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Selected AbstractsPreservation of sight in diabetes: developing a national risk reduction programmeDIABETIC MEDICINE, Issue 9 2000L. Garvican SUMMARY Background Early treatment for diabetic retinopathy is effective at saving sight, but dependent on pre-symptomatic detection. Although 60% of people with diabetes have their eyes examined annually, few UK health authorities have systematic programmes that meet the British Diabetic Association's standards for sensitivity (> 80%) and specificity (> 95%). Screening is generally performed by general practitioners and optometrists, with some camera-based schemes, operated by dedicated staff. The National Screening Committee commissioned a group to develop a model and cost estimates for a comprehensive national risk-reduction programme. Ophthalmoscopy Evidence indicates that direct ophthalmoscopy using a hand-held ophthalmoscope does not give adequate specificity and sensitivity, and should be abandoned as a systematic screening technique. Indirect ophthalmoscopy using a slit lamp is sensitive and specific enough to be viable, and widespread availability in high street optometrists is an advantage, but the method requires considerable skill. Photographic schemes The principal advantage of camera-based screening is the capturing of an image, for patient education, review of disease progression, and quality assurance. Digital cameras are becoming cheaper, and are now the preferred option. The image is satisfactory for screening and may be transmitted electronically. With appropriate training and equipment, different professional groups might participate in programme delivery, based on local decisions. Cost issues Considerable resources are already invested in ad hoc screening, with inevitable high referral rates incurring heavy outpatient costs. Treatment for advanced disease is expensive, but less likely to be effective. The costs of a new systematic screening and treatment programme appear similar to current expenditure, as a result of savings in treatment of late-presenting advanced retinopathy. Conclusion A systematic national programme based on digital photography is proposed. [source] Temperate marine reserves: global ecological effects and guidelines for future networksCONSERVATION LETTERS, Issue 6 2009Gavin B. Stewart Abstract Marine reserves, areas closed to all fishing and other extractive activities, provide a refuge for species of commercial and conservation importance. Given the considerable resources committed to designing temperate reserve networks, we synthesized data from temperate reserves worldwide to determine their ecological effects. In common with other studies, we found higher density, biomass, and species richness in temperate marine reserves compared to adjacent exploited areas. However, there was considerable heterogeneity in magnitude of effect among reserves, variability which was largely unexplained by species or reserve characteristics. Our analytical approach allowed for formal power analyses, indicating that detection of large reserve effects in temperate systems globally requires monitoring at least 37 reserves. These results must be qualified by the limitations of data available and will undoubtedly vary at different spatio-temporal scales and for different focal species, but provide guidance for the design and monitoring of future marine conservations plans. International commitments toward establishment of multiple reserves offer a unique opportunity to assess reserve effectiveness; this opportunity can only be realized if reserves are designed to achieve clear and quantifiable objectives and are adequately monitored before and after establishment, based on appropriate power analyses, to assess how well those objectives are achieved. [source] Nurse and resident satisfaction in magnet long-term care organizations: do high involvement approaches matter?JOURNAL OF NURSING MANAGEMENT, Issue 3 2006KENT V. RONDEAU PhD Aim, This study examines the association of high involvement nursing work practices with employer-of-choice (magnet) status in a sample of Canadian nursing homes. Background, In response to a severe shortage of registered nursing personnel, it is imperative for health care organizations to more effectively recruit and retain nursing personnel. Some long-term care organizations are developing employee-centred cultures that allow them to effectively enhance nurse and resident satisfaction. At the same time, many nursing homes have adopted progressive nursing workplace practices (high involvement work practices) that emphasize greater employee empowerment, participation and commitment. Method, A mail survey was sent to the director of nursing in 300 nursing homes in western Canada. In total, 125 useable questionnaires were returned and constituted the data set for this study. Separate ordinary least squares regressions are performed with magnet strength, nurse satisfaction and resident satisfaction used as dependent variables. Results, Nursing homes that demonstrate strong magnet (employer-of-choice) characteristics are more likely to have higher levels of nurse and patient satisfaction, even after controlling for a number of significant factors at the establishment level. Magnet nursing homes are more likely to have progressive participatory decision-making cultures and much more likely to spend considerable resources on job-related training for their nursing staff. The presence of high involvement work practices is not found to be a significant predictor in magnet strength, nurse or resident satisfaction. Conclusion, Merely adopting more high involvement nursing work practices may be insufficient for nursing homes, which desire to become ,employers-of-choice' in their marketplaces, especially if these practices are adopted without a concomitant investment in nurse training or an enhanced commitment to establishing a more democratic and participatory decision-making style involving all nursing staff. [source] Biodiversity recovery during rainforest reforestation as indicated by rapid assessment of epigaeic ants in tropical and subtropical AustraliaAUSTRAL ECOLOGY, Issue 4 2009SCOTT D. PIPER Abstract There is growing interest in the potential for reforestation to assist the recovery of rainforest biodiversity. There is also a need to identify taxonomically tractable groups for use as cost-effective indicators when monitoring the status of biodiversity within reforested sites. Insects are an important component of terrestrial biodiversity but often require considerable resources to sample at species level. Ant genera and generic-based functional groups have been suggested as possible indicators of environmental disturbance. Here we ask to what extent the development of biodiversity is indicated by epigaeic ant genera and functional groups, across different types of reforestation in tropical and subtropical Australia. In each region, we used pitfall traps to sample the ants in replicate sites of: unmanaged regrowth, monoculture and mixed species plantations and ,ecological restoration' plantings, together with reference sites in pasture and rainforest. We recorded 35 epigaeic ant genera (and 4623 individuals) from 50 tropical sites, and 39 genera (and 9904 individuals) from 54 subtropical sites, with 47 genera overall. Community composition of both genera and functional groups differed between pasture and rainforest, although many genera were widespread in both. Reforested sites were intermediate between pasture and rainforest in both regions, and showed a gradient associated with decreasing grass and increasing tree and litter cover. Older monoculture plantations and ecological restoration plantings had the most rainforest-like ant assemblages, and mixed-species cabinet timber plots the least, of the reforested sites. We conclude that ground-active ant genera and functional groups sampled in rapid surveys by pitfall-trapping showed only a modest ability to discriminate among different types of reforestation. Species-level identification, perhaps together with expanded sampling effort, could be more informative, but would require resourcing beyond the scope of rapid assessments. [source] Making the biodiversity monitoring system sustainable: Design issues for large-scale monitoring systemsAUSTRAL ECOLOGY, Issue 1 2004IAN WATSON Abstract There is strong demand for information about the status of, and trends in, Australia's biodiversity. Almost inevitably, this demand for information has led to demand for a broad-scale monitoring system. However, the decision to embark on a monitoring system should only be made once it has been established that a monitoring system is the optimal way to inform management. We stress the need to invest resources in assessing whether a monitoring system is necessary before committing resources to the design and implementation of the system. Current debate associated with the design of a biodiversity monitoring system has similarities to the debate within the range management profession in the early 1970s. The experience with range monitoring shows that large-scale monitoring systems such as those being proposed will require considerable resources, recurrently expended into the distant future, but with only a limited ability to adapt to new demands. Those involved in any biodiversity monitoring system will need to understand the implications of investing in a long-term monitoring programme. Monitoring sustainability will only be possible if the monitoring system is itself sustainable. We discuss a number of issues that need to be addressed before the system is at all sustainable. These attributes are a mix of biophysical, social and institutional attributes and highlight the view that monitoring systems of the type being suggested comprise an unusual mixture of attributes not found in typical scientific activity. The present paper is not a technical manual, but rather considers some of the design issues associated with designing and implementing large-scale monitoring systems. 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