The challenges of marine spatial planning in the Arctic: Results from the ACCESS programme.

Marine spatial planning is increasingly used to manage the demands on marine areas, both spatially and temporally, where several different users may compete for resources or space, to ensure that development is as sustainable as possible. Diminishing sea-ice coverage in the Arctic will allow for potential increases in economic exploitation, and failure to plan for cross-sectoral management could have negative economic and environmental results. During the ACCESS programme, a marine spatial planning tool was developed for the Arctic, enabling the integrated study of human activities related to hydrocarbon exploitation, shipping and fisheries, and the possible environmental impacts, within the context of the next 30 years of climate change. In addition to areas under national jurisdiction, the Arctic Ocean contains a large area of high seas. Resources and ecosystems extend across political boundaries. We use three examples to highlight the need for transboundary planning and governance to be developed at a regional level.

Portable colposcopy in low-resource settings.

Screening for cervical dysplasia is an important public health effort worldwide. In unscreened populations, the incidence of cervical cancer ranges between 2 and 4% of the adult female population, whereas less than 0.1% of the screened population of Caucasian women has cervical cancer in the United States. In developing countries, cervical cytology is difficult to implement successfully because of the cost, cultural constraints, limited access to pathology services, etc. Bypassing cytology and going directly to colposcopy has been successfully implemented as a screening strategy for dysplasia in low resource settings. In this article we describe the development and utilization of a portable binocular colposcope that does not require electricity.

Agglutination of blood cardioplegia by cold reacting autoantibodies.

Cold-reacting autoantibodies occasionally occur in patients requiring cardiac operations. This report describes the clinical course of 1 patient with cold-reacting autoantibodies and intracoronary agglutination of the blood cardioplegia solution. Observations made in vivo and in vitro are considered in discussing recommendations for the management of extracorporeal circulation and cardioplegic arrest in patients with clinically silent cold-reacting autoantibodies.