Knowledge About and Attitudes towards End of Life Care for Gay, Lesbian, Bisexual & Transgender People (Phase 2)

Increasing evidence suggests that many gay, lesbian, bisexual and transgender (GLBT) people are being denied their legal rights in their own end-of-life care and the end-of-life care of their partners and other important people in their lives. A study in the Northern Rivers region of NSW in 2009, which investigated end-of-life care issues for GLBT people and the use of legal mechanisms such as Advance Care Planning to support the rights of GLBT people at the end of life (Lienert T, Cartwright C, Beck K. 2010) found evidence of active discrimination and abuse of GLBT people. Building on the findings of the Phase 1 study, a second State-wide study funded by a grant from the Law and Justice Foundation of NSW was conducted in 2009-2010.Stage 1, which is the subject of this Report, is a state-wide hard copy and on-line survey and a series of in-depth interviews

The Experiences of Gay, Lesbian, Bisexual and Transgender People around End-of-Life Care

All States and Territories in Australia have implemented legislation relating to end-of-life decision-making and substitute judgment. However, reports to relevant legal and community services indicate that many gay, lesbian, bisexual and transgender (GLBT) people in NSW -- estimated to be about four to five percent of the population -- are being denied their legal rights in the end-of-life care of their partners and other important people in their lives

Must Do @ VCU

Must Do @ VCU is a set of annual collegial activities that can be performed throughout the year, by faculty, staff and students. These VCU-centered activities are considered to be the things that give VCU its identity. The goal of Must Do @ VCU is to generate a sense of community and of belonging to the University. VCU is a relatively new University and its traditions are therefore not well-established. Must Do @ VCU aims to build on shared experiences as a method to establish VCU culture

The Data Imaginary: Fears and Fantasies

The Data Imaginary: Fears and Fantasies brings together eminent and emerging artists and designers to show how creative applications of data technology are crucial for a vital, inclusive and sustainable future. The exhibition includes artworks and designs that engage audiences in critical, playful and agentic reflections on data and creative technologies. Through the exhibition, workshops, podcast and publication, the audience will be empowered to respond to climate change patterns and future city design, interact with empathy from remote locations, learn about Indigenous cultural knowledges and reflect on everyday habits that secure data privacy. Dedicated url: http://thedataimaginary.com

Clinical Experience and Examination Performance: Is There a Correlation?

Context  The Liaison Committee on Medical Education (LCME) requires there to be: ‘…comparable educational experiences and equivalent methods of evaluation across all alternative instructional sites within a given discipline’. It is an LCME accreditation requirement that students encounter similar numbers of patients with similar diagnoses. However, previous empirical studies have not shown a correlation between the numbers of patients seen by students and performance on multiple-choice examinations. Objective  This study examined whether student exposure to patients with specific diagnoses predicts performance on multiple-choice examination questions pertaining to those diagnoses. Methods  The Department of Pediatrics at the University of Nebraska Medical Center has collected patient logbooks from clerks since 1994. These contain information on patient demographics and students\u27 roles in patient care. During week 7 of an 8-week course, students took an examination intended to help them prepare for their final examination. Logbooks and pre-examination questions were coded using standard ICD-9 codes. Data were analysed using Minitab statistical software to determine dependence between patient encounters and test scores. Subjects comprised a convenience sample of students who completed the clerkship during 1997−2000. Results  Our analysis indicates that performance on a multiple-choice examination is independent of the number of patients seen. Conclusions  Our data suggest knowledge-based examination performance cannot be predicted by the volume of patients seen. Therefore, too much emphasis on examination performance in clinical courses should be carefully weighed against clinical performance to determine the successful completion of clerkships

How much marsh restoration is enough to deliver wave attenuation coastal protection benefits?

© The Author(s), 2022. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Castagno, K., Ganju, N., Beck, M., Bowden, A., & Scyphers, S. How much marsh restoration is enough to deliver wave attenuation coastal protection benefits? Frontiers in Marine Science, 8, (2022): 756670, https://doi.org/10.3389/fmars.2021.756670.As coastal communities grow more vulnerable to sea-level rise and increased storminess, communities have turned to nature-based solutions to bolster coastal resilience and protection. Marshes have significant wave attenuation properties and can play an important role in coastal protection for many communities. Many restoration projects seek to maximize this ecosystem service but how much marsh restoration is enough to deliver measurable coastal protection benefits is still unknown. This question is critical to guiding assessments of cost effectiveness and for funding, implementation, and optimizing of marsh restoration for risk reduction projects. This study uses SWAN model simulations to determine empirical relationships between wave attenuation and marsh vegetation. The model runs consider several different common marsh morphologies (including systems with channels, ponds, and fringing mudflats), vegetation placement, and simulated storm intensity. Up to a 95% reduction in wave energy is seen at as low as 50% vegetation cover. Although these empirical relationships between vegetative cover and wave attenuation provide essential insight for marsh restoration, it is also important to factor in lifespan estimates of restored marshes when making overall restoration decisions. The results of this study are important for coastal practitioners and managers seeking performance goals and metrics for marsh restoration, enhancement, and creation

Controlled clinical trial of canine therapy versus usual care to reduce patient anxiety in the emergency department

Objective Test if therapy dogs reduce anxiety in emergency department (ED) patients. Methods In this controlled clinical trial (NCT03471429), medically stable, adult patients were approached if the physician believed that the patient had “moderate or greater anxiety.” Patients were allocated on a 1:1 ratio to either 15 min exposure to a certified therapy dog and handler (dog), or usual care (control). Patient reported anxiety, pain and depression were assessed using a 0–10 scale (10 = worst). Primary outcome was change in anxiety from baseline (T0) to 30 min and 90 min after exposure to dog or control (T1 and T2 respectively); secondary outcomes were pain, depression and frequency of pain medication. Results Among 93 patients willing to participate in research, 7 had aversions to dogs, leaving 86 (92%) were willing to see a dog six others met exclusion criteria, leaving 40 patients allocated to each group (dog or control). Median and mean baseline anxiety, pain and depression scores were similar between groups. With dog exposure, median anxiety decreased significantly from T0 to T1: 6 (IQR 4–9.75) to T1: 2 (0–6) compared with 6 (4–8) to 6 (2.5–8) in controls (P<0.001, for T1, Mann-Whitney U and unpaired t-test). Dog exposure was associated with significantly lower anxiety at T2 and a significant overall treatment effect on two-way repeated measures ANOVA for anxiety, pain and depression. After exposure, 1/40 in the dog group needed pain medication, versus 7/40 in controls (P = 0.056, Fisher’s exact test). Conclusions Exposure to therapy dogs plus handlers significantly reduced anxiety in ED patients

Auditing the Editor: A Review of Key Translational Issues in Epigenetic Editing

Currently, most advances in site-specific epigenetic editing for human use are concentrated in basic research, yet, there is considerable interest to translate this technology beyond the bench. This review highlights recent developments with epigenetic editing technology in comparison with the canonical CRISPR-Cas genome editing, as well as the epistemic and ethical considerations with preemptive translation of epigenetic editing into clinical or commercial use in humans. Key considerations in safety, equity, and access to epigenetic editing are highlighted, with a spotlight on the ethical, legal, and social issues of this technology in the context of global health equity

The tammar wallaby major histocompatibility complex shows evidence of past genomic instability

BACKGROUND The major histocompatibility complex (MHC) is a group of genes with a variety of roles in the innate and adaptive immune responses. MHC genes form a genetically linked cluster in eutherian mammals, an organization that is thought to confer functional and evolutionary advantages to the immune system. The tammar wallaby (Macropus eugenii), an Australian marsupial, provides a unique model for understanding MHC gene evolution, as many of its antigen presenting genes are not linked to the MHC, but are scattered around the genome. RESULTS Here we describe the 'core' tammar wallaby MHC region on chromosome 2q by ordering and sequencing 33 BAC clones, covering over 4.5 MB and containing 129 genes. When compared to the MHC region of the South American opossum, eutherian mammals and non-mammals, the wallaby MHC has a novel gene organization. The wallaby has undergone an expansion of MHC class II genes, which are separated into two clusters by the class III genes. The antigen processing genes have undergone duplication, resulting in two copies of TAP1 and three copies of TAP2. Notably, Kangaroo Endogenous Retroviral Elements are present within the region and may have contributed to the genomic instability. CONCLUSIONS The wallaby MHC has been extensively remodeled since the American and Australian marsupials last shared a common ancestor. The instability is characterized by the movement of antigen presenting genes away from the core MHC, most likely via the presence and activity of retroviral elements. We propose that the movement of class II genes away from the ancestral class II region has allowed this gene family to expand and diversify in the wallaby. The duplication of TAP genes in the wallaby MHC makes this species a unique model organism for studying the relationship between MHC gene organization and function.This work was funded by an ARC Discovery Grant to KB and SB, and a Wellcome Trust Grant (084071) to SB. HVS was supported by a University of Sydney Postgraduate Award and a William and Catherine McIlrath Scholarship for travel to the Sanger Institute. JK and HVS are supported in part by Wellcome Trust Programme grant 089305. KB is supported by a University of Sydney Thompson fellowship and an ARC Future Fellowship