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The title molecule, C21H18O8, crystallizes in two crystal polymorphs, see also Nallasivam, Nethaji, Vembu & Jaswant [Acta Cryst. (2009), E65, o312–o313]. The main difference between the two polymorphs is in the conformation of the oxomethylacetate groups with regard to the almost planar [total puckering amplitude 0.047 (2) Å] chromene ring. In the title compound, the best planes of the oxomethylacetate groups through the non-H atoms are almost perpendicular to the chromene ring [making dihedral angles of 89.61 (6) and 80.59 (5)°], while in the second polymorph the molecules are close to planar. Both crystal structures are stabilized by C—H...O.

The title molecule, C21H18O8, crystallizes in two crystal polymorphs, see also Nallasivam, Nethaji, Vembu & Jaswant [Acta Cryst. (2009), E65, o314–o315]. The molecules of both polymorphs differ by the conformation of the oxomethylacetate groups. The title molecules are rather planar compared to the molecules of the other polymorph. In the title molecule, one of the oxomethylacetate groups is disordered (occupancies of 0.6058/0.3942). The structures of both polymorphs are stabilized by C—H...O and C—H...π interactions. Due to the planarity of the title molecules and similar intermolecular interactions, the title molecules are more densely packed than those of the other polymorph.

In the title compound, C29H22O4, the chromene ring is almost planar with a small puckering [0.143 (2) Å]. The crystal structure is stabilized by C—H...O and C—H...π interactions. Edge-to-face (centroid–centroid distances of 3.894 and 3.673 Å) and face-to-face (centroid–centroid distance of 3.460 Å) π–π-ring electron interactions are also observed.

ABSTRACT We present a statistical comparison of CO depletion in a set of local molecular clouds within the Gould Belt using Sub-millimetre Common User Bolometer Array (SCUBA) and Heterodyne Array Receiver Programme (HARP) data. This is the most wide-ranging study of depletion thus far within the Gould Belt. We estimate CO column densities assuming local thermodynamic equilibrium and, for a selection of sources, using the radiative transfer code radex in order to compare the two column density estimation methods. High levels of depletion are seen in the centres of several dust cores in all the clouds. We find that in the gas surrounding protostars, levels of depletion are somewhat lower than for starless cores with the exception of a few highly depleted protostellar cores in Serpens and NGC 2024. There is a tentative correlation between core mass and core depletion, particularly in Taurus and Serpens. Taurus has, on average, the highest levels of depletion. Ophiuchus has low average levels of depletion which could perhaps be related to the anomalous dust grain size distribution observed in this cloud. High levels of depletion are often seen around the edges of regions of optical emission (Orion) or in more evolved or less dynamic regions such as the bowl of L1495 in Taurus and the north-western region of Serpens. [ABSTRACT FROM AUTHOR]

As part of a James Clerk Maxwell Telescope (JCMT) Legacy Survey of star formation in the Gould Belt, we present early science results for Taurus. CO maps have been secured along the north-west ridge and bowl, collectively known as L 1495, along with deep CO and C O maps in two subregions. With these data, we search for molecular outflows, and use the distribution of flows, Herbig–Haro (HH) objects and shocked H line-emission features, together with the population of young stars, protostellar cores and starless condensations to map star formation across this extensive region. In total, 21 outflows are identified. It is clear that the bowl is more evolved than the ridge, harbouring a greater population of T Tauri stars and a more diffuse, more turbulent ambient medium. By comparison, the ridge contains a much younger, less widely distributed population of protostars which, in turn, is associated with a greater number of molecular outflows. We estimate the ratio of the numbers of pre-stellar to protostellar cores in L 1495 to be 1.3–2.3, and of gravitationally unbound starless cores to (gravitationally bound) pre-stellar cores to be 1. If we take previous estimates of the protostellar lifetime of 5 10 yr, this indicates a pre-stellar lifetime of 9( 3) 10 yr. From the number of outflows, we also crudely estimate the star formation efficiency in L 1495, finding it to be compatible with a canonical value of 10–15 per cent. We note that molecular outflow-driving sources have redder near-infrared colours than their HH jet-driving counterparts. We also find that the smaller, denser cores are associated with the more massive outflows, as one might expect if mass build-up in the flow increases with the collapse and contraction of the protostellar envelope. [ABSTRACT FROM AUTHOR]

Aim: Clinical studies following a first episode of psychosis (FEP) have increasingly exposed the complexity of identifying predictive outcome variables. We aimed to explore the utility of NEET status (not in education, employment or training) at FEP onset in predicting high threshold clinical remission (absence of positive symptoms and off antipsychotic medication for 6 months) at 3 years following treatment with an early intervention for psychosis service., Methods: We studied an established retrospective naturalistic cohort of 354 patients with FEP (the S1P cohort)., Results: Baseline NEET status was identified in 172 patients (49%) and was significantly associated with mean duration of untreated psychosis (p = .035). Only 64 (21%) achieved defined remission criteria by 3 years. Multivariate logistic regression analysis revealed baseline NEET status as the only variable significantly associated with remission status (p < .001)., Conclusion: NEET may represent an important predictive variable of symptomatic outcomes which requires prospective evaluation., (© 2024 John Wiley & Sons Australia, Ltd.)

Aim: This study aimed to examine the transition process of paediatric rheumatology patients from the Monash Children's Hospital (MCH) in Melbourne in order to identify areas that could be improved., Methods: Retrospective review of clinical data from the rheumatology database of paediatric rheumatology patients eligible for transition between January 2015 and September 2020., Results: One hundred and sixty-five patients were included; 57 patients were transitioned. Of patients transitioned to an adult service, 38 (88%) were on medication and 14 (33%) had active disease. All patients transitioned to the general practitioner (GP) had inactive disease off medication. Juvenile idiopathic arthritis (JIA) (non-systemic) was the most common diagnosis in patients transitioned. The mean age at which transition was first discussed was 18.0 years; the first referral was made at a mean of 18.3 years. The mean age at the first adult appointment was 18.5 years. Thirty-nine (91%) patients had a referral completed and 8 (19%) had a transfer letter. Thirteen (93%) patients transferred to the GP had a transfer letter. Transfer documents to an adult public rheumatology service rated 4.3 for quality, compared to 5.5 to the GP. Transfer of care was confirmed in 40 (93%) patients transitioned to an adult service; however, correspondence was available for only 3 (7%)., Conclusion: Although the transition process at MCH was adequate, it could be improved through earlier discussion of the process and improved referrals and documentation. A readiness-to-transfer checklist and a young adult clinic have the potential to improve the process of transition to adult rheumatology care., (© 2024 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Background: To describe the 3- and 5-year outcomes of an inception cohort of Australian children with JIA for whom 1-year outcomes have previously been published., Methods: Data regarding clinical outcomes of the original cohort of 134 patients at 3 and 5 years were sought. Relevant clinical features and medication exposures entered prospectively into an electronic record were collected and analyzed using descriptive statistics., Results: Data were available for 110 and 98 patients at 3 and 5 years, respectively. The proportion of patients with active joints progressively decreased from 34% at 12 months to 21% at 3 years and 16% at 5 years. Cumulative exposure to methotrexate increased between 3 and 5 years (75%-80%), however, point prevalence use decreased (45%-41%). Cumulative exposure and point prevalence use of bDMARDS both increased between 3 and 5 years; 30%-42% and 29%-33%, respectively. Thirty-five percent of patients had inactive joint disease off medications at 5 years, which occurred most frequently in patients with sJIA and oligoarthritis., Conclusion: Five-year outcomes of Australian children with JIA are good, with only a small minority having ongoing active joint disease at 5 years. bDMARDS play an increasing role in management over time; however, methotrexate use remains significant. A majority of children remain on medications at 5 years., (© 2024 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Whilst antipsychotic medication reduces risk of relapse following a first episode of psychosis (FEP), some individuals can discontinue medication and remain relapse free. We aimed to identify patient and service-specific factors which influence clinical outcome following antipsychotic discontinuation. The outcomes 'admission to hospital' and 'remaining free from psychotic symptoms', both within one year from discontinuation, were explored retrospectively in an established naturalistic cohort of 354 patients with FEP. Logistic regression analysis was used to explore influence of routinely available baseline and treatment course variables on these outcomes. Seventy-seven individuals (22 %) fully discontinued antipsychotic treatment within a year, at mean 102 days from initiation. Only antipsychotic type had significant association with discontinuation; aripiprazole was discontinued more than olanzapine (p = 0.028). Seventeen individuals required admission to hospital; significantly associated with prior admission at first illness onset (p = 0.004), and prior legal detention to hospital (p = 0.001). Admission was less likely in those discontinuing aripiprazole vs olanzapine (p = 0.044). Twenty-four patients remained psychosis symptom free and were most significantly likely to have received clinician support in discontinuation; this group had no association with either initial duration of untreated psychosis or prior duration of antipsychotic treatment. Future studies exploring outcomes following antipsychotic discontinuation require consistency of choice of outcome measures and sample stratification by vulnerability factors including severity of first illness episode, whether remaining symptom free after first episode, which medication switched from and baseline functioning. The impact and nature of clinician support to discontinue requires further exploration alongside its association with abruptness of discontinuation., Competing Interests: Declaration of competing interest No conflict of interest is recorded for all study authors., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: The advent of new treatments for Juvenile Idiopathic Arthritis (JIA) has prompted interest in systematically studying the outcomes of patients treated in the 'modern era'. Such data provide both benchmarks for assessing local outcomes and important information for use in counselling families of newly diagnosed patients. While data are available for cohorts in Europe and North America, no such data exist for Australian patients. The aim was to examine the demographics, treatment and outcomes at 12 months of an inception cohort of newly diagnosed patients with JIA at a single tertiary referral paediatric rheumatology centre in Australia., Methods: Retrospective review of prospectively collected data from patients newly diagnosed with JIA between 2010 and 2014 at the Royal Children's Hospital in Melbourne., Results: One hundred thirty four patients were included (62% female). Oligoarthritis was the single largest category of JIA (36%) and rheumatoid factor positive polyarthritis the least common (2%). Undifferentiated JIA accounted for 13% of patients and was the third largest category. Across the cohort 94% received NSAIDs, 53% oral steroids, 62% methotrexate and 15% a biologic DMARD. Intra-articular steroids were used in 62%, most commonly in the oligoarticular subtype (94%). 95% of patients achieved a joint count of zero at a median of 4.1 months, however flares occurred in 42%. At 12 months 65% had no active joint disease, though more than half remained on medication., Conclusion: Australian children with JIA managed in the modern era have similar characteristics and achieve short term outcomes comparable to cohorts in Europe and North America, with high rates of joint remission in the first 12 months of follow-up but with a significant relapse rate and requirement for ongoing medication.

Objectives: To evaluate the effect of two inhaled essential oils (black pepper or angelica) on the nicotine habits of students, staff, and faculty on a U.S. college campus., Design: Comparative study with pre-/post-test measures., Setting: Community college in rural East Texas., Participants: Convenience sample of 20 volunteers from the college community (students, faculty, and staff) who were regular (daily) users of nicotine (cigarettes, snuff, or chewing tobacco)., Interventions: Inhalation of one drop of essential oil on a tissue for 2 minutes when participant was craving nicotine., Outcome Measures: (1) Pre-inhalation journal recording of self-assessed level of craving for nicotine on a 0-10 scale, (2) post-inhalation journal recording of self-assessed level of craving for nicotine on a 0-10 scale, and (3) minutes that participant waited from start of inhalation until next use of tobacco., Results: Both black pepper and angelica reduced the level of nicotine craving and allowed a longer delay before next use of tobacco. However, black pepper reduced the level of craving more than did angelica, and angelica allowed for a longer delay than did black pepper., Conclusions: Aromatherapy may be useful in nicotine withdrawal. Further studies are warranted.

Background: Traditional funding models for public paediatric rheumatology care are typically based on providing medical services for a defined number of clinics per week. Anecdotally there is significant demand by patients and families for out-of-clinic communication with care providers and services provided under traditional funding models may not meet this need. Our aim was to determine the extent and nature of this 'hidden' demand in a tertiary paediatric rheumatology centre., Methods: Communication data and diagnoses were extracted from the Rheumatology service database at our centre for the period 1/1/2009 to 31/12/2011. Clinical activity data over the same time were obtained from hospital clinic databases., Results: There were 5672 instances of communication with 749 patients/families over 3 years, (mean 7.3/weekday). This increased over time in parallel with clinical activity. 41% of clinic patients sought communication with the team out of clinic hours. 58% were telephone calls, 36% emails and 6% letters. The communication topics were for advice, results or general updates (28%), medication queries (24%), appointment/admission coordination (20%), disease flare or other disease events (14%), psychosocial, school or transition issues (6%) and miscellaneous queries (8%). Of the most frequent communicators, those with juvenile idiopathic arthritis were the majority (85%). The remainder had other chronic inflammatory conditions., Conclusions: The communication and support needs of patients with chronic rheumatic diseases and their families extend beyond that which can be provided in the clinic environment. It is essential that funding for paediatric rheumatology services allows for staffing sufficient to meet this need.

Objectives: The objective of this pilot study was to determine the effectiveness of a mixture of essential oils (peppermint, basil, and helichrysum) on mental exhaustion, or moderate burnout (ME/MB) using a personal inhaler., Design: This was a randomized, controlled, double-blind pilot study. Data were collected 3 times a day for 3 weeks (Monday-Friday). The first week was baseline for both groups, the second week was intervention (aromatherapy or placebo), and the third week was washout., Settings/location: Participants used a personal inhaler at home or at work., Subjects: The subjects comprised a convenience sample of 13 women and 1 man who each had self-assessed ME/MB., Interventions: Participants were randomized to receive a personal inhaler containing either a mixture of essential oils or rose water (as used in Indian cooking)., Outcome Measures: The outcome measures were a 0-10 scale with 10=worst feeling of burnout, 0=no feeling of burnout. There was a qualitative questionnaire rating aroma and a questionnaire listing perceived stressors., Results: While both groups had a reduction in perception of ME/MB, the aromatherapy group had a much greater reduction., Conclusions: The results suggest that inhaling essential oils may reduce the perceived level of mental fatigue/burnout. Further research is warranted.

Objectives: To evaluate the effect of topically applied black pepper essential oil on easing intravenous catheter insertion (IVC) in patients with no palpable or visible veins compared to a control group (standard nursing practice)., Design: Randomized, controlled study., Subjects: One hundred twenty hospitalized patients, who were referred to a hospital vascular team because of difficulty in accessing veins for IVC insertion., Interventions: Topical application of 20% essential oil of black pepper in aloe vera gel or standard nursing care (hot packs with or without vigorous tactile stimulation)., Outcome Measures: Pre- and post-test vein visibility and/or palpability and number of attempts at IVC insertion., Results: A higher percentage of patients achieved optimal scoring (vein score=2) or improved scoring (vein score of 1 or 2) to black pepper intervention than standard nursing care. The black pepper group also reduced the number of patients whose veins were still not visible or palpable after the intervention to nearly half that of the control group (p<0.05). The number of IVC attempts following black pepper was also half that of the control group., Conclusion: Topical application of black pepper is a viable and effective way to enhance vein visibility and palpability prior to intravenous insertion in patients with limited vein accessibility; it also improves ease of IVC insertion.

In response to the Fukushima nuclear reactor accident, on March 20th, 2011, Natural Resources Canada conducted aerial radiation surveys over water just off the west coast of Vancouver Island. Dose-rate levels were found to be consistent with background radiation, however a clear signal due to (133)Xe was observed. Methods to extract (133)Xe count rates from the measured spectra, and to determine the corresponding (133)Xe activity concentration, were developed. The measurements indicate that (133)Xe concentrations on average lie in the range of 30-70 Bq/m(3)., (Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.)

Obesity within today's workforce is increasingly recognized as a challenge for both public health professionals and ergonomists. The two disciplines share a scientific, evidence-based approach to practice and now have the opportunity to address a common health issue, namely obesity. This paper shows, through an overview of the current literature, how and where obesity is impacting on the workplace and how the health of the workforce is being affected. Ergonomics and public health priorities have been mapped and challenges suitable for the application of existing knowledge and further research have been identified. Areas of common endeavour, for example how sedentary work may be exacerbating obesity, have been identified as candidate topics for joint activity by ergonomists and public health professionals.

Aromatherapy is often misunderstood and consequently somewhat marginalized. Because of a basic misinterpretation, the integration of aromatherapy into UK hospitals is not moving forward as quickly as it might. Aromatherapy in UK is primarily aimed at enhancing patient care or improving patient satisfaction, and it is frequently mixed with massage. Little focus is given to the real clinical potential, except for a few pockets such as the Micap/South Manchester University initiative which led to a Phase 1 clinical trial into the effects of aromatherapy on infection carried out in the Burns Unit of Wythenshawe Hospital. This article discusses the expansion of aromatherapy within the US and follows 10 years of developing protocols and policies that led to pilot studies on radiation burns, chemo-induced nausea, slow-healing wounds, Alzheimers and end-of-life agitation. The article poses two questions: should nursing take aromatherapy more seriously and do nurses really need 60 hours of massage to use aromatherapy as part of nursing practice?

Objective: The purpose of this study was to explore the effect of aromatherapy on menstrual cramps and symptoms of dysmenorrhea., Design: The study was a randomized placebo-controlled trial., Subjects: The subjects were 67 female college students who rated their menstrual cramps to be greater than 6 on a 10-point visual analogue scale, who had no systemic or reproductive diseases, and who did not use contraceptive drugs., Intervention: Subjects were randomized into three groups: (1) an experimental group (n = 25) who received aromatherapy, (2) a placebo group (n = 20), and (3) a control group (n = 22). Aromatherapy was applied topically to the experimental group in the form of an abdominal massage using two drops of lavender (Lavandula officinalis), one drop of clary sage (Salvia sclarea), and one drop of rose (Rosa centifolia) in 5 cc of almond oil. The placebo group received the same treatment but with almond oil only, and the control group received no treatment., Outcome Measures: The menstrual cramps levels was assessed using a visual analogue scale and severity of dysmenorrhea was measured with a verbal multidimensional scoring system., Results: The menstrual cramps were significantly lowered in the aromatherapy group than in the other two groups at both post-test time points (first and second day of menstruation after treatment). From the multiple regression aromatherapy was found to be associated with the changes in menstrual cramp levels (first day: Beta = -2.48, 95% CI: -3.68 to -1.29, p < 0.001; second day: Beta = -1.97, 95% CI: -3.66 to -0.29, p = 0.02 and the severity of dysmenorrhea (first day: Beta = 0.31, 95% CI: 0.05 to 0.57, p = 0.02; second day: Beta = 0.33, 95% CI: 0.10 to 0.56, p = 0.006) than that found in the other two groups., Conclusions: These findings suggest that aromatherapy using topically applied lavender, clary sage, and rose is effective in decreasing the severity of menstrual cramps. Aromatherapy can be offered as part of the nursing care to women experiencing menstrual cramps or dysmenorrhea.

Clinical aromatherapy is the use of essential oils for expected outcomes that are measurable and is a therapy that is used as part of nursing care in Switzerland, Germany, Australia, Canada, the United Kingdom, and, more recently, the United States. Essential oils are steam distillates obtained from aromatic plants. These volatile extracts have been used for many years by French hospitals against airborne bacteria and fungi. As antimicrobial agents, essential oils may be appropriate in HIV/AIDS for specific opportunistic infections. Aromatherapy can also alter perceptions of chronic pain, help maintain skin integrity, and is useful in stress management. Methods of application vary depending on the site of infection and the psychological profile of the patient and can include inhalation, compresses, baths, massage, and the "m" technique. This article will explore the potential use of essential oils in HIV/AIDS focusing on four opportunistic infections: Cryptococcus neoformans, Candida albicans, methicillin-resistant Staphylococcus aureus, and herpes simplex types I and II.

Aromatherapy is the fastest growing of all complementary therapies among nurses in the United States. Although aromatherapy has been used by the public for recreation for thousands of years and by nurses throughout the world during the last 15 years, it is only in the last few years that aromatherapy has become recognized by US State Boards of Nursing as a legitimate part of holistic nursing. Aromatherapy is now set to become one of the most popular tools that nurses can use to enhance their nursing care and simultaneously empower themselves. This article explores the potential role of aromatherapy in nursing, highlights four essential oils, and suggests practical ways that nurses can begin using this gentle therapy.

Complementary therapies are being used by nurses across America to enhance patient care. Aroma-therapy is a tool for holistic nursing that appears to enhance pain control and could prove to be a useful addition to peri-anesthesia nursing practice. This report addresses the emergence of non-conventional therapies and examines the potential role for aroma-therapy in peri-anesthesia pain management. Tables provide information about essential oils and application methods.

Chronic pain consumes approximately $70 billion per year and affects some 80 million Americans. Increasingly, aromatherapy has been used as part of an integrated, multidisciplinary approach to pain management. This therapy is thought to enhance the parasympathetic response through the effects of touch and smell, encouraging relaxation at a deep level. Relaxation has been shown to alter perceptions of pain. Even if one ignores the possibility that essential oils have pharmacologically active ingredients--or the potential pharmacokinetic potentization of conventional drugs by essential oils--aromatherapy might possibly play a role in the management of chronic pain through relaxation. Clinical trials are in the early stages, but evidence suggests that aromatherapy might be used as a complementary therapy for managing chronic pain. As such, this article examines the potential role of clinical aromatherapy as a complementary therapy in the care of patients with chronic pain. Although the use of aromatherapy is not restricted to nursing, at least 1 state board of nursing has recognized the therapeutic value of aromatherapy and voted to accept it as part of holistic nursing care.