Tropical cyanobacterial blooms: A review of prevalence, problem taxa, toxins and influencing environmental factors

© 2015, Page Press Publications. All rights reserved. Toxic cyanobacterial blooms are a major issue in freshwater systems in many countries. The potentially toxic species and their ecological causes are likely to be different in tropical zones from those in temperate water bodies; however, studies on tropical toxic cyanobacterial blooms are sporadic and currently there is no global synthesis. In this review, we examined published information on tropical cyanobacterial bloom occurrence and toxin production to investigate patterns in their growth and distribution. Microcystis was the most frequently occurring bloom genus throughout tropical Asia, Africa and Central America, while Cylindrospermopsis and Anabaena blooms occurred in various locations in tropical Australia, America and Africa. Microcystis blooms were more prevalent during the wet season while Cylindrospermopsis blooms were more prevalent during the dry period. Microcystin was the most encountered toxin throughout the tropics. A meta-analysis of tropical cyanobacterial blooms showed that Microcystis blooms were more associated with higher total nitrogen concentrations, while Cylindrospermopsis blooms were more associated with higher maximum temperatures. Meta-analysis also showed a positive linear relationship between levels of microcystin and N:P (nitrate:phosphate) ratio. Tropical African Microcystis blooms were found to have the lowest microcystin levels in relation to biomass and N:P (nitrate:phosphate) compared to tropical Asian, Australian and American blooms. There was also no significant correlation between microcystin concentration and cell concentration for tropical African blooms as opposed to tropical Asian and American blooms. Our review illustrates that some cyanobacteria and toxins are more prevalent in tropical areas. While some tropical countries have considerable information regarding toxic blooms, others have few or no reported studies

On the Uses of Belladonna

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Foodservice in hospital: development of a theoretical model for patient experience and satisfaction using one hospital in the UK National Health Service as a case study

Hospital foodservice does not operate in isolation but requires the cooperation and integration of several disciplines to provide the ultimate patient experience. The objective of this research was to explore the antecedents to patient satisfaction and experience, including the service element. Accordingly, focus groups were conducted with doctors (n = 4), nurses (n = 5), ward hostesses (n = 3) and patients together with their visitors (n = 10), while open-ended interviews were conducted with the foodservice manager, facilities manager, chief dietitian, orthopaedic ward dietitian and chief pharmacist. Themes centred on ‘patients’, ‘foodservice’ and ‘mealtimes’, and results show that food qualities, particularly temperature and texture, are important factors impinging on patient satisfaction, and the trolley system of delivery is an acceptable style of service. Service predisposition demonstrates little relevance to patient satisfaction towards overall meal enjoyment. A theoretical model has been developed that identifies hospital foodservice in a cyclic relationship with the community primary healthcare team

Multiple ethnic identities and the Christchurch Malaysian Chinese

This thesis is concerned with multiple ethnic identification in a multiethnic society. The primary objective is to investigate the fundamental dynamics which underlie the ethnic phenomenon. This is undertaken by empirically evaluating the validity of two hypotheses on ethnic identification. The theoretical framework employed is formulated from a number of works on ethnicity, particularly Barth's (1969) theory on boundaries, and Cohen's (1978) theory on nesting dichotomization. The first hypothesis concerns the flexible and situational nature of ethnic identification. Individuals identify according to sets of shared qualities which stand in contrast to other sets of shared qualities within different contexts. The second hypothesis concerns nesting identities. Individuals identify in a set of nesting dichotomizations of inclusiveness and exclusiveness. Empirical evidence from a case study carried out on the Malaysian Chinese community in Christchurch, New Zealand, largely verified the validity of the two hypotheses. The thesis concludes with three main findings. First it is found that ethnic identification is based on relevant and significant contrasts and similarities in relation to others which create the boundary for an identity. Second, ethnic identification is flexible, situational and individual in nature. Individuals exhibit particularism, employ different criteria and identify differently in different contexts. This quality of ethnic identification is responsible for multiple ethnic identities. Third, it is found that for some people, ethnic identification is a function of interactive experiences. This suggests that ethnic identification is not simply a function of socialization as is widely believed. The findings of the study confirm that ethnicity is an interactive phenomenon. As a result of these findings, it is suggested that ethnicity should be conceptualized in a way which would more adequately reflect ethnicity within contemporary society

Generisches Simulationsmodell für Stückgutspeditionsanlagen auf Basis der Anforderungen von KMUs

Simulation can be used to plan and optimize less-than-truckload (LTL) terminals. To develop simulation models, specific expertise in this field is needed, which often requires high financial investments for acquisition of this knowledge. Due to limited financial resources, SMEs are often incapable to get to this expertise. The objective of the paper is to develop a generic model for LTL terminal planning that can be used without simulation expertise and that can be adapted to individual SME layouts. Therefore, based on focus group interviews with SMEs, a catalog of requirements is developed, including input variables and design criteria. Key performance indicators (KPIs) are defined to evaluate the results. A feasibility study for implementing a generic model based on the identified requirements is then performed. The implementation is done by modeling the I-layout of an LTL terminal

Development and external validation of a prognostic model for time to readmission or death in multimorbid patients

Objective To develop and externally validate a prognostic model built on important factors predisposing multimorbid patients to all-cause readmission and/or death. In addition to identify patients who may benefit most from a comprehensive clinical pharmacist intervention. Methods A multivariable prognostic model was developed based on data from a randomised controlled trial investigating the effect of pharmacist-led medicines management on readmission rate in multimorbid, hospitalised patients. The derivation set comprised 386 patients randomised in a 1:1 manner to the intervention group, i.e. with a pharmacist included in their multidisciplinary treatment team, or the control group receiving standard care at the ward. External validation of the model was performed using data from an independent cohort, in which 100 patients were randomised to the same intervention, or standard care. The setting was an internal medicines ward at a university hospital in Norway. Results The number of patients who were readmitted or had died within 18 months after discharge was 297 (76.9 %) in the derivation set, i.e. the randomized controlled trial, and 69 (71.1 %) in the validation set, i.e. the independent cohort. Charlson comorbidity index (CCI; low, moderate or high), previous hospital admissions within the previous six months and heart failure were the strongest prognostic factors and were included in the final model. The efficacy of the pharmaceutical intervention did not prove significant in the model. A prognostic index (PI) was constructed to estimate the hazard of readmission or death (low, intermediate or high-risk groups). Overall, the external validation replicated the result. We were unable to identify a subgroup of the multimorbid patients with better efficacy of the intervention. Conclusions A prognostic model including CCI, previous admissions and heart failure can be used to obtain valid estimates of risk of readmission and death in patients with multimorbidity.publishedVersio

Limiea Woolf, Mildred E. Mowe, Madge E. Iverson, Cynthia Cynthia J. Willett, Reve J. Abelow, Ruth S. Elderkin, Carl Locke, Rev. Brown, Barbara Dascher, John H. Doscker to James Meredith (7 October 1962)

https://egrove.olemiss.edu/mercorr_pro/2039/thumbnail.jp

How to transport a polar bear, and other idiosyncrasies in providing emergency medical services in the Arctic

With few roads and rugged terrain, Svalbard has two search and rescue helicopters that also provide helicopter emergency medical service (HEMS)—and unusual transfer missions.acceptedVersio