryl ester transfer). When BMS-200150 is added to cultured HepG2 cells, a human liver-derived cell line that secretes apoB containing lipoproteins, it inhibits apoB secretion in a concentration dependent manner. These results support the hypothesis that transport of lipid, and in particular, the transport of neutral lipid by MTP, plays a critical role in the assembly of apoB containing lipoproteins.

Assessing adherence to asthma medication and inhaler regimens: a psychometric analysis of adult self-report scales.

Poor adherence to recommended regimens is a substantial problem in the clinical management of adults with asthma and other chronic diseases. Research on adherence assessment is complicated by methodological difficulties including limitations associated with the use of self-report measures. In this study, psychometric techniques were used to analyze two self-report scales for assessing adherence to recommended medication and inhaler use regimens in adults with asthma. Results indicated that the two scales had standard deviations large enough to detect variation adherence, had adequate reliability, and reflected the impact of an intervention designed to improve adherence. The results supported the usefulness of these scales for research on adherence. Additional analyses indicated that the two scales could be combined if the research goal required an overall measure of adherence.

Pediatric oncologists' assessment of oncology education in U.S. medical schools: Cancer Education Survey II.

The status of cancer education in U.S. medical schools was reassessed in the Cancer Education Survey II, which was initiated in 1989. One thousand and thirty-five cancer educators from 126 of the country's 128 medical schools participated, including 65 pediatric oncologists and 36 family physicians. All agreed that the most important aspects of cancer to teach medical students are early detection and cancer prevention; they considered less important electives in basic science, radiation therapy, and surgical oncology. The 101 pediatric oncologists and family physicians believed that more curriculum time should be devoted to cancer epidemiology, psychosocial aspects, and palliative care. Approximately one third of these 101 physicians also expressed the desire to have more teaching materials available in five general areas: patient education about pediatric cancer, nutrition, epidemiology, palliative care, and continuing care. Lay-language information about pediatric cancer, participation in clinical trials, and current cancer research is still needed.

Scale for assessing functional impairment in adults with asthma.

Improved outcome measures for asthma research, especially measures of functional status and quality of life, have become increasingly important. This research describes one such measure, the University of Alabama at Birmingham (UAB) Functional Impairment Scale. This scale consists of eight items to assess the impact of asthma on various aspects of daily living. The psychometric properties of the UAB Scale were assessed in two samples. The coefficient alpha reliabilities were high in both samples (.83 and .84), and the item-total correlations indicated all items were measuring the same trait. The score distributions covered the entire range of possible scores, and the central tendencies and dispersions confirmed the presence of enough variation to detect differences in functional impairment among individuals. Correlations between the UAB Scale and other asthma-related measures support construct validity. All of these results support the potential usefulness of the UAB Scale.

Use of the USMLE to select residents.

Many studies have examined the relationships between students' performances on the National Board of Medical Examiners (NBME) Part I and Part II examinations and their postgraduate clinical performances. Most studies have found a positive relationship between students' NBME examination scores and the ratings of residents' clinical performances and/or scores on specialty board certification examinations. Surveys of residency directors have also shown that NBME scores are used as part of the process for selecting residents, although other data and other selection criteria are considered more useful than the NBME scores. One area of continued concern is that a large body of data on the United States Medical Licensing Examination (USMLE) is not yet available. However, the predictive validity of the NBME scores supports the use of USMLE scores as part of the review process to screen potential residents. Residency directors should continue to use a variety of criteria in their final selection decisions and are encouraged to use their own program-specific data to establish and monitor particular cutoff scores for screening applicants.

Biennial survey of physician clinical-nutrition training programs.

This is the fourth survey of physician clinical-nutrition training programs. As in previous reports, current fellowship training programs were identified, descriptive information obtained, and program content surveyed. In addition, a questionnaire developed by the American Board of Nutrition Committee on Fellowship Training Programs was used to determine the degree of emphasis given to content in the areas of basic nutrition science, clinical applications, and research training. Among the 38 programs identified, uniform ratings of importance were found in all major topic areas. There was also uniformity in most subtopics, with minor exceptions. As expected, in the area of nutrition in the life cycle, pediatric training programs emphasized infancy and childhood whereas medical-surgical programs emphasized adulthood and aging. Alcoholism was emphasized in medical-surgical training programs whereas cystic fibrosis and inborn errors of metabolism were emphasized in pediatric programs. Nutrition in burn patients received minor emphasis in all programs. The overall uniformity of curricular content in training programs confirms the contention that clinical nutrition has a defined clinical scope and should be considered for establishment as a recognized subspecialty in American medicine.

Use of focus group methodology to develop an asthma self-management program useful for community-based medical practices.

Health education programs developed in academic medical centers are not optimally disseminated to community clinical settings. Strategies are needed to translate the findings of research on health education programs into programs useful in a wide range of health care settings. Focus group techniques were used to provide data for revising a successful university-based asthma self-management program to make it more practical for use by community physicians. Physicians representing a variety of specialties attended the sessions and provided feedback on the utility of various components of the original program. The discussions revealed that many physicians felt they did not have the time or resources to conduct the original program and identified elements viewed as impractical. This physician input contributed significantly to the development of a revised program with a briefer, less costly intervention. The revised program was later evaluated by focus group participants. Eighty-eight percent of those who evaluated the revised program agreed they would be able and willing to use the program in their own practices. As a formative evaluation tool, the focus group technique made available useful information that would have been difficult to obtain through evaluation forms alone.

Features of asthma in older adults.

A study compared clinical and functional features of elderly patients with asthma to younger patients at a university medical center. Older patients had a larger than predicted reduction in pulmonary function parameters even though physician-assessed severity, duration of diagnosed asthma, and smoking status were no different between groups. A significant increase in the comorbid diagnosis of chronic obstructive pulmonary disease was noted in older patients with asthma. These two points support the hypothesis that long-standing asthma may lead to irreversible airflow obstruction. Older patients reported better medication compliance and decreases in some respiratory symptoms and demonstrated lower health care utilization.