Bridging the Gap: Developing a Palliative Approach to Care for Young Adults with Life Limiting Conditions

Bridging the Gap: Developing a Palliative Approach to Care for Young Adults with Life Limiting Conditions

More young adults (YAs) with life limiting conditions (LLC) are surviving into adulthood as earlier diagnosis and improved medical management in pediatric care lead to higher rates of survival for cancer, congenital heart and neuromuscular conditions. When these YAs leave pediatric care, they leave behind comprehensive and coordinated health, social and education services for uncoordinated adult systems, with limited access to palliative services they received in pediatric care.

YAs with LLCs will benefit from a public health palliative approach to care. This approach better matches their chronic disease trajectories of a series of declining plateaus over a period of months to years, punctuated by unpredictable periodic crises. Public health palliative care is a blended provision of health care and community services based on evidence that health care is most effective and least expensive when offered in conjunction with a complement of services that reflects social determinants of health and well-being. For YAs with LLCs, these resources will support their health, social, vocational, independent living, and educational goals to maximize their opportunities in an abbreviated time frame.


The objectives of this workshop are to:

1. Provide an overview of the young adult population with palliative care needs.
2. Discuss current care of this population.
3. Highlight results from three recent projects to examine and address needs of this population.
4. Dialogue with audience about other programs, initiatives, or ideas to address the needs of this population.

We look forward to robust conversations and ideas from your practice and research.

A Gap with a Deficit of Large Grains in the Protoplanetary Disk around TW Hya

We report 3 au resolution imaging observations of the protoplanetary disk aroundTW Hya at 145 and 233 GHz with the Atacama Large Millimeter/Submillimeter Array.Our observations revealed two deep gaps (~25-50 %) at 22 and 37 au and shallowergaps (a few %) at 6, 28, and 44 au, as recently reported by Andrews et al. (2016). Thecentral hole with a radius of  3 au was also marginally resolved. The most remarkablefinding is that the spectral index α(R) between bands 4 and 6 peaks at the 22 au gap.The derived power-law index of the dust opacity β(R) is  ~1.7 at the 22 au gap anddecreases toward the disk center to ~0. The most prominent gap at 22 au could becaused by the gravitational interaction between the disk and an unseen planet with amass of ≲1.5 MNeptune although other origins may be possible. The planet-induced gap is supported by the fact that β(R) is enhanced at the 22 au gap, indicating a deficitof mm-sized grains within the gap due to dust filtration by a planet.

Resolving conflict in bipolar societies: The fate of political settlements in Fiji and Northern Ireland

Ethnically divided societies that might be described as ‘balanced bicommunal’ (where there are two communities, each of which comes close to representing half of the population) pose a particular challenge to conventional principles of collective decision-making, and commonly threaten political stability. This article analyses the experience of two such societies – Northern Ireland and Fiji – with a view to exploring whether there are common processes in the route by which political stability has been pursued. We assess the manner in which a distinctive relationship with Great Britain and its political culture has interacted with local conditions to produce a highly competitive, bipolar party system. This leads to consideration of the devices that have been adopted in an effort to bridge the gap between the communities: the Fiji constitution as amended in 1997, and Northern Ireland’s Good Friday Agreement of 1998. We focus, in particular, on the use of unusual (preferential voting) formulas for the election of parliamentarians and of an inclusive principle in the selection of ministers, and consider the contribution of these institutional devices to the attainment of political stability. We find that, in both cases, the intervention of forces from outside the political system had a decisive impact, though in very different ways. In addition to being underpinned by solid institutional design, for political settlements to work effectively, some minimal level of trust between rival elites is required.