Truncated bimodal latitudinal diversity gradient in early Paleozoic phytoplankton.

The latitudinal diversity gradient (LDG)-the decline in species richness from the equator to the poles-is classically considered as the most pervasive macroecological pattern on Earth, but the timing of its establishment, its ubiquity in the geological past, and explanatory mechanisms remain uncertain. By combining empirical and modeling approaches, we show that the first representatives of marine phytoplankton exhibited an LDG from the beginning of the Cambrian, when most major phyla appeared. However, this LDG showed a single peak of diversity centered on the Southern Hemisphere, in contrast to the equatorial peak classically observed for most modern taxa. We find that this LDG most likely corresponds to a truncated bimodal gradient, which probably results from an uneven sediment preservation, smaller sampling effort, and/or lower initial diversity in the Northern Hemisphere. Variation of the documented LDG through time resulted primarily from fluctuations in annual sea-surface temperature and long-term climate changes.

Influence of societal and practice contexts on health professionals' clinical reasoning: a scoping study protocol.

INTRODUCTION: In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts. Although several studies have been conducted with respect to the institutional dimension influencing health professionals' CR, no clear integration of their results is yet available. The aim of this study is to synthesise and disseminate current knowledge on the influence of the institutional dimension of contexts on health professionals' CR. METHODS AND ANALYSIS: A scoping study of the scientific literature from January 1980 to March 2013 will be undertaken to summarise and disseminate research findings about the influence of the institutional dimension on CR. Numerous databases (n=18) from three relevant fields (healthcare, health law and politics and management) will be searched. Extended search strategies will include the manual search of bibliographies, health-related websites, public registries and journals of interest. Data will be collected and analysed using a thematic chart and content analysis. A systematic multidisciplinary team approach will allow optimal identification of relevant studies, as well as effective and valid content analysis and dissemination of the results. DISCUSSION: This scoping study will provide a rigorous, accurate and up-to-date synthesis of existing knowledge regarding: (1) those aspects of the institutional dimension of health professionals' societal and practice contexts that impact their CR and (2) how these aspects influence health professionals' CR. Through the synergy of a multidisciplinary research team from a wide range of expertise, clinical pertinence and an exhaustive dissemination of results to knowledge-users will be ensured.

Practical high pathogenicity avian influenza first-response training exercises.

The response to an avian influenza outbreak, especially highly pathogenic avian influenza (HPAI), should focus on four basic principles: 1) protect humans first, 2) protect animals 3) contain the virus, and 4) ensure that the outbreak remains a single event, by preparing response teams to work together effectively through advance training. The Stamping Out Pandemic and Avian Influenza (STOP AI) project is a U.S. Agency for International Development-funded global activity. STOP AI has designed and conducted practical, experiential training exercises that engage participants in simulated experiences that enhance their confidence and ability to apply these principles during a real HPAI outbreak. This article describes three specific exercises: 1) wearing and removing personal protective equipment (PPE) in a controlled environment, 2) site zoning, and 3) a planning and resource mapping exercise staged in Poultopia--a fictional region in a developing country. The PPE activity emphasizes the physical challenges of working in full PPE and the importance of proper equipment removal. In the zoning exercise, response teams focus on the areas and the tasks required by setting up a clean area, transit corridor, infected/culling area, and nontransit areas at a farm, village, or other location. In Poultopia, participants must determine where surveillance should occur, decide where roadblocks should be placed during an outbreak, choose which birds to cull first and determine how to dispose of them safely, ascertain the types of personnel and equipment needed, and assess timing issues. The Poultopia scenarios are adapted to the conditions of the region where the training takes place, thus adding to their realism and utility. The practical techniques described here have been taught successfully through STOP AI in more than 30 countries in Europe, Asia, and Africa.

Accessibility of occupational therapy community services: a legal, ethical, and clinical analysis.

ABSTRACT Accessibility of health care services is a major concern in many countries. This paper examines the impact of limited access to occupational therapy community services on the right to services, distributive justice (resource distribution based on social solidarity), and service quality. Legal documents and relevant scientific papers were analyzed from three standpoints: legal, ethical, and clinical. Random use of criteria to prioritize requests, partial response to complex needs, task delegation, and long waiting times, all affect distributive justice and compromise the right to and quality of services. Various alternatives are suggested to ensure a balance between the distribution and quality of occupational therapy services.