42 research outputs found

    Improving the framework for assessment of ecological change in the Arctic: A circumpolar synthesis of freshwater biodiversity

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    1. Climate warming and subsequent landscape transformations result in rapid ecological change in Arctic freshwaters. Here we provide a synthesis of the diversity of benthic diatoms, plankton, macrophytes, macroinvertebrates, and fish in Arctic freshwaters.2. We developed a multi-organism measure of alpha diversity to characterise circumpolar spatial patterns and their environmental correlates, and we assessed ecoregion-level beta diversity for all organism groups across the Arctic.3. Alpha diversity was lowest at high latitudes and elevations and where dispersal barriers exist. Diversity was positively related to temperature, and both temperature and connectivity limited diversity on high latitude islands. Beta diversity was highly variable among ecoregions for most organism groups, ranging from 0 (complete similarity) to 1 (complete dissimilarity). The high degree of dissimilarity within many ecoregions illustrates the uniqueness of many Arctic freshwater communities.4. Northward range expansion of freshwater taxa into Arctic regions may lead to increased competition for cold-stenothermic and cold-adapted species, and ultimately lead to the extinction of unique Arctic species. Societal responses to predicted impacts include: (1) actions to improve detection of changes (e.g., harmonised monitoring, remote sensing) and engagement with Arctic residents and Indigenous Peoples; and (2) actions to reduce the impact of unwanted changes (e.g., reductions of CO2 emissions, action against the spread of invasive species).5. Current Arctic freshwater monitoring shows large gaps in spatial coverage, while time series data are scarce. Arctic countries should develop an intensified, long-term monitoring programme with routine reporting. Such an approach will allow detection of long-term changes in water quality, biodiversity, and ecosystem services of Arctic freshwaters

    Patient-reported outcome measures of the impact of cancer on patient’s everyday lives: a systematic review

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    Purpose: Patients with advanced disease are living longer and commonly used patient-reported outcome measures (PROMs) may miss relevant elements of the quality of extended survival. This systematic review examines the measures used to capture aspects of the quality of survival including impact on patients’ everyday lives such as finances, work and family roles. Methods: Searches were conducted in MEDLINE, EMBASE, CINAHL and PsycINFO restricted to English language articles. Information on study characteristics, instruments and outcomes was systematically extracted and synthesised. A predefined set of criteria was used to rate the quality of studies. Results: From 2761 potentially relevant articles, 22 met all inclusion criteria, including 10 concerning financial distress, 3 on roles and responsibilities and 9 on multiple aspects of social well-being. Generally, studies were not of high quality; many lacked bias free participant selection, had confounding factors and had not accounted for all participants. High levels of financial distress were reported and were associated with multiple demographic factors such as age and income. There were few reports concerned with impacts on patients’ roles/responsibilities in everyday life although practical and emotional struggles with parenting were identified. Social difficulties were common and associated with multiple factors including being a caregiver. Many studies were single time-point surveys and used non-validated measures. Exceptions were employment of the COST and Social Difficulties Inventory (SDI), validated measures of financial and social distress respectively. Conclusions: Impact on some important parts of patients’ everyday lives is insufficiently and inconsistently captured. Further PROM development focussing on roles and responsibilities, including work and caring for dependents, is warranted. Implications for Cancer Survivors: Factors such as finances, employment and responsibility for caring for dependents (e.g. children and elderly relatives) can affect the well-being of cancer survivors. There is a need to ensure that any instruments used to assess patients’ social well-being are broad enough to include these areas so that any difficulties arising can be better understood and appropriately supported
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