Sedimentological, mineralogical, biogeochemical and micropaleontological parameters on sediment core PS69/849-2, Burton Basin, MacRobertson Shelf, East Antarctica

A multi-proxy study including sedimentological, mineralogical, biogeochemical and micropaleontological methods was conducted on sediment core PS69/849-2 retrieved from Burton Basin, MacRobertson Shelf, East Antarctica. The goal of this study was to depict the deglacial and Holocene environmental history of the MacRobertson Land-Prydz Bay region. A special focus was put on the timing of ice-sheet retreat and the variability of bottom-water formation due to sea ice formation through the Holocene. Results from site PS69/849-2 provide the first paleo-environmental record of Holocene variations in bottom-water production probably associated to the Cape Darnley polynya, which is the second largest polynya in the Antarctic. Methods included end-member modeling of laser-derived high-resolution grain size data to reconstruct the depositional regimes and bottom-water activity. The provenance of current-derived and ice-transported material was reconstructed using clay-mineral and heavy-mineral analysis. Conclusions on biogenic production were drawn by determination of biogenic opal and total organic carbon. It was found that the ice shelf front started to retreat from the site around 12.8 ka BP. This coincides with results from other records in Prydz Bay and suggests warming during the early Holocene optimum next to global sea level rise as the main trigger. Ice-rafted debris was then supplied to the site until 5.5 cal. ka BP, when Holocene global sea level rise stabilized and glacial isostatic rebound on MacRobertson Land commenced. Throughout the Holocene, three episodes of enhanced bottom-water activity probably due to elevated brine rejection in Cape Darnley polynya occured between 11.5 and 9 cal. ka BP, 5.6 and 4.5 cal. ka BP and since 1.5 cal. ka BP. These periods are related to shifts from warmer to cooler conditions at the end of Holocene warm periods, in particular the early Holocene optimum, the mid-Holocene warm period and at the beginning of the neoglacial. In contrast, between 7.7 and 6.7 cal. ka BP, brine rejection shut down, maybe owed to warm conditions and pronounced open-water intervals.

Direct and general support and depot maintenance repair parts and special tools lists : theodolite, directional; 0.002-mil graduation, 5.9 in. long telescope; detachable tribrach; w/accessories and tripod (Wild Heerbrugg model T-2-56-C-MIL), FSN 6675-682-4635 ... (Wild Heerbrugg model T-2-56-C-MIL, reference), FSN 6675-988-5225.

Includes index.

Operator, organizational, direct support, general support, and depot maintenance manual : theodolite, surveying, directional, 0.002 mil graduation w/extension leg tripod (Keuffel & Esser model KE-2 special), FSN 6675-903-7661.

"September 1968."

Part 2. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: A patient perspective

An important goal of the care for the mechanically ventilated patient is to minimize patient discomfort and anxiety. This is partly achieved by frequent use of chemical and physical restraints. The majority of patients in intensive care will receive some form of sedation. The goal and use of sedation has changed considerably over the past few decades with literature evidencing trends toward overall lighter sedation levels and daily interruption of sedation. Conversely, the use of physical restraint for the ventilated patient in ICU differs considerably between nations and continents. A large portion of the literature on the use of physical restraint is from general hospital wards and residential homes, and not from the ICU environment. Recent literature suggests minimal use of physical restraint in the ICU, and that reduction programmes have been initiated. However, very few papers illuminate the patient's experience of physical and chemical restraints as a treatment strategy. In Part 1 of this two-part review, the evidence on chemical and physical restraints was explored with specific focus on definitions of terms, unplanned extubation, agitation, delirium as well as the impact of nurse–patient ratios in the ICU on these issues. This paper, Part 2, examines the evidence related to chemical and physical restraints from the mechanically ventilated patient's perspective.

Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management : Baseline findings and six-month outcomes

Background: Effective self-management of diabetes is essential for the reduction of diabetes-related complications, as global rates of diabetes escalate. Methods: Randomised controlled trial. Adults with type 2 diabetes (n = 120), with HbA1c greater than or equal to 7.5 %, were randomly allocated (4 × 4 block randomised block design) to receive an automated, interactive telephone-delivered management intervention or usual routine care. Baseline sociodemographic, behavioural and medical history data were collected by self-administered questionnaires and biological data were obtained during hospital appointments. Health-related quality of life (HRQL) was measured using the SF-36. Results: The mean age of participants was 57.4 (SD 8.3), 63 % of whom were male. There were no differences in demographic, socioeconomic and behavioural variables between the study arms at baseline. Over the six-month period from baseline, participants receiving the Australian TLC (Telephone-Linked Care) Diabetes program showed a 0.8 % decrease in geometric mean HbA1c from 8.7 % to 7.9 %, compared with a 0.2 % HbA1c reduction (8.9 % to 8.7 %) in the usual care arm (p = 0.002). There was also a significant improvement in mental HRQL, with a mean increase of 1.9 in the intervention arm, while the usual care arm decreased by 0.8 (p = 0.007). No significant improvements in physical HRQL were observed. Conclusions: These analyses indicate the efficacy of the Australian TLC Diabetes program with clinically significant post-intervention improvements in both glycaemic control and mental HRQL. These observed improvements, if supported and maintained by an ongoing program such as this, could significantly reduce diabetes-related complications in the longer term. Given the accessibility and feasibility of this kind of program, it has strong potential for providing effective, ongoing support to many individuals with diabetes in the future.

Positive associations of serum Perfluoroalkyl substances with uric acid and hyperuricemia in children from Taiwan

To investigate the risk of hyperuricemia in relation to Perfluoroalkyl substances (PFASs) in children from Taiwan, 225 Taiwanese children aged 12-15 years were recruited from 2009 to 2010. Linear and logistic regression models were employed to examine the influence of PFASs on serum uric acid levels. Findings revealed that eight of ten PFASs analyses were detected in > 94% of the participants' serum samples. Multivariate linear regression models revealed that perfluorooctanic acid (PFOA) was positively associated with serum uric acid levels (β=0.1463, p<0.05). Of all the PFASs analyses, only PFOA showed a significant effect on elevated levels of hyperuricemia (aOR=2.16, 95%CI: 1.29-3.61). When stratified by gender, the association between serum PFOA and uric acid levels was only evident among boys (aOR=2.76, 95%CI: 1.37-5.56). In conclusion, PFOA was found to be associated with elevated serum levels of uric acid in Taiwanese children, especially boys. Further research is needed to elucidate these links.