Ecological implications of pedogenesis and geochemistry of ultramafic soils in Kinabalu Park (Malaysia)

In Sabah, Malaysia, ultramafic rock outcrops are widespread (totalling 3500 km2, one of the main outcrops in the tropical zone), and predominantly of the peridotite type. However, strongly serpentinised peridotite is also locally common, particularly along fault lines in the Mt. Kinabalu area. This study aimed to determine the extent of chemical variation in ultramafic soils in relation to the degree of serpentinisation and the weathering intensity, and consequent potential ecological implications linked to resulting soil chemical fertility. It was hypothesized that young soils and soils derived from bedrock with a significant degree of serpentinisation strongly differ from typical Geric Ferralsols and result in soil chemistries with more adverse properties to plant life (e.g. low availability of the essential nutrients N, P, K and Ca and high concentrations of potentially phytotoxic Mg and Ni). Ultramafic soil diversity linked to the age of the soil or the degree of serpentinisation would thus be a main factor of plant diversity and distribution. The diverse topography of Kinabalu Park (ultramafic soils present between 400 and 2950 m asl) has given rise to high pedodiversity with the broad overall ultramafic soil types being: (i) deep laterite soils (Geric Ferralsols); (ii) moderately deep montane soils (Dystric Cambisols) with mor humus; (iii) shallow skeletal soils at high altitude (Eutric Cambisols Hypermagnesic); and (iv) bare serpentinite soils (Hypereutric Leptosols Hypermagnesic) at low altitude (200–700 m asl). Leptosols on serpentinite and Eutric Cambisols have the most extreme chemical properties in the whole Kinabalu Park area both with very high Mg:Ca molar quotients, with either high available Ni (Cambisols) or high pH (Leptosols). These soils host specific and adapted vegetation (high level of endemism) that tolerates geochemical peculiarities, including Ni hyperaccumulators. Geric Ferralsols present far less chemical constraints than Hypermagnesian Cambisols soils to the vegetation and host a tall and very diverse rainforest, not so different than that on non-ultramafic soils. It therefore appears that altitude, soil age and degree of bedrock serpentinisation are the main determining factors of soil properties: the qualifier “ultramafic” alone is not sufficient to define soil geochemical and ecological conditions in the Kinabalu Park area, probably more than in any other ultramafic region in the world

Exploring the development of early career nurses: insights 4 years after graduation

Aim To explore how Early Career Nurses perceive their preparedness for nursing practice, the teaching and learning experiences, and the role of professional experience placements on their professional development. Design A qualitative study using a hermeneutic phenomenological approach. Method The study involved 25 Early Career Nurses who participated in follow-up interviews 4 years post-graduation in Australia between 2022 and 2024. Data were collected through semi-structured interviews and analysed using Thematic Analysis. Results Three key themes emerged: gaps in preparedness, the power of being embedded and too many balls to juggle. Participants indicated a mixed sense of preparedness with significant gaps in clinical skills. They emphasised the critical role of professional experience placements and mentorship to bridge the gap between theoretical knowledge and practical application. Placements and mentorship opportunities were considered essential to develop confidence and competence for effective nursing practice. Conclusion The study highlights the necessity for nursing curricula to address significant gaps in clinical skills, particularly in surgical and emergency nursing. By incorporating more simulation-based learning, interprofessional education and robust mentorship programmes, nursing education can better prepare graduates for the realities of clinical practice. These enhancements will help ease the transition from academic training to clinical practice, reducing reality shock and fostering a more confident, competent and resilient nursing workforce

Navigating a nursing career four years after graduation: A qualitative descriptive study exploring drivers of staying amid wanting to leave

Aim: To explore the lived experience of Early Career Nurses four years post-graduation and identify factors influencing their decision to stay in or leave the profession. Background: The retention of Early Career Nurses is a critical issue globally, with many leaving the profession within the first few years. Various interventions have been implemented to support Early Career Nurses, but eh complexities of retention require a more nuanced understanding, particularly for those in the latter stages of their transition. Design: A qualitative descriptive study Methods: Early Career Nurses who participated in a longitudinal study as undergraduate nursing students were interviewed 48 months after graduation. The study used phenomenological approach to explore key experiences and phenomena. Data were analysed using Thematic Analysis, adhering to COREQ guidelines. Results: Among the 25 participants, key themes identified included being 'Overworked and undervalued" and being 'Anchored by care'. Early Career Nurses experienced significant pressures, including incivility, poor management and staffing shortages, leading to the desire to leave th profession. However, a strong commitment to patient care and support from peers and family helped some Early Career Nurses remain in the profession. Conclusion: The study highlights the need for systemic changes to support Early Career Nurses, including empathetic leadership, adequate training and supportive work environments. Addressing these issues is essential for the well-being of Early Career Nurses and maintaining high standards of patient care. Understanding eh unique challenges faced by Early Career Nurses can inform strategies to improve retention and support their professional development

Psychosocial interventions for supporting women to stop smoking in pregnancy

Background: Tobacco smoking remains one of the few preventable factors associated with complications in pregnancy, and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and is increasing in low- to middle-income countries. Objectives: To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. Search methods: In this sixth update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register (13 November 2015), checked reference lists of retrieved studies and contacted trial authors. Selection criteria: Randomised controlled trials, cluster-randomised trials, and quasi-randomised controlled trials of psychosocial smoking cessation interventions during pregnancy. Data collection and analysis: Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, with meta-regression conducted in STATA 14. Main results: The overall quality of evidence was moderate to high, with reductions in confidence due to imprecision and heterogeneity for some outcomes. One hundred and two trials with 120 intervention arms (studies) were included, with 88 trials (involving over 28,000 women) providing data on smoking abstinence in late pregnancy. Interventions were categorised as counselling, health education, feedback, incentives, social support, exercise and dissemination. In separate comparisons, there is high-quality evidence that counselling increased smoking cessation in late pregnancy compared with usual care (30 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.73) and less intensive interventions (18 studies; average RR 1.25, 95% CI 1.07 to 1.47). There was uncertainty whether counselling increased the chance of smoking cessation when provided as one component of a broader maternal health intervention or comparing one type of counselling with another. In studies comparing counselling and usual care (largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy. However, a clear effect was seen in smoking abstinence at zero to five months postpartum (11 studies; average RR 1.59, 95% CI 1.26 to 2.01) and 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), with a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77). In other comparisons, the effect was unclear for most secondary outcomes, but sample sizes were small. Evidence suggests a borderline effect of health education compared with usual care (five studies; average RR 1.59, 95% CI 0.99 to 2.55), but the quality was downgraded to moderate as the effect was unclear when compared with less intensive interventions (four studies; average RR 1.20, 95% CI 0.85 to 1.70), alternative interventions (one study; RR 1.88, 95% CI 0.19 to 18.60), or when smoking cessation health education was provided as one component of a broader maternal health intervention. There was evidence feedback increased smoking cessation when compared with usual care and provided in conjunction with other strategies, such as counselling (average RR 4.39, 95% CI 1.89 to 10.21), but the confidence in the quality of evidence was downgraded to moderate as this was based on only two studies and the effect was uncertain when feedback was compared to less intensive interventions (three studies; average RR 1.29, 95% CI 0.75 to 2.20). High-quality evidence suggests incentive-based interventions are effective when compared with an alternative (non-contingent incentive) intervention (four studies; RR 2.36, 95% CI 1.36 to 4.09). However pooled effects were not calculable for comparisons with usual care or less intensive interventions (substantial heterogeneity, I2 = 93%). High-quality evidence suggests the effect is unclear in social support interventions provided by peers (six studies; average RR 1.42, 95% CI 0.98 to 2.07), in a single trial of support provided by partners, or when social support for smoking cessation was provided as part of a broader intervention to improve maternal health. The effect was unclear in single interventions of exercise compared to usual care (RR 1.20, 95% CI 0.72 to 2.01) and dissemination of counselling (RR 1.63, 95% CI 0.62 to 4.32). Importantly, high-quality evidence from pooled results demonstrated that women who received psychosocial interventions had a 17% reduction in infants born with low birthweight, a significantly higher mean birthweight (mean difference (MD) 55.60 g, 95% CI 29.82 to 81.38 g higher) and a 22% reduction in neonatal intensive care admissions. However the difference in preterm births and stillbirths was unclear. There did not appear to be adverse psychological effects from the interventions. The intensity of support women received in both the intervention and comparison groups has increased over time, with higher-intensity interventions more likely to have higher-intensity comparisons, potentially explaining why no clear differences were seen with increasing intervention intensity in meta-regression analyses. Among meta-regression analyses: studies classified as having 'unclear' implementation and unequal baseline characteristics were less effective than other studies. There was no clear difference between trials implemented by researchers (efficacy studies), and those implemented by routine pregnancy staff (effectiveness studies), however there was uncertainty in the effectiveness of counselling in four dissemination trials where the focus on the intervention was at an organisational level. The pooled effects were similar in interventions provided for women classified as having predominantly low socio-economic status, compared to other women. The effect was significant in interventions among women from ethnic minority groups; however not among indigenous women. There were similar effect sizes in trials with biochemically validated smoking abstinence and those with self-reported abstinence. It was unclear whether incorporating use of self-help manuals or telephone support increased the effectiveness of interventions. Authors' conclusions: Psychosocial interventions to support women to stop smoking in pregnancy can increase the proportion of women who stop smoking in late pregnancy and the proportion of infants born low birthweight. Counselling, feedback and incentives appear to be effective, however the characteristics and context of the interventions should be carefully considered. The effect of health education and social support is less clear. New trials have been published during the preparation of this review and will be included in the next update

Biallelic MED27 variants lead to variable ponto-cerebello-lental degeneration with movement disorders

MED27 is a subunit of the Mediator multiprotein complex, which is involved in transcriptional regulation. Biallelic MED27 variants have recently been suggested to be responsible for an autosomal recessive neurodevelopmental disorder with spasticity, cataracts and cerebellar hypoplasia. We further delineate the clinical phenotype of MED27-related disease by characterizing the clinical and radiological features of 57 affected individuals from 30 unrelated families with biallelic MED27 variants. Using exome sequencing and extensive international genetic data sharing, 39 unpublished affected individuals from 18 independent families with biallelic missense variants in MED27 have been identified (29 females, mean age at last follow-up 17 ± 12.4 years, range 0.1-45). Follow-up and hitherto unreported clinical features were obtained from the published 12 families. Brain MRI scans from 34 cases were reviewed. MED27-related disease manifests as a broad phenotypic continuum ranging from developmental and epileptic-dyskinetic encephalopathy to variable neurodevelopmental disorder with movement abnormalities. It is characterized by mild to profound global developmental delay/intellectual disability (100%), bilateral cataracts (89%), infantile hypotonia (74%), microcephaly (62%), gait ataxia (63%), dystonia (61%), variably combined with epilepsy (50%), limb spasticity (51%), facial dysmorphism (38%) and death before reaching adulthood (16%). Brain MRI revealed cerebellar atrophy (100%), white matter volume loss (76.4%), pontine hypoplasia (47.2%) and basal ganglia atrophy with signal alterations (44.4%). Previously unreported 39 affected individuals had seven homozygous pathogenic missense MED27 variants, five of which were recurrent. An emerging genotype-phenotype correlation was observed. This study provides a comprehensive clinical-radiological description of MED27-related disease, establishes genotype-phenotype and clinical-radiological correlations and suggests a differential diagnosis with syndromes of cerebello-lental neurodegeneration and other subtypes of 'neuro-MEDopathies'

Oxygen consumption in healthy women and in women with coronary artery disease

No abstract availableSchool of Physical Therap

The effects of weight-lifting on bone mineral density in premenopausal women

Sixty-eight women, aged 23-46 participated in a twelve-month exercise program; half as weight-lifters, using Nautilus equipment, half as controls. The two groups were matched according to age, size (body mass index), and typical activity level. Data collection included bone mineral density (BMD) of the lumbar spine, using dual-photon absorptiometry, and of the os calcis, using sing1e-photon absorptiometry. Lean body mass was measured via the underwater weighing technique; urinary calcium/creatinine and urinary gammacarboxyglutamic acid (Gia) were calculated. Diet records were collected on five occasions. Strength was assessed using the one repetition maximum strength test. All subjects were given a daily 500 mg supplement of elemental calcium in the form of calcium carbonate. There was no significant difference between groups in terms of the consumption of calcium, phosphorus, or caffeine, in urinary ca1cium/creatinine or Gia, or in lean body mass. The weight-lifting group had an increase in lumbar BMD of 0.81 percent, while the control group exhibited a 0.5 percent decrease. A correlated T-test revealed a significant difference between the matched pairs, in lumbar BMD. The os calcis showed almost no measureable change in either group. The effectiveness of an exercise program, in preventing age-related bone loss, is dicussed, along with the characteristics necessary for an exercise program to be accepted by the general female population.School of Physical Therap