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"Stewart, Rob"
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Whale fall
\"When a whale passes away, its body sinks to the ocean floor and becomes an energy-rich food source for organisms living in the deep sea\"-- Provided by publisher.
Book
Little Evidence of Benthic Community Resilience to Bottom Trawling on Seamounts After 15 Years
The resilience and recovery dynamics of deep-sea habitats impacted by bottom trawling are poorly known. This paper reports on a fishing impact recovery comparison based on four towed camera surveys over a 15-year period (2001-2015) on a group of small seamounts on the Chatham Rise, east of New Zealand, on which pre-disturbance benthic communities are dominated by thicket-forming scleractinian corals. The six seamounts studied encompass a range of trawl histories, including one with high and persistent levels of trawling throughout the survey period, two with intermittent and intermediate levels of trawling, two which were low/untrawled, and one, ‘Morgue’, which was closed to trawling in 2001, having been heavily trawled up to that point. Still photographs from all surveys were analysed for the identification and abundance of all visible benthic fauna with effort made to ensure consistency of data among surveys. Because increases in image resolution and quality over time resulted in a persistent trend of increasing abundances, analyses were concentrated on comparisons among seamounts within surveys and how these relationships changed with time. The abundance, species richness, and diversity of benthic communities were higher on low/untrawled seamounts than on those that had been trawled. Multivariate community structure showed similar patterns at each survey point, the low/untrawled seamounts being strongly dissimilar to the persistently trawled seamount, with the others ranged between these extremes, broadly in accordance with their cumulative trawl histories. Community structure on the persistently trawled seamount was less variable than on the other seamounts throughout the study period, possibly because of regular ‘re-setting’ of the community by disturbance from trawling. Although there was some variability in results between whole seamount and summit sector analyses, in general communities on Morgue remained similar to those on the persistently trawled seamount, showing no indication of steps towards recovery to its pre-disturbance state following its closure. These results indicate low resilience of benthic communities on the seamounts to the effects of bottom trawling.
Journal Article
Green Lantern by Geoff Johns
Book one: \"It's been years since the the death of Hal Jordan and the end of the Green Lantern Corps. But as the Torchbearer Kyle Rayner is about to find out, an adventure of epic and mythological proportions is about to begin as the former Lantern returns to the land of the living to atone for his sins. With stunning art from Ethan Van Sciver and Carlos Pacheco, this recut graphic novel series begins with this first book in Geoff Johns' legendary run.\"-- Provided by publisher.
Book
Intensive versus Guideline Blood Pressure and Lipid Lowering in Patients with Previous Stroke: Main Results from the Pilot ‘Prevention of Decline in Cognition after Stroke Trial’ (PODCAST) Randomised Controlled Trial
Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial.
In a multicentre, partial-factorial trial, patients with recent stroke, absence of dementia, and systolic BP (SBP) 125-170 mmHg were assigned randomly to at least 6 months of intensive (target SBP <125 mmHg) or guideline (target SBP <140 mmHg) BP lowering. The subset of patients with ischaemic stroke and total cholesterol 3.0-8.0 mmol/l were also assigned randomly to intensive (target LDL-cholesterol <1.3 mmol/l) or guideline (target LDL-c <3.0 mmol/l) lipid lowering. The primary outcome was the Addenbrooke's Cognitive Examination-Revised (ACE-R).
We enrolled 83 patients, mean age 74.0 (6.8) years, and median 4.5 months after stroke. The median follow-up was 24 months (range 1-48). Mean BP was significantly reduced with intensive compared to guideline treatment (difference -10·6/-5·5 mmHg; p<0·01), as was total/LDL-cholesterol with intensive lipid lowering compared to guideline (difference -0·54/-0·44 mmol/l; p<0·01). The ACE-R score during treatment did not differ for either treatment comparison; mean difference for BP lowering -3.6 (95% CI -9.7 to 2.4), and lipid lowering 4.4 (95% CI -2.1 to 10.9). However, intensive lipid lowering therapy was significantly associated with improved scores for ACE-R at 6 months, trail making A, modified Rankin Scale and Euro-Qol Visual Analogue Scale. There was no difference in rates of dementia or serious adverse events for either comparison.
In patients with recent stroke and normal cognition, intensive BP and lipid lowering were feasible and safe, but did not alter cognition over two years. The association between intensive lipid lowering and improved scores for some secondary outcomes suggests further trials are warranted.
ISRCTN ISRCTN85562386.
Journal Article
Malawi Mental Health Guide: Overview and Evaluation of a Mental Health Quick Reference Guide and Phone App for Use in Non-specialist Settings
AimsIn Malawi, there are three Consultant psychiatrists for a population of approximately 20 million people. We cannot rely solely on specialists to provide mental health care. We produced the Malawi Quick Guide to Mental Health (the Guide) to improve the psychiatric health-care resources available to frontline mental health workers in Malawi, thus improving service provision to patients. We aimed to evaluate its impact on the frontline non-specialists who provide most mental health care in Malawi.MethodsIn collaboration with the Malawi Ministry of Health, the University of Malawi, St John of God Malawi, and a Malawian user group, a group of psychiatrists with experience working in Malawi co-produced the Malawi Quick Guide to Mental Health. It provides practical information for assessing and managing mental disorders in Malawi. We distributed the Guide to over 400 health centres in Malawi. Next, we converted the Guide into a freely available phone app in both Android and Apple stores.To study its impact, we baseline surveyed frontline mental health professionals regarding their access to basic psychiatry guidelines and information in clinics, as well as their confidence in delivering mental health care. We repeated this survey six months after the distribution of the printed Guide and six months after the app launch.ResultsBaseline survey: 20 health-care professionals representing regions throughout Malawi responded. 70% of respondents were between 25–40 years old and 45% were female. All respondents either agreed or strongly agreed that they needed more support caring for mentally unwell patients. 15% had no access to any resources whatsoever to guide their care.Printed guide survey: 95% agreed or strongly agreed that having a printed copy of the Guide increased their confidence in caring for patients. Information resource accessibility, availability and usage in mental health clinics had improved from baseline. The respondents found the Guide helped their day-to-day practice, with 95% rating it either extremely helpful or very helpful. 95% either agreed or strongly agreed that it had improved the care they provided their patients.App survey: 66% of respondents prefer using the app over the textbook version. All agreed that the app made them more confident in caring for their patients and that their care had improved because of the app. They were all likely to recommend it to a colleague. It has now been downloaded almost 1000 times.ConclusionA free, co-produced mental health book and phone app have helped to address the issue of limited access to basic psychiatry guidelines and information in clinics in Malawi. This has improved clinicians’ confidence and their perceived patient care.
Journal Article
Continuity of care and mortality in people with schizophrenia
People with schizophrenia have shortened lives. This excess mortality seems to be related to physical health conditions that may be amenable to better primary and secondary prevention. Better continuity of care may enhance such interventions as well as help prevent death by self-injury.
We set out to examine the relationship between the continuity of care of patients with schizophrenia, their mortality and cause of death.
Pseudoanonymised community data from 5551 people with schizophrenia presenting over 11 years were examined for changes in continuity of care using the numbers of community teams caring for them and the Modified Modified Continuity Index. These and demographic variables were related to death certifications of physical illness from the Office of National Statistics and mortal self-injury from clinical data. Data were analysed using generalised estimating equations.
We found no independent relationship between levels of continuity of care and overall mortality. However, lower levels of relationship continuity were significantly and independently related to death by self-injury.
We found no evidence that continuity of care is important in the prevention of physical causes of death in schizophrenia. However, there is evidence that declining relationship continuity of care has an independent effect on deaths as a result of self-injury. We suggest that there should be more attention focused on the improvement of continuity of care for these patients.
Journal Article
A cohort study of the impact of COVID‐19 on the quality of life of people newly diagnosed with dementia and their family carers
Introduction COVID‐19 has impacted people with dementia and their family carers, yet little is known about effects on overall quality of life. Methods In a UK cohort study, pre‐ and post‐pandemic data were collected from 114 carers and 93 recently diagnosed people with dementia. Latent growth curve modeling examined change in quality of life. Results Carers reported significant decline in quality of life, although no change was demonstrated by people with dementia. In multivariable analyses, higher levels of cognitive impairment, deprivation, study site, and lower number of memory clinic contacts were associated with greater decline in carer quality of life. Discussion Maintaining life quality for people with dementia during the pandemic appears to have come at the expense of their family carers. This inequity has fallen hardest on those caring for people with more severe dementia, in deprived areas, and with least support from memory services. These effects may be prevented or reversed by post‐diagnostic care.
Journal Article
Outbreak of Listeriosis in South Africa Associated with Processed Meat
A total of 937 cases of listeriosis associated with consumption of the processed meat polony were identified in South Africa. Pregnant girls and women, neonates, and persons infected with HIV-1 were disproportionately affected. Molecular techniques identified cases associated with this event and the source of the contamination.
Journal Article
Slaughter Nick for president
When an out-of-work actor discovers through Facebook that he’s been wildly famous in Serbia for almost two decades, he sets out to discover why. SLAUGHTER NICK FOR PRESIDENT examines how Rob Stewart became a symbol of freedom for non-violent Serbian protests through his role as Nick Slaughter on CBS’s Tropical Heat (aka Sweating Bullets). Stewart’s Serbian visit, dubbed “Slaughtermania” by the national press, uncovers the surprising meaning behind the show’s popularity, the blurred distinction between an actor and his character, and tells the inspiring story of the Serbian protesters.
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