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The use of remote sensing for assessing long-term changes of wetlands has provided essential information on the distribution and status of wetlands around the world. High resolution global maps of wetland extent now include water cover, water bodies, mangroves and many other wetland types. Yet our knowledge of the distribution and extent of tidal flats, a fringing ecosystem that occurs between land and sea, remains surprisingly poor. The process of regular tidal inundation renders tidal flats fully exposed only at low tide and completely unobservable at high tide, which has severely limited our ability to observe tidal flats with satellites. Therefore, fundamental information such as the global distribution of tidal flats and how they have changed over time remains largely unknown at anything other than local scales. This chapter introduces a satellite remote sensing project that overcame this limitation to develop high resolution maps of the intertidal zone using the full Landsat Archive images. The project was initiated to contribute to solving a fundamental conservation problem: identifying the cause of the ongoing collapse of migratory shorebird populations in the East Asian-Australasian Flyway. This migration is one of the world’s largest bird movements, involving millions of individuals. By developing a time series of tidal flat extent in the Yellow Sea region of East Asia, a critical staging site for millions of migratory shorebirds, we discovered that more than two-thirds of tidal flats had disappeared over a 50 year period. The high-resolution maps and the detection of alarmingly high rates of habitat loss have catalysed a range of conservation actions since 2012, demonstrating that data gathered with satellite remote sensing can have significant and lasting influence on conservation actions.
Despite national guidelines recommending early concurrent palliative care for individuals newly diagnosed with metastatic cancer, few community cancer centers, especially those in underserved rural areas do so. We are implementing an early concurrent palliative care model, ENABLE (Educate, Nurture, Advise, Before Life Ends) in four, rural-serving community cancer centers. Our objective was to develop a “toolkit” to assist community cancer centers that wish to integrate early palliative care for patients with newly diagnosed advanced cancer and their family caregivers.
Guided by the RE-AIM (Reach, Effectiveness–Adoption, Implementation, Maintenance) framework, we undertook an instrument-development process based on the literature, expert and site stakeholder review and feedback, and pilot testing during site visits.
We developed four instruments to measure ENABLE implementation: (1) the ENABLE RE-AIM Self-Assessment Tool to assess reach, adoption, implementation, and maintenance; (2) the ENABLE General Organizational Index to assess institutional implementation; (3) an Implementation Costs Tool; and (4) an Oncology Clinicians' Perceptions of Early Concurrent Oncology Palliative Care survey.
Significance of results:
We developed four measures to determine early palliative care implementation. These measures have been pilot-tested, and will be integrated into a comprehensive “toolkit” to assist community cancer centers to measure implementation outcomes. We describe the lessons learned and recommend strategies for promoting long-term program sustainability.