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Management Interventions (management + intervention)
Kinds of Management Interventions Selected AbstractsCost Analysis of the Geriatric Resources for Assessment and Care of Elders Care Management InterventionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Steven R. Counsell MD OBJECTIVES: To provide, from the healthcare delivery system perspective, a cost analysis of the Geriatric Resources for Assessment and Care of Elders (GRACE) intervention, which is effective in improving quality of care and outcomes. DESIGN: Randomized controlled trial with physicians as the unit of randomization. SETTING: Community-based primary care health centers. PARTICIPANTS: Nine hundred fifty-one low-income seniors aged 65 and older; 474 participated in the intervention and 477 in usual care. INTERVENTION: Home-based care management for 2 years by a nurse practitioner and social worker who collaborated with the primary care physician and a geriatrics interdisciplinary team and were guided by 12 care protocols for common geriatric conditions. MEASUREMENTS: Chronic and preventive care costs, acute care costs, and total costs in the full sample (n=951) and predefined high-risk (n=226) and low-risk (n=725) groups. RESULTS: Mean 2-year total costs for intervention patients were not significantly different from those for usual care patients in the full sample ($14,348 vs $11,834; P=.20) and high-risk group ($17,713 vs $18,776; P=.38). In the high-risk group, increases in chronic and preventive care costs were offset by reductions in acute care costs, and the intervention was cost saving during the postintervention, or third, year ($5,088 vs $6,575; P<.001). Mean 2-year total costs were higher in the low-risk group ($13,307 vs $9,654; P=.01). CONCLUSION: In patients at high risk of hospitalization, the GRACE intervention is cost neutral from the healthcare delivery system perspective. A cost-effectiveness analysis is needed to guide decisions about implementation in low-risk patients. [source] Bayesian Networks and Adaptive Management of Wildlife HabitatCONSERVATION BIOLOGY, Issue 4 2010ALISON L. HOWES herramientas para la toma de decisiones; incertidumbre ecológica; pastoreo feral; regímenes de quema; validación de modelos Abstract:,Adaptive management is an iterative process of gathering new knowledge regarding a system's behavior and monitoring the ecological consequences of management actions to improve management decisions. Although the concept originated in the 1970s, it is rarely actively incorporated into ecological restoration. Bayesian networks (BNs) are emerging as efficient ecological decision-support tools well suited to adaptive management, but examples of their application in this capacity are few. We developed a BN within an adaptive-management framework that focuses on managing the effects of feral grazing and prescribed burning regimes on avian diversity within woodlands of subtropical eastern Australia. We constructed the BN with baseline data to predict bird abundance as a function of habitat structure, grazing pressure, and prescribed burning. Results of sensitivity analyses suggested that grazing pressure increased the abundance of aggressive honeyeaters, which in turn had a strong negative effect on small passerines. Management interventions to reduce pressure of feral grazing and prescribed burning were then conducted, after which we collected a second set of field data to test the response of small passerines to these measures. We used these data, which incorporated ecological changes that may have resulted from the management interventions, to validate and update the BN. The network predictions of small passerine abundance under the new habitat and management conditions were very accurate. The updated BN concluded the first iteration of adaptive management and will be used in planning the next round of management interventions. The unique belief-updating feature of BNs provides land managers with the flexibility to predict outcomes and evaluate the effectiveness of management interventions. Resumen:,El manejo adaptativo es un proceso interactivo de recopilación de conocimiento nuevo relacionado con el comportamiento de un sistema y el monitoreo de las consecuencias ecológicas de las acciones de manejo para refinar las opciones de manejo. Aunque el concepto se originó en la década de los 1970s, rara vez es incorporado activamente en la restauración ecológica. Las redes Bayesianas (RBs) están emergiendo como herramientas eficientes para la toma de decisiones ecológicas en el contexto del manejo adaptativo, pero los ejemplos de su aplicación en este sentido son escasos. Desarrollamos una RB en el marco del manejo adaptativo que se centra en el manejo de los efectos del pastoreo feral y los regímenes de quemas prescritas sobre la diversidad de aves en bosques subtropicales del este de Australia. Construimos la RB con datos para predecir la abundancia de aves como una función de la estructura del hábitat, la presión de pastoreo y las quemas prescritas. Los resultados del análisis de sensibilidad sugieren que la presión de pastoreo incrementó la abundancia de melífagos agresivos, que a su vez tuvieron un fuerte efecto negativo sobre paserinos pequeños. Posteriormente se llevaron a cabo intervenciones de manejo para reducir la presión del pastoreo feral y quemas prescritas, después de las cuales recolectamos un segundo conjunto de datos de campo para probar la respuesta de paserinos pequeños a estas medidas. Utilizamos estos datos, que incorporaron cambios ecológicos que pueden haber resultado de la intervención de manejo, para validar y actualizar la RB. Las predicciones de la abundancia de paserinos pequeños bajo las nuevas condiciones de hábitat y manejo fueron muy precisas. La RB actualizada concluyó la primera iteración de manejo adaptativo y será utilizada para la planificación de la siguiente ronda de intervenciones de manejo. La característica única de actualización de la RBs permite que los manejadores tengan flexibilidad para predecir los resultados y evaluar la efectividad de las intervenciones de manejo. [source] The integration of ecological risk assessment and structured decision making into watershed managementINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2007Dan W Ohlson Abstract Watershed management processes continue to call for more science and improved decision making that take into account the full range of stakeholder perspectives. Increasingly, the core principles of ecological risk assessment (i.e., the development and use of assessment endpoints and conceptual models, conducting exposure and effects analysis) are being incorporated and adapted in innovative ways to meet the call for more science. Similarly, innovative approaches to adapting decision analysis tools and methods for incorporating stakeholder concerns in complex natural resource management decisions are being increasingly applied. Here, we present an example of the integration of ecological risk assessment with decision analysis in the development of a watershed management plan for the Greater Vancouver Water District in British Columbia, Canada. Assessment endpoints were developed, ecological inventory data were collected, and watershed models were developed to characterize the existing and future condition of 3 watersheds in terms of the potential risks to water quality. Stressors to water quality include sedimentation processes (landslides, streambank erosion) and forest disturbance (wildfire, major insect or disease outbreak). Three landscape-level risk management alternatives were developed to reflect different degrees of management intervention. Each alternative was evaluated under different scenarios and analyzed by explicitly examining value-based trade-offs among water quality, environmental, financial, and social endpoints. The objective of this paper is to demonstrate how the integration of ecological risk assessment and decision analysis approaches can support decision makers in watershed management. [source] Family-Based Weight Management With Latino Mothers and ChildrenJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2008Kathy Shadle James PURPOSE.,This paper aims to design a culturally appropriate weight management intervention for high-risk Latino families and to examine the feasibility of recruiting program participants. DESIGN AND METHODS.,A descriptive design using qualitative and quantitative data collected during preliminary phases of an ongoing intervention study. RESULTS.,From the preliminary works, a curriculum was revised for Latino families who have overweight children. The curriculum was modified to include suggestions from the focus groups, including helping mothers set limits with their children and make the transition to lighter foods and a more active family life. PRACTICE IMPLICATIONS.,The information will aid professionals in the process of program design for Latino families who have weight concerns. [source] Indirect effects of invasive species removal devastate World Heritage IslandJOURNAL OF APPLIED ECOLOGY, Issue 1 2009Dana M. Bergstrom Summary 1Owing to the detrimental impacts of invasive alien species, their control is often a priority for conservation management. Whereas the potential for unforeseen consequences of management is recognized, their associated complexity and costs are less widely appreciated. 2We demonstrate that theoretically plausible trophic cascades associated with invasive species removal not only take place in reality, but can also result in rapid and drastic landscape-wide changes to ecosystems. 3Using a combination of population data from of an invasive herbivore, plot-scale vegetation analyses, and satellite imagery, we show how a management intervention to eradicate a mesopredator has inadvertently and rapidly precipitated landscape-wide change on sub-Antarctic Macquarie Island. This happened despite the eradication being positioned within an integrated pest management framework. Following eradication of cats Felis catus in 2001, rabbit Oryctolagus cuniculus numbers increased substantially although a control action was in place (Myxoma virus), resulting in island-wide ecosystem effects. 4Synthesis and applications. Our results highlight an important lesson for conservation agencies working to eradicate invasive species globally; that is, risk assessment of management interventions must explicitly consider and plan for their indirect effects, or face substantial subsequent costs. On Macquarie Island, the cost of further conservation action will exceed AU$24 million. [source] A comparison of regeneration dynamics following gap creation at two geographically contrasting heathland sitesJOURNAL OF APPLIED ECOLOGY, Issue 5 2000A.J. Britton 1.,Lowland Calluna -dominated heathlands are a high priority for conservation in Europe. As an anthropogenic subclimax community they require regular management intervention to maintain their conservation interest. 2.,Increasingly, Calluna is disappearing from lowland heathlands and being replaced by grasses, especially in the Netherlands and more recently in south-east England. While Calluna is highly competitive over much of its life cycle, its competitive ability is reduced during the regeneration phase that follows the death of stands or results from management activity. 3.,We examined the influence of five factors on regeneration of vegetation in gaps in two broadly similar lowland dry heaths over a 3-year period. These were: geographical location (combining a variety of environmental contrasts); dominant species (Calluna or grasses); management techniques; gap size; and seed source availability. 4.,Site location had the greatest effect on patterns of regeneration. Regeneration on the Wirral (north-west England) was faster and more dominated by Calluna than regeneration in Breckland (south-east England), which was dominated by other species including grasses and annual plants. Addition of Calluna seed at the Breckland site failed to increase Calluna cover. It was concluded that climatic or other environmental factors were the most probable cause of poor regeneration. 5.,Cover of grasses in regenerating areas was greatest in Breckland, where Deschampsia was able to establish in all gaps where there was a seed source (either in the surrounding vegetation or applied as a treatment). On the Wirral, Deschampsia establishment was limited, even in gaps where a seed source was applied. 6.,This work has implications for the conservation management of heathlands, which currently follows a standard prescription throughout the UK. It is suggested that management regimes should be tailored to suit the conditions prevailing at individual sites as regeneration dynamics may be extremely variable. [source] Spiders as potential indicators of elephant-induced habitat changes in endemic sand forest, Maputaland, South AfricaAFRICAN JOURNAL OF ECOLOGY, Issue 2 2010Charles R. Haddad Abstract Elephant impacts on spider assemblages, and the potential use of spiders as indicators of habitat changes was assessed in central Maputaland, South Africa. Three habitats, namely undisturbed sand forest, elephant disturbed sand forest and mixed woodland, were sampled. To ensure a thorough representation of all spider guilds, spiders were collected by tree beating, sweep netting, active searching, leaf litter sifting and pitfall traps. In total, 2808 individual spiders, representing 36 families, 144 determined genera and 251 species were collected. Spider abundance was highest in the undisturbed sand forest (n = 1129, S = 179), followed by elephant disturbed sand forest (n = 1006, S = 165) and mixed woodland (n = 673, S = 171). Assemblages of the two sand forests were more similar than to the mixed woodland assemblage. Active hunting species were indicators of the more open vegetation of elephant disturbed sand forest (six active hunters, no web-builders) and mixed woodland (ten active hunters, one web-builder), whereas web-builders are indicators of the dense, complex vegetation structure of undisturbed sand forest (six web-builders, three active hunters). Elephant-induced changes to the vegetation structure in this high diversity, high endemism region result in changes in the composition of spider assemblages, and may need to be mitigated by management intervention. Résumé L'impact des éléphants sur les assemblages d'araignées, et l'utilisation éventuelle des araignées comme indicateurs de changements des habitats, ont étéévalués dans le centre du Maputaland, en Afrique du Sud. Trois habitats ont étééchantillonnés, à savoir la forêt sableuse intacte, la forêt sableuse perturbée par des éléphants et la forêt mixte. Pour garantir une représentation complète de toutes les guildes d'araignées, on a récolté des araignées en frappant sur les arbres, en agitant des filets, en pratiquant une recherche active, en tamisant la litière de feuilles, et avec des pièges. Au total, on a récolté 2 808 araignées; représentant 36 familles, 144 genres déterminés et 251 espèces. L'abondance d'araignées était la plus grande dans la forêt sableuse non perturbée (n = 1129, S = 179), suivie par la forêt sableuse perturbée par les éléphants (n = 1006, S = 165), puis par la forêt mixte (n = 673, S = 171). Les assemblages des deux forêts sableuses étaient plus semblables entre eux qu'avec celui de la forêt mixte. Les espèces d'araignées qui chassent activement étaient des indicateurs de la végétation plus ouverte de la forêt perturbée par les éléphants (six chasseurs actifs, aucun constructeur de toile) et de la forêt mixte (dix chasseurs actifs, un constructeur de toile), alors que les constructeurs de toile étaient des indicateurs de la structure dense et complexe de la végétation de la forêt sableuse intacte (six constructeurs de toile, trois chasseurs actifs). Les éléphants induisaient des changements dans la structure de la végétation de cette région à la diversitéélevée et d'un fort endémisme, ce qui entraînait des modifications de la composition des assemblages d'araignées. Cela pourrait devoir être atténué par une intervention de la gestion. [source] Browsing impact of large herbivores on Acacia xanthophloea Benth in Lake Nakuru National Park, KenyaAFRICAN JOURNAL OF ECOLOGY, Issue 2 2009N. Dharani Abstract Significant differences (P<0.05) were found in growth of plant height, canopy cover and stem diameter of Acacia xanthophloea trees in fenced plot as compared with unfenced plot both in the wet and in the dry seasons. Finding of this study showed that although heavy browsing reduced the height and canopy of trees, it did not kill any trees and seedling regeneration took place simultaneously. Despite the presence of large herbivores that impact some considerable browsing pressure results indicate that the A. xanthophloea habitat type would continue to remain in balance in the presence of recruitment of seedlings and saplings. The conditions at the time of study indicate that the browsing on A. xanthophloea was not significant and was not serious enough to warrant management intervention at present. Résumé Des différences significatives (P<0,05) ont été relevées dans la croissance en hauteur, le couvert de la canopée et le diamètre des tiges d'Acacia xanthophloea dans des parcelles clôturées, comparées à des parcelles non clôturées, en saison sèche comme en saison des pluies. Les résultats de cette étude ont montré que, même si un pâturage intense réduisait la hauteur et la canopée des arbres, il n'en tuait aucun et que la régénération des jeunes plants se faisait simultanément. Malgré la présence de grands herbivores qui exercent une pression considérable, les résultats indiquent que le type d'habitat àA. xanthophloea resterait équilibré grâce au recrutement de jeunes plants et de repousses. Les conditions prévalant au moment de l'étude indiquaient que la consommation d'A. xanthophloea n'était pas significative et qu'elle n'était pas assez grave pour justifier pour le moment une intervention en matière de gestion. [source] An evaluation of a Diabetes Specialist Nurse prescriber on the system of delivering medicines to patients with diabetesJOURNAL OF CLINICAL NURSING, Issue 12 2008Nicola Carey BSc Aim., To evaluate the impact of a Diabetes Specialist Nurse prescriber on insulin and oral hypoglycaemic agent medication errors and length of stay. Background., The National Health Service has committed to a 40% reduction in the number of drug errors in the use of prescribed medicines. Drug errors in diabetes care are a common cause of significant morbidity and complications. Nurse prescribing creates an opportunity for nurses to improve care for these patients. Design., A quasi-experiment using six wards in a single hospital trust. Methods., Inpatient care of a convenience sample of patients with diabetes was evaluated before (n = 27) and after (n = 29) the intervention of a Diabetes Specialist Nurse prescriber. Prospective data were collected to measure insulin and oral hypoglycaemic medication errors and length of stay. Results., There was a significant reduction in the total number of errors between the pre-intervention and intervention group (mean reduction 21 errors) (p = 0·016). The median length of stay was reduced by three days. The total number of errors and length of stay were affected by admission category (p = 0·0004). Conclusions., A medicines management intervention, provided by a Diabetes Specialist Nurse prescriber, had a positive effect on the system of delivering medicines to patients with diabetes and significantly reduced the number of errors. This reduction had some effect on length of stay. The cost saving was sufficient to finance a Diabetes Specialist Nurse prescriber post. Relevance to clinical practice., (i) Errors frequently occur in the prescription and administration of medicines to patients with diabetes. (ii) The education of healthcare professionals is a factor contributing to these errors. (iii) Nurse prescribing provides a new system by which to educate patients and staff about their medicines. (iv) A Diabetes Specialist Nurse prescriber can reduce insulin and OHA MEs. This reduction had some effect on LOS. [source] Interventions for Weight Management in Postpartum WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2008Colleen Keller ABSTRACT Objective:, To report the results of a comprehensive review of published intervention studies to identify the best evidence available for guiding weight management interventions in postpartum women. Data Sources:, Electronic searches were conducted of three electronic databases: Cumulative Index to Nursing and Allied Health Literature; Medline; and the Science Citation Index, Expanded, in the Web of Science from 1994 to May 2007. Keyword searches were conducted using the terms obesity, obese, overweight, postpartum, pregnancy weight, and weight management in postpartum women. Study Selection:, Six studies were selected that met the inclusion criteria of testing interventions and one that reported preintervention planning and targeted a weight management intervention for postpartum women. Data Extraction:, All six interventions showed significant impact with diet and exercise or some combination on body composition in the targeted sample of women. Data Synthesis:, The strengths of previous studies include an emphasis on precision in outcome measures and experimental conditions; limitations were that the theoretical basis for the interventions was frequently omitted and limited attention given to the cultural, social, and contextual factors established in descriptive research. Conclusions:, Interventions need to target women early in their childbearing years to have the most significant long-term impact. [source] Improved pain management in pediatric postoperative liver transplant patients using parental education and non-pharmacologic interventionsPEDIATRIC TRANSPLANTATION, Issue 2 2006Paul J. Sharek Abstract:, A pain management intervention, consisting of pretransplant parental education and support, pre- and postoperative behavioral pediatrics consultation, postoperative physical and occupational therapy consultation, and implementation of non-pharmacologic pain management strategies, was introduced to all pediatrics patients receiving liver transplants at Lucile Packard Children's Hospital beginning August 2001. Children receiving transplants pre-intervention (May, 2000 to February, 2001) and post-intervention (August, 2001 to March, 2002) were compared using pain scores, parent perception of pain ratings, length of stay, ventilator days, total cost, and opioid use. A total of 27 children were evaluated (13 historical control, 14 intervention). The two populations did not differ on age at transplant (mean age 53.8 vs. 63.6 months), sex (46.1% vs. 50% male), ethnicity (53.8% vs. 57.1% white, non-Hispanic) weight at transplant (17.5 vs. 24.7 kg), percent with biliary atresia as the primary reason for transplant (42.9% vs. 69.2%), percent with status 1 transplant listing score (38.5% vs. 50.0%), or public insurance status (30.8 vs. 57.2% with Medicaid). No differences were found in mean pediatric intensive care unit (PICU) postoperative length of stay (6.7 vs. 5.3 days), total postoperative length of stay (17.5 vs. 17.5 days), total inpatient length of stay (27.0 vs. 24.4 days), time to extubation (30 vs. 24.3 h), total cost ($147 983 vs. $157 882) or opioid use through postoperative day (POD) 6 (0.24 vs. 0.25 mg/kg/day morphine equivalent). A decrease in mean pain score between POD 0 and 6 (2.82 vs. 2.12; p = 0.047), a decrease in mean parental pain perception score (3.1 vs. 2.1; p = 0.001), and an increase in number of pain assessments per 12 h shift (3.43 vs. 6.79; p < 0.005) were seen. A comprehensive non-pharmacologic postoperative pain management program in children receiving a liver transplant was associated with decreased pain scores, improved parent perception of pain, and an increased number of pain assessments per 12 h shift. No increases in lengths of stay (PICU, postoperative, total), time to extubation, or total cost were found. [source] The genetic rescue of the Florida pantherANIMAL CONSERVATION, Issue 2 2006S. L. Pimm Abstract We examine the consequences of panthers introduced from Texas into south Florida, an area housing a small, isolated, inbred and distinct subspecies (Puma concolor coryi). Once part of a continuous, widespread population, panthers became isolated in south Florida more than a century ago. Numbers declined and the occurrence of genetic defects increased. Hoping to reverse the genetic damage, managers introduced eight female panthers from Texas into south Florida in the mid-1990s. This action was highly controversial and we explain the arguments for and against the intervention. We synthesized data systematically collected on the Florida panthers from before, during and after this management intervention. These data include information on movements, breeding, mortality, survivorship and range. There is no evidence that purebred Florida females produce fewer kittens at a later age or less often than do hybrid cats (i.e. those with a Texas ancestor). Hybrid kittens have about a three times higher chance of becoming adults as do purebred ones. Hybrid adult females survive better than purebred females; there is no obvious difference between the males. Males die younger than females, are more often killed by other males and are more likely to disperse longer distances into habitats that are dangerous to them. Hybrids are expanding the known range of habitats panthers occupy and use. [source] The experiences of staff concerning the introduction and impact of a fall prevention intervention in aged care facilities: a qualitative studyAUSTRALASIAN JOURNAL ON AGEING, Issue 4 2003Meg Butler Objective: Falls in aged care facilities are a major public health concern. A pilot study tested the acceptability of a falls risk management intervention. Method: Focus group discussions with care giving staff and falls coordinators and individual interviews with principal nurse managers were taped and transcribed and thematic analysis identified main issues for staff in utilising the intervention. Results: Acceptance of the intervention was high for principal nurse managers and falls coordinators, although the paper work was found to be time consuming. While most caregivers found undertaking fall prevention strategies worthwhile, others found such strategies were irrelevant to them as they "knew" their residents. Conclusions: Among all levels of staff, falls among residents were regarded as stressful events. While the general acceptunce of the intervention programme was high, resistance to changing practices of care by some staff could limit the wider implementation of such a programme. Further research is needed to examine appropriate delivery of educational messages for caregivers, which include multiple cultural understandings. [source] Bayesian Networks and Adaptive Management of Wildlife HabitatCONSERVATION BIOLOGY, Issue 4 2010ALISON L. HOWES herramientas para la toma de decisiones; incertidumbre ecológica; pastoreo feral; regímenes de quema; validación de modelos Abstract:,Adaptive management is an iterative process of gathering new knowledge regarding a system's behavior and monitoring the ecological consequences of management actions to improve management decisions. Although the concept originated in the 1970s, it is rarely actively incorporated into ecological restoration. Bayesian networks (BNs) are emerging as efficient ecological decision-support tools well suited to adaptive management, but examples of their application in this capacity are few. We developed a BN within an adaptive-management framework that focuses on managing the effects of feral grazing and prescribed burning regimes on avian diversity within woodlands of subtropical eastern Australia. We constructed the BN with baseline data to predict bird abundance as a function of habitat structure, grazing pressure, and prescribed burning. Results of sensitivity analyses suggested that grazing pressure increased the abundance of aggressive honeyeaters, which in turn had a strong negative effect on small passerines. Management interventions to reduce pressure of feral grazing and prescribed burning were then conducted, after which we collected a second set of field data to test the response of small passerines to these measures. We used these data, which incorporated ecological changes that may have resulted from the management interventions, to validate and update the BN. The network predictions of small passerine abundance under the new habitat and management conditions were very accurate. The updated BN concluded the first iteration of adaptive management and will be used in planning the next round of management interventions. The unique belief-updating feature of BNs provides land managers with the flexibility to predict outcomes and evaluate the effectiveness of management interventions. Resumen:,El manejo adaptativo es un proceso interactivo de recopilación de conocimiento nuevo relacionado con el comportamiento de un sistema y el monitoreo de las consecuencias ecológicas de las acciones de manejo para refinar las opciones de manejo. Aunque el concepto se originó en la década de los 1970s, rara vez es incorporado activamente en la restauración ecológica. Las redes Bayesianas (RBs) están emergiendo como herramientas eficientes para la toma de decisiones ecológicas en el contexto del manejo adaptativo, pero los ejemplos de su aplicación en este sentido son escasos. Desarrollamos una RB en el marco del manejo adaptativo que se centra en el manejo de los efectos del pastoreo feral y los regímenes de quemas prescritas sobre la diversidad de aves en bosques subtropicales del este de Australia. Construimos la RB con datos para predecir la abundancia de aves como una función de la estructura del hábitat, la presión de pastoreo y las quemas prescritas. Los resultados del análisis de sensibilidad sugieren que la presión de pastoreo incrementó la abundancia de melífagos agresivos, que a su vez tuvieron un fuerte efecto negativo sobre paserinos pequeños. Posteriormente se llevaron a cabo intervenciones de manejo para reducir la presión del pastoreo feral y quemas prescritas, después de las cuales recolectamos un segundo conjunto de datos de campo para probar la respuesta de paserinos pequeños a estas medidas. Utilizamos estos datos, que incorporaron cambios ecológicos que pueden haber resultado de la intervención de manejo, para validar y actualizar la RB. Las predicciones de la abundancia de paserinos pequeños bajo las nuevas condiciones de hábitat y manejo fueron muy precisas. La RB actualizada concluyó la primera iteración de manejo adaptativo y será utilizada para la planificación de la siguiente ronda de intervenciones de manejo. La característica única de actualización de la RBs permite que los manejadores tengan flexibilidad para predecir los resultados y evaluar la efectividad de las intervenciones de manejo. [source] Depression and the metabolic syndrome: gender-dependent associationsDEPRESSION AND ANXIETY, Issue 8 2008Sharon Toker Ph.D. Abstract This study was designed to test the extent to which depressive symptoms are associated with the presence of the metabolic syndrome (MS) and each of its components, and whether these relationships are gender dependent. Participants were apparently healthy employed men (N=2,355) and women (N=1,525) who underwent a routine health check between the years 2003 and 2005. We used logistic regression analysis, predicting the MS by depressive symptoms, as assessed by the Patient Health Questionnaire, and the following control variables: age, education, smoking status, physical exercise, anxiety, and burnout. As hypothesized, we found that depression among women, but not men, was associated with a 1.94-fold risk of having the MS, and with an elevated risk of having two of its five components: elevated waist circumference (odds ratio, OR=2.23) and elevated glucose levels (OR=2.44). In addition, a positive trend was observed toward an association with the other three components: low high-density lipoprotein, hypertension, and elevated triglycerides. Among men depression was associated with elevated waist circumference only (OR=1.77). These findings suggest that especially among women, the association between depression and cardiovascular diseases might be linked to metabolic processes. If replicated in longitudinal studies, these findings may have important health-care policy implications with regard to depression management interventions. Depression and Anxiety 0:1,9, 2007. © 2007 Wiley-Liss, Inc. [source] Synthesis of pattern and process in biodiversity conservation assessment: a flexible whole-landscape modelling frameworkDIVERSITY AND DISTRIBUTIONS, Issue 3 2010Simon Ferrier Abstract Aim, To describe a general modelling framework for integrating multiple pattern- and process-related factors into biodiversity conservation assessments across whole landscapes. Location, New South Wales (Australia), and world-wide. Methods, The framework allows for a rich array of alternatives to the target-based model traditionally underpinning systematic conservation planning and consists of three broad modelling components. The first component models the future state (condition) of habitat across a landscape as a function of present state, current and projected pressures acting on this state, and any proposed, or implemented, management interventions. The second component uses this spatially explicit prediction of future habitat state to model the level of persistence expected for each of a set of surrogate biodiversity entities. The third component then integrates these individual expectations to estimate the overall level of persistence expected for biodiversity as a whole. Results, Options are explored for tailoring implementation of the framework to suit planning processes varying markedly in purpose, and in availability of data, time, funding and expertise. The framework allows considerable flexibility in the nature of employed biodiversity surrogates (species-level, discrete or continuous community-level) and spatial data structures (polygonal planning units, or fine-scaled raster), the level of sophistication with which each of the three modelling components is implemented (from simple target-based assessment to complex process-based modelling approaches), and the forms of higher-level analysis supported (e.g. optimal plan development, priority mapping, interactive scenario evaluation). Main conclusions, The described framework provides a logical, and highly flexible, foundation for integrating disparate pattern- and process-related factors into conservation assessments in dynamic, multiple-use landscapes. [source] A conceptual selenium management modelINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 3 2009Peter M Chapman Abstract We describe herein a conceptual selenium (Se) management model, directed toward coal mining in western Canada, but which can be applied to other coal mines and, with appropriate modification, to other industrial sources of Se to aquatic and terrestrial environments. This conceptual model provides a transparent means to integrate and synthesize existing information that can be used to provide an adaptive approach for managing ecological exposures and associated risk. It is particularly useful for visualizing and subsequently developing management interventions for Se control and risk reduction. The model provides a structured process by which critical information needs can be identified and addressed. It effectively provides the foundation for making management decisions related to Se discharges to aquatic and terrestrial environments by showing interrelationships of the various media and receptors as well as primary sources, release mechanisms, secondary sources, and exposure pathways. [source] Care management, dementia care and specialist mental health services: an evaluationINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2002David Challis Abstract Objective To evaluate a model of intensive case management for people with dementia based in a community-based mental health service for older people. Method Quasi-experimental design. Individuals in one community team setting received case management and were compared with those in a similar team without such a service. Fortythree matched pairs were identified. Eligible older people and their carers were interviewed at uptake and again at 6 and 12 months. Results The impact of the scheme upon placement occurred in the second year at the end of which 51% of the experimental group remained at home compared with 33% of the comparison group. For the experimental group significant improvements in the social contacts of older people were noted; a decrease in the stress of their carers was observed, together with a reduction in their input to the care of the client; and there were significant improvements on ratings of overall need reduction, aspects of daily living and level of risk. Differences between the two groups based on service receipt showed higher costs for the experimental group. Discussion The benefits to older people and their carers confirms previous findings that the most effective case management interventions are those targeted on a highly specific client group. Issues which influence the cost-effectiveness of intensive case management are discussed. The benefits of locating this service within a specialist mental health team are explored in the context of current initiatives to promote greater service integration between health and social services. Copyright © 2002 John Wiley & Sons, Ltd. [source] Management implications of the Macquarie Island trophic cascade revisited: a reply to Dowding et al. (2009)JOURNAL OF APPLIED ECOLOGY, Issue 5 2009Dana M. Bergstrom Summary 1. The management of non-indigenous species is not without its complications. In Bergstrom et al.'s (2009) study, we demonstrated that feral cats Felis catus on sub-Antarctic Macquarie Island were exerting top-down control on the feral rabbit Oryctolagus cuniculus population, and that the eradication of the cats led to a substantial increase in rabbit numbers and an associated trophic cascade. 2. Dowding et al. (2009) claim our modelling was flawed for various reasons, but primarily that a reduction in the application of the rabbit control agent, Myxoma virus, coinciding with cat removal, was a major driver of rabbit population release. 3. We explore this proposition (as well as others) by examining rates of Myxoma viral release between 1991 and 2006 (with an attenuation factor for the years, 2003,2006) in association with presence/absence of cats against two estimates of rabbit population size. Myxoma viral release was a significant factor in the lower estimates of rabbit population, but the effect was small, and was not significant for higher rabbit population estimates. By contrast, the presence or absence of cats remained highly significant for both estimates. 4.Synthesis and applications. We re-affirm our position that top-down control of rabbit numbers by cats, prior to their eradication, was occurring on Macquarie Island. Nonetheless, we agree with Dowding et al. (2009) that systems with multiple invasive species represent complex situations that require careful scrutiny. Such scrutiny should occur in advance of, during, and following management interventions. [source] Indirect effects of invasive species removal devastate World Heritage IslandJOURNAL OF APPLIED ECOLOGY, Issue 1 2009Dana M. Bergstrom Summary 1Owing to the detrimental impacts of invasive alien species, their control is often a priority for conservation management. Whereas the potential for unforeseen consequences of management is recognized, their associated complexity and costs are less widely appreciated. 2We demonstrate that theoretically plausible trophic cascades associated with invasive species removal not only take place in reality, but can also result in rapid and drastic landscape-wide changes to ecosystems. 3Using a combination of population data from of an invasive herbivore, plot-scale vegetation analyses, and satellite imagery, we show how a management intervention to eradicate a mesopredator has inadvertently and rapidly precipitated landscape-wide change on sub-Antarctic Macquarie Island. This happened despite the eradication being positioned within an integrated pest management framework. Following eradication of cats Felis catus in 2001, rabbit Oryctolagus cuniculus numbers increased substantially although a control action was in place (Myxoma virus), resulting in island-wide ecosystem effects. 4Synthesis and applications. Our results highlight an important lesson for conservation agencies working to eradicate invasive species globally; that is, risk assessment of management interventions must explicitly consider and plan for their indirect effects, or face substantial subsequent costs. On Macquarie Island, the cost of further conservation action will exceed AU$24 million. [source] Interventions for Weight Management in Postpartum WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2008Colleen Keller ABSTRACT Objective:, To report the results of a comprehensive review of published intervention studies to identify the best evidence available for guiding weight management interventions in postpartum women. Data Sources:, Electronic searches were conducted of three electronic databases: Cumulative Index to Nursing and Allied Health Literature; Medline; and the Science Citation Index, Expanded, in the Web of Science from 1994 to May 2007. Keyword searches were conducted using the terms obesity, obese, overweight, postpartum, pregnancy weight, and weight management in postpartum women. Study Selection:, Six studies were selected that met the inclusion criteria of testing interventions and one that reported preintervention planning and targeted a weight management intervention for postpartum women. Data Extraction:, All six interventions showed significant impact with diet and exercise or some combination on body composition in the targeted sample of women. Data Synthesis:, The strengths of previous studies include an emphasis on precision in outcome measures and experimental conditions; limitations were that the theoretical basis for the interventions was frequently omitted and limited attention given to the cultural, social, and contextual factors established in descriptive research. Conclusions:, Interventions need to target women early in their childbearing years to have the most significant long-term impact. [source] Associations of Trying to Lose Weight, Weight Control Behaviors, and Current Cigarette Use Among US High School StudentsJOURNAL OF SCHOOL HEALTH, Issue 8 2009Jonetta L. Johnson MPH ABSTRACT BACKGROUND: Approximately one-quarter of high school students currently use cigarettes. Previous research has suggested some youth use smoking as a method for losing weight. The purpose of this study was to describe the association of current cigarette use with specific healthy and unhealthy weight control practices among 9th,12th grade students in the United States. METHODS: Youth Risk Behavior Survey data (2005) were analyzed. Behaviors included current cigarette use, trying to lose weight, and current use of 2 healthy and 3 unhealthy behaviors to lose weight or to keep from gaining weight. Separate logistic regression models calculated adjusted odds ratios (AORs) for associations of current cigarette use with trying to lose weight (Model 1) and the 5 weight control behaviors, controlling for trying to lose weight (Model 2). RESULTS: In Model 1, compared with students who were not trying to lose weight, students who were trying to lose weight had higher odds of current cigarette use (AOR = 1.30, 95% CI: 1.15,1.49). In Model 2, the association of current cigarette use with the 2 healthy weight control behaviors was not statistically significant. Each of the 3 unhealthy weight control practices was significantly associated with current cigarette use, with AORs for each behavior approximately 2 times as high among those who engaged in the behavior, compared with those who did not. CONCLUSION: Some students may smoke cigarettes as a method of weight control. Inclusion of smoking prevention messages into existing weight management interventions may be beneficial. [source] Nutrient losses from rain-fed bench terraced cultivation systems in high rainfall areas of the mid-hills of NepalLAND DEGRADATION AND DEVELOPMENT, Issue 5 2007G. P. Acharya Abstract Between the elevations of 1000 and 2000,m in the mid-hills of Nepal, over 12 million people subsist on land-holdings of less than 0·5,ha. These farmers have limited access to commercial inputs such as fertilisers and are reliant on organic manures for soil fertility maintenance. Participatory research was conducted with farmers on bari land (upper slope rain-fed crop terraces) in the hill community of Landruk (bench terraces 0,5° slope, 3000,3500,mm annual rainfall, which aimed to develop soil and water management interventions that controlled erosion without resulting in high leaching, and so were effective in minimising total nutrient losses. Interventions tested were the control of water movement through diversion of run-on and planting fodder grasses on terrace risers on bench terraces. The interventions were effective in reducing soil loss from the bari land in comparison with existing farmer practices, but no effect was observed on nutrient losses in solution form through runoff and leaching. Losses of NO3 -N in leachate ranged from 17·3 to 99·7,kg,ha,1,yr,1, but only 0·7 to 5·6,kg,ha,1,yr,1 in runoff. The overall nutrient balance suggests that the system is not sustainable. Fertility is heavily dependent on livestock inputs and if the current trends of declining livestock numbers due to labour constraints continue, further losses in productivity can be expected. However, farmers are interested in interventions that tie ecosystem services with productivity enhancement and farmers' priorities should be used as entry points for promoting interventions that are system compatible and harness niche opportunities. Copyright © 2007 John Wiley & Sons, Ltd. [source] Raising awareness about fecal incontinence,,NEUROUROLOGY AND URODYNAMICS, Issue 4 2010Donna Z. Bliss Abstract There is a lack of awareness about fecal incontinence despite its prevalence and adverse impact on quality of life. Inadequate knowledge about fecal incontinence deters help-seeking, therapeutic consultation, and clinical research about effective prevention and management strategies. A systematic, evidenced-based approach to raise awareness of fecal incontinence is essential to forward progress and overcome multiple barriers. In this manuscript, strategies of this approach are prioritized and focus on increasing continence literacy and communication, emphasizing prevention and screening, disseminating evidenced-based management interventions, and promoting larger scale impact through effective partnerships. Neurourol. Urodynam. 29:612,615, 2010. Copyright © 2010 Wiley-Liss, Inc. [source] Using limiting factors analysis to overcome the problem of long time horizonsNEW DIRECTIONS FOR EVALUATION, Issue 122 2009Raymond Gullison In recent years, donors to biodiversity conservation projects have sought greater accountability, using professional evaluators to help assess the degree to which grantees are achieving conservation objectives. One of the most formidable challenges evaluators face is the time required both for ecological systems to respond to management interventions and over which grantees must maintain their biodiversity conservation gains. The authors present a simple methodology, called limiting factors analysis, which was developed during the course of evaluating several large portfolios of conservation projects. The method is a practical basis for rapidly assessing whether current conditions are likely to prevent grantees from achieving their long-term objectives. Use of the methodology is illustrated with examples from recent evaluations of the Andes Amazon Initiative and the Columbia Basin Water Transactions Program. © Wiley Periodicals, Inc. [source] Effects of Social Support and Conflict on Parenting Among Homeless MothersAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2009Jaime V. Marra MA Research has shown that having a supportive social network is generally beneficial for individuals, particularly those who arc homeless or at risk of homelessness. However, conflict within these networks may diminish the positive effects of social support on well-being, and these effects may be felt acutely within a vulnerable population with multiple needs. This study examined the impact of conflict and social support on parenting behaviors in a sample of mothers who are homeless and were involved in a study of case management interventions of varying intensity. We found that women who reported high emotional and instrumental social support self-reported greater improvements in parenting consistency over time than those who reported lower levels of support. However, three-way interactions showed that conflict in support networks was a risk factor for harsh parenting practices among participants who reported lower levels of instrumental social support. Results suggest that social support may enhance homeless mothers' ability' to provide consistent parenting, but that these benefits may he undermined if conflict occurs in combination with limited levels of instrumental social support. [source] Effects of stress management on PNI-based outcomes in persons with HIV diseaseRESEARCH IN NURSING & HEALTH, Issue 2 2003Nancy L. McCain Abstract A pretest,posttest, repeated-measures design was used to evaluate the effects of two stress management interventions on a battery of outcomes derived from a psychoneuroimmunological (PNI) framework. The effects of cognitive-behavioral relaxation training groups (CBSM) and social support groups (SSG) were compared with a WAIT-listed control group on the outcomes of psychosocial functioning, quality of life, neuroendocrine mediation, and somatic health. Participants were 148 individuals (119 men, 29 women), diagnosed with HIV disease; 112 (76%) completing the study groups. Using analysis of covariance, the CBSM group was found to have significantly higher postintervention emotional well-being and total quality-of-life scores than did either the SSG or WAIT groups. SSG participants had significantly lower social/family well-being scores immediately postintervention and lower social support scores after 6 months. The findings point to a pressing need for further, well-controlled research with these common intervention modalities. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:102,117, 2003 [source] Species richness and abundance of defoliating Lepidoptera associated with Eucalyptus grandis in Brazil and their response to plant ageAUSTRAL ECOLOGY, Issue 6 2001J. C. Zanuncio Abstract The present paper documents patterns of species richness and abundance in Lepidoptera associated with a Eucalyptus grandis plantation, and how these patterns relate to plant age. The large number of species collected (1385), the lack of dominant species and the absence of pest outbreaks during the survey may be related to the high level of plant diversity of the native forest reserves in the area. There was no clear pattern of seasonal variation in species richness, but there were seasonal fluctuations in abundance, with minor defoliator species prevailing in October at the start of the rainy season. Species richness and abundance of Lepidoptera were positively correlated, with both variables decreasing in older plantations. However, the greatest numbers of major outbreak species and minor eucalypt defoliators were observed in plants after the mid-point (6 years old) of their cutting cycle (7,10 years). This may be because of a larger amount of better-quality plant leaves after this mid-point or the reduction in silvicultural management interventions at this period of the Eucalyptus cutting cycle. The abundance of the main outbreak species observed in the survey, Stenalcidia grosica Schaus (Geometridae), was negatively correlated with plant age. Nonetheless, the effect was weak (r = , 0.21, P = 0.03) and we were not able to find further significant correlations between plant age and abundance of the other most frequent and constant species that were collected. [source] The Unintended Consequences of Culture Interventions: A Study of Unexpected OutcomesBRITISH JOURNAL OF MANAGEMENT, Issue 1 2002L. C. Harris The topic of managing culture has been central to organizational culture research for the last two decades. Although critical theorists argue that culture management efforts are prone to unintended consequences, few empirical studies have explicitly explored this issue. The study reported in this article is designed to redress this imbalance in the literature through focusing on the exploration and description of the unintended consequences of culture management interventions. The aims of the study are to locate and describe how management actions during culture change initiatives result in unintended consequences and then subsequently to explore and describe these effects. The article begins with an overview of contemporary research into the nature of culture, the rationale, approaches and perspectives on culture management as well as research into unintended consequences. After a discussion of the research design and methods employed, the results of the study are presented. These findings review and elucidate eight forms of management action during culture change programmes that resulted in unintended consequences, which had serious consequences for the organizations concerned. The article concludes with the discussion of implications and conclusions for theorists and practitioners. [source] | |||||||||||||||||||||||||