Extreme eutrophication and salinisation in the Coorong estuarine-lagoon ecosystem of Australia's largest river basin (Murray-Darling).

Estuaries in rainfall poor regions are highly susceptible to climatic and hydrological changes. The Coorong, a Ramsar-listed estuarine-coastal lagoon at the end of the Murray-Darling Basin (Australia), has experienced declining ecological health over recent decades. Twenty years of environmental data were analysed to assess patterns and drivers of water quality changes. Large areas of the Coorong are now persistently hyper-saline (salinity >80 psu) and hypereutrophic (total nitrogen, TN > 4 mg L-1, total phosphorus, TP > 0.2 mg L-1, chlorophyll a > 50 µg L-1) which coincided with reduced flushing due to diminished freshwater inflows and increasing evapo-concentration. Sediment quality also was related to flushing, with higher concentrations of organic carbon, TN, TP and sulfides as salinity increased. While total nutrient levels are very high, dissolved inorganic nutrients are generally low. Increased lagoonal flushing would be beneficial to reduce the hypersalinisation and hypereutrophication and improve ecosystem health.

The Factors Associated With Older Adults Receiving Care in Jamaica / Factores Asociados con los Adultos Mayores que Reciben Cuidados en Jamaica

ABSTRACT Objective: To ascertain the level of care and the predisposing, enabling and need factors associated with care received by older adults using Andersen's framework. Methods: The 2012 Jamaica Survey of Living Conditions was used to conduct descriptive, bivariate and binary logistic analyses for the receipt of care among older adults defined by activities of daily living (ADL) and the instrumental activities of daily living (IADL) measures. The ADL sample comprised 3152 older adults and the IADL sample comprised 3141 older adults. Results: Approximately 16% of older adults received ADL care and significant binary logistic associations with age, area of residence, living arrangements, source of financial support, disability, and perceived health status were found. Approximately 69% received IADL care and significant binary logistic associations with gender, age, employed, living arrangements, wealth status, source of financial support, satisfaction with life accomplishments, disability and perceived health status were found for those receiving IADL care. Conclusion: Predisposing, enabling and need factors of the Andersen framework predict ADL and IADL care. Therefore, plans for care of older adults must address those 70 years or older who live alone, have a disability, a chronic illness and rate their health poorly.

RESUMEN Objetivo: Determinar el nivel de cuidados y los factores predisponentes, capacitantes y de necesidad asociados con el cuidado recibido por los adultos mayores, usando el modelo de Andersen. Métodos: La Encuesta de Condiciones de Vida en Jamaica 2012 fue utilizada para realizar análisis descriptivos, bivariantes y logísticos binarios en relación con el recibimiento de cuidados entre los adultos mayores, definidos por las medidas de las actividades de la vida diaria (AVD) y las actividades instrumentales de la vida diaria (AIVD). La muestra de AVD abarcó 3152 adultos mayores y la muestra de AIVD abarcó 3141 adultos mayores. Resultados: Aproximadamente el 16% de los adultos mayores recibieron cuidados de AVD, y en su análisis se hallaron asociaciones logísticas binarias significativas con la edad, el área de residencia, la situación de vivienda, la fuente de apoyo financiero, la discapacidad y el estado de salud percibido. Aproximadamente el 69% recibió cuidados de AIVD, y en su análisis se hallaron asociaciones logísticas binarias con el género, la edad, los empleados, la situación de vivienda, la situación económica, la fuente de apoyo financiero, la satisfacción con los logros de vida, la discapacidad, y el estado de salud percibido. Conclusión: Los factores predisponentes, capacitantes y de necesidad del modelo de Andersen predicen los cuidados de AVD y AIVD. Por lo tanto, los planes para el cuidado de adultos mayores tienen que abarcar a aquellas personas de 70 años o más que viven solas, tienen una discapacidad, una enfermedad crónica, y valoran su salud como pobre.

Impaired fertility in Jamaica: evidence from fertility surveys.

OBJECTIVE: It has been a long held belief that increased contraceptive use is primarily responsible for lowered fertility in Jamaica since the 1970s. However, historically, subfecundity has played a major role in suppressing fertility rates. In order to reveal the prevalence and trend in fertility impairment, a study was conducted using data from the 1989, 1993, 1997 and 2002 reproductive health surveys. METHODS: Bivariate analysis was used to highlight women lack of childbearing in the five-year period prior to the survey and the reasons they provide for their inability to become pregnant. Using the impairment typology of Chandra and Stephen (1998), cross-tabulations were used to present the sociodemographic background of women determined to experience fertility impairment. RESULTS: The data reveal that 28 per cent of sexually experienced women aged 15-49 years in 1989 and 31 per cent in 2002 reported some form of fecundity impairment. Impairment is largely due to subfecundity resulting from miscarriage or abortion, rather than failure to conceive. Women with impairment were predominantly found in married and common-law unions, were mothers, were 30 years or older, had experienced fetal loss, were working, and did not want an additional child. CONCLUSION: As childbearing and increasing age raise the prevalence of impairment, many women are unlikely to meet their family building goals. We therefore recommend that health screening for conditions related to infertility be introduced.

Sport-specific power assessment for rock climbing.

AIM: The popularity of rock climbing has resulted in a growing research base for the sport. However, at present there is a lack of sport-specific measures of performance in the field. The aim of this study was to examine the use of the powerslap test as a sport specific power measure. METHODS: The participants in this study were categorised into four different ability groups (novice, intermediate, advanced and elite) based on self reported lead grade. Two separate experiments were conducted to determine validity and reliability. The powerslap test was conducted on a revolution board with two variations - wide and narrow grip, for both sides of the body. The test started with the climber hanging at full extension from two holds from which a pull up movement was made releasing one hand to slap a scaled score board above. RESULTS: There was a significant relationship between powerslap scores and climbing ability (Left Wide: r=0.7, P<0.0005; right wide: r=0.69, P<0.0005; left narrow: r=0.73, P<0.0005; right narrow: r =0.72, P<0.0005). Further to this, scores on the powerslap narrow test were significantly differentiated by climber ability (LEFT: F(3,37)=15.74, P<0.0005; right: F(3,37)=12.16, P<0.0005). Limits of agreement and intra-class correlation indicated that the powerslap test is a reliable performance measure. CONCLUSION: According to the present findings the narrow grip variation of the powerslap test is a useful sport-specific power test that is related to climbing performance.

Ketamine sedation for children in the emergency department.

OBJECTIVE: To introduce a protocol for dissociative sedation using ketamine for children requiring painful procedures within the emergency department. METHOD: A medical literature search was performed along with a review of existing ketamine-use protocols in emergency departments from Australia and the United States. Our hospital anaesthetic department and our emergency department nursing staff were closely involved in protocol design. A series of nursing education sessions were held prior to the drug being used within the emergency department. Twenty-eight children aged 1.5-12 years were administered ketamine sedation prior to undergoing a painful procedure. Ketamine was administered either i.m. (dose 3-4 mg/kg) or i.v. (dose 1.00-2.75 mg/kg) depending on physician preference. Midazolam (dose 0.02 mg/kg) and atropine (dose 0.02 mg/kg) were given as adjuncts in the majority of cases. RESULTS: Onset of sedation was rapid (range 1-7 min) for both routes and provided excellent procedural conditions. Discharge time averaged 103 min (range 67-180 min) from time of drug administration. Side-effects included vomiting, rash, diplopia, salivation and one case of a distressing emergence reaction. On telephone follow up 1-3 days after the sedation, no delayed adverse events were reported. CONCLUSION: Ketamine is a safe and effective sedative agent for use in children requiring immobilization to enable performance of a painful procedure. It is important to involve both anaesthetic staff and emergency department nursing staff in sedation protocol development to ensure a smooth introduction. We present a protocol for ketamine use in children undergoing painful procedures within the emergency department.

Haemangioendothelioma (Kupffer cell angiosarcoma), myelofibrosis, splenic atrophy, and myeloma paraproteinaemia after parenteral thorotrast administration.

A case of thorotrastosis occurred 25 years after thorotrast angiography, with the previously unrecorded association of myeloma type paraproteinaemia. The relationship between haemangioendothelioma due to thorotrast and other vascular sarcomas of the liver is briefly reviewed.