18 research outputs found

    Pictorial and Spiritual Spaces A Personal Journey Through Painting and Meditation

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    The way that an artist works is directly affected by the way that they perceive and interact with their surroundings. My work over the past year has dealt with the way that I perceive different universal aspects of human experience such as death, separation and personal motivation. The work itself consists of large representational figurative paintings executed in acrylic, oil and various drawing mediums on canvas, linen, or illustration board. Each piece is preceded by a number of preparatory drawings in which space, characters, and narrative evolve. The way that I approach subject matter and the execution of paintings has been changed over the past year by experiences in meditation, including a nine day silent meditation retreat in the Vipassana tradition, and recent training in the practice of the Shamatha meditation practice. Specifically, cultivation and training of attentional stability through meditation have become two of the main grounds for the way I spend time with my artwork. The work presented here is also strongly grounded in the Western European traditions of narrative figurative painting. I believe that there is a direct correlation between training in representational painting and meditation; I have found that the emphasis that both place on observing and perceiving reality in the most accurate way intertwine in my work

    Committing to ecological restoration: Efforts around the globe need legal and policy clarification

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    At the September 2014 United Nations Climate Summit, governments rallied around an international agreement—the New York Declaration on Forests—that underscored restoration of degraded ecosystems as an auspicious solution to climate change. Ethiopia committed to restore more than one-sixth of its land. Uganda, the Democratic Republic of Congo, Guatemala, and Colombia pledged to restore huge areas within their borders. In total, parties committed to restore a staggering 350 million hectares by 2030.Fil: Suding, Kathering. State University Of Colorado-boulder; Estados UnidosFil: Higgs, Eric. University Of Victoria; CanadáFil: Palmer, Margaret. University of Maryland; Estados UnidosFil: Callicott, J. Baird. University Of North Texas; Estados UnidosFil: Anderson, Christopher Brian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; ArgentinaFil: Baker, Matthew. University Of Maryland; Estados UnidosFil: Gutrich, John J.. Southern Oregon University; Estados UnidosFil: Hondula, Kelly L.. University of Maryland; Estados UnidosFil: Lafevor, Matthew C.. University of Maryland; Estados UnidosFil: Larson, Brendon M. H.. University Of Waterloo; CanadáFil: Randall, Alan. Ohio State University; Estados Unidos. University Of Sidney; AustraliaFil: Ruhl, J. B.. Vanderbilt University; Estados UnidosFil: Schwartz, Katrina Z. S.. Woodrow Wilson International Center for Scholars; Estados Unido

    Benefits and harms of oral anticoagulant therapy in chronic kidney disease: a systematic review and meta-analysis

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    Background: Effects of oral anticoagulation in chronic kidney disease (CKD) are uncertain. Purpose: To evaluate the benefits and harms of vitamin K antagonists (VKAs) and non–vitamin K oral anticoagulants (NOACs) in adults with CKD stages 3 to 5, including those with dialysis-dependent end-stage kidney disease (ESKD). Data Sources: English-language searches of MEDLINE, EMBASE, and Cochrane databases (inception to February 2019); review bibliographies; and ClinicalTrials.gov (25 February 2019). Study Selection: Randomized controlled trials evaluating VKAs or NOACs for any indication in patients with CKD that reported efficacy or bleeding outcomes. Data Extraction: Two authors independently extracted data, assessed risk of bias, and rated certainty of evidence. Data Synthesis: Forty-five trials involving 34 082 participants who received anticoagulation for atrial fibrillation (AF) (11 trials), venous thromboembolism (VTE) (11 trials), thromboprophylaxis (6 trials), prevention of dialysis access thrombosis (8 trials), and cardiovascular disease other than AF (9 trials) were included. All but the 8 trials involving patients with ESKD excluded participants with creatinine clearance less than 20 mL/min or estimated glomerular filtration rate less than 15 mL/min/1.73 m2. In AF, compared with VKAs, NOACs reduced risks for stroke or systemic embolism (risk ratio [RR], 0.79 [95% CI, 0.66 to 0.93]; high-certainty evidence) and hemorrhagic stroke (RR, 0.48 [CI, 0.30 to 0.76]; moderate-certainty evidence). Compared with VKAs, the effects of NOACs on recurrent VTE or VTE-related death were uncertain (RR, 0.72 [CI, 0.44 to 1.17]; low-certainty evidence). In all trials combined, NOACs seemingly reduced major bleeding risk compared with VKAs (RR, 0.75 [CI, 0.56 to 1.01]; low-certainty evidence). Limitation: Scant evidence for advanced CKD or ESKD; data mostly from subgroups of large trials. Conclusion: In early-stage CKD, NOACs had a benefit–risk profile superior to that of VKAs. For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs or NOACs. Primary Funding Source: None. (PROSPERO: CRD42017079709

    The association of depression and all-cause and cause-specific mortality: an umbrella review of systematic reviews and meta-analyses

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    Background: Depression is a prevalent and disabling mental disorder that frequently co-occurs with a wide range of chronic conditions. Evidence has suggested that depression could be associated with excess all-cause mortality across different settings and populations, although the causality of these associations remains unclear. Methods: We conducted an umbrella review of systematic reviews and meta-analyses of observational studies. PubMed, PsycINFO, and Embase electronic databases were searched through January 20, 2018. Systematic reviews and meta-analyses that investigated associations of depression and all-cause and cause-specific mortality were selected for the review. The evidence was graded as convincing, highly suggestive, suggestive, or weak based on quantitative criteria that included an assessment of heterogeneity, 95% prediction intervals, small-study effects, and excess significance bias. Results: A total of 26 references providing 2 systematic reviews and data for 17 meta-analytic estimates met inclusion criteria (19 of them on all-cause mortality); data from 246 unique studies (N = 3,825,380) were synthesized. All 17 associations had P < 0.05 per random effects summary effects, but none of them met criteria for convincing evidence. Associations of depression and all-cause mortality in patients after acute myocardial infarction, in individuals with heart failure, in cancer patients as well as in samples from mixed settings met criteria for highly suggestive evidence. However, none of the associations remained supported by highly suggestive evidence in sensitivity analyses that considered studies employing structured diagnostic interviews. In addition, associations of depression and all-cause mortality in cancer and post-acute myocardial infarction samples were supported only by suggestive evidence when studies that tried to adjust for potential confounders were considered. Conclusions: Even though associations between depression and mortality have nominally significant results in all assessed settings and populations, the evidence becomes weaker when focusing on studies that used structured interviews and those that tried to adjust for potential confounders. A causal effect of depression on all-cause and cause-specific mortality remains unproven, and thus interventions targeting depression are not expected to result in lower mortality rates at least based on current evidence from observational studies

    Analysis and Implementation of OVSF Address Decoders

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    International audienceDemand for Internet of Things (IoT) devices has generated interest in fault-tolerant address decoders. Address decoders affect the energy required to establish a data link and monitor a wireless channel through metrics such as detection probability and false alarm probability. This brief establishes a framework for calculating detection and false alarm probabilities and shows that limiting the number of correctable errors eliminates simultaneous false alarms, reduces the probability of false alarm, and reduces the maximum normalized power consumption of a sleep node due to false alarms by 16.9 dB. The probability expressions are formulated so that the detection probability, the false alarm probability, the energy to transmit, and the power to monitor a channel can be adjusted digitally, yielding a counter-based implementation that reduces the energy consumption of the address decoder to 1.3 pJ/bit for a data rate of 200 bps in 0.18 μm CMO

    Implementation of the Frailty Care Bundle (FCB) to promote mobilisation, nutrition and cognitive engagement in older people in acute care settings: protocol for an implementation science study

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    Background: Older people are among the most vulnerable patients in acute care hospitals. The hospitalisation process can result in newly acquired functional or cognitive deficits termed hospital associated decline (HAD). Prioritising fundamental care including mobilisation, nutrition, and cognitive engagement can reduce HAD risk. Aim: The Frailty Care Bundle (FCB) intervention aims to implement and evaluate evidence-based principles on early mobilisation, enhanced nutrition and increased cognitive engagement to prevent functional decline and HAD in older patients. Methods: A hybrid implementation science study will use a pragmatic prospective cohort design with a pre-post mixed methods evaluation to test the effect of the FCB on patient, staff, and health service outcomes. The evaluation will include a description of the implementation process, intervention adaptations, and economic costs analysis. The protocol follows the Standards for Reporting Implementation Studies (StaRI). The intervention design and implementation strategy will utilise the behaviour change theory COM-B (capability, motivation, opportunity) and the Promoting Action on Research Implementation in Health Services (i-PARIHS). A clinical facilitator will use a co-production approach with staff. All patients will receive care as normal, the intervention is delivered at ward level and focuses on nurses and health care assistants (HCA) normative clinical practices. The intervention will be delivered in three hospitals on six wards including rehabilitation, acute trauma, medical and older adult wards. Evaluation: The evaluation will recruit a volunteer sample of 180 patients aged 65 years or older (pre 90; post 90 patients). The primary outcomes are measures of functional status (modified Barthel Index (MBI)) and mobilisation measured as average daily step count using accelerometers. Process data will include ward activity mapping, staff surveys and interviews and an economic cost-impact analysis. Conclusions: This is a complex intervention that involves ward and system level changes and has the potential to improve outcomes for older patients

    Disruption of an ant-plant mutualism shapes interactions between lions and their primary prey

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    Mutualisms often define ecosystems, but they are susceptible to human activities. Combining experiments, animal tracking, and mortality investigations, we show that the invasive big-headed ant (Pheidole megacephala) makes lions (Panthera leo) less effective at killing their primary prey, plains zebra (Equus quagga). Big-headed ants disrupted the mutualism between native ants (Crematogaster spp.) and the dominant whistling-thorn tree (Vachellia drepanolobium), rendering trees vulnerable to elephant (Loxodonta africana) browsing and resulting in landscapes with higher visibility. Although zebra kills were significantly less likely to occur in higher-visibility, invaded areas, lion numbers did not decline since the onset of the invasion, likely because of prey-switching to African buffalo (Syncerus caffer). We show that by controlling biophysical structure across landscapes, a tiny invader reconfigured predator-prey dynamics among iconic species
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