Supporting patients with low health literacy: what role do radiation therapists play?

Purpose: Health literacy plays a key role in a patient’s ability to use health information and services, and can affect health outcomes. This study aimed to explore radiation therapists’ perspectives on how they support people with lower health literacy who are undergoing radiotherapy. Methods: Semi-structured interviews were conducted with 25 radiation therapists working in radiation oncology departments in New South Wales, Australia. Results: The four key themes were (1) the process of identifying a patient with low health literacy, (2) the perceived consequences of low health literacy, (3) managing and responding to the needs of different health literacy groups and (4) recommendations to address low health literacy in radiotherapy. Radiation therapists appeared to make an informal, intuitive judgment about a patient’s health literacy, using a variety of verbal and non-verbal cues as well as impromptu conversations with the multi-disciplinary team. Patients perceived to have lower health literacy were described as having greater difficulties assimilating knowledge and engaging in self-care. Although participants reported communicating to patients at a basic level initially, they subsequently tailored their communication to match a patient’s health literacy. Strategies reported to communicate to low health literacy groups ranged from using lay language with minimal medical terminology, using visual aids (photos), using analogies, reiterating information and asking family members with higher literacy to attend consultations. Conclusion: A more structured approach to supporting patients with low health literacy and integrating health literacy training in radiation oncology departments may help to minimise the adverse outcomes typically experienced by this population

Communication about genetic testing with breast and ovarian cancer patients: a scoping review

© 2018, The Author(s). Genetic testing of patients with cancer is increasingly offered to guide management, resulting in a growing need for oncology health professionals to communicate genetics information and facilitate informed decision-making in a short time frame. This scoping review aimed to map and synthesise what is known about health professionals’ communication about genetic testing for hereditary breast and ovarian cancer with cancer patients. Four databases were systematically searched using a recognised scoping review method. Areas and types of research were mapped and a narrative synthesis of the findings was undertaken. Twenty-nine papers from 25 studies were included. Studies were identified about (i) information needs, (ii) process and content of genetic counselling, (iii) cognitive and emotional impact, including risk perception and recall, understanding and interpretation of genetic test results, and anxiety and distress, (iv) patients’ experiences, (v) communication shortly after diagnosis and (vi) alternatives to face-to-face genetic counselling. Patients’ need for cancer-focused, personalised information is not always met by genetic counselling. Genetic counselling tends to focus on biomedical information at the expense of psychological support. For most patients, knowledge is increased and anxiety is not raised by pre-test communication. However, some patients experience anxiety and distress when results are disclosed, particularly those tested shortly after diagnosis who are unprepared or unsupported. For many patients, pre-test communication by methods other than face-to-face genetic counselling is acceptable. Research is needed to identify patients who may benefit from genetic counselling and support and to investigate communication about hereditary breast and ovarian cancer by oncology health professionals

Framework for assessing and mitigating the impacts of offshore wind energy development on marine birds

Offshore wind energy development (OWED) is rapidly expanding globally and has the potential to contribute significantly to renewable energy portfolios. However, development of infrastructure in the marine environment presents risks to wildlife. Marine birds in particular have life history traits that amplify population impacts from displacement and collision with offshore wind infrastructure. Here, we present a broadly applicable framework to assess and mitigate the impacts of OWED on marine birds. We outline existing techniques to quantify impact via monitoring and modeling (e.g., collision risk models, population viability analysis), and present a robust mitigation framework to avoid, minimize, or compensate for OWED impacts. Our framework addresses impacts within the context of multiple stressors across multiple wind energy developments. We also present technological and methodological approaches that can improve impact estimation and mitigation. We highlight compensatory mitigation as a tool that can be incorporated into regulatory frameworks to mitigate impacts that cannot be avoided or minimized via siting decisions or alterations to OWED infrastructure or operation. Our framework is intended as a globally-relevant approach for assessing and mitigating OWED impacts on marine birds that may be adapted to existing regulatory frameworks in regions with existing or planned OWED

Diving into the vertical dimension of elasmobranch movement ecology

Knowledge of the three-dimensional movement patterns of elasmobranchs is vital to understand their ecological roles and exposure to anthropogenic pressures. To date, comparative studies among species at global scales have mostly focused on horizontal movements. Our study addresses the knowledge gap of vertical movements by compiling the first global synthesis of vertical habitat use by elasmobranchs from data obtained by deployment of 989 biotelemetry tags on 38 elasmobranch species. Elasmobranchs displayed high intra- and interspecific variability in vertical movement patterns. Substantial vertical overlap was observed for many epipelagic elasmobranchs, indicating an increased likelihood to display spatial overlap, biologically interact, and share similar risk to anthropogenic threats that vary on a vertical gradient. We highlight the critical next steps toward incorporating vertical movement into global management and monitoring strategies for elasmobranchs, emphasizing the need to address geographic and taxonomic biases in deployments and to concurrently consider both horizontal and vertical movements

Diving into the vertical dimension of elasmobranch movement ecology

Knowledge of the three-dimensional movement patterns of elasmobranchs is vital to understand their ecological roles and exposure to anthropogenic pressures. To date, comparative studies among species at global scales have mostly focused on horizontal movements. Our study addresses the knowledge gap of vertical movements by compiling the first global synthesis of vertical habitat use by elasmobranchs from data obtained by deployment of 989 biotelemetry tags on 38 elasmobranch species. Elasmobranchs displayed high intra- and interspecific variability in vertical movement patterns. Substantial vertical overlap was observed for many epipelagic elasmobranchs, indicating an increased likelihood to display spatial overlap, biologically interact, and share similar risk to anthropogenic threats that vary on a vertical gradient. We highlight the critical next steps toward incorporating vertical movement into global management and monitoring strategies for elasmobranchs, emphasizing the need to address geographic and taxonomic biases in deployments and to concurrently consider both horizontal and vertical movements

Diving into the vertical dimension of elasmobranch movement ecology

Knowledge of the three-dimensional movement patterns of elasmobranchs is vital to understand their ecological roles and exposure to anthropogenic pressures. To date, comparative studies among species at global scales have mostly focused on horizontal movements. Our study addresses the knowledge gap of vertical movements by compiling the first global synthesis of vertical habitat use by elasmobranchs from data obtained by deployment of 989 biotelemetry tags on 38 elasmobranch species. Elasmobranchs displayed high intra- and interspecific variability in vertical movement patterns. Substantial vertical overlap was observed for many epipelagic elasmobranchs, indicating an increased likelihood to display spatial overlap, biologically interact, and share similar risk to anthropogenic threats that vary on a vertical gradient. We highlight the critical next steps toward incorporating vertical movement into global management and monitoring strategies for elasmobranchs, emphasizing the need to address geographic and taxonomic biases in deployments and to concurrently consider both horizontal and vertical movements

Seabird meta-Population Viability Model (mPVA) methods.

The seabird meta-population viability model (mPVA) uses a generalized approach to project abundance and quasi-extinction risk for 102 seabird species under various conservation scenarios. The mPVA is a stage-structured projection matrix that tracks abundance of multiple populations linked by dispersal, accounting for breeding island characteristics and spatial distribution. Data are derived from published studies, grey literature, and expert review (with over 500 contributions). Invasive species impacts were generalized to stage-specific vital rates by fitting a Bayesian state-space model to trend data from Islands where invasive removals had occurred, while accounting for characteristics of seabird biology, breeding islands and invasive species. Survival rates were estimated using a competing hazards formulation to account for impacts of multiple threats, while also allowing for environmental and demographic stochasticity, density dependence and parameter uncertainty.•The mPVA provides resource managers with a tool to quantitatively assess potential benefits of alternative management actions, for multiple species•The mPVA compares projected abundance and quasi-extinction risk under current conditions (no intervention) and various conservation scenarios, including removal of invasive species from specified breeding islands, translocation or reintroduction of individuals to an island of specified location and size, and at-sea mortality amelioration via reduction in annual at-sea deaths

A biologging database of mobulid rays from the Gulf of California, Mexico.

We initiated a tagging program in 2004 to determine the large-scale and long-term movement patterns of three species of Mobulid Ray (Mobula mobular, M. munkiana, M. thurstoni). Between 2004 and 2014 we deployed 48 pop-up archival (PAT) tags that recorded temperature, pressure, and light level. Pressure and light level records were then used to calculate animal depth and geolocation. Transmitted and when available recovered raw data files from successful deployments (n = 45) were auto-ingested from the manufacturer into the United States Animal Telemetry Networks (ATN) Data Assembly Center (DAC). Through the ATN DAC, all necessary metadata were compiled, dataset was prepped for release, and derived geolocation trajectories (n = 43) were visualized within their public facing data portal. These data and the full metadata records are available for download from the ATN portal as well as permanently archived under the DataONE Research Workspace member node

Using meta-population models to guide conservation action

Biodiversity conservation is limited by resources, data, and time for execution. To maximize efficacy, it is best if conservation plans are strategically evaluated for cost, feasibility, and likely impact prior to implementation. We present a framework to systematically examine the likely impact of proposed conservation plans for threatened taxa. As a case study of this framework we use the national Action Plan for Seabird Conservation in New Zealand and 27 threatened seabirds identified for conservation interventions. To evaluate impact, we applied a recently developed seabird meta-population viability analysis model (seabird mPVA) that employs the most current population and adjustable demographic data to assess threatened seabird viability at a global scale under various management scenarios. This publicly available, web-based tool is intended to meet the needs of threatened seabird managers at the initial phase of conservation planning. We used the seabird mPVA to model population trends and potential seabird viability gains from conservation actions that include: bycatch mitigation, invasive species removal, and seabird translocation prescribed in the action plan for individual species. Our model’s ranking of New Zealand seabirds by current quasi-extinction vulnerability roughly correlated with the seabirds’ IUCN Red List status and New Zealand Threat Classification System. We found modeled conservation impact of proposed actions and assigned priority to be generally positively correlated, but variable in magnitude. If all prescribed conservations actions were implemented, our model predicted significant mitigation of quasi-extinction risk for nine species (Antipodean Albatross, Auckland Island Shag, Black-fronted Tern, Fairy Tern, Rough-faced Shag, Northern Royal Albatross, Pitt Island Shag, Stewart Island Shag, Yellow-eyed Penguin). This approach, and our model, can be adapted to other taxonomic groups to provide a consistent framing for the prioritization of species for conservation investment and predictions about the benefits of specific conservation actions for those species

Globally threatened vertebrates on islands with invasive species.

Global biodiversity loss is disproportionately rapid on islands, where invasive species are a major driver of extinctions. To inform conservation planning aimed at preventing extinctions, we identify the distribution and biogeographic patterns of highly threatened terrestrial vertebrates (classified by the International Union for Conservation of Nature) and invasive vertebrates on ~465,000 islands worldwide by conducting a comprehensive literature review and interviews with more than 500 experts. We found that 1189 highly threatened vertebrate species (319 amphibians, 282 reptiles, 296 birds, and 292 mammals) breed on 1288 islands. These taxa represent only 5% of Earths terrestrial vertebrates and 41% of all highly threatened terrestrial vertebrates, which occur in <1% of islands worldwide. Information about invasive vertebrates was available for 1030 islands (80% of islands with highly threatened vertebrates). Invasive vertebrates were absent from 24% of these islands, where biosecurity to prevent invasions is a critical management tool. On the 76% of islands where invasive vertebrates were present, management could benefit 39% of Earths highly threatened vertebrates. Invasive mammals occurred in 97% of these islands, with Rattus sp. as the most common invasive vertebrate (78%; 609 islands). Our results provide an important baseline for identifying islands for invasive species eradication and other island conservation actions that reduce biodiversity loss