Standardized Measures of Coastal Wetland Condition: Implementation at a Laurentian Great Lakes Basin-Wide Scale

Since European settlement, over 50 % of coastal wetlands have been lost in the Laurentian Great Lakes basin, causing growing concern and increased monitoring by government agencies. For over a decade, monitoring efforts have focused on the development of regional and organism-specific measures. To facilitate collaboration and information sharing between public, private, and government agencies throughout the Great Lakes basin, we developed standardized methods and indicators used for assessing wetland condition. Using an ecosystem approach and a stratified random site selection process, birds, anurans, fish, macroinvertebrates, vegetation, and physico-chemical conditions were sampled in coastal wetlands of all five Great Lakes including sites from the United States and Canada. Our primary objective was to implement a standardized basin-wide coastal wetland monitoring program that would be a powerful tool to inform decision-makers on coastal wetland conservation and restoration priorities throughout the Great Lakes basin

European Cystic Fibrosis Society standards of care: best practice guidelines

Specialised CF care has led to a dramatic improvement in survival in CF: in the last four decades, well above what was seen in the general population over the same period. With the implementation of newborn screening in many European countries, centres are increasingly caring for a cohort of patients who have minimal lung disease at diagnosis and therefore have the potential to enjoy an excellent quality of life and an even greater life expectancy than was seen previously. To allow high quality care to be delivered throughout Europe, a landmark document was published in 2005 that sets standards of care. Our current document builds on this work, setting standards for best practice in key aspects of CF care. The objective of our document is to give a broad overview of the standards expected for screening, diagnosis, pre-emptive treatment of lung disease, nutrition, complications, transplant/end of life care and psychological support. For comprehensive details of clinical care of CF, references to the most up to date European Consensus Statements, Guidelines or Position Papers are provided in Table 1. We hope that this best practice document will be useful to clinical teams both in countries where CF care is developing and those with established CF centres

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

ECFS best practice guidelines: the 2018 revision

Developments in managing CF continue to drive dramatic improvements in survival. As newborn screening rolls-out across Europe, CF centres are increasingly caring for cohorts of patients who have minimal lung disease on diagnosis. With the introduction of mutation-specific therapies and the prospect of truly personalised medicine, patients have the potential to enjoy good quality of life in adulthood with ever-increasing life expectancy. The landmark Standards of Care published in 2005 set out what high quality CF care is and how it can be delivered throughout Europe. This underwent a fundamental re-write in 2014, resulting in three documents; center framework, quality management and best practice guidelines. This document is a revision of the latter, updating standards for best practice in key aspects of CF care, in the context of a fast-moving and dynamic field. In continuing to give a broad overview of the standards expected for newborn screening, diagnosis, preventative treatment of lung disease, nutrition, complications, transplant/end of life care and psychological support, this consensus on best practice is expected to prove useful to clinical teams both in countries where CF care is developing and those with established CF centres. The document is an ECFS product and endorsed by the CF Network in ERN LUNG and CF Europe

The Role of Meaning in Attitudes toward Evolution

Humans seek to have meaning in their lives. Worldviews, such as science and religion, help structure one’s world and provide meaning. Both the Meaning Maintenance Model (Heine, Proulx, & Vohs, 2006) and Terror Management Theory, suggest the importance of meaning (Greenberg, Pyszczynski, & Solomon, 1986). Threats to one’s meaning create existential anxiety, which causes one to reject competing worldviews (Greenberg et al., 1990). Worldviews manage existential anxiety by providing order and security (Rosenblatt et al., 1989). This existential anxiety and the need to validate our meaning may cause tension between competing worldviews—particularly between science and religion. Data were collected from a sample of 197 community members and Hope College students combined. Participants were randomly assigned to one of three conditions: meaning affirmation, meaning challenge, or control. Participants completed questionnaires regarding their views towards religion, science, and meaning in life. Next, participants read a fabricated essay, supposedly written by a Harvard scholar. Depending on condition, the essay addressed life’s importance (affirmation), life’s meaninglessness (challenge), or computers (control). Participants then completed measures of biased thinking. Next, participants read a mixed-evidence essay on evolution, rated the essay, and completed questionnaires regarding their attitude toward evolution. Participants also completed measures regarding their attitudes toward science, religion, and evolution again. Participants were then debriefed. Our hypotheses were supported and the results revealed that threats to meaning enhance biases. We also found that participants who hold religious beliefs centered on God’s protection and promises of specialness perceived the mixed-evidence essay to be significantly more critical of evolution when their meaning was threatened. This supports our hypothesis that meaning threats elicit worldview-consistent information processing, resulting in more negative attitudes towards evolution. This study shows that when our life’s meaning is challenged, we rely so much on our own worldviews that we dismiss divergent worldviews

The Effects of Existential Threats and Relationship Security on Social Attitudes

Human beings function best when they have a sense of meaning in their lives. We imbue meaning to things in our lives as a shield against our overwhelming fear of death (Greenberg, Pyszczynski, & Solomon, 1986). After facing thoughts of death, it has been suggested that one increases defensiveness towards outgroup members (Van Tongeren, Green, Davis, Worthington, & Reid). Past research has indicated that relationship commitment correlates with a range of positive psychological outcomes. In the present study, our aim is to determine whether positive relationships act as a terror management mechanism to decrease defensiveness towards members of the out-group (feminists). We hypothesize that priming a secure relationship and thoughts about physical pain will lead to less negative ratings of an out-group member (confederate posing as a feminist) than the ratings of a participant primed with an insecure relationship and thoughts about their own death. After completing a series of individual difference measures, participants were randomly assigned to one of four conditions (secure relationship/physical pain; secure relationship/death; insecure relationship/physical pain; insecure relationship/death). Both primes consisted of a writing activity. Following this, participants completed another series of relationship and outcome measures. Once completing the packet, participants were directed to a room to be debriefed by a lab assistant wearing a shirt that read, “this is what a feminist looks like.” After the debriefing, participants were to evaluate the RA. We discuss our findings and the implications of our research. This study will contribute to the understanding of Terror Management Theory and what potential safeguards might be beneficial