Dementia care in rural and remote areas: The first year of a CIHR New Emerging Team.

The Canadian Institutes of Health Research (CIHR) New Emerging Team (NET) program was designed to provide 5 years of support for the creation of new teams or the development of existing teams of investigators conducting collaborative multidisciplinary research in identified areas of focus. A NET group at the University of Saskatchewan was funded under the Cognitive Impairment in Aging focus for a project titled Strategies to Improve the Care of Persons with Dementia in Rural and Remote Areas. In this article we describe the research program developed by the team and implemented during the first year of our mandate

Storms Are an Important Driver of Change in Tropical Forests

Tropical forest dynamics and composition have changed over recent decades, but the proximate drivers of these changes remain unclear. Investigations into these trends have focused on increasing drought stress, CO2, temperature, and fires, whereas convective storms are generally overlooked. We argue that existing literature provides clear support for the importance of storms as drivers of forest change. We reanalyze the largest plot-based study of tropical forest carbon dynamics to show that lightning frequency—an indicator of storm activity—strongly predicts forest carbon storage and residence time, and its inclusion improves model fit and weakens evidence for the effects of high temperatures. Convective storm activity has increased 5%–25% per decade over the past half century. Extrapolating from historic trends, we estimate that storms likely contribute ca. 50% of the reported increases in biomass mortality across Amazonia, with all realistic combinations of assumptions indicating a possible range of 12%–118%. Spatial variation in storm activity shows weak relationships with drought, demonstrating that forests can experience high drought stress, high storm activity, or both. Accordingly, we hypothesise that convective storms are among the most important drivers of tropical forest change, and as such, they require significant research investment to avoid misguiding science, policy, and management

Women’s preferences for inpatient and outpatient priming for labour induction: a discrete choice experiment

BACKGROUND In many countries a high proportion of births begin as induced labours. Induction can be lengthy if cervical priming is required prior to induction. This usually occurs as an inpatient, however, an alternative is to allow women to go home after satisfactory fetal monitoring. The aim of this study was to assess the preferences of women for cervical priming for induction of labour in an outpatient or inpatient setting. METHOD A discrete choice experiment (DCE) was conducted alongside a randomised trial of inpatient and outpatient cervical priming (the OPRA trial) in two maternity hospitals in South Australia. 362 participants were included, and women’s preferences for cervical priming for induction of labour were assessed. RESULTS Women were willing to accept an extra 1.4 trips to hospital (2.4 trips total) and a total travel time of 73.3 minutes to be able to return to their own home while waiting for the priming to work. For enhanced inpatient services, women were willing to accept a total travel time of 54.7 minutes to have a private room with private bathroom while waiting for the priming to work. The overall benefit score for outpatient priming was 3.63, 3.59 for enhanced inpatient care and 2.89 for basic inpatient care, suggesting slightly greater preferences for outpatient priming. Preferences for outpatient priming increased when women could return to their own home (compared to other offsite accommodation), and decreased with more trips to hospital and longer travel time. CONCLUSIONS Our results suggest that outpatient priming was slightly more preferred than either enhanced inpatient priming or basic care; these results should be confirmed in different clinical settings. There may be merit in providing women information about both options in the future, as preferences varied according to the characteristics of the services on offer and the sociodemographic background of the woman.Kirsten Howard, Karen Gerard, Pamela Adelson, Robert Bryce, Chris Wilkinson, and Deborah Turnbul

The biogeography of the Amazonian tree flora

We describe the geographical variation in tree species composition across Amazonian forests and show how environmental conditions are associated with species turnover. Our analyses are based on 2023 forest inventory plots (1 ha) that provide abundance data for a total of 5188 tree species. Withinplot species composition reflected both local environmental conditions (especially soil nutrients and hydrology) and geographical regions. A broader-scale view of species turnover was obtained by interpolating the relative tree species abundances over Amazonia into 47,441 0.1-degree grid cells. Two main dimensions of spatial change in tree species composition were identified. The first was a gradient between western Amazonia at the Andean forelands (with young geology and relatively nutrient-rich soils) and central–eastern Amazonia associated with the Guiana and Brazilian Shields (with more ancient geology and poor soils). The second gradient was between the wet forests of the northwest and the drier forests in southern Amazonia. Isolines linking cells of similar composition crossed major Amazonian rivers, suggesting that tree species distributions are not limited by rivers. Even though some areas of relatively sharp species turnover were identified, mostly the tree species composition changed gradually over large extents, which does not support delimiting clear discrete biogeographic regions within Amazonia