Southern ocean carbon and heat impact on climate.

The Southern Ocean greatly contributes to the regulation of the global climate by controlling important heat and carbon exchanges between the atmosphere and the ocean. Rates of climate change on decadal timescales are therefore impacted by oceanic processes taking place in the Southern Ocean, yet too little is known about these processes. Limitations come both from the lack of observations in this extreme environment and its inherent sensitivity to intermittent processes at scales that are not well captured in current Earth system models. The Southern Ocean Carbon and Heat Impact on Climate programme was launched to address this knowledge gap, with the overall objective to understand and quantify variability of heat and carbon budgets in the Southern Ocean through an investigation of the key physical processes controlling exchanges between the atmosphere, ocean and sea ice using a combination of observational and modelling approaches. Here, we provide a brief overview of the programme, as well as a summary of some of the scientific progress achieved during its first half. Advances range from new evidence of the importance of specific processes in Southern Ocean ventilation rate (e.g. storm-induced turbulence, sea-ice meltwater fronts, wind-induced gyre circulation, dense shelf water formation and abyssal mixing) to refined descriptions of the physical changes currently ongoing in the Southern Ocean and of their link with global climate. This article is part of a discussion meeting issue 'Heat and carbon uptake in the Southern Ocean: the state of the art and future priorities'.

Lungurra Ngoora--a pilot model of care for aged and disabled in a remote Aboriginal community--can it work?

INTRODUCTION: The literature on the health of and services for older Aboriginal and Torres Strait Islander populations is relatively sparse. This study explored the development and implementation of a locally designed community service model of care for older people, and people with disability and/or mental health problems in remote Aboriginal Australia. METHODS: Based on extensive community consultation with older people, families, carers, community members and stakeholders, a model of care was developed to address unmet needs for the target population and their carers in the remote community of Looma, in the Kimberley region of Australia. The model was implemented and evaluated over 12 months. The main outcome measures included the number of services (including home services, meals, transport, respite, personal care and advocacy) provided. Outcomes of community participation, capacity building, resources, partnerships, workforce, service delivery and cultural protection were assessed qualitatively by an external evaluator. RESULTS: The number of people receiving community care services in Looma increased from eight to 22, and services increased in all domains from 140 total services delivered for 1 month at baseline to 2356 by the final month of the program. CONCLUSIONS: The Lungurra Ngoora community care service model pilot project demonstrated a successful collaborative service model that addressed the care needs of older persons, those with disability and mental illness, and their carers in this remote community. The developmental approach, and model structure, could serve as a template for future delivery of services in remote Aboriginal communities.

Study of the Dependency on Magnetic Field and Bias Voltage of an AC-Biased TES Microcalorimeter.

At SRON we are studying the performance of a Goddard Space Flight Center single pixel TES microcalorimeter operated in an AC bias configuration. For x-ray photons at 6 keV the pixel shows an x-ray energy resolution ΔEFWHM =3.7 eV, which is about a factor 2 worse than the energy resolution observed in an identical DC-biased pixel. In order to better understand the reasons for this discrepancy we characterised the detector as a function of temperature, bias working point and applied perpendicular magnetic field. A strong periodic dependency of the detector noise on the TES AC bias voltage is measured. We discuss the results in the framework of the recently observed weak-link behaviour of a TES microcalorimeter.

Culture shock and healthcare workers in remote Indigenous communities of Australia: what do we know and how can we measure it?

INTRODUCTION: Culture shock or cultural adaptation is a significant issue confronting non-Indigenous health professionals working in remote Indigenous communities in Australia. This article is presented in two parts. The first part provides a thorough background in the theory of culture shock and cultural adaptation, and a comprehensive analysis of the consequences, causes, and current issues around the phenomenon in the remote Australian healthcare context. Second, the article presents the results of a comprehensive literature review undertaken to determine if existing studies provide tools which may measure the cultural adaptation of remote health professionals. METHODS: A comprehensive literature review was conducted utilising the meta-databases CINAHL and Ovid Medline. RESULTS: While there is a plethora of descriptive literature about culture shock and cultural adaptation, empirical evidence is lacking. In particular, no empirical evidence was found relating to the cultural adaptation of non-Indigenous health professionals working in Indigenous communities in Australia. In all, 15 international articles were found that provided empirical evidence to support the concept of culture shock. Of these, only 2 articles contained tools that met the pre-determined selection criteria to measure the stages of culture shock. The 2 instruments identified were the Culture Shock Profile (CSP) by Zapf and the Culture Shock Adaptation Inventory (CSAI) by Juffer. CONCLUSIONS: There is sufficient evidence to determine that culture shock is a significant issue for non-Indigenous health professionals working in Indigenous communities in Australia. However, further research in this area is needed. The available empirical evidence indicates that a measurement tool is possible but needs further development to be suitable for use in remote Indigenous communities in Australia.

Use of combined treatment of hepatitis B immune globulin and lamivudine as prevention of hepatitis B virus recurrence in liver allograft.

Antiviral prophylaxis with lamivudine appears to reduce hepatitis B virus (HBV) infection after liver transplantation, although recurrence of infection occurs in at least 20% of the patients because of the development of drug resistance. Treatment for HBV reinfection with lamivudine pretransplantation and posttransplantation together with hepatitis B immunoglobulin could abolish recurrence of HBV infections following liver transplantation. We report the experience at our center in which lamivudine has been used in combination with low doses of immunoglobulin. Lamivudine (100 mg/d) was administered to liver transplant candidates for at least 4 weeks before transplantation and was continued posttransplantation indefinitely. Immunoglobulin was administered intramuscularly (10,000 IU at time of liver transplantation; 1,000 IU for 1 week; 1,000 IU weekly the first month; and 1,000 IU monthly thereafter). Lamivudine and low-dose immunoglobulin administration prevents posttransplantation recurrence of hepatitis B with 100% efficiency; it is well tolerated and is less cost-effective than high-dose immunoglobulin regimens.

TT virus infection in patients with chronic hepatitis B and response of TTV to lamivudine.

AIM: To investigate the responses of TT virus (TTV) and hepatitis B virus (HBV) to a long-term lamivudine therapy. METHODS: Sixteen patients infected with both TTV and HBV were treated with lamivudine 100 mg daily for 30 months. Blood samples were drawn at the beginning of the therapy and subsequently at month 3, 6, 9, 12 and 30. Serum TTV was quantified by real time PCR and serum HBV was detected by hybridization assay and nested polymerase chain reaction. RESULTS: TTV infection was detected in 100 % of HBV-infected patients. Loss of serum TTV DNA after one year of treatment occurred in 1/16 (6 %) patients. At the end of therapy, TTV DNA was positive in 94 % of them. The decline of HBV viremia was evident at 3 months after therapy and the response rate was 31 %, 44 %, 63 %, 50 % and 50 % at month 3, 6, 9, 12 and 30, respectively. CONCLUSION: TTV replication is not sensitive to lamivudine and is highly prevalent in HBV-infected patients.

Changing practice in residential aged care using participatory methods.

BACKGROUND: Residential aged care staff play a significant role in the day-to-day lives of residents yet are faced with many barriers to providing care that promotes resident wellbeing. APPROACH: Action research is a useful approach for clarifying issues, identifying education and training needs, and identifying, and in some cases overcoming, organizational barriers to change. The Well for Life project aimed to enhance the social and physical health and well being of residents of aged care settings by empowering the staff of facilities to make change. The project had a particular focus on nutrition and physical activity. This paper reports on the action research group process undertaken during Phase I of the Well for Life project. Five residential aged care settings participated in the action research process facilitated by project staff independent of the facilities. The action plan and outcomes from one of these settings is used to illustrate the process and outcomes. FINDINGS: The main findings of the project indicate that using a process that encourages staff involvement in identification of issues and actions can facilitate change in the practice of resident care. The action research groups identified specific gaps in knowledge and skill leading to targeted education that addressed areas of need. The importance of presenting information and learning opportunities for staff in a variety of formats was also recognized, as was the importance of organizational context, management support and empowerment of staff to make change.

Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian population.

BACKGROUND/AIM: The present study describes (i) the natural distribution of the three putative periodontopathogens Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in an Australian population and (ii) the relationship between these organisms, pocket depths and supragingival plaque scores. METHODS: Subgingival plaque was collected from the shallowest and deepest probing site in each sextant of the dentition. In total, 6030 subgingival plaque samples were collected from 504 subjects. An ELISA utilising pathogen-specific monoclonal antibodies was used to quantitate bacterial numbers. RESULTS: : A. actinomycetemcomitans was the most frequently detected organism (22.8% of subjects) followed by P. gingivalis and P. intermedia (14.7% and 9.5% of subjects respectively). The majority of infected subjects (83%) were colonised by a single species of organism. A. actinomycetemcomitans presence was over-represented in the youngest age group but under-represented in the older age groups. Conversely, P. gingivalis and P. intermedia presence was under-represented in the youngest age group but over-represented in the older age groups. Differing trends in the distribution of these bacteria were observed between subjects depending upon the site of the infection or whether a single or mixed infection was present; however, these differences did not reach significance. Bacterial presence was strongly associated with pocket depth for both A. actinomycetemcomitans and P. gingivalis. For A. actinomycetemcomitans, the odds of a site containing this bacterium decrease with deeper pockets. In contrast, for P. gingivalis the odds of a site being positive are almost six times greater for pockets >3 mm than for pockets < or =3 mm. These odds increase further to 15.3 for pockets deeper than 5 mm. The odds of a site being P. intermedia positive were marginally greater (1.16) for pockets deeper than 3 mm. CONCLUSIONS: This cross-sectional study in a volunteer Australian population, demonstrated recognised periodontal pathogens occur as part of the flora of the subgingival plaque. Prospective longitudinal studies are needed to examine the positive relationship between pocket depth and pathogen presence with periodontal disease initiation and/or progression.

Use of clomipramine in treatment of obsessive-compulsive disorder, separation anxiety and noise phobia in dogs: a preliminary, clinical study.

OBJECTIVE: To evaluate the efficacy and tolerance of a treatment protocol for obsessive-compulsive disorder, separation anxiety and noise phobia in dogs. DESIGN: A study was undertaken to assess clinical responses in 24 dogs diagnosed with one or more of three behavioural disorders stated above to a treatment regimen that included clomipramine and behaviour modification. PROCEDURE: A detailed behavioural and clinical history was obtained for each dog. Obsessive-compulsive disorder was diagnosed in nine cases: primary presenting complaints were tail-chasing, shadow-chasing, circling and chewing; one case was diagnosed with concurrent separation anxiety. Separation anxiety was diagnosed in 14 cases: presenting complaints included destruction, vocalisation and escaping in the absence of the owner; four cases also exhibited noise phobia. The study also included one dog diagnosed with noise phobia only and another with inappropriate fear responses. Clomipramine was administered orally twice daily. The starting dose was 1 to 2 mg/kg bodyweight. The dose was increased incrementally to a maximum of 4 mg/kg if needed. A behaviour modification program was designed and the owner instructed on its implementation. Dogs continued medication for at least 1 month after clinical signs disappeared or were acceptably reduced, then withdrawal of medication was attempted by decreasing drug dosage at weekly intervals while behaviour modification continued. RESULTS: The presenting clinical sign was largely improved or disappeared in 16 dogs, 5 demonstrated slight to moderate improvement and the behaviour was unchanged in 3. Clomipramine withdrawal was attempted in nine cases: this was successful in five. CONCLUSION: Clomipramine was effective and well-tolerated in controlling signs of obsessive-compulsive disorder and/or separation anxiety and/or noise phobia in 16 of 24 assessable cases, when used in combination with behaviour modification, and improvement in clinical signs was noted in 5 others.

Emotional eating and eating disorder psychopathology.

The study examined to what extent emotional eating, restrained eating, and bulimic tendencies are found together in naturally occurring groups, and whether these groups differ in terms of the psychological characteristics relevant to eating disorders. One hundred twenty-seven normal-weight women filled in The Dutch Eating Behavior Questionnaire, The Eating Attitudes Test, The Eating Disorder Inventory, and five measures of psychological well-being. Cluster analysis revealed three dieter subgroups (Normal Dieters, Emotional Dieters, and Bulimic Dieters) and one nondieter group. The results showed that only some restrained eaters were emotional eaters and that only some emotional eaters had bulimic tendencies. In addition, emotional and bulimic dieters differed from nondieters more strikingly in terms of eating disorder psychopathology and low psychological well-being than normal dieters did. The results suggest that emotional eating is not responsible for overeating only but may, in concert with chronic dieting, also relate to the general psychopathology found to underlie eating disorders.

Continuum and linearity hypotheses on the relationship between psychopathology and eating disorder symptomatology.

This article discusses various notions of continuity and discontinuity relating to eating disorders, and suggests that current research on the subject is implicitly based on hypotheses on linearity. In this study, we tested these hypotheses by asking 265 female participants to complete the Eating Attitude Test (EAT) and Eating Disorder Inventory (EDI). We found a linear increase in psychological disturbances from normalcy to the milder forms of disordered eating, but a sharp and non-linear increase among the women with more severe signs of eating disorders. The results indicate that neither linearity nor non-linearity alone sufficiently describes the relationship between predisposing factors and eating disorder symptomatology.

Food choice ideologies: the modern manifestations of normative and humanist views of the world.

Two studies examined whether everyday food choice motives (FCMs) and abstract values constitute food choice ideologies (FCIs), whether these ideologies reflect the same normativism-humanism polarity as Tomkins' theory suggests to reflect ideologies in general, and whether various dietary groups endorse FCIs in different ways. In Study 1, 82 female participants filled in the Food Choice Questionnaire, a short version of Schwartz's Value Survey, and Tomkins' Polarity Scale. The results reflected four FCIs: ecological ideology (EI), health ideology (HI), pleasure ideology (PI) and convenience ideology (CI). Study 2 (N=144) replicated the results for ecological and health ideologies but not for pleasure and convenience ideologies. In both studies, EI, which was typical for vegetarians, was associated with a humanist view of the world, whereas HI was related to a normative view of the world. The results suggest that food choice has become a new site where one expresses one's philosophy of life.

Loss of pleasure, ideological food choice reasons and eating pathology.

The study compared four types of dieters who stressed ideological food-choice reasons and pleasure in their food choice in different ways. A total of 66 female dieters were included in the study. As hypothesized, the dieters in the high ideology-low pleasure cluster showed more signs of eating disorders, lower psychological well-being and more body-dissatisfaction than other dieters. The differences in internalization of societal thinness ideals and magical beliefs about food and health were not significant. The discussion considers the reasons for the dysfunctionality of the high ideology-low pleasure motive combination in food choice.

Measurement of ethical food choice motives.

The two studies describe the development of three complementary scales to the Food Choice Questionnaire developed by Steptoe, Pollard & Wardle (1995). The new items address various ethical food choice motives and were derived from previous studies on vegetarianism and ethical food choice. The items were factor analysed in Study 1 (N=281) and the factor solution was confirmed in Study 2 (N=125), in which simple validity criteria were also included. Furthermore, test-retest reliability was assessed with a separate sample of subjects (N=36). The results indicated that the three new scales, Ecological Welfare (including subscales for Animal Welfare and Environment Protection), Political Values and Religion, are reliable and valid instruments for a brief screening of ethical food choice reasons.

A longitudinal study of visual function in carriers of X-linked recessive retinitis pigmentosa.

OBJECTIVE: This study was carried out to evaluate the progression of visual function impairment in carriers of X-linked recessive retinitis pigmentosa. We also assessed the relationship between the retinal findings at presentation and the extent of deterioration. DESIGN: Observational, retrospective, case series. PARTICIPANTS: Twenty-seven carriers of X-linked recessive retinitis pigmentosa. METHODS: Each carrier was clinically categorized into one of four grades (grades 0 through 3) depending on the presence or absence of a tapetal-like retinal reflex and the extent of peripheral pigmentary degeneration. A complete ophthalmologic examination was performed and data for visual acuity, visual field area, and electroretinographic measurements were collected on the most recent visit in both eyes. These were then compared with similar data obtained on their initial visits. MAIN OUTCOME MEASURES: A comparison of visual function was carried out between the initial visit and the most recent visit on each carrier. The visual acuity was measured with Snellen's acuity charts. The visual fields to targets V-4-e and II-4-e were planimeterized and used for the analysis. The electroretinographic (ERG) measures used were light-adapted single-flash b-wave amplitudes and 30-Hz red flicker for cone function, dark-adapted maximal b-wave amplitudes, and response to a low intensity blue-flash for rod function. RESULTS: None of the 11 carriers with a tapetal-like reflex only (grade 1) showed any significant change in visual acuity or fields as compared with 3 of 7 (43%) carriers with diffuse peripheral pigmentary findings (grade 3) who showed significant deterioration in visual acuity in at least one eye, and 6 of 7 (86%) who showed a significant decrease in visual field area with at least one target size in at least one eye. By comparison, only 1 of 10 carriers with a grade 1 fundus finding demonstrated a significant decrease in maximal dark-adapted ERG function as compared with 5 of 6 (83%) carriers with grade 3 in response to a single-flash stimulus and with 4 of 5 (80%) carriers in response to a single-flash blue stimulus. For the single-flash photopic response, none of the 10 carriers with grade 1 showed any significant deterioration, whereas 2 of 4 (50%) with grade 3 did show such deterioration. The ERG responses for carriers with grade 2 were in between the extent of decrease in ERG amplitudes of those in carriers with grades 1 and 3. CONCLUSIONS: In our cohort of X-linked retinitis pigmentosa carriers, those with only a tapetal-like retinal reflex at presentation had a better prognosis to retain visual function than those with peripheral retinal pigmentation. These data are useful in counseling such carriers as to their visual prognosis.

Assessment of Magical Beliefs about Food and Health.

The Magical Beliefs About Food and Health scale (MFH) was developed to assess individual differences in the tendency to adopt eating and health instructions that many magazines, health care books and food ideologies regard as valid but which obey universal laws of similarity and contagion. In a study of 216 individuals, the total MFH score showed good internal consistency and it was associated with various validity criteria as hypothesized (e.g. vegetarianism and other ideological commitments to food choice, female gender, increased neuroticism, experiential thinking, positive attitudes towards alternative medicine, low sensation seeking and endorsement of universalism values). Factor analysis yielded two factors: General Magical Beliefs and Animal Products as Food Contaminants. In addition, three other items (the Animal Products as Personality Contaminants scale) cross-loaded on the two factors. The factor structure and test-retest reliability were confirmed with separate samples. The results showed that the total MFH score is a reliable and valid measure of magical food and health beliefs, and that the subscales may prove useful when a multidimensional assessment of magical beliefs is needed.

Pleasure, pursuit of health or negotiation of identity? Personality correlates of food choice motives among young and middle-aged women.

The clustering of four food choice motives (health, weight concern, pleasure and ideological reasons) and the relationship between personality and the food choice motives were analysed among young and middle-aged women in two studies. The personality variables included personal strivings, magical beliefs about food, awareness and internalization of thinness pressures, appearance and weight dissatisfaction, depression, self-esteem and symptoms of eating disorders. Study 1 was done with 171 young and middle-aged women. In Study 2, with data provided by 118 senior high-school girls, one cluster of girls who did not regard any of the food choice motives as important was found, otherwise the food choice clusters were fairly similar in both studies. They were labelled as health fosterers, gourmets, ideological eaters, health dieters and distressed dieters. Only the second dieter group, distressed dieters, showed low psychological well-being and symptoms of disordered eating. The results also indicated that ideological food choice motives (i.e. expression of one's identity via food) were best predicted by vegetarianism, magical beliefs about food and health, and personal strivings for ecological welfare and for understanding self and the world.

Cognitive strategies and self-esteem as predictors of brace-wear noncompliance in patients with idiopathic scoliosis and kyphosis.

Psychological determinants of brace-wear compliance were analyzed among 113 patients who used a brace because of an adolescent idiopathic scoliosis (92%), kyphosis (5%), or both (3%). The results showed that noncompliant girls did not expect to succeed in dealing with scoliosis and that they were anxious about the possibility of failure. They also had low self-esteem and did not seek social support from other people. Noncompliant boys, in contrast, had high self-esteem and high achievement success expectation. Among patients with a short time of brace use, low compliance was best predicted by low amount of reflective thinking and a good body-image. In turn, among patients who had used the brace for >6 months, low compliance was best predicted by high amount of reflective thinking, poor body-image, low social success expectation, and low master orientation in social behavior. Only sleeping problems predicted compliance across gender and the time of brace use: the more the patients experienced sleeping problems, the less they used the brace.

Clinical validation of characteristics of the alcoholic family.

PURPOSE: To validate, from a client and family perspective, the defining characteristics for the nursing diagnosis altered family processes: alcoholism; and to identify demographic, family, and selected treatment information from clients and family members. METHODS: Subjects (N = 150) completed Fehring's (1987) Clinical Diagnostic Validation (CVD) Index for 110 defining characteristics of the nursing diagnosis altered family processes: alcoholism. FINDINGS: Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness. CONCLUSIONS: These clinically validated characteristics will complete the assessment phase of this research and direct the path to future studies to determine appropriate goals/outcomes and interventions related to alcoholic families.