925 resultados para National Library of Medicine (U.S.)
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On verso: Huntington & Clark. Successors to Millard. 224 Woodward Ave., Detroit, Mich. Negatives retained for future orders. Duplicates at any time at reduced rates. We have the 70,000 negatives made by Powelson and Millard. Left to right: Ellen Bradford Murray, Maria Louise Graham, Louisa Terese Black
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Background: Nausea can be a debilitating symptom for patients with a life-limiting illness. While addressing reversible components, nonpharmacological strategies and antiemetics are the main therapeutic option. The choice of medication, dose, and route of administration remain highly variable. Objective: The aim of this study was to codify the current clinical approaches and quantify any variation found nationally. Methods: A cross-sectional study utilizing a survey of palliative medicine clinicians examined prescribing preferences for nausea using a clinical vignette. Respondent characteristics, the use of nonpharmacological interventions, first- and second-line antiemetic choices, commencing and maximal dose, and time to review were collected. Results: Responding clinicians were predominantly working in palliative medicine across a range of settings with a 49% response rate (105/213). The main nonpharmacological recommendation was “small, frequent snacks.” Metoclopramide was the predominant first-line agent (69%), followed by haloperidol (26%), while second-line haloperidol was the predominant agent (47%), with wide variation in other nominated agents. Respondents favoring metoclopramide as first-line tended to use haloperidol second-line (65%), but not vice versa. Maximal doses for an individual antiemetic varied up to tenfold. Conclusion: For nausea, a commonly encountered symptom in palliative care, clinicians' favored metoclopramide and haloperidol; however, after these choices, there was large variation in antiemetic selection. While most clinicians recommended modifying meal size and frequency, use of other nonpharmacological therapies was limited.
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Since 1999, NOAA’s Biogeography Branch of the Center for Coastal Monitoring and Assessment (CCMA-BB) has been working with federal and territorial partners to characterize, monitor, and assess the status of the marine environment around northeastern St. Croix, U.S. Virgin Islands. This effort is part of the broader NOAA Coral Reef Conservation Program’s (CRCP) National Coral Reef Ecosystem Monitoring Program (NCREMP). With support from CRCP’s NCREMP, CCMA conducts the “Caribbean Coral Reef Ecosystem Monitoring project” (CREM) with goals to: (1) spatially characterize and monitor the distribution, abundance, and size of marine fauna associated with shallow water coral reef seascapes (mosaics of coral reefs, seagrasses, sand and mangroves); (2) relate this information to in situ fine-scale habitat data and the spatial distribution and diversity of habitat types using benthic habitat maps; (3) use this information to establish the knowledge base necessary for enacting management decisions in a spatial setting; (4) establish the efficacy of those management decisions; and (5) develop data collection and data management protocols. The monitoring effort in northeastern St. Croix was conducted through partnerships with the National Park Service (NPS) and the Virgin Islands Department of Planning and Natural Resources (VI-DPNR). The geographical focal point of the research is Buck Island Reef National Monument (BIRNM), a protected area originally established in 1961 and greatly expanded in 2001; however, the work also encompassed a large portion of the recently created St. Croix East End Marine Park (EEMP). Project funding is primarily provided by NOAA CRCP, CCMA and NPS. In recent decades, scientific and non-scientific observations have indicated that the structure and function of the coral reef ecosystem around northeastern St. Croix have been adversely impacted by a wide range of environmental stressors. The major stressors have included the mass Diadema die off in the early 1980s, a series of hurricanes beginning with Hurricane Hugo in 1989, overfishing, mass mortality of Acropora corals due to disease and several coral bleaching events, with the most severe mass bleaching episode in 2005. The area is also an important recreational resource supporting boating, snorkeling, diving and other water based activities. With so many potential threats to the marine ecosystem and a dramatic change in management strategy in 2003 when the park’s Interim Regulations (Presidential Proclamation No. 7392) established BIRNM as one of the first fully protected marine areas in NPS system, it became critical to identify existing marine fauna and their spatial distributions and temporal dynamics. This provides ecologically meaningful data to assess ecosystem condition, support decision making in spatial planning (including the evaluation of efficacy of current management strategies) and determine future information needs. The ultimate goal of the work is to better understand the coral reef ecosystems and to provide information toward protecting and enhancing coral reef ecosystems for the benefit of the system itself and to sustain the many goods and services that it offers society. This Technical Memorandum contains analysis of the first six years of fish survey data (2001-2006) and associated characterization of the benthos (1999-2006). The primary objectives were to quantify changes in fish species and assemblage diversity, abundance, biomass and size structure and to provide spatially explicit information on the distribution of key species or groups of species and to compare community structure inside (protected) versus outside (fished) areas of BIRNM. (PDF contains 100 pages).
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Coastal and marine ecosystems support diverse and important fisheries throughout the nation’s waters, hold vast storehouses of biological diversity, and provide unparalleled recreational opportunities. Some 53% of the total U.S. population live on the 17% of land in the coastal zone, and these areas become more crowded every year. Demands on coastal and marine resources are rapidly increasing, and as coastal areas become more developed, the vulnerability of human settlements to hurricanes, storm surges, and flooding events also increases. Coastal and marine environments are intrinsically linked to climate in many ways. The ocean is an important distributor of the planet’s heat, and this distribution could be strongly influenced by changes in global climate over the 21st century. Sea-level rise is projected to accelerate during the 21st century, with dramatic impacts in low-lying regions where subsidence and erosion problems already exist. Many other impacts of climate change on the oceans are difficult to project, such as the effects on ocean temperatures and precipitation patterns, although the potential consequences of various changes can be assessed to a degree. In other instances, research is demonstrating that global changes may already be significantly impacting marine ecosystems, such as the impact of increasing nitrogen on coastal waters and the direct effect of increasing carbon dioxide on coral reefs. Coastal erosion is already a widespread problem in much of the country and has significant impacts on undeveloped shorelines as well as on coastal development and infrastructure. Along the Pacific Coast, cycles of beach and cliff erosion have been linked to El Niño events that elevate average sea levels over the short term and alter storm tracks that affect erosion and wave damage along the coastline. These impacts will be exacerbated by long-term sea-level rise. Atlantic and Gulf coastlines are especially vulnerable to long-term sea-level rise as well as any increase in the frequency of storm surges or hurricanes. Most erosion events here are the result of storms and extreme events, and the slope of these areas is so gentle that a small rise in sea level produces a large inland shift of the shoreline. When buildings, roads and seawalls block this natural migration, the beaches and shorelines erode, threatening property and infrastructure as well as coastal ecosystems.
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Coral reef ecosystems are some of the most complex and important ecosystems in the marine environment. They are also among the most biologically diverse and economically valuable ecosystems on earth, producing billions of dollars in food, as well as providing a suite of ecological services, such as recreation and tourism activities and coastal protection from storm and wave action. Yet, despite their value and importance, these fragile ecosystems are declining at an alarming rate (Waddell and Clarke (eds.) 2008) due to a myriad of threats both natural and manmade, including climate change, fishing pressure, and runoff and sedimentation. In response, the Unites States Coal Reef Task Force was established in 1998 by Presidential Executive Order 13089 to lead U.S. efforts to preserve and protect the nation’s coral reef ecosystems. In order to better understand the current state of coral reef ecosystems and successfully mitigate the impacts of stressors, informational products, such as benthic (or sea floor) habitat maps, are critical. Benthic habitat maps support the ability to prioritize areas for further study and protection, and offer a baseline to evaluate the changes in ecosystems over time. In 2000, the United States Coral Reef Task Force charged NOAA with leading federal efforts to produce comprehensive digital maps of all U.S. shallow-water (approximately 0 to 30 m in depth) coral reef ecosystem habitats.
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Since 2001, biannual fish and habitat monitoring has been conducted for the shallow (> 30 m), colonized pavement and gorgonian dominated Buck Island Reef National Monument (BIRNM) St. Croix, USVI and adjacent waters. during October, 2005, widespread coral bleaching was observed within the ∼50 square-kilometer study area that was preceded by 10 wks of higher than average water temperatures (28.9–30.1 °C). Random transects (100 square meters) were conducted on linear reefs, patch reefs, bedrock, pavement, and scattered coral/rock habitats during October 2005, and April and October 2006, and species specific bleaching patterns were documented. During October 2005 approximately 51% of live coral cover was bleached. Nineteen of 23 coral species within 16 genera and two hydrocoral species exhibited signs of bleaching. Coral cover for Montastraea annularis and species of the genus Agaricia were the most affected, while other species exhibited variability in their susceptibility to bleaching. Bleaching was evident at all depths (1.5–28 m), was negatively correlated with depth, and positively correlated with habitat complexity. Bleaching was less prevalent at all depths and habitat types upon subsequent monitoring during April (15%) and October (3%) 2006. Four species and one genus did not exhibit signs of bleaching throughout the study period (Dendrogyra cylindrus, Eusmilia fastigata, Mussa angulosa, Mycetophyllia aliciae, Scolymia spp.).
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Limited information currently exists on the recovery periods of bleached corals as well as the spatial extent, causative factors, and the overall impact of bleaching on coral reef ecosystems. During October, 2005, widespread coral bleaching was observed within Buck Island Reef National Monument (BUIS) St. Croix, USVI. The bleaching event was preceded by 10 weeks of higher than average water temperatures (28.9-30.1°C). Random transects (100 square meters) over hard bottom habitats (N=94) revealed that approximately 51% of live coral cover was bleached. Nineteen of 23 coral species within 16 genera and two hydrocoral species exhibited signs of bleaching; species-specific bleaching patterns were variable throughout the study area. Coral cover for Montastraea annularisand species of the genus Agariciawere the most affected, while other species exhibited variability to bleaching. Although a weak but significant negative relationship (r2=0.10, P=0.0220) was observed, bleaching was evident at all depths (1.5-28 m). Bleaching was spatially autocorrelated (P=0.001) and hot-spot analysis identified a cluster of high bleaching stations northeast of Buck Island. Bleaching was significantly reduced within all depth zones and habitat types upon subsequent monitoring during April (15%) and October (3%) 2006.