The Priority Goals and Underlying Impairments Contributing to Goal-Related Problems of People with Parkinson's Disease Receiving a Community-Based Rehabilitation Program.

Background: Goal setting is a core rehabilitation practice in Parkinson's disease (PD). Targeting therapy towards specific goals leads to greater improvements in performance and psychosocial outcomes. Goal setting in PD is feasible, and although the nature of goals has been described in previous studies, the underlying impairments related to goals have not been described. Understanding the nature of goals ensures that interventions for people with PD are aligned with their needs and priorities. Understanding the underlying impairments highlights which symptoms have the biggest impact on daily life and is necessary for planning appropriate interventions to target them. Aim: To describe the nature of the goals of people with PD; the underlying impairments related to goals; and to compare differences between high and low priority goals. Method: Deductive content analysis was used to map goal statements to the international classification of function (ICF) activity and participation category and to map therapist field notes detailing the primary underlying impairment to the ICF Body Functions category. These results were then compared across goal priority rankings. Results: 88 goals of 22 people with PD were analysed. We found that people with PD set diverse goals across all chapters of the ICF Activity and Participation category, with "self-care" goals making up the highest proportion of goals. The primary underlying impairment related to the goals was predominantly related to impairments in "mental functions" under the Body Functions category. Regardless of goal priority, most goal-related underlying impairments were found to be in the "mental functions" category. Conclusion: The goals of this sample of community-dwelling people with PD highlight their diverse needs and priorities. These findings indicate that nonmotor symptoms, namely, executive dysfunction and amotivation most commonly impact the performance of and participation in activities of greatest importance to people with PD. This trial is registered with ACTRN12621001483842.

The impact of jejunostomy feeding on nutritional outcomes after oesophagectomy.

BACKGROUND: Nutritional status is compromised long-term following oesophagectomy. Controversy surrounds the optimal route for nutrition support postoperatively and there is wide variation in the use of feeding jejunostomy tubes. METHODS: A retrospective service evaluation was conducted for all consecutive adults who underwent oesophagectomy for a cancer diagnosis within a specialist centre between April 2016 and July 2019 (n = 165). Nutritional and clinical outcomes were compared for patients who received jejunostomy feeding (n = 24), versus those who did not (n = 141). RESULTS: Patients with feeding jejunostomy lost significantly less weight at both 6 and 12 months postoperatively compared to those without jejunostomy (p ≤ 0.001 and p = 0.001, respectively). This remained statistically significant in multiple regression, controlling for age, gender, preoperative tumour staging and adjuvant treatment (p ≤ 0.001 and p = 0.03, respectively). Median length of home enteral feeding was 10 weeks after discharge in the jejunostomy group. We observed minor jejunostomy tube-related complications in four patients (16.7%). Of those readmitted within 90 days of surgery in the non-jejunostomy group, nutritional failure was a factor in 43.2% of these readmissions. "Rescue tube feeding" was required by 8.5% of the non-jejunostomy group within the first postoperative year, including 6.4% within 90 days of surgery. CONCLUSIONS: Use of short-term supplementary jejunal feeding in addition to oral intake after hospital discharge is beneficial for maintaining weight after oesophagectomy. We suggest a future randomised-controlled trial to confirm these findings.

Efficacy and Feasibility of the CO-OP Approach in Parkinson's Disease: RCT Study Protocol.

Background. Parkinson's disease (PD) leads to cognitive dysfunction which limits participation and occupational performance. Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is effective in other adult neurological populations and warrants investigation in PD. Purpose. To describe a study protocol evaluating the preliminary efficacy and feasibility of CO-OP approach in PD. Method. A randomised controlled trial (RCT) with adults with PD was assigned to either: CO-OP training-intensive (CO-OP-I, 20 sessions) or waitlist control (WLC) followed by CO-OP-standard (CO-OP-S, 10 sessions). Outcomes. Occupational performance and satisfaction of adults with PD in chosen goals. Measures will be obtained at baseline, post-intervention, and 3-month follow-up. Implications. As the first RCT focused on CO-OP in PD, this trial will provide evidence for the potential of this approach in PD and lay the groundwork for future large-scale trials. Trial Registration. Australian New Zealand Clinical Trials registry, ACTRN12621001483842. Registered November 1, 2021; retrospectively registered 3 months after commencement.

Nutrition Care Process Model Approach to Surgical Prehabilitation in Oncology.

The nutrition care process is a standardized and systematic method used by nutrition professionals to assess, diagnose, treat, and monitor patients. Using the nutrition care process model, we demonstrate how nutrition prehabilitation can be applied to the pre-surgical oncology patient.

Current Landscape of Nutrition Within Prehabilitation Oncology Research: A Scoping Review.

Background: Prehabilitation aims to improve functional capacity prior to cancer treatment to achieve better psychosocial and clinical outcomes. Prehabilitation interventions vary considerably in design and delivery. In order to identify gaps in knowledge and facilitate the design of future studies, we undertook a scoping review of prehabilitation studies to map the range of work on prehabilitation being carried out in any cancer type and with a particular focus on diet or nutrition interventions. Objectives: Firstly, to describe the type of prehabilitation programs currently being conducted. Secondly, to describe the extent to which prehabilitation studies involved aspects of nutrition, including assessment, interventions, implementation, and outcomes. Eligibility Criteria: Any study of quantitative or qualitative design that employed a formal prehabilitation program before cancer treatment ("prehabilitation" listed in keywords, title, or abstract). Sources of Evidence: Search was conducted in July 2020 using MEDLINE, PubMed, EMBASE, EMCARE, CINAHL, and AMED. Charting Methods: Quantitative data were reported as frequencies. Qualitative nutrition data were charted using a framework analysis that reflects the Nutrition Care Process Model: assessment, intervention, and monitoring/evaluation of the nutrition intervention. Results: Five hundred fifty unique articles were identified: 110 studies met inclusion criteria of a formal prehabilitation study in oncology. prehabilitation studies were mostly cohort studies (41%) or randomized-controlled trials (38%) of multimodal (49%), or exercise-only (44%) interventions that were applied before surgery (94%). Nutrition assessment was inconsistently applied across these studies, and often conducted without validated tools (46%). Of the 110 studies, 37 (34%) included a nutrition treatment component. Half of these studies provided the goal for the nutrition component of their prehabilitation program; of these goals, less than half referenced accepted nutrition guidelines in surgery or oncology. Nutrition interventions largely consisted of counseling with dietary supplementation. The nutrition intervention was indiscernible in 24% of studies. Two-thirds of studies did not monitor the nutrition intervention nor evaluate nutrition outcomes. Conclusion: Prehabilitation literature lacks standardized and validated nutritional assessment, is frequently conducted without evidence-based nutrition interventions, and is typically implemented without monitoring the nutrition intervention or evaluating the intervention's contribution to outcomes. We suggest that the development of a core outcome set could improve the quality of the studies, enable pooling of evidence, and address some of the research gaps identified.

A global meta-analysis of the ecological impacts of alien species on native amphibians.

The exponential increase in species introductions during the Anthropocene has brought about a major loss of biodiversity. Amphibians have suffered large declines, with more than 16% considered to be threatened by invasive species. We conducted a global meta-analysis of the impacts of alien species on native amphibians to determine which aspects of amphibian ecology are most affected by plant, invertebrate, fish, amphibian, reptile, or mammal introductions. Measures of fitness were most strongly affected; amphibian performance was consistently lower in the presence of alien species. While exposure to alien species caused a significant decrease in amphibian behavioural activity when compared with a no species control, this response was stronger towards a control of native impacting species. This indicates a high degree of prey naiveté towards alien species and highlights the importance of using different types of controls in empirical studies. Alien invertebrates had the greatest overall impact on amphibians. This study sets a new agenda for research on biological invasions, highlighting the lack of studies investigating the impacts of alien species on amphibian terrestrial life-history stages. It also emphasizes the strong ecological impacts that alien species have on amphibian fitness and suggests that future introductions or global spread of alien invertebrates could strongly exacerbate current amphibian declines.

Emerging infectious diseases and biological invasions: a call for a One Health collaboration in science and management.

The study and management of emerging infectious diseases (EIDs) and of biological invasions both address the ecology of human-associated biological phenomena in a rapidly changing world. However, the two fields work mostly in parallel rather than in concert. This review explores how the general phenomenon of an organism rapidly increasing in range or abundance is caused, highlights the similarities and differences between research on EIDs and invasions, and discusses shared management insights and approaches. EIDs can arise by: (i) crossing geographical barriers due to human-mediated dispersal, (ii) crossing compatibility barriers due to evolution, and (iii) lifting of environmental barriers due to environmental change. All these processes can be implicated in biological invasions, but only the first defines them. Research on EIDs is embedded within the One Health concept-the notion that human, animal and ecosystem health are interrelated and that holistic approaches encompassing all three components are needed to respond to threats to human well-being. We argue that for sustainable development, biological invasions should be explicitly considered within One Health. Management goals for the fields are the same, and direct collaborations between invasion scientists, disease ecologists and epidemiologists on modelling, risk assessment, monitoring and management would be mutually beneficial.

A Tournaisian (earliest Carboniferous) conglomerate-preserved non-marine faunal assemblage and its environmental and sedimentological context.

A conglomerate bed from the Tournaisian Ballagan Formation of Scotland preserves a rich array of vertebrate and other nonmarine fossils providing an insight into the wider ecosystem and paleoenvironment that existed during this pivotal stage of Earth history. It challenges hypotheses of a long-lasting post-extinction trough following the end-Devonian extinction event. The fauna recovered includes a wide size range of tetrapods, rhizodonts, and dipnoans, from tiny juveniles or small-bodied taxa up to large adults, and more than one taxon of each group is likely. Some fauna, such as actinopterygians and chondrichthyans, are rare as macrofauna but are better represented in the microfossil assemblage. The fauna provides evidence of the largest Carboniferous lungfish ever found. The specimens are preserved in a localized, poorly-sorted conglomerate which was deposited in the deepest part of a river channel, the youngest of a group of channels. In addition to the fossils (micro- and macro-), the conglomerate includes locally-derived clasts of paleosols and other distinctive elements of the surrounding floodplains. Charcoal fragments represent small woody axes and possible larger trunk tissue from arborescent pteridosperms. Preservation of the fossils indicates some aerial exposure prior to transport, with abrasion from rolling. The findings presented here contrast with other published trends in vertebrate size that are used to interpret a reduction in maximum sizes during the Tournaisian. The richness of the fauna runs counter to the assumption of a depauperate nonmarine fauna following the end-Devonian Hangenberg event, and charcoal content highlights the occurrence of fire, with the requisite levels of atmospheric oxygen during that stage.

Author Correction: 150,000-year palaeoclimate record from northern Ethiopia supports early, multiple dispersals of modern humans from Africa.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Rapid adaptive response to a Mediterranean environment reduces phenotypic mismatch in a recent amphibian invader.

Invasive species frequently cope with ecological conditions that are different from those to which they adapted, presenting an opportunity to investigate how phenotypes change across short time scales. In 2000, the guttural toad Sclerophrys gutturalis was first detected in a peri-urban area of Cape Town, where it is now invasive. The ability of the species to invade Cape Town is surprising as the area is characterized by a Mediterranean climate significantly drier and colder than that of the native source area. We measured field hydration state of guttural toads from the invasive Cape Town population and a native source population from Durban. We also obtained from laboratory trials: rates of evaporative water loss and water uptake, sensitivity of locomotor endurance to hydration state, critical thermal minimum (CTmin) and sensitivity of CTmin to hydration state. Field hydration state of invasive toads was significantly lower than that of native toads. Although the two populations had similar rates of water loss and uptake, invasive toads were more efficient in minimizing water loss through postural adjustments. In locomotor trials, invasive individuals noticeably outperformed native individuals when dehydrated but not when fully hydrated. CTmin was lower in invasive individuals than in native individuals, independent of hydration state. Our results indicate that an invasive population that is only 20 years old shows adaptive responses that reduce phenotypic mismatch with the novel environment. The invasion potential of the species in Cape Town is higher than we could infer from its characteristics in the native source population.

150,000-year palaeoclimate record from northern Ethiopia supports early, multiple dispersals of modern humans from Africa.

Climatic change is widely acknowledged to have played a role in the dispersal of modern humans out of Africa, but the timing is contentious. Genetic evidence links dispersal to climatic change ~60,000 years ago, despite increasing evidence for earlier modern human presence in Asia. We report a deep seismic and near-continuous core record of the last 150,000 years from Lake Tana, Ethiopia, close to early modern human fossil sites and to postulated dispersal routes. The record shows varied climate towards the end of the penultimate glacial, followed by an abrupt change to relatively stable moist climate during the last interglacial. These conditions could have favoured selection for behavioural versatility, population growth and range expansion, supporting models of early, multiple dispersals of modern humans from Africa.

A framework for engaging stakeholders on the management of alien species.

Alien species can have major ecological and socioeconomic impacts in their novel ranges and so effective management actions are needed. However, management can be contentious and create conflicts, especially when stakeholders who benefit from alien species are different from those who incur costs. Such conflicts of interests mean that management strategies can often not be implemented. There is, therefore, increasing interest in engaging stakeholders affected by alien species or by their management. Through a facilitated workshop and consultation process including academics and managers working on a variety of organisms and in different areas (urban and rural) and ecosystems (terrestrial and aquatic), we developed a framework for engaging stakeholders in the management of alien species. The proposed framework for stakeholder engagement consists of 12 steps: (1) identify stakeholders; (2) select key stakeholders for engagement; (3) explore key stakeholders' perceptions and develop initial aims for management; (4) engage key stakeholders in the development of a draft management strategy; (5) re-explore key stakeholders' perceptions and revise the aims of the strategy; (6) co-design general aims, management objectives and time frames with key stakeholders; (7) co-design a management strategy; (8) facilitate stakeholders' ownership of the strategy and adapt as required; and (9) implement the strategy and monitor management actions to evaluate the need for additional or future actions. In case additional management is needed after these actions take place, some extra steps should be taken: (10) identify any new stakeholders, benefits, and costs; (11) monitor engagement; and (12) revise management strategy. Overall, we believe that our framework provides an effective approach to minimize the impact of conflicts created by alien species management.

How repeatable is the Environmental Impact Classification of Alien Taxa (EICAT)? Comparing independent global impact assessments of amphibians.

The magnitude of impacts some alien species cause to native environments makes them targets for regulation and management. However, which species to target is not always clear, and comparisons of a wide variety of impacts are necessary. Impact scoring systems can aid management prioritization of alien species. For such tools to be objective, they need to be robust to assessor bias. Here, we assess the newly proposed Environmental Impact Classification for Alien Taxa (EICAT) used for amphibians and test how outcomes differ between assessors. Two independent assessments were made by Kraus (Annual Review of Ecology Evolution and Systematics, 46, 2015, 75-97) and Kumschick et al. (Neobiota, 33, 2017, 53-66), including independent literature searches for impact records. Most of the differences between these two classifications can be attributed to different literature search strategies used with only one-third of the combined number of references shared between both studies. For the commonly assessed species, the classification of maximum impacts for most species is similar between assessors, but there are differences in the more detailed assessments. We clarify one specific issue resulting from different interpretations of EICAT, namely the practical interpretation and assigning of disease impacts in the absence of direct evidence of transmission from alien to native species. The differences between assessments outlined here cannot be attributed to features of the scheme. Reporting bias should be avoided by assessing all alien species rather than only the seemingly high-impacting ones, which also improves the utility of the data for management and prioritization for future research. Furthermore, assessments of the same taxon by various assessors and a structured review process for assessments, as proposed by Hawkins et al. (Diversity and Distributions, 21, 2015, 1360), can ensure that biases can be avoided and all important literature is included.

Past penguin colony responses to explosive volcanism on the Antarctic Peninsula.

Changes in penguin populations on the Antarctic Peninsula have been linked to several environmental factors, but the potentially devastating impact of volcanic activity has not been considered. Here we use detailed biogeochemical analyses to track past penguin colony change over the last 8,500 years on Ardley Island, home to one of the Antarctic Peninsula's largest breeding populations of gentoo penguins. The first sustained penguin colony was established on Ardley Island c. 6,700 years ago, pre-dating sub-fossil evidence of Peninsula-wide occupation by c. 1,000 years. The colony experienced five population maxima during the Holocene. Overall, we find no consistent relationships with local-regional atmospheric and ocean temperatures or sea-ice conditions, although the colony population maximum, c. 4,000-3,000 years ago, corresponds with regionally elevated temperatures. Instead, at least three of the five phases of penguin colony expansion were abruptly ended by large eruptions from the Deception Island volcano, resulting in near-complete local extinction of the colony, with, on average, 400-800 years required for sustainable recovery.

Phylogenetic and environmental context of a Tournaisian tetrapod fauna.

The end-Devonian to mid-Mississippian time interval has long been known for its depauperate palaeontological record, especially for tetrapods. This interval encapsulates the time of increasing terrestriality among tetrapods, but only two Tournaisian localities previously produced tetrapod fossils. Here we describe five new Tournaisian tetrapods (Perittodus apsconditus, Koilops herma, Ossirarus kierani, Diploradus austiumensis and Aytonerpeton microps) from two localities in their environmental context. A phylogenetic analysis retrieved three taxa as stem tetrapods, interspersed among Devonian and Carboniferous forms, and two as stem amphibians, suggesting a deep split among crown tetrapods. We also illustrate new tetrapod specimens from these and additional localities in the Scottish Borders region. The new taxa and specimens suggest that tetrapod diversification was well established by the Tournaisian. Sedimentary evidence indicates that the tetrapod fossils are usually associated with sandy siltstones overlying wetland palaeosols. Tetrapods were probably living on vegetated surfaces that were subsequently flooded. We show that atmospheric oxygen levels were stable across the Devonian/Carboniferous boundary, and did not inhibit the evolution of terrestriality. This wealth of tetrapods from Tournaisian localities highlights the potential for discoveries elsewhere.

Frog eat frog: exploring variables influencing anurophagy.

Background. Frogs are generalist predators of a wide range of typically small prey items. But descriptions of dietary items regularly include other anurans, such that frogs are considered to be among the most important of anuran predators. However, the only existing hypothesis for the inclusion of anurans in the diet of post-metamorphic frogs postulates that it happens more often in bigger frogs. Moreover, this hypothesis has yet to be tested. Methods. We reviewed the literature on frog diet in order to test the size hypothesis and determine whether there are other putative explanations for anurans in the diet of post-metamorphic frogs. In addition to size, we recorded the habitat, the number of other sympatric anuran species, and whether or not the population was invasive. We controlled for taxonomic bias by including the superfamily in our analysis. Results. Around one fifth of the 355 records included anurans as dietary items of populations studied, suggesting that frogs eating anurans is not unusual. Our data showed a clear taxonomic bias with ranids and pipids having a higher proportion of anuran prey than other superfamilies. Accounting for this taxonomic bias, we found that size in addition to being invasive, local anuran diversity, and habitat produced a model that best fitted our data. Large invasive frogs that live in forests with high anuran diversity are most likely to have a higher proportion of anurans in their diet. Conclusions. We confirm the validity of the size hypothesis for anurophagy, but show that there are additional significant variables. The circumstances under which frogs eat frogs are likely to be complex, but our data may help to alert conservationists to the possible dangers of invading frogs entering areas with threatened anuran species.

Plasticity of thermal tolerance and metabolism but not water loss in an invasive reed frog.

Phenotypic plasticity may buffer the selection pressures on organisms that inhabit novel or rapidly-changing environments. We investigated plasticity of thermal tolerance, energetic and water loss traits and their interaction with behaviour in a small-bodied, arboreal anuran (Hyperolius marmoratus Rapp, Hyperoliidae) undergoing rapid range expansion into the winter rainfall region of South Africa. After short-term exposure to three temperatures (acclimation treatments) commonly encountered in their historical and novel ranges, frogs exhibited a broad thermal tolerance range (mean±s.d.: 42.1±2.9 °C) and higher plasticity in CTmax than in CTmin. Resting metabolic rate was lowest in cold-acclimated animals, while active metabolic rates were lowest in warm-acclimated frogs, likely reflecting compensation towards energy conservation. Evaporative water loss was not significantly altered by the acclimation treatments in either resting or active animals, indicating limited plasticity in this trait compared to metabolism. Our results suggest that plasticity of temperature limits and metabolism may benefit this species in variable environments such as those encountered in its expanded range. Lack of plasticity in water loss during resting and activity suggests that these frogs rely on their high cutaneous resistance and behavioural means to buffer climate variation. This study highlights the importance of synergistic interactions between physiology and behaviour in determining amphibian responses to temperature variation.

Metabolism of Maillard reaction products by the human gut microbiota--implications for health.

The human colonic microbiota imparts metabolic versatility on the colon, interacts at many levels in healthy intestinal and systemic metabolism, and plays protective roles in chronic disease and acute infection. Colonic bacterial metabolism is largely dependant on dietary residues from the upper gut. Carbohydrates, resistant to digestion, drive colonic bacterial fermentation and the resulting end products are considered beneficial. Many colonic species ferment proteins but the end products are not always beneficial and include toxic compounds, such as amines and phenols. Most components of a typical Western diet are heat processed. The Maillard reaction, involving food protein and sugar, is a complex network of reactions occurring during thermal processing. The resultant modified protein resists digestion in the small intestine but is available for colonic bacterial fermentation. Little is known about the fate of the modified protein but some Maillard reaction products (MRP) are biologically active by, e. g. altering bacterial population levels within the colon or, upon absorption, interacting with human disease mechanisms by induction of inflammatory responses. This review presents current understanding of the interactions between MRP and intestinal bacteria. Recent scientific advances offering the possibility of elucidating the consequences of microbe-MRP interactions within the gut are discussed.

Lake sediments record sensitivity of two hydrologically closed upland lakes in Mexico to human impact.

We provide evidence of rapid, recent environmental change in two lakes in the highlands of central Mexico. Multiple sediment cores were obtained from Lago de Zirahuén (Michoacán) and Laguna de Juanacatlán (Jalisco). Analysis of diatom assemblages, magnetic susceptibility, and metal concentrations was carried out, with the chronology provided by 210Pb dating, 14C dating, and tephrochronology. There is evidence of catchment disturbance during the colonial period in both basins, but the most striking feature at both sites is the rapid change in diatom assemblages during the last 20 y, indicating the onset of eutrophication. Limnological data from Lago de Zirahuén support this interpretation, although none are available from Laguna de Juanacatlán. Paleolimnology is a powerful tool in tracking recent change, particularly in the absence of regular limnological monitoring programs. These lakes appear to be highly sensitive to changes in catchment exploitation, which must be considered in future drainage basin management.