Search

To identify how patient journey mapping is being undertaken and reported.A scoping review of the literature was undertaken using JBI guidance.Databases were searched in July 2021 (16th-21st), including Ovid's Medline, Embase, Emcare and PsycINFO; Scopus; Web of Science Core Collection, the Directory of Open Access Journals; Informit and; ProQuest Dissertations and Theses Global.Eligible articles included peer-reviewed literature documenting journey mapping methodologies and studies conducted in healthcare services. Reviewers used Covidence to screen titles and abstracts of located sources, and to screen full-text articles. A table was used to extract data and synthesize results.Eighty-one articles were included. An acceleration of patient journey mapping research was observed, with 76.5% (n = 62) of articles published since 2015. Diverse mapping approaches were identified. Reporting of studies was inconsistent and largely non-adherent with relevant, established reporting guidelines.Patient journey mapping is a relatively novel approach for understanding patient experiences and is increasingly being adopted. There is variation in process details reported. Considerations for improving reporting standards are provided.Patient journey mapping is a rapidly growing approach for better understanding how people enter, experience and exit health services. This type of methodology has significant potential to inform new, patient centred models of care and facilitate clinicians, patients and health professionals to better understand gaps and strategies in health services. The synthesised results of this review alert researchers to options available for journey mapping research and provide preliminary guidance for elevating reporting quality.

Hats aid in reducing exposure to both direct and diffuse ultraviolet light, but hats are of mixed styles and the resultant sun-protection value is variable. Adult male patients have higher rates of skin cancer, especially of the head and neck, than other subgroups. The UK and Australia have set standards for what constitutes a sunhat, whereas no such standard exists in Ireland. We explored adult male sunhats for sale during the summer in a single urban region in the west of Ireland. All the hats available were compared with the UK standard, BS 8466:2006. Almost 90% of the hats available did not meet this standard and thus did not offer adequate sun protection. Ireland requires legislation on what constitutes a sun-hat and more availability and visibility of such hats for men to encourage the use of hats for photoprotection.

Objective This scoping review will assess the literature that documents or utilizes patient journey mapping methodologies in health care settings. It will also examine the reporting processes of studies that use this methodology. Introduction Health care systems are complex and can be challenging for patients to navigate. Using patient journey mapping as a research method promotes a deeper understanding of patient experiences when navigating these systems. Patient journey mapping provides valuable insights into where systems are working well, where gaps in care exist, and how the system could respond to these gaps. Inclusion criteria This review will consider peer-reviewed articles and publicly available academic literature documenting patient journey mapping methodologies. The review will also consider studies providing guidance and recommendations on how to report patient journey mapping studies in health care services and systems. Methods The proposed review will follow JBI guidance for scoping reviews. The following databases will be searched: MEDLINE, Embase, Emcare, PsycINFO, Scopus, Web of Science Core Collection, the Directory of Open Access Journals, Informit, and ProQuest Dissertations and Theses Global. The search will not be limited to year of publication but will be limited to studies reported in English. The PRISMA-ScR extension will be used to document the literature search. Two reviewers will screen titles, abstracts, and full-text articles. An extraction table will be used to extract relevant data from all included articles and to facilitate data analysis.

Background Members of racial and ethnic minority groups have been disproportionately impacted by coronavirus-2019 (COVID-19). The objective of the study is to describe associations between race and ethnicity on clinical outcomes such as need for mechanical ventilation and mortality. Methods Retrospective cohort study of patients with severe COVID-19 infection admitted within a large, not-for-profit healthcare system in the mid-Atlantic region between March and July, 2020. Patient demographic data and clinical outcomes were abstracted from the electronic health record. Logistic regressions were performed to estimate associations between race and ethnicity and the clinical outcomes. Results The study population (N = 2931) was stratified into 1 of 3 subgroups: non-Hispanic White (n = 466), non-Hispanic Black (n = 1611), and Hispanic (n = 654). The average age of White, Black, and Hispanic patients was 69 ± 17.06, 64 ± 15.9, and 50 ± 15.53 years old, respectively ( P Conclusion Our analysis demonstrated that Hispanic patients were more likely require mechanical ventilation but had lower mortality when compared to White patients, with lower average age likely mediating this association. These findings emphasize the importance of outreach efforts to communities of color to increase prevention measures and vaccination uptake to reduce infection with COVID-19.

This case report describes a women in her 50s with obesity, end-stage kidney disease, and type 2 diabetes who presented with severe painful, erythematous nonhealing ulcerated skin lesions with necrotic eschars on the right lower abdomen.

Cortisol is a robust circadian signal that synchronises peripheral circadian clocks with the central clock in the suprachiasmatic nucleus via glucocorticoid receptors that regulate peripheral gene expression. Misalignment of the cortisol rhythm with the sleep–wake cycle, as occurs in shift work, is associated with negative health outcomes, but underlying molecular mechanisms remain largely unknown. We experimentally induced misalignment between the sleep–wake cycle and melatonin and cortisol rhythms in humans and measured time series blood transcriptomics while participants slept in-phase and out-of-phase with the central clock. The cortisol rhythm remained unchanged, but many glucocorticoid signalling transcripts were disrupted by mistimed sleep. To investigate which factors drive this dissociation between cortisol and its signalling pathways, we conducted bioinformatic and temporal coherence analyses. We found that glucocorticoid signalling transcripts affected by mistimed sleep were enriched for binding sites for the transcription factor SP1. Furthermore, changes in the timing of the rhythms of SP1 transcripts, a major regulator of transcription, and changes in the timing of rhythms in transcripts of the glucocorticoid signalling pathways were closely associated. Associations between the rhythmic changes in factors that affect SP1 expression and its activity, such as STAT3, EP300, HSP90AA1, and MAPK1, were also observed. We conclude that plasma cortisol rhythms incompletely reflect the impact of mistimed sleep on glucocorticoid signalling pathways and that sleep–wake driven changes in SP1 may mediate disruption of these pathways. These results aid understanding of mechanisms by which mistimed sleep affects health.

Problem/Background Perinatal death has far reaching emotional effects for all involved in this devastating event. The opportunity for learning as a result of this catastrophe, however, remains unexplored. Aim To explore midwives’ experiences of caring through, and learning from, perinatal death, to better inform the effective planning and delivery of education that optimises both midwifery and self-care. Methods A naturalistic interpretive multiple case study design. Seventeen midwives, located in Australia, participated in an online group activity hosted as a blog, followed by telephonic focus groups and in-depth email interviews. Findings Thematic data analysis revealed seven major themes: Grappling with the reality of perinatal death; Struggling with personal and professional heartache; Seeking the space to grieve as a professional; Being with the woman and her family; Finding a new purpose; Strengthened through support; and Developing the courage to care. Discussion The initial turmoil and impact of loss reflected the catastrophic nature of perinatal death. Midwives uncovered a journey to acceptance and learning, realising a determination to enhance expertise and discovering value in experiential knowledge. Insecurity regarding competence and confidence to manage perinatal death and bereavement care was highlighted. However, sharing their stories revealed professional fulfilment, personal strength, and solidarity amongst midwives who have endured similar experiences. Conclusion A coordinated approach to support and the dissemination of experiential knowledge and learning could be developed within an online model of narrative sharing and discussion. Debriefing, support and sharing of expertise in this way may foster engagement within and beyond the workplace.

Background Twenty-four-hour rhythmicity in mammalian tissues and organs is driven by local circadian oscillators, systemic factors, the central circadian pacemaker and light-dark cycles. At the physiological level, the neural and endocrine systems synchronise gene expression in peripheral tissues and organs to the 24-h-day cycle, and disruption of such regulation has been shown to lead to pathological conditions. Thus, monitoring rhythmicity in tissues/organs holds promise for circadian medicine; however, most tissues and organs are not easily accessible in humans and alternative approaches to quantify circadian rhythmicity are needed. We investigated the overlap between rhythmic transcripts in human blood and transcripts shown to be rhythmic in 64 tissues/organs of the baboon, how these rhythms are aligned with light-dark cycles and each other, and whether timing of tissue-specific rhythmicity can be predicted from a blood sample. Results We compared rhythmicity in transcriptomic time series collected from humans and baboons using set logic, circular cross-correlation, circular clustering, functional enrichment analyses, and least squares regression. Of the 759 orthologous genes that were rhythmic in human blood, 652 (86%) were also rhythmic in at least one baboon tissue and most of these genes were associated with basic processes such as transcription and protein homeostasis. In total, 109 (17%) of the 652 overlapping rhythmic genes were reported as rhythmic in only one baboon tissue or organ and several of these genes have tissue/organ-specific functions. The timing of human and baboon rhythmic transcripts displayed prominent ‘night’ and ‘day’ clusters, with genes in the dark cluster associated with translation. Alignment between baboon rhythmic transcriptomes and the overlapping human blood transcriptome was significantly closer when light onset, rather than midpoint of light, or end of light period, was used as phase reference point. The timing of overlapping human and baboon rhythmic transcriptomes was significantly correlated in 25 tissue/organs with an average earlier timing of 3.21 h (SD 2.47 h) in human blood. Conclusions The human blood transcriptome contains sets of rhythmic genes that overlap with rhythmic genes of tissues/organs in baboon. The rhythmic sets vary across tissues/organs, but the timing of most rhythmic genes is similar in human blood and baboon tissues/organs. These results have implications for development of blood transcriptome-based biomarkers for circadian rhythmicity in tissues and organs.

We examined the sun-protection practices of 61 men attending a dermatology department in the west of Ireland. Most worked outdoors, either currently or in the past. Although most wore hats as a sun-protection measure, the majority wore baseball caps, with smaller numbers wearing other types of hats that do not offer protection to the head and neck. Use of SPF products was widespread, but often not used habitually.

Published on 06 Feb 2022 The COVID-19 pandemic, and the resulting closure of daycare centers worldwide, led to unprecedented changes in children’s learning environments. This period of increased time at home with caregivers, with limited access to external sources (e.g., daycares) provides a unique opportunity to examine the associations between the caregiver-child activities and children’s language development. The vocabularies of 1742 children aged 8-36 months across 13 countries and 12 languages were evaluated at the beginning and end of the first lockdown period in their respective countries (from March to September 2020). Children who had less passive screen exposure and whose caregivers read more to them showed larger gains in vocabulary development during lockdown, after controlling for SES and other caregiver-child activities. Children also gained more words than expected (based on normative data) during lockdown; either caregivers were more aware of their child’s development, or vocabulary development benefited from intense caregiver-child interaction during lockdown, or both. We discuss these results in the context of the extraordinary circumstances of the COVID-19 pandemic and highlight limitations of the study. Funding for Polish sample: grant from National Science Center NCN (Poland), no 2018/31/B/HS6/03916. NK was partly supported by the Research Council of Norway through its Centres of Excellence funding scheme [project number 223265].

Renal transplant recipients (RTRs) are at increased risk of keratinocyte cancer (KC), especially cutaneous squamous cell carcinoma (cSCC). Previous studies identified a genetic variant of theWe sought to find further genetic variation inGenotyping of a combined RTR population (Polymorphism atWe report the association of a SNP in the

Background The Needs in Recovery Assessment (NiRA) is a newly developed needs assessment tool, designed to identify the needs of people recovering from mental illness. This tool has been evaluated outside of the clinical context for validity and reliability. The aim of this study is to introduce the NiRA into clinical practice and to evaluate the value of the NiRA as an adjunct to service delivery from the perspectives of stakeholders and to evaluate the barriers and facilitators of embedding the NiRA in a mental health service. Methods The establishment of the NiRA in a tertiary mental health unit over a 6-month period will be evaluated using a multi-methods approach. Quantitative data will be collected using the NiRA itself and the Recovery Self-Assessment (RSA). Face-to-face interviews with service users and clinicians will be conducted following the initial completion of the NiRA, with a follow-up interview for service users on discharge from the service. Regular informal follow-up with clinicians throughout the study will support the introduction of the NiRA. Descriptive statistics will be used to analyse quantitative data, and descriptive qualitative methods will be used to analyse data from interviews. Discussion Aligning mental health services with recovery-oriented frameworks of care is imperative. The NiRA is a tool that has been designed in accordance with recovery principles and may assist services to be more recovery-oriented. If the NiRA is able to achieve the aims and objectives of this project, a larger implementation study will be conducted. Trial registration Australian and New Zealand Clinical Trial Registry (ANZCTR), ACTRN12621000316808

Onomatopoeia are disproportionately high in number in infants’ early words compared to adult language. Studies of infant language perception have proposed an iconic advantage for onomatopoeia, which may make them easier for infants to learn. This study analyses infants’ early word production to show a phonological motivation for onomatopoeia in early acquisition. Cross-linguistic evidence from 16 infants demonstrates how these forms fit within a phonologically-systematic developing lexicon. We observe a predominance of consonant harmony and open cv syllables in infants’ early words—structures that are typical of onomatopoeia across languages. Infants’ acquisition of onomatopoeia is shown to be driven by a preference for structures that are easy to plan and produce. These data present an original perspective on onomatopoeia in early development, highlighting the role of production in language acquisition in general, and onomatopoeic words in particular.

Infants’ early babbling allows them to engage in proto-conversations with caretakers, well before clearly articulated, meaningful words are part of their productive lexicon. Moreover, the well-rehearsed sounds from babble serve as a perceptual ‘filter’, drawing infants’ attention towards words that match the sounds they can reliably produce. Using naturalistic home recordings of 44 10-11-month-olds (an age with high variability in early speech sound production), this study tests whether infants’ early consonant productions match words and objects in their environment. We find that infants’ babble matches the consonants produced in their caregivers’ speech. Infants with a well-established consonant repertoire also match their babble to objects in their environment. Our findings show that infants’ early consonant productions are shaped by their input: by 10 months, the sounds of babble match what infants see and hear.

Toxic epidermal necrolysis and Staphylococcal scalded skin syndrome (SSSS) are potentially life-threatening dermatological emergencies that present in a similar clinical fashion. Toxic epidermal necrolysis is typically triggered by anticonvulsant and other neurological medications and reports clindamycin inducing the disease is exceedingly rare. SSSS seldomly occurs in adult patients. We present the case of a 60-year-old male presenting with dermatological rash covering >80% his body surface. Diagnosis and therapy involved multidisciplinary contribution from medical physicians, dermatologists, microbiologists and histopathologists to provide a favourable outcome.

Onomatopoeia appear in high quantities in many infants’ earliest words, yet there is minimal research in this area. Instead, findings from the wider iconicity literature are generalised to include onomatopoeia, leading to the assumption that their iconic status makes them inherently learnable, thereby prompting their early production. In this review we bring together the literature on onomatopoeia specifically and iconicity more generally to consider infants’ acquisition from three perspectives: perception, production, and interaction. We consider these findings in relation to Imai and Kita’s (2014) ‘sound symbolism bootstrapping hypothesis’ to determine whether their framework can account for onomatopoeia alongside other iconic forms.

Polymorphisms in the human circadian clock gene PERIOD3 (PER3) are associated with a wide variety of phenotypes such as diurnal preference, delayed sleep phase disorder, sleep homeostasis, cognitive performance, bipolar disorder, type 2 diabetes, cardiac regulation, cancer, light sensitivity, hormone and cytokine secretion, and addiction. However, the molecular mechanisms underlying these phenotypic associations remain unknown. Per3 knockout mice (Per3–/–) have phenotypes related to activity, sleep homeostasis, anhedonia, metabolism, and behavioral responses to light. Using a protocol that induces behavioral differences in response to light in wild type and Per3–/– mice, we compared genome-wide expression in the eye and hypothalamus in the two genotypes. Differentially expressed transcripts were related to inflammation, taste, olfactory and melatonin receptors, lipid metabolism, cell cycle, ubiquitination, and hormones, as well as receptors and channels related to sleep regulation. Differentially expressed transcripts in both tissues co-localized with Per3 on an ∼8Mbp region of distal chromosome 4. The most down-regulated transcript is Prdm16, which is involved in adipocyte differentiation and may mediate altered body mass accumulation in Per3–/– mice. eQTL analysis with BXD mouse strains showed that the expression of some of these transcripts and also others co-localized at distal chromosome 4, is correlated with brain tissue expression levels of Per3 with a highly significant linkage to genetic variation in that region. These data identify a cluster of transcripts on mouse distal chromosome 4 that are co-regulated with Per3 and whose expression levels correlate with those of Per3. This locus lies within a topologically associating domain island that contains many genes with functional links to several of the diverse non-circadian phenotypes associated with polymorphisms in human PER3.

There has been a shift from using the term sexually transmitted disease (STD) to sexually transmitted infection (STI), primarily based on conjecture that STI is less stigmatizing. However, there is a dearth of evidence regarding how the public actually perceives these terms.Students at a Midwestern university participated in an online survey and were randomized to the open-ended question "What comes to mind when you think of the term sexually transmitted disease (STD)?" (n = 205) or "What comes to mind when you think of the term sexually transmitted infection (STI)?" (n = 208). Conventional content analysis was conducted to identify response themes. Cross tabulations with the χ statistic determined the number of participants that endorsed each theme and any differences between the STD and STI responses.Almost all themes occurred in similar numbers across the STD and STI responses. Overarching themes for both terms were contracted through sex; specific STDs/STIs; severe; negative emotional affect; types of people who get STDs/STIs; physical symptoms; preventable; common; and treatable/curable. However, participants were more likely to mention that STDs were common (P = 0.030) and reported less negative emotional affect for STIs (P = 0.024). Two themes emerged only in the STI group: STDs (P = 0.001) and site of infection (P = 0.003).With some exceptions, late adolescents have overlapping conceptualizations of the terms STD and STI. The most commonly reported themes revealed likely areas of misinformation. Although language is an important aspect of health communication, more than a terminology change is needed to reduce the stigma associated with STDs/STIs.

Soils are a nonrenewable resource that support a wide array of ecosystem functions. The scope of these functions depends on the nature and properties of the soil at a given location on the Earth. Demand for better soil information has been growing since the development of soil science in the nineteenth century. This recent interest is driven by an increasing recognition of the ecological, economic, and societal benefits of understanding soil properties and the value of that knowledge for realizing management objectives for agriculture, grazing, forestry, and other land uses. Soil surveys are one method for amassing soil data and mapping the extent of various soil types. The Federal Government has singularly been a long-term sponsor of soil surveys in the United States. The history of these surveys is richly documented and illustrated by Helms and others (2008). Soil surveys describe horizontal (e.g., soil series) and vertical (e.g., horizon depth) properties of soils. Soil mapping enhances assessments of spatial variability in the development and properties of soils as a function of geology, climate, topography, and vegetation. Extensive sampling of soils in concert with other attributes (e.g., forest or rangeland composition) can provide focused estimates and understanding of the linkages between soils and vegetation growth, mortality, and C stocks (O’Neill et al. 2005) (Box 9.1). Thus, soils are not independent of biogeophysical settings and climate, but rather are a result of these variables. Management interpretations of soil functions and processes such as erosion, potential vegetation growth, and hydrologic function integrate these factors and offer an index for land use limitations and opportunities.

Background: Over 1000 horses are investigated annually for Hendra virus (HeV)-like illness, of which very few (

Literature examining the effects of mothers' work status on infant language development is mixed, with little focus on varying work-schedules and early vocabulary. We use naturalistic data to analyze the productive vocabulary of 44 17-month-olds in relation to mothers' work status (Full-time, Part-time, Stay-at-home) at 6 and 18 months. Infants who experienced a combination of care from mothers and other caretakers had larger productive vocabularies than infants in solely full-time maternal or solely other-caretaker care. Our results draw from naturalistic data to suggest that this care combination may be particularly beneficial for early lexical development.

biomarkers. We also touch upon the changing biomarker environment, the increased focus on multigene testing, and how that might impact the development, commercialization and clinical practice of PM. Potential limiting factors for the adoption of genetic biomarkers

Cluster BE1 Streptomyces bacteriophages belong to the Siphoviridae, with genome sizes over 130 kbp, and they contain direct terminal repeats of approximately 11 kbp. Eight newly isolated closely related cluster BE1 phages contain 43 to 48 tRNAs, one transfer-messenger RNA (tmRNA), and 216 to 236 predicted open reading frames (ORFs), but few of their genes are shared with other phages, including those infecting Streptomyces species.

A perceptual advantage for iconic forms in infant language learning has been widely reported in the literature, termed the “sound symbolism bootstrapping hypothesis” by Imai and Kita (2014). However, empirical research in this area is limited mainly to sound symbolic forms, which are very common in languages such as Japanese but less so in Indo-European languages such as English. In this study, we extended this body of research to onomatopoeia—words that are thought to be present across most of the world’s languages and that are known to be dominant in infants’ early lexicons. In a picture-mapping task, 10- and 11-month-old infants showed a processing advantage for onomatopoeia (e.g., woof woof) over their conventional counterparts (e.g., doggie). However, further analysis suggests that the input may play a key role in infants’ experience and processing of these forms.

Compounds of formula (I), or a pharmaceutically acceptable salts or solvates thereof : wherein -X- represents a group of formula (a), (b), (c), (d), (e), (f) or (g) : Being selective inhibitors of human MEK (MAPKK) enzymes, are accordingly of benefit in medicine, for example in the treatment of inflammatory, autoimmune, cardiovascular, proliferative (including oncological) and nociceptive

In the era of open abdomen management, the complication of enterocutaneous fistula (ECF) seems to be increasing in frequency. In nontrauma patients, reported mortality rates are 7% to 20%, and spontaneous closure rates are approximately 25%. This study is the largest series of ECFs reported exclusively caused by trauma and examines the characteristics unique to this population.Trauma patients with an ECF at a single regional trauma center over a 10-year period were reviewed. Parameters studied included fistula output, site, nutritional status, operative history, and fistula resolution (spontaneous vs. operative).Approximately 2,224 patients received a trauma laparotomy and survived longer than 4 days. Of these, 43 patients (1.9%) had ECF. The rate of ECF in men was 2.22% and 0.74% in women. Patients with open abdomen had a higher ECF incidence (8% vs. 0.5%) and lower rate of spontaneous closure (37% vs. 45%). Spontaneous closure occurred in 31% with high-output fistulas, 13% with medium output, and 55% with low output. The mortality rate of ECF was 14% after an average stay of 59 days in the intensive care unit.With damage-control laparotomies, the traumatic ECF rate is increasing and is a different entity than nontraumatic ECF. Although the two populations have similar mortality rates, the trauma cohort demonstrates higher spontaneous closure rates and a curiously higher rate of development in men. Fistula output was not predictive of spontaneous closure.

Bioremediation is a widely accepted technology for the remediation of hydrocarbon-contaminated soil. Treatability studies are usually carried out to assess the biodegradation potential of the contaminants and to design optimal treatments. Laboratory studies measuring soil respiration are often used. One method consists of monitoring the mineralization of a 14C-labeled hydrocarbon surrogate added to the contaminated soil. This study investigates the ability of this method to properly predict the removal of the hydrocarbon contaminants initially found in soils. Mineralization of 14C-labeled hexadecane was monitored in seven soils contaminated with various hydrocarbon mixtures, both fresh and weathered, in microcosm experiments. Reduction of total petroleum hydrocarbon (TPH) concentrations was measured simultaneously in separate microcosms. Both types of microcosms were subjected to the same amendment regimes. For all soils, poor correlation was observed between the mineralization and TPH reduction ...

Changing societal trends have revealed an increased prevalence of mental illness and diminished health resources from which to offer services. This has lead to a need to develop new and more efficient police and health service models of practice. Services offered by the police department in the management of mental health crisis in the community are essential in minimising the risk of individuals with mental health problems causing harm to themselves or a member of the public. In addressing the difficulties associated with police playing an important role in the management of mental health crisis in the community, but having little training in mental health issues, this paper discusses a proposed innovation for New South Wales police in Australia through the development of a Crisis Intervention Team model.

Background: Calciphylaxis is a rare disorder that is very unusual outside the setting of end-stage kidney disease. Case Summary: A 64-year-old woman with normal renal function presented with painful leg ulcers. She had previously received 300 000 IU of vitamin D3 followed by daily calcium and vitamin D3 supplementation. A skin biopsy was consistent with calciphylaxis, and she was treated with sodium thiosulphate infusions and wound debridement. Conclusion: Calcium and vitamin D3 supplements are widely prescribed. We report a case of calciphylaxis triggered by calcium and vitamin D3 supplementation in a patient with none of the typical risk factors. Our patient had an excellent response to treatment with sodium thiosulphate.

1. Wildlife managers often require estimates of abundance. Direct methods of estimation are often impractical, especially in closed-forest environments, so indirect methods such as dung or nest surveys are increasingly popular. 2. Dung and nest surveys typically have three elements: surveys to estimate abundance of the dung or nests; experiments to estimate the production (defecation or nest construction) rate; and experiments to estimate the decay or disappearance rate. The last of these is usually the most problematic, and was the subject of this study. 3. The design of experiments to allow robust estimation of mean time to decay was addressed. In most studies to date, dung or nests have been monitored until they disappear. Instead, we advocate that fresh dung or nests are located, with a single follow-up visit to establish whether the dung or nest is still present or has decayed. 4. Logistic regression was used to estimate probability of decay as a function of time, and possibly of other covariates. Mean time to decay was estimated from this function. 5. Synthesis and applications. Effective management of mammal populations usually requires reliable abundance estimates. The difficulty in estimating abundance of mammals in forest environments has increasingly led to the use of indirect survey methods, in which abundance of sign, usually dung (e.g. deer, antelope and elephants) or nests (e.g. apes), is estimated. Given estimated rates of sign production and decay, sign abundance estimates can be converted to estimates of animal abundance. Decay rates typically vary according to season, weather, habitat, diet and many other factors, making reliable estimation of mean time to decay of signs present at the time of the survey problematic. We emphasize the need for retrospective rather than prospective rates, propose a strategy for survey design, and provide analysis methods for estimating retrospective rates.

The Kola Peninsula is characterised by vast environmental contrasts. Large areas are almost in pristine condition. However, mining and associated industrial activity generate one of the largest sources of heavy metal and sulphur emissions in the world and create `technogenic wastelands' around smelters. Due to the lack of monitoring data, insufficient knowledge is available regarding the acidification history of lakes on the peninsula. In this study, palaeolimnological techniques were used to reveal the pre-industrial pH status of 32 small lakes in order to evaluate the role of human impacts on freshwater ecosystems. Diatom-inferred pH reconstructions demonstrated that for 22 (68.75%) of the lakes, the pH was below 6.5 and in eight (25%) below 6.0 during the pre-industrial period; signs of recent acidification could be detected only in seven lakes of which five are located relatively close to current pollution sources. Furthermore, no substantial changes between the pre-industrial and modern species richness and composition were observed, indicating relatively stable environmental conditions. Most of the lakes seem to have undergone long-term acidification and are mainly affected by natural acidifying factors (e.g., vegetation, bedrock, climate, sea salt). The effect of anthropogenic emissions seems to be surprisingly geographically restricted and controlled mainly by the surrounding topography and prevailing winds. However, although many lakes seem to be in relatively pristine condition, only a significant reduction in heavy metal and sulphur emissions will prevent the lakes from acidifying in the future.

The influence of natural terrestrial disturbances on the limnology of northern lakes is little known, yet important for understanding the ecology of these remote ecosystems. The Riviere George Caribou Herd (RGCH) in northern Quebec has undergone a large population increase since the 1950s, which has been accompanied by pronounced impacts (i.e., degradation of vegetation cover, soil erosion) on terrestrial environments of the Riviere George region. The goal of our study was to evaluate if the increased caribou activity and resulting terrestrial impacts have been accompanied by impacts on adjacent aquatic ecosystems. We studied the recent diatom assemblages (i.e., about the last two centuries) preserved in six sediment cores taken from lakes located in the most heavily impacted region, and in one core from a lake showing little evidence of recent caribou activity in the catchment basin. Core chronologies based on 210Pb dating techniques indicated that average mass sedimentation rates in this subarctic region were very low (0.0039 to 0.012 g cm-2 yr-1). Perhaps surprisingly, diatom assemblages from all seven cores showed very little change, indicating remarkably stable limnological conditions throughout the past -200 yr. The lack of a signal from caribou activity is most likely due to (1) short-term impacts being too transitory to be registered in the sediment record, and (2) long-term impacts not representing a significant perturbation outside the natural variability of these aquatic ecosystems. In contrast to other arctic regions, the limnological stability of our study sites suggests that recent climatic change impacts have been negligible in this region of northern Quebec, which seems to confirm climate model predictions that northern Quebec and Labrador will remain climatically stable under global warming scenarios.

Incidence of breast cancer (BC) varies among ethnic groups, with higher rates in white than in African-American women. Until now, most epidemiological and genetic studies have been carried out in white women. To investigate whether interactions between genetic and reproductive risk factors may explain part of the ethnic disparity in BC incidence, a genetic epidemiology study was conducted, between 1989 and 1994, at the Howard University Cancer Center (Washington, DC), which led to the recruitment of 245 African-American families. Segregation analysis of BC was performed by use of the class D regressive logistic model that allows for censored data to account for a variable age of onset of disease, as implemented in the REGRESS program. Segregation analysis of BC was consistent with a putative dominant gene effect (P < 0.000001) and residual sister-dependence (P < 0.0001). This putative gene was found to interact significantly with age at menarche (P = 0.048), and an interaction with a history of spontaneous abortions was suggested (P = 0.08). A late age at menarche increased BC risk in gene carriers but had a protective effect in non-gene carriers. A history of spontaneous abortions had a protective effect in gene carriers and increased BC risk in non-gene carriers. Our findings agree partially with a similar analysis of French families showing a significant gene x parity interaction and a suggestive gene x age at menarche interaction. Investigating gene x risk factor interactions in different populations may have important implications for further biological investigations and for BC risk assessment.

The terrestrial condition assessment (TCA) evaluates effects of uncharacteristic stressors and disturbance agents on land-type associations (LTAs) to identify restoration opportunities on national forest system (NFS) lands in the United States. A team of agency scientists and managers, representing a broad array of natural resource disciplines, developed a logic structure for the TCA to identify appropriate data sources to support analyses. Primary national data sources included observed insect- and pathogen-induced mortality, key critical loads for soil and the atmosphere, long term seasonal departures in temperature and precipitation, road densities, uncharacteristic wildfires, historical fire regime departure, wildfire potential, insect and pathogen risk, and vegetation departure from natural range of variability. The TCA was implemented with the ecosystem management decision support (EMDS) system, a spatial decision support system for landscape analysis and planning. EMDS uses logic models to interpret data, synthesizes information over successive layers of logic topics, and draws inferences about the ecological integrity of LTAs as an initial step to identifying high priority LTAs for landscape restoration on NFS lands. Results from the analysis showed that about 74 percent of NFS lands had moderate or better overall ecological integrity. Major impacts to ecological integrity included risk of mortality due to insects and disease, extent of current mortality, extent of areas with high and very high wildfire hazard potential, uncharacteristically severe wildfire, and elevated temperatures. In the discussion, we consider implications for agency performance reporting on restoration activities, and subsequent possible steps, including strategic and tactical planning for restoration. The objective of the paper is to describe the TCA framework with results from a national scale application on NFS lands.

Noril'sk, a major center for mining and smelting of high-sulphur nickel-copper ores, is considered one of the most polluted regions on this planet. Yet, long-term data on limnological changes in nearby lakes are lacking. Paleolimnological approaches were used to compare pre-industrial diatom assemblages with recent assemblages in 17 Noril'sk-area lakes in order to assess the effects of the metallurgical operations. Relative to other regions of intense mining and smelting activities, the Noril'sk diatom assemblages have experienced relatively little change sincepre-industrial times. The lakes are well protected against the effects of acidification due to their strong buffering capacities as a result of the surrounding bedrock and overlying glacial deposits. The alkaline nature of the lakes appears to have suppressed the environmental availability of metals, as most likely formed insoluble metallic complexes andbecame incorporated into the lake sediments. Changes between recent and pre-industrial diatom assemblages were recorded for some lakes; however, the taxa contributing to the greatest amount of this change were small, benthic Fragilariaspecies, and not acid and metal-tolerant taxa, as observed in similarly impacted regions. Emissions from mining activities resulting in watershed disturbances, such as increased erosion, likely accounted for shifts in these species over time.

Diatom assemblages and limnological data were analyzed from 74 lakes spanning arctic treeline in three geographical regions of northern Russia: near the mouth of the Pechora River, on the Taimyr Peninsula, and near the mouth of the Lena River. Analysis of similarities indicated that diatom assemblages in tundra and forest lakes were significantly different from each other in all regions, with tundra lakes generally associated with higher abundances of small benthic Fragilaria Lyngbye taxa. Canonical correspondence analysis identified variables related to ion concentrations (e.g. Na+, dissolved inorganic carbon), lake depth, silica concentrations, and surface water temperatures as factors that explained significant amounts of variation in the diatom assemblages. Across treeline, the generally higher surface water temperatures of the forested lakes consistently accounted for a significant proportion of the diatom distribution patterns. Major ion concentrations also explained significant amounts of variation in the diatom assemblages across treeline for all three regions; however, regional trends were most likely influenced by local factors (i.e. ocean proximity or anthropogenic activities). The importance of climatic gradients across treeline (e.g. temperature) diatom distributions provides additional evidence that diatoms may be useful as paleoclimatic indicators. However, combination of the three calibration sets revealed that local water chemistry determinants (e.g. lithology, marine influence) overrode the influence of climatic gradients in explaining diatom distributions, suggesting that regional differences must be minimized for successful combination of geographically separate calibration sets.