Cross-disciplinarity in the advance of Antarctic ecosystem research.

The biodiversity, ecosystem services and climate variability of the Antarctic continent and the Southern Ocean are major components of the whole Earth system. Antarctic ecosystems are driven more strongly by the physical environment than many other marine and terrestrial ecosystems. As a consequence, to understand ecological functioning, cross-disciplinary studies are especially important in Antarctic research. The conceptual study presented here is based on a workshop initiated by the Research Programme Antarctic Thresholds - Ecosystem Resilience and Adaptation of the Scientific Committee on Antarctic Research, which focussed on challenges in identifying and applying cross-disciplinary approaches in the Antarctic. Novel ideas and first steps in their implementation were clustered into eight themes. These ranged from scale problems, through risk maps, and organism/ecosystem responses to multiple environmental changes and evolutionary processes. Scaling models and data across different spatial and temporal scales were identified as an overarching challenge. Approaches to bridge gaps in Antarctic research programmes included multi-disciplinary monitoring, linking biomolecular findings and simulated physical environments, as well as integrative ecological modelling. The results of advanced cross-disciplinary approaches can contribute significantly to our knowledge of Antarctic and global ecosystem functioning, the consequences of climate change, and to global assessments that ultimately benefit humankind.

Types of female partners reported by black men who have sex with men and women (MSMW) and associations with intercourse frequency, unprotected sex and HIV and STI prevalence.

We used baseline data from a study of Black MSM/MSMW in 6 US cities to examine the association of female partnership types with disease prevalence and sexual behaviors among the 555 MSMW participants. MSMW reported more than three times as many total and unprotected sex acts with each primary as they did with each non-primary female partner. We compared MSMW whose recent female partners were: (1) all primary ("PF only", n = 156), (2) both primary and non-primary ("PF & NPF", n = 186), and (3) all non-primary ("NPF only", n = 213). HIV/STI prevalence did not differ significantly across groups but sexual behaviors did. The PF only group had the fewest male partners and was the most likely to have only primary male partners; the PF & NPF group was the most likely to have transgender partners. PF & NPF men reported the most sex acts (total and unprotected) with females; NPF only men reported the fewest. Implications for HIV risk and prevention are discussed.

Trophic structure of coastal Antarctic food webs associated with changes in sea ice and food supply.

Predicting the dynamics of ecosystems requires an understanding of how trophic interactions respond to environmental change. In Antarctic marine ecosystems, food web dynamics are inextricably linked to sea ice conditions that affect the nature and magnitude of primary food sources available to higher trophic levels. Recent attention on the changing sea ice conditions in polar seas highlights the need to better understand how marine food webs respond to changes in such broad-scale environmental drivers. This study investigated the importance of sea ice and advected primary food sources to the structure of benthic food webs in coastal Antarctica. We compared the isotopic composition of several seafloor taxa (including primary producers and invertebrates with a variety of feeding modes) that are widely distributed in the Antarctic. We assessed shifts in the trophic role of numerically dominant benthic omnivores at five coastal Ross Sea locations. These locations vary in primary productivity and food availability, due to their different levels of sea ice cover, and proximity to polynyas and advected primary production. The delta15N signatures and isotope mixing model results for the bivalves Laternula elliptica and Adamussium colbecki and the urchin Sterechinus neumeyeri indicate a shift from consumption of a higher proportion of detritus at locations with more permanent sea ice in the south to more freshly produced algal material associated with proximity to ice-free water in the north and east. The detrital pathways utilized by many benthic species may act to dampen the impacts of large seasonal fluctuations in the availability of primary production. The limiting relationship between sea ice distribution and in situ primary productivity emphasizes the role of connectivity and spatial subsidies of organic matter in fueling the food web. Our results begin to provide a basis for predicting how benthic ecosystems will respond to changes in sea ice persistence and extent along environmental gradients in the high Antarctic.

The association of serum anticholinergic activity with delirium in elderly medical patients.

To investigate the hypothesis that elevated serum anticholinergic activity is independently associated with delirium in ill elderly persons, the authors performed a cross-sectional study of 67 acutely ill older medical inpatients. The presence of delirium was evaluated with the Confusion Assessment Method, and the presence of many delirium symptoms was measured by the Delirium Symptom Interview. Demographic data and clinical characteristics that may be important for the development of delirium were also collected. Logistic regression techniques demonstrated that elevated serum anticholinergic activity was independently associated with delirium. Among the subjects with delirium, a greater number of delirium symptoms was associated with higher serum anticholinergic activity.

Costs and management of urinary incontinence in long-term care.

The three aims of the study were (1) to assess the impact and cost of urinary incontinence in long-term care, (2) to determine whether 24-hour incontinence monitoring provides information that improves management, and (3) to ascertain whether costs (nursing time and laundry) could be reduced. The setting was two 24-bed long-term care units in an urban hospital. The research was conducted in three stages. During the initial stage, the impact of incontinence was measured on each unit. Impact was defined as total number of incontinent episodes, nursing time spent changing these patients, and laundry costs, measured during a 7-day period on each unit. After this phase of the investigation, individualized 24-hour incontinence monitoring, followed by recommendations and implementation of care plan, was carried out on one unit. No monitoring or recommendations for care were completed on the other unit, which served as a control. During the third phase of the study, the number of incontinent episodes, nursing time, and laundry costs were again measured on both units. Initially (58%) of residents (24/48) were incontinent, representing 859 episodes of urinary leakage each week that required 45 hours of nursing time to change clothing, containment devices, and bed linens. The direct costs of the nursing time and laundry, expressed in Canadian dollars were $8.60/day per incontinent resident. After 24-hour monitoring of 10 residents one on unit, suggestions were made for various incontinence management programs. An unexpected but simple recommendation was a change to a better containment system for urinary leakage. When impact was measured, a 13% reduction in the number of incontinent episodes was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Stabilometry in balance assessment of dizzy and normal subjects.

Normal adults and patients referred to the Dizzy Clinic at the Medical College of Ohio had their standing balance assessed during combinations of normal and altered visual and somatosensory orientation conditions using a fixed-force platform to measure center-of-pressure translations. Significant differences were identified between normal subjects and dizzy patients, depending on the particular diagnostic category, the sensory condition tested, and the particular sway component being measured. Patients with central and peripheral vestibular dysfunctions had significantly greater sway than all other categories in most test conditions, especially with eyes closed and with a visual conflict dome while standing on a foam surface. The central vestibular dysfunction and peripheral vestibular dysfunction groups could be differentiated statistically under eyes-closed and visual conflict-foam conditions. The normal and psychogenic groups could not be differentiated statistically for any test conditions except one: there was significantly greater mean anterior/posterior sway displacement in the psychogenic group compared with all other diagnostic categories for the eyes-open foam test condition. Our results indicate that static stabilometry recordings of postural sway can be used to evaluate and quantify a dizzy patient's ability to receive and process vestibular, visual, and somatosensory-proprioceptive cues for postural stability. It can also be used to monitor patients with vestibular disorders and to document their responses to rehabilitation programs.

Compartment syndrome as a presentation of non-Hodgkin's lymphoma.

An 80-year-old woman sustained an injury to her left leg and presented having a compartment syndrome. Biopsy at the time of fasciotomy revealed lymphoma infiltrating the muscles of the left leg. We conclude that tumors may present as compartment syndrome and should be included with the differential diagnosis.

Comparison of soft dressing and rigid dressing in the healing of amputated limbs of rabbits.

Thirty white male New Zealand rabbits underwent forelimb amputation below the elbow under sterile operating conditions. Fifteen of the amputation stumps were dressed in a soft, bulky dressing while the remaining 15 rabbits had their stumps immobilized in a rigid plaster dressing. On each of the postoperative days 3, 6, 9, 12 and 15, three rabbits from each group were killed and the amputated limb disarticulated and fixed in formalin. Then, histological examination of the suture line and subcutaneous tissue was carried out by a pathologist to determine the effects, if any, that the type of immobilization has on wound healing. Based on microscopic evaluation of wound approximation, interstitial edema and presence of granulation tissue, there was no significant difference between the stumps immobilized in a plaster dressing and those dressed with a soft, bulky dressing.

Over fifty support group for patients in a rehabilitation hospital. Commentary.

The psychosocial needs of newly disabled 50- to 85-year-old individuals are often neglected in rehabilitation. The Rehabilitation Hospital of the Medical College of Ohio has addressed these needs with the establishment of an over 50 support group. Topics chosen by the group focused on common fears and concerns. The group has been valuable in offering opportunities for peer reinforcement, problem solving, and ventilation of feelings in a safe and supportive setting which had not before existed.

Diagnostic-related groups: their impact on an inpatient rehabilitation program.

Prospective payment by diagnostic-related groups (DRGs) was expected to result in early discharges from acute care hospitals. Early transfers of patients to rehabilitation programs were anticipated, since inpatient rehabilitation programs were exempt from the prospective payment plan. A retrospective study of 516 patient records at our hospital between July 1, 1983, and June 30, 1985, was undertaken to examine changes in the major parameters of the rehabilitation program. No changes in proportions of individuals by diagnostic group, age, or gender were found. No significant change in length of stay occurred. After prospective payment took effect, the average patient admitted to rehabilitation was more impaired regardless of age, yet patients over 65 years showed comparable functional levels at discharge. More medical complications during rehabilitation stay were noted. Most patients continued to return to a home environment. Most parameters did not change after the advent of DRGs.

Day hospital service in rehabilitation medicine: an evaluation.

The purpose of this study was to evaluate Day Hospital care in rehabilitation medicine as an alternative to intensive inpatient care. The study design called for two groups of randomly selected patients who met all admission criteria for intensive inpatient rehabilitation, who had Medicare or Medicaid insurance coverage, and who had a responsible other person living in the home. Those in the Day Hospital group were sent home after a short period of family training and then were taken to the hospital for treatment five days a week. The control group remained in the hospital on the rehabilitation service as inpatients and received the routine care provided to all other inpatients on that service. Data on utilization of health services, both during and after rehabilitation, cost of services, medical, functional, psychologic and social outcomes were collected for all study participants and analyzed. Findings showed no essential difference between the two groups in physical or functional outcome; however at full capacity with the research costs removed, the Day Hospital method proved the more cost effective.

Prosthetic use: correlation of clinic team and ergonomic laboratory in predicting its success.

A group of 92 patients with lower limb amputations were evaluated in an effort to determine whether an appropriate clinical decision to prescribe a prosthesis could be made without using elaborate evaluation testing. The assessments were made independently by a clinic team and by an ergonomic laboratory, each applying its own criteria for predicting successful prosthetic use. The high correlation between the two areas indicated that the ergonomic laboratory made no additional contribution toward the decision to supply a patient who had no complicating features with a prosthesis. Nineteen patients had significant ST depressions during exercise testing and of these, nine died within one year. Two patients with no ST segment depressions died within one year.

Energy costs of below-knee prostheses using two types of suspension.

The choice of suspension in below-knee prosthetics poses a problem for the clinician because cuff suspension weighs less than side-joint-thigh corset suspension but the latter offers more stability. The energy costs of one compared with the other is of prime consideration when dealing with the older person after an amputation. To determine the energy costs of cuff and side-joint-thigh corset suspension, 17 patients were selected for study. A sepcial prosthetic bucket was fabricated for each patient and designed so that the suspensions could be quickly and easily interchanged. Trials with each method of suspension were carried out before and after a training period, and the cardiorespiratory parameters were measured. After the training period all patients demonstrated less oxygen consumption, but the type of suspension did not affect energy costs.

The influence of short term exposure to two different environmental temperatures on electrolyte concentrations of fowl semen.

The concentration of some of the electrolytes found in fowl semen changed when birds were transferred from a temperature environment of 19 degrees C to either 8 degrees or 30 degrees C. The pH of the semen obtained from males transferred to the 30 degrees C. environment significantly decreased as opposed to a significant increase in the pH of the semen obtained from males transferred to the 8 degrees C. environment. Sodium and potassium concentrations significantly increased in whole semen in both transfer groups, while magnesium increased significantly only in whole semen from males transferred to the 8 degrees C. environment. Sodium increased in seminal plasma when the males transferred from 19 degrees C. environment to the 8 degrees C. environment. The data indicate that an abrupt change to either a warmer or colder environment causes a change in electrolyte concentration of cock semen.