In palliative care, we strive to provide care to the whole patient. When we think about the whole patient, we include the people who are important in our patients' lives. Our New York City-based palliative care team has found that caring for patients' loved ones has proven to be an even more important aspect of the care we have provided during the COVID epidemic. In this article, we describe the multicomponenet interdisciplinary interventions we have implemented to enhance our ability to create a therapeutic alliance with family members and facilitate the provision of goal concordant care to patients with COVID during this extremely difficult time.

This study examined associations between maltreatment and early developmental vulnerabilities in a population sample of 68,459 children (M = 5.62 years, SD = .37) drawn from the Australian state of New South Wales, using linked administrative data for the children and their parents (collected 2001-2009). Associations were estimated between (a) any maltreatment, (b) the number of maltreatment types, and (c) the timing of first reported maltreatment and vulnerability and risk status on multiple developmental domains (i.e., physical, social, emotional, cognitive, and communication). Pervasive associations were revealed between maltreatment and all developmental domains; children exposed to two or more maltreatment types, and with first maltreatment reported after 3 years of age, showed greater likelihood of vulnerability on multiple domains, relative to nonmaltreated children.

Dispersal, retention, and population connectivity are impacted by current regime and the behaviors that drive larval distribution, so understanding both is key to informing restoration of native species like the Olympia oyster (Ostrea lurida) across its range in western North America. This study explores the relationships between several factors (temperature, [chl a], larval size, tidal stage, and estimated current speed) and Olympia oyster larval vertical distributions in Fidalgo Bay (48.4828, − 122.5811), a shallow, tidally flushed bay in the Salish Sea. Olympia oyster larvae collected from four depths over the tidal cycle from July 11–14, 2017, were ~ 20% deeper near slack tide and shallower during the faster parts of both ebb and flood, with a threshold for this transition around an estimated 25 cm s−1. This pattern does not suggest tidally timed migrations as has been shown in another population of Olympia oysters, nor can this pattern be totally explained by passive processes. Larvae did not cluster at depths with specific temperatures or [chl a] but there was a difference in larval size between surface and bottom waters, with older, larger larvae more common at the bottom. Fidalgo Bay does not exhibit two-way flow or strong vertical shear, so vertical distribution of larvae likely has little effect on transport in this system but might in other similarly shallow habitat areas with higher stratification that are target restoration sites in the Salish Sea. These results add to the growing number of studies that show location-specific differences in larval vertical distribution and behavior within taxa and underscore the importance of integrating local hydrodynamics into predictions of bivalve larval transport.

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