Timing of Infections in the Threespine Stickleback (Gasterosteus aculeatus) by Schistocephalus solidus in Alaska.

This study provides direct evidence for the timing of infections by Schistocephalus solidus in the threespine stickleback (Gasterosteus aculeatus) of south-central Alaska. Young-of-the-year fish in Cheney Lake were infected during their first summer within a few months after hatching in May-June. Infections appear to continue under ice cover on the lake during the subsequent fall and winter. Few, if any, 1-yr-old fish seemed to be infected for the first time, although 1-yr-old hosts with established parasites apparently acquired additional infections.

Life-history plasticity in female threespine stickleback.

The postglacial adaptive radiation of the threespine stickleback fish (Gasterosteus aculeatus) has been widely used to investigate the roles of both adaptive evolution and plasticity in behavioral and morphological divergence from the ancestral condition represented by present-day oceanic stickleback. These phenotypes tend to exhibit high levels of ecotypic differentiation. Population divergence in life history has also been well studied, but in contrast to behavior and morphology, the extent and importance of plasticity has been much less well studied. In this review, we summarize what is known about life-history plasticity in female threespine stickleback, considering four traits intimately associated with reproductive output: age/size at maturation, level of reproductive effort, egg size and clutch size. We envision life-history plasticity in an iterative, ontogenetic framework, in which females may express plasticity repeatedly across each of several time frames. We contrast the results of laboratory and field studies because, for most traits, these approaches give somewhat different answers. We provide ideas on what the cues might be for observed plasticity in each trait and, when possible, we inquire about the relative costs and benefits to expressed plasticity. We end with an example of how we think plasticity may play out in stickleback life history given what we know of plasticity in the ancestor.

Iterative development and the scope for plasticity: contrasts among trait categories in an adaptive radiation.

Phenotypic plasticity can influence evolutionary change in a lineage, ranging from facilitation of population persistence in a novel environment to directing the patterns of evolutionary change. As the specific nature of plasticity can impact evolutionary consequences, it is essential to consider how plasticity is manifested if we are to understand the contribution of plasticity to phenotypic evolution. Most morphological traits are developmentally plastic, irreversible, and generally considered to be costly, at least when the resultant phenotype is mis-matched to the environment. At the other extreme, behavioral phenotypes are typically activational (modifiable on very short time scales), and not immediately costly as they are produced by constitutive neural networks. Although patterns of morphological and behavioral plasticity are often compared, patterns of plasticity of life history phenotypes are rarely considered. Here we review patterns of plasticity in these trait categories within and among populations, comprising the adaptive radiation of the threespine stickleback fish Gasterosteus aculeatus. We immediately found it necessary to consider the possibility of iterated development, the concept that behavioral and life history trajectories can be repeatedly reset on activational (usually behavior) or developmental (usually life history) time frames, offering fine tuning of the response to environmental context. Morphology in stickleback is primarily reset only in that developmental trajectories can be altered as environments change over the course of development. As anticipated, the boundaries between the trait categories are not clear and are likely to be linked by shared, underlying physiological and genetic systems.

Platinum stable isotope analysis of geological standard reference materials by double-spike MC-ICPMS.

We report a method for the chemical purification of Pt from geological materials by ion-exchange chromatography for subsequent Pt stable isotope analysis by multiple-collector inductively coupled plasma mass spectrometry (MC-ICPMS) using a 196Pt-198Pt double-spike to correct for instrumental mass bias. Double-spiking of samples was carried out prior to digestion and chemical separation to correct for any mass-dependent fractionation that may occur due to incomplete recovery of Pt. Samples were digested using a NiS fire assay method, which pre-concentrates Pt into a metallic bead that is readily dissolved in acid in preparation for anion-exchange chemistry. Pt was recovered from anion-exchange resin in concentrated HNO3 acid after elution of matrix elements, including the other platinum group elements (PGE), in dilute HCl and HNO3 acids. The separation method has been calibrated using a precious metal standard solution doped with a range of synthetic matrices and results in Pt yields of ≥90% with purity of ≥95%. Using this chemical separation technique, we have separated Pt from 11 international geological standard reference materials comprising of PGE ores, mantle rocks, igneous rocks and one sample from the Cretaceous-Paleogene boundary layer. Pt concentrations in these samples range from ca. 5 ng g-1 to 4 µg g-1. This analytical method has been shown to have an external reproducibility on δ198Pt (permil difference in the 198Pt/194Pt ratio from the IRMM-010 standard) of ±0.040 (2 sd) on Pt solution standards (Creech et al., 2013, J. Anal. At. Spectrom. 28, 853-865). The reproducibility in natural samples is evaluated by processing multiple replicates of four standard reference materials, and is conservatively taken to be ca. ±0.088 (2 sd). Pt stable isotope data for the full set of reference materials have a range of δ198Pt values with offsets of up to 0.4‰ from the IRMM-010 standard, which are readily resolved with this technique. These results demonstrate the potential of the Pt isotope system as a tracer in geochemical systems.

Resistance to changing practice from pro re nata prescriptions to patient group directions in acute mental health settings.

Poor practice associated with pro re nata (PRN) prescriptions in mental health is known to be common and can increase the risk of serious and potentially fatal side effects. A contributing factor to poor practice is the lack of a clear chain of accountability between the decision to prescribe and administer PRN prescriptions. To address this problem, a patient group direction (PGD) for acute behavioural disturbance (lorazepam 0.5-2 mg) and staff training materials were developed. The intention was to replace PRN prescriptions with the PGD in two mental health trusts. One of the potential benefits of this would be the removal of the contribution of PRN to high and combined dose antipsychotic prescriptions. This proposal, however, was met with significant resistance in both trusts and did not replace PRN as a result. A series of interviews and focus groups were conducted with 16 RMNs working in the two trusts, to explore the reasons why the PGD was met with resistance. Senior nurses perceived resistance to be associated with anxieties over increased responsibility for decision making. Junior nurses reported concerns regarding the medicalization of the nursing role, the paperwork associated with the PGD and the training approach used. Future efforts to implement PGDs in mental health settings must carefully consider the methods for engaging effectively with participating organizations, in terms of managing change and completing the necessary groundwork for successful implementation.

Rapid shifts in multiple life history traits in a population of threespine stickleback.

Measurement of the rate of phenotypic or genetic change provides data bearing on many questions of fundamental interest to biologists, including how fast changes can proceed, whether shifts occur gradually or in bursts and how long high rates of change can be sustained. Because traits exist in functionally and genetically correlated suites, studies tracking many traits are likely to be the most informative. We quantify very rapid phenotypic changes in egg size (now smaller), clutch size (larger) and the age/size of both breeding females and males (younger, smaller) in an Alaskan population, with these traits shifting at rates from 0.13 to 0.30 haldanes over a 10-year period. In contrast, female reproductive effort and the allometric relationship of clutch size to body size changed little. These shifts appear to be caused by an altered selective landscape, with the presumed selective agent being increasing lake productivity. Some of the traits undoubtedly have at heritable component and thus represent genetic evolution as well as phenotypic.

Psychotropic PRN use among older people's inpatient mental health services.

Concerns have been expressed about the use of antipsychotics with older people, particularly in those who have dementia. Pro re nata (PRN) psychotropic medications including antipsychotics are commonly used to manage disturbed and distressed behaviour. This audit aimed to understand the use of PRN psychotropic medications in older people's inpatient mental health services and the quality of prescriptions and nursing documentation associated with this. A retrospective audit was undertaken on 154 patients on 11 wards in three Mental Health Trusts in the North West of England. A proforma adapted from previous research was used to collect data. Eighty-seven patients were prescribed combinations of 14 psychotropic drugs in 145 different prescriptions as PRN. Seventy-six doses of PRN were administered to 26 patients (range 1-17 doses). The most commonly administered drug was Lorazepam (n = 28, 36.8%). Drugs were most frequently administered during the night (n = 33, 43.4%). The majority of administrations of PRN were not documented (n = 45, 59.2%). PRN appeared to be used differently (smaller doses and less frequently) in this study compared to previous research of those aged under 65. Further work needs to examine the use of the use of PRN psychotropic medicines and the older person, and focus on developing alternative nonpharmacological interventions.

Host mortality and variability in epizootics of Schistocephalus solidus infecting the threespine stickleback, Gasterosteus aculeatus.

SUMMARY: An analysis of the metrics of Schistocephalus solidus infection of the threespine stickleback, Gasterosteus aculeatus, in Walby Lake, Alaska, showed that an epizootic ended between 1996 and 1998 and another occurred between 1998 and 2003. The end of the first epizootic was associated with a crash in population size of the stickleback, which serves as the second intermediate host. The likely cause of the end of that epizootic is mass mortality of host fish over winter in 1996-1997. The deleterious impact of the parasite on host reproduction and increased host predation associated with parasitic manipulation of host behaviour and morphology to facilitate transmission might also have played a role, along with unknown environmental factors acting on heavily infected fish or fish in poor condition. The second epizootic was linked to relatively high levels of prevalence and mean intensity of infection, but parasite:host mass ratios were quite low at the peak and there were no apparent mass deaths of the host. A number of abiotic and biotic factors are likely to interact to contribute to the occurrence of epizootics in S. solidus, which appear to be unstable and variable. Epizootics appear to depend on particular and, at times, rare sets of circumstances.

Medicine use in older people's inpatient mental health services.

The aims of this audit were to establish the range and volumes of medicines used in older people's mental health settings and to explore the safety of the prescribing habits through the application of the revised Beers criteria. An audit of all patients on all selected wards (both functional and organic) for current prescriptions of all drugs routinely prescribed on the census day was undertaken on 11 wards in three Mental Health NHS Trusts in the North West of England. Data were collected on 154 patients in 11 different inpatient settings in three Mental Health Trusts. A total of 153 patients had 882 prescriptions of 196 drugs (mean 5.8 drugs). Most frequently prescribed drugs were aspirin (n= 57, 6.5%), paracetamol (n= 36, 4.1%) and quetiapine (n= 35, 4.0%). Nine of the 48 potentially inappropriate medicines in the revised Beers criteria had been prescribed, although at within appropriate limits. The audit highlights the complexity of poly-pharmacotherapy in older adults admitted to mental health services. Further works needs to establish whether nurses have the clinical knowledge and skills to ensure safe practice. There appears to be continued variation in prescribing practice.

A multilevel analysis of long-term psychological distress among Belarusians affected by the Chernobyl disaster.

BACKGROUND: Radiation contamination and sociopolitical instability following the Chernobyl nuclear power plant disaster have had a profound impact on Belarus. OBJECTIVE: To investigate the factors that impact long-term mental health outcomes of this population almost 20 years after the disaster. STUDY DESIGN: Cross-sectional study. METHODS: In-person interviews were conducted with 381 men and women from two geographic areas of differing radiation contamination within Belarus. Participants completed surveys of demographics, psychosocial factors and psychological distress. Individual-level characteristics were combined with household-level measures of radiation contamination exposure and family characteristics to create multilevel predictive models of psychological distress. RESULTS: Between-household effects accounted for 20% of variability in depression and anxiety scores, but only 8% of variability in somatization scores. Degree of chronic daily stressors showed a significant positive relationship with psychological distress, whereas mastery/controllability showed a significant inverse relationship with distress. At household level, perceived family problems, but not level of residential radiation contamination, was the best predictor of distress. CONCLUSIONS: Multilevel modelling indicates that long-term psychological distress among Belarusians affected by the Chernobyl disaster is better predicted by stress-moderating psychosocial factors present in one's daily life than by level of residential radiation contamination.

The impact of a good practice manual on professional practice associated with psychotropic PRN in acute mental health wards: an exploratory study.

BACKGROUND: As required or pro re nata (PRN) psychotropic medicines are frequently used in acute mental health wards. PRN is known to contribute to polypharmacy and high doses of antipsychotic medication. Few studies have attempted to improve clinician's use of these potentially harmful drugs. AIMS: The objectives of the study were to determine the impact and acceptability of a good practice manual on prescribing and administration practices of PRN psychotropic medication in acute mental health wards. DESIGN: The study used a pre-post exploratory design with two acute mental health wards in the NW of England. RESULTS: Over the total trial period of 10 weeks, 28 of 35 patients received 484 doses of PRN. Patients had a mean of 3.6 prescriptions of 14 different PRN medications in 34 different dose combinations prescribed. Medication errors beyond poor quality of prescribing occurred in 23 of the 35 patients (65.7%). Prescription quality improved following the introduction of the intervention but quality of nursing notes reduced. Acceptability of the manual to both nursing and medical staff was high. CONCLUSION: The introduction of the manual appeared to influence some of the practices associated with the prescribing and administration of PRN psychotropic medications. Further, larger, more robust studies are required in this area. In particular research is required to identify the reasons why professionals continue to rely so heavily on using PRN medication.

Multidisciplinary consensus of best practice for pro re nata (PRN) psychotropic medications within acute mental health settings: a Delphi study.

There is a limited evidence base for the use of pro re nata (PRN) 'as required' psychotropic medication within acute mental health settings. This study aimed to explore expert opinion concerning issues and best practice for the prescribing and administration of psychotropic PRN medications within acute inpatient mental health settings. Eighteen experts participated in three Delphi rounds of a modified Delphi panel to establish consensus. A total of 271 items were initially generated from four questions. As a result of the consensus process the number of items retained reduced to 78, then 34 items and finally 13 items. Clinicians' practice could be informed by the 13 recommendations established by the Delphi panel. Further research is required to establish the clinical effectiveness of these recommendations.

Surveying the attitudes of acute mental health nurses.

Recent UK policy and guidance indicates the importance of positive attitudes towards mental health service users. This is especially true in acute inpatient care, where service users are often at their most vulnerable and have higher levels of contact with mental health staff. The following paper details secondary analysis of data collected for the validation of an attitude measurement scale with a sample of 140 nursing staff in acute settings. The results demonstrate that a wide range of attitudes are held by mental health nurses towards acute mental health care. Overall, the results indicate generally positive attitudes. Significant differences were found between qualified and unqualified staff, and males and females for some questions. Recommendations are made for future attitudinal research of mental health staff.

Consumption of black tea or coffee and risk of ovarian cancer.

The goal of this study was to investigate the associations between ovarian cancer risk and usual consumption of black tea, regular coffee, or decaffeinated coffee. Using a hospital-based case-control design, participants included 414 women with primary epithelial ovarian, fallopian, or peritoneal cancer and 868 age- and region-matched women with nonneoplastic conditions. All participants completed a comprehensive epidemiologic questionnaire. Black tea consumption was associated with a linear decline in ovarian cancer risk (P for trend 0.03), with individuals consuming two or more cups daily experiencing a 30% decline in risk (adjusted OR 0.70, 95% CI 0.51-0.97). Similar declines were noted among individuals consuming two or more cups of decaffeinated coffee daily (adjusted OR 0.71, 95% CI 0.51-0.99; P for trend 0.002). However, no association was noted between any level of regular coffee consumption and risk of ovarian cancer. The chemoprotective effects of phytochemicals in black tea and decaffeinated coffee may be important, although the effects of phytochemicals in regular coffee may be counteracted by the elevated risk associated with its higher caffeine content.

Service users' experiences of 'as needed' psychotropic medications in acute mental healthcare settings.

AIMS: This paper reports a study which aimed to explore service users' views and experiences of the processes associated with the prescription and administration of 'as needed' (p.r.n.) psychotropic medications in acute mental health settings. BACKGROUND: Few studies have explored the use of 'as needed' medication in acute mental healthcare settings. Such medication is frequently requested by service users, but the literature is unclear about the reasons for these requests or service users' experiences of this treatment. METHOD: A convenience sample of 22 inpatients participated in face-to-face semi-structured interviews exploring their treatment experiences of 'as needed' psychotropic medication in acute mental health settings in a large city in the United Kingdom in 2005. Thematic content analysis was carried out. RESULTS: Interviewees highlighted the value of 'as needed' medications. However, the process associated with their use was perceived as confusing and stigmatizing. Service users had limited understanding of and felt unsupported in attempts to use alternatives approaches. Additionally, the decision-making and information-giving processes were unclear to them, which raises issues of power and control in acute mental health settings. CONCLUSIONS: Nurses should take account of the issues of power and control when administering 'as needed' medication. The provision of adequate treatment information should be a priority to enable informed choices to be made about this form of medication.

Active and passive smoking and risk of ovarian cancer.

It is unclear whether smoking is a risk factor for epithelial ovarian cancer, although some studies have suggested that it may be associated with an increased risk of mucinous tumors. This study investigated the effect of smoking and environmental tobacco smoke (ETS) on ovarian cancer risk among 434 women with primary epithelial ovarian, peritoneal, or fallopian cancers and 868 age- and region-matched hospital controls with nonneoplastic conditions. All participants completed a comprehensive epidemiologic questionnaire. Results indicate that decreased risk of ovarian cancer was associated with being a nonsmoker exposed to ETS (adjusted odds ratio [aOR] 0.68, 95% confidence interval [CI] 0.46-0.99), a former smoker (aOR 0.76, 95% CI 0.53-1.10), or a current smoker (aOR 0.53, 95% CI 0.32-0.88). A similar protective effect was noted for smokers with moderate or high exposure based on smoking intensity, duration, and cumulative exposure, as well as for never smokers exposed to ETS. Results did not differ substantially by histologic subtype. Although prevailing theories of ovarian cancer etiology implicate incessant ovulation, characteristics of the study population suggest that anovulation was not the protective mechanism in this study. Immunosuppression by nicotine or upregulation of enzymes that metabolize carcinogens may be responsible for the effects observed.

Organizing and delivering training for acute mental health services: a discussion paper.

Recent policy statements that address the quality of care provided by acute mental health services have highlighted an urgent need for specialist nurse education and training. However, examples of how to design and implement such training initiatives are sparse. Drawing on recent experience of developing an innovative training programme for acute psychiatric settings, this paper seeks to examine some of the key issues associated with current training provision for acute inpatient mental health workers. The methodological and practical concerns surrounding this type of initiative are discussed with the main aspects of programme content, service user participation, team training and organizational challenges being explored. Resulting from this work, several recommendations regarding the content, organization and delivery of future training initiatives are made.

Findings from long-term monitoring studies at MSW landfill facilities with leachate recirculation.

This paper presents findings from long-term monitoring studies performed at full-scale municipal solid waste landfill facilities with leachate recirculation. Data from two facilities at a landfill site in Delaware, USA were evaluated as part of this study: (1) Area A/B landfill cells; and (2) two test cells (one with leachate recirculation and one control cell). Data from Area A/B were compared with proposed waste stability criteria for leachate quality, landfill gas production, and landfill settlement. Data from the test cells were directly compared with each other. Overall, the trends at Area A/B pointed to the positive effects (i.e., more rapid waste degradation) that may be realized through increasing moisture availability in a landfill relative to the reported behavior of more traditionally operated (i.e., drier) landfills. Some significant behavioral differences between the two test cells were evident, including dissimilarities in total landfill gas production quantity and the extent of waste degradation observed in recovered time capsules. Differences in leachate quality were not as dramatic as anticipated, probably because the efficiency of the leachate recirculation system at distributing leachate throughout the waste body in the recirculation cell was low.