Feasibility, acceptability and potential effectiveness of a mobile health (mHealth) weight management programme for New Zealand adults

Background
Mobile health (mHealth) behaviour change programmes use mobile phones and the internet to deliver health information and behaviour change support to participants. Such programmes offer a potentially cost-effective way to reach many individuals who do not currently access weight loss services. We developed a mHealth weight management programme using proven face-to-face behaviour change techniques and incorporating target population input. Our aim was to evaluate the feasibility, acceptability and potential effectiveness of this programme for ethnically diverse adults with a view to informing a larger trial.

Results
Fifty three adults who had a BMI of ≥25 kg/m2 and wanted to lose weight (81% female, mean age 42 years, mean BMI 35.7 kg/m2, 26% Maori, 34% Pacific) received the eight-week mHealth weight loss programme. Anthropometric measures were taken at two face-to-face assessments at baseline and 12-weeks (i.e. four weeks after cessation of intervention).

Twelve-week follow-up measurements were available for 36/53 participants (68%). Non-completers were younger and more likely to be male and of Pacific ethnicity. Thirty five participants (66%) reported reading ‘all or most’ text messages sent and 96% responded to at least one text data collection question over the eight-week active intervention period. Eighty one per cent of participants logged in to the study website at least once during the eight-week study period. In the intention-to-treat analysis, mean weight change was -1.0 kg (SD 3.1) at 12 weeks (p = 0.024) and change in BMI was -0.34 kg/m2 (SD 1.1) (p = 0.026). In the completers only analysis (n = 36), mean weight change was -1.4 kg (SD 3.6) (p = 0.023) and change in BMI was -0.50 kg/m2 (SD 1.3) (p = 0.025).

Conclusions
A mHealth weight management programme is feasible to deliver to an ethnically diverse population. Changes in body weight and BMI at 12 weeks indicate that the programme could be effective in supporting people with weight loss. However, the high dropout rate indicates a need for further improvements to the programme.

Communicating with nurses: the experiences of 10 individuals with an acquired severe communication impairment

Successful communication is integral to quality health care and successful nursing practice. Ten people who had been in hospital in the 12 months prior to the study and who had no functional speech at that time were interviewed about their communication experiences with nurses. Overall, these individuals experienced difficulties, some of which appeared to be related to a lack of augmentative and alternative communication (AAC) resources and a lack of knowledge of AAC among nurses. In addition, the participants noted that nurses did not always have the time or the skills to communicate effectively with them. The participants suggested strategies to improve communication interactions between patients with no or limited functional speech and nurses. These strategies include pre-admission briefing and training nurses about effective strategies for communicating with patients who are unable to speak, including the use of augmentative and alternative communication systems.

Nursing the patient with severe communication impairment

Background. Effective communication with patients is critical to effective nursing practice. Surprisingly, there is little information on nurses' experiences in caring for patients who are unable to speak. Purpose and method. This study provides descriptive information from interviews with 20 nurses who cared for patients with severe communication impairment. The interview protocol explored positive and negative experiences of nursing patients with severe communication impairment. Frequency counts and descriptive analyses were conducted to identify the major themes emerging from the interviews. Results. The results suggest that nurse-patient communication is difficult when the patient has severe communication impairment, although some nurses discovered effective strategies to facilitate communication with such patients. Many of the difficulties could be viewed as a breakdown in understanding arising from the lack of a readily interpretable communication system that could be used by nurse and patient. Conclusions. The results suggest a need for training nurses in the use of alternative modes of communication. Nurses also need access to a variety of simple augmentative communication devices for use with patients who are unable to speak. Finally, nurses should collaborate with speech pathologists on the development of preadmission information and bedside training for people who are admitted to hospital with severe communication impairment.

Paleoreconstruction of estuarine sediments reveal human-induced weakening of coastal carbon sinks

Human activities in coastal areas frequently cause loss of benthic macrophytes (e.g. seagrasses) and concomitant increases in microalgal production through eutrophication. Whether such changes translate into shifts in the composition of sediment detritus is largely unknown, yet such changes could impact the role these ecosystems play in sequestrating CO 2. We reconstructed the sedimentary records of cores taken from two sites within Botany Bay, Sydney - the site of European settlement of Australia - to look for human-induced changes in dominant sources of detritus in this estuary. Cores covered a period from the present day back to the middle Holocene (~6000 years) according to 210Pb profiles and radiocarbon ( 14C) dating. Depositional histories at both sites could not be characterized by a linear sedimentation rate; sedimentation rates in the last 30-50 years were considerably higher than during the rest of the Holocene. C : N ratios declined and began to exhibit a microalgal source signature from around the time of European settlement, which could be explained by increased nutrient flows into the Bay caused by anthropogenic activity. Analysis of stable isotopic ratios of 12C/ 13C showed that the relative contribution of seagrass and C 3 terrestrial plants (mangroves, saltmarsh) to detritus declined around the time of rapid industrial expansion (~1950s), coinciding with an increase in the contribution of microalgal sources. We conclude that the relative contribution of microalgae to detritus has increased within Botany Bay, and that this shift is the sign of increased industrialization and concomitant eutrophication. Given the lower carbon burial efficiencies of microalgae (~0.1%) relative to seagrasses and C 3 terrestrial plants (up to 10%), such changes represent a substantial weakening of the carbon sink potential of Botany Bay - this occurrence is likely to be common to human-impacted estuaries, and has consequences for the role these systems play in helping to mitigate climate change. © 2011 Blackwell Publishing Ltd.

Detachment and flow cytometric quantification of seagrass-associated bacteria

A new protocol was developed to detach bacteria from seagrass tissue and subsequently enumerate cells using flow cytometry (FCM). A method involving addition of the surfactant Tween 80 and vortexing resulted in maximum detachment efficiency of seagrass attached bacteria, providing a robust protocol for precisely enumerating seagrass-associated bacteria with FCM. Using this approach we detected cell concentrations between 2.0×10(5) and 8.0×10(6)cells mg(-1) DW tissue.

Among vitamin B12 deficient older people, high folate levels are associated with worse cognitive function: combined data from three cohorts

Folate fortification of food aims to reduce the number of babies born with neural tube defects, but has been associated with cognitive impairment when vitamin B12 levels are deficient. Given the prevalence of low vitamin B12 levels among the elderly, and the global deployment of food fortification programs, investigation of the associations between cognitive impairment, vitamin B12, and folate are needed.

Quantifying and modelling the carbon sequestration capacity of seagrass meadows-a critical assessment

Seagrasses are among the planet's most effective natural ecosystems for sequestering (capturing and storing) carbon (C); but if degraded, they could leak stored C into the atmosphere and accelerate global warming. Quantifying and modelling the C sequestration capacity is therefore critical for successfully managing seagrass ecosystems to maintain their substantial abatement potential. At present, there is no mechanism to support carbon financing linked to seagrass. For seagrasses to be recognised by the IPCC and the voluntary C market, standard stock assessment methodologies and inventories of seagrass C stocks are required. Developing accurate C budgets for seagrass meadows is indeed complex; we discuss these complexities, and, in addition, we review techniques and methodologies that will aid development of C budgets. We also consider a simple process-based data assimilation model for predicting how seagrasses will respond to future change, accompanied by a practical list of research priorities.

Women's preferences for selective estrogen reuptake modulators: an investigation using the time trade off technique

PurposeSelective Estrogen Receptor Modulators (SERMs) reduce the risk of breast cancer for women at increased risk by 38%. However, uptake is extremely low and the reasons for this are not completely understood. The aims of this study were to utilize time trade-off methods to determine the degree of risk reduction required to make taking SERMs worthwhile to women, and the factors associated with requiring greater risk reduction to take SERMs. MethodsWomen at increased risk of breast cancer (N = 107) were recruited from two familial cancer clinics in Australia. Participants completed a questionnaire either online or in pen and paper format. Hierarchical multiple linear regression analysis was used to analyze the data. ResultsOverall, there was considerable heterogeneity in the degree of risk reduction required to make taking SERMs worthwhile. Women with higher perceived breast cancer risk and those with stronger intentions to undergo (or who had undergone) an oophorectomy required a smaller degree of risk reduction to consider taking SERMs worthwhile. ConclusionWomen at increased familial risk appear motivated to consider SERMs for prevention. A tailored approach to communicating about medical prevention is essential. Health professionals could usefully highlight the absolute (rather than relative) probability of side effects and take into account an individual’s perceived (rather than objective) risk of breast cancer.

Physiological and morphological responses of the temperate seagrass Zostera muelleri to multiple stressors: investigating the interactive effects of light and temperature

Understanding how multiple environmental stressors interact to affect seagrass health (measured as morphological and physiological responses) is important for responding to global declines in seagrass populations. We investigated the interactive effects of temperature stress (24, 27, 30 and 32°C) and shading stress (75, 50, 25 and 0% shade treatments) on the seagrass Zostera muelleri over a 3-month period in laboratory mesocosms. Z. muelleri is widely distributed throughout the temperate and tropical waters of south and east coasts of Australia, and is regarded as a regionally significant species. Optimal growth was observed at 27°C, whereas rapid loss of living shoots and leaf mass occurred at 32°C. We found no difference in the concentration of photosynthetic pigments among temperature treatments by the end of the experiment; however, up-regulation of photoprotective pigments was observed at 30°C. Greater levels of shade resulting in high photochemical efficiencies, while elevated irradiance suppressed effective quantum yield (ΔF/FM'). Chlorophyll fluorescence fast induction curves (FIC) revealed that the J step amplitude was significantly higher in the 0% shade treatment after 8 weeks, indicating a closure of PSII reaction centres, which likely contributed to the decline in ΔF/FM' and photoinhibition under higher irradiance. Effective quantum yield of PSII (ΔF/FM') declined steadily in 32°C treatments, indicating thermal damage. Higher temperatures (30°C) resulted in reduced above-ground biomass ratio and smaller leaves, while reduced light led to a reduction in leaf and shoot density, above-ground biomass ratio, shoot biomass and an increase in leaf senescence. Surprisingly, light and temperature had few interactive effects on seagrass health, even though these two stressors had strong effects on seagrass health when tested in isolation. In summary, these results demonstrate that populations of Z. muelleri in south-eastern Australia are sensitive to small chronic temperature increases and light decreases that are predicted under future climate change scenarios.

Swivelling the spotlight: stardom, celebrity and ‘me’

Celebrity studies critiques the ways in which celebrity culture constructs discourses of authenticity and disclosure, offering the cultural and economic circulation of the ‘private’ self. Rarely, however, do we turn the spotlight on ourselves as not only scholars of stardom and celebrity, but also part of the audience. Autoethnography has become increasingly important across different disciplines, although its status within media and cultural studies is less visible and secure, not least because the emphasis on personal attachments to media forms may threaten the discipline’s still contested claim to cultural legitimacy. The study of stars and celebrities has often found itself at the ‘lower’ end of this already debased continuum, perhaps making such tensions particularly acute. Based on three personal narratives of engagements with stars and celebrities, this co-authored article explores the potential relationships between autoethnography and celebrity studies, and considers the personal, intellectual, and political implications of bringing the scholar into the celebrity frame.

Can macroalgae contribute to blue carbon? An Australian perspective

Macroalgal communities in Australia and around the world store vast quantities of carbon in their living biomass, but their prevalence of growing on hard substrata means that they have limited capacity to act as long-term carbon sinks. Unlike other coastal blue carbon habitats such as seagrasses, saltmarshes and mangroves, they do not develop their own organic-rich sediments, but may instead act as a rich carbon source and make significant contributions in the form of detritus to sedimentary habitats by acting as a “carbon donor” to “receiver sites” where organic material accumulates. The potential for storage of this donated carbon however, is dependent on the decay rate during transport and the burial efficiency at receiver sites. To better understand the potential contribution of macroalgal communities to coastal blue carbon budgets, a comprehensive literature search was conducted using key words, including carbon sequestration, macroalgal distribution, abundance and productivity to provide an estimation of the total amount of carbon stored in temperate Australian macroalgae. Our most conservative calculations estimate 109.9 Tg C is stored in living macroalgal biomass of temperate Australia, using a coastal area covering 249,697 km2. Estimates derived for tropical and subtropical regions contributed an additional 23.2 Tg C. By extending the search to include global studies we provide a broader context and rationale for the study, contributing to the global aspects of the review. In addition, we discuss the potential role of calcium carbonate-containing macroalgae, consider the dynamic nature of macroalgal populations in the context of climate change, and identify the knowledge gaps that once addressed will enable robust quantification of macroalgae in marine biogeochemical cycling of carbon. We conclude that macroalgal communities have the potential to make ecologically meaningful contributions toward global blue carbon sequestration, as donors, but given that the fate of detached macroalgal biomass remains unclear, further research is needed to quantify this contribution.