A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

Currently it is estimated that about 1 billion people globally have non-alcoholic fatty liver disease (NAFLD), a condition in which liver fat exceeds 5 % of liver weight in the absence of significant alcohol intake. Due to the central role of the liver in metabolism, the prevalence of NAFLD is increasing in parallel with the prevalence of obesity, insulin resistance and other risk factors of metabolic diseases. However, the contribution of liver fat to the risk of type 2 diabetes mellitus and CVD, relative to other ectopic fat depots and to other risk markers, is unclear. Various studies have suggested that the accumulation of liver fat can be reduced or prevented via dietary changes. However, the amount of liver fat reduction that would be physiologically relevant, and the timeframes and dose–effect relationships for achieving this through different diet-based approaches, are unclear. Also, it is still uncertain whether the changes in liver fat per se or the associated metabolic changes are relevant. Furthermore, the methods available to measure liver fat, or even individual fatty acids, differ in sensitivity and reliability. The present report summarises key messages of presentations from different experts and related discussions from a workshop intended to capture current views and research gaps relating to the points above.

One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increasing Threat Perception (TP). This process was examined by comparing two different definitions of uncertainty: ambiguity versus unpredictability. N = 104 participants were measured for IU and then made worry and TP estimates for four different scenario types: Ambiguous Scenarios (where an outcome could be interpreted as threatening), Unpredictable Positive Scenarios (where a surprising and positive outcome was anticipated), as well as Positive and Negative Scenarios (with certain outcome). Both Ambiguous and Unpredictable Positive Scenarios more strongly predicted the relationship between IU and worry scores than (certain) Positive or Negative Scenarios. The relationship between IU and ‘ambiguous worry’ was largely explained by TP estimates, whereas the relationship between IU and ‘Unpredictable Positive Worry’ was largely independent of TP. Results suggest ambiguity and unpredictability are differentially explained by TP such that they produce different types of response. The authors argue ambiguity and unpredictability are explanatory components within IU.

Background: Care planning is a multidisciplinary process used to develop an individualised recovery plan for each service user. The success of this process will depend on the extent to which members of mental health teams can work with one another, with service users, and with other service providers in developing a coordinated plan that meets service user needs across multiple domains.

Aims: This paper examined the teamworking challenges that Community Mental Health Teams (CMHTs) face during the care planning process and how such challenges may be managed.

Method: A narrative review of published articles and policy documents relevant to teamworking and recovery-focused care planning within mental health teams.

Findings: Teamworking challenges include the provision of integrated rather than fragmented care, the empowerment of the service user, and development of a distributed model of leadership, responsibility and decision making.

Conclusions: CMHTs face a range of substantial but manageable challenges in attempting to implement recovery-focused care planning. Recommendations include the need to integrate recovery-orientated skills and values into professional training, the need for greater multidisciplinary training opportunities, and the need to evaluate CMHTs based on recovery-orientated criteria.

Jointed goatgrass is an exotic species introduced into the western United States from Eurasia. The weed is an agricultural pest infesting winter wheat fields and causing economic loss. Common ancestry between the two species enables interspecific hybridization, thus providing a mechanism for gene flow to occur. This can facilitate the accumulation of novel genes, which could increase the wild species' competitiveness with wheat and its ability to invade novel habitats. Interest in the development of transgenic wheat cultivars has increased the concern for interspecific gene flow. Gene introgression requires recurrent backcrossing to the weedy species after the initial hybridization event. Field experiments were conducted at two locations in Colorado in 2007–2008 and 2008–2009, with jointed goatgrass acting as the sole source of viable pollen for fertilization of transplanted hybrid plants. Backcrossing rates were determined by conducting germination studies on spikes collected from a total of 206 hybrid plants. Pollination by jointed goatgrass led to the production of 463 BC1 plants from seed produced on these 206 hybrid plants. Ninety-five percent confidence intervals estimate the rate of backcrossing at 0.028 to 0.306% and 0.077 to 0.604%, with medians of 0.062 and 0.152%, respectively, at the two locations. The results demonstrate that backcrossing to jointed goatgrass can occur, despite low rates of hybrid fertility. Subsequent backcrossing would make it likely that a wheat gene conferring a selective advantage will introgress into the weedy population. For the U.S. Great Plains, it is possible that transgenic wheat cultivars will be released in the future and determining proper management of these cultivars is necessary to minimize hybridization and advantageous gene introgression into weedy relatives.

Walter G, Byrne S, Griffiths O, Hunt G, Soh N, Cleary M, Duffy P, Crawford G, Krabman P, Concannon P, Malhi G. Can young people reliably rate side effects of low-dose antipsychotic medication using a self-report survey?

Gene flow between jointed goatgrass and winter wheat is a concern because transfer of herbicide-resistance genes from imidazolinone-resistant (IR) winter wheat cultivars to jointed goatgrass could restrict weed-management options for this serious weed of winter wheat cropping systems. The objectives of this study were (1) to investigate the frequency of interspecific hybridization between IR wheat and jointed goatgrass in eastern Colorado, and (2) to determine the gene action of the IR acetolactate synthase (ALS) allele in IR wheat by jointed goatgrass and in IR wheat by imidazolinone-susceptible (IS) wheat backgrounds. Jointed goatgrass was sampled side-by-side with IR wheat and at distances up to 53 m away in both experimental plots and at commercial field study sites in 2003, 2004, and 2005. A greenhouse-screening method was used to identify IR hybrids in collected jointed goatgrass seed. The average percentage of hybridization across sites and years when IR wheat and jointed goatgrass were grown side-by-side was 0.1%, and the maximum was 1.6%. The greatest distance over which hybridization was documented was 16 m. The IR ALS allele contributed 25% of untreated ALS activity in jointed goatgrass by IR wheat F1 plants, as measured by an in vitro ALS assay. The hybridization rate between wheat and jointed goatgrass and the expression of the IR wheat ALS allele in hybrid plants will both influence trait introgression into jointed goatgrass.

Primary salivary adenocarcinoma of the head and neck is rare. In cases where cervical metastases are evident or suspected, neck dissection is likely to play a role in management. However, there is little data in the literature regarding the findings and outcome of neck dissection in these patients. The present study comprised a review of 12 patients with high-grade salivary adenocarcinoma (salivary ductal carcinoma or adenocarcinoma, not otherwise specified (NOS). Eight underwent neck dissection (four modified radical, four selective). Histological examination showed evidence of cervical metastases in five. The prevalence of occult metastases in the N0 neck was 40 per cent. Computed tomography (CT) and magnetic resonance imaging (MRI) were not useful in detecting occult neck disease. Five patients had no evidence of disease at the most recent follow up. Neck dissection is indicated in patients with high-grade salivary adenocarcinoma, and may provide information for planning adjuvant treatment.

A prospective study into the aetiology of acute food bolus obstruction (AFBO) was carried out on 17 consecutive patients who presented with this complaint. There were nine males and eight females. Twelve patients (71 per cent) had symptoms of oesophageal disease and 10 patients (59 per cent) had prior food bolus obstruction. Investigations included endoscopy, barium swallow, oesophageal pH and manometry studies. Evidence of oesophageal pathology was found in 12/14 (86 per cent) of patients investigated. No patients had malignancy and the most common abnormality, gastroesophageal reflux (GOR) was found in eight out of 14 (57 per cent) of cases. Oesophageal dysmotility was seen in five out of 12 (42 per cent) patients who had manometric studies.

With such a high incidence of recurrence of AFBO, we suggest that patients with this condition be investigated to exclude malignancy and to identify benign oesophageal pathology using techniques such as oesophageal pH and manometry. Appropriate treatment of oesophageal disease may help prevent recurrence of this distressing condition.

Factors affecting marketing margins were identified and assessed using a relative price spread technique. Margins were disaggregated into slaughter-to-wholesale and wholesale-to-retail for a more complete understanding. Marketing costs, concentration, demand, and price were used to explain variations within these margins. Results showed that packer concentration had a significant effect on margins. Forces of supply and demand (as represented by production and market price) and changes in marketing costs also explained the variation in margins. A higher degree of price transmission from slaughter-to-wholesale level was observed in comparison to the wholesale-to-retail level.

Key determinants of monthly wholesale prices for 12 beef cuts include the quantity of the specific cut, stickiness in prices, marketing costs, quantities of pork and chicken, and seasonality. Seasonal patterns across the respective cuts are very different. Relative to the price in December, prices at the wholesale level in other months can be as much as 6 percent lower to as much as 21 percent higher.