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Objective: To assess the attitudes of health care professionals engaged in open disclosure (OD) to the legal risks and protections that surround this activity.Design and Participants: National cross-sectional survey of 51 experienced OD practitioners conducted in mid 2009.Main Outcome Measures: Perceived barriers to OD; awareness of and attitudes towards medicolegal protections; recommendations for reform.Results: The vast majority of participants rated fears about the medicolegal risks (45/51) and inadequate education and training in OD skills (43/51) as major or moderate barriers to OD. A majority (30/51) of participants viewed qualified privilege laws as having limited or no effect on health professionals' willingness to conduct OD, whereas opinion was divided about the effect of apology laws (state laws protecting expressions of regret from subsequent use in legal proceedings). In four states and territories (Western Australia, South Australia, Tasmania and the Northern Territory), a majority of participants were unaware that their own jurisdiction had apology laws that applied to OD. The most frequent recommendations for legal reform to improve OD were strengthening existing protections (23), improving education and awareness of applicable laws (11), fundamental reform of the medical negligence system (8), and better alignment of the activities of certain legal actors (eg, coroners) with OD practice (6).Conclusions: Concerns about both the medicolegal implications of OD and the skills needed to conduct it effectively are prevalent among health professionals at the leading edge of the OD movement in Australia. The ability of current laws to protect against use of this information in legal proceedings is perceived as inadequate. [ABSTRACT FROM AUTHOR] more...

Intracerebroventricular (i.c.v.) administration of the novel hypothalamic neuropeptide orexin-A stimulates food intake in rats, and delays the onset of behavioural satiety (i.e. the natural transition from feeding to resting). Furthermore, preliminary findings with the selective orexin-1 receptor antagonist, SB-334867, suggest that orexin-A regulation of food intake is mediated via the orexin1 receptor. At present, however, little is known about either the intrinsic effects of SB-334867 on the normal structure of feeding behaviour, or its effects upon orexin-A-induced behavioural change. In the present study, we have employed a continuous monitoring technique to characterize the effects of SB-334867 (3-30 mg/kg, i.p.) on the microstructure of rat behaviour during a 1-h test with palatable wet mash. Administered alone, SB-334867 (30 mg/kg, but not lower doses) significantly reduced food intake and most active behaviours (eating, grooming, sniffing, locomotion and rearing), while increasing resting. Although suggestive of a behaviourally nonselective (i.e. sedative) action, the structure of feeding behaviour was well-preserved at this dose level, with the reduction in behavioural output clearly attributable to an earlier onset of behavioural satiety. As previously reported, orexin-A (10 µg per rat i.c.v.) stimulated food intake, increased grooming and delayed the onset of behavioural satiety. Pretreatment with SB-334867 dose-dependently blocked these effects of orexin-A, with significant antagonism evident at dose levels (3-10 mg/kg) below those required to produce intrinsic behavioural effects under present test conditions. Together, these findings strongly support the view that orexin-A is involved in the regulation of feeding patterns and that this influence is mediated through the orexin-1 receptor. [ABSTRACT FROM AUTHOR] more...

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Existing projections of climate change impacts focus primarily on direct abiotic impacts on individuals and populations. However, these models often ignore species interactions, which are vital for determining community composition and structure. To evaluate both direct and indirect effects of climate change on species distributions, we applied the Menge–Sutherland model, which describes the relative role of predation and environmental stress in regulating community structure. Using a space‐for‐time approach, we tested the predictions that (1) predators are more strongly impacted by increasing environmental stress than prey (as described in the Menge–Sutherland model) and (2) incorporating indirect (predator) effects increases our ability to predict impacts of increased temperature on prey distributions. We surveyed vertical distributions of predators (sea stars) and a foundational prey species (mussels) at 20 intertidal sites spanning a thermal gradient along the West Coast of the United States. Using generalized linear models and structural equation models, we found that as temperature increased, the upper limits of foundational prey species decreased (a direct effect), while prey lower limits also shifted downward, due to an indirect effect of temperature on predator distributions. Under future climate change, mussel ranges may undergo vertical shifts toward subtidal habitats, allowing for localized persistence of mussels and associated species. Our model comparisons indicate that this framework—incorporating both direct and indirect environmental stress effects within a classic community regulation model—can improve prediction of responses to warming. Community regulation models could be expanded to inform management and conservation efforts during unprecedented climate and ecological change. [ABSTRACT FROM AUTHOR] more...

COVID-19 disrupted infant contact with people beyond the immediate family. Because grandparents faced higher COVID-19 risks due to age, many used video chat instead of interacting with their infant grandchildren in person. We conducted a semi-naturalistic, longitudinal study with 48 families, each of whom submitted a series of video chats and surveys, and most (n = 40) also submitted a video of an in-person interaction. Families were mostly highly-educated, White/Caucasian, and lived between 1 and 2700 miles apart. We used multilevel models to examine grandparents' and parents' sensitivity during video chat across time (centered at February 1, 2021, the approximate date of vaccine availability). Grandparent video chat sensitivity changed as a function of date and parent sensitivity. Parent sensitivity changed as a function of date, grandparent sensitivity, and geographic distance. We then modeled infants' affective valence during video chat and in-person interactions with their grandparents, which was only predicted by grandparent sensitivity, not modality or other factors. This study demonstrates that caregivers were sensitive toward infants during video chat interactions despite fluctuations in family stress and reduced in-person contact during COVID-19 and that grandparent sensitivity predicted positive infant affect during both video chat and in-person interactions., (© 2022 International Congress of Infant Studies.) more...

Orexin-A is a novel neuropeptide initially isolated from hypothalamic extracts but now known to be present in fibres distributed throughout the rat CNS including many regions associated with sleep-wake regulation. The recognition of a particularly dense innervation of orexinergic nerves in the locus coeruleus, together with the observed increase in firing rate of locus coeruleus neurons following application of orexin-A in vitro, further highlighted a potential involvement of the peptide in modulating the arousal state. The present study was undertaken to determine the effects of intracerebroventricularly (ICV) administered orexin-A on the sleep-wake cycle of conscious rats using electroencephalographic and electromyographic recordings. When administered at the onset of the normal sleep period, orexin-A (1, 10 or 30 microg/rat ICV) produced a dose-dependent increase in the time rats spent awake during the second and third hours after dosing. The enhancement of arousal was accompanied by a marked reduction in paradoxical sleep and deep slow wave sleep at the highest dose. The latency to the first occurrence of paradoxical sleep was also prolonged. This overall profile of increased arousal and decreased paradoxical sleep is consistent with a high rate of firing of locus coeruleus neurons as would be expected to occur following ICV administration of orexin-A. It is concluded that orexin-A may play an important physiological role in regulating the sleep-wake state, a hypothesis considerably strengthened by the recently reported narcoleptic phenotype of prepro-orexin (the precursor for orexin-A) knockout mice. more...

Background: A number of clinical studies have assessed the efficacy of short-term twice-daily Helicobacter pylori eradication regimens but few have investigated the proportion of patients in whom duodenal ulcer disease was healed with these regimens., Aim: To compare the safety and efficacy of four 1-week H. pylori eradication regimens in the healing of H. pylori associated duodenal ulcer disease., Methods: Following endoscopic confirmation of duodenal ulcer disease and a positive CLO test, patients underwent a 13C-urea breath test to confirm H. pylori status. Treatment with one of four regimens: LAC, LAM, LCM or OAM, where L is lansoprazole 30 mg b.d., A is amoxycillin 1 g b.d., M is metronidazole 400 mg b.d., C is clarithromycin 250 mg b.d., and O is omeprazole 20 mg b.d., was assigned randomly to those patients who were H. pylori positive, with 62 (LAC), 64 (LAM), 61 (LCM) and 75 (OAM) patients in each treatment group. Follow-up breath tests and endoscopies were performed at least 28 days after the end of treatment., Results: Duodenal ulcer disease was healed 28 days after treatment in 53/62 (85.5%) patients who were treated with LAC, 52/64 (81.3%) of patients treated with LAM, 49/61 (80.3%) of patients treated with LCM and 60/75 (80.0%) of patients treated with OAM (intention-to-treat analysis, n = 262, assumed unhealed if no follow-up endoscopy was performed). All the treatments were of similar efficacy (P = 0.85, chi-squared test) with regard to the healing of duodenal ulcer disease., Conclusions: The four 1-week treatment regimens were equally effective in healing H. pylori associated duodenal ulcer disease. more...