When assessing comparative effectiveness, the meta-analysis did not distinguish between studies comparing active with sham treatment conditions, and those comparing 2 alternative, active cognitive interventions. The meta-analysis also excluded noncontrolled and single-case

studies that might elucidate innovative and potentially effective treatments. Among the systematic reviews discussed above,3, 4, 5 and 6 only 2 articles were not included in our prior reviews. FK506 purchase We therefore identified the need to review the literature since 2002 and update our previous practice recommendations accordingly. The current study is an updated review of the literature published from 2003 through 2008 addressing cognitive rehabilitation for people with TBI or stroke. We systematically reviewed and analyzed studies

that allowed us to evaluate the effectiveness of interventions for cognitive limitations. We integrated these findings in our current practice recommendations. The development of evidence-based recommendations followed our prior methodology for identification of the relevant literature, review and classification of studies, and development of recommendations. These methods are described in more detail in our initial publication.1 For the current review, online literature searches using PubMed and Infotrieve were conducted using the terms attention, awareness, cognitive, communication, executive, language, memory, perception, problem solving, and reasoning combined with each of the terms rehabilitation, remediation, and training for articles published between UK-371804 nmr 2003 and 2008. Articles were assigned to 1 of 6 possible categories (based on interventions for attention, vision and visuospatial functioning, language and communication skills, memory, executive function, or comprehensive-integrated interventions) that specifically address the rehabilitation of cognitive disability. Articles were reviewed 4-Aminobutyrate aminotransferase by 2 task force members who were experienced in the process of conducting a systematic review of cognitive rehabilitation studies, and classified as providing Level I, Level II,

or Level III evidence. The task force initially identified citations for 198 published articles. The abstracts or complete articles were reviewed in order to eliminate articles according to the following exclusion criteria: (1) nonintervention articles, including nonclinical experimental manipulation, (2) theoretical articles or descriptions of treatment approaches, (3) review articles, (4) articles without adequate specification of interventions, (5) articles that did not include participants primarily with a diagnosis of TBI or stroke, (6) studies of pediatric subjects, (7) single case reports without empirical data, (8) nonpeer reviewed articles and book chapters, (9) articles describing pharmacologic interventions, and (10) non-English language articles. One hundred forty-one articles were selected for inclusion following this screening process.

In addition, the Ti contents in the stock suspension, drinking water, and food were also analyzed. The lungs after BALF sampling, kidneys, and spleen were homogenized with 2 mL of ultrapure water (Milli-Q Advantage

A10 Ultrapure Water Purification System, Merck Millipore, USA), and the liver was homogenized with 10 mL of ultrapure water. An electric homogenizer (PT10-35 Kinematica AG and NS-50; Microtec Co. Ltd., Japan) was used and the resulting homogenates were stored at <−30 °C until analysis. All samples were treated with acid prior to determination of Ti levels. Nitric acid (HNO3; 68%, 0.5 mL) and hydrogen peroxide (H2O2; 35%, 0.2 mL) were added to 0.1 mL of BALF, HNO3 (1 mL), and sulfuric acid (H2SO4; 98%, 0.2 mL) were added to 1 g of homogenized buy Lapatinib tissues, HNO3 (0.5 mL) and H2SO4 (0.1 mL) were added to whole lymph node samples, HNO3 (1 mL) and H2O2 (0.3 mL) were added to

0.02 g of animal feed, and H2SO4 (0.5 mL) and hydrofluoric acid (HF; 38%, 0.5 mL) were added to 20 μL and 100 μL for high and low concentrations of the administered TiO2 suspension, respectively. Drinking water was diluted 10-fold with 10% HNO3 solution, with no subsequent handling. All acids used in the present study were ultrapure grade reagents (TAMAPURE-AA-100, Tama Chemicals Co., Ltd., Japan). The acidified samples (apart from drinking water) were placed in a 7 mL perfluoroalkylvinylether vessel, which was inserted into a 100 mL digestion vessel of a microwave sample preparation instrument (ETHOS 1; Milestone Srl

Selleck Selumetinib Italy or Speedwave 4; Berghof, Germany), and they were heated to 180 °C for 20 min or 200 °C for 20 min. After cooling to 40 °C, the acid-treated samples, with the exception of the TiO2 nanoparticle suspensions, were diluted to 5 mL (BALF and lymph nodes) or 10 mL (the other organs and feed) with ultrapure water (made by PURELAB Option-R 7 and PURELAB Flex UV from Veolia Water Solutions and Technologies, crotamiton France). Samples of the acid-treated TiO2 nanoparticle suspensions were heated on a hotplate for approximately 2 h until white fuming sulfuric acid was generated. After cooling, the solution was diluted to 50 mL with 10% HNO3. The sample Ti contents were then determined by ICP-SFMS using a Finnigan ELEMENT II (Thermo Fisher Scientific Inc. , Germany), and the Ti content in the administered TiO2 nanoparticle suspensions was determined by ICP atomic emission spectrometry (ICP-AES; SPS4000, SII NanoTechnology Inc., Japan). For ICP-SFMS, RF power was 1250 W, cool gas flow rate was 16 L/min, auxiliary gas flow rate was 0.87 L/min, sample gas flow rate was 0.870–0.965 L/min, additional gas flow rate was 0.080–0.180 L/min, mass resolution (R) was 4000, and the measured mass number m/z was 49. For ICP-AES, RF power was 1.3 kW, plasma gas flow rate was 16 L/min, additional gas flow rate was 0.5 L/min, carrier gas flow rate was 1.0 L/min, and wavelength was 334.941 nm. In the present study, 49Ti (mass: 48.

The 116KYRYHLKPFCKKAD130 epitope was situated in the C-terminal region ( Fernandes

et al., http://www.selleckchem.com/products/Y-27632.html 2010) which, in Bothrops genus proteins, is considered responsible for the myotoxic activity observed in Lys49-PLA2s ( Chioato et al., 2007). The Lys116–Asp130 epitope has a basic characteristic (theoretical pI = 9.75) that was rich in positively charged amino acids and differed from most of the acidic Asp49-PLA2s, which presented theoretical pI’s of approximately 4.0. This positively charged region could exert a strong influence on the binding of antibodies in the anti-bothropic horse antivenom with BthTX-I. Four epitopes were specifically recognized by the anti-crotalic horse antivenom: Gln11–Lys20 (BthTX-I), Thy70–Glu78 (BthTX-II), Tyr52–Tyr73, and Phe106–Phe119 (BthA-I) (Fig. 4). For BthTX-I, the sequence

11QETGKNPAK20 was located in a transition region within the three dimensional model that corresponded with the end of an alpha helix I, which was followed by the Ca2+-binding loop (Fernandes et al., 2010). This epitope showed a basic characteristic (theoretical pI equal INK 128 cost to 8.59). The comparative analysis of snake venom PLA2s amino acid sequences showed that the glutamine in position 11 was conserved in all of the Lys49-PLA2s from the Bothrops genus. Therefore, this residue may be responsible for the interaction between this epitope

and the anti-crotalic horse antivenom, since this is the only amino acid with an observed change when compared with the same region in BthTX-II, which is not recognized by this antivenom. The proline in position 18 was present in almost all Lys49-PLA2s or was replaced by alanine, serine or glycine in basic PLA2s. In BthTX-II, the acidic 70TDRYSYSRE78 (theoretical pI = 5.73) epitope was three-dimensionally located in the β-wing region ( Correa et al., 2008). The comparative analysis showed that the 77RE78 → 77WK78 replacement observed in Lys49-PLA2s was not recognized as an epitope from the absence of observed interactions between this same region and the anti-crotalic horse antivenom. In BthA-I, the 52YGKVTGCDPKIDSY73 epitope (theoretical pI = 8.14) was located in three dimensional Astemizole model between the final alpha helix II and the beginning of the β-wing ( Magro et al., 2004). The Val55 was conserved in acidic PLA2s from the Bothrops genus. When it was replaced by leucine or methionine in the sequence of the basic PLA2s, no interactions were measured for this region with the anti-crotalic horse antivenom. The other BthA-I epitope, Phe106–Phe119, had an acidic characteristic (theoretical pI = 6.04). In the three dimensional model, it was located in the C-terminal loop of this protein ( Magro et al., 2004).

5A and B) while the MMCs from the oil exposed killifish were

significantly greater in number in comparison to the control killifish (Fig. 5C and D). Overall, splenic MMCs from the oil-exposed sea trout were much larger than those from control fish (Fig. 5B and D and Table 1). Spleen tissues and peripheral blood from Gulf killifish collected from Terrebonne Bay in August 2010, and sea trout collected from the north eastern Gulf of Mexico in November find more 2010 demonstrated changes suggesting exposure to hydrocarbons. The blood cell changes were similar to those associated with increased disease susceptibility, and the tissue changes were indicative of environmental stress. Similar conclusions Pifithrin-�� molecular weight regarding fish health were made following the EVOS in Prince William Sound, Alaska in 1989. Oil exposure resulted in significant mortality and physical and genetic abnormalities in Pacific herring (Marty et al., 1999). Fish population declines began the year following the EVOS (Thorne and Thomas, 2008) and increased occurrence of fish diseases continued for several years (Carls et al., 1998). Following the EVOS, several studies were performed in contaminated and non-contaminated areas of Prince William Sound. Higher mortality and increased occurrence of lesions in Pacific herring (Clupea pallasi) exposed to water contaminated with

weathered crude oil were significantly correlated to water TPAH concentrations ( Carls et al., 1998). In three other studies, herring eggs and/or larva were collected from oiled and un-oiled beaches immediately after the EVOS. Eggs and/or larva exposed to oil had significantly PIK-5 more morphological deformities and cytogenetic damage and higher mortality ( Hose et al., 1996, McGurk and Brown, 1996 and Norcross et al., 1996). Additionally, examination of tissues

of adult herring revealed hepatic necrosis and an increased score for melano-macrophage aggregates. Significantly higher levels of tissue PAH concentrations were present in exposed fish ( Marty et al., 1999). Increased occurrences of external lesions and diseases have occurred in twenty species of fish since the 2010 oil spill (Cowan, 2013). Many pollutants accumulate in aquatic ecosystems. Stress can affect cellular distributions in fish hematopoietic tissues resulting in decreased lymphocyte and hemoblast counts, and increased granulocyte counts (Peters and Schwarzer, 1985). Hematology is an indicator of immunological status and can provide definitive diagnoses (Duncan et al., 1994 and Campbell and Ellis, 2007). The role of white blood cells is to defend against pathogens (Marieb and Hoehn, 2010). Exposing humans to fuel and petroleum products resulted in significant decreases of white blood cells, or leukocytopenia (d’Azevedo et al., 1996 and Okoro et al., 2006). Carls et al.

A PAAF aumenta a acuidade global da técnica, mas a sensibilidade para malignidade é inferior nos doentes com pancreatite crónica (54-74%) comparativamente com aqueles em que o restante parênquima

pancreático é normal (89-91%). Além disso, o número médio de passagens necessárias para estabelecer o diagnóstico definitivo é superior no primeiro grupo de doentes103, 104, 105 and 106. A introdução da elastografia e dos agentes de contraste aplicados à EE poderá vir a ser particularmente importante neste contexto (fig. 5)32 and 35. Encontra-se atualmente em debate a indicação para vigilância regular dos doentes com pancreatite crónica, pelo facto de esta constituir um fator de risco para carcinoma pancreático107, selleck chemicals não existindo até ao momento recomendações formais para rastreio destes doentes, nem

evidência de benefício clínico. Os achados endossonográficos na pancreatite aguda são variáveis e inespecíficos. O pâncreas pode ter um aspeto normal ou apresentar-se ligeiramente aumentado e hipoecóico devido ao edema, e com áreas focais hipoecóicas indicativas de necrose parenquimatosa. Podem coexistir aspetos de inflamação extrapancreática, como edema da parede duodenal e coleções líquidas peripancreáticas. Tofacitinib Dados preliminares sugerem um papel da EE na avaliação de fatores preditivos da evolução da pancreatite aguda108, mas mais estudos são necessários para confirmação deste potencial valor prognóstico. Uma das principais aplicações da EE neste

contexto é a investigação etiológica da pancreatite aguda idiopática (10%), particularmente na suspeita de etiologia biliar, quando a ultrassonografia abdominal e a TC não documentam a existência de litíase. A EE é comparável à CPRM na deteção de coledocolitíase109 and 110, mas é superior na deteção de microlitíase (< 3 mm) e lama biliar111. Os microcálculos apresentam-se como focos hiperecóicos flutuantes, sem cone de sombra, e a lama biliar como conteúdo ecóico móvel no interior da vesícula ou da via biliar. Celecoxib Tem vindo a ser sugerida uma abordagem baseada na EE para seleção dos doentes candidatos a CPRE e papilotomia, com o objetivo de reduzir o risco de complicações. No entanto, os dados que suportam a adoção desta estratégia de triagem no contexto da pancreatite aguda são, ainda, limitados112. A EE apresenta, adicionalmente, uma elevada sensibilidade na identificação de causas menos frequentes de pancreatite aguda, como tumores não visualizados por outros métodos de imagem, sendo que 5-7% dos tumores pancreáticos apresentam-se na forma de pancreatite aguda113, pancreas divisum e pancreatite crónica. As alterações inflamatórias presentes durante o episódio agudo podem prejudicar a aquisição de imagens adequadas do pâncreas, pelo que se recomenda um intervalo de pelo menos 4-6 semanas antes da realização de EE para estas indicações. O valor da avaliação por EE após um episódio único de pancreatite aguda idiopática permanece controverso.

, 2006b and Teets et al., 2008). RCH therefore seems, in the

limited number of organisms studied, to ameliorate chilling injury as opposed to freezing damage. In the current study, we investigated the strength of the RCH response in E. murphyi and its relevance in the context of the maritime Antarctic climate, and examined whether RCH has any effect on the whole body freezing temperature, commonly known as the supercooling point (SCP). Summer acclimatized larvae of E. murphyi were collected from soil and moss on Signy Island (60oS 45oW) near to the British Antarctic Survey Signy Research Station between January CX-5461 cost and March 2011. They were transported to the University of Birmingham under cool conditions (+4 °C) and subsequently held in plastic boxes containing substratum from the site of collection at +4 °C (0:24 L:D). For comparative purposes, experiments tested both juvenile larvae

(L1 and L2 stages) and mature larvae (L3 and L4). These two groups were separated on the basis of size and colouration ( Cranston, 1985). However, due to GSK-3 signaling pathway the limited number of juveniles, only mature larvae were used in the following experiments – 2.4 (ii), 2.5 and 2.7. The temperature at which 10–20% survival occurs (DTemp, Lee et al., 1987) was determined by exposing larvae (3 × 10 replicates) to progressively lower sub-zero temperatures (−9 to −14 °C) for 8 h, before being re-warmed to the rearing temperature (+4 °C) at 0.2 °C min−1. Larvae were re-warmed from sub-zero temperatures to the rearing temperature at 0.2 °C min−1, as preliminary trials suggested that larvae experienced greater mortality if directly transferred (data not shown). Three replicates Carbachol of 10 individuals were placed in Eppendorf tubes, inside glass test tubes plugged with sponge, in an alcohol bath

(Haake Phoenix II C50P, Thermo Electron Corporation), prior to each experimental treatment. Control groups were handled, and exposed, in the same way at +4 °C. The temperature experienced by the larvae was measured by placing a thermocouple within an identical Eppendorf tube into one of the glass test tubes. At the end of experimental treatments, the larvae were rapidly transferred (over ice) from the Eppendorf tubes into plastic recovery capsules containing substratum and returned to the rearing conditions (+4 °C, 0:24 L:D). Survival, defined by individuals moving either spontaneously or in response to gentle contact stimulus, was assessed 24 and 72 h after treatment. The highest temperature at which survival was between 10 and 20% after 72 h recovery was defined as the DTemp. Replicate collection, controls, thermocouple use, recovery and survival assessment were the same for all following experimental procedures unless stated otherwise. In order to detect an RCH response, larvae (3 × 10 replicates) were subjected to the following treatments: 1) 1 h at 0 or −5 °C, before being transferred to the DTemp for 8 h and then re-warmed to +4 °C at 0.2 °C min−1.

4 for stable stratification and equal to 1 for unstable stratification. The boundary conditions for k and ε read: equation(14a) k=u∗3Cμ3/4+maxB0kd1Cμ3/43/4, equation(14b) ε=u∗3kd1, equation(14c) u∗2=τsρo, equation(14d) B=gρo∂ρ∂TFnρocp+∂ρ∂SFsalt, where d1 is the distance from the boundary to the centre of the nearboundary grid cell, κ von Karman’s constant, u* the friction velocity, τs the wind surface stress and B the buoyancy flux due to net click here heat (Fn) and salt (Fsalt) fluxes. In the absence of momentum and buoyancy fluxes, minimum values of k and ε are applied. The constants are discussed

in greater detail in Omstedt & Axell (2003). The initial temperature and salinity conditions for the EMB were taken from January 1958. The temperature and ATM/ATR tumor salinity were 16.6 ° C and 38.5 PSU respectively, from the surface to a depth of 150 m. Then temperature and salinity changed linearly to 14.1 ° C and 38.7 PSU respectively, at a depth of 600 m. From a depth of 600 m to the bottom, temperature and salinity were set to 14.1 ° C and 38.7 PSU respectively.

The initial conditions for the turbulent model assumed only constant and small values for the turbulent kinetic energy Morin Hydrate and its dissipation rate. The sensible heat flux Fh is given by equation(15) Fh−CHρacpaWa(Ts−Ta),Fh−CHρacpaWaTs−Ta, where CH is the heat

transfer coefficient and cpa the heat capacity of air. The latent heat flux Fe is calculated as equation(16) Fe=CEρaLeWa(qs−qa),Fe=CEρaLeWaqs−qa, where qs is the specific humidity of air at the sea surface, assumed to be equal to the saturation value at temperature Ts, calculated as equation(17) qs=0.622RsPaexpcq1TsTs+273.15−cq2, where Rs = 611, cq1 = 17.27, cq2 = 35.86, and Pa is the air pressure at the reference level. The specific humidity of air at the reference level qa is accordingly calculated as equation(18) qa=0.622RsRhPaexpcq1TaTa+273.15−cq2, where Rh is the relative humidity (0 ≤ Rh ≤ 1). The heat flux due to net long-wave radiation Fl is given by the difference between the upward and downward propagation of long-wave radiation ( Bodin 1979), according to: equation19) Fl=εsσsTs+273.144−σsTa+273.154a1+a2ea1/21+a3N2, where εs is the emissivity of the sea surface, σs the Stefan-Boltzmann coefficient, and a1, a2 and a3 = 0.68, 0.0036 and 0.18 are constants. Furthermore, Nc is the cloud coverage and ea is the water vapour pressure in the atmosphere, related to qa as follows: equation(20) ea=Pa0.622qa.

117 per 100 person-years (PY). The

incidence of DVT appears Z-VAD-FMK research buy to increase markedly with age.12 Heit et al13 found that institutionalization (current or recent hospitalization or nursing home residence) was independently associated with 21.72 odds (among those with recent surgery) and 7.98 odds (without recent surgery) of having VTE. In another study, Heit et al14 found that 59% of VTE cases in the community could be attributed to institutionalization: hospitalization for surgery accounted for 24%; hospitalization for medical illness 22%; and nursing home residence 13%. To facilitate risk assessment for the unique characteristics of nursing home residents, a literature-based long term care (LTC) risk stratification tool for VTE has recently been developed by Zarowitz et al.15 In the nursing home setting, 3 studies evaluated the incidence of VTE diagnosed during facility residence,16, 17 and 18 and 1 study evaluated prevalence of asymptomatic disease.19 Using Minnesota Case Mix Review Program (MCMRP) data for the period 1988 to 1994, Liebson et al16 found a crude incidence rate of 1.2 (95% confidence interval [CI]:

0.9–1.5) to 1.5 (95% CI: 1.1–1.9) cases per 100 PY. In the same study, analysis of a second database (Rochester Epidemiology Project of Olmstead County, MN, 1998–1994) revealed a crude incidence rate of 3.6 (95% CI: 3.0–4.2) cases per 100 PY.16 Gomes 5-Fluoracil manufacturer et al,17 compiling Minimum Data Set (MDS) and Medicare records for residents in Kansas for the period

1997 to 1998, found a crude VTE incidence rate of 1.30 events per 100 PY (95% CI: 1.10–1.51) when excluding warfarin users. Gatt et al18 evaluated VTE incidence for residents with a length of stay (LOS) of 3 months or longer in a nursing home in Jerusalem, Israel, during the period 1991 to 2001. The crude incidence rate of VTE was similar in both chronically immobilized and mobile cohorts: 1.39 and 1.58 per 100 PY, respectively (P = .77). 18 Arpaia et al19 recently concluded that “[d]ata on the frequency of VTE among nonacute patients nursed at home or in long term care residential homes are still scarce.” The O-methylated flavonoid current study updates earlier US research regarding the incidence of VTE events that occur during nursing home residence16 and 17 and introduces an analysis of the proportion of nursing home admissions that were coded for VTE. Data for this study were extracted for the data collection period January 1, 2007, to June 30, 2009, from the AnalytiCare longitudinal LTC database (www.analyticare.com). This database included MDS 2.0 assessments, pharmacy dispensing records, and resident characteristics from 181 nursing home facilities across 19 states (29% of facilities had 0–100 beds, 70% 101–200 beds, 1% >200 beds).

Our study would confirm that percutaneous PFO closure is a safe procedure, pointing out that early complications Fluorouracil and those during follow-up are not uncommon and are mostly related to cardiac arrhythmias. We thank Dr. Andrea Smith for help with English version. “
“Chronic hyperventilation syndrome (CHVS, tetania and spasmophilia) represents a relatively common but poorly understood clinical entity. Approximately 10% of patients in a general internal medicine practice are reported to have CHVS. Chronic hyperventilation syndrome typically present with recurrent and different respiratory, neurological, cardiac or

dysphoric symptoms, however, the underlying pathophysiology has not been clearly elucidated so far [1]. Patients with CHVS usually undergo extensive and expensive investigations but in majority of them no organic causes are discovered. Chronic hyperventilation syndrome is thought to result from hypocapnia, hypocalcemia or alcalosis due to psychogenic hyperventilation but although CHVS and psychiatric disorders may overlap, only quarter of patients with hyperventilation syndrome manifest panic disorder. Different stressors such as emotional distress but also sodium lactate, caffeine, isoproterenol can provoke an exaggerated respiratory response. We hypothesized that various

endogenic trigger substances might enter the systemic circulation through cardiac or pulmonary right-to-left shunt (RLS) instead of being trapped in the pulmonary capillaries

and contribute with development buy JQ1 of CHVS. The aim of this single center study was to evaluate the incidence of RLS in patients with CHVS. Twenty-eight patients with previously diagnosed CHVS and 25 healthy subjects (control group, CG) were prospectively recruited to the study and admitted to Clinic of Neurology, Military Medical Institute, Warsaw, Poland. Chronic hyperventilation Thiamet G syndrome was diagnosed basing on typical recurrent clinical symptoms (dizziness, numbness, paresthesias or near syncope), which could be reproduced by voluntary hyperventilation. The diagnosis was confirmed with presence of spontaneous electromyographic (EMG) activity with 2 or more multiplets during provocative ischemia and hyperventilation [2]. All patients with CHVS had undergone brain neuroimaging (MRI), EEG, carotid duplex ultrasonography and transcranial Doppler (TCD) ultrasonography to exclude organic causes of the symptoms before entering the study. Total and ionized calcium was within the normal reference range levels in all examined subjects. Patients were consulted with neuropsychologist and endocrinologist. Three patients in whom diagnosis of panic disorder (n = 1), agoraphobia (n = 1) or endocrine disturbance (n = 1) had been established were not included into the trial.

Articles were presented in this selleck chemicals llc way for an audience of printed journals. However as most researchers now access articles online, readership styles and how information is gathered have changed quite considerably. In order to enhance the online article, and to adapt to the needs of our community, we are introducing two new features

– graphical abstracts and research highlights: ■ A graphical abstract is a concise, pictorial and visual summary of the main findings of the article, which could either be a summarising or concluding figure from the article or a figure that is specially designed for the purpose. A graphical abstract captures the content of the paper for readers at a single glance. For more information and examples, please see: www.elsevier.com/graphicalabstracts User surveys have indicated that readers highly appreciate both of these features. They allow readers to quickly gain an understanding of the article, serve as a navigation mechanism to click here specific sub-sections of the results and figures. Also, these features encourage browsing, promote interdisciplinary scholarship and help readers identify more quickly which papers are most relevant to their research interests. Please note that authors of this journal are asked to provide research highlights with their submission. Graphical abstracts are desirable, however remain optional. The Publisher “
“Oceans

and humans have interacted since ancient times. Over thousands of years, the oceans and seas have served as a source of food, provided livelihoods, and generated commerce, as well as disseminating people and connecting civilizations around the world. Their importance is reflected in many cultural practices, and is manifest in inspirational art. Inevitably the oceans influence our health and wellbeing. Damaged coastal and marine ecosystems arising from natural disasters or as a SSR128129E result of human exploitation have led to a range

of negative consequences for human health (including loss of life); at the same time, there is increasing evidence that interactions with coastal and marine environments may also have important beneficial impacts on wellbeing (Bowen et al., 2006, Fleming et al., 2006, Fleming and Laws, 2006, Walsh et al., 2008 and Bowen et al., 2014). Over the past two decades, the importance of oceans for human health as an area for research, training and policy has been recognized in the US. This is evidenced by the establishment of a network of dedicated oceans and human health research centres in both academic and government institutions funded by the National Science Foundation (NSF), the National Institute of Environmental Health Sciences (NIEHS), and the National Oceanographic and Atmospheric Administration (NOAA) (National Research Council, 1999, Knap et al., 2002 and Laws et al., 2008). With the exception of a few specific regional programmes (e.g.