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Published epidemiologic data on the administration rates of enteral/parenteral home nutrition is very limited. The aim of this first nationwide study was to assess the availability of pediatric home enteral nutrition (HEN) services in Poland. The questionnaire was sent to all regional centers providing pediatric HEN services in Poland (n = 14). The analysis included the number of pediatric patients who received HEN in 2010, their demographic characteristics and geographical distribution. Furthermore, the distributions of indications and methods of enteral nutrition administration were analyzed, along with the reasons of withdrawal from the HEN program. The number and fraction of children receiving HEN increased in 2010, from 433 (11.34 per 1 million inhabitants) on January 1st to 525 (13.75) on December 31st. Marked differences were observed in geographical distribution of this parameter, from zero to up to 30 pediatric patients per 1 million inhabitants. Median age of patients was 6 years (range: 9 months–18 years). In most cases, HEN was prescribed due to neurological disorders (n = 337, 64.2%), and administered by means of gastrostomy (n = 450, 85.71%). This study revealed the dynamic development of pediatric HEN services in Poland but also documented their potential regional shortages.

Spatial patterns and temporal succession in soft-bottom macroinvertebrate assemblages are described for an area of the southern San Diego shelf which is influenced by both anthropogenic and natural events. The study transect covered 19 km along the 60 m-depth contour and spanned the terminus of the Point Loma wastewater outfall (32°40′N; 117°17′W). Ordination and classification analyses revealed that eight major benthic assemblages occurred in the study area from 1986–1990. These analyses further indicated that: (1) the impact of wastewater discharge on the benthos was asymmetric about the outfall, and (2) primary and secondary impact zones existed within the outfall footprint. The primary impact extended only 0.5 km south, but usually up to 1 km north, of the point of discharge, reflecting the prevailing northerly flow of currents along the San Diego coast. Stations within the primary impact zone usually supported similar faunal assemblages at any point in time. A lessened, or secondary, impact was apparent at stations 1 to 2 km south and 2 km north of the outfall. The two stations ≥9 km to the north appeared to be outside the outfall footprint. Assemblages in the three zones did not differ greatly in species composition, but did differ with respect to organismal density, relative abundances (dominance hierarchy) of component species, and temporal persistence. Biostimulation of the benthos, manifest as increased species richness and organismal abundance, was apparent in the primary impact zone from 1986–1988, although dominance was relatively low. Dominance increased at these sites during 1989 and 1990 due to large increases in populations of a few small species, such as the polychaete Myriochele sp. M and the ostracod Euphilomedes carcharodonta. Biomass was slightly elevated in the primary impact zone during 1986–1987; however, this trend was not sustained. Communities within the outfall footprint were much less persistent over time than those beyond it. The observed shifts in benthic assemblages within the outfall footprint corresponded to natural oceanographic cycles (i.e., the transition from El Nino to La Nina conditions) and anthropogenic changes (i.e., changes in wastewater output). These observations suggest that the Point Loma outfall has a localized effect on the stability of infaunal communities. Possible destabilization mechanisms are explored. Finally, comparisons with pre-discharge data taken during 1956–1957 revealed that about half of the species present prior to construction of the outfall were still common in 1990, after 27 yr of wastewater discharge, although large increases in species diversity and abundance seem to have occurred at all stations.