Animals of the serengeti Kennedy, Adam Scott; Kennedy, Adam Scott; Kennedy, Vicki
2014., 20140312, 2014, 2014-03-12, Letnik:
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eBook
Containing 146 stunning color photos,Animals of the Serengetiis a remarkable look at the mammals and reptiles most likely to be encountered in the world-famous Serengeti National Park and Ngorongoro ...Crater. With an eye-catching layout, accessible text, and easy-to-use format, this detailed photographic guide includes 89 species of mammal and reptile. Useful "Top Tips"-shared by local Tanzanian guides that work in the region-provide visitors with insights into behavioral habits and how to locate specific animals. Filled with vivid anecdotes,Animals of the Serengetiwill enable any safari traveler to identify the area's wildlife with ease.
Covers the 89 species likely to be encountered in Tanzania's Serengeti National Park and Ngorongoro Conservation AreaFeatures male and female variationsAccessible text aimed at safari visitors of all levels
Dyspnea is a cardinal symptom of chronic obstructive pulmonary disease (COPD), and its severity and magnitude increases as the disease progresses, leading to significant disability and a negative ...effect on quality of life. Refractory dyspnea is a common and difficult symptom to treat in patients with advanced COPD. There are many questions concerning optimal management and, specifically, whether various therapies are effective in this setting. The present document was compiled to address these important clinical issues using an evidence-based systematic review process led by a representative interprofessional panel of experts. The evidence supports the benefits of oral opioids, neuromuscular electrical stimulation, chest wall vibration, walking aids and pursed-lip breathing in the management of dyspnea in the individual patient with advanced COPD. Oxygen is recommended for COPD patients with resting hypoxemia, but its use for the targeted management of dyspnea in this setting should be reserved for patients who receive symptomatic benefit. There is insufficient evidence to support the routine use of anxiolytic medications, nebulized opioids, acupuncture, acupressure, distractive auditory stimuli (music), relaxation, handheld fans, counselling programs or psychotherapy. There is also no evidence to support the use of supplemental oxygen to reduce dyspnea in nonhypoxemic patients with advanced COPD. Recognizing the current unfamiliarity with prescribing and dosing of opioid therapy in this setting, a potential approach for their use is illustrated. The role of opioid and other effective therapies in the comprehensive management of refractory dyspnea in patients with advanced COPD is discussed.
One of the greatest attractions of a trip to Kenya is the chance to see animals such as lions, cheetah, leopards, zebra, and giraffe up close and in their natural habitats.Animals of the Masai Marais ...a lavish photographic guide that explores the charismatic wildlife most likely to be encountered by a safari visitor to the Masai Mara National Reserve in southwest Kenya. More than 140 stunning photographs showcase 65 mammals and 17 reptile species, including 6 snakes. Designed to be informative and locally accurate, rather than purely identification-based, this easy-to-use book pays particular attention to wildlife behavior and is written from the firsthand experiences of the authors and the knowledge of local safari guides. Numerous "Top Tips" throughout show readers how and where to locate specific species. The only field guide to focus solely on the wildlife of the Masai Mara National Reserve,Animals of the Masai Marawill be indispensable to visitors to this famous park and all nature enthusiasts with an interest in this area of the world.
The only photographic guide specific to the animals of the Masai Mara National ReserveMore than 140 remarkable photographs covering 65 mammals and 17 reptile species, including 6 snakesAccessible text explores animal behavior and other interesting factsA brief and informative introduction to the habitats of the Masai Mara
We conducted a nine-session Mindfulness Based Stress Reduction (MBSR) educational program for clinician-facilitators who conduct grief support groups, and evaluated the impact of MBSR education on ...the self-efficacy of facilitators. Fifteen grief support group clinician-facilitators were assessed on 13 dimensions of self-efficacy. Using a mixed methods approach, we evaluated survey responses and short-answer narratives. Grief group facilitators, even those with prior mindfulness knowledge and practice, made substantial gains in self-efficacy in both professional and personal practice.
With the current focus on improving efficiencies and quality of care within the Canadian healthcare system, primary healthcare (PHC) is receiving renewed attention. The time is right for highlighting ...the value that registered nurses (RNs) can bring to collaborative practice in primary care settings. This paper discusses the untapped utilization of RNs in primary care in Canada, arguing for a strong leadership role for nurses and citing examples of RN services that could enhance care and improve population health and cost-effectiveness. Internationally, other countries with strong PHC strategies in place offer potential lessons regarding features that could be adapted in Canada.
OBJECTIVES:A number of stimulus presentation features of the tone burst–evoked N1-P2 cortical response were investigated to identify any advantage over simple stimulation when the test is used for ...hearing threshold estimation. The speed of establishing objective thresholds at 1, 3, and 8 kHz in both ears was also measured in what was designed to be an efficient test protocol, together with the precision of the threshold estimates with reference to subjects’ conventional audiograms.
DESIGN:Twenty-four volunteer subjects were recruited and tested by both behavioral and electrophysiological methods. A low-intensity, 3-kHz stimulus was used when the stimulus features were studied. The parameter was the N1-P2 amplitude.
RESULTS:Changing the side of presentation (randomly or by alternating ears), varying the interstimulus interval and inserting a 10-second recovery period midway though an averaging run had no demonstrable effect on response amplitude, both individually or in combination, contrary to earlier reports. Establishing the 6 threshold estimates took an average 20.6 minutes. The mean error in the N1-P2 threshold estimate was 6.5 dB, with no significant effect of frequency. After correcting for this bias, 94% of individual threshold estimates were within 15 dB of the behavioral threshold and 80% were within 10 dB.
CONCLUSIONS:This study suggests that cortical electric response audiometry has a performance that is as good as or better than the auditory brain stem response for threshold estimation in adults and that sophisticated stimulation techniques do not appear to be required. An efficient test protocol that automates many laborious tasks reduces the test time to less than half that previously reported in the literature for this response.
Interior Health in British Columbia advocates for and supports advanced practice nurses, inclusive of regional clinical nurse specialists (CNSs). CNSs develop evidence-informed programs, education, ...policies and practice standards. The article uses an advanced practice nursing framework to anchor two case studies: (1) the operationalization and implementation of a regional CNS role in primary care and (2) the use of a knowledge translation strategy to build clinical capacity in serious illness conversations. These case studies embody the CNS role and provide a voice for CNSs to communicate the ways in which their advanced practice nursing role is pivotal in healthcare system transformation and for providing quality patient care.
Abstract
SHARPIN is a component of the linear ubiquitination assembly complex and a key regulator of NFkB and integrin signaling. SHARPIN-deficient mice develop a phenotype known as chronic ...proliferative dermatitis (cpdm), characterized by progressive epidermal hyperplasia, apoptosis of keratinocytes, cutaneous and systemic eosinophilic inflammation, and hypoplasia of secondary lymphoid organs. We recently reported that the cutaneous inflammation in SHARPIN-deficient mice (Sharpincpdm) develops independently of B and T lymphocytes. We therefore sought to determine the role of innate lymphoid cells (ILCs) in the dermatitis of Sharpincpdm mice. ILCs were identified as a discrete population of CD45+ Lin−CD90.2hi cells in the skin and draining lymph nodes (LN) of wild type (WT) and Sharpincpdm mice. The number of ILCs was markedly increased in Sharpincpdm mice. The majority of cells were group 2 ILC (ILC2) as indicated by labeling for GATA3, IL5, and IL13. The skin of Sharpincpdm mice had increased expression of Il33 and Tslp mRNA. To determine the role of IL33, double mutant mice were generated in which the receptor for IL33 (Il1lr1 also known as ST2) was deleted. Loss of IL33-signaling greatly reduced the number of ILCs and reduced the severity of the dermatitis. These experiments suggest that the dermatitis in Sharpincpdm mice is driven by IL33-dependent ILC2. Supported by the NIH (AR049288).
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