147 research outputs found

    Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: A comprehensive review

    Get PDF
    Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples’ preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly’s hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples’ experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas

    Expanding NEON biodiversity surveys with new instrumentation and machine learning approaches

    Full text link
    A core goal of the National Ecological Observatory Network (NEON) is to measure changes in biodiversity across the 30-yr horizon of the network. In contrast to NEON’s extensive use of automated instruments to collect environmental data, NEON’s biodiversity surveys are almost entirely conducted using traditional human-centric field methods. We believe that the combination of instrumentation for remote data collection and machine learning models to process such data represents an important opportunity for NEON to expand the scope, scale, and usability of its biodiversity data collection while potentially reducing long-term costs. In this manuscript, we first review the current status of instrument-based biodiversity surveys within the NEON project and previous research at the intersection of biodiversity, instrumentation, and machine learning at NEON sites. We then survey methods that have been developed at other locations but could potentially be employed at NEON sites in future. Finally, we expand on these ideas in five case studies that we believe suggest particularly fruitful future paths for automated biodiversity measurement at NEON sites: acoustic recorders for sound-producing taxa, camera traps for medium and large mammals, hydroacoustic and remote imagery for aquatic diversity, expanded remote and ground-based measurements for plant biodiversity, and laboratory-based imaging for physical specimens and samples in the NEON biorepository. Through its data science-literate staff and user community, NEON has a unique role to play in supporting the growth of such automated biodiversity survey methods, as well as demonstrating their ability to help answer key ecological questions that cannot be answered at the more limited spatiotemporal scales of human-driven surveys

    Multiple Organ System Defects and Transcriptional Dysregulation in the Nipbl+/− Mouse, a Model of Cornelia de Lange Syndrome

    Get PDF
    Cornelia de Lange Syndrome (CdLS) is a multi-organ system birth defects disorder linked, in at least half of cases, to heterozygous mutations in the NIPBL gene. In animals and fungi, orthologs of NIPBL regulate cohesin, a complex of proteins that is essential for chromosome cohesion and is also implicated in DNA repair and transcriptional regulation. Mice heterozygous for a gene-trap mutation in Nipbl were produced and exhibited defects characteristic of CdLS, including small size, craniofacial anomalies, microbrachycephaly, heart defects, hearing abnormalities, delayed bone maturation, reduced body fat, behavioral disturbances, and high mortality (75–80%) during the first weeks of life. These phenotypes arose despite a decrease in Nipbl transcript levels of only ∼30%, implying extreme sensitivity of development to small changes in Nipbl activity. Gene expression profiling demonstrated that Nipbl deficiency leads to modest but significant transcriptional dysregulation of many genes. Expression changes at the protocadherin beta (Pcdhb) locus, as well as at other loci, support the view that NIPBL influences long-range chromosomal regulatory interactions. In addition, evidence is presented that reduced expression of genes involved in adipogenic differentiation may underlie the low amounts of body fat observed both in Nipbl+/− mice and in individuals with CdLS

    Similarity of Traveling-Wave Delays in the Hearing Organs of Humans and Other Tetrapods

    Get PDF
    Transduction of sound in mammalian ears is mediated by basilar-membrane waves exhibiting delays that increase systematically with distance from the cochlear base. Most contemporary accounts of such “traveling-wave” delays in humans have ignored postmortem basilar-membrane measurements in favor of indirect in vivo estimates derived from brainstem-evoked responses, compound action potentials, and otoacoustic emissions. Here, we show that those indirect delay estimates are either flawed or inadequately calibrated. In particular, we argue against assertions based on indirect estimates that basilar-membrane delays are much longer in humans than in experimental animals. We also estimate in vivo basilar-membrane delays in humans by correcting postmortem measurements in humans according to the effects of death on basilar-membrane vibrations in other mammalian species. The estimated in vivo basilar-membrane delays in humans are similar to delays in the hearing organs of other tetrapods, including those in which basilar membranes do not sustain traveling waves or that lack basilar membranes altogether

    Harnessing the NEON data revolution to advance open environmental science with a diverse and data-capable community

    Get PDF
    It is a critical time to reflect on the National Ecological Observatory Network (NEON) science to date as well as envision what research can be done right now with NEON (and other) data and what training is needed to enable a diverse user community. NEON became fully operational in May 2019 and has pivoted from planning and construction to operation and maintenance. In this overview, the history of and foundational thinking around NEON are discussed. A framework of open science is described with a discussion of how NEON can be situated as part of a larger data constellation—across existing networks and different suites of ecological measurements and sensors. Next, a synthesis of early NEON science, based on >100 existing publications, funded proposal efforts, and emergent science at the very first NEON Science Summit (hosted by Earth Lab at the University of Colorado Boulder in October 2019) is provided. Key questions that the ecology community will address with NEON data in the next 10 yr are outlined, from understanding drivers of biodiversity across spatial and temporal scales to defining complex feedback mechanisms in human–environmental systems. Last, the essential elements needed to engage and support a diverse and inclusive NEON user community are highlighted: training resources and tools that are openly available, funding for broad community engagement initiatives, and a mechanism to share and advertise those opportunities. NEON users require both the skills to work with NEON data and the ecological or environmental science domain knowledge to understand and interpret them. This paper synthesizes early directions in the community’s use of NEON data, and opportunities for the next 10 yr of NEON operations in emergent science themes, open science best practices, education and training, and community building

    EVALUATION OF GAMMA-RAY ATTENUATION TECHNIQUES FOR MEASURING THE DENSITY AND HOMOGENEITY OF THORIUM OXIDE SLURRIES CIRCULATING AT 300 C

    No full text
    The feasftbility of using gamma -ray attenuation techniques was demonstrated in determining the density and homogeneity of slurries circulating at 300 deg C. The method appears to have general utility in the engineering studies of slurry because the equipment is mounted externally and does not interfere with the system under investigation. Two types of detector systems were evaluated for routine service. The decimal counter-recorder system was found more adaptable for rugged operations, whereas the single channel analyzer was fouW to be more accurate and flexible. (auth
    corecore