An overview on the role of Hexanchiformes in marine ecosystems: biology, ecology and conservation status of a primitive order of modern sharks

The large size, high trophic level and wide distribution of Hexanchiformes (cow and frilled sharks) should position this order as important apex predators in coastal and deep-water ecosystems. This review synthesizes available information on Hexanchiformes, including information not yet published, with the purpose of evaluating their conservation status and assessing their ecological roles in the dynamics of marine ecosystems. Comprising six species, this group has a wide global distribution, with members occurring from shallow coastal areas to depths of c. 2500 m. The limited information available on their reproductive biology suggests that they could be vulnerable to overexploitation (e.g. small litter sizes for most species and suspected long gestation periods). Most of the fishing pressure exerted on Hexanchiformes is in the form of commercial by-catch or recreational fishing. Comprehensive stock and impact assessments are unavailable for most species in most regions due to limited information on life history and catch and abundance time series. When hexanchiform species have been commercially harvested, however, they have been unable to sustain targeted fisheries for long periods. The potentially high vulnerability to intense fishing pressure warrants a conservative exploitation of this order until thorough quantitative assessments are conducted. At least some species have been shown to be significant apex predators in the systems they inhabit. Should Hexanchiformes be removed from coastal and deep-water systems, the lack of sympatric shark species that share the same resources suggests no other species would be capable of fulfilling their apex predator role in the short term. This has potential ecosystem consequences such as meso-predator release or trophic cascades. This review proposes some hypotheses on the ecology of Hexanchiformes and their role in ecosystem dynamics, highlighting the areas where critical information is required to stimulate research directions.

Movement patterns of the draughtboard shark Cephaloscyllium laticeps (Scyliorhinidae) determined by passive tracking and conventional tagging

A combination of passive tracking and conventional tagging was used to provide insight into the movement patterns of the draughtboard shark Cephaloscyllium laticeps, the most common catshark in coastal areas of southern Australia. A series of acoustic receivers deployed throughout south-eastern Tasmania as well as a receiver array along an isolated reef, Crayfish Point Reserve (CPR), passively tracked 25 C. laticeps from January to July 2003. Cephaloscyllium laticeps were present from 4 to 98 days. The majority of the C. laticeps stayed within the CPR where most individuals were active throughout the night. They were found actively moving (i.e. when a C. laticeps was consecutively detected by two or more non-overlapping receivers, suggesting the individual was moving) and spending periods of minor movements (i.e. when an individual was consecutively detected by only one receiver, suggesting it was at rest). The length of these minor movements periods, observed both day and night, ranged from 1 h to 5 days. In addition to passive tracking, 1552 conventionally tagged C. laticeps were released in the eastern and south-western coastal areas of Tasmania and within the CPR between January 2000 and April 2007. The CPR showed a higher recapture rate, 38%, than eastern and south-western areas where the recapture rates were 10 and 3%, respectively. Within the CPR, 36% of the sharks were recaptured on multiple occasions. The maximum time at liberty ranged from 1 month to 7 years. The majority of the C. laticeps were recaptured in the vicinity of where they were released (<10 km), although larger longer-term movements of up to 300 km were recorded. The large amount of multiple recaptures within the CPR, in addition to acoustic tagging results, indicated a high degree of site fidelity for C. laticeps. This isolated reef appears to be an important habitat for this species, and therefore, the current protection status of this area is probably beneficial for the conservation of C. laticeps.

Information needs of family members of critically ill patients in intensive care unit of a tertiary hospital

BACKGROUND AND AIMS. The experience in intensive care unit (ICU) has created an intense emotional situation both to patients and their family members. The aim of this study was to determine the family members information needs of critically ill patients in ICU.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted on 200 family members of patients admitted in ICU. A face to face interview was conducted and a self-report questionnaire of the Critical Care Family Needs Inventory (CCFNI) was used.

RESULTS

Findings reported CCFNI five sub-attributes that ranked from highest to lowest included: support (mean 39.13 ± 6.189); proximity (mean 27.17 ± 3.384); information (mean 24.25 ± 3.093); assurance (mean 22.67 ± 1.862) and comfort (mean 16.24 ± 2.776). There were no significant differences in needs between family members with different gender (p >0.05). However, there were significant differences in support needs between family members with admission to ICU with (t=-2.111; p <0.05). There were significant differences in assurance needs (F=3.542; p <0.05) and information needs (F=3.681; p <0.05) between family members with age. There were no significant differences in needs between family members with different education level (p >0.05) whereas assurance needs were significant differences with education level of (F=3.542; p <0.05).

CONCLUSION

The results suggest that family members perceived support and proximity as the most crucial need. Comfort need was viewed as least important. Although this study was conducted in a tertiary hospital, the findings could still provide insight for nurses to improve the delivery of care to patients and family members.

Mechanisms linking affective reactions to competition-related and competition-extraneous concerns in male martial artists

The main aim of this study was to examine affective linkages between competition-related and competition-extraneous concern domains. A secondary purpose was to establish the contributions of pre-competition affects to post-competition performance appraisals, independent of pre-competition performance expectations. Thirty-nine highly skilled male martial artists were assessed at five random times a day for a week and 1 h before a major competition on affective states and sources of concern. They also reported their performance expectations and post-competition performance appraisals. Affective states triggered by competition-related and competition-extraneous concerns persisted in time. Carry-over effects were stronger after reports of competition-related concerns, emphasizing the subjective importance of the competitive event. Although positive (enjoyment and surprise) and negative (sadness and guilt) affective spill-over was observed from competition-extraneous to competition-related concerns, the reverse held true only for disgust. These findings may be due to the athletes' ability to regulate affective reactions within a sporting setting, in particular. Spill-over from competition-extraneous to competition-related concerns is indicative of a lesser degree of control over work/study and family life. Given that average weekly negative affects and anger/disgust were independent predictors of post-competition performance appraisals, the phenomenon of spill-over and other affective linkage mechanisms in sport warrant further investigation.

Predictors of pre- and post-competition affective states in male martial artists: a multilevel interactional approach

The aims of this study were to examine (a) the effects of competition-related and competition-extraneous concerns on affective states; (b) the relationships of primary and secondary appraisal with affective states and (c) the main and moderating effects of personality traits on pre- and post-competition affects. Thirty-nine male elite martial artists were assessed on 12 affective states, concerns and dimensions of primary and secondary appraisal at five random times a day across 1 week before and 3 days after a competition. On the competition day, they were assessed 1 h before and immediately after the contest. Competitive trait anxiety, neuroticism and extraversion were measured at the start of the study. The competition was the most significant and stressful event experienced in the examined period and had a pervasive influence on athletes' affective states. All examined appraisal and personality factors were somewhat associated with pre- and post-competition affective states. Competitive trait anxiety was a key moderator of the relationship between cognitive appraisal and affective states. This study supports the idea that cognitive appraisal and situational and personality factors exert main and interactive effects on athletes' pre- and post-competition affects. These factors need to be accounted for in planning of emotion regulation interventions.

Seasonal occurrence and population structure of the broadnose sevengill shark Notorynchus cepedianus in coastal habitats of south-east Tasmania

Research longline sampling was conducted seasonally from December 2006 to February 2009 to investigate the occurrence and population structure of the broadnose sevengill shark Notorynchus cepedianus in coastal areas of south-east Tasmania. Notorynchus cepedianus showed a consistent temporal trend in seasonal occurrence in Norfolk Bay characterized by high abundances in summer to near absence in winter. This pattern was less pronounced in the Derwent Estuary, where fish were still caught during winter. The absence of smaller total length (L(T) ) classes (<80 cm) from the catches suggests that N. cepedianus are not using these coastal habitats as nursery areas. Of the 457 individuals tagged, 68 (15%) were recaptured. Time at liberty ranged from 6 days to almost 4 years and all but one of the recaptures were caught in its original tagging location, suggesting site fidelity. The large number of N. cepedianus in these coastal systems over summer indicates that these areas are important habitats for this species and that N. cepedianus may have a significant influence on community dynamics through both direct and indirect predator-prey interactions.

Caregiver burden, time spent caring and health status in the first 12 months following stroke

OBJECTIVE

To quantify time caring, burden and health status in carers of stroke patients after discharge from rehabilitation; to identify the potentially modifiable sociodemographic and clinical characteristics associated with these outcomes.

METHODS

Patients and carers prospectively interviewed 6 (n=71) and 12 (n=57) months after discharge. Relationships of carer and patient variables with burden, health status and time analysed by Gaussian and Poisson regression.

RESULTS

Carers showed considerable burden at 6 and 12 months. Carers spent 4.6 and 3.6 hours per day assisting patients with daily activities at 6 and 12 months, respectively. Improved patient motor and cognitive function were associated with reductions of up to 20 minutes per day in time spent in daily activities. Better patient mental health and cognitive function were associated with better carer mental health.

CONCLUSIONS

Potentially modifiable factors such as these may be able to be targeted by caregiver training, support and education programmes and outpatient therapy for patients.

Insulin for type 2 diabetes: choosing a second-line insulin regimen

Guidance has been published on the choice of initial insulin regimen for patients with type 2 diabetes [NPH (isophane) insulin or a long-acting insulin analogue] but not on how to choose a second regimen when glycaemic control becomes unsatisfactory.

AIMS

To develop pragmatic clinical guidance for choosing a second-line insulin regimen tailored to the individual needs of patients with type 2 diabetes after failure of first-line insulin therapy.

METHODS

Formulation of a consensus by expert panel based on published evidence and best clinical practice, taking into account patient preferences, lifestyle and functional capacity.

RESULTS

Six patient-dependent factors relevant to the choice of second-line insulin regimen and three alternative insulin regimens (twice-daily premixed, basal-plus and basal-bolus) were identified. The panel recommended one or more insulin regimens compatible with each factor, emphasising the fundamental importance of a healthy lifestyle that includes exercise and weight reduction. These recommendations were incorporated into an algorithm to provide pragmatic guidance for clinicians.

CONCLUSION

The three alternative insulin regimens offer different benefits and drawbacks and it is important to make the right choice to optimise outcomes for patients.

Exenatide

Exenatide is the first in a new class of compounds, which possess similar activity to the naturally-occurring hormone glucagon-like peptide-1 (GLP-1). It mirrors many of the effects of GLP-1, improving glycaemic control through a combination of mechanisms, which include glucose-dependent stimulation of insulin secretion, suppression of glucagon secretion, slowing of gastric emptying and reduced appetite. Phase III clinical trials showed exenatide therapy for 30 weeks significantly reduced glycated haemoglobin, and fasting and postprandial plasma glucose compared with baseline when added to metformin and sulfonylureas or a combination of the two, with an average weight loss of approximately 2 kg. Exenatide can also be used in combination with thiazolidinediones and may be an alternative to insulin in patients requiring additional therapy. In patients with established Type 2 diabetes, control of both glycaemia and body weight are important to minimise the risk of future diabetes complications. Open-label extensions from these pivotal trials demonstrate that patients treated with exenatide for < or = 3 years sustained the reductions in glycaemic control achieved at 30 weeks and had a progressive reduction in body weight. Exenatide is generally well tolerated; nausea is the most commonly reported side effect, but can be significantly reduced when a target dose of exenatide is achieved in patients with gradual dose titration. Hypoglycaemia has been encountered in clinical trials of exenatide, especially on initiation of therapy with sulfonylureas (not with metformin). Exenatide may enable patients with Type 2 diabetes to improve glycaemic control and reduce or eliminate the risk of hypoglycaemia and weight gain.

Resistance of disposable drapes to bacterial penetration

PURPOSE

To test the bacterial penetrability of disposable non-woven drapes used specifically for total hip arthroplasty.

METHODS

12 round agar plates were inoculated with 107 colony-forming units/ml of coagulase-negative staphylococci (CNS) and incubated in air at 37 degrees Celsius for 18 hours to obtain a semi-confluent growth of organisms. Six brands of disposable drapes were tested; each was assigned to 2 plates. Each disposable drape was placed between a round agar plate and an inverted square agar plate filled with blood agar. After 30 and 90 minutes, the square agar plates were removed and incubated for 48 hours and inspected for growth of CNS.

RESULTS

Bacterial penetration was time dependant. Certain brands of drapes were more impenetrable than others; none was impenetrable at all time points, but most remained so or allowed passage of fewer than 100 colony-forming units at 90 minutes.

CONCLUSION

It is recommended that drapes be rigorously tested with regard to their resistance to bacterial penetration.

Potential role of oral DPP-4 inhibitors in the ADA/EASD consensus statement algorithm for achieving and maintaining tight glycaemic control in type 2 diabetes: recommendations for oral antidiabetic agents

A recently published American Diabetes Association/European Association for the Study of Diabetes consensus statement on the management of hyperglycaemia in type 2 diabetes emphasises the achievement and maintenance of normal glycaemic control and the rapid addition of medications and transition to new regimens when glycaemic goals are not achieved or sustained. An algorithm for the use of available interventions is supplied to help practitioners avoid prolonged periods of inadequate glycaemic control. Recommendations include rapid transition to combination treatment with oral agents and with insulin plus oral agents. The currently available oral agents are reviewed here with respect to the consensus statement recommendations, and the characteristics of the new class of oral dipeptidyl peptidase-4 inhibitors are summarised. These agents offer clinically meaningful reductions in HbA1c without significant risk of hypoglycaemia and without causing weight gain; they also offer the theoretical potential of improving or maintaining beta-cell function and thus, favourably affecting the progressive loss of function that is characteristic of type 2 diabetes. Potential uses of these agents in the context of the consensus statement recommendations are considered.

DPP-4 inhibitors and their potential role in the management of type 2 diabetes

The dipeptidyl peptidase 4 (DPP-4) inhibitors enhance the body's own ability to control blood glucose by increasing the active levels of incretin hormones in the body. Their mechanism of action is distinct from any existing class of oral glucose-lowering agents. They control elevated blood glucose by triggering pancreatic insulin secretion, suppressing pancreatic glucagon secretion, and signalling the liver to reduce glucose production. The leading DPP-4 inhibitors have shown clinically significant HbA1c reductions up to 1 year of treatment and offer many potential advantages over existing diabetes therapies including a low risk of hypoglycaemia, no effect on body weight, and the potential, based on animal and in vitro studies, for the regeneration and differentiation of pancreatic beta-cells. They are efficacious as monotherapy and also in combination with commonly prescribed antidiabetic agents and are suitable for once-daily oral dosing. Consequently, many DPP-4 inhibitors such as vildagliptin (Galvus; LAF-237), sitagliptin (Januvia; MK-0431), and saxagliptin (BMS-477118) have advanced into late-stage human clinical trials. Search strategy and selection criteria This review was built on a systematic MEDLINE search for publications on the subject with the key words: DPP-4 inhibitor; vildagliptin (LAF-237); sitagliptin (MK-0431); saxagliptin (BMS-477118); and type 2 diabetes; up to August 2006. Meeting abstracts were also searched, as much of the data currently only exists in abstract form. Take home message for clinician The DPP-4 inhibitors appear to have great potential for the treatment of type 2 diabetes, but time will tell if this will be realized. While they do not lower glucose to a greater extent than existing therapies, they offer many potential advantages, including the ability to achieve sustainable reductions in HbA1c with a well-tolerated agent that has a low risk of hypoglycaemia and no weight gain, and which can be administered as a once-daily oral dose.