Randomized controlled trial demonstrates novel tools to assess patient outcomes of Indigenous cultural safety training.

BACKGROUND: Health care routinely fails Indigenous peoples and anti-Indigenous racism is common in clinical encounters. Clinical training programs aimed to enhance Indigenous cultural safety (ICS) rely on learner reported impact assessment even though clinician self-assessment is poorly correlated with observational or patient outcome reporting. We aimed to compare the clinical impacts of intensive and brief ICS training to control, and to assess the feasibility of ICS training evaluation tools, including unannounced Indigenous standardized patient (UISP) visits. METHOD: Using a prospective parallel group three-arm randomized controlled trial design and masked standardized patients, we compared the clinical impacts of the intensive interactive, professionally facilitated, 8- to10-h Sanyas ICS training; a brief 1-h anti-bias training adapted to address anti-Indigenous bias; and control continuing medical education time-attention matched to the intensive training. Participants included 58 non-Indigenous staff physicians, resident physicians and nurse practitioners from family practice clinics, and one emergency department across four teaching hospitals in Toronto, Canada. Main outcome measures were the quality of care provided during UISP visits including adjusted odds that clinician would be recommended by the UISP to a friend or family member; mean item scores on patient experience of care measure; and clinical practice guideline adherence for NSAID renewal and pain assessment. RESULTS: Clinicians in the intensive or brief ICS groups had higher adjusted odds of being highly recommended to friends and family by standardized patients (OR 6.88, 95% CI 1.17 to 40.45 and OR 7.78, 95% CI 1.05 to 58.03, respectively). Adjusted mean item patient experience scores were 46% (95% CI 12% to 80%) and 40% (95% CI 2% to 78%) higher for clinicians enrolled in the intensive and brief training programs, respectively, compared to control. Small sample size precluded detection of training impacts on clinical practice guideline adherence; 100% of UISP visits were undetected by participating clinicians. CONCLUSIONS: Patient-oriented evaluation design and tools including UISPs were demonstrated as feasible and effective. Results show potential impact of cultural safety training on patient recommendation of clinician and improved patient experience. A larger trial to further ascertain impact on clinical practice is needed. TRIAL REGISTRATION: Clinicaltrials.org NCT05890144. Retrospectively registered on June 5, 2023.

Influences on reproductive decision-making among forcibly displaced women resettling in high-income countries: a scoping review and thematic analysis.

BACKGROUND: Forced displacement impacts the health, rights and safety of women, which is further compounded by gender inequality. In particular, this has consequences for forcibly displaced women's reproductive health once resettled in a new country. To ensure the reproductive health and rights of forcibly displaced women during and after resettlement, there must be careful consideration of their reproductive decision-making taking into account the context and environment of the host country. AIM: This scoping review aimed to explore the influences on reproductive decision-making among forcibly displaced women resettling in high-income countries. METHOD: A scoping review was conducted following the PRISMA-ScR for reporting. EBSCO was used to search databases covering global health, health policy, psychology, sociology, and philosophy for articles published from 1 January 2012 to 27 April 2022. Data extracted from each article included author(s), year of publication, publication type, aims/objectives, study design, sampling method, data collection or eligibility criteria, study population (i.e., sample size and characteristics), migration status, country(ies) of origin, host country(ies), key findings and limitations. Two independent reviewers screened all articles against eligibility criteria using Covidence. Data charting and thematic analysis were performed independently by one reviewer. FINDINGS: Nineteen articles published between 2013 and 2022 mostly conducted in the United States (36.8%) and Australia (21.1%), with the majority reporting on qualitative findings (68.4%), and women from a wide array of countries and cultures (most commonly African countries) were included. Influences on women's reproductive decision-making related to the contexts before displacement, during displacement, and after arrival, with influences on women's reproductive decision-making identified specific to the context. The influences before displacement included conflict; religious beliefs; socio-cultural gendered expectations; and external control over reproductive autonomy. During displacement influences included paternalism and access to education. Influences after arrival included pressure, restriction, coercion; knowledge and misconceptions; patriarchal power dynamics; and seeking empowerment. An adapted socio-ecological model was developed to interpret the findings. CONCLUSION: This review highlights the complexity and nuances within forcibly displaced women's experiences which influence their reproductive decision-making. Further research may review the evidence base to provide guidance for healthcare professionals and health policies aimed at empowering women to make autonomous reproductive decisions; develop training for healthcare professionals to prevent pressure, restriction and coercion of women's reproductive autonomy; and inform development of policy that takes an intersectional approach to women's health rights and gender equality.

Energetic eruptions leading to a peculiar hydrogen-rich explosion of a massive star.

Every supernova so far observed has been considered to be the terminal explosion of a star. Moreover, all supernovae with absorption lines in their spectra show those lines decreasing in velocity over time, as the ejecta expand and thin, revealing slower-moving material that was previously hidden. In addition, every supernova that exhibits the absorption lines of hydrogen has one main light-curve peak, or a plateau in luminosity, lasting approximately 100 days before declining. Here we report observations of iPTF14hls, an event that has spectra identical to a hydrogen-rich core-collapse supernova, but characteristics that differ extensively from those of known supernovae. The light curve has at least five peaks and remains bright for more than 600 days; the absorption lines show little to no decrease in velocity; and the radius of the line-forming region is more than an order of magnitude bigger than the radius of the photosphere derived from the continuum emission. These characteristics are consistent with a shell of several tens of solar masses ejected by the progenitor star at supernova-level energies a few hundred days before a terminal explosion. Another possible eruption was recorded at the same position in 1954. Multiple energetic pre-supernova eruptions are expected to occur in stars of 95 to 130 solar masses, which experience the pulsational pair instability. That model, however, does not account for the continued presence of hydrogen, or the energetics observed here. Another mechanism for the violent ejection of mass in massive stars may be required.

The effect of preference and actual days spent working from home on stress and musculoskeletal pain in older workers.

OBJECTIVES: The rapid shift to working from home (WFH) due to the COVID-19 pandemic provided a unique opportunity to examine the relationship between preferred and actual days spent working from home on employees musculoskeletal pain (MSP) and stress in older workers. METHODS: This study uses three waves of data from the Employees Working from Home (EWFH) study collected in May 2021 (n = 451), November 2021 (n = 358) and May 2022 (n = 320) during the COVID-19 pandemic. A generalised mixed-effect model was used to model the relationships between preference and actual days spent WFH, stress and MSP. Exploratory mediation analysis was conducted to further explore significant relationships between actual days WFH and outcomes. RESULTS: WFH was associated with increasing stress levels in older participants, when the actual number of days WFH increased (B: 0.051, 95% CI: 0.008, 0.094) and when the number of days WFH exceeded their preferences (B: 0.218, 95% CI: 0.087, 0.349). Actual number of days spent WFH and stress in older employees was mediated through their sense of community (Indirect effect: 0.014, 95% CI: 0.003, 0.03; p = 0.006). The relationship between WFH and MSP was variable. For older employees, WFH more than their preferred number of days was associated with a higher likelihood of reporting MSP (OR: 4.070, 95% CI: 1.204, 13.757). CONCLUSIONS: Findings from this study support the need for flexible policies to support WFH which take into account employees preferences. For older workers, a sense of community was found to be important and proactive attempts to restore this will be important for maintain their health and supporting sustainable employment.

Working from home during the COVID 19 pandemic: a longitudinal examination of employees' sense of community and social support and impacts on self-rated health.

BACKGROUND: The COVID 19 pandemic resulted in the introduction of public health measures including mandated and recommended work from home orders to reduce transmission. This provided a unique opportunity to examine sense of community and social support within the workplace and self-rated general health. This paper examines employees' workplace sense of community and social support across one year of the COVID 19 pandemic and associated self-rated general health. METHODS: Analysis of longitudinal data (October 2020, May 2021, and November 2021) from the Employees Working from Home study conducted in Victoria, Australia during the COVID 19 pandemic was undertaken. Trajectory analyses were used to describe workplace sense of community and social support over time. Multinomial logistic regression was used to determine the associations between demographics, gender, caring responsibilities, and group membership based on the Growth Mixture Modelling. Generalised Mixed Models were used to measure effects of sense of community and social support on self-rated health. RESULTS: Increasing sense of community and social support in the workplace resulted in increased self-rated health. Trajectory analysis found two stable and distinct groups for sense of community. Social support varied with time; however, trajectory membership was not dependent on gender or caring responsibilities and had no relationship with return to the office. CONCLUSION: Sense of community and social support in the workplace are important determinants of employees' health, and as such, workplace strategies to improve sense of community and social support are required not only for employees working from home, but also those who have returned to the office, particularly as hybrid work arrangements become more common.

Re-defining reproductive coercion using a socio-ecological lens: a scoping review.

BACKGROUND: Reproductive coercion is a significant public health issue in Australia which has mainly been conceptualised as a form of violence at the interpersonal level. This limited scope ignores the role of the gendered drivers of violence and fails to encompass a socio-ecological lens which is necessary to consider the multiple interacting layers that create the context in which reproductive coercion occurs. The aim of the scoping review was to explore how the reproductive coercion is defined by international research. Specifically, how is reproductive coercion defined at the social-cultural-systems-structural levels, and are the definitions of reproductive coercion inclusive of the conditions and contexts in which reproductive coercion occurs? METHODS: A scoping review was undertaken to explore existing definitions of reproductive coercion. Searches were conducted on Embase, Cochrane Library, Informit Health Collection, and the EBSCOHost platform. Google was also searched for relevant grey literature. Articles were included if they were: theoretical research, reviews, empirical primary research, grey literature or books; published between January 2018 and May 2022; written in English; and focused on females aged 18-50 years. Data from eligible articles were deductively extracted and inductively thematically analysed to identify themes describing how reproductive coercion is defined. RESULTS: A total of 24 articles were included in the scoping review. Most research defined reproductive coercion at the interpersonal level with only eight articles partially considering and four articles fully considering the socio-cultural-systems-structural level. Thematic analysis identified four main themes in reproductive coercion definitions: Individual external exertion of control over a woman's reproductive autonomy; Systems and structures; Social and cultural determinants; and Freedom from external forces to achieve reproductive autonomy. CONCLUSIONS: We argue for and propose a more inclusive definition of reproductive coercion that considers the gendered nature of reproductive coercion, and is linked to power, oppression and inequality, which is and can be perpetrated and/or facilitated at the interpersonal, community, organisational, institutional, systems, and societal levels as well as by the state.

Do work-family conflict or family-work conflict mediate relationships between work-related hazards and stress and pain?

INTRODUCTION: Previous research has identified associations between work-family conflict (WFC) and health outcomes (e.g., musculoskeletal pain). This study investigated whether WFC and family-work conflict explain relationships between exposure to work-related hazards and musculoskeletal pain and stress for workers undertaking some or all of their work at home. Possible differences by home workspace location were also explored. METHODS: Longitudinal survey data were collected from workers in Australia engaged in work from home for at least two days per week. Data was collected at four timepoints approximately 6 months apart (Baseline [October 2020] n = 897; Wave 1 [May/June 2021] n = 368; Wave 2 [October/November 2021] n = 336; Wave 3 [May 2022] n = 269). Subjective measures of work-related psychosocial hazards, occupational sitting and physical activity, musculoskeletal pain, and stress were collected via an online questionnaire. Mediation analyses were conducted using the R package "mediation." Analyses were also conducted with the data set stratified by home office location, using R version 4.1.3. RESULTS: Both WFC and family-work conflict acted as mediators between psychosocial work-related hazards and musculoskeletal pain and stress. WFC mediated more relationships than family-work conflict. Location of home workspace was important, particularly for those working in a space at home where they may be subject to interruptions. CONCLUSION: Addressing WFC is a legitimate means through which musculoskeletal pain and stress can be reduced. Organizational risk management strategies need to address all work-related risks, including those stemming from work-life interaction.

The victims, villains and heroes of 'panic buying': News media attribution of responsibility for COVID-19 stockpiling.

Societies often respond to a crisis by attributing blame to some groups while constructing others as victims and heroes. While it has received scant sociological attention, 'panic buying' is a critical indicator of such public sentiment at the onset of a crisis, and thus a crucial site for analysis. This article traces dynamics of blame in news media representations of an extreme period of panic buying during COVID-19 in Australia. Analysis reveals that lower socio-economic and ethnically diverse consumers were blamed disproportionately. Unlike wealthier consumers who bulk-bought online, shoppers filling trollies in-store were depicted as selfish and shameful, described using dehumanising language, and portrayed as 'villains' who threatened social order. Supermarkets were cast simultaneously as 'victims' of consumer aggression and 'heroes' for their moral leadership, trustworthiness and problem-solving. This portrayal misunderstands the socio-emotional drivers of panic buying, exacerbates stigma towards already disadvantaged groups, and veils the corporate profiteering that encourages stockpiling.

A rapid review of mental and physical health effects of working at home: how do we optimise health?

BACKGROUND: The coronavirus (COVID-19) pandemic has resulted in changes to the working arrangements of millions of employees who are now based at home and may continue to work at home, in some capacity, for the foreseeable future. Decisions on how to promote employees' health whilst working at home (WAH) need to be based on the best available evidence to optimise worker outcomes. The aim of this rapid review was to review the impact of WAH on individual workers' mental and physical health, and determine any gender difference, to develop recommendations for employers and employees to optimise workers' health. METHOD: A search was undertaken in three databases, PsychInfo, ProQuest, and Web of Science, from 2007 to May 2020. Selection criteria included studies which involved employees who regularly worked at home, and specifically reported on physical or mental health-related outcomes. Two review authors independently screened studies for inclusion, one author extracted data and conducted risk of bias assessments with review by a second author. RESULTS: Twenty-three papers meet the selection criteria for this review. Ten health outcomes were reported: pain, self-reported health, safety, well-being, stress, depression, fatigue, quality of life, strain and happiness. The impact on health outcomes was strongly influenced by the degree of organisational support available to employees, colleague support, social connectedness (outside of work), and levels of work to family conflict. Overall, women were less likely to experience improved health outcomes when WAH. CONCLUSIONS: This review identified several health outcomes affected by WAH. The health/work relationship is complex and requires consideration of broader system factors to optimise the effects of WAH on workers' health. It is likely mandated WAH will continue to some degree for the foreseeable future; organisations will need to implement formalised WAH policies that consider work-home boundary management support, role clarity, workload, performance indicators, technical support, facilitation of co-worker networking, and training for managers.

Social Support and Women's Reproductive Decision Making: Testing Emergent Fit of "Optimizing Support for the Preservation of Self".

Despite the strong association between social support and positive health outcomes, little is understood about its role in women's reproductive decision making. Developing insight into how women perceive, mobilize, and experience social support is critical to understanding their lived experiences of reproductive decision making and to implementing appropriate supporting structures to help women realize their reproductive choices. In this study, emergent fit with existing inductive research on the phenomenon of reproductive support is discussed. The existing theory of "optimizing social support for the preservation of self" and its underpinning categorical framework is maintained, but the extant categorical themes were all nuanced, refined, replaced, or removed to better reflect the support phenomenon among a wider cohort of women. This article builds on the existing knowledge base by producing a substantive theory of "optimizing social support for the preservation of self" with wider applicability.

Macrophages Educated with Exosomes from Primed Mesenchymal Stem Cells Treat Acute Radiation Syndrome by Promoting Hematopoietic Recovery.

In the setting of radiation-induced trauma, exposure to high levels of radiation can cause an acute radiation syndrome (ARS) causing bone marrow (BM) failure, leading to life-threatening infections, anemia, and thrombocytopenia. We have previously shown that human macrophages educated with human mesenchymal stem cells (MSCs) by coculture can significantly enhance survival of mice exposed to lethal irradiation. In this study, we investigated whether exosomes isolated from MSCs could replace direct coculture with MSCs to generate exosome educated macrophages (EEMs). Functionally unique phenotypes were observed by educating macrophages with exosomes from MSCs (EEMs) primed with bacterial lipopolysaccharide (LPS) at different concentrations (LPS-low EEMs or LPS-high EEMs). LPS-high EEMs were significantly more effective than uneducated macrophages, MSCs, EEMs, or LPS-low EEMs in extending survival after lethal ARS in vivo. Moreover, LPS-high EEMs significantly reduced clinical signs of radiation injury and restored hematopoietic tissue in the BM and spleen as determined by complete blood counts and histology. LPS-high EEMs showed significant increases in gene expression of STAT3, secretion of cytokines like IL-10 and IL-15, and production of growth factors like FLT-3L. LPS-EEMs also showed increased phagocytic activity, which may aid with tissue remodeling. LPS-high EEMs have the potential to be an effective cellular therapy for the management of ARS.

Exploring the use of resources to support gender equality in Australian workplaces.

ISSUE ADDRESSED: Numerous resources exist to support workplaces to undertake gender equality work; however, it is often unclear which existing resources are being utilised by Australian workplaces. One group that can provide insight into the use of existing resources is the professionals who have undertaken gender equality work in their organisation. METHODS: Purposive sampling was used to identify informants with experience undertaking gender equality work. A sample of 12 informants was recruited from five employment sectors: five informants from the women('s health sector; two from other organisations in the health sector; three from local government; and one each from manufacturing and education. One in-depth semi-structured interview was conducted with each informant. Interview transcripts were analysed using thematic analysis. RESULTS: Four themes emerged from data analysis: "Organisational Context," "Legitimising Gender Equality Work," "Demystifying Gender Equality" and "Embedding Gender Equality into the Workplace." Mechanisms such as drawing on the evidence base, developing internal communications strategies, establishing a working group, undertaking training, conducting an audit, and reviewing policies and procedures were used to embed gender-based considerations into the workplace. A range of resources to underpin most of these approaches was discussed by informants. CONCLUSIONS: Informants had a sound understanding of approaches they could use to address existing gender inequality; however, they did not always utilise existing resources to support them to undertake their chosen approach. SO WHAT?: A clearer online database needs to be established to allow workplaces to access a compilation of existing resources and any evaluation on their use.

Snapshot of medication abortion provision in the primary health care setting of regional and rural Victoria.

OBJECTIVE: This study aimed to identify enablers and barriers to the provision of medication abortion in the primary health care setting of regional and rural areas of Victoria, Australia. DESIGN: An online cross-sectional questionnaire was used. SETTING: Regional and rural areas of Victoria, Australia. PARTICIPANTS: Thirty-nine GPs and 30 primary health care nurses. MAIN OUTCOME MEASURES: Abortion views, medication abortion knowledge and practice, interest in medication abortion training and provision, and perceived uptake barriers. RESULTS: Most participants reported being consulted by women with unintended pregnancies and most of them included abortion counselling in their consultation. However, familiarity with provision of medication abortion was limited, and only five GPs and two primary health care nurses were currently medication abortion providers. The majority of participants expressed a high level of interest in receiving medication abortion training, but indicated a wide range of barriers to service provision, such as a lack of training opportunities, legal uncertainties or surgical access concerns in case of complications. CONCLUSIONS: Findings demonstrate the need for education on medication abortion and training opportunities. Most identified barriers to service uptake are addressable and relate to a lack of local support services, including the absence of a 24-hour contact advice service, insufficient follow-up access and a lack of local ultrasound facilities. These barriers require educational programs at professional, organisational and community level to ensure that interested rural and regional primary health care providers can start offering medication abortion for their patients.

Evolution of steroid hormones in reproductive females of the threespine stickleback fish.

Hormones play a prominent role in animal development, mediating the expression of traits and coordinating phenotypic responses to the environment. Their role as physiological integrators has implications for how populations respond to natural selection and can impact the speed and direction of evolutionary change. However, many emerging and established fish models with the potential to be ecologically or evolutionarily informative are small-bodied, making hormone sampling through traditional methods (whole-body or plasma) lethal or highly disruptive. Sampling methodology has thus restricted study design, often limiting sample sizes, and has prevented the study of at-risk/endangered populations. We utilize water-borne hormone sampling, a minimally invasive method of measuring the rate of steroid hormone release across the gills and further validate this method in a novel, evolutionary context. First, we compare water-borne hormone measures of cortisol with those quantified from plasma and whole-body samples collected from the same individuals to establish the relationship between concentrations quantified via the three methods. We then compare the release of steroid hormones in three populations of threespine stickleback to establish the sensitivity of this tool in measuring within-individual and between-individual variation in biologically relevant contexts (reproductive stages), and in assessing differences among populations with distinct evolutionary histories. We demonstrate a strong positive relationship between cortisol concentrations measured with water-borne, plasma, and whole-body collection techniques. Tracking estradiol and testosterone throughout clutch production in females produced anticipated patterns associated with growing and maturing eggs, with divergence in estradiol production in one population. Additionally, differences among populations in cortisol levels at ovulation paralleled the relative presence of a social stressor, and thus expected energetic needs within each population. We confirm that water-borne hormone sampling is sufficiently sensitive to capture biologically relevant fluctuations in steroid hormones between environmental contexts and demonstrate that among-population differences are detectable. This technique can be applied broadly to small fish to answer important ecological and evolutionary questions. By linking population variation in hormones and the multivariate phenotype, this technique will help elucidate both proximate mechanisms underlying phenotypic development and variation, and the way hormone networks alter evolutionary responses to selection.

Supernova SN 2011fe from an exploding carbon-oxygen white dwarf star.

Type Ia supernovae have been used empirically as 'standard candles' to demonstrate the acceleration of the expansion of the Universe even though fundamental details, such as the nature of their progenitor systems and how the stars explode, remain a mystery. There is consensus that a white dwarf star explodes after accreting matter in a binary system, but the secondary body could be anything from a main-sequence star to a red giant, or even another white dwarf. This uncertainty stems from the fact that no recent type Ia supernova has been discovered close enough to Earth to detect the stars before explosion. Here we report early observations of supernova SN 2011fe in the galaxy M101 at a distance from Earth of 6.4 megaparsecs. We find that the exploding star was probably a carbon-oxygen white dwarf, and from the lack of an early shock we conclude that the companion was probably a main-sequence star. Early spectroscopy shows high-velocity oxygen that slows rapidly, on a timescale of hours, and extensive mixing of newly synthesized intermediate-mass elements in the outermost layers of the supernova. A companion paper uses pre-explosion images to rule out luminous red giants and most helium stars as companions to the progenitor.

The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey.

BACKGROUND: Psychosocial job stressors, such as low control and high demands, have been found to influence the health and wellbeing of doctors. However, past research in this area has relied on cross-sectional data, which limits causal inferences about the influence of psychosocial job stressors on health. In this study, we examine this relationship longitudinally while also assessing whether the relationship between psychosocial job stressors and health is modified by gender. METHODS: The data source was seven annual waves of the Medicine in Australia: Balancing Employment and Life (MABEL) survey. The outcome was self-rated health (measured using the SF-12), and key exposures reflected job control, job demands, work-life balance variables, employment arrangements, and aggression experienced at work. We used longitudinal fixed and random effects regression models to assess within and between-person changes in health. RESULTS: Excessive job demands, low job control, feelings of not being rewarded at work, and work-life imbalance were associated with higher within-person odds of poorer self-rated health. Gender differences were apparent. For female doctors, work arrangements and work-life imbalance were associated with poorer self-rated health whilst task-based job stressors were associated with poorer self-rated health in male doctors. CONCLUSIONS: These results suggest the importance of addressing adverse working environments among doctors. TRIAL REGISTRATION: Not applicable.

A cross-sectional study examining the extent of unwanted sexual attention and unhealthy intimate relationships among female university students.

Issue addressed: Unwanted sexual attention and unhealthy intimate relationships have the potential to have serious negative health consequences. To date, there has been scant focus on these issues among university students in Australia. The aim of the current study was to describe the extent of unwanted sexual attention and unhealthy intimate relationships experienced in their lifetime by female university students aged 18-25 years.Methods: A cross-sectional study was undertaken involving 465 female students aged 18-25 years. Students were recruited through one faculty within a Victorian university and invited to complete an anonymous online questionnaire.Results: Sixty-seven per cent (n = 312) of female students reported experiencing unwanted sexual attention in their lifetime. The most common form of unwanted sexual attention was kissing or touching over clothes (98%; n = 306). Over 43% (n = 124) of the female students reported that the experience of unwanted sexual experience occurred after their protests were ignored. Thirty per cent (n = 135) of the female students reported experiencing at least one element of an unhealthy intimate relationship.Conclusions: The high rates of unwanted sexual attention and unhealthy intimate relationships among female university students is of concern given the negative impact such events can have on individual's physical, emotional and social well being.So what?: Public health and health promotion action is required to prevent female students from experiencing unwanted sexual attention and unhealthy intimate relationships, and to address the negative health and well being consequences.

A metagenome for lacustrine Cladophora (Cladophorales) reveals remarkable diversity of eukaryotic epibionts and genes relevant to materials cycling.

Periphyton dominated by the cellulose-rich filamentous green alga Cladophora forms conspicuous growths along rocky marine and freshwater shorelines worldwide, providing habitat for diverse epibionts. Bacterial epibionts have been inferred to display diverse functions of biogeochemical significance: N-fixation and other redox reactions, phosphorus accumulation, and organic degradation. Here, we report taxonomic diversity of eukaryotic and prokaryotic epibionts and diversity of genes associated with materials cycling in a Cladophora metagenome sampled from Lake Mendota, Dane Co., WI, USA, during the growing season of 2012. A total of 1,060 distinct 16S, 173 18S, and 351 28S rRNA operational taxonomic units, from which >220 genera or species of bacteria (~60), protists (~80), fungi (6), and microscopic metazoa (~80), were distinguished with the use of reference databases. We inferred the presence of several algal taxa generally associated with marine systems and detected Jaoa, a freshwater periphytic ulvophyte previously thought endemic to China. We identified six distinct nifH gene sequences marking nitrogen fixation, >25 bacterial and eukaryotic cellulases relevant to sedimentary C-cycling and technological applications, and genes encoding enzymes in aerobic and anaerobic pathways for vitamin B12 biosynthesis. These results emphasize the importance of Cladophora in providing habitat for microscopic metazoa, fungi, protists, and bacteria that are often inconspicuous, yet play important roles in ecosystem biogeochemistry.

Navigating the ethics of cross-cultural health promotion research.

Health promotion researchers must consider the ethics of their research, and are usually required to abide by a set of ethical requirements stipulated by governing bodies (such as the Australian National Health and Medical Research Council) and human research ethics committees (HRECs). These requirements address both deontological (rule-based) and consequence-based issues. However, at times there can be a disconnect between the requirements of deontological issues and the cultural sensitivity required when research is set in cultural contexts and settings etic to the HREC. This poses a challenge for health promotion researchers who must negotiate between meeting both the requirements of the HREC and the needs of the community with whom the research is being conducted. Drawing on two case studies, this paper discusses examples from cross-cultural health promotion research in Australian and international settings where disconnect arose and negotiation was required to appropriately meet the needs of all parties. The examples relate to issues of participant recruitment and informed consent, participants under the Australian legal age of consent, participant withdrawal when this seemingly occurs in an ad hoc rather than a formal manner and reciprocity. Although these approaches are context specific, they highlight issues for consideration to advance more culturally appropriate practice in research ethics and suggest ways a stronger anthropological lens can be applied to research ethics to overcome these challenges.

Care in context: Becoming an STS researcher.

This collaborative article, written by graduate students who attended the Politics of Care in Technoscience Workshop, brings the themes in this volume to bear on their own developing science and technology study projects and research practices. Exploring the contours of five specific moments where questions of care have arisen in the course of their everyday research, they do not find a single or untroubled definition of care; instead, care is often a site of ambivalence, tension, and puzzlement. However, despite this uneasiness, they argue that taking the time to reflect on the multiple, sometimes conflicting, forms and definitions of care within a specific research context can inform the way that science and technology studies scholars envision and conduct their work.