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Effective Management (effective + management)
Terms modified by Effective Management Selected AbstractsKEEPING PACE WITH EVOLVING PRISON POPULATIONS FOR EFFECTIVE MANAGEMENTCRIMINOLOGY AND PUBLIC POLICY, Issue 2 2003JOHN WOOLDREDGE [source] Effective Management of ICD Patient Psychosocial Issues and Patient Critical EventsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2009SAMUEL F. SEARS Ph.D. The clinical management of implantable cardioverter-defibrillator (ICD) patients involves successful medical and psychosocial care to reduce mortality and morbidity. Desirable quality of life (QoL) and psychosocial outcomes for ICD patients are achievable for a majority of ICD patients. Patient critical events, such as ICD shocks or ICD recalls, may occur that can dramatically alter the course of patient adjustment if not properly managed. Continuing care strategies that attend to patient critical events as they emerge may improve the psychosocial adjustment and improve the return to optimal daily functioning for ICD patients. This paper reviews QoL and psychosocial outcomes for ICD patients, patient critical events, and clinical implications for patient care. Patient critical events discussed in this paper include perioperative education, ICD shock events, device recalls, and end of life. The clinical management strategies for each of these patient critical events are suggested including patient education, psychosocial information provision, activity prescriptions, recall planning, and shock planning. [source] Multidisciplinary Teaming to Promote Effective Management of Type 1 Diabetes for AdolescentsJOURNAL OF SCHOOL HEALTH, Issue 6 2001MaryAnn Tapper Strawhacker BSN, RN Special Education Nursing Consultant ABSTRACT: Intensive diabetes therapy can reduce the long-term microvascular complications of Type 1 diabetes and improve glucose control. Managing the demands of intensive therapy however, often poses a burden on adolescents and their families. Through multidisciplinary teaming, the school health office can facilitate active participation in treatment, coordinate services, and maximize use of community resources. This paper presents a general overview of intensive diabetes therapy, psychosocial implications of chronic illness in adolescence, effects of chronic illness on the family, and behavior change strategies to improve adherence with disease management guidelines. [source] Psychodrama: helping families to adapt to childhood diabetesEUROPEAN DIABETES NURSING, Issue 3 2006B Bektas RN. Abstract Effective management of diabetes in children requires a holistic approach that takes into account the roles of diabetes education, treatment and disease management, and the integral role of family relationships. Psychodrama is a group-based psychological support technique that aims to improve the acceptance and understanding of diabetes within the families of diagnosed children. Through group improvisation, role plays and feedback sessions, the families of children with diabetes participate in a cathartic process that helps them to share their problems, benefit from others' insight and feedback and to discuss behavioural changes that will avoid similar problems in the future. The families that participated in this study reported an enhanced understanding of the contribution that relationships with their children have on the successful management of their diabetes. Through recognition of the reasons for their anxieties about their children's diabetes, they were able to address fixed behavioural patterns in a supportive, non-judgmental arena, and to work towards positive change. Their children benefited indirectly through changes in their parents' behaviour and improved communication within their families. A reduction in the children's HbA1c levels was observed through the course of the study, although this could not be considered a direct result of psychodrama. Copyright © 2006 FEND. [source] Effective management of adverse effects while on oral chemotherapy: implications for nursing practiceEUROPEAN JOURNAL OF CANCER CARE, Issue 2010K. HARROLD rn, bsc ( hons ), chemotherapy, iv access clinical nurse specialist HARROLD K. (2010) European Journal of Cancer Care19, 12,20 Effective management of adverse effects while on oral chemotherapy: implications for nursing practice The publication of guidelines by the United Kingdom National Patient Safety Agency and the National Confidential Enquiry into Patient Outcome and Death which looked into deaths within 30 days of systemic anticancer therapy and the more recent position statement from the United Kingdom Oncology Nursing Society have all highlighted the need for an improvement in the care and management of patients receiving oral chemotherapy. While it is essential that patients are aware of the rationale behind dose interruption and modification if they are to effectively deal with toxicities and complications that may arise, they also require access to a clear line of communication in order to facilitate early intervention. The value of pre treatment patient education and ongoing support for these patients has already been extensively documented and while a multidisciplinary team approach in this is vital, nurses are ideally placed to take a leading role in these two aspects of treatment management. This article aims to detail and review current best management practices for the most commonly reported toxicities associated with capecitabine, an oral chemotherapeutic agent used in the management of patients with colorectal cancer. Only if both the patient and the health care professional supporting them are aware of best management practices will the impact of toxicities be minimised and treatment outcomes optimised. [source] Lack of management of cardiovascular risk factors in type 2 diabetic patientsINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2007K. E. Yun Summary Effective management of diabetic patients includes comprehensive control for not only blood sugar, but also other cardiovascular risk factors. We assessed whether haemoglobin A1c (A1C) concentrations, blood pressure, low density lipoprotein (LDL) cholesterol levels and microalbuminuria were regularly measured in 281 patients with type 2 diabetes who received care for over 1 year in the Department of Family Medicine located in an urban area of Korea. Subsequently, in patients with A1C > 7%; blood pressure >130/80 mmHg; LDL cholesterol levels >100 mg/dl; or microalbuminuria, we evaluated the status of management for those cardiovascular risk factors. Physicians were most likely to measure A1C levels (98.6%), but less likely to measure microalbuminuria (56.2%), LDL cholesterol (73.7%), or blood pressure (74.4%). Patients whose A1C levels were above the goal (78.2%) were likely to receive optimal therapy. In contrast, only 21.1% of patients with uncontrolled blood pressure and 5.3% of patients with LDL cholesterol levels above the target range received optimal management. Of the 36 patients with microalbuminuria or overt proteinuria, 66.7% took angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Measurement of parameters indicating cardiovascular risk factors in type 2 diabetic patients was not optimal, particularly regular measurements for microalbuminuria and for controlling LDL-cholesterol and blood pressure. These findings indicate a need for greater education of comprehensive cardiovascular management in type 2 diabetic patients and their physicians. [source] Reducing the Incidence of Denture Stomatitis: Are Denture Cleansers Sufficient?JOURNAL OF PROSTHODONTICS, Issue 4 2010Anto Jose MSc Abstract Purpose:,Candida albicans is the predominant oral yeast associated with denture stomatitis. With an increasing population of denture wearers, the incidence of denture stomatitis is increasing. Effective management of these patients will alleviate the morbidity associated with this disease. The aim of this study was to examine the capacity of four denture cleansers to efficiently decontaminate and sterilize surfaces covered by C. albicans biofilms. Materials and Methods: Sixteen C. albicans strains isolated from denture stomatitis patients and strain ATCC 90028 were grown as mature confluent biofilms on a 96-well format and immersed in Dentural, MedicalÔ Interporous®, Steradent Active Plus, and Boots Smile denture cleansers according to the manufacturers' instructions or overnight. The metabolic activity and biomass of the biofilms were then quantified, and scanning electron microscopy (SEM) used to examine treated biofilms. Results: Dentural was the most effective denture cleanser, reducing the biomass by greater than 90% after 20 minutes. Steradent Active plus was significantly more effective following 10-minute immersion than overnight (p < 0.001). All cleansers reduced the metabolic activity by greater than 80% following overnight immersion; however, Boots Smile exhibited significantly reduced metabolic activity following only a 15-minute immersion (p < 0.001). SEM revealed residual C. albicans material following Dentural treatment. Conclusions: This study showed that denture cleansers exhibit effective anti- C. albicans biofilm activity, both in terms of removal and disinfection; however, residual biofilm retention that could lead to regrowth and denture colonization was observed. Therefore, alternative mechanical disruptive methods are required to enhance biofilm removal. [source] Diagnosis and management of geriatric insomnia: A guide for nurse practitionersJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2008MN (Nurse Practitioner), Preetha Krishnan RN Abstract Purpose: To discuss the assessment, diagnosis, and management of geriatric insomnia, a challenging clinical condition of older adults frequently seen by primary care providers. Data sources: Extensive literature review of the published research articles and textbooks. Conclusions: Complaints of insomnia among older adults are frequently ignored, considered a part of the normal aging process or viewed as a difficult to treat condition. Geriatric insomnia remains a challenge for primary care providers because of the lack of evidence-based clinical guidelines and limited treatment options available. Effective management of this condition is necessary for improved quality of life, which is a primary issue for the elderly and their families. Therefore, geriatric insomnia warrants thorough attention from the nurse practitioners (NPs) who provide care for older adults. Implications for practice: Undiagnosed or under treated insomnia can cause increased risk for falls, motor vehicle accidents, depression, and shorter survival. Insomniacs double their risk for cardiovascular disease, stroke, cancer, and suicide compared to their counterparts. Insomnia is also associated with increased healthcare utilization and institutionalization. NPs could play a central role in reducing the negative consequences of insomnia through a systematic approach for diagnosis, evaluation, and management. [source] Effective management of a psoriatic flare with narrowband UVB phototherapy during efalizumab therapy without discontinuing treatmentJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2007JM Carrascosa [source] Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crisesMEDICAL EDUCATION, Issue 4 2008Jennifer M Weller Objectives, We placed anaesthesia teams into a stressful environment in order to explore interactions between members of different professional groups and to investigate their perspectives on the impact of these interactions on team performance. Methods, Ten anaesthetists, 5 nurses and 5 trained anaesthetic assistants each participated in 2 full-immersion simulations of critical events using a high-fidelity computerised patient simulator. Their perceptions of team interactions were explored through questionnaires and semi-structured interviews. Written questionnaire data and interview transcriptions were entered into N6 qualitative software. Data were analysed by 2 investigators for emerging themes and coded to produce reports on each theme. Results, We found evidence of limited understanding of the roles and capabilities of team members across professional boundaries, different perceptions of appropriate roles and responsibilities for different members of the team, limited sharing of information between team members and limited team input into decision making. There was a perceived impact on task distribution and the optimal utilisation of resources within the team. Conclusions, Effective management of medical emergencies depends on optimal team function. We have identified important factors affecting interactions between different health professionals in the anaesthesia team, and their perceived influences on team function. This provides evidence on which to build appropriate and specific strategies for interdisciplinary team training in operating theatre staff. [source] Teaching and learning about human sexuality in undergraduate medical educationMEDICAL EDUCATION, Issue 5 2002Mary Dixon-Woods Background Effective management of the doctor's role in relation to human sexuality requires sensitivity and tact, an ability to put patients at ease, use of appropriate language, and therapeutic, non-discriminatory attitudes. However, previous research suggests that medical students and doctors may hold negative attitudes towards homosexuality and some forms of sexual behaviour. Some educational programmes have started to help students develop communication skills for sexual health consultations, but little work has addressed the broader issue of attitudes and values which may underlie behaviour. It is vital that medical students begin early the process of reflection and recognition of how their attitudes and values might influence their care of patients. In this paper we report on a course designed to initiate this process at Leicester-Warwick Medical School (LWMS). Course description The course utilizes techniques of desensitization, problem-solving and reflection to enable the students to achieve the learning outcomes, which are primarily oriented towards reflection and self-development. It uses a variety of teaching and learning strategies, combining peer learning with self-directed learning, and small-group learning with whole class learning. Course evaluation We report observations and a before-and-after questionnaire study of students' views and attitudes. This evaluation suggests that the course is successful in reducing students' anxieties about human sexuality and improving their confidence in developing appropriate skills. Conclusions The LWMS course is one model which might be used to begin the process of encouraging medical students to develop ways of appropriately managing their responsibilities in relation to human sexuality. [source] Effective management of smoking in an oral dysplasia clinic in LondonORAL DISEASES, Issue 1 2006TWJ Poate Background:, Precancerous lesions precede the development of oral cancer; of several clinical types the most common is leukoplakia. The risk factors include tobacco and excess alcohol use and diets low in antioxidants. Studies concerning the management of risk factors related to oral precancer are meager. Objectives:, We investigated the effectiveness of smoking cessation at a dysplasia clinic among patients followed up for at least for 12 months. Methods:, Data from case notes relating to180 patients with white and red patches of oral mucosa (excluding other benign disorders confirmed by biopsy findings) attending a dysplasia clinic at a teaching hospital in London and seen by one consultant between 1993 and 2003 were transcribed. Effect of referring to a smoker's clinic to receive specialist help was evaluated against brief advice given at the dysplasia clinic ± medications. Results:, The mean age at the first visit was 48.5 years (±12.5), 65% were male, and 88% were white European. One hundred and sixty-two patients (90%) had used tobacco and 83% were current smokers. Of the smokers 95% had smoked over 10 years, the majority smoking over 10 cigarettes per day. Nine were alcohol misusers including two binge drinkers. One hundred and forty-six were diagnosed with oral leukoplakia, 16 with non-homogeneous types (speckled or nodular). Three patients were diagnosed with an erythroplakia. Nineteen per cent exhibited the presence of dysplasia and one subject had in situ carcinoma. Five patients in the sample quit smoking prior to arrival in the dysplasia clinic. Twenty-seven cases (20%) with oral leukoplakia quit smoking while registered as a patient at the dysplasia clinic: 17 of 100 subjects quit with brief advice ± medications and 10 of 30 following referral to the smoker's clinic. The difference between the two groups was significant for point prevalence abstinence at the last visit to the clinic (minimum 12 months follow up). Out of a total of 180 precancer cases managed in the dysplasia clinic (mean follow up 4.2 years) three patients subsequently developed invasive carcinoma during follow up. Conclusions:, Smoking cessation needs to be an integral component of management of cases attending a dysplasia clinic and referring to smoker's clinics could help to improve the effectiveness of managing patients with oral precancer to quit smoking. [source] Effective management of accelerated phase myelofibrosis with low-dose splenic radiotherapy,AMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2010A. Pardanani No abstract is available for this article. [source] Diagnosis and Management of the Painful Ankle/Foot.PAIN PRACTICE, Issue 4 2003Interpretation, Management, Part 2: Examination ,,Abstract: Diagnosis, interpretation, and subsequent management of ankle/foot pathology can be challenging to clinicians. A sensitive and specific physical examination is the strategy of choice for diagnosing selected ankle/foot injuries and additional diagnostic procedures, at considerable cost, may not provide additional information for clinical diagnosis and management. Because of a distal location in the sclerotome and the reduced convergence of afferent signals from this region to the dorsal horn of the spinal cord, pain reference patterns are low and the localization of symptoms is trustworthy. Effective management of the painful ankle/foot is closely linked to a tissue-specific clinical examination. The examination of the ankle/foot should include passive and resistive tests that provide information regarding movement limitations and pain provocation. Special tests can augment the findings from the examination, suggesting compromises in the structural and functional integrity of the ankle/foot complex. The weight bearing function of the ankle/foot compounds the clinician's diagnostic picture, as limits and pain provocation are frequently produced only when the patient attempts to function in weight bearing. As a consequence, clinicians should consider this feature by implementing numerous weightbearing components in the diagnosis and management of ankle/foot afflictions. Limits in passive motion can be classified as either capsular or non-capsular patterns. Conversely, patients can present with ankle/foot pain that demonstrates no limitation of motion. Bursitis, tendopathy, compression neuropathy, and instability can produce ankle/foot pain that is challenging to diagnose, especially when they are the consequence of functional weight bearing. Numerous non-surgical measures can be implemented in treating the painful ankle/foot, reserving surgical interventions for those patients who are resistant to conservative care.,, [source] Patent ductus arteriosus flow patterns in the treatment of congenital diaphragmatic herniaPEDIATRICS INTERNATIONAL, Issue 4 2009Shinya Okamoto Abstract Background:, Congenital diaphragmatic hernia (CDH) mortality still remains high, due to lung hypoplasia and persistent pulmonary hypertension of the neonate (PPHN). Effective management of PPHN and time of operation are quite important to the improvement of CDH treatment. In order to determine the optimal time for operation, we monitored PPHN with cardiac ultrasound. Methods:, PPHN was assessed with three parameters: patent ductus arteriosus flow patterns (PDAFP), %left ventricular diameter at diastole, and left ventricular fraction of shortening (LVFS). Four patients with an antenatal diagnosis were treated under this protocol. Diaphragm repair was performed when PDAFP became left to right shunt dominant and the pre- and postoperative course was analyzed with regular chart reviews. Results:, The alveolar-arterial oxygen difference levels of four patients were 590, 335, 613 and 530 mmHg, and operations were carried out when the patients were 2, 2, 3 and 2 days old, respectively. In three of the four patients (all except case 3) the PDAFP changed from right to left shunt dominant or bidirectional (BD), to left to right shunt dominant within 48 h. The %left ventricular diameter at diastole was relatively stable around the time of operation. The LVFS of all patients decreased after the operation. Only the LVFS of case 3 decreased temporarily to less than 30% (which indicates poor left ventricular function) but recovered. No patients needed extracorporeal membrane oxygenation support. All patients survived the procedure and were extubated. Case 3, who took 10 days to become left to right shunt dominant after the operation, needed home oxygenation therapy for 10 months. Conclusions:, PDAFP was a reliable marker of PPHN on a high-frequency oscillatory ventilator to determine the optimal time for the operation for CDH. The optimal time for operation is supposed to be the time when PDAFP become left to right shunt dominant. [source] Managing the matrix for large carnivores: a novel approach and perspective from cheetah (Acinonyx jubatus) habitat suitability modellingANIMAL CONSERVATION, Issue 1 2006J. R. Muntifering Abstract Effective management within the human-dominated matrix, outside of formally protected areas, is of paramount importance to wide-ranging carnviores. For instance, the largest extant population of cheetahs Acinonyx jubatus currently persists on privately owned Namibian ranchlands, and provides an excellent case study to examine and design matrix conservation approaches. Although human-caused mortality is likely the principal threat to this population, ancedotal evidence suggests that ,bush encroachment', the widespread conversion of mixed woodland and savannah habitats to dense, Acacia -dominated thickets, is another probable threat. A better understanding of cheetah habitat use, outside of protected areas, could be used to directly influence habitat management strategies and design local restoration and conflict mitigation efforts. To identify specific habitat characteristics associated with cheetah use, we used radio-telemetry locations to identify areas used intensively by cheetahs on commercial Namibian farms. We then compared the habitat characteristics of these ,high-use' areas with adjacent ,low-use' areas. A binary logistic regression model correctly categorized 92% of plot locations as high or low use, and suggested that cheetahs may be utilizing ,rewarding patches' with better sighting visibility and greater grass cover. We discuss the possible reasons for kudu Tragelaphus strepsiceros, Namibian cheetahs' preferred prey, exhibiting significantly lower abundance in high-use areas. Using habitat characteristics to identify areas intensively utilized by cheetahs has important implications for guiding future habitat restoration and developing effective predator conflict mitigation efforts. [source] Mammalian Densities in a Neotropical Wetland Subject to Extreme Climatic EventsBIOTROPICA, Issue 3 2010Arnaud Léonard Jean Desbiez ABSTRACT Effective management and conservation of an ecosystem requires information on species assemblages as well as reliable estimates of population sizes to plan, implement and evaluate management strategies. The Brazilian Pantanal is one of the world's largest freshwater wetlands and considered a priority landscape for wildlife conservation. It is subject to pluri-annual extreme dry and wet periods, which cause extreme flood and drought events, which strongly affect wildlife. Using the line-transect method, this study examined the distribution of densities and metabolic biomass of medium- to large-sized nonvolant mammals in forest, cerrado and floodplain landscapes, in an area with low anthropogenic influence, in the central area of the Brazilian Pantanal during a prolonged drought. Comparisons with a previous survey conducted during years of average rainfall in part of the study area suggest that population fluctuations of certain species are closely associated with water due to the drought. Results from this study showed that mammal assemblages varied between landscapes. Forested landscapes have the highest densities of mammals and are the most important in terms of relative energy consumption. In addition, at the time of the study, frugivores were found to have higher energy consumption than browser/grazers across the three landscapes; most fruits are produced in forested areas stressing their importance. By converting forested landscapes into grasslands, the intensification of ranching practices seriously threatens biodiversity and ecological processes in the region. Abstract in Portuguese is available at http://www.blackwell-synergy.com/loi/btp [source] Chronic pelvic pain in women: still a challengeBJU INTERNATIONAL, Issue 9 2008Orietta Dalpiaz Chronic pelvic pain (CPP), a common condition particularly in reproductive-aged women, causes disability and distress, and significantly compromises quality of life and affects healthcare costs. The pathogenesis of CPP is still poorly understood and consequently poorly managed. Furthermore, the lack of a consensus on the definition of CPP greatly hinders epidemiological studies. Patients present with various associated problems, including bladder or bowel dysfunction, gynaecological pathologies or sexual dysfunction, and other systemic or constitutional symptoms. Other conditions, e.g. depression, anxiety and drug addiction, can also coexist. Effective management presupposes an integrated knowledge of all pelvic organs and other systems, including musculoskeletal, neurological and psychiatric systems. The key to treating CPP is to treat it as the complex disease it is. Treatment options range from conservative medical therapy to surgical intervention, and are primarily directed towards symptom relief. Unsatisfactory results of treatment render this condition a frustrating problem for both patients and physicians. [source] Design and realization of the cooperative work system based on equipments sharingCOMPUTER APPLICATIONS IN ENGINEERING EDUCATION, Issue 4 2009Bo Yan Abstract With analysis on the necessity and functions of the equipments sharing platform and the cooperative work system for colleges and universities, this paper designs the cooperative work system to provide cooperative support for resource query and reservation. The system classifies users' resource application roles, divides users' application information into different cooperative grades, and provides a basis for users' cooperative work. Functions, authorization, page flow, operating methods, and relevant database table of cooperative roles are shown in detail. At the same time, the ASP system will be introduced into the system, and a special fee management system will be established for effective management of the system. Functions and page flow of the fee management system are also designed. © 2009 Wiley Periodicals, Inc. Comput Appl Eng Educ 17: 372,378, 2009; Published online in Wiley InterScience (www.interscience.wiley.com); DOI 10.1002/cae.20195 [source] The Conservation Relevance of Epidemiological Research into Carnivore Viral Diseases in the SerengetiCONSERVATION BIOLOGY, Issue 3 2007SARAH CLEAVELAND conservación de carnívoros; investigación epidemiológica; moquillo; rabia; Serengeti Abstract:,Recent outbreaks of rabies and canine distemper in wildlife populations of the Serengeti show that infectious disease constitutes a significant cause of mortality that can result in regional extirpation of endangered species even within large, well-protected areas. Nevertheless, effective management of an infectious disease depends critically on understanding the epidemiological dynamics of the causative pathogen. Pathogens with short infection cycles cannot persist in small populations in the absence of a more permanent reservoir of infection. Development of appropriate interventions requires detailed data on transmission pathways between reservoirs and wildlife populations of conservation concern. Relevant data can be derived from long-term population monitoring, epidemic and case-surveillance patterns, genetic analyses of rapidly evolving pathogens, serological surveys, and intervention studies. We examined studies of carnivore diseases in the Serengeti. Epidemiological research contributes to wildlife conservation policy in terms of management of endangered populations and the integration of wildlife conservation with public health interventions. Long-term, integrative, cross-species research is essential for formulation of effective policy for disease control and optimization of ecosystem health. Resumen:,Brotes recientes de rabia y moquillo en poblaciones silvestres del Serengeti muestran que las enfermedades infecciosas constituyen una causa significativa de mortandad que puede resultar en la extirpación regional de especies en peligro, aun en áreas extensas bien protegidas. Sin embargo, el manejo efectivo de una enfermedad infecciosa depende críticamente del entendimiento de la dinámica epidemiológica del patógeno. Los patógenos con ciclo infeccioso corto no pueden persistir en poblaciones pequeñas en ausencia de un reservorio de la infección más permanente. El desarrollo de intervenciones adecuadas requiere de datos detallados de las vías de transmisión entre reservorios y poblaciones de vida silvestre de preocupación para la conservación. Se pueden derivar datos importantes del monitoreo de poblaciones a largo plazo, de patrones de epidemias y de estudios de caso, del análisis genético de patógenos que evolucionan rápidamente, de muestreos sexológicos y de estudios de intervención. Examinamos estudios de enfermedades de carnívoros en el Serengeti. La investigación epidemiológica contribuye a las políticas de conservación de vida silvestre en términos de la gestión de poblaciones en peligro y de la integración de la conservación con intervenciones de salud pública. La investigación a largo plazo e integradora es esencial para la formulación de políticas efectivas para el control de enfermedades y la optimización de la salud del ecosistema. [source] Understanding the Causes of Disease in European Freshwater CrayfishCONSERVATION BIOLOGY, Issue 6 2004BRETT F. EDGERTON Aphanomyces astaci; bioseguridad; epizootia; langostinos de agua dulce; patología de langostinos; peste de langostinos Abstract:,Native European freshwater crayfish (Astacida, Decapoda) are under severe pressure from habitat alteration, the introduction of nonindigenous species, and epizootic disease. Crayfish plague, an acute disease of freshwater crayfish caused by the fungus-like agent Aphanomyces astaci, was introduced into Europe in the mid-nineteenth century and is responsible for ongoing widespread epizootic mortality in native European populations. We reviewed recent developments and current practices in the field of crayfish pathology. The severity of crayfish plague has resulted in an overemphasis on it. Diagnostic methods for detecting fungi and fungal-like agents, and sometimes culturing them, are frequently the sole techniques used to investigate disease outbreaks in European freshwater crayfish. Consequently, the causes of a significant proportion of outbreaks are undetermined. Pathogen groups well known for causing disease in other crustaceans, such as viruses and rickettsia-like organisms, are poorly understood or unknown in European freshwater crayfish. Moreover, the pathogenic significance of some long-known pathogens of European freshwater crayfish remains obscure. For effective management of this culturally significant and threatened resource, there is an urgent need for researchers, diagnosticians, and resource managers to address the issue of disease in European freshwater crayfish from a broader perspective than has been applied previously. Resumen:,Los langostinos nativos de Europa (Astacida, Decapada) están bajo severa presión por alteración del hábitat, la introducción de especies no nativas y una enfermedad epizoótica. La peste de langostinos, una enfermedad aguda de langostinos de agua dulce producida por el agente micoide Aphanomyces astaci, fue introducida a Europa a mediados del siglo diecinueve y es responsable de la actual mortalidad epizoótica de poblaciones Europeas nativas. Revisamos acontecimientos recientes y prácticas actuales en el campo de la patología de langostinos. La severidad de la peste de langostinos ha resultado en un excesivo énfasis en ella. Los métodos para diagnosticar, y algunas veces cultivar, hongos y agentes micoides frecuentemente son la única técnica empleada al investigar brotes de la enfermedad en langostinos de agua dulce en Europa. Consecuentemente, no están determinadas las causas de una proporción significativa de los brotes. Grupos patógenos, como virus y organismos similares a rickettsias, bien conocidos por producir enfermedades en otros crustáceos son poco o nada conocidos en langostinos de agua dulce de Europa. Más aún, el significado patogénico de algunos patógenos de langostinos de agua dulce de Europa largamente conocidos es oscuro. Para el manejo efectivo de este recurso culturalmente significativo y amenazado es urgente la necesidad de investigadores, diagnosticadores y gestores de recursos para atender el asunto de la enfermedad en langostinos de agua dulce europeos desde una perspectiva más amplia que la previamente aplicada. [source] Reassessing the value of nursery areas to shark conservation and managementCONSERVATION LETTERS, Issue 2 2009Michael John Kinney Abstract Concern over declining shark populations has led to an intense interest in their conservation and management. Due to the difficulties involved in managing adult sharks, focus has been placed on young juvenile and neonate age classes that inhabit discrete inshore nursery areas. However, past confusion over what qualifies as a nursery habitat has led to the identification of vast coastal areas as nurseries, making conservation unfeasible. With the establishment of more discerning criteria for nursery area identification such concerns have been somewhat alleviated, but while effort has been put into defining, identifying, mapping, and in some cases protecting nursery areas, little attention has been paid to the practical value of nurseries for the recovery of exploited shark populations. Often neonate and young juveniles are considered the most critical age classes in terms of population stability/recovery, but evidence is mounting that suggests life stages outside the nursery may be more important in this regard. While nursery area protection should remain a component in shark management strategies it will be critical to link early life stage conservation with management strategies that encompass older individuals residing outside nurseries if effective management is to be achieved. [source] Postprandial hyperglycaemia in type 2 diabetes: pathophysiological aspects, teleological notions and flags for clinical practiceDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S2 2004Eleni I. Boutati Abstract Type 2 diabetes subjects carry an excess risk for micro- and macrovascular disease and a higher cardiovascular morbidity and mortality rate. The beneficial impact of tight glycaemic control,evidenced by the integrated marker of fasting glucose and postprandial glucose values, the HbA1c,for the prevention of microvascular complications is definitely confirmed. Over the past few years, several studies have identified postprandial hyperglycaemia as a better predictor of cardiovascular or even of all-cause mortality, as well as an independent risk factor for atherosclerosis. The continuous glucose monitoring could offer a rationale means for the detection of postprandial hyperglycaemia and ultimately for its effective management. Advances in technology keep a promise for a reliable, convenient and closer to the idea of the artificial endocrine pancreas glucose sensor. Subcutaneous glucose levels charted by one of the new sensors were found to be well correlated with venous glucose measurements. Intervention for a healthy lifestyle is frequently hampered by patients' poor compliance. The availability of diverse antidiabetic agents provides options for targeting the glycaemic goal and a choice more fitted to the particularized pathophysiology of each individual subject. Drugs targeting postprandial glycaemia may prove to represent the ,sine qua non' for the ,return' of postprandial glucose values at a ,non-deleterious' threshold, either as monotherapy for the early stages of the disease or as combination therapy later in the progression of diabetes. Copyright © 2004 John Wiley & Sons, Ltd. [source] Peripheral arterial disease in diabetes,a reviewDIABETIC MEDICINE, Issue 1 2010E. B. Jude Diabet. Med. 27, 4,14 (2010) Abstract Diabetic patients are at high risk for peripheral arterial disease (PAD) characterized by symptoms of intermittent claudication or critical limb ischaemia. Given the inconsistencies of clinical findings in the diagnosis of PAD in the diabetic patient, measurement of ankle-brachial pressure index (ABI) has emerged as the relatively simple, non-invasive and inexpensive diagnostic tool of choice. An ABI < 0.9 is not only diagnostic of PAD even in the asymptomatic patient, but is also an independent marker of increased morbidity and mortality from cardiovascular diseases. With better understanding of the process of atherosclerosis, avenues for treatment have increased. Modification of lifestyle and effective management of the established risk factors such as smoking, dyslipidaemia, hyperglycaemia and hypertension retard the progression of the disease and reduce cardiovascular events in these patients. Newer risk factors such as insulin resistance, hyperfibrinogenaemia, hyperhomocysteinaemia and low-grade inflammation have been identified, but the advantages of modifying them in patients with PAD are yet to be proven. Therapeutic angiogenesis, on the other hand, represents a promising therapeutic adjunct in the management of PAD in these patients. Outcomes after revascularization procedures, such as percutaneous transluminal angioplasty and surgical bypasses in diabetic patients, are poorer, with increased perioperative morbidity and mortality compared with that in non-diabetic patients. Amputation rates are higher due to the distal nature of the disease. Efforts towards increasing awareness and intensive treatment of the risk factors will help to reduce morbidity and mortality in diabetic patients with PAD. [source] Civil Society and the State: Turkey After the EarthquakeDISASTERS, Issue 2 2002Rita Jalali On 17 August 1999 Turkey was hit by a massive earthquake. Over 17,000 lives were lost and there was extensive damage to Turkey's heartland. This paper examines how various public and private institutions, including state and civil society institutions such as NGOs and the media responded to the needs of earthquake survivors. It documents the extensive involvement of NGOs in the relief efforts immediately after the disaster and examines the impact of such participation on state-civil society relations in the country. The data show that state response to the disaster went through several phases from a period of ineptitude to effective management. The paper credits the media and the NGOs for acting as advocates for survivors and forcing changes at the state level. The paper argues that an ideal response system, which fully addresses the needs of victims, can only be based on state-civil society relations that are both collaborative and adversarial. [source] Conservation biogeography , foundations, concepts and challengesDIVERSITY AND DISTRIBUTIONS, Issue 3 2010David M. Richardson Abstract Conservation biogeography involves the application of biogeographical principles, theories, and analyses to problems regarding biodiversity conservation. The field was formally defined in 2005, and considerable research has been conducted in the ensuing 5 years. This editorial sets the context for 16 contributions in a special issue of Diversity and Distributions on developments and challenges in conservation biogeography. Papers are grouped into the following main themes: species distribution modelling; data requirements; approaches for assigning conservation priorities; approaches for integrating information from numerous disparate sources; special challenges involving invasive species; and the crucial issue of determining how elements of biodiversity are likely to respond to rapid climate change. One paper provides a synthesis of requirements for a robust conservation biogeography for freshwater ecosystems. Conservation biogeography is well poised to make a significant contribution to the process of providing policy makers with objectively formulated scenarios and options for the effective management of biodiversity. The editorial, and the papers in the special issue, deliberate on many of the exciting developments in play in the field, and the many complex challenges that lie ahead. [source] Modelling species distributions without using species distributions: the cane toad in Australia under current and future climatesECOGRAPHY, Issue 4 2008Michael Kearney Accurate predictions of the potential distribution of range-shifting species are required for effective management of invasive species, and for assessments of the impact of climate change on native species. Range-shifting species pose a challenge for traditional correlative approaches to range prediction, often requiring the extrapolation of complex statistical associations into novel environmental space. Here we take an alternative approach that does not use species occurrence data, but instead captures the fundamental niche of a species by mechanistically linking key organismal traits with spatial data using biophysical models. We demonstrate this approach with a major invasive species, the cane toad Bufo marinus in Australia, assessing the direct climatic constraints on its ability to move, survive, and reproduce. We show that the current range can be explained by thermal constraints on the locomotor potential of the adult stage together with limitations on the availability of water for the larval stage. Our analysis provides a framework for biologically grounded predictions of the potential for cane toads to expand their range under current and future climate scenarios. More generally, by quantifying spatial variation in physiological constraints on an organism, trait-based approaches can be used to investigate the range-limits of any species. Assessments of spatial variation in the physiological constraints on an organism may also provide a mechanistic basis for forecasting the rate of range expansion and for understanding a species' potential to evolve at range-edges. Mechanistic approaches thus have broad application to process-based ecological and evolutionary models of range-shift. [source] Spatial metrics and methods for riverscapes: quantifying variability in riverine fish habitat patternsENVIRONMETRICS, Issue 5 2009Céline Le Pichon Abstract Defining the optimal configuration of all habitats required during a life cycle, called vital habitat, is a necessary step for effective management of riverine fishes and restoration of river habitats. Landscape ecology provides many metrics and methods to study the composition and configuration of habitats, but they need to be adapted for fishes in river environments or riverscapes. For example, hydrographic distance seems more appropriate than Euclidean distance for measuring distances between vital habitats in riverscapes. We adapted some metrics to assess habitats patterns of a threatened cyprinid species (Barbus barbus) for natural and artificial riverscapes of the Seine river, France. Composition metrics provided essential quantification of the relative abundance of the vital habitats, whereas configuration metrics were relevant to quantify their spatial arrangement and spatial relationships. Nearest-neighbor hydrographic distance was useful to evaluate the influence of flow variability in the natural riverscape, but was not relevant to discriminate the artificial riverscape from the natural one. Conversely, a proximity index revealed high fragmentation in the artificial riverscape. Spatial habitat relationships between feeding and resting habitats, evaluated with a moving window analysis, provided a map of daily activity patches and emphasized the gaps in the biological continuity of the riverscape. The spatial metrics and methods we adapted to the particularities of the Seine river allowed us to detect natural and artificial variability in fish habitat patterns. They should help in evaluating impacts of habitat alteration and isolation and prioritize preservation and restoration policies in human-impacted rivers. Copyright © 2008 John Wiley & Sons, Ltd. [source] Integrating physiology and life history to improve fisheries management and conservationFISH AND FISHERIES, Issue 4 2006Jeffery L. Young Abstract Knowledge of life-history traits is increasingly recognized as an important criterion for effective management and conservation. Understanding the link between physiology and life history is an important component of this knowledge and in our view is particularly relevant to understanding marine and freshwater fishes. Such linkages (i.e. the life-history/physiology nexus) have been recently advocated for avian systems and here we explore this concept for fish. This paper highlights the gap in fisheries literature with regard to understanding the relationship between physiology and life history, and proposes ways in which this integration could improve fisheries management and conservation. We use three case studies on different fishes (i.e. the Pacific salmon, the grouper complex and tuna) to explore these issues. The physiological structure and function of fish plays a central role in determining stock response to exploitation and changes in the environment. Physiological measures can provide simple indicators necessary for cost-effective monitoring in the evaluation of fisheries sustainability. The declining state of world fisheries and the need to develop and implement restoration strategies, such as hatchery production or protected areas, provides strong incentive to better understand the influence of physiology on population and reproductive dynamics and early life history. Physiology influences key population-level processes, particularly those dealing with reproduction, which must be incorporated into the design and successful implementation of specific and broadscale initiatives (e.g. aquatic protected areas and bycatch reduction). Suggestions are made for how to encourage wider application of the physiology/life-history link, in fisheries management and conservation, as well as more broadly in education and research. [source] Favorable Response to Analgesics Does Not Predict a Benign Etiology of HeadacheHEADACHE, Issue 6 2008Jennifer V. Pope MD Background., Distinguishing between primary and secondary headaches (HAs) is essential for the safe and effective management of patients with HA. A favorable response to analgesics may be observed with both classes of HAs and therefore is not a good predictor of who needs further evaluation. Objective., To systematically review the data that a favorable response to analgesics including triptans should not be used to exclude a serious secondary cause of HA. Design., PubMed search of English-language articles between 1980 and 2007 and reference lists of these articles. Two authors independently reviewed articles for study results and quality. Inclusion was based on 100% agreement between authors. We included articles that described secondary HAs as (1) having a favorable response to analgesics and/or (2) having a favorable response to sumatriptan. Of the 548 studies identified by our search strategy, 18 were included in our final analysis. Results., Seven of the 18 studies found that 46/103 patients (44%) described a significant or complete resolution of secondary HA from medications such as anti-emetics and nonsteroidal anti-inflammatory drugs (NSAIDs). Eleven of the 18 articles including 25/25 patients (100%) described a significant or complete resolution of secondary HA from sumatriptan, a serotonin 5HT agonist. Conclusions., A favorable response to analgesics including triptans should not be used to exclude a serious secondary cause of HA. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||