Education and training methods for healthcare professionals to lead conversations concerning deceased organ donation: An integrative review

Objectives: To determine which training methods positively influenced healthcare professionals’ communication skills and families’ deceased organ donation decision-making. Methods: An integrative review using systematic methods and narrative synthesis for data analysis. Electronic databases of PubMed, Cumulative Index to Nursing and Allied Health Literature (EBSCO), Embase (OVID) and ProQuest Dissertations & Theses Global, were searched between August 1997 and March 2020, retrieving 1019 papers. Included papers (n = 14) were appraised using the Medical Education Research Study Quality Instrument. Results: Training programmes offered theory, experiential learning, feedback and debriefing including self-reflection, the opportunity to role-play and interact with simulated participants within realistic case scenarios. Programmes reported observed and self-rated improvements in communication learning and confidence. The methodological quality score averaged 13, (72% of maximum); few studies used an experimental design, examined behavioural change or families’ perspectives. Weak evidence suggested training could increase organ donation authorisation/consent rates. Conclusions: Multiple training strategies are effective in improving interprofessional healthcare professionals’ confidence and learning of specialised communication. Methodological limitations restricted the ability to present definitive recommendations and further research is warranted, inclusive of family decision-making experiences. Practice implications: Learning of specialised communication skills is enhanced by using multiple training strategies, including role-play and debriefing

Plant Growth Optimization by Vegetable Production System in HI-SEAS Analog Habitat

The Vegetable Production System (Veggie) is a scientific payload designed to support plant growth for food production under microgravity conditions. The configuration of Veggie consists of an LED lighting system with modular rooting pillows designed to contain substrate media and time-release fertilizer. The pillows were designed to be watered passively using capillary principles but have typically been watered manually by the astronauts in low-Earth orbit (LEO). The design of Veggie allows cabin air to be drawn through the plant enclosure for thermal and humidity control and for supplying CO2 to the plants. Since its delivery to the International Space Station (ISS) in 2014, Veggie has undergone several experimental trials by various crews. Ground unit testing of Veggie was conducted during an 8-month Mars analog study in a semi-contained environment of a simulated habitat located at approximately 8,200 feet (2,500 m) elevation on the Mauna Loa volcano on the Island of Hawaii. The Hawaii Space Exploration Analog and Simulation (HI-SEAS) offered conditions (habitat, mission, communications, etc.) intended to simulate a planetary exploration mission. This paper provides data and analyses to show the prospect for optimized use of the current Veggie design for human habitats. Lessons learned during the study may provide opportunities for updating the system design and operational parameters for current Veggie experiments being conducted onboard the ISS and for payloads on future deep space missions

Geographical and climatic limits of needle types of one- and two-needled pinyon pines

Aim The geographical extent and climatic tolerances of one- and two-needled pinyon pines (Pinus subsect. Cembroides) are the focus of questions in taxonomy, palaeoclimatology and modelling of future distributions. The identification of these pines, traditionally classified by one- versus two-needled fascicles, is complicated by populations with both one- and two-needled fascicles on the same tree, and the description of two more recently described one-needled varieties: the fallax-type and californiarum-type. Because previous studies have suggested correlations between needle anatomy and climate, including anatomical plasticity reflecting annual precipitation, we approached this study at the level of the anatomy of individual pine needles rather than species. Location Western North America. Methods We synthesized available and new data from field and herbarium collections of needles to compile maps of their current distributions across western North America. Annual frequencies of needle types were compared with local precipitation histories for some stands. Historical North American climates were modeled on a c. 1-km grid using monthly temperature and precipitation values. A geospatial model (ClimLim), which analyses the effect of climate modulated physiological and ecosystem processes, was used to rank the importance of seasonal climate variables in limiting the distributions of anatomical needle types. Results The pinyon needles were classified into four distinct types based upon the number of needles per fascicle, needle thickness and the number of stomatal rows and resin canals. The individual needles fit well into four categories of needle types, whereas some trees exhibit a mixture of two needle types. Trees from central Arizona containing a mixture of Pinus edulis and fallax-type needles increased their percentage of fallax-type needles following dry years. All four needle types occupy broader geographical regions with distinctive precipitation regimes. Pinus monophylla and californiarum-type needles occur in regions with high winter precipitation. Pinus edulis and fallax-type needles are found in regions with high monsoon precipitation. Areas supporting californiarum-type and fallax-type needle distributions are additionally characterized by a more extreme May–June drought. Main conclusions These pinyon needle types seem to reflect the amount and seasonality of precipitation. The single needle fascicle characterizing the fallax type may be an adaptation to early summer or periodic drought, while the single needle of Pinus monophylla may be an adaptation to summer–autumn drought. Although the needles fit into four distinct categories, the parent trees are sometimes less easily classified, especially near their ancestral Pleistocene ranges in the Mojave and northern Sonoran deserts. The abundance of trees with both one- and two-needled fascicles in the zones between P. monophylla, P. edulis and fallax-type populations suggest that needle fascicle number is an unreliable characteristic for species classification. Disregarding needle fascicle number, the fallax-type needles are nearly identical to P. edulis, supporting Little’s (1968) initial classification of these trees as P. edulis var. fallax, while the californiarum-type needles have a distinctive morphology supporting Bailey’s (1987) classification of this tree as Pinus californiarum

Thinking about growth : a cognitive mapping approach to understanding small business development

School of Managemen

Projecting the Bethe-Salpeter Equation onto the Light-Front and back: A Short Review

The technique of projecting the four-dimensional two-body Bethe-Salpeter equation onto the three-dimensional Light-Front hypersurface, combined with the quasi-potential approach, is briefly illustrated, by placing a particular emphasis on the relation between the projection method and the effective dynamics of the valence component of the Light-Front wave function. Some details on how to construct the Fock expansion of both i) the Light-Front effective interaction and ii) the electromagnetic current operator, satisfying the proper Ward-Takahashi identity, will be presented, addressing the relevance of the Fock content in the operators living onto the Light-Front hypersurface. Finally, the generalization of the formalism to the three-particle case will be outlined.Comment: 16 pages, macros included. Mini-review to be printed in a regular issue of Few-Body Systems devoted to the Workshop on "Relativistic Description of Two- and Three-body Systems in Nuclear Physics" ECT* Trento, 19 - 23 October 200

Exploring rumen microbe-derived fibre-degrading activities for improving feed digestibility

Ruminal fibre degradation is mediated by a complex community of rumen microbes, and its efficiency is crucial for optimal dairy productivity. Enzymes produced by rumen microbes are primarily responsible for degrading the complex structural polysaccharides that comprise fibre in the plant cell walls of feed materials. Because rumen microbes have evolved with their ruminant hosts over millions of years to perform this task, their enzymes are hypothesised to be optimally suited for activity at the temperature, pH range, and anaerobic environment of the rumen. However, fibre-rich diets are not fully digested, which represents a loss in potential animal productivity. Thus, there is opportunity to improve fibre utilisation through treating feeds with rumen microbe-derived fibrolytic enzymes and associated activities that enhance fibre degradation. This research aims to gain a better understanding of the key rumen microbes involved in fibre degradation and the mechanisms they employ to degrade fibre, by applying cultivation-based and culture-independent genomics approaches to rumen microbial communities of New Zealand dairy cattle. Using this knowledge, we aim to identify new opportunities for improving fibre degradation to enhance dairy productivity. Rumen content samples were taken over the course of a year from a Waikato dairy production herd. Over 1,000 rumen bacterial cultures were obtained from the plant-adherent fraction of the rumen contents. Among these cultures, two, 59 and 103 potentially new families, genera and species of rumen bacteria were identified, respectively. Many of the novel strains are being genome sequenced within the Hungate 1000 rumen microbial reference genome programme, which is providing deeper insights into the range of mechanisms used by the individual strains for fibre degradation. This information has been used to guide the selection of rumen bacterial strains with considerable potential as fibrolytic enzyme producers in vitro, with the intent of developing the strains so that their enzymes may be used as feed pre-treatments for use on farm. Culture-independent metagenomic approaches were also used to explore the activities involved in fibre degradation from the rumen microbial communities. Functional screening has revealed a range of novel enzymes and a novel fibre disrupting activity. Enrichment for the cell-secreted proteins from the community revealed evidence of a diverse range of cellulosomes, which are cell-surface associated multi-enzyme complexes that efficiently degrade plant cell wall polysaccharides. Biochemical and structural characterisation of these proteins has been conducted. In conclusion, cultivation and culture-independent genomic approaches have been applied to New Zealand bovine rumen microbial communities, and have provided considerable new insights into ruminal fibre degradation processes. Novel activities and bacterial species that display desirable activities on fibrous substrates in vitro are now being explored for their potential to improve ruminal fibre degradation, to allow the development of new technologies that will enhance dairy productivity

An action for the exact string black hole

A local action is constructed describing the exact string black hole discovered by Dijkgraaf, Verlinde and Verlinde in 1992. It turns out to be a special 2D Maxwell-dilaton gravity theory, linear in curvature and field strength. Two constants of motion exist: mass M>1, determined by the level k, and U(1)-charge Q>0, determined by the value of the dilaton at the origin. ADM mass, Hawking temperature T_H \propto \sqrt{1-1/M} and Bekenstein-Hawking entropy are derived and studied in detail. Winding/momentum mode duality implies the existence of a similar action, arising from a branch ambiguity, which describes the exact string naked singularity. In the strong coupling limit the solution dual to AdS_2 is found to be the 5D Schwarzschild black hole. Some applications to black hole thermodynamics and 2D string theory are discussed and generalizations - supersymmetric extension, coupling to matter and critical collapse, quantization - are pointed out.Comment: 41 pages, 2 eps figures, dedicated to Wolfgang Kummer on occasion of his Emeritierung; v2: added ref; v3: extended discussion in sections 3.2, 3.3 and at the end of 5.3 by adding 2 pages of clarifying text; updated refs; corrected typo

Can forest management based on natural disturbances maintain ecological resilience?

Given the increasingly global stresses on forests, many ecologists argue that managers must maintain ecological resilience: the capacity of ecosystems to absorb disturbances without undergoing fundamental change. In this review we ask: Can the emerging paradigm of natural-disturbance-based management (NDBM) maintain ecological resilience in managed forests? Applying resilience theory requires careful articulation of the ecosystem state under consideration, the disturbances and stresses that affect the persistence of possible alternative states, and the spatial and temporal scales of management relevance. Implementing NDBM while maintaining resilience means recognizing that (i) biodiversity is important for long-term ecosystem persistence, (ii) natural disturbances play a critical role as a generator of structural and compositional heterogeneity at multiple scales, and (iii) traditional management tends to produce forests more homogeneous than those disturbed naturally and increases the likelihood of unexpected catastrophic change by constraining variation of key environmental processes. NDBM may maintain resilience if silvicultural strategies retain the structures and processes that perpetuate desired states while reducing those that enhance resilience of undesirable states. Such strategies require an understanding of harvesting impacts on slow ecosystem processes, such as seed-bank or nutrient dynamics, which in the long term can lead to ecological surprises by altering the forest's capacity to reorganize after disturbance

Optimised mixing and flow resistance during shear flow over a rib roughened boundary

A series of numerical investigations has been performed to study the effect of lower boundary roughness on turbulent flow in a two-dimensional channel. The roughness spacing to height ratio, w/k, has been investigated over the range 0.12 to 402 by varying the horizontal rib spacing. The square roughness elements each have a cross-sectional area of (0.05 H)2, where H is the full channel height. The Reynolds number, Reτ is fixed based on the value of the imposed pressure gradient, dp/dx, and is in the range 6.3 × 103 − 4.5 × 104. A Reynolds Averaged Navier–Stokes (RANS) based turbulence modelling approach is adopted using a commercial CFD code, ANSYS-CFX 14.0. Measurements of eddy viscosity and friction factor have been made over this range to establish the optimum spacings to produce maximum turbulence enhancement, mixing and resistance to flow. These occur when w/k is approximately 7. It is found that this value is only weakly dependent on Reynolds number, and the decay rate of turbulence enhancement as a function of w/k ratio beyond this optimum spacing is slow. The implications for heat transfer design optimisation and particle transport are considered