Critical research needs for managing coral reef marine protected areas: perspectives of academics and managers.

Marine protected areas (MPAs) are a primary policy instrument for managing and protecting coral reefs. Successful MPAs ultimately depend on knowledge-based decision making, where scientific research is integrated into management actions. Fourteen coral reef MPA managers and sixteen academics from eleven research, state and federal government institutions each outlined at least five pertinent research needs for improving the management of MPAs situated in Australian coral reefs. From this list of 173 key questions, we asked members of each group to rank questions in order of urgency, redundancy and importance, which allowed us to explore the extent of perceptional mismatch and overlap among the two groups. Our results suggest the mismatch among MPA managers and academics is small, with no significant difference among the groups in terms of their respective research interests, or the type of questions they pose. However, managers prioritised spatial management and monitoring as research themes, whilst academics identified climate change, resilience, spatial management, fishing and connectivity as the most important topics. Ranking of the posed questions by the two groups was also similar, although managers were less confident about the achievability of the posed research questions and whether questions represented a knowledge gap. We conclude that improved collaboration and knowledge transfer among management and academic groups can be used to achieve similar objectives and enhance the knowledge-based management of MPAs.

The significance of human papilloma virus atypia ('wart virus infection') found alone on cervical cytology screening.

A series of 429 patients has been analysed in which the cytology smear report suggested human papillomavirus (HPV) infection alone. All patients were examined colposcopically and in 58 (13.6%) associated histologically confirmed cervical intraepithelial neoplasia (CIN) was demonstrated. CIN subsequently developed in an additional 10% of those patients who returned for follow-up over an ensuing 3-year period. Follow-up with repeat cervical cytology smears alone was unreliable as 4% of patients even with normal repeat smears has histologically proven CIN and a further 4% of these patients subsequently developed CIN. Colposcopy is recommended in all patients whose cytology smear shows HPV infection.

Acute respiratory alkalosis and acidosis and rabbit intestinal ion transport in vivo.

The effects of acute respiratory alkalosis and acidosis on electrolyte transport in the rabbit ileum, colon, and gallbladder were studied. During in situ perfusion, anesthetized animals were ventilated with 0, 3, or 8% CO2 gas, creating states of alkalosis (pH 7.49 +/- 0.01, PCO2 = 27.0 +/- 0.9 mmHg, HCO3 = 21.7 mM), normocapnia (pH 7.38 +/- 0.02, PCO2 = 41.3 +/- 1.1 mmHg, HCO3 = 25.9 +/- 0.4 mM), and acidosis (pH 7.21 +/- 0.01, PCO2 = 66.3 +/- 1.3 mmHg, HCO3 = 28.1 +/- 0.8 mM). In the ileum alkalosis decreased the net absorption of water (-36%), sodium (-44%), and chloride (-27%), whereas acidosis had the opposite effect on water (+69%), sodium (+98%), and chloride (+32%) absorption and reduced bicarbonate secretion. Small changes in net potassium absorption occurred in the direction of water movement. There was no effect on the ileal transmural potential difference (PD). The colon and gallbladder did not respond to the acid-base disorders with changes in electrolyte transport or PD. These results suggest that systemic pH and/or PCO2 affect an electroneutral sodium chloride absorptive process in the rabbit ileum. The simple presence of this absorptive process in the gallbladder was not a sufficient basis for this organ to respond to alterations in systemic pH.

Effect of cycloheximide on corticosteroid-induced changes in colonic function.

Chronic parenteral mineralocorticoid and glucocorticoid treatment increases colonic sodium and water absorption and mucosal Na-K-ATPase activity. Cycloheximide, a protein synthesis inhibitor, was utilized to compare the mechanisms of action of these corticosteroids. Rats were injected with 50 or 100 micrograms/100 g body wet cycloheximide every 12 h, 0.5 or 3 mg/100 g deoxycorticosterone (DOCA) daily, or 3 mg/100 g methylprednisolone (MP) daily, singly or in combination for 2 days. In water absorption, transmural potential difference, and the specific activity of Na-K-ATPase were measured. Cycloheximide alone did not alter colonic water, sodium, or chloride absorption or Na-K-ATPase activity but did increase transmural potential difference. DOCA-induced increases in colonic absorption and Na-K-ATPase were completely prevented by cycloheximide. Cycloheximide completely prevented the increase in Na-K-ATPase in MP-treated rats but only partially reduced the MP-induced increase in sodium and water absorption. These results suggest that this enzyme is not the primary site of glucocorticoid action. It remains to be determined whether an increase in Na-K-ATPase activity is a necessary part of the maximal colonic response to chronic glucocorticoid treatment.

Shoulder dystocia: a study of 47 cases.

Shoulder dystocia at vaginal delivery occurred in 0.2% of cases. Antenatal prediction of this complication was very difficult. In primigravidae in labour, delay late in the first stage was a warning sign; induction of labour, the use of regional analgesia, and forceps delivery for delay in the second stage of labour were associated with subsequent shoulder dystocia, although a cause-effect relationship was not established. The immediate maternal and fetal morbidity were high, nearly 30% of the babies suffering from a severe neural or bony injury. Forty-four per cent of the babies were beyond 41 weeks of gestation, and 70% weighed over 4,000 g. The avoidance of postmaturity by elective induction of labour at 41 weeks of gestation would significantly reduce the incidence of shoulder impaction at delivery.

Antenatal care: selection of the high risk patient.

Despite the best antenatal care, complications may arise during the course of any pregnancy, labour or puerperium. Some groups of women are more likely to develop complications. A method of detecting these high risk patients is discussed.