Gender, migration, and drought: an exploratory study of women's roles in Mallee farming communities

A gender difference exists in access to resources and decision-making in issues of drought as women are overwhelmingly denied a “voice” (Clarke, 2014). This is particularly prevalent in irrigation and farming communities, which carry on a legacy of patriarchal stewardship over farming and agricultural matters. This exploratory study considers the role of women in farming practice in the Mallee region and how they view their position as decision-makers in drought and water management. This study presents three key findings from interviews of women within the region: women are increasingly adopting the label “farmer” so that they can be “counted” and given decision-making power regarding drought and water. Interviewees also stated a distinct difference in gender relations within horticultural dryland farming compared to irrigation farming. That is, many found that gender dynamics were more progressive and equal within dryland. Some stated that this was due to many irrigation farmers being recent migrants and more likely to have traditional gender roles in their own family unit. The dynamic between white settler farming women and those who had recently settled in the area (first-generation migrants) was wholly unexpected and highlights a potential “us-and-them” distinction in farming. Despite the psychological distance of drought during the time of the interviews (many had recently experienced flooding), there was nevertheless a strong sense of the danger of drought and the foreboding sense that it was coming. Interviewees stated that women were pivotal during times of drought as they were the ones to draw on community networks for help, to apply for grants, and also to supplement family income from off-farm work. This research should be noted for its limitations, particularly regarding the low sample size. As an exploratory study, it cannot be said to be representative and, as such, can only present potential areas for future research.</p

The effect of sphingosine‐1‐phosphate on the endothelial glycocalyx during ischemia‐reperfusion injury in the isolated rat heart

Objective: Sphingosine‐1‐phosphate is a natural metabolite that is cardioprotective, but its effects on endothelial glycocalyx damage during ischemia‐reperfusion are unknown. Therefore, we investigated the effect of sphingosine‐1‐phosphate on the endothelial glycocalyx during ischemia‐reperfusion. Methods: Isolated hearts from Wistar rats were perfused on a Langendorff system with Krebs‐Henseleit buffer and pretreated with sphingosine‐1‐phosphate (10 nmol/L) before ischemia‐reperfusion. Infarct size was measured by triphenyl tetrazolium chloride staining (n ≥ 6 per group). Cardiac edema was assessed by calculating total water content (n = 7 per group) and histologically quantifying the interstitial compartment (n ≥ 3 per group). The post‐ischemic coronary release of syndecan‐1 was quantified using ELISA. Syndecan‐1 immunostaining intensity was assessed in perfusion‐fixed hearts (n ≥ 3 per group). Results: Pretreatment with sphingosine‐1‐phosphate decreased infarct size in isolated hearts subjected to ischemia‐reperfusion (P = .01 vs ischemia‐reperfusion). However, sphingosine‐1‐phosphate had no effect on syndecan‐1 levels in the coronary effluent or on the intensity of the syndecan‐1 immunostaining signal in cardiac tissue. Heart total water content was not significantly different between control and ischemic groups but was significantly decreased in hearts treated with sphingosine‐1‐phosphate alone. Conclusion: These results suggest that sphingosine‐1‐phosphate‐induced cardioprotection against ischemia‐reperfusion injury is not mediated by the maintenance of syndecan‐1 in the endothelial glycocalyx

Fulminant Staphylococcus lugdunensis septicaemia following a pelvic varicella-zoster virus infection in an immune-deficient patient: a case report

<p>Abstract</p> <p>Introduction</p> <p>The deadly threat of systemic infections with coagulase negative <it>Staphylococcus lugdunensis </it>despite an appropriate antibiotic therapy has only recently been recognized. The predominant infectious focus observed so far is left-sided native heart valve endocarditis, but bone and soft tissue infections, septicaemia and vascular catheter-related bloodstream infections have also been reported. We present a patient with a fatal <it>Staphylococcus lugdunensis </it>septicaemia following zoster bacterial superinfection of the pelvic region.</p> <p>Case presentation</p> <p>A 71-year old male diagnosed with IgG kappa plasmocytoma presented with a conspicuous weight loss, a hypercalcaemic crisis and acute renal failure. After initiation of haemodialysis treatment his condition improved rapidly. However, he developed a varicella-zoster virus infection of the twelfth thoracic dermatome requiring intravenous acyclovir treatment. Four days later the patient presented with a fulminant septicaemia. Despite an early intravenous antibiotic therapy with ciprofloxacin, piperacillin/combactam and vancomycin the patient died within 48 hours, shortly before the infective isolate was identified as <it>Staphylococcus lugdunensis </it>by polymerase chain reaction.</p> <p>Conclusion</p> <p>Despite <it>S. lugdunensis </it>belonging to the family of coagulase-negative staphylococci with an usually low virulence, infections with <it>S. lugdunensis </it>may be associated with an aggressive course and high mortality. This is the first report on a <it>Staphylococcus lugdunensis </it>septicaemia following a zoster bacterial superinfection of the pelvic region.</p

Guidance on the management of left ventricular assist device (LVAD) supported patients for the non-LVAD specialist healthcare provider: executive summary

The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD supported patients. Device-related, and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of LVAD implanting centres. The probability of an LVAD supported patient presenting with medical emergency to a local ambulance team, emergency department medical team and internal or surgical wards in a non-LVAD implanting centre is increasing. The purpose of this paper is to supply the immediate tools needed by the non-LVAD specialized physician - ambulance clinicians, emergency ward physicians, general cardiologists, and internists - to comply with the medical needs of this fast-growing population of LVAD supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department, and from the emergency department to the internal or surgical wards and eventually back to the general practitioner.Cardiolog

HFA of the ESC position paper on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider Part 3: at the hospital and discharge.

The growing population of left ventricular assist device (LVAD)-supported patients increases the probability of an LVAD- supported patient hospitalized in the internal or surgical wards with certain expected device related, and patient-device interaction complication as well as with any other comorbidities requiring hospitalization. In this third part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, definitions and structured approach to the hospitalized LVAD-supported patient are presented including blood pressure assessment, medical therapy of the LVAD supported patient, and challenges related to anaesthesia and non-cardiac surgical interventions. Finally, important aspects to consider when discharging an LVAD patient home and palliative and end-of-life approaches are described

HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non-hospital settings in the community.

The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD-supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD-supported patients. The expected and non-expected device-related and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD-supported patients, mainly those supported with the 'destination therapy' indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD-supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non-LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non-LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, to comply with the medical needs of this fast-growing population of LVAD-supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department and from the emergency department to the internal or surgical wards and eventually to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD-supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD-supported patients

Heart Failure Association of the European Society of Cardiology position paper on the management of left ventricular assist device-supported patients for the non-left ventricular assist device specialist healthcare provider: Part 2: at the emergency department.

The improvement in left ventricular assist device (LVAD) technology and scarcity of donor hearts have increased dramatically the population of the LVAD-supported patients and the probability of those patients to present to the emergency department with expected and non-expected device-related and patient-device interaction complications. The ageing of the LVAD-supported patients, mainly those supported with the 'destination therapy' indication, increases the risk for those patients to suffer from other co-morbidities common in the older population. In this second part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, definitions and structured approach to the LVAD-supported patient presenting to the emergency department with bleeding, neurological event, pump thrombosis, chest pain, syncope, and other events are presented. The very challenging issue of declaring death in an LVAD-supported patient, as the circulation is artificially preserved by the device despite no other signs of life, is also discussed in detail

Vitamin A derivatives in the prevention and treatment of human cancer.

Vitamin A is essential for normal cellular growth and differentiation. A vast amount of laboratory data have clearly demonstrated the potent antiproliferative and differentiation-inducing effects of vitamin A and the synthetic analogues (retinoids). Recent in-vitro work has led to the exciting proposal that protein kinase-C may be centrally involved in many of retinoids' anticancer actions including the effects on ornithine decarboxylase induction, intracellular polyamine levels, and epidermal growth factor receptor number. Several intervention trials have clearly indicated that natural vitamin A at clinically tolerable doses has only limited activity against human neoplastic processes. Therefore, clinical work has focused on the synthetic derivatives with higher therapeutic indexes. In human cancer prevention, retinoids have been most effective for skin diseases, including actinic keratosis, keratoacanthoma, epidermodysplasia verruciformis, dysplastic nevus syndrome, and basal cell carcinoma. Several noncutaneous premaligancies, however, are currently receiving more attention in retinoid trials. Definite retinoid activity has been documented in oral leukoplakia, laryngeal papillomatosis, superficial bladder carcinoma, cervical dysplasia, bronchial metaplasia, and preleukemia. Significant therapeutic advances are also occurring with this class of drugs in some drug-resistant malignancies and several others that have become refractory, including advanced basal cell cancer, mycosis fungoides, melanoma, acute promyelocytic leukemia, and squamous cell carcinoma of the skin and of the head and neck. This report comprehensively presents the clinical data using retinoids as anticancer agents in human premalignant disorders and outlines the ongoing and planned studies with retinoids in combination and adjuvant therapy

Exploring the Role of Trust in Drinking Water Systems in Western Virginia

As the impacts of global change drivers and anthropogenic influences increase, the lakes and reservoirs that communities rely on for their drinking water are threatened by more frequent, severe, and unpredictable disturbances. This study was a part of an interdisciplinary effort to understand and increase resilience in water systems to improve managers adaptive capacity to cope with these disturbances. A key element of social resilience is trust, which can improve the speed and effectiveness of management actions and can spillover into community wellbeing and behavioral outcomes, including acceptance or rejection of tap water. Using a four-stage drop off pick up method, I surveyed 611 residents in Roanoke, Virginia to examine the role of trust in drinking water systems between a community and their utility. I first focused on factors that related to a person's trust in their water utility. I examined the relationship between four determinants of trust ecology, the salience of a trusting behavior, and trust, as well as and the effects of information provision about new water security technologies on trust. I then assessed trust's role in characterizing drinking water behavior (i.e. water source usage) alongside factors of risk, water quality evaluations, and salience. I found that trust can be high in low salience situations and information provision had no effect on trust, suggesting that people might take their water security for granted when it is not at the forefront of their thoughts. Calculated beliefs about a utility's capability were only linked to increasing trust when those beliefs were negative, suggesting that people might have a threshold where their utility is capable enough to trust. Even in the absence of the information to form affinitive judgments, value and goodwill-based judgments were important to community trust. Lastly, understanding behaviors might provide indicators for managers about the state of community perceptions of their water since trust, risk perceptions, and evaluations of tap water's taste, smell, and appearance varied based on an individual's water source choice. These findings demonstrate the complexity and importance of community's trust in their water managers. This study of, and continued research into, trust can help us further our understanding of, and the tools to build, the resilient water systems needed to preserve water security and community health.Master of ScienceThe raw water sources that utilities use to treat drinking water are typically lakes and reservoirs. This means that the safety of public drinking water is reliant on the stability of the surface water sources that water utilities use. Because of extreme weather, warming temperatures, and human land use, disturbances to surface lakes and reservoirs are becoming more frequent, severe, and unpredictable. A key goal of water-quality researchers is to learn how to develop systems that are more capable of adapting to these disturbances. Trust is an asset to water systems ability to handle disturbance. If people trust their water utility, they offer less resistance to new management plans and worry less about their water. To better understand trust in water utilities, I conducted a survey on residents in Roanoke Virginia. Trust in an institution is a function of an individual's calculation that their water utility can deliver safe drinking water (rational determinants), their feelings of value affinity or goodwill to their utility (affinitive determinants), their natural inclination to trust (dispositional determinants), and their belief that the water utility is regulated by a larger system of procedures (systems determinants). Trust also varies based on salience of a trusting behavior, which, in this case, was the degree to which citizens are aware of and think about their drinking water safety and supply. I assessed how these four judgments and salience relate to trust, and if providing information about new technology designed to keep water safe could increase trust. I then looked how trust interacted with other factors of risk, water quality evaluations, and people's awareness of their drinking water to characterize the perceptions of people who drink from different water sources. I found that when people have had consistent outcomes for their water security, they don't think about their water much but still have high trust that it to be safe. Providing people with information about water safety technology did not impact their trust. All four determinants had different relationships with trust. Levels of trust plateaued after neutral levels of capability beliefs and moderate levels of value and goodwill judgements were reached while broader system beliefs maintained a strong positive relationship with trust and disposition maintained a weak positive relationship with trust. Affinitive, rational, and procedural determinants were important to trust. People were more likely to drink tap water if they had higher trust in their utility, lower risk perceptions, and more favorable tap water quality evaluations. Salience, though important to trust formation, played less of a role in characterizing drinking water behavior. Overall my findings show that several factors interact together to form trust, and that trust, once formed, plays an important role in characterizing different drinking water behaviors. This study and future attempts to learn about trust can help us understand how to build water system's adaptive capabilities and preserve community health through disturbances