Vegetation dieback in the Mississippi River Delta triggered by acute drought and chronic relative sea-level rise.

Vegetation dieback and recovery may be dependent on the interplay between infrequent acute disturbances and underlying chronic stresses. Coastal wetlands are vulnerable to the chronic stress of sea-level rise, which may affect their susceptibility to acute disturbance events. Here, we show that a large-scale vegetation dieback in the Mississippi River Delta was precipitated by salt-water incursion during an extreme drought in the summer of 2012 and was most severe in areas exposed to greater flooding.

Salt Water Exposure Exacerbates the Negative Response of Haplotypes to Sea-Level Rise.

The response of coastal wetlands to sea-level rise (SLR) largely depends on the tolerance of individual plant species to inundation stress and, in brackish and freshwater wetlands, exposure to higher salinities. is a cosmopolitan wetland reed that grows in saline to freshwater marshes. has many genetically distinct haplotypes, some of which are invasive and the focus of considerable research and management.

The cost of self-promotion: ecological and demographic implications of the mentor effect in natural plant populations.

Under the mentor effect, compatible heterospecific pollen transfer induces self-pollen germination in otherwise self-incompatible plants. The mentor effect could be considered a novel mode of reproductive interference if it negatively impacts fitness. Yet to date, this phenomenon has predominately been investigated under experimental conditions rather than in situ.

Psychotherapy session frequency: A naturalistic examination in a university counseling center.

With increasing demand for psychotherapy services, clinicians are carrying increasingly large caseloads (Bailey et al., 2020). As the number of new intakes exceeds the number of clinical hours available each week in some settings, psychotherapy is delivered on an attenuated schedule for returning clients (rather than the traditional weekly frequency); there is, however, little support for the efficacy of this practice.

Supported decision-making and mental capacity assessment in care homes: A qualitative study.

Up to 75% of UK care home residents may lack the mental capacity to make certain decisions (Wade, Clinical Rehabilitation, 2019, 33, 1561-1570). Care home staff need evidence-based tools to help them assess residents' mental capacity and provide decision-making support (NICE, Decision-making and mental capacity NICE guideline NG108, 2018). The Mental Capacity Assessment Support Toolkit (MCAST) was designed to support multidisciplinary healthcare staff to prepare, complete and document legally compliant mental capacity assessments.

Implementing disruptive technological change in UK healthcare: exploring development of a smart phone app for remote patient monitoring as a boundary object using qualitative methods.

Purpose: Developing technological innovations in healthcare is made complex and difficult due to effects upon the practices of professional, managerial and other stakeholders. Drawing upon the concept of boundary object, this paper explores the challenges of achieving effective collaboration in the development and use of a novel healthcare innovation in the English healthcare system.

Design/methodology/approach: A case study is presented of the development and implementation of a smart phone application (app) for use by rheumatoid arthritis patients.

Sexual and natural selection on pollen morphology in Taraxacum.

Premise: Spiny pollen has evolved independently in multiple entomophilous lineages. Sexual selection may act on exine traits that facilitate male mating success by influencing the transfer of pollen from the anther to the body of the pollinator, while natural selection acts to increase pollen survival. We postulated that relative to sexual congeners, apomictic dandelions undergo relaxed selection on traits associated with male mating success.

Providing 'the bigger picture': benefits and feasibility of integrating remote monitoring from smartphones into the electronic health record.

Objectives: To establish the acceptability and feasibility of collecting daily patient-generated health data (PGHD) using smartphones and integrating PGHD into the electronic health record, using the example of RA.

Methods: The Remote Monitoring of RA smartphone app was co-designed with patients, clinicians and researchers using qualitative semi-structured interviews and focus groups, including selection of question sets for symptoms and disease impact. PGHD were integrated into the electronic health record of one hospital and available in graphical form during consultations.

Who cares for the carers at hospital discharge at the end of life? A qualitative study of current practice in discharge planning and the potential value of using The Carer Support Needs Assessment Tool (CSNAT) Approach.

Background: Carer factors prevent patients achieving timely and appropriate hospital discharge. There is a lack of research into interventions to support carers at hospital discharge.

Aim: To explore whether and how family carers are currently supported during patient discharge at end of life; to assess perceived benefits, acceptability and feasibility of using The Carer Support Needs Assessment Tool (CSNAT) Approach in the hospital setting to support carers.

Factors influencing practitioner adoption of carer-led assessment in palliative homecare: A qualitative study of the use of the Carer Support Needs Assessment Tool (CSNAT).

Introduction: Informal caregivers play a pivotal role in supporting patients approaching the end of life. The Carer Support Needs Assessment Tool (CSNAT) is designed to facilitate person-centred assessment and support through a process that is practitioner-facilitated, but carer-led. This study explored practitioners' experiences of implementing the CSNAT in palliative homecare.

Assessing the impact of a Carer Support Needs Assessment Tool (CSNAT) intervention in palliative home care: a stepped wedge cluster trial.

Objectives: To test the impact on family carers of a Carer Support Needs Assessment Tool (CSNAT) intervention to facilitate carer-led assessment and support during end of life care.

Method: Mixed method, part-randomised, stepped wedge cluster trial with 6 palliative home care services comparing carers receiving the intervention with those receiving standard care. Postal survey with carers 4-5 months postbereavement measured adequacy of end of life support, current mental and physical health (Short Form 12 Health Survey SF-12), level of grief (Texas Revised Inventory of Grief, TRIG) and distress (Distress Thermometer, DT), place of death and carer satisfaction with place of death.

Developing a person-centred approach to carer assessment and support.

Community nurses play an important role in providing palliative care and support for patients and carers at home. The Carer Support Needs Assessment Tool (CSNAT) provides practitioners with an evidence-based comprehensive tool to use with carers in palliative home care. As a practice tool, the CSNAT uses a person-centred approach-that is, the process of carer assessment and support is facilitated by practitioners but is carerled.

Functional mismatch in a bumble bee pollination mutualism under climate change.

Ecological partnerships, or mutualisms, are globally widespread, sustaining agriculture and biodiversity. Mutualisms evolve through the matching of functional traits between partners, such as tongue length of pollinators and flower tube depth of plants. Long-tongued pollinators specialize on flowers with deep corolla tubes, whereas shorter-tongued pollinators generalize across tube lengths.

The role of the Carer Support Needs Assessment Tool in palliative home care: A qualitative study of practitioners' perspectives of its impact and mechanisms of action.

Background: The importance of supporting family carers is well recognised in healthcare policy. The Carer Support Needs Assessment Tool is an evidence-based, comprehensive measure of carer support needs to facilitate carer support in palliative home care.

Aim: To examine practitioner perspectives of the role of the Carer Support Needs Assessment Tool intervention in palliative home care to identify its impact and mechanisms of action.

Predicting National Dental Hygiene Board Examination success based on specific admission factors.

Purpose: The purpose of this study was to determine if there are specific admissions criteria that are significantly correlated with a student's National Board Dental Hygiene Examination (NBDHE) total score and case-based score. Specifically, the study examined the relation between an individual's reading acuity and their scores on the NBDHE. Because of the competitive nature of most dental hygiene admissions, selecting those applicants who are more likely to be successful in the academic program and pass the NBDHE is critical.

Clinical nurse specialists as entrepreneurs: constrained or liberated.

Aims: This qualitative study explored the experiences of two groups of clinical nurse specialists--continence advisors and tissue viability nurses--working in primary care in the UK. In particular, the study focused on how clinical nurse specialists' relationships with other health-care professionals had an impact on their role.

Background: Clinical nurse specialists are recognized worldwide as having expertise in a given field, which they use to develop the practice of others.

Clinical nurse specialists and the practice of community nurses.

Aim: This paper presents the findings of a study of the roles of Clinical Nurse Specialists and community nurses working in primary care.

Background: Clinical Nurse Specialists are recognized internationally as expert practitioners who could facilitate the implementation of evidence-based practice. However, others may misunderstand their role and greater support may be required if organizations are to capitalize on the skills of Clinical Nurse Specialists.

HIV/AIDS in correctional settings: a salient priority for the CDC and HRSA.

Correctional facilities constitute an excellent opportunity to provide treatment, care, and prevention services for a population that may not otherwise access these services. The Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) recognize the public health importance of correctional settings and have begun to develop formal strategies to address the HIV/AIDS-relevant needs of incarcerated individuals. The Centers for Disease Control and Prevention and HRSA have implemented policies, activities, and strategic plans to reduce the HIV/AIDS disease burden among the high-risk populations that pass through the nation's prisons and jails.