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Acoustic tomography systems provide an integrated, synoptic measurement of ocean temperature. By recording the time it takes for a sound signal to travel from a sound source to a receiver, the depth- and range-average sound speed along the geodesic path between the sound source and the receiver can be obtained through inversion. Sound speed and ocean temperature are empirically related; salinity plays a negligible role. The ACOBAR acoustic tomography experiment in central Fram Strait was carried out from September 2010 to September 2012. It consisted of 3 moorings with sound sources and receivers forming a triangle, and one mooring with only receivers in the middle. The steel-sphere flotation of the northernmost mooring imploded in the start of the experiment, so that mooring was not recovered. The three remaining moorings formed a smaller triangle that provided travel time measurements along three paths. Measurements were taken 8 times a day for two of the paths, 8 times every other day for the other paths. The distances covered by the acoustic measurements are 188 - 201 km. Complex data processing was used to determine peaks in the acoustic arrival coda and to correct them for mooring motion and clock drift; travel-time accuracy is O(10) ms. The travel time measurements were inverted to obtain range-depth average sound speed using a statistical approach. The sound speed obtained from each section was then converted to mean ocean temperature. The mean ocean temperature data are published as a set of 8 NetCDF files, compliant with Climate and Forecast (CF) [1] and OceanSITES metadata conventions [2]. Each file contains one year of measurements from one of the sections. The files contain the ocean temperature data, together with theoretical and statistical error estimates and metadata such as discovery metadata and adequate-use metadata. Each data point is provided with a statistical quality measure and a quality flag based on this measure., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article., (© 2022 The Authors.)

Purpose: To explore strategies for improving patient outcomes in type 2 diabetes., Data Sources: The literature related to type 2 diabetes management, behavior change, communication, diabetes self-management, and coaching., Conclusions: The strategies currently suggested for improving patient outcomes, e.g., increasing provider adherence to evidence-based management guidelines, streamlining practice systems, and promoting patient lifestyle changes through intensive education, have produced mixed outcomes. Of the many complexities involved in managing type 2 diabetes, motivating patients to change behavior may be the most challenging. A suggestion for improving patient self-management of type 2 diabetes is to use coaching communication within a framework of behavior change in the context of the primary care encounter between nurse practitioners (NPs) and their patients., Implications for Practice: Given the varied outcomes of current strategies, coaching by NPs may provide a feasible alternative for improving patient outcomes in type 2 diabetes. Coaching communication can be implemented during office visits as an intervention without cost. To effectively implement this approach, however, practicing NPs and NP students need more formal education in this expected but underdeveloped NP role competency. NPs are called upon to contribute to the body of knowledge needed to validate the merits of coaching for their patients.

Two patients had many acute episodes of biliary pain with elevated liver function tests 12-48 h after the last ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs) (including paracetamol) alone or in combination with codeine. One had known intolerance to NSAIDs, but paracetamol had not been previously incriminated in the pathogenesis of the attacks. In this patient the combined use of paracetamol and codeine probably also increased the severity of the episodes. We conclude that in some patients in whom endoscopic cholangiography is normal, biliary pain and abnormal liver function tests could be the result of NSAIDs. A thorough drug history is required in such cases.

The incidence of Crohn's disease in western Norway was estimated in a prospective epidemiologic study during the years 1984 and 1985. The total population in the area was 807,000. Both inpatients and outpatients were included. Five hundred and fifty general practitioners and 12 hospitals participated in the study. A total of 86 patients were diagnosed, giving a mean annual incidence of 5.3 per 100,000. For patients between 15 and 19 years of age-specific incidence rate was 16.0 The M/F sex ratio was 0.9. In the same period 240 patients with ulcerative colitis were diagnosed (mean annual incidence, 14.8 per 100,000), giving a ratio of 2.8 between ulcerative colitis and Crohn's disease and an annual incidence of 20.1 per 100,000 for inflammatory bowel disease. Familial occurrence of IBD was found for 12% of the patients.