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On October 10, 2020, the Memorial Sloan Kettering Cancer Center Supportive Care Service hosted their first-ever United States (US) World Hospice and Palliative Care Day (WHPCD) Celebration. The purpose of this article is to describe the US inaugural event in alignment with the broader goals of WHPCD and provide lessons learned in anticipation of the second annual conference to be held on October 5–6, 2021.
Description of the inaugural event in the context of COVID-19 and WHPCD, co-planning conference team reflection, and attendee survey responses.
The Worldwide Hospice Palliative Care Alliance initially launched WHPCD in 2005 as an annual unified day of action to celebrate and support hospice and palliative care around the world. The US-based innovative virtual conference featured 23 interprofessional hospice and palliative care specialists and patient and family caregiver speakers across nine diverse sessions addressing priorities at the intersection of COVID-19, social injustice, and the global burden of serious health-related suffering. Two primary aims guided the event: community building and wisdom sharing. Nearly 270 registrants from at least 16 countries and one dozen states across the US joined the free program focused on both personal and professional development.
Significance of results
Unlike many other academic conferences and professional gatherings that were relegated to online forums due to pandemic-related restrictions, the US WHPCD Celebration was intentionally established to create a virtual coming together for collective reflection on the barriers and facilitators of palliative care delivery amid vast societal change. The goal to ensure a globally relevant and culturally inclusive agenda will continue to draw increased participation at an international level during future annual events. Finally, the transparent and respectful sharing of palliative care team experiences in the year preceding the conference established a safe environment for both individual expression and scholarly discussion.
Pollination services are critical for food production. Although domesticated honey bees are important pollinators in agriculture, there is growing interest in supporting naturally occurring wild bees. Diversifying pollination management strategies by encouraging healthy wild bee communities may be especially useful for growers of insect-pollinated crops, such as apples. Although research has identified several land management practices that can enhance local pollinator communities on farms, there are few studies on the factors that influence growers to adopt pollinator-supporting actions on their land. Here, we surveyed 75 Canadian apple growers and used regression models to explore the influence of farm characteristics and perceptions about bees on the likelihood of adopting 15 unique pollinator-supporting practices. We also provide a descriptive analysis of growers' pollination management practices and self-assessed resourcefulness on the ability to improve habitat for wild pollinators on the farm. We found that an increase in three variables: awareness of wild bees, perception of the severity of threats facing wild populations, and the perception of the benefits provided by wild bees is associated with more pollinator-supporting practices on the farm. Overall, growers were less likely to adopt pollinator-friendly practices as the fraction of rented land increased and as the perceived costs of implementing these practices rose. We found ‘low-hanging fruit’ (i.e., pollinator-supporting practices that could be easily and inexpensively implemented) were adopted by less than one-third of growers and that the majority of those surveyed had little to no knowledge on what actions to take if they wanted to improve their farms for wild bees or where to go for that knowledge. Our results suggest that policies and programs that focus on raising grower awareness of wild bees, increasing grower perception of their benefits, and reducing the perceived costs of implementing pollinator-supporting practices may positively affect their uptake. A deeper understanding of grower perceptions will provide essential insight into how growers may contribute to wild pollinator conservation while potentially increasing agricultural production and reducing vulnerability borne of heavy reliance on managed pollinators.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment.
We conducted a randomized controlled trial of weekly yoga classes (n = 63) v. health education classes (Healthy Living Workshop; HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning.
At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b = −0.82, s.e. = 0.88, p = 0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = −1.38, s.e. = 0.57, p = 0.02). At 6-month follow-up, 51% of yoga participants demonstrated a response (⩾50% reduction in depression symptoms) compared with 31% of HLW participants (odds ratio = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time.
Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.
We assessed the impact of a reflex urine culture protocol, an intervention aimed to reduce unnecessary urine culturing, in intensive care units at a tertiary care hospital. Significant decreases in urine culturing rates and reported rates of catheter-associated urinary tract infection followed implementation of the protocol.
To determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line–associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN)
Descriptive analysis of 2013 NHSN data
Selected inpatient locations in acute care hospitals
A descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type.
From 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%.
An understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest.
Self-emission x-ray shadowgraphy provides a method to measure the ablation-front trajectory and low-mode nonuniformity of a target imploded by directly illuminating a fusion capsule with laser beams. The technique uses time-resolved images of soft x-rays (
keV) emitted from the coronal plasma of the target imaged onto an x-ray framing camera to determine the position of the ablation front. Methods used to accurately measure the ablation-front radius (
), image-to-image timing (
ps) and absolute timing (
ps) are presented. Angular averaging of the images provides an average radius measurement of
and an error in velocity of
. This technique was applied on the Omega Laser Facility [Boehly et al., Opt. Commun. 133, 495 (1997)] and the National Ignition Facility [Campbell and Hogan, Plasma Phys. Control. Fusion 41, B39 (1999)].
Since hospitals in a region often share patients, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in one hospital could affect other hospitals.
Using extensive data collected from Orange County (OC), California, we developed a detailed agent-based model to represent patient movement among all OC hospitals. Experiments simulated MRSA outbreaks in various wards, institutions, and regions. Sensitivity analysis varied lengths of stay, intraward transmission coefficients (β), MRSA loss rate, probability of patient transfer or readmission, and time to readmission.
Each simulated outbreak eventually affected all of the hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5% to 15%) resulted in a 2.9% average increase in relative prevalence at all other hospitals (ranging from no effect to 46.4%). Single-hospital intensive care unit outbreaks (modeled increase from 5% to 15%) caused a 1.4% average relative increase in all other OC hospitals (ranging from no effect to 12.7%).
MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.
This study aimed to describe the transmission dynamics, the serological and virus excretion patterns of Nipah virus (NiV) in Pteropus vampyrus bats. Bats in captivity were sampled every 7–21 days over a 1-year period. The data revealed five NiV serological patterns categorized as high and low positives, waning, decreasing and increasing, and negative in these individuals. The findings strongly suggest that NiV circulates in wild bat populations and that antibody could be maintained for long periods. The study also found that pup and juvenile bats from seropositive dams tested seropositive, indicating that maternal antibodies against NiV are transmitted passively, and in this study population may last up to 14 months. NiV was isolated from the urine of one bat, and within a few weeks, two other seronegative bats seroconverted. Based on the temporal cluster of seroconversion, we strongly believe that the NiV isolated was recrudesced and then transmitted horizontally between bats during the study period.
Since the pioneering text by Mathur and Epstein over 35 years ago, much of the work on this subject has been extended or superseded, producing an enormous body of scattered literature. This edited volume unifies the subject, pulling material together and underpinning it with fundamental theory to produce the only complete, up-to-date reference on all major areas of spouted bed research and practice. With contributions from internationally renowned research groups, this book guides the reader through new developments, insights and models. The hydrodynamic and reactor models of spouted and spout-fluid beds are examined, as well as such topics as particle segregation, heat and mass transfer, mixing and scale-up. Later chapters focus on drying, particle-coating and energy-related applications based on spouted and spout-fluid beds. This is a valuable resource for chemical and mechanical engineers in research and industry.
This introductory chapter follows the contours, and in some cases even the exact wording, of Chapter 1 in Spouted Beds, the only book prior to the present publication that deals exclusively with this subject. Indeed, the current venture was originally to be a revised version of that 1974 book by the present editors. However, after writing the first draft of this chapter for the revision, we realized that the breadth and variety of work on spouted and spout-fluid beds since 1974 required input from a wide range of authors for coverage to be completed in a finite time. Changes in the subsequent draft were mainly with respect to layout of chapter topics (Section 1.6). Despite advances since 1974, the earlier book of that year remains a repository of useful information not available in this volume or elsewhere.
The spouted bed
Consider a vessel open at the top and filled with relatively coarse particulate solids. Suppose fluid is injected vertically through a centrally located small opening at the base of the vessel. If the fluid injection rate is high enough, the resulting high-velocity jet causes a stream of particles to rise rapidly in a hollowed central core within the bed of solids. These particles, after being carried somewhat beyond the peripheral bed level, rain back onto the annular region between the hollowed core and the column wall, where they slowly travel downward and, to some extent, inward as a loosely packed bed.
Spouted beds have now been studied and applied for more than 50 years; during this period there has been a continual output of research papers in the engineering literature, considerable efforts to apply spouted beds in agriculture-related and industrial operations, and five international symposia dedicated solely to spouted beds. The book Spouted Beds by Kishan Mathur and the first-named editor of this volume summarized the field up to 1974. Since then there have been several reviews, but none that have surveyed the entire field comprehensively, including aspects that were barely touched in the earlier book or that were entirely absent. Examples of new areas include mechanically assisted spouting, slot-rectangular spouted beds, spouted and spout-fluid bed gasifiers, spouted bed electrolysis, and application of computational fluid dynamics (CFD) to spouted beds.
Our original intention was to prepare a sequel to the Mathur and Epstein book, but we soon realized that this chore would be too daunting, especially in view of competing time commitments. We therefore adopted the idea of a multiauthored book for which we would provide editing and prepare a subset of the chapters ourselves. Our intent was to choose an international array of authors able to provide a truly comprehensive view of the field, fundamentals as well as applications. Almost all those whom we asked to participate agreed to do so, and they have been remarkably cooperative in submitting material, following instructions, and responding to requests for changes, many of these being editorial in nature.