Ecosystem-based fisheries management forestalls climate-driven collapse.

Climate change is impacting fisheries worldwide with uncertain outcomes for food and nutritional security. Using management strategy evaluations for key US fisheries in the eastern Bering Sea we find that Ecosystem Based Fisheries Management (EBFM) measures forestall future declines under climate change over non-EBFM approaches. Yet, benefits are species-specific and decrease markedly after 2050. Under high-baseline carbon emission scenarios (RCP 8.5), end-of-century (2075-2100) pollock and Pacific cod fisheries collapse in >70% and >35% of all simulations, respectively. Our analysis suggests that 2.1-2.3 °C (modeled summer bottom temperature) is a tipping point of rapid decline in gadid biomass and catch. Multiyear stanzas above 2.1 °C become commonplace in projections from ~2030 onward, with higher agreement under RCP 8.5 than simulations with moderate carbon mitigation (i.e., RCP 4.5). We find that EBFM ameliorates climate change impacts on fisheries in the near-term, but long-term EBFM benefits are limited by the magnitude of anticipated change.

Advancing age and cervical cancer screening and prognosis.

OBJECTIVES: To determine associations between advancing age and screening behavior and prognosis in long-term members of a prepaid health plan diagnosed with invasive cervical cancer (ICC). DESIGN: Case series. SETTING: Prepaid health plan. PARTICIPANTS: All women diagnosed with ICC at Kaiser Permanente Medical Care Program-Northern California health plan from 1988 to 1994. MEASUREMENTS: From medical records, we recorded participants' age, stage at diagnosis, tumor histology, and results of and reasons for all previous cervical smears. We limited our analysis to women who had been members of the health plan for at least 30 of the 36 months preceding diagnosis (n = 455). RESULTS: Women in older age groups were less likely than younger women to have been screened within the 3 years before diagnosis (P = .005 for trend). Nonadherence to follow-up of abnormal cervical smears was uncommon (17/455, 3.7%) and not age related (P = .932 for trend). The proportions of ICC that were interval cancers, defined as ICC diagnosed within 3 years of a negative screening smear, were highest in women under age 30 (P = .004 for trend). In multivariate analyses controlling for stage at diagnosis, women age 60 and older were not more likely to die of ICC within 3 years of diagnosis than were women younger than age 60 (odds ratio 1.30, 95% confidence interval 0.75-2.28). CONCLUSION: The disproportionate burden of cervical cancer observed in older women appears to be largely attributable to lack of screening within the 3 years before diagnosis.

Papanicolaou smear history and diagnosis of invasive cervical carcinoma among members of a large prepaid health plan.

BACKGROUND: Despite the widespread use of Papanicolaou (Pap) smear screening, substantial morbidity and mortality from cervical carcinoma continue in the U.S. Although access to screening is a major barrier to use of the Pap smear, invasive cervical carcinoma (ICC) still is observed in health plan members who have comprehensive preventive care coverage. METHODS: For all women diagnosed with ICC between 1988 and 1994 in a large prepaid health plan, the authors retrospectively reviewed the medical records for prediagnosis Pap smear history to identify antecedents to ICC. RESULTS: Of 642 women diagnosed as having ICC, 455 (71%) had been plan members for > or = 30 of the 36 months before diagnosis. Of these 455 women, 240 (53%) had no Pap smear during the 6-36 months prior to diagnosis (i.e., were nonadherent to screening), 127 (28%) had only "normal" Pap smear results, 42 (9%) had at least 1 abnormal Pap smear and were adequately followed, 17 (4%) had at least 1 abnormal result without adequate follow-up, and 29 (6%) were classified as "other." Compared with adherent women, more nonadherent women presented with later stage disease, were symptomatic at the time of diagnosis, were older, and were of a race/ethnicity other than non-Hispanic white. CONCLUSIONS: Nonadherence to screening recommendations was found to be the most important modifiable antecedent to ICC in this population. The rate of incidence of ICC could be reduced by interventions to increase screening in women who do not have Pap smears regularly and by the use of newer screening technologies to reduce the false-negative rate of Pap smears.

Differential immune system changes with acute and persistent stress for optimists vs pessimists.

This study investigated whether acute and persistent stressors and life change events were followed by changes in immune status, and whether dispositional optimism moderated these relationships. Thirty-nine healthy women ages 18-45 were followed prospectively for 3 months, with weekly assessment of acute and persistent stressors and monthly assessment of life events and immune parameters (NK cell cytotoxicity, and CD4 and CD8 T cell subsets). The study used an autoregressive linear model to examine how weekly appraised acute and persistent stress levels were associated with immune parameters in the subsequent week. Analyses revealed that the immune outcomes were differentially affected by acute and persistent stressors. Further, the association between acute stress and subsequent immune parameters was buffered by an optimistic perspective. However, when stress persisted at high levels, optimists showed more subsequent immune decrements than pessimists.

Persistent stress as a predictor of genital herpes recurrence.

BACKGROUND: Results of several studies suggest that psychological stress and negative mood can trigger genital herpes recurrences, but results are inconsistent. OBJECTIVE: To determine whether short-term or persistent psychological stress or specific negative moods are predictive of genital herpes recurrences in women. METHODS: A prospective cohort study followed up participants for 6 months using weekly assessments of stress and mood, monthly assessments of life change events, and diary reports of genital herpes recurrences confirmed by medical examination when feasible. The community sample consisted of 58 women, aged 20 to 44 years, with a 1- to 10-year history of visible genital herpes recurrence and at least 1 recurrence in the previous 6 months. RESULTS: Persistent stress predicted recurrence in the subsequent week (odds ratio, 1.08 per unit increase in stress; 95% confidence interval, 1.01-1.15; P=.03). After adjusting for recurrence in the previous week, the more weekly persistent stress reported, the greater the likelihood of recurrence the following week. Also, an increased recurrence rate occurred after the month during which participants experienced their highest levels of anxiety (P =.03). There were no significant associations between recurrence and short-term stress, life events, depressive mood, anger, or phase of menstrual cycle. CONCLUSIONS: Persistent stressors and highest level of anxiety predicted genital herpes recurrence, whereas transient mood states, short-term stressors, and life change events did not. Women with herpes can be reassured that short-term stressful life experiences and dysphoric mood states do not put them at risk for increased outbreaks of recurrent genital herpes.

Missed opportunities for cervical cancer screening of HMO members developing invasive cervical cancer (ICC).

OBJECTIVE: To identify potential missed opportunities and to suggest interventions for cervical cancer screening in members of a prepaid health plan by examining the membership histories and medical records of women who had no Pap smear performed in the 3 years prior to the diagnosis of ICC. METHODS: Medical records of all 642 members of a prepaid health plan developing ICC during the period from 1988 to 1994 were reviewed and details of patient interaction with the health care system were abstracted. Assessment of screening history and history of clinic visits was limited to the period 36 months prior to diagnosis, but excluded the last 6 months prior to diagnosis, so as to avoid including smears or visits which were part of the evaluation that led to the recognition of ICC. RESULTS: Of women developing ICC, 384/642 (60%) had not had a smear in the period from 36 months to 6 months preceding the diagnosis. Of these 384 unscreened women, 241 (63%) had been insured by our HMO for at least 30 of the 36 months prior to diagnosis. Contact with the medical system in one of the primary care outpatient clinics was documented in 180/241 (75%) of these long-standing members during the specified period. Considering only Internal Medicine and Family Practice clinic visits, 169/241 (70%) had been seen at least once and 101/241 (42%) had been seen 3 or more times. CONCLUSION: Most long-standing HMO members developing ICC without benefit of recent Pap smear screening were seen in primary care outpatient clinics in the 3 years preceding their diagnosis.

Using self-generated identification codes to match questionnaires in panel studies of adolescent substance use.

The usefulness of self-generated codes for anonymously linking data in panel studies of adolescent substance use was investigated in a study of Irish post-primary students and sample bias resulting from this procedure considered. A seven element code exactly matched 71% of questionnaires over one month when school absences were taken into account. Allowing codes to differ on one element to compensate for respondent errors increased matching success to 88% without resulting in appreciable mismatching. Unmatched compared with exactly matched respondents tended to be male, lower SES, have more spending money, and were less closely bonded to school and religion. They also were more involved in smoking, drinking, and drug use and had more favorable beliefs toward these behaviors. Off-one respondents generally were intermediate on these measures. However, the differences were small and the characteristics of the combined matched respondents closely resembled those of the total sample. When predicting substance use, the regression coefficients were quite similar for the matched and unmatched groups and the total sample. The data thus provide evidence for the usefulness of self-generated codes in panel and longitudinal studies of adolescents when anonymity and confidentiality are of concern.

Comprehensive evaluation of a model alcohol education curriculum.

A comprehensive evaluation was conducted of a representative alcohol education program designed to enhance knowledge and self-esteem, instill appropriate attitudes and teach the decision-making skills necessary for youth to make responsible decisions about the use of alcohol. The curriculum was implemented approximately as intended. The immediate, cumulative and longer-term effects of curriculum exposure on the variables thought to mediate alcohol use were modest or unsystematic. There was no consistent evidence of carryover effects from curriculum exposure on subsequent use of alcohol, cigarettes or other drugs. The curriculum was ineffective in attaining its goals.

The problematic prospects for prevention in the classroom: should alcohol education programs be expected to reduce drinking by youth?

Junior and senior high-school students completed a questionnaire, either once or twice (in successive years), providing measures of variables in three principal sets: (1) curricular variables, those typically addressed in contemporary alcohol education programs (knowledge about alcohol, attitudes toward alcohol, decision-making skills and self-esteem); (2) drinking behavior; and (3) noncurricular variables (demographic and social-psychological traits that typically characterize students before they are exposed to alcohol education programs). Bivariate analyses suggested that the curricular variables are related to drinking behavior, whereas multivariate analyses indicated that these same variables contribute little to the explanation of adolescent drinking when adjusted for the noncurricular variables, most of which are logically and/or chronologically prior to curriculum exposure. It is concluded that contemporary alcohol education programs do address variables that, when considered alone, appear to be related to drinking. However, these same variables make such a small independent contribution to drinking behavior that it is unlikely even a highly successful classroom intervention directed at these variables would do much to prevent alcohol use or abuse by youth.

Phosphorylation of synaptic membrane glycoproteins: the effects of Ca2+ and calmodulin.

Synaptic membranes were incubated with [gamma-32P]ATP, and glycoproteins were isolated by affinity chromatography on concanavalin A agarose. Glycoproteins accounted for 1.5-2.5% of the total 32P incorporated into synaptic membrane proteins. Ca2+ and calmodulin enhanced the phosphorylation of synaptic membrane glycoproteins approximately threefold. In the presence of Ca2+ and calmodulin, the rate of glycoprotein dephosphorylation was also increased three- to four-fold. Gel electrophoretic analysis identified several synaptic membrane glycoproteins that incorporated 32P, with the most highly labeled glycoprotein under basal phosphorylating conditions having an apparent Mr of 205,000 (gpiii). Ca2+ and calmodulin produced a marked increase in the phosphorylation of a glycoprotein with an apparent Mr of 180,000 (gpiv) and lesser increases in the labeling of three other glycoproteins. Membranes that had been labeled with [gamma-32P]ATP were extracted with Triton X-100 under conditions that yield a detergent-insoluble residue enriched in postsynaptic structures. The Triton X-100 insoluble residue accounted for 20-25% of the 32P associated with synaptic membrane glycoproteins. Gpiv and other glycoproteins, the phosphorylation of which was stimulated by calmodulin, were located exclusively in the Triton X-100 insoluble residue, whereas gpiii and other calmodulin-insensitive glycoproteins partitioned predominantly into the Triton X-100-soluble fraction. Phosphopeptide maps and phosphoamino acid analysis of gpiv isolated from synaptic membranes and a postsynaptic glycoprotein of apparent Mr of 180,000 (gp180) isolated from synaptic junctions indicated that the former protein was identical to the previously identified postsynaptic-specific gp180. In addition to phosphoserine and phosphothreonine, gpiv also contained phosphotyrosine, identifying it as a substrate for tyrosine-protein kinase as well as for Ca2+/calmodulin-dependent protein kinase.

Self-generated identification codes for anonymous collection of longitudinal questionnaire data.

The success of a self-generated identification code for linking longitudinal questionnaire data was examined. The matching procedure developed for linking questionnaires, including a simple technique to compensate for nonidentical codes, yielded a high success rate (92% linkage of cases over a one-month interval and 78% over a one-year interval) and very few incorrectly linked cases. The procedure worked equally well with elementary and high school students, and the resulting samples were representative of the student population on a wide range of measures. Some suggestions are offered regarding the elements comprising self-generated codes.

Behavior change following self-confrontation: a test of the value-mediation hypothesis.

This study presents a reanalysis of data from Rokeach's self-confrontation experiments using path analytic techniques. Contrary to Rokeach's interpretations, findings indicate that behavior changes following self-confrontation are not primarily mediated through changes in value priorities. Rather, the available data suggest that the self-confrontation process involves the resolution of inconsistencies between behaviors and self-conceptions that are revelaed during the treatment session. The authors interpret these findings within the framework of Rokeach's general theory of self-disatisfaction and cognitive-behavioral change. Suggestions for future directions in self-confrontation research are offered.