A Methodology for the Assessment of Climate Change Adaptation Options for Cultural Heritage Sites

Cultural sites are particularly important to Indigenous peoples, their identity, cosmology and sociopolitical traditions. The benefits of local control, and a lack of professional resources, necessitate the development of planning tools that support independent Indigenous cultural site adaptation. We devised and tested a methodology for non-heritage professionals to analyse options that address site loss, build site resilience and build local adaptive capacity. Indigenous rangers from Kakadu National Park and the Djelk Indigenous Protected Area, Arnhem Land, Australia, were engaged as fellow researchers via a participatory action research methodology. Rangers rejected coastal defences and relocating sites, instead prioritising routine use of a risk field survey, documentation of vulnerable sites using new digital technologies and widely communicating the climate change vulnerability of sites via a video documentary. Results support the view that rigorous approaches to cultural site adaptation can be employed independently by local Indigenous stakeholders

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Using Multiple Sources of Knowledge to Reach Clinical Understanding of Chronic Fatigue Syndrome

PURPOSE Chronic fatigue syndrome (CFS), or myalgic encephalitis (ME), is a contentious condition and often a diagnosis of exclusion. Current policy in the United Kingdom recommends management in primary care. We explored how patients with CFS/ME and family physicians understand this condition and how their understanding might affect the primary care consultation

Australian Indigenous rangers managing the impacts of climate change on cultural heritage sites

Over 100 Australian Indigenous ranger groups manage a significant proportion of Australia’s natural and cultural resources. Two Indigenous ranger groups in Australia’s monsoonal far north are concerned about a perceived escalation of impacts on cultural heritage sites arising from climate change, variation and extremes. A preliminary version of a tool to assist them in managing these impacts was synthesised from other community-based climate adaptation tools. It contained phases for scoping, risk analysis and options analysis. In the testing and further development of the tool, rangers identified risks to shell mounds and middens (remains of shellfish meals that have accumulated over time), earth mounds (mounds of earth that contain cultural material) and rock art (paintings and engravings found in caves and open sites) caused by more frequent and extreme sea level rise events, and inland river flooding events. They set goals, considered barriers and assessed the availability of appropriate resources. During the tools risk analysis phase, rangers sought to prioritise sites with the greatest exposure and sensitivity to not only the identified climate impacts but also a range of other threats such as fi re and feral animals. While the risk analysis phase used a modified field survey approach, it sought to complement the original model with a cultural value assessment methodology that would allow further prioritisation on the basis of site significance. To date, over 100 sites have been assessed with the tool and allocated one of five possible management priorities. In considering adaptive options, rangers confronted limits to climate change adaptation for the prioritised heritage sites. For sites most in peril from climate extremes, digital documentation was chosen over salvage or physical protection. However, rangers were concerned that confinement of sites to a database would undermine their ongoing use of them in traditional cultural practice. They therefore considered the possibility of combining photogrammetry-derived 3-D models with augmented-reality applications to re-experience lost sites in their original non-virtual locations. Validation of ranger group organisational capacity to use the climate change planning tool bodes well for its use by other Indigenous ranger groups

Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis

Abstract Background The evidence base for a range of psychosocial and behavioural interventions in managing and supporting patients with long-term conditions (LTCs) is now well-established. With increasing numbers of such patients being managed in primary care, and a shortage of specialists in psychology and behavioural management to deliver interventions, therapeutic interventions are increasingly being delivered by general nurses with limited training in psychological interventions. It is unknown what issues this raises for the nurses or their patients. The purpose of the study was to examine the challenges faced by non-specialist nurses when delivering psychological interventions for an LTC (chronic fatigue syndrome/myalgic encephalomyelitis [CFS/ME]) within a primary care setting. Methods A qualitative study nested within a randomised controlled trial [ISRCTN 74156610] explored the experiences and acceptability of two different psychological interventions (pragmatic rehabilitation and supportive listening) from the perspectives of nurses, their supervisors, and patients. Semi structured in-depth interviews were conducted with three nurse therapists, three supervisors, and 46 patients. An iterative approach was used to develop conceptual categories from the dataset. Results Analyses identified four sets of challenges that were common to both interventions: (i) being a novice therapist, (ii) engaging patients in the therapeutic model, (iii) dealing with emotions, and (iv) the complexity of primary care. Each challenge had the potential to cause tension between therapist and patient. A number of strategies were developed by participants to manage the tensions. Conclusions Tensions existed for nurses when attempting to deliver psychological interventions for patients with CFS/ME in this primary care trial. Such tensions should be addressed before implementing psychological interventions within routine clinical practice. Similar tensions may be found for other LTCs. Our findings have implications for developing therapeutic alliances and highlight the need for regular supervision.</p