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In this chapter the major conservation issues bears face is reviewed and management actions that can address these conservation issues are highlighted. The future of bears across the world is bright for some species but dark for others. In some areas such as North America and in parts of Europe and Asia, bear populations have increased and stabilized because of increased management effort and increasing support for bears and their needs by the humans who share habitat with them. However, for most bear species, the future is uncertain. Andean bears continue to be threatened by habitat loss and human encroachment. In much of Asia outside Japan, Asiatic black bear, sloth bear, and sun bear populations are increasingly threatened by unmanaged excessive mortality combined with habitat loss to timber harvest, plantation agriculture, and human encroachment. The long-term future for polar bears is threatened by the unmanageable threat of climate change. Giant pandas are fragmented into small populations despite intense conservation efforts. Improving public and political support for bears is the most important need if we are to realize successful bear conservation and management.
This chapter comprises the following sections: names, taxonomy, subspecies and distribution, descriptive notes, habitat, movements and home range, activity patterns, feeding ecology, reproduction and growth, behavior, parasites and diseases, status in the wild, and status in captivity.
Background: Including infection preventionists (IPs) in hospital design, construction, and renovation projects is important. According to the Joint Commission, “Infection control oversights during building design or renovations commonly result in regulatory problems, millions lost and even patient deaths.” We evaluated the number of active major construction projects at our 800-bed hospital with 6.0 IP FTEs and the IP time required for oversight. Methods: We reviewed construction records from October 2018 through October 2019. We classified projects as active if any construction occurred during the study period. We describe the types of projects: inpatient, outpatient, non–patient care, and the potential impact to patient health through infection control risk assessments (ICRA). ICRAs were classified as class I (non–patient-care area and minimal construction activity), class II (patients are not likely to be in the area and work is small scale), class III (patient care area and work requires demolition that generates dust), and class IV (any area requiring environmental precautions). We calculated the time spent visiting construction sites and in design meetings. Results: During October 2018–October 2019, there were 51 active construction projects with an average of 15 active sites per week. These sites included a wide range of projects from a new bone marrow transplant unit, labor and delivery expansion and renovation, space conversion to an inpatient unit to a project for multiple air handler replacements. All 51 projects were classified as class III or class IV. We visited, on average, 4 construction sites each week for 30 minutes per site, leaving 11 sites unobserved due to time constraints. We spent an average of 120 minutes weekly, but 450 minutes would have been required to observe all 15 sites. Yearly, the required hours to observe these active construction sites once weekly would be 390 hours. In addition to the observational hours, 124 hours were spent in design meetings alone, not considering the preparation time and follow-up required for these meetings. Conclusions: In a large academic medical center, IPs had time available to visit only a quarter of active projects on an ongoing basis. Increasing dedicated IP time in construction projects is essential to mitigating infection control risks in large hospitals.
Background: Blood cultures are essential diagnostic tools used to identify bloodstream infections and to guide antimicrobial therapy. However, collecting cultures without clear indications or that do not inform management can lead to false-positive results and unnecessary use of antibiotics. Blood culture practices vary significantly in critically ill children. Our objective was to create a consensus guideline focusing on when to safely avoid blood cultures in pediatric intensive care unit (PICU) patients. Methods: A panel of multidisciplinary experts, many participating in the Blood Culture Improvement Guidelines and Diagnostic Stewardship for Antibiotic Reduction in Critically Ill Children (Bright STAR) Collaborative, engaged in a 2-part modified Delphi process. Round 1 consisted of a preparatory literature summary and an electronic survey sent to subject matter experts (SMEs). In the survey, SMEs rated a series of recommendations about when to avoid blood cultures on a 5-point Likert scale, 1 being the lowest score and 5 being the highest score. Consensus was achieved for each recommendation if 75% of respondents chose a score of 4 or 5, and these were included in the final guideline. Any recommendations that did not meet these a priori criteria for consensus were set aside for discussion during the in-person expert panel review (round 2). An outside expert in consensus methodology facilitated round 2. After a review of the survey results and comments from round 1 and group discussion, the SMEs voted on these recommendations in real time. Voting was blinded. Participants included Bright STAR site leads, national content experts, and representatives from relevant national societies. Results: We received 29 completed surveys from 34 invited participants for an 85% response rate. Of the 27 round 1 recommendations, 18 met predetermined criteria for consensus. Round 2 included 26 in-person voting participants who (1) discussed and modified the 9 recommendations that had not met round 1 consensus, and (2) modified for clarity or condensed from multiple into single recommendations the 18 recommendations that had met the round 1 consensus. The final document contains 19 recommendations that provide guidance on how to safely improve blood culture use in PICU patients (Table 1). Also, 8 recommendations discussed did not reach consensus for inclusion. Conclusions: Using a modified Delphi process, we created consensus recommendations on when to avoid blood cultures and prevent overuse in critically ill children. These guidelines are a critical step in disseminating diagnostic stewardship and reducing unnecessary testing on a wider scale.
Funding: Agency for Healthcare Research and Quality, R18 HS025642-01, 9/2017 – 9/2020 (Aaron Milstone, PI)
The perinatal period is a vulnerable time for the development of psychopathology, particularly mood and anxiety disorders. In the study of maternal anxiety, important questions remain regarding the association between maternal anxiety symptoms and subsequent child outcomes. This study examined the association between depressive and anxiety symptoms, namely social anxiety, panic, and agoraphobia disorder symptoms during the perinatal period and maternal perception of child behavior, specifically different facets of development and temperament. Participants (N = 104) were recruited during pregnancy from a community sample. Participants completed clinician-administered and self-report measures of depressive and anxiety symptoms during the third trimester of pregnancy and at 16 months postpartum; child behavior and temperament outcomes were assessed at 16 months postpartum. Child development areas included gross and fine motor skills, language and problem-solving abilities, and personal/social skills. Child temperament domains included surgency, negative affectivity, and effortful control. Hierarchical multiple regression analyses demonstrated that elevated prenatal social anxiety symptoms significantly predicted more negative maternal report of child behavior across most measured domains. Elevated prenatal social anxiety and panic symptoms predicted more negative maternal report of child effortful control. Depressive and agoraphobia symptoms were not significant predictors of child outcomes. Elevated anxiety symptoms appear to have a distinct association with maternal report of child development and temperament. Considering the relative influence of anxiety symptoms, particularly social anxiety, on maternal report of child behavior and temperament can help to identify potential difficulties early on in mother–child interactions as well as inform interventions for women and their families.
Historians divide over the question of how far “classic” European colonial experience in overseas empires provided the model for the Nazi empire in eastern Europe. Missing from arguments on either side of the debate have been the colonialists themselves. The Ukraine Project to enlist Dutch plantation companies for occupied Ukraine shows what happened when efforts were made to transfer traditional colonial expertise into the Nazi East. From the perspective of the project's proponents, there was indeed continuity between the two imperialisms. However, the company at the center of the project, the Deli Maatschappij, the ruling and tone-setting firm on Sumatra, saw no connection with its East Indies history and spurned all efforts to take it into Ukraine. Thus the Ukraine Project, despite its short-lived and failed history, complicates arguments from both perspectives and offers a trans-imperial history of a different sort than we are accustomed to encountering.
Economic hardship (EH) may link to poorer child diet, however whether this association is due to resource limitations or effects on family functioning is unknown. This study examines whether parenting stress mediates the association between EH and child consumption of foods high in saturated fats and added sugars (SFAS).
Data were collected from the Fragile Families and Child Wellbeing study. EH was assessed using eight items collected when children were between 1–9 years old. Mothers reported parenting stress and frequency of child consumption of high SFAS foods when children were 9 years old. Latent growth curve modelling (LGCM) and structural equation modelling tested direct associations between the starting level/rate of change in EH and high SFAS food consumption, and parenting stress as a mediator of the association.
Twenty US cities.
Mothers/children (n 3846) followed birth through age 9 years, oversampled ‘high-risk’, unmarried mothers.
LGCM indicated a curvilinear trend in EH from ages 1–9, with steeper increases from ages 3–9 years. EH did not directly predict the frequency of high SFAS foods. Average EH at 3 and 5 years and change in EH from ages 1–9 predicted higher parenting stress, which in turn predicted more frequent consumption of high SFAS foods.
Findings suggest it may be important to consider parenting stress in early prevention efforts given potential lasting effects of early life EH on child consumption of high SFAS foods. Future research should explore how supports and resources may buffer effects of EH-related stress on parents and children.
The coronavirus disease 2019 (COVID-19) has greatly impacted health-care systems worldwide, leading to an unprecedented rise in demand for health-care resources. In anticipation of an acute strain on established medical facilities in Dallas, Texas, federal officials worked in conjunction with local medical personnel to convert a convention center into a Federal Medical Station capable of caring for patients affected by COVID-19. A 200,000 square foot event space was designated as a direct patient care area, with surrounding spaces repurposed to house ancillary services. Given the highly transmissible nature of the novel coronavirus, the donning and doffing of personal protective equipment (PPE) was of particular importance for personnel staffing the facility. Furthermore, nationwide shortages in the availability of PPE necessitated the reuse of certain protective materials. This article seeks to delineate the procedures implemented regarding PPE in the setting of a COVID-19 disaster response shelter, including workspace flow, donning and doffing procedures, PPE conservation, and exposure event protocols.
Restless legs syndrome (RLS) is a neurological disorder characterized by an urge to move and uncomfortable sensations. Genetic studies have identified polymorphisms in up to 19 risk loci, including MEIS1 and BTBD9. Rodents deficient in either homolog show RLS-like phenotypes. However, whether MEIS1 and BTBD9 interact in vivo is unclear. Here, with C. elegans, we observed that the hyperactive egg-laying behavior caused by loss of BTBD9 homolog was counteracted by knockdown of MEIS1 homolog. This was further investigated in mutant mice with Btbd9, Meis1, or both knocked out. The double knockout mice showed an earlier onset of the motor deficit in a wheel running test but did not have increased sensitivity to heat stimuli as observed in single knock outs. Meis1 protein level was not influenced by Btbd9 deficiency, and Btbd9 transcription was not affected by Meis1 haploinsufficiency. Our results demonstrate that MEIS1 and BTBD9 do not regulate each other.
The breakdown of the columnar grains and lamellar α + β colony microstructure in two-phase Ti alloys during conversion of ingot to billet is critical to the development of desired combination of mechanical properties. Colony breakdown occurs during a series of thermomechanical processing steps in the α + β phase field. However, fundamental knowledge of the microstructural dependence of this transformation is limited, particularly its dependence on the initial orientation of the α + β colony relative to the imposed strain-path. In this study, the viscoplastic self-consistent polycrystal plasticity model is used to examine deformation behavior as a function of crystal loading direction. Criteria were developed to predict relative globularization rates; it was found that both slip system activities in the α phase and relative crystal rotations of each phase must be considered. Predictions are demonstrated to be consistent with literature and suggest that further experimental investigation of relative globularization rates is necessary.
A primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Healthʼs (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic–public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic–public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.
The outbreaks of anti-Jewish violence in the former Habsburg lands in the fall of 1918 are often overlooked, in part because of the subsequent violence in Hungary (1919–1921), in part because of the myth of Czechoslovak exceptionalism that emerged during the interwar period. It is tempting to view the post-war power vacuum as the main context – and catalyst – for this wave of violence that erupted after the collapse of the monarchy. A closer look at the anti-Jewish violence, however, suggests that it was part of the state-building process, or at least part of an effort to demarcate the exclusive terms of membership in the newly-established states. In explaining or justifying the anti-Jewish violence, perpetrators (and their supporters) often invoked the canard of Jewish “provocation” or the myth of Jewish “power” as part of a larger discourse of exclusion that placed Jews outside the Hungarian, Polish, or Czechoslovak body politic.
When autocratic ruling parties accede to democratization, they do not always fade away into history. Following forty-one transitions since 1940, including those in Mexico, Taiwan, Bulgaria and Ghana, the ruling party survived and won power after democratization. Why do some former autocratic parties prosper under democracy while others quickly dissolve? What effect does this have on democratic survival? This article uses original data to predict the post-transition fates of eighty-four autocratic ruling parties through 2015. Whereas extant theories emphasize radical reinvention and outsider struggle, the author argues that success is instead about maintaining ruling-party advantages into the democratic period. Parties succeed when they have authoritarian legacies that easily translate to democratic competition, such as broad programmatic experience, strong organization and policy success. In addition, democratic institutions that disadvantage new parties and actors benefit autocratic parties. Lastly, an instrumental variables design shows that autocratic party success negatively impacts democratic survival and quality.
Species distribution models (SDMs) are statistical tools used to develop continuous predictions of species occurrence. ‘Integrated SDMs’ (ISDMs) are an elaboration of this approach with potential advantages that allow for the dual use of opportunistically collected presence-only data and site-occupancy data from planned surveys. These models also account for survey bias and imperfect detection through the use of a hierarchical modelling framework that separately estimates the species–environment response and detection process. This is particularly helpful for conservation applications and predictions for rare species, where data are often limited and prediction errors may have significant management consequences. Despite this potential importance, ISDMs remain largely untested under a variety of scenarios. We performed an exploration of key modelling decisions and assumptions on an ISDM using the endangered Baird’s tapir (Tapirus bairdii) as a test species. We found that site area had the strongest effect on the magnitude of population estimates and underlying intensity surface and was driven by estimates of model intercepts. Selecting a site area that accounted for the individual movements of the species within an average home range led to population estimates that coincided with expert estimates. ISDMs that do not account for the individual movements of species will likely lead to less accurate estimates of species intensity (number of individuals per unit area) and thus overall population estimates. This bias could be severe and highly detrimental to conservation actions if uninformed ISDMs are used to estimate global populations of threatened and data-deficient species, particularly those that lack natural history and movement information. However, the ISDM was consistently the most accurate model compared to other approaches, which demonstrates the importance of this new modelling framework and the ability to combine opportunistic data with systematic survey data. Thus, we recommend researchers use ISDMs with conservative movement information when estimating population sizes of rare and data-deficient species. ISDMs could be improved by using a similar parameterization to spatial capture–recapture models that explicitly incorporate animal movement as a model parameter, which would further remove the need for spatial subsampling prior to implementation.
A novel high-power impulse plasma source (HiPIPS) technology that combines atmospheric pressure plasma jets with high-power pulsed direct current generators is described. Pulsed power is applied in microsecond pulses (20 µs) at low duty cycle (10%) and low frequency (0.5 kHz) leading to high peak power densities (10–75 kW) and high peak currents (100–250 A) while maintaining low average power (<40 W) and low processing temperatures (<50 °C). These conditions result in the generation of a highly dense plasma discharge (ne = 6.23 × 1016 cm−3) for surface modification and deposition of coatings. Using HiPIPS, Ar-initiated metallic Ti, CoCr, or Ti–6Al–4V plasma was generated, and the plasma properties were characterized by measuring current–voltage characteristics, electron densities (Langmuir probe), and optical emission spectra. HiPIPS CoCr and Ti–6Al–4V coatings were deposited for proof of concept of the technique. The resulting coatings were examined with scanning electron microscopy, energy-dispersive X-ray spectroscopy, and nanoindentation.