Is our understanding of aquatic ecosystems sufficient to quantify ecologically driven climate feedbacks?

The Earth functions as an integrated system-its current habitability to complex life is an emergent property dependent on interactions among biological, chemical, and physical components. As global warming affects ecosystem structure and function, so too will the biosphere affect climate by altering atmospheric gas composition and planetary albedo. Constraining these ecosystem-climate feedbacks is essential to accurately predict future change and develop mitigation strategies; however, the interplay among ecosystem processes complicates the assessment of their impact. Here, we explore the state-of-knowledge on how ecological and biological processes (e.g., competition, trophic interactions, metabolism, and adaptation) affect the directionality and magnitude of feedbacks between ecosystems and climate, using illustrative examples from the aquatic sphere. We argue that, despite ample evidence for the likely significance of many, our present understanding of the combinatorial effects of ecosystem dynamics precludes the robust quantification of most ecologically driven climate feedbacks. Constraining these effects must be prioritized within the ecological sciences for only by studying the biosphere as both subject and arbiter of global climate can we develop a sufficiently holistic view of the Earth system to accurately predict Earth's future and unravel its past.

La Terre fonctionne comme un système intégré­son habitabilité pour une vie complexe est une propriété émergente qui dépend des interactions entre les composantes biologiques, chimiques et physiques. Le réchauffement climatique affecte la structure et la fonction des écosystèmes, et en retour, la biosphère affecte également le climat en modifiant la composition des gaz atmosphériques et l'albédo planétaire. Il est essentiel de quantifier ces rétroactions entre les écosystèmes et le climat afin de prédire avec précision les changements futurs et élaborer des stratégies d'atténuation; cependant, l'interaction entre les processus écologiques complique l'évaluation de leurs impacts. Dans cet article, nous examinons l'état des connaissances sur la façon dont les processus écologiques et biologiques (par exemple, la concurrence, les interactions trophiques, le métabolisme, l'adaptation) affectent la directionnalité et l'ampleur des rétroactions entre les écosystèmes et le climat à l'aide d'exemples issus du monde aquatique. Nous soutenons que, malgré les nombreuses preuves de l'importance de plusieurs de ces rétroactions, notre compréhension limitée des effets additifs des processus écosystémiques empêche de faire une quantification robuste de la plupart des rétroactions climatiques d'origine écologique. Circonscrire ces effets doit être une priorité pour les sciences aquatiques, car ce n'est qu'en étudiant la biosphère en tant que sujet et arbitre du climat planétaire que nous pourrons développer une vision suffisamment holistique du système terrestre pour prédire avec précision l'avenir de la Terre et élucider son passé.

Gaming industry employees' responses to responsible gambling training: a public health imperative.

Gaming industry employees work in settings that create personal health risks. They also have direct contact with customers who might engage in multiple risky activities (e.g., drinking, smoking, and gambling) and might need to facilitate help-seeking by patrons or co-workers who experience problems. Consequently, the empirical examination of the processes and procedures designed to prepare employees for such complex situations is a public health imperative. In the current study we describe an evaluation of the Casino, Inc. Play Responsibly responsible gaming program. We surveyed 217 employees prior to and 1 month after (n = 116) they completed a multimedia driven responsible gambling training program. We observed that employees improved their knowledge of responsible gambling concepts from baseline to follow-up. The Play Responsibly program was more successful in providing new knowledge than it was in correcting mistaken beliefs that existed prior to training. We conclude, generally, that Play Responsibly is associated with increases in employees' responsible gambling knowledge.

Deep ocean microbial communities produce more stable dissolved organic matter through the succession of rare prokaryotes.

The microbial carbon pump (MCP) hypothesis suggests that successive transformation of labile dissolved organic carbon (DOC) by prokaryotes produces refractory DOC (RDOC) and contributes to the long-term stability of the deep ocean DOC reservoir. We tested the MCP by exposing surface water from a deep convective region of the ocean to epipelagic, mesopelagic, and bathypelagic prokaryotic communities and tracked changes in dissolved organic matter concentration, composition, and prokaryotic taxa over time. Prokaryotic taxa from the deep ocean were more efficient at consuming DOC and producing RDOC as evidenced by greater abundance of highly oxygenated molecules and fluorescent components associated with recalcitrant molecules. This first empirical evidence of the MCP in natural waters shows that carbon sequestration is more efficient in deeper waters and suggests that the higher diversity of prokaryotes from the rare biosphere holds a greater metabolic potential in creating these stable dissolved organic compounds.

Unified understanding of intrinsic and extrinsic controls of dissolved organic carbon reactivity in aquatic ecosystems.

Despite our growing understanding of the global carbon cycle, scientific consensus on the drivers and mechanisms that control dissolved organic carbon (DOC) turnover in aquatic systems is lacking, hampered by the mismatch between research that approaches DOC reactivity from either intrinsic (inherent chemical properties) or extrinsic (environmental context) perspectives. Here we propose a conceptual view of DOC reactivity in which the combination of intrinsic and extrinsic factors controls turnover rates and determines which reactions will occur. We review three major types of reactions (biological, photochemical, and flocculation) from an intrinsic chemical perspective and further define the environmental features that modulate the expression of chemically inherent reactivity potential. Finally, we propose hypotheses of how extrinsic and intrinsic factors together shape patterns in DOC turnover across the land-to-ocean continuum, underscoring that there is no intrinsic DOC reactivity without environmental context. By acknowledging the intrinsic-extrinsic control duality, our framework intends to foster improved modeling of DOC reactivity and its impact on ecosystem services.

Disordered gambling, type of gambling and gambling involvement in the British Gambling Prevalence Survey 2007.

BACKGROUND: The purpose of this study was to examine the relationships between types of gambling and disordered gambling, with and without controlling for gambling involvement (i.e. the number of types of games with which respondents were involved during the past 12 months). METHODS: We completed a secondary data analysis of the 2007 British Gambling Prevalence Survey (BGPS), which collected data in England, Scotland and Wales between September 2006 and March 2007. The sample included 9003 residents, aged 16 or older, recruited from 10 144 randomly selected addresses. 5832 households contributed at least one participant. Post-facto weighting to produce a nationally representative sample yielded 8968 observations. The BGPS included four primary types of measures: participation in gambling (during the past 12 months and during the past 7 days), disordered gambling assessments, attitudes toward gambling and descriptive information. RESULTS: Statistically controlling for gambling involvement substantially reduced or eliminated all statistically significant relationships between types of gambling and disordered gambling. CONCLUSIONS: Gambling involvement is an important predictor of disordered gambling status. Our analysis indicates that greater gambling involvement better characterizes disordered gambling than does any specific type of gambling.

Predictors of velopharyngeal insufficiency after Le Fort I maxillary advancement in patients with cleft palate.

PURPOSE: Approximately 25% to 40% of patients with cleft lip/palate develop maxillary retrusion that requires Le Fort I osteotomy. Maxillary advancement brings the soft palate forward, and this may cause velopharyngeal insufficiency (VPI). The goal of this study was to identify predictors that place patients with repaired cleft palate at risk of developing VPI after Le Fort I advancement. MATERIALS AND METHODS: This was a retrospective study of nonsyndromic patients with cleft lip/palate who had a Le Fort I osteotomy between 2000 and 2008. Charts were reviewed and data were collected on patient characteristics, preoperative speech assessments, and nasopharyngoscopic reports. Pre- and postoperative cephalometric radiographs were used to measure maxillary advancement and to assess the structure of the velopharynx. Simple logistic regression analysis examined the association between each predictive variable and postoperative VPI, as indicated by need for pharyngeal flap. Predictors with P ≤ .10 were included in the multivariate regression model. In both the univariate and the multivariate analyses, P ≤ .05 was considered statistically significant. RESULTS: Univariate analysis showed a significant association between preoperative soft palatal length and need for a pharyngeal flap (P = .005). By multivariate analysis, both preoperative soft palatal length and postoperative pharyngeal depth were associated with need for pharyngeal flap (P = .003 and P = .030). CONCLUSION: This study shows that a short soft palate is associated with VPI after Le Fort I osteotomy. Assessment of palatal length and pharyngeal depth on cephalometric radiographs is helpful in predicting postoperative VPI and need for a pharyngeal flap in patients with cleft palate after maxillary advancement.

Positioning the caudal septum during primary repair of unilateral cleft lip.

BACKGROUND: Since 1995, the senior surgeon has straightened the deviated anterocaudal septum in all infants undergoing primary repair of unilateral complete cleft lip/palate. METHODS: A retrospective assessment was done on 17 patients who did not have septal correction and 17 patients who did have septal correction at the time of nasolabial repair. Operative reports were reviewed, and secondary procedures on the nose were documented.Posterior-anterior cephalograms were used to measure septal deviation from the midline, angle of septal deviation, and width of the inferior turbinate on the noncleft side. The angle subtended by the superior and inferior segments of the cartilaginous septum was measured at the point of maximal septal deviation. RESULTS: The uncorrected group had a mean maximal septal deviation from the midline of 5.8 mm compared with 4.1 mm in the corrected group (P < 0.01). The uncorrected group had a mean width of the contralateral inferior turbinate of 12.7 mm compared with 10.2 mm in the corrected group (P < 0.01). The uncorrected group had a mean subtended angle of 137.8 degrees compared with 147.9 degrees in the corrected group (P < 0.01). CONCLUSIONS: Positioning the anterior caudal septum during primary repair of unilateral complete cleft lip results in less septal deviation and a smaller contralateral turbinate as documented by posteroanterior cephalometry in adolescence.

Optimizing DSM-IV-TR classification accuracy: a brief biosocial screen for detecting current gambling disorders among gamblers in the general household population.

OBJECTIVE: To develop a pathological gambling (PG) screen for efficient application to the household population and for clinicians to use with treatment seekers. METHOD: We applied a series of multivariate discriminant functions to past-12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)-based, gambling-related problems; the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) measured and collected this data. The NESARC conducted computer-assisted personal interviews with 43 093 households and identified the largest sample of pathological gamblers drawn from the general household population. RESULTS: We created a 3-item, brief biosocial gambling screen (BBGS) with high sensitivity (Sensitivity = 0.96; 76 of 79 pathological gamblers correctly identified) and high specificity (Specificity = 0.99; 10 892 of 11 027 nonpathological gamblers correctly identified). CONCLUSIONS: Major US studies reveal extensive comorbidity of PG with other mental illnesses. The BBGS features psychometric advantages for health care providers that should encourage clinicians and epidemiologists to consider current PG along with other problems. The BBGS is practical for clinical application because it uses only 3 items and they are easy to ask, answer, and include in all modes of interviewing, including self-administered surveys. The BBGS has a strong theoretical foundation because it includes 1 item from each of the addiction syndrome 3 domains: neuroadaptation (for example, withdrawal); psychosocial characteristics (for example, lying); and adverse social consequences of gambling (for example, obtaining money from others).

PTSD among a treatment sample of repeat DUI offenders.

Recent studies indicate that posttraumatic stress disorder (PTSD) is one of the most common psychiatric comorbidities among driving-under-the-influence (DUI) offenders in treatment. Investigation of DUI offenders' PTSD and clinical characteristics could have important implications for prevention and treatment. This prospective study examined the demographic and clinical characteristics of repeat DUI offenders with PTSD symptoms at baseline and 1-year follow-up. Seven hundred twenty-nine DUI offenders admitted to a 2-week inpatient program participated in the study. Participants with PTSD evidenced more severe psychiatric comorbidity and reported a higher DUI recidivism rate at 1-year than those without PTSD. This study suggests a need to address PTSD among DUI offenders, as well as to further develop methodologies for accurately reporting DUI recidivism.

One decade of self exclusion: Missouri casino self-excluders four to ten years after enrollment.

For more than a decade, casinos around the world have offered self-exclusion programs (SEPs) to gamblers seeking help with their gambling behavior. Despite the proliferation of SEPs, little is known about the long-term outcomes for gamblers who utilize these programs. The current study assessed the experiences of a sample (N = 113) of Missouri self-excluders (SEs) for as long as 10 years after their initial enrollment in the Missouri Voluntary Exclusion Program (MVEP). Most SEs had positive experiences with MVEP and reduced their gambling and gambling problems after enrollment. However, 50% of SEs who attempted to trespass at Missouri casinos after enrollment were able to, indicating that the benefit of MVEP was attributable more to the act of enrollment than enforcement. SEs who engaged in complementary treatment or self-help groups had more positive outcomes than those who did not, suggesting that SEPs ought to encourage and provide information about additional support and treatment options to participants.

Gambling problem symptom patterns and stability across individual and timeframe.

Few studies investigate gambling problems at the symptom level; even fewer investigate how symptom patterns change throughout the course of a gambling disorder. The current study utilized the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; Grant et al., 2004) to investigate how the specific symptoms of disordered gambling relate to its severity and course. Results demonstrated that symptom patterns and stability changed as the number of symptoms endorsed increased. Symptom patterns varied considerably from prior to past year (PPY) to past year (PY) timeframes. Certain symptoms were more stable than others and held predictive value as markers of emerging pathological gambling (PG). In particular, gambling to escape problems was one of the most stable symptoms and also predictive of progression to PG; reliance on others to support gambling was predictive of progression to PG among participants at-risk for PG. The differential diagnostic value of various reported symptoms, as well as their lack of stability, has implications for both researchers and clinicians.

Palatoplasty outcomes in nonsyndromic patients with cleft palate: a 29-year assessment of one surgeon's experience.

The primary objective of cleft palate repair is velopharyngeal competence without fistula. The reported incidence of fistula and velopharyngeal insufficiency (VPI) is variable. Our purpose was to assess the senior surgeon's 29-year palatoplasty experience with respect to incidence of fistula and VPI. Our hypotheses were that VPI is related to (1) age at palatoplasty, (2) cleft palate type, and (3) VPI and palatal fistula incidence decrease with the surgeon's experience. We reviewed the records of all children with cleft palate treated by the senior author between 1976 and 2004. Cleft palate was categorized according to Veau. Palatoplasty was performed on 449 patients, using a 2-flap technique with muscular retropositioning. The mean age at palatoplasty was 11.6 +/- 4.9 months (range, 7.0-46.4 months). The incidence of palatal fistula was 2.9%, and velopharyngeal sufficiency was found in 85.1% of patients. We found a significant association between age at palatoplasty and VPI (P = 0.009, odds ratio, 1.06 [95% confidence interval, 1.02-1.10]). Velopharyngeal insufficiency was also associated with the Veau hierarchy (P = 0.001). Incidence of VPI was independent of surgeon experience (P = 0.2). In conclusion, the incidence of palatal fistula was low. Velopharyngeal insufficiency was associated with increasing age at palatoplasty and with the Veau hierarchy.

Externalizing and self-medicating: Heterogeneity among repeat DUI offenders.

AIM: Despite significant reductions in Driving Under the Influence (DUI) in the United States during recent decades, DUI continues to be a major public health threat. The current study investigated the intersection of two domains known to influence DUI: criminal history and psychiatric comorbidity. METHODS: DUI recidivists (N = 743) attending a court-mandated two-week inpatient DUI program completed a computerized mental health assessment as part of their intake to that program. Participants' criminal records were obtained 4-5 years after program attendance. FINDINGS: This study identified three primary repeat DUI offender subtypes with distinct patterns of criminal behavior and psychiatric comorbidity: (Type I) those whose DUI emerges from a pattern of drinking to cope with mood and anxiety problems, (Type II) those whose DUI emerges as part of a larger pattern of externalizing and criminal behavior, and (Type III) those whose DUI offenses reflect more acute triggers and isolated episodes of excessive drinking. CONCLUSION: These findings suggest that current treatment models used in DUI programs are inadequate to address the heterogeneity in the population of DUI recidivists and that earlier and more comprehensive screening would allow for better targeting of resources to DUI offender subtypes.

Inside the virtual casino: a prospective longitudinal study of actual Internet casino gambling.

BACKGROUND: Participation in Internet gambling is growing rapidly, as is concern about its possible effects on the public's health. This article reports the results of the first prospective longitudinal study of actual Internet casino gambling behaviour. METHODS: Data include 2 years of recorded Internet betting activity by a cohort of gamblers who subscribed to an Internet gambling service during February 2005. We examined computer records of each transaction and transformed them into measures of gambling involvement. The sample included 4222 gamblers who played casino games. RESULTS: The median betting behaviour was to play casino games once every 2 weeks during a period of 9 months. Subscribers placed a median of 49 bets of euro4 each playing day. Subscribers lost a median of 5.5% of total monies wagered. We determined a group of heavily involved bettors whose activity exceeded that of 95% of the sample; these players bet every fifth day during 17.5 months. On each playing day, these most involved bettors placed a median of 188 bets of euro25. Their median percent of wagers lost, 2.5%, was smaller than that lost by the total sample. CONCLUSION: Our findings suggest that Internet casino betting behaviour results in modest costs for most players, while some, roughly 5%, have larger losses. The findings also show the need to consider time spent as a marker of disordered gambling. These findings provide the evidence to steer public health debates away from speculation and toward the creation of empirically-based strategies to protect the public health.

A study of South Korean casino employees and gambling problems.

BACKGROUND: Casino employees are exposed to disproportionately high levels of gambling, drinking and smoking compared to other occupations. Because of their occupation, they have the opportunity to detect and prevent pathological gambling (PG). AIMS: To identify differences in the mental health status and social attitudes towards PG among casino workers in South Korea depending upon whether they report any gambling problems. METHODS: Data were collected from 388 full-time casino employees. This data provided information about the prevalence of gambling problems, alcohol and tobacco use and depression. Employees were grouped according to their scores on the Korean version of South Oaks Gambling Screen (SOGS), and those employees who gambled without experiencing any gambling problems (Group NP: SOGS = 0) and those who reported any gambling problems (Group P: SOGS > 0) were compared. An exploratory factor analyses identified the domains of casino employee social attitudes towards gambling. RESULTS: Employees who reported gambling problems (Group P) reported a higher prevalence of smoking, alcohol problems and depression (P < 0.01) compared to employees who did not report gambling problems (Group NP). The primary employee social attitude towards gambling was identified by the factor of 'Disease concept/social awareness'. Group NP reported more positive attitudes in this domain than Group P (P < 0.01). CONCLUSIONS: Employees who reported any gambling problems reported a less positive attitude towards developing the public health system to be responsive to gambling problems. These findings indicate a need to develop health education programmes that focus more specifically on casino employees with gambling problems.

Virtual harm reduction efforts for Internet gambling: effects of deposit limits on actual Internet sports gambling behavior.

BACKGROUND: In an attempt to reduce harm related to gambling problems, an Internet sports betting service provider, bwin Interactive Entertainment, AG (bwin), imposes limits on the amount of money that users can deposit into their online gambling accounts. We examined the effects of these limits on gambling behavior. METHODS: We compared (1) gambling behavior of those who exceeded deposit limits with those who did not, and (2) gambling behavior before and after exceeding deposit limits. We analyzed 2 years of the actual sports gambling behavior records of 47000 subscribers to bwin. RESULTS: Only 160 (0.3%) exceeded deposit limits at least once. Gamblers who exceeded deposit limits evidenced higher average number of bets per active betting day and higher average size of bets than gamblers who did not exceed deposit limits. Comparing the gambling behavior before and after exceeding deposit limits revealed slightly more unfavorable gambling behavior after exceeding deposit limits. CONCLUSION: Our findings indicate that Internet gamblers who exceed deposit limits constitute a group of bettors willing to take high risks; yet, surprisingly, they appear to do this rather successfully because their percentage of losses is lower than others in the sample. However, some of these gamblers exhibit some poor outcomes. Deposit limits might be necessary harm reduction measures to prevent the loss of extremely large amounts of money and cases of bankruptcy. We discuss how these limits might be modified based on our findings.

Real limits in the virtual world: self-limiting behavior of Internet gamblers.

The recent expansion of Internet gambling has stimulated debate, policy, and research on this relatively new phenomenon and its potential consequences. The current study focuses on bettors experiencing problems by sampling Internet gamblers who imposed limits on the amount they were allowed to deposit to a betting site. We analyzed the betting transactions over 18 months of all gamblers who subscribed to an online betting site in February, 2005 (N = 47,134), 567 of whom utilized the site's self-limit feature. Self-limiting gamblers played a wider variety of games and placed more bets than others prior to imposing limits. After imposing limits, self-limiters reduced their activity, but did not reduce the amount they wagered per bet. Time spent gambling, not just money spent, appears to be an important indicator of gambling problems. Self-limit programs appear to be promising options for Internet gamblers at-risk for gambling problems.

The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment-sentencing option.

Psychiatric comorbidity likely contributes to driving under the influence (DUI) of alcohol among repeat offenders. This study presents one of the first descriptions of the prevalence and comorbidity of psychiatric disorders among repeat DUI offenders in treatment. Participants included all consenting eligible admissions (N = 729) to a 2-week inpatient treatment facility for court-sentenced repeat DUI offenders (i.e., offenders electing treatment in place of prison time) from April 17, 2005, to April 23, 2006. Participants completed the Composite International Diagnostic Interview, which assessed the following disorders using criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994): alcohol use and drug use, bipolar, generalized anxiety, posttraumatic stress, intermittent explosive, conduct, attention deficit, nicotine dependence, pathological gambling, and major depressive. Repeat DUI offenders evidenced higher lifetime and 12-month prevalence of alcohol use and drug use disorders, conduct disorder, posttraumatic stress disorder, generalized anxiety disorder, and bipolar disorder compared with the general population. Almost half qualified for lifetime diagnoses of both addiction (i.e., alcohol, drug, nicotine, and/or gambling) and a psychiatric disorder. Lifetime and past-year comorbidity rates were higher among participants than in the general population. These results suggest that clinicians should consider multimorbidity within DUI treatment protocols.

Implementation of a consumer-directed approach in behavioral health care: problems and prospects.

Consumer-directed care, a payment system designed to make patients aware of the costs of care, requires treatment seekers to be active participants in their health care. Core components of consumer-directed care, such as higher deductibles and increased decision-making responsibilities, might preclude its easy translation from medical to behavioral health care. Aspects of behavioral disorders will force providers, insurers, and patients to compensate for unique barriers to increasing self-care, such as stigma, neuropsychological complications, and poor self-efficacy. This column describes important components of consumer-directed care and the unique barriers that behavioral health care creates for those components. Possible best practices are suggested for surmounting those barriers.

Assessing the playing field: a prospective longitudinal study of internet sports gambling behavior.

Internet gambling is growing rapidly, as is concern about its possible effect on the public's health. This paper reports the results of the first prospective longitudinal study of actual Internet sports gambling behavior during eight study months. Data include recorded fixed-odds bets on the outcome of sporting contests and live-action bets on the outcome of events within contests for 40,499 Internet sports gambling service subscribers who enrolled during February 2005. We tracked the following primary gambling behaviors: daily totals of the number of bets made, money bet, and money won. We transformed these variables into measures of gambling involvement. We analyzed behavior for both fixed-odds and live-action bets. The median betting behavior of the 39,719 fixed-odds bettors was to place 2.5 bets of 4 euro (approximately $5.3 US) every fourth day during the median 4 months from first to last bet. This typical pattern incurred a loss of 29% of the amount wagered. The median betting behavior of the 24,794 live-action bettors was to place 2.8 wagers of 4 euro every fourth day during the median duration of 6 weeks at a loss of 18% of the amount wagered. We also examined the behavior of empirically determined groups of heavily involved bettors whose activity exceeded that of 99% of the sample.