Health appeal appraisal and memory in older adults: the effects of goal and valence framing.

Relative to younger adults, older adults have a preference and memory advantage for appeals framed to focus on emotion goals (e.g., loving or caring) or positive outcomes (e.g., benefits of health behaviors). Here we examined whether combining goal (emotion vs. future) and valence framing (positive vs. negative) could optimize older adults' appraisal and memory for health appeals. Sixty younger (ages 18-29) and 60 older (ages 64-87) adults viewed, rated and recalled one of the four versions of a health pamphlet, each with a unique combination of goal and valence framing. The results showed a memory advantage for pamphlets focusing on emotion over future goals in both age groups. Older adults also showed a more favorable appraisal and a weak memory advantage for the positively- and emotion-framed pamphlet, relative to younger adults. Thus combining goal and valence framing could optimize the effectiveness of older adults' health appeal communication..

Indigenous community participation in resource development decision-making: Practitioner perceptions of legal and voluntary arrangements.

Indigenous nations worldwide are working with and lobbying private and public resource developers to ensure meaningful engagement in decisions tied to resource development in their territories. The diversity of approaches for engagement can be framed along a continuum, with voluntary practices at one end and legal responsibilities at the other. Given this continuum, the roles and responsibilities of various actors involved have become blurred, which leads to poor practice. In an effort to bring clarity, the aim of this research was to understand the distinctions between voluntary practices and legal responsibilities among key actors, identify how key actors understood their different roles and responsibilities, and explain the implications of these differences. In partnership with a First Nation and a public power utility in Northern Saskatchewan, Canada, we employed semi-structured interviews and group workshops with Indigenous, industry, and government actors who participate in environmental management and resource development decisions. We found that actors had distinct motivations for interacting with one another, that perceptions of voluntary practices and legal responsibilities aligned among some participants but not among others, and that participants were indeed confused about their roles and responsibilities in relation to legal requirements and voluntary engagement activities. Furthermore, we learned that clarifying the intended roles of those involved in resource development decisions would be insufficient for improving practice. This is because improved clarity may not address underlying mistrust of government by Indigenous people, or may not be possible where rights and interests are intertwined under a broad conception of Indigenous rights. Findings also suggest the need for government and industry to work with Indigenous nations as self-determining entities, rather than imposing unilateral processes upon them. Consequently, more serious scrutiny, understanding and action is needed by government and industry when employing and assessing voluntary actions and legal measures for Indigenous inclusion in resource development decision-making processes.

Process Makes Perfect: Perceptions of Effectiveness in Collaborative Environmental Governance.

In evaluating effectiveness for collaborative environmental governance arrangements, a key concern is describing not just the processes and actors that are a part of these systems, but also the impacts that these processes have on ecological and social conditions. Existing research delineates an emphasis on process variables over outcome variables, as well as the difficulties of demonstrating causal relationships between collaborative governance processes and ecological outcomes. In this paper, we examined how process and outcome criteria are used by sponsors, industry practitioners, and participants of collaborative environmental governance (CEG) arrangements in Canada's forest sector to ascertain effectiveness. We explicitly sought evidence from sponsors and industry practitioners of self-described effective forest advisory committees, anticipating that sponsors or practitioners might place greater emphasis than participants on outcome criteria over process criteria. We analyzed data from a nation-wide survey of forest advisory committee participants, conducted interviews with sponsoring agencies, and completed two in-depth case studies. We found that sponsors and industry practitioners, like participants, perceived a strong relationship between process and effectiveness. The perspectives of all participants helped us articulate ten key process criteria that they determined as essential for CEG. By including the insights of sponsoring agencies, our study provides both on-the-ground and management interpretations of process and outcomes as well as a nuanced approach to understanding the relationship between the two. However, we conclude that systematic evaluation approaches involving outcome-based criteria are still necessary and would provide a clear step towards encouraging accountability in CEG decision-making, both for sponsors and members.

Comprehensive meta-analysis of resilience interventions.

BACKGROUND/RATIONALE: There is no current consensus on operational definitions of resilience. Instead, researchers often debate the optimal approach to understanding resilience, while continuing to explore ways to enhance and/or promote its qualities in various populations. The goal of the current meta-analysis is to substantiate existing evidence examining the promotion of resilience through various interventions. Particular emphasis was placed upon the factors that contribute to variability across interventions, such as age, gender, duration of intervention, intervention approaches and risk exposure of targeted population. METHOD: The literature search was conducted on May 28, 2019. Search terms included "resilience intervention" OR "promoting resilience" OR "promoting resiliency" OR "resilience-based intervention". A total of 268 studies, with 1584 independent samples, were included in the meta-analysis. In addition to overall efficacy, outcome-based analyses were conducted for intervention outcomes based on action, biophysical, coping, emotion, resilience, symptoms, and well-being. Finally, moderators of age, gender, length of intervention, intervention approach, intervention target, and the level of risk exposure of the sampled population were examined as moderators. RESULTS: The multi-level meta-analysis indicated that resilience-promoting interventions yielded a small, but statistically significant overall effect, Hedges's g = 0.48 (SE = 0.04, 95% CI = [0.40, 0.56]. The variability in study effect sizes within and between studies was significant, p < .001, with many falling short of the threshold for practical significance. DISCUSSION: Findings lend some support for the overall efficacy of resilience interventions. However, empirical results should be cautiously interpreted in tandem with their theoretical relevance and potential advancements to the construct of resilience. Variabilities across findings reflect the current ambiguities surrounding the conceptualization and operationalization of resilience. Directions for future research on resilience as well as practical considerations are discussed.

Advancements to the Multi-System Model of Resilience: updates from empirical evidence.

In this paper, we discuss further advancements to the Multi-System Model of Resilience through examining empirical factor structures of the Multi-System Model of Resilience Inventory along with other measures of resilience. Evidence from multiple sampled populations provided support for the three-systems organization of the model and highlight its similarities and differences in relation to other measures of resilience. The MSMR conceptualizes resilience as a capacity that enables functioning across a continuum from vulnerability to resilience, whereby internal and external resources interface with dynamic coping processes in response to varying needs and goals. Meaningful applications of this model and future steps in model and measurement developments are discussed.

Reframing the individual stress response: Balancing our knowledge of stress to improve responsivity to stressors.

Although responses to stressors have both adverse and positive consequences on health, many believe that stress is entirely negative. Research revealed that negative beliefs about stress can hinder well-being and result in the avoidance of stressors. Stress-optimizing interventions that target various stress appraisal processes may be a useful tool to reframe how individuals understand and respond to stressors. The current study extends previous findings on stress reframing and sought to examine the extent to which the presentation of information about stress outcomes may influence the individual to respond to subsequent stressors. Seventy-seven undergraduate students (96% female) were randomized into one of four reframing conditions (balanced stress outcomes, negative stress outcomes, positive stress outcomes, and control) and underwent a psychosocial stressor. Results highlight similarities between balanced and positive framings of stress across measures of heart rate and blood pressure, whereas subjective ratings of stress and electrodermal activity suggest balanced framing may be efficacious in attenuating stress. Findings are discussed in the context of differing stress-optimizing interventions and consider the complexities of the individual stress response.

Identifying transformational space for transdisciplinarity: using art to access the hidden third.

A challenge for transdisciplinary sustainability science is learning how to bridge diverse worldviews among collaborators in respectful ways. A temptation in transdisciplinary work is to focus on improving scientific practices rather than engage research partners in spaces that mutually respect how we learn from each other and set the stage for change. We used the concept of Nicolescu's "Hidden Third" to identify and operationalize this transformative space, because it focused on bridging "objective" and "subjective" worldviews through art. Between 2014 and 2017, we explored the engagement of indigenous peoples from three inland delta regions in Canada and as a team of interdisciplinary scholars and students who worked together to better understand long-term social-ecological change in those regions. In working together, we identified five characteristics associated with respectful, transformative transdisciplinary space. These included (1) establishing an unfiltered safe place where (2) subjective and objective experiences and (3) different world views could come together through (4) interactive and (5) multiple sensory experiences. On the whole, we were more effective in achieving characteristics 2-5-bringing together the subjective and objective experiences, where different worldviews could come together-than in achieving characteristic 1-creating a truly unfiltered and safe space for expression. The novelty of this work is in how we sought to change our own engagement practices to advance sustainability rather than improving scientific techniques. Recommendations for sustainability scientists working in similar contexts are provided.

The Advanced Practice Provider Perspective: Treating Patients With Immuno-Oncology Combination Therapy Across Tumor Types.

A number of immune checkpoint inhibitors (ICIs) have been approved by the U.S. Food and Drug Administration (FDA) as immuno-oncology (IO) monotherapy for multiple solid and hematologic tumor types across various lines of therapy. Furthermore, evidence shows some patients may derive additional benefit from IO combination therapy. Three IO combination regimens, nivolumab plus ipilimumab, and pembrolizumab or atezolizumab plus chemotherapy, are approved by the FDA as of April 2019. Because peripheral immune surveillance via T-cell activity is increased to attack malignant cells, the antitumor effects of ICIs may be accompanied by immune-mediated adverse reactions (IMARs). Although potentially more efficacious than monotherapy, IO combination therapies are associated with increased incidences of IMARs vs. IO monotherapy. Advanced practice providers (APPs) are uniquely placed within the multidisciplinary team to counsel patients with cancer on their IO treatment and educate them about identifying manifestations of IMARs. Advanced practice providers should be aware of the presentation and time to onset of IMARs, appropriate management to reduce risk of organ dysfunction, and guidelines for treating these patients. This article reviews IO/IO and IO/chemotherapy combination regimens with respect to clinical efficacy and safety, and discusses the role of the APP in managing IMARs associated with IO combination therapy.

A problem of social fit? Assessing the role of bridging organizations in the recoupling of socio-ecological systems.

The decoupling of human-ecosystem relationships in underutilized forested or agricultural regions poses a threat to cultural and biological diversities. Some scholars have proposed transformative strategies involving local-led efforts to reconnect social and ecological systems with the support of bridging organizations (BOs). However, empirically-based understandings about how and under what conditions BOs can address context-specific social conditions to enable transformation work remain limited. Using the concept of social fit - how institutional arrangements address contextual social conditions to enhance governance effectiveness - this study examines the work of the Kyoto Model Forest Association (KMFA), a BO, in improving the relationship between forests and people in Kyoto, Japan. We employed a mixed method approach involving a questionnaire survey, document review, semi-structured interviews, and direct observations. Our findings showed that to improve human-ecosystem interdependence, the KMFA prioritized the provision of public education; invested in places and systems to reduce participation costs; built trust and reduced value mismatches; provided incentives and built management capacity; provided leadership to diverse local forestry groups; facilitated institutional integration of forest and non-forest organizations; and drew resources from diverse organizations. These roles broadened the participation of different actors with novel connections to local ecosystems, enhanced self-organizing capacities, and streamlined the roles of forest management institutions. To sustain these efforts, the KMFA needs to continuously adapt to meet the needs and perceptions of diverse and dynamic actors and to broaden participation. Our analysis provides evidence of the efficacy of BOs to recouple human-ecosystem relationships and improve governance outcomes in underutilized social-ecological systems.

Re-conceptualizing stress: Shifting views on the consequences of stress and its effects on stress reactivity.

BACKGROUND: The consequences of stress are typically regarded from a deficit-oriented approach, conceptualizing stress to be entirely negative in its outcomes. This approach is unbalanced, and may further hinder individuals from engaging in adaptive coping. In the current study, we explored whether negative views and beliefs regarding stress interacted with a stress framing manipulation (positive, neutral and negative) on measures of stress reactivity for both psychosocial and physiological stressors. METHOD: Ninety participants were randomized into one of three framing conditions that conceptualized the experience of stress in balanced, unbalanced-negative or unbalanced-positive ways. After watching a video on stress, participants underwent a psychosocial (Trier Social Stress Test), or a physiological (CO2 challenge) method of stress-induction. Subjective and objective markers of stress were assessed. RESULTS: Most of the sampled population regarded stress as negative prior to framing. Further, subjective and objective reactivity were greater to the TSST compared to the CO2 challenge. Additionally, significant cubic trends were observed in the interactions of stress framing and stress-induction methodologies on heart rate and blood pressure. Balanced framing conditions in the TSST group had a significantly larger decrease in heart rate and diastolic blood pressure following stress compared to the positive and negative framing conditions. CONCLUSION: Findings confirmed a deficit-orientation of stress within the sampled population. In addition, results highlighted the relative efficacy of the TSST compared to CO2 as a method of stress provocation. Finally, individuals in framing conditions that posited stress outcomes in unbalanced manners responded to stressors less efficiently. This suggests that unbalanced framing of stress may have set forth unrealistic expectations regarding stress that later hindered individuals from adaptive responses to stress. Potential benefits of alternative conceptualizations of stress on stress reactivity are discussed, and suggestions for future research are made.

A synthesis of convergent reflections, tensions and silences in linking gender and global environmental change research.

This synthesis article joins the authors of the special issue "Gender perspectives in resilience, vulnerability and adaptation to global environmental change" in a common reflective dialogue about the main contributions of their papers. In sum, here we reflect on links between gender and feminist approaches to research in adaptation and resilience in global environmental change (GEC). The main theoretical contributions of this special issue are threefold: emphasizing the relevance of power relations in feminist political ecology, bringing the livelihood and intersectionality approaches into GEC, and linking resilience theories and critical feminist research. Empirical insights on key debates in GEC studies are also highlighted from the nine cases analysed, from Europe, the Americas, Asia, Africa and the Pacific. Further, the special issue also contributes to broaden the gender approach in adaptation to GEC by incorporating research sites in the Global North alongside sites from the Global South. This paper examines and compares the main approaches adopted (e.g. qualitative or mixed methods) and the methodological challenges that derive from intersectional perspectives. Finally, key messages for policy agendas and further research are drawn from the common reflection.

What's counted as a reindeer herder? Gender and the adaptive capacity of Sami reindeer herding communities in Sweden.

Researchers of adaptive capacity and sustainable livelihoods have frequently used social, cultural, human, economic and institutional capitals to better understand how rural and resource-dependent communities address environmental, social and economic stresses. Yet few studies have considered how men and women contribute differently to these capitals to support community resilience overall. Our research sought to understand the differential contributions of Sami men and women to the adaptive capacity of reindeer husbandry and reindeer herding communities in northern Sweden. Our focus revealed a gendered division of labour in reindeer herding as an economic enterprise as well as gendered contributions to a broader conceptualization of reindeer husbandry as a family and community-based practice, and as a livelihood and cultural tradition. Based on our results, we recommend that community resilience be enhanced by generating more opportunities for men to achieve higher levels of human and economic capital (particularly outside of herding activities) and encouraging women to contribute more directly to institutional capital by participating in the formation and implementation of legislation, policies and plans.

Multistable Perception in Older Adults: Constructing a Whole from Fragments.

Visual perception is constructive in nature; that is, a coherent whole is generated from ambiguous fragments that are encountered in dynamic visual scenes. Creating this coherent whole from fragmented sensory inputs requires one to detect, identify, distinguish and organize sensory input. The organization of fragments into a coherent whole is facilitated by the continuous interactions between lower level sensory inputs and higher order processes. However, age-related declines are found in both neural structures and cognitive processes (e.g., attention and inhibition). The impact of these declines on the constructive nature of visual processing was the focus of this study. Here we asked younger adults, young-old (65-79 years), and old-old adults (80+ years) to view a multistable figure (i.e., Necker cube) under four conditions (free, priming, volition, and adaptation) and report, via a button press, when percepts spontaneously changed. The oldest-olds, unlike young-olds and younger adults, were influenced by priming, had less visual stability during volition and showed less ability to adapt to multistable stimuli. These results suggest that the ability to construct a coherent whole from fragments declines with age. More specifically, vision is constructed differently in the old-olds, which might influence environmental interpretations and navigational abilities in this age group.

Nursing Roles in Cardiac Safety: Romidepsin in Patients With T-Cell Lymphoma.

PURPOSE/OBJECTIVES: To provide information to help nurses mitigate cardiac risks among patients receiving romidepsin (Istodax®), a histone deacetylase (HDAC) inhibitor approved by the U.S. Food and Drug Administration for the treatment of relapsed/refractory cutaneous and peripheral T-cell lymphoma. 
. DATA SOURCES: Clinical studies of romidepsin represented the primary data sources. Supporting references included class information on HDAC inhibitors, as well as data regarding the impact of electrolyte imbalances and antiemetic treatment on electrocardiogram (ECG) data.
. DATA SYNTHESIS: Cardiac concerns during treatment with romidepsin are multifactorial. Electrolyte deficiencies, which are associated with ECG abnormalities and dysrhythmias, are common among patients with T-cell lymphoma. In addition, clinically insignificant changes in the corrected QT interval reported with romidepsin are primarily attributable to concomitant use of prophylactic antiemetics and likely exaggerated by transient increases in heart rate. 
. CONCLUSIONS: Data support the cardiac safety of romidepsin while cautioning about the need for nurses' vigilance regarding consistent electrolyte supplementation, appropriate antiemetic selection, and heart rate monitoring. 
. IMPLICATIONS FOR NURSING: By recognizing drug-related and non-drug-related influences on cardiac safety during treatment with romidepsin, as well as other anticancer agents, nurses can identify risks, report them, and recommend appropriate interventions, which, ultimately, facilitates improved patient outcomes.

Learning Through New Approaches to Forest Governance: Evidence from Harrop-Procter Community Forest, Canada.

Collaborative forest governance arrangements have been viewed as promising for sustainable forestry because they allow local communities to participate directly in management and benefit from resource use or protection. Such arrangements are strengthened through social learning during management activities that can enhance capacity to solve complex problems. Despite significant research on social learning in collaborative environmental governance, it is not clear how social learning evolves over time, who influences social learning, and whether learning influences management effectiveness. This study investigates how social learning outcomes change over time, using an in-depth study of a community forest in Canada. Personal interviews, focus group meetings, and participant observation revealed that most participants started engaging in community forestry with limited knowledge and learned as they participated in management activities. However, as the community forest organization became effective at complying with forestry legislation, learning opportunities and outcomes became more restricted. Our results run contrary to the prevalent view that opportunities for and outcomes of social learning become enlarged over time. In our case, learning how to meet governmental requirements increased professionalism and reduced opportunities for involvement and learning to a smaller group. Our findings suggest the need to further test propositions about social learning and collaborative governance, particularly to determine how relationships evolve over time.

Nursing Implications of Chemotherapy Agents and Their Associated Side Effects in Patients With Pancreatic Cancer.

BACKGROUND: Survival for patients with advanced (locally advanced unresectable and metastatic disease) pancreatic cancer is very poor; however, several advances in treatment have been made during the past several years. Gemcitabine (Gemzar®)-based regimens, FOLFIRINOX, and nab-paclitaxel (Abraxane®)-based regimens have demonstrated efficacy in patients with advanced pancreatic cancer. Understanding the unique safety profile of each of these regimens is crucial in helping nurses identify symptoms, develop patient education strategies, and ultimately improve outcomes. OBJECTIVES: This article aims to provide background information on and nursing implications of the treatment of patients with advanced pancreatic cancer by exploring the mechanism of action and efficacy and safety profiles of standard treatment regimens. METHODS: Key trials of standard treatment regimens used in the treatment of advanced pancreatic cancer were examined with respect to efficacy outcomes and the most commonly observed adverse events. Symptom identification and management strategies are discussed from the nursing perspective. FINDINGS: The current standard treatment options for patients with advanced pancreatic cancer have differences in efficacy and safety profiles. Nurses should educate themselves on these differences, particularly on associated adverse events and their management.

Compensatory plasticity in the deaf brain: effects on perception of music.

When one sense is unavailable, sensory responsibilities shift and processing of the remaining modalities becomes enhanced to compensate for missing information. This shift, referred to as compensatory plasticity, results in a unique sensory experience for individuals who are deaf, including the manner in which music is perceived. This paper evaluates the neural, behavioural and cognitive evidence for compensatory plasticity following auditory deprivation and considers how this manifests in a unique experience of music that emphasizes visual and vibrotactile modalities.

Building a community of practice for sustainability: strengthening learning and collective action of Canadian biosphere reserves through a national partnership.

Deliberation, dialogue and systematic learning are now considered attributes of good practice for organizations seeking to advance sustainability. Yet we do not know whether organizations that span spatial scales and governance responsibilities can establish effective communities of practice to facilitate learning and action. The purpose of this paper is to generate a framework that specifies actions and processes of a community of practice designed to instill collective learning and action strategies across a multi-level, multi-partner network. The framework is then used to describe and analyze a partnership among practitioners of Canada's 16 UNESCO biosphere reserves, and additional researchers and government representatives from across Canada. The framework is a cycle of seven action steps, beginning and ending with reflecting on and evaluating present practice. It is supported by seven characteristics of collaborative environmental management that are used to gauge the success of the partnership. Our results show that the partnership successfully built trust, established shared norms and common interest, created incentives to participate, generated value in information sharing and willingness to engage, demonstrated effective flow of information, and provided leadership and facilitation. Key to success was the presence of a multi-lingual facilitator who could bridge cultural differences across regions and academia-practitioner expectations. The project succeeded in establishing common goals, setting mutual expectations and building relations of trust and respect, and co-creating knowledge. It is too soon to determine whether changes in practices that support sustainability will be maintained over the long term and without the help of an outside facilitator.

Retest learning in the absence of item-specific effects: does it show in the oldest-old?

This study examined whether the nonitem-specific retest learning effects, previously shown with young-old adults primarily in their 60s and 70s, could be extended to oldest-old adults aged 80 and onward. Twenty-one oldest-olds participated in an 8-session retest training program with three ability domains: perceptual speed, inductive reasoning, and visual attention. Their data were compared with the data of 30 young-olds collected in a previous work (Yang, Reed, Russo, & Wilkinson, 2009). The two age groups showed largely equivalent retest learning effects. In addition, only young-olds were able to benefit from item-specific retest learning, specifically in reasoning and perceptual speed tests.