Hemispheric asymmetry in ocean change and the productivity of ecosystem sentinels.

Climate change and other human activities are causing profound effects on marine ecosystem productivity. We show that the breeding success of seabirds is tracking hemispheric differences in ocean warming and human impacts, with the strongest effects on fish-eating, surface-foraging species in the north. Hemispheric asymmetry suggests the need for ocean management at hemispheric scales. For the north, tactical, climate-based recovery plans for forage fish resources are needed to recover seabird breeding productivity. In the south, lower-magnitude change in seabird productivity presents opportunities for strategic management approaches such as large marine protected areas to sustain food webs and maintain predator productivity. Global monitoring of seabird productivity enables the detection of ecosystem change in remote regions and contributes to our understanding of marine climate impacts on ecosystems.

A survey of public attitudes towards barking dogs in New Zealand.

AIMS: To investigate public attitudes towards barking dogs in New Zealand in order to quantify the extent to which people perceive barking dogs to be a problem, to compare tolerance of barking with that of other common suburban noises, to assess the level of public understanding about the function of barking, to determine risk factors for intolerance of barking and to assess knowledge of possible strategies for the investigation and management of problem barking. METHODS: A 12-page questionnaire was sent to 2,000 people throughout New Zealand randomly selected from the electoral roll. Risk factors for being bothered by barking were examined using logistic regression analysis. RESULTS: A total of 1,750 questionnaires were successfully delivered; of these, 727 (42%) were returned. Among respondents, 356/727 (49.0%) indicated that frequent barking during the day would bother them while 545/727 (75.0%) would be bothered by barking at night. Barking and howling were ranked above other suburban noises as a cause of annoyance. Risk factors for being bothered by daytime barking were not being home during the day, not owning a dog, and considering a dog bite to be a serious health risk. Risk factors for being bothered by night-time barking were not being home during the day, marital status, considering dog bites to pose a serious health risk, and having been frightened by a dog. Overall, 510/699 (73%) respondents understood that barking was a form of communication. Action likely to be taken by 666 respondents hearing frequent barking included notifying and offering to help the owner (119; 17.8%), complaining to the owner (127; 19.1%) or the authorities (121; 18.2%), or doing nothing (299; 48%). Possible responses by 211 dog owners if they had a barking dog included seeking help from dog trainers (59; 28%) or behaviourists (54; 26%), buying an anti-barking device (33; 15%) or getting rid of the dog (20; 10%). CONCLUSIONS: Barking was considered to be potentially disturbing by respondents to this survey. Attitudes towards barking were most influenced by age, dog ownership, past experience with dogs and attitude towards dog bites. Public understanding of the possible reasons for barking and appropriate methods of managing the behaviour when it becomes a problem could be improved by better education and the provision of information through veterinary clinics and social media.

Characteristics of adult dog owners in New Zealand.

AIM: To investigate the characteristics of adult dog owners in New Zealand, and to identify factors that influence dog ownership. METHODS: A 12-page questionnaire comprising 48 questions was sent to 2,000 people throughout New Zealand randomly selected from the electoral roll. RESULTS: Seven hundred and twenty-seven completed questionnaires were received from 1,750 questionnaires successfully delivered, a response rate of 42%. Twenty-nine percent (211/727) of respondents currently owned dogs, and 32% (233/727) had never owned a dog; the remaining 39% (283/727) had some history of dog ownership. The level of dog ownership was influenced by the type of dwelling, region, age, marital status, presence and age of children, and type of personality. CONCLUSIONS: Dog owners in New Zealand are likely to be aged between 18 and 55 years, educated to secondary school level or above, live in a rural or suburban area, be married or in a de-facto relationship with children over the age of one year, and consider themselves to be of positive character.

Myocardial perfusion scintigraphy: the evidence.

This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by comparison with the numbers of revascularisations and coronary angiograms performed. Furthermore, MPS activity levels in this country fall far short of those in comparable European countries, with about half as many scans being undertaken per year. Currently, the number of MPS studies performed annually in the UK is 1,200/million population/year. We estimate the real need to be 4,000/million/year. The current average waiting time is 20 weeks and we recommend that clinically appropriate upper limits of waiting time are 6 weeks for routine studies and 1 week for urgent studies.

Transient disappearance of left bundle branch block pattern: an unusual ECG presentation of acute pulmonary embolism.

A 61 year old man developed acute pulmonary embolism while in hospital. His previous and admission electrocardiograms (ECGs) showed a typical left bundle branch block (LBBB) pattern. Immediately after the onset of acute pulmonary embolism, LBBB disappeared from his body surface ECG with sinus bradycardia, normalisation of QRS duration, prolonged QT interval, and marked T abnormalities to the right precordial leads. Recovery from pulmonary embolism resulted in reappearance of his left bundle branch pattern. Delayed conduction of the previously unaffected right bundle branch resulting in roughly equivalent onset of ventricular activation is the most likely reason. Rate dependent LBBB is also discussed.

Does social support buffer functional decline in elderly patients with unipolar depression?

OBJECTIVE: This study tested whether social support protects against functional decline, either generally or selectively, in the most severely depressed elderly patients undergoing treatment for major depressive disorder. METHOD: In a prospective cohort study design, 113 patients with incident and prevalent unipolar depression were followed for 12 months while they were undergoing naturalistic treatment. Outcome measures included performance on basic and instrumental activities of daily living; predictor variables included Hamilton Depression Rating Scale scores and four domains of informal social support. The analysis employed multivariable ordinary least squares regression models. RESULTS: Improved scores on instrumental activities of daily living and stable scores on basic activities of daily living characterized the subjects. In adjusted analyses, instrumental social support provided marginal protection against worsening performance on instrumental activities of daily living, which were primarily a function of baseline depression severity. Large social networks, more frequent social interaction, and the perceived adequacy of social support played a modest buffering role against declines in performance on basic activities of daily living among the most depressed elderly patients. CONCLUSIONS: Instrumental support was generally protective against worsening performance on instrumental abilities of daily living among elderly patients with recurrent unipolar depression. Subjective and structural dimensions of social support protected the most severely depressed elderly patients against the loss of basic maintenance abilities.

Preference for place of death in a continuing care retirement community.

PURPOSE: To describe death-related planning and preferences for place of death among well elders in a community characterized by a low rate of hospital deaths. DESIGN AND METHODS: Cross-sectional prevalence survey of independent-living residents (n = 219) of a continuing-care retirement community (CCRC) in Central North Carolina characterized by a low rate of hospital deaths. RESULTS: Death-related planning played a part in the decision of 40% of residents to move to the CCRC. A majority of residents reported a clear preference for place of death, and a majority of these preferred to die on the CCRC campus. Most residents wanted to discuss their preferences for place of death with their health care provider. Preferences for place of death appear consistent across age cohorts and are relevant to elders' long-term care decisions. IMPLICATIONS: Given the striking discrepancy between patients' preferences for nonhospital deaths and the high prevalence of hospital deaths in the United States, this often-neglected issue should be routinely addressed in end-of-life planning. The CCRC may be a practice model that is particularly compatible with personal preferences for place of death.

Does private religious activity prolong survival? A six-year follow-up study of 3,851 older adults.

BACKGROUND: Previous studies have linked higher religious attendance and longer survival. In this study, we examine the relationship between survival and private religious activity. METHODS: A probability sample of elderly community-dwelling adults in North Carolina was assembled in 1986 and followed for 6 years. Level of participation in private religious activities such as prayer, meditation, or Bible study was assessed by self-report at baseline, along with a wide variety of sociodemographic and health variables. The main outcome was time (days) to death or censoring. RESULTS: During a median 6.3-year follow-up period, 1,137 subjects (29.5%) died. Those reporting rarely to never participating in private religious activity had an increased relative hazard of dying over more frequent participants, but this hazard did not remain significant for the sample as a whole after adjustment for demographic and health variables. When the sample was divided into activity of daily living (ADL) impaired and unimpaired, the effect did not remain significant for the ADL impaired group after controlling for demographic variables (hazard ratio [RH] 1.11, 95% confidence interval [CI] 0.91-1.35). However, the increased hazard remained significant for the ADL unimpaired group even after controlling for demographic and health variables (RH 1.63, 95% CI 1.20-2.21), and this effect persisted despite controlling for numerous explanatory variables including health practices, social support, and other religious practices (RH 1.47, 95% CI 1.07-2.03). CONCLUSIONS: Older adults who participate in private religious activity before the onset of ADL impairment appear to have a survival advantage over those who do not.

Chain removal of myomata by colpotomy.

Multiple myomectomy was performed in 67 women between June 1996 and July 1998. In almost every case, myomas were sutured one to another with a single stitch of 1 silk, forming a chain, and taken out through the vaginal cul-de-sac. We believe this method reduces the risk of losing myomas inside the peritoneal cavity and shortens operating time. (J Am Assoc Gynecol Laparosc 6(3):337-338, 1999)

Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme.

OBJECTIVE: To examine and evaluate improvements in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status in postmyocardial infarction patients during and after a comprehensive 12 month exercise rehabilitation programme. SUBJECTS: The sample population comprised 124 patients with a clinical diagnosis of myocardial infarction (122 men and two women). INTERVENTIONS: 62 patients were randomly allocated to a regular weekly aerobic training programme, three times a week for 12 months, and compared with 62 matched controls who did not receive any formal exercise training. A five year follow up questionnaire/interview was subsequently conducted on this population to determine selected vocational/lifestyle changes. RESULTS: Significant improvements in cardiorespiratory fitness (p < 0.01-0.001), psychological profiles (p < 0.05-0.001), and quality of life scores (p < 0.001) were recorded in the treatment population when compared with their matched controls. Although there were no significant differences in mortality, a larger percentage of the regular exercisers resumed full time employment and they returned to work earlier than the controls. Controls took lighter jobs, lost more time from work, and suffered more non-fatal reinfarctions (p < 0.05-0.01). CONCLUSIONS: Regularly supervised and prolonged aerobic exercise training improves cardiorespiratory fitness, psychological status, and quality of life. The trained population also had a reduction in morbidity following myocardial infarction, and significant improvement in vocational status over a five year follow up period.

Social correlates of the dimensions of depression in the elderly.

Few investigations of the social correlates of depressive symptomatology have addressed variation in the correlates across multiple dimensions of depression scales. We examined the relationships of selected social, clinical, and demographic correlates with four dimensions of the Center for Epidemiologic Studies-Depression (CES-D) scale in 3,401 community-dwelling elders in the Piedmont area of North Carolina. These correlates explained significant variation in somatic complaints and depressed affect; effects of chronic disability and recent negative events were particularly robust. Having a confidant explained reduced symptomatology for all four dimensions, but particularly for low positive affect and interpersonal problems. Positive affect was also buttressed by helping others. These patterns have particular relevance where treatment for depression is divorced from considerations of the social environment of the elderly patient.

Psychosocial and physical correlates of chronic depression.

This study used a case-control design to address differences in psychosocial, physical and clinical profiles between subjects who presented with a chronic index episode of major depression and those who presented with a non-chronic index episode. Subjects were adult patients participating in the Duke University Mental Health Clinical Research Center (MHCRC) for the Study of Depression in Later Life. Cases (N = 88) who reported duration of depressive symptoms lasting > or = 24 months at enrollment were compared to controls (N = 354) who reported symptoms lasting 1-12 months. The groups were compared with respect to selected demographic and clinical variables, physical function deficits, medical comorbidity, social support constructs and number of recent stressful life events. Social support and physical health were more relevant to chronicity of major depressive illness than were severity of illness or family history. Older age (> 60 years) intensified the deleterious effect of recent negative life events and reduced the deleterious effect of functional impairment on chronic major depression. These findings require special emphasis where treatment for chronic major depression is divorced from considerations of the social environment and functional capacity.

Ontogeny and thymus-dependence of T cell surface antigens in Xenopus: flow cytometric studies on monoclonal antibody-stained thymus and spleen.

Recently generated anti-Xenopus T cell monoclonal antibodies (mAbs) to the 120 kDa XTLA-1 determinant and against the putative CD5 and CD8 homologues, together with anti-IgM and anti-MHC class II mAbs, are used in dual colour flow cytometric experiments to characterize cell surface antigenic expression on lymphocytes in thymus and spleen of Xenopus laevis during larval and early adult life and also in metamorphosis-inhibited animals. Histological confirmation of T cell emergence early in larval ontogeny is supplied by cryostat sections stained for CD8. Five-day thymectomy, i.e. prior to T-lineage cell differentiation in the thymus, abolishes T cell marker expression in the spleen for up to 1 year. Moreover, late larval (20 days) or early adult (3 months) thymectomy (i.e. removal after peripheralization of T cells has occurred) also leads to severe depletion of mAb-defined T cells in the spleen.

Correlation of xenon-enhanced computed tomography-defined cerebral blood flow reactivity and collateral flow patterns.

BACKGROUND AND PURPOSE: A chronic compromise of cerebral hemodynamics has been shown to identify a group of patients at an increased risk for stroke. Because a "steal phenomenon" induced by a vasodilatory challenge has characterized the group at greatest risk, it was hypothesized that these individuals would also have a severe compromise of primary collaterals and an increased dependence on leptomeningeal collaterals. METHODS: Twenty-three patients with symptomatic cerebrovascular disease underwent angiography and xenon-enhanced computed tomographic cerebral blood flow studies before and after 1 g IV acetazolamide within 6 months of each other. Cerebral blood flow vasoreactivity was classified by whether cerebral blood flow increased (> 5%) or was unchanged (+/- 5%) (group 1) or fell by > 5% (group 2) in any vascular territory. Angiographic collateralization was classified into four types: normal (type 1), willisian (type 2), ophthalmic (type 3), and leptomeningeal (type 4). RESULTS: Twenty percent (2/10) of group 1 patients and 69% (9/13) of group 2 patients (P = .0009) had leptomeningeal collaterals. CONCLUSIONS: A negative flow reactivity is significantly associated with a dependence on leptomeningeal collaterals and implies a state of maximal hemodynamic compromise.

Intrasellar and suprasellar paraganglioma: CT and MR findings.

We present the CT and MR findings of an intrasellar and suprasellar paraganglioma in a 17-year-old girl. Paragangliomas in this location are rare. The lesion had several imaging features characteristic of paragangliomas including marked enhancement after contrast and multiple vascular flow voids.

The temperature of cavitation.

Ultrasonic irradiation of liquids causes acoustic cavitation: the formation, growth, and implosive collapse of bubbles. Bubble collapse during cavitation generates transient hot spots responsible for high-energy chemistry and emission of light. Determination of the temperatures reached in a cavitating bubble has remained a difficult experimental problem. As a spectroscopic probe of the cavitation event, sonoluminescence provides a solution. Sonoluminescence spectra from silicone oil were reported and analyzed. The observed emission came from excited state C(2) (Swan band transitions, d(3)IIg-a(3)II(micro)), which has been modeled with synthetic spectra as a function of rotational and vibrational temperatures. From comparison of synthetic to observed spectra, the effective cavitation temperature was found to be 5075 +/- 156 K.