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Although neuropalliative care is a relatively new field, there is increasing evidence for its use among the degenerative parkinsonian syndromes, including idiopathic Parkinson disease, progressive supranuclear palsy, multiple system atrophy, dementia with Lewy bodies, and corticobasal syndrome. This chapter outlines the current state of evidence for palliative care among individuals with the degenerative parkinsonian syndromes with discussion surrounding: (1) disease burden and needs across the conditions; (2) utility, timing, and methods for advance care planning; (3) novel care models for the provision of palliative care; and 4) end-of-life care issues. We also discuss currently unmet needs and unanswered questions in the field, proposing priorities for research and the assessment of implemented care models.

Medical education has drastically transformed during the COVID-19 pandemic. Measures such as adopting telemedicine visits, minimizing the number of trainees on service, discontinuing external rotations, and converting in-person to online didactics have been broadly and swiftly implemented. While these innovations have promoted greater interconnectivity amongst institutions and made continuing medical education possible, international exchange programs in medical education are still largely disrupted. In response to the changing guidelines and restrictions necessitated by the COVID-19 pandemic, the authors used Kern's six-step approach to design and implement a virtual curriculum to replace the in-person activities of the 2020-2021 Neurology Peru-Rochester exchange program (NeuroPro). Twenty-seven trainees participated in this virtual adaptation. The average daily attendance was ≥85% and the program was rated 9/10 on average in a feedback survey (63% response rate). The median percentage of correct answers during the pre-test was 64% and it increased to 79% during the post-test (P = 0.003). Virtual adaptation of international exchange programs in medical education is feasible to safely continue international collaborative efforts to promote symbiotic building of local expertise and cross-cultural exchange during the ongoing COVID-19 pandemic and beyond.

Accurate wetland maps are of critical importance for preserving the ecosystem functions provided by these valuable landscape elements. Though extensive research into wetland mapping methods using remotely sensed data exists, questions remain as to the effects of data type and classifi cation scheme on classifi cation accuracy when high spatial resolution data are used. The goal of this research was to examine the effects on wetland mapping accuracy of varying input datasets and thematic detail in two physiographically different study areas using a decision tree classifi er. The results indicate that: topographic data and derivatives signifi cantly increase mapping accuracy over optical imagery alone, the source of the elevation data and the type of topographic derivatives used were not major factors, the inclusion of radar and leaf-off imagery did not improve mapping accuracy, and increasing thematic detail resulted in signifi cantly lower mapping accuracies i.e., particularly in more diverse wetland areas.

Accurate and current wetland maps are critical tools for water resources management, however, many existing wetland maps were created by manual interpretation of one aerial image for each area of interest. As such, these maps do not inherently contain information about the intra- and interannual hydrologic cycles of wetlands, which is important for effective wetland mapping. In this paper, several sources of remotely sensed data will be integrated and evaluated for their suitability to map wetlands in a forested region of northern Minnesota. These data include: aerial photographs from two different times of a growing season, National Elevation Dataset and topographical derivatives such as slope and curvature, and multitemporal satellite-based synthetic aperture radar (SAR) imagery and polarimetric decompositions. We identified the variables that are most important to accurately classify wetland from upland areas and discriminate between wetland types for a forested region of northern Minnesota using the d...

Research evidence suggests that services are struggling to adequately address the increasing incidence of self-injury and the needs of women who self-injure, while national self-injury support-groups across the UK appear to be growing in number. Despite their reported value, evidence regarding the role of self-injury support-groups in women's management of their self-injury is lacking although government policy and official guidelines are advocating the incorporation of support-groups into self-injury services. Seven semi-structured interviews were conducted and analysed using Grounded Theory to investigate the role of three UK self-injury support-groups in women's management of self-injury and associated difficulties. Empowerment-as-process emerged as the core theme of self-injury support-groups, mediated through experiences of belonging, sharing, autonomy, positive feeling and change. Findings are discussed in relation to relevant theory and research, followed by critical evaluation and implications of the study. Copyright © 2006 John Wiley & Sons, Ltd.

Decisions have recently been given by the European Court of Justice in Luxembourg which are of vital importance for the cause of equality between men and women. They demonstrate the relevance of the European provisions on equal pay and opportunity and serve to warn that no one who has a complaint on this subject can afford to be unaware of the European law. Five cases have been referred by the UK courts to the European court and each concerns equal pay and opportunity between men and women. The individuals have been assisted by the Equal Opportunities Commission (EOC), a statutory body in the UK. The individual's trade unions have also given assistance in some of the cases.

The United Kingdom sex discrimination legislation has been in force since 1975. Few amendments have been made although experience has shown that the legislation is not as effective as it might be. Changes have been forced by decisions of the European Court but these may have limited effect since the U.K. government has demonstrated a lack of commitment to the principles of equal treatment and equal pay. Women are entering non-traditional areas of employment but not in sufficient numbers to breakdown the horizontal segregation which exists. The vertical segregation also continues with few women holding senior or influential positions in industry, the public service, education or the judiciary. The law is not having the impact which was expected. It is being used very little to pursue equal pay cases. While sex discrimination complaints to the tribunals are increasing, the use of the strategic enforcement powers by the Equal Opportunities Commission is diminishing.