Our purpose is to categorize palliative care development, country by country, throughout the world, showing changes over time. We adopt a multi-method approach. Development is categorized using a six-part typology: Group 1 (no known hospice-palliative care activity) and Group 2 (capacity-building activity) are the same as developed during a previous study (2006), but Groups 3 and 4 have been subdivided to produce two additional levels of categorization: 3a) Isolated palliative care provision, 3b) Generalized palliative care provision, 4a) Countries where hospice-palliative care services are at a stage of preliminary integration into mainstream service provision, and 4b) Countries where hospice-palliative care services are at a stage of advanced integration into mainstream service provision. In 2011, 136 of the world's 234 countries (58%) had at least one palliative care service--an increase of 21 (+9%) from 2006, with the most significant gains having been made in Africa. Advanced integration of palliative care has been achieved in only 20 countries (8.5%). Total countries in each category are as follows: Group 1, 75 (32%); Group 2, 23 (10%); Group 3a, 74 (31.6%); Group 3b, 17 (7.3%); Group 4a, 25 (10.7%); and Group 4b, 20 (8.5%). Ratio of services to population among Group 4a/4b countries ranges from 1:34,000 (in Austria) to 1:8.5 million (in China); among Group 3a/3b countries, from 1:1000 (in Niue) to 1:90 million (in Pakistan). Although more than half of the world's countries have a palliative care service, many countries still have no provision, and major increases are needed before palliative care is generally accessible worldwide.

Palliative care is coming to be regarded as a human right. Yet globally, palliative care development appears patchy and comparative data about the distribution of services are generally unavailable. Our purpose is to categorize hospice-palliative care development, country by country, throughout the world, and then depict this development in a series of world and regional maps. We adopt a multimethod approach, which involves the synthesis of evidence from published and grey literature, regional experts, and a task force of the European Association of Palliative Care. Development is categorized using a four-part typology constructed during a previous review of palliative care in Africa. The four categories are (1) no identified hospice-palliative care activity, (2) capacity building activity but no service, (3) localized palliative care provision, and (4) countries where palliative care activities are approaching integration with mainstream service providers. We found palliative care services in 115/234 countries. Total countries in each category are as follows: (1) no identified activity 78 (33%), (2) capacity building 41 (18%), (3) localized provision 80 (34%), and (4) approaching integration 35 (15%). The ratio of services to population among Group 4 countries ranges from 1:43,000 (in the UK) to 1:4.28 million (in Kenya); among Group 3 countries it ranges from 1:14,000 (in Gibraltar) to 1:158 million (in Pakistan). The typology differentiates levels of palliative care development across the four hemispheres and in rich and poor settings. Although half of the world's countries have a palliative care service, far more are needed before such services are generally accessible worldwide.

Movement of a eukaryotic cell along a substrate occurs by extension of lamellipodia and pseudopodia at the anterior and retraction at the posterior of the cell. The molecular and structural mechanisms of these movements are uncertain. Dictyostelium discoideum contains two forms of myosin. Here we show by immunofluorescence microscopy that non-filamentous myosin I occurs at the leading edges of the lamellipodial projections of migrating Dictyostelium amoebae, which are devoid of myosin II, whereas filamentous myosin II is concentrated in the posterior of the cells. On the basis of these locations of the two forms of myosin and their known biochemical and biophysical properties, we suggest that actomyosin I may contribute to the forces that cause extension at the leading edge of a motile cell, while the contraction of actomyosin II at the rear squeezes the cell mass forward. Myosin I isozymes might have similar roles in metazoan cells, for example at the leading edges of neuronal growth cones, and in the extension of lamellipodia and pseudopodia of leukocytes, macrophages and fibroblasts.

Tones were delivered directly to the stapes in anesthetized cats after removal of the tympanic membrane, malleus, and incus. Measurements were made of the complex amplitudes of the sound pressure on the stapes PS, stapes velocity VS, and sound pressure in the vestibule PV. From these data, acoustic impedance of the stapes and cochlea ZSC delta equal to PS/US, and of the cochlea alone ZC delta equal PV/US were computed (US delta equal to volume velocity of the stapes = VS X area of the stapes footplate). Some measurements were made on modified preparations in which (1) holes were drilled into the vestibule and scala tympani, (2) the basal end of the basilar membrane was destroyed, (3) cochlear fluid was removed, or (4) static pressure was applied to the stapes. For frequencies between 0.5 and 5 kHz, ZSC approximately equal to ZC; this impedance is primarily resistive ([ZC] approximately equal to 1.2 X 10(6) dyn-s/cm5) and is determined by the basilar membrane and cochlear fluids. For frequencies below 0.3 kHz, [ZSC] greater than [ZC] and ZSC is primarily determined by the stiffness of the annular ligament; drying of the ligament or changes in the static pressure difference across the footplate can produce large changes in [ZSC]. For frequencies below 30 Hz, ZC is apparently controlled by the stiffness of the round-window membrane. All of the results can be represented by an network of eight lumped elements in which some of the elements can be associated with specific anatomical structures. Computations indicate that for the cat the sound pressure at the input to the cochlea at behavioral threshold is constant between 1 and 8 kHz, but increases as frequency is decreased below 1 kHz. Apparently, mechanisms within the chochlea (or more centrally) have an important influence on the frequency dependence of behavioral threshold at low frequencies.