Language matters for biodiversity.

Language is central to the way people learn about the natural world. A salient concern of the biodiversity conservation arena has been to understand how language can be employed by scientists to communicate knowledge to nonexpert audiences and build ecological literacy. The use of analogy and narrative by scientists are prominent techniques. In this article, we consider how these two modes of language-based reasoning extend into ordinary conversational language use by the public, specifically when articulating everyday understanding and experiences of biodiversity. Drawing on a process of public engagement in a UK woodland environment, a typological framework based on principles of analogical and narrative reasoning is developed to characterize the precise character of processes of everyday biodiversity sense making. The implications of the framework are discussed in the context of future biodiversity research, particularly its participatory and educational dimensions.

Nature, smells, and human wellbeing.

The link between nature and human wellbeing is well established. However, few studies go beyond considering the visual and auditory underpinnings of this relationship, even though engaging with nature is a multisensory experience. While research linking smell to wellbeing exists, it focuses predominantly on smells as a source of nuisance/offence. Smells clearly have a prominent influence, but a significant knowledge gap remains in the nexus of nature, smell, and wellbeing. Here, we examine how smells experienced in woodlands contribute to wellbeing across four seasons. We show that smells are associated with multiple wellbeing domains, both positively and negatively. They are linked to memories, and specific ecological characteristics and processes over space/time. By making the link between the spatiotemporal variability in biodiversity and wellbeing explicit, we unearth a new line of enquiry. Overall, the multisensory experience must be considered by researchers, practitioners, policy-makers and planners looking to improve wellbeing through nature.

The features and processes underpinning high-quality data generation in participatory research and engagement activities.

Participatory approaches are widely used by researchers to gather data and insight about how the environment is perceived, valued and used. The participatory activities may be creating information as part of curiosity-driven blue-skies research or to inform policy/practise decision-making.The quality and usability of data derived from participatory approaches are heavily influenced by how activities are conducted. We share a set of features and processes that underpin the generation of high-quality data, based on our collective experience of developing and undertaking participatory activities with an environmental and conservation focus.We propose four general features: (a) Depth and breadth of engagement; (b) robustness of the approach; (c) allowing space for surprises; (d) usability across contexts. We also provide a practical toolbox of processes, and associated facilitation techniques, which can be employed to maximise participant engagement and generate quality data.The features and processes are a practical guide for project leaders/teams to consider in the context of their work, rather than a set of inflexible rules. They should be relevant regardless of the participatory methods used, or the research, policy or practice setting being addressed.

Do ecosystem service frameworks represent people's values?

Since the Millennium Ecosystem Assessment was published, a plethora of ecosystem service frameworks have been developed to conceptualise the links between the natural environment and society. The intended geographic scales of application, the policy/practice context, and the scientific disciplines involved have driven variations in how the frameworks are constructed. However, the frameworks are homogenous in that they have been created predominately based on expert opinions and views of how ecosystem services are structured. Here, we use the Common International Classification of Ecosystem Services (CICES) to examine the extent to which frameworks capture people's values for British woodlands. Our findings reveal several disparities between how experts and the public conceptualise ecosystem services. The considerable refinement and specificity provided by CICES does not align with public values (e.g. some provisioning, and regulation and maintenance, services), which tend to be more generalised. We also demonstrate differences in values explained by social characteristics (e.g. ethnicity) that need to be accounted for in decision-making processes. Moving forwards, we need to consider how society views the services derived from nature and reflect this in frameworks to ensure ecosystem service approaches are effective, transparent and widely supported.

Paraneoplastic Phenomena in a Patient With Locally Destructive and Metastatic Renal Cell Carcinoma.

Renal cell carcinoma (RCC) accounts for approximately 80% of all primary renal neoplasms in United States causing approximately 65 000 new cases of RCC and 14 000 deaths each year. Symptoms of RCC typically include weight loss and night sweats but may also feature paraneoplastic phenomena in advanced stages as well as flank pain, gross hematuria, scrotal varicocele, inferior vena cava pathology, and a palpable abdominal mass. In this article, we present the course of a patient with advanced RCC, from initial presentation through workup and to eventual diagnosis. The case features late-onset symptoms, extensive paraneoplastic phenomena, and significant physical examination findings. We also review the literature available on RCC and critically analyze inefficiencies of the workup retrospectively.

Seasonal persistence of faecal indicator organisms in soil following dairy slurry application to land by surface broadcasting and shallow injection.

Dairy farming generates large volumes of liquid manure (slurry), which is ultimately recycled to agricultural land as a valuable source of plant nutrients. Different methods of slurry application to land exist; some spread the slurry to the sward surface whereas others deliver the slurry under the sward and into the soil, thus helping to reduce greenhouse gas (GHG) emissions from agriculture. The aim of this study was to investigate the impact of two slurry application methods (surface broadcast versus shallow injection) on the survival of faecal indicator organisms (FIOs) delivered via dairy slurry to replicated grassland plots across contrasting seasons. A significant increase in FIO persistence (measured by the half-life of E. coli and intestinal enterococci) was observed when slurry was applied to grassland via shallow injection, and FIO decay rates were significantly higher for FIOs applied to grassland in spring relative to summer and autumn. Significant differences in the behaviour of E. coli and intestinal enterococci over time were also observed, with E. coli half-lives influenced more strongly by season of application relative to the intestinal enterococci population. While shallow injection of slurry can reduce agricultural GHG emissions to air it can also prolong the persistence of FIOs in soil, potentially increasing the risk of their subsequent transfer to water. Awareness of (and evidence for) the potential for 'pollution-swapping' is critical in order to guard against unintended environmental impacts of agricultural management decisions.

A Case Study of Visit-Driven Preventive Care Screening Using Clinical Decision Support: The Need to Redesign Preventive Care Screening.

INTRODUCTION: In the traditional model of care, an annual visit was dedicated to the task of assessing and delivering preventive care. With the move away from annual physicals, primary care physicians are addressing preventive services at every clinic visit often aided by electronic clinical decision support (CDS) systems. METHODS: We conducted a case study of a visit-driven CDS system in use at a primary care clinic. Steady-state performance was assessed via control charts of quality metrics, data regarding completion of recommendations, and an analysis of screening intervals achieved with patient visits. RESULTS: Under this visit-driven CDS system, quality metric performance was poor and declining. Almost half of the patients were not screened (46.5%), and the other half were overscreened the majority of the time (83.3%). Recommended preventive services were ordered less than half the time (42.6%), despite CDS reminders. DISCUSSION: Various barriers and systematic inefficiencies combined to produce ineffective screening in this visit-driven CDS preventive service delivery system. As a result, we conclude a visit-driven system cannot produce optimal results. In order to improve performance, preventive services should be delivered separately from clinical visits, perhaps by a "preventive service ranger" (PSR) utilizing the CDS system to review each patient once annually. Under such a system, patients would receive preventive services in an organized and efficient fashion, potentially leading to better continuity, higher quality metrics that are mathematically predictable, and improved satisfaction.

Uncertainties in the governance of animal disease: an interdisciplinary framework for analysis.

Uncertainty is an inherent feature of strategies to contain animal disease. In this paper, an interdisciplinary framework for representing strategies of containment, and analysing how uncertainties are embedded and propagated through them, is developed and illustrated. Analysis centres on persistent, periodic and emerging disease threats, with a particular focus on cryptosporidiosis, foot and mouth disease and avian influenza. Uncertainty is shown to be produced at strategic, tactical and operational levels of containment, and across the different arenas of disease prevention, anticipation and alleviation. The paper argues for more critically reflexive assessments of uncertainty in containment policy and practice. An interdisciplinary approach has an important contribution to make, but is absent from current real-world containment policy.

Management of ocular thermal and chemical injuries, including amniotic membrane therapy.

PURPOSE OF REVIEW: To provide a concise review of the literature regarding potential management strategies of ocular thermal and chemical injuries. RECENT FINDINGS: After experiencing a serious ocular surface burn, either thermal or chemical, the goal of therapy is to restore a normal ocular surface and corneal clarity. If extensive corneal scarring and/or limbal stem cell deficiency are present, techniques such as limbal stem cell grafting, amniotic membrane transplantation and possibly a keratoprosthesis can be employed to help restore vision. This article will review the literature available and discuss how these techniques have improved the prognosis of patients with serious thermal and chemical injuries. SUMMARY: Ocular thermal and chemical injuries are a true ocular emergency and require immediate and intensive evaluation and treatment. The sequelae of an ocular burn can be severe and particularly challenging to manage. Improvements in the understanding of the pathophysiology of a radiant energy or chemical injury as well as advancements in ocular surface reconstruction have provided hope for patients in whom would otherwise have a dismal visual prognosis.

Variations on the tmRNA gene.

tmRNA employs both tRNA-like and mRNA-like properties as it rescues stalled bacterial ribosomes, while targeting the defective mRNA and incomplete nascent protein for degradation. We describe variation of the tmRNA gene (ssrA) and how it informs tmRNA structure and function. Endosymbiont tmRNAs tend to lose secondary structure and length in the mRNA-like region as nucleotide composition drifts with that of the whole genome. A dramatic gene structure variation is circular permutation, which produces two-piece tmRNAs in three bacterial lineages; new sequences blur these lineages. We present evidence that Sinorhizobium two-piece tmRNA retains the 5'-triphosphate of transcriptional initiation and predict a new structure at the 5' end of cyanobacterial two-piece tmRNA precursor. ssrA is a target for some mobile DNAs and a passenger on others. It has been found interrupted (but not functionally disrupted) by mobile elements such as group I introns, genomic islands and palindromic elements. The alphaproteobacterial permuted genes are significantly less frequently interrupted by genomic islands than are their standard counterparts, yet are a hotspot for insertion or swapping of rickettsial palindromic elements, in contrast to other rickettsial loci that show steady decay of a single ancestral element. Bacteriophages, plasmids and genomic islands can carry tmRNA genes; we describe a native bacterial ssrA disrupted by insertion of a genomic island that carries its own ssrA, a genome encoding both one- and two-piece tmRNA, and a phage encoding a tmRNA variant lacking the mRNA-like function, which may counteract host tmRNA during infection.

Candida keratitis after descemet stripping and automated endothelial keratoplasty.

PURPOSE: To report the donor-to-host transmission of Candida albicans after Descemet stripping and automated endothelial keratoplasty (DSAEK). METHODS: An 80-year-old woman with pseudophakic bullous keratopathy developed an infiltrate in the donor corneal lenticule after DSAEK. RESULTS: Donor corneoscleral rim cultures grew C. albicans. Gram stain of the removed corneal lenticule demonstrated budding yeast and pseudohyphae, and cultures yielded C. albicans. Despite topical and systemic antifungal therapy and therapeutic penetrating keratoplasty, the patient developed a blind painful eye and underwent enucleation. CONCLUSIONS: This case report indicates that fungal keratitis may occur from donor-to-host transmission after DSAEK. The location of the infected tissue poses diagnostic and therapeutic challenges for the surgeon.