The Mekong delta is recognised as one of the world's most vulnerable mega-deltas, being subject to a range of environmental pressures including sea level rise, increasing population, and changes in ...flows and nutrients from its upland catchment. With changing climate and socioeconomics there is a need to assess how the Mekong catchment will be affected in terms of the delivery of water and nutrients into the delta system. Here we apply the Integrated Catchment model (INCA) to the whole Mekong River Basin to simulate flow and water quality, including nitrate, ammonia, total phosphorus and soluble reactive phosphorus. The impacts of climate change on all these variables have been assessed across 24 river reaches ranging from the Himalayas down to the delta in Vietnam. We used the UK Met Office PRECIS regionally coupled climate model to downscale precipitation and temperature to the Mekong catchment. This was accomplished using the Global Circulation Model GFDL-CM to provide the boundary conditions under two carbon control strategies, namely representative concentration pathways (RCP) 4.5 and a RCP 8.5 scenario. The RCP 4.5 scenario represents the carbon strategy required to meet the Paris Accord, which aims to limit peak global temperatures to below a 2 °C rise whilst seeking to pursue options that limit temperature rise to 1.5 °C. The RCP 8.5 scenario is associated with a larger 3–4 °C rise. In addition, we also constructed a range of socio-economic scenarios to investigate the potential impacts of changing population, atmospheric pollution, economic growth and land use change up to the 2050s. Results of INCA simulations indicate increases in mean flows of up to 24%, with flood flows in the monsoon period increasing by up to 27%, but with increasing periods of drought up to 2050. A shift in the timing of the monsoon is also simulated, with a 4 week advance in the onset of monsoon flows on average. Decreases in nitrogen and phosphorus concentrations occur primarily due to flow dilution, but fluxes of these nutrients also increase by 5%, which reflects the changing flow, land use change and population changes.
Water quality along the Mekong River System
(Phosphorus mg/l Left and Nitrate-N mg/l right) Display omitted
•Climate will alter Mekong flows and seasonal patterns•Flooding will increase in the lower Mekong•Droughts will increase as Dam development increases•Socioeconomic effects will enhance nutrient fluxes into the delta•Eutrophication and increased delta flooding will occur
The internet can deliver scalable and accessible treatments for addiction and sexual health. This study investigated reasons for changing pornography use and the feasibility and impact of a brief ...internet-delivered intervention. The intervention delivered goal setting and goal review, action and coping planning, self-monitoring, social support and shaping knowledge through the provision of information on how others have reduced their pornography use. Participants (n = 84) were predominantly from Australia or New Zealand and spent an average of 6.9 (SD = 6.6) hours per week viewing pornography. Reasons to reduce were addiction related (i.e., tolerance, repeated attempts to change, mood modification and negative affect such as guilt, shame, hiding) and decrements to mental health, relationships, achievement, and sexual satisfaction. Participants who enrolled in the intervention (n = 25) selected an abstinence goal (76%) and developed plans associated with avoidance of sites, people or devices and urge management. Barriers to action plans were related to temptation, triggers, and sub-optimal plan implementation. Post-treatment evaluation (n = 14) indicated reduced frequency (d = 1.04) and days spent viewing pornography (d = 0.83) as well as improved self-efficacy, mental well-being, and psychological distress. The study indicates that a brief intervention may be feasible for addressing problematic pornography use.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Background and aims
Despite the over‐representation of people with gambling problems in mental health populations, there is limited information available to guide the selection of brief screening ...instruments within mental health services. The primary aim was to compare the classification accuracy of nine brief problem gambling screening instruments (two to five items) with a reference standard among patients accessing mental health services.
Design
The classification accuracy of nine brief screening instruments was compared with multiple cut‐off scores on a reference standard.
Setting
Eight mental health services in Victoria, Australia.
Participants
A total of 837 patients were recruited consecutively between June 2015 and January 2016.
Measurements
The brief screening instruments were the Lie/Bet Questionnaire, Brief Problem Gambling Screen (BPGS) (two‐ to five‐item versions), NODS‐CLiP, NODS‐CLiP2, Brief Biosocial Gambling Screen (BBGS) and NODS‐PERC. The Problem Gambling Severity Index (PGSI) was the reference standard.
Findings
The five‐item BPGS was the only instrument displaying satisfactory classification accuracy in detecting any level of gambling problem (low‐risk, moderate‐risk or problem gambling) (sensitivity = 0.803, specificity = 0.982, diagnostic efficiency = 0.943). Several shorter instruments adequately detected both problem and moderate‐risk, but not low‐risk, gambling: two three‐item instruments (NODS‐CLiP, three‐item BPGS) and two four‐item instruments (NODS‐PERC, four‐item BPGS) (sensitivity = 0.854–0.966, specificity = 0.901–0.954, diagnostic efficiency = 0.908–0.941). The four‐item instruments, however, did not provide any considerable advantage over the three‐item instruments. Similarly, the very brief (two‐item) instruments (Lie/Bet and two‐item BPGS) adequately detected problem gambling (sensitivity = 0.811–0.868, specificity = 0.938–0.943, diagnostic efficiency = 0.933–0.934), but not moderate‐risk or low‐risk gambling.
Conclusions
The optimal brief screening instrument for mental health services wanting to screen for any level of gambling problem is the five‐item Brief Problem Gambling Screen (BPGS). Services wanting to employ a shorter instrument or to screen only for more severe gambling problems (moderate‐risk/problem gambling) can employ the NODS‐CLiP or the three‐item BPGS. Services that are only able to accommodate a very brief instrument can employ the Lie/Bet Questionnaire or the two‐item BPGS.
The prevalence of opioid use in therapeutic and recreational settings has steadily increased throughout the western world. The addition of fentanyl into heroin products can produce potentially ...dangerous consequences, even to opioid tolerant individuals who may be unaware of such additions. Following an observed spike of heroin-fentanyl related deaths in Melbourne, Australia, a study was undertaken to determine the prevalence of these cases. All reportable deaths occurring in Victoria during 2015 and submitted to the toxicology laboratory were analysed using LC-MS-MS to confirm the combination of the heroin marker 6-acetylmorphine and/or morphine, and fentanyl. Over 4,000 coronial cases in 2015 underwent toxicological analysis for these drugs, there were nine cases identified that involved fentanyl-laced heroin. There was no specific mention of fentanyl use in any of these cases. All occurred within 2 months and in two distinct locations. The first four deaths occurred within 3 days of each other, in neighboring suburbs. The ages ranged from 25 to 57 years with an average of 40 and median of 37 years, and consisted of eight males and one female. The average and median femoral blood concentration of fentanyl was 18 and 20 ng/mL (range: <1-45 ng/mL), and morphine 140 and 80 ng/mL (range: 20-400 ng/mL), respectively. All nine cases had 6-acetylmorphine detectable in blood. Urine analysis was also performed where available. A syringe, powder and spoon found at the scene of one case were also analysed and found to be positive for both heroin and fentanyl, which supported the likelihood of fentanyl-laced heroin. This is the first reported case series of fatalities involving heroin and fentanyl outside of North America in published literature. These findings may help inform public health and prevention strategies serving to decrease the potential for such fatalities in the future.
There is a growing body of literature on internet-related behaviours and their associated problems, including Internet Addiction (IA). Although evidence suggests most people self-treat, little is ...known about the type, or efficacy, of the methods they implement. The current study sought to identify and describe the change strategies used to limit or reduce IA (including internet gaming and internet pornography). The study explored the content of 79 websites containing behaviour change advice provided by experts and consumers. A total of 4459 change strategies were identified. Through pragmatic content analysis, they were classified into 19 categories and organised into four phases of goal achievement. Across the entire sample, the most frequently promoted or discussed change strategy was seeking alternatives to internet usage (20% of total strategies), followed by maintaining readiness to change (10%), and avoidance of triggers of internet usage (10%). We found the frequency and content of 16 out of the 19 change strategies differs according to the type of internet problem (i.e., general, gaming, or pornography). This research provides detailed information for the development of tailored interventions. It indicates that interventions for IA could contain the same types of change strategies, but that the specific detail of strategies needs to be tailored towards the specific type of internet problem.
•A broad range of behaviour change strategies for internet use are promoted online.•Strategies for internet use are most frequently focused on limiting behaviour.•Planning and evaluation are infrequently used strategies for limiting internet use.•Intervention content should be specific for internet, gaming and pornography.
Performing point‐of‐care urine drug screen testing at autopsy by a forensic pathologist may provide an early indication of the presence of analytes of interest during autopsy. An evaluation for the ...screening of 14 classes of common drugs of abuse in postmortem urine by the point‐of‐care screening device, Alere iCup DX 14, is presented. One hundred ninety postmortem urine samples were screened with the iCup occurring at autopsy by the forensic pathologist. Positive and negative results obtained from the screening kit were evaluated against confirmatory test results obtained using routine forensic toxicology analyses that employed LC‐MS/MS and GC‐MS to detect a combination of over 85 common drugs of abuse and medications. Sensitivity for each respective iCup drug class ranged from 66% (buprenorphine) to 100% (methadone, tricyclic antidepressants). Specificity for each respective iCup drug class ranged from 89% (benzodiazepines) to 100% (amphetamines, barbiturates, buprenorphine, 3,4‐methylenedioxymethamphetamine, methadone). Positive predictive values ranged from 44% (benzodiazepines) to 100% (amphetamines, barbiturates, buprenorphine, methylenedioxymethamphetamine, methadone), while negative predictive values ranged from 96% (methamphetamine) to 100% (barbiturates, methadone, tricyclic antidepressants). A high false‐positive rate was yielded by the benzodiazepine class. The lack of fentanyl screening in the point‐of‐care device is a significant limitation considering its prolific prevalence in forensic casework. The results obtained in the study should be acknowledged when considering the use of the Alere iCup DX 14 in the context of postmortem casework to help indicate potential drug use contemporaneously with autopsy and when requiring such preliminary results prior to the release of a final forensic toxicology report.
Abstract The ‘concerned significant others’ (CSOs) of people with problem gambling frequently seek professional support. However, there is surprisingly little research investigating the ...characteristics or help-seeking behaviour of these CSOs, particularly for web-based counselling. The aims of this study were to describe the characteristics of CSOs accessing the web-based counselling service (real time chat) offered by the Australian national gambling web-based counselling site, explore the most commonly reported CSO impacts using a new brief scale (the Problem Gambling Significant Other Impact Scale: PG-SOIS), and identify the factors associated with different types of CSO impact. The sample comprised all 366 CSOs accessing the service over a 21 month period. The findings revealed that the CSOs were most often the intimate partners of problem gamblers and that they were most often females aged under 30 years. All CSOs displayed a similar profile of impact, with emotional distress (97.5%) and impacts on the relationship (95.9%) reported to be the most commonly endorsed impacts, followed by impacts on social life (92.1%) and finances (91.3%). Impacts on employment (83.6%) and physical health (77.3%) were the least commonly endorsed. There were few significant differences in impacts between family members (children, partners, parents, and siblings), but friends consistently reported the lowest impact scores. Only prior counselling experience and Asian cultural background were consistently associated with higher CSO impacts. The findings can serve to inform the development of web-based interventions specifically designed for the CSOs of problem gamblers.
The calcium-sensing receptor (CaSR) is a G-protein-coupled receptor that has an extracellular bilobed venus flytrap domain (VFTD) predicted to contain five calcium (Ca(2+))-binding sites. To ...elucidate the structure-function relationships of the VFTD, we investigated 294 unrelated probands with familial hypocalciuric hypercalcaemia (FHH), neonatal severe primary hyperparathyroidism (NSHPT) or autosomal dominant hypocalcaemic hypercalciuria (ADHH) for CaSR mutations and performed in vitro functional expression studies and three-dimensional modelling of mutations involving the VFTD. A total of 70 different CaSR mutations were identified: 35 in FHH, 10 in NSHPT and 25 in ADHH patients. Furthermore, a CaSR variant (Glu250Lys) was identified in FHH and ADHH probands and demonstrated to represent a functionally neutral polymorphism. NSHPT was associated with a large proportion of truncating CaSR mutations that occurred in the homozygous or compound heterozygous state. Thirty-four VFTD missense mutations were identified, and 18 mutations were located within 10 Å of one or more of the predicted Ca(2+)-binding sites, particularly at the VFTD cleft, which is the principal site of Ca(2+) binding. Mutations of residues 173 and 221, which are located at the entrance to the VFTD cleft binding site, were associated with both receptor activation (Leu173Phe and Pro221Leu) and inactivation (Leu173Pro and Pro221Gln), thereby highlighting the importance of these residues for entry and binding of Ca(2+) by the CaSR. Thus, these studies of disease-associated CaSR mutations have further elucidated the role of the VFTD cleft region in Ca(2+) binding and the function of the CaSR.
South Africa is a water-scarce country with increasing pressure on its water resources. Urgent interventions are needed to protect water security within this rapidly developing country. This paper ...reports on an interdisciplinary Water Security Colloquium, convened by the South African Young Academy of Science in 2014. A selected group of water professionals from academia, civil society and local government was brought together to discuss water security under three focus themes: ‘public expectations and municipal obligations’, ‘water security and governance: challenges and advances’, and ‘water re-use: health and infrastructural considerations’. Participant perceptions were generated using a focus group methodology, combined with participatory data collection methods. Under each theme, inputs were categorised as ‘challenges’, ‘gaps in knowledge’, and ‘solutions/recommendations’ and these inputs were thereafter ranked in order of importance via a ‘voting’ process. Major challenges perceived included a lack of both skills and political will in government, a need to restore citizen trust in government intention and capability to deliver water-related services, and a failure to up-scale existing water re-use technology. Participants identified understanding of the process and implications of the Green and Blue Drop Programmes, knowledge transfer to the public, and the role of educators as major knowledge gaps. The top suggestions proposed included creating public awareness around and buy-in to initiatives to improve water security, accessible and user-friendly conversion of research results to implementation, and ensuring an active role for educators in creating awareness around water security. In view of the concerns identified, participants suggested as potential solutions: improving government and public understanding around water issues, incentivising water re-use and conservation, introducing rising block tariffs and improving human capacity development in the water sector. Developing the ecological infrastructure that protects both quantity and quality of water and building strong partnerships among all stakeholders were also recognised as key.
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