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Meeting the complex demands of conservation requires a multi-skilled workforce operating in a sector that is respected and supported. Although professionalization of conservation is widely seen as desirable, there is no consistent understanding of what that entails. Here, we review whether and how eight elements of professionalization observed in other sectors are applicable to conservation: (1) a defined and respected occupation; (2) official recognition; (3) knowledge, learning, competences and standards; (4) paid employment; (5) codes of conduct and ethics; (6) individual commitment; (7) organizational capacity; and (8) professional associations. Despite significant achievements in many of these areas, overall progress is patchy, and conventional concepts of professionalization are not always a good fit for conservation. Reasons for this include the multidisciplinary nature of conservation work, the disproportionate influence of elite groups on the development and direction of the profession, and under-representation of field practitioners and of Indigenous peoples and local communities with professional-equivalent skills. We propose a more inclusive approach to professionalization that reflects the full range of practitioners in the sector and the need for increased recognition in countries and regions of high biodiversity. We offer a new definition that characterizes conservation professionals as practitioners who act as essential links between conservation action and conservation knowledge and policy, and provide seven recommendations for building a more effective, inclusive and representative profession.
The current study was conducted to examine the types of adjustments used to support students with special educational needs in mainstream classrooms and how schools monitored the effectiveness of the adjustments they use. A range of stakeholders were interviewed in 22 mainstream schools across New South Wales, Australia, and the interviews were analysed for key themes. Some schools had a narrow focus on a few key areas, with teaching assistants being the most commonly reported adjustment. Few schools used formal formative monitoring to evaluate the effectiveness of adjustments. Options for improvement schools could consider include examining the breadth of adjustments, establishing clear measurable goals, considering alternative strategies for use of teaching assistants, and ensuring adjustments are monitored.
Protest is ubiquitous in contemporary societies, as is illustrated by any review of recent news headlines. Tarrow and Meyer (1998) refer to the proliferation of protest and its diffusion into everyday life as characteristics of "the social movement society." Social networks are integral to understanding social movement processes. This chapter provides a broad overview of the SNA methodological toolkit, with a focus on ego-networks, so that social movements scholars better understand how networks shape social movement recruitment and support, communication, and social-political influence. The chapter is structured as followed. First, we provide a contextual overview of research on networks, collective action and social movements that underlines the importance of SNA approaches to social movement research. Second, we introduce a set of standard ego-network approaches to social movements and discuss some of the attendant challenges of these approaches. Third, we discuss less well-established qualitative and mixed-methods network approaches to social movements research. Fourth, we describe and discuss some consideration relevant to conducting longitudinal social network analysis, and modeling network dynamics. Finally, we discuss virtual networks as sources of social movements data collection and analysis.
Throughout the coronavirus disease 2019 (COVID-19) pandemic, health and social care workers have faced unprecedented professional demands, all of which are likely to have placed considerable strain on their psychological well-being.
To measure the national prevalence of mental health symptoms within healthcare staff, and identify individual and organisational predictors of well-being.
The COVID-19 Staff Wellbeing Survey is a longitudinal online survey of psychological well-being among health and social care staff in Northern Ireland. The survey included four time points separated by 3-month intervals; time 1 (November 2020; n = 3834) and time 2 (February 2021; n = 2898) results are presented here. At time 2, 84% of respondents had received at least one dose of a COVID-19 vaccine. The survey included four validated psychological well-being questionnaires (depression, anxiety, post-traumatic stress and insomnia), as well as demographic and organisational measures.
At time 1 and 2, a high proportion of staff reported moderate-to-severe symptoms of depression (30–36%), anxiety (26–27%), post-traumatic stress (30–32%) and insomnia (27–28%); overall, significance tests and effect size data suggested psychological well-being was generally stable between November 2020 and February 2021 for health and social care staff. Multiple linear regression models indicated that perceptions of less effective communication within their organisation predicted greater levels of anxiety, depression, post-traumatic stress and insomnia.
This study highlights the need to offer psychological support to all health and social care staff, and to communicate with staff regularly, frequently and clearly regarding COVID-19 to help protect staff psychological well-being.
Ethnohistoric accounts indicate that the people of Australia's Channel Country engaged in activities rarely recorded elsewhere on the continent, including food storage, aquaculture and possible cultivation, yet there has been little archaeological fieldwork to verify these accounts. Here, the authors report on a collaborative research project initiated by the Mithaka people addressing this lack of archaeological investigation. The results show that Mithaka Country has a substantial and diverse archaeological record, including numerous large stone quarries, multiple ritual structures and substantial dwellings. Our archaeological research revealed unknown aspects, such as the scale of Mithaka quarrying, which could stimulate re-evaluation of Aboriginal socio-economic systems in parts of ancient Australia.
In the study of electoral politics and political behavior in the developing world, India is often considered to be an exemplar of the centrality of contingency in distributive politics, the role of ethnicity in shaping political behavior, and the organizational weakness of political parties. Whereas these axioms have some empirical basis, the massive changes in political practices, the vast variation in political patterns, and the burgeoning literature on subnational dynamics in India mean that such generalizations are not tenable. In this article, we consider research on India that compels us to rethink the contention that India neatly fits the prevailing wisdom in the comparative politics literature. Our objective is to elucidate how the many nuanced insights about Indian politics can improve our understanding of electoral behavior both across and within other countries, allowing us to question core assumptions in theories of comparative politics.
The benefits of no-till fallow, which include reduced soil erosion, improved soil health, and increased stored soil water, are in jeopardy because of the widespread development of glyphosate resistance in Russian thistle. The objective of this research was to evaluate the efficacy of soil-active, residual herbicides for Russian thistle control in no-till fallow. The combinations of sulfentrazone + carfentrazone and flumioxazin + pyroxasulfone, and metribuzin alone were each applied in late fall, late winter, and split-applied in late fall and late winter at three sites: Adams, OR, in 2017–2018; Lind, WA, in 2018–2019; and Ralston, WA, in 2019–2020. All treatments provided good to excellent control of the initial flush of Russian thistle when assessed in mid-May, except the late-fall application of metribuzin at all three sites, and the late-fall application of sulfentrazone + carfentrazone at Adams. Cumulative Russian thistle densities, evaluated monthly throughout the fallow season, were lowest for the sulfentrazone + carfentrazone treatments, except for the late-fall application at Adams. However, flumioxazin + pyroxasulfone and metribuzin provided greater control of tumble mustard and prickly lettuce than did sulfentrazone + carfentazone. Sulfentrazone + carfentrazone, flumioxazin + pyroxasulfone, and metribuzin can all be used for Russian thistle control in fallow. To reduce the risk for crop injury to subsequently planted winter wheat, a late-fall application of sulfentrazone + carfentrazone may be the preferred treatment in low-rainfall regions where winter wheat–fallow is commonly practiced. A late-winter application may be preferred in higher rainfall regions where a 3-year rotation (e.g., winter wheat–spring wheat–fallow) is common. Flumioxazin + pyroxasulfone should be considered if other broadleaf weeds, such as tumble mustard or prickly lettuce, are of concern. The use of these soil-applied herbicides will reduce the need for the frequent application of glyphosate for Russian thistle control in no-till fallow.
Novel endometrial cancer (EC) early-detection approaches may reduce racial disparities in mortality. We conducted six community-based focus groups with White and Black women (N = 57 participants) in February-March 2020 to explore acceptability of a home-based tampon sampling approach for EC. Participants also completed a survey. Data were analyzed using qualitative content analysis. Awareness of EC and risk factors was low. Acceptability regarding home sampling was high, but participants expressed concerns about instruction complexity and potential risks. Black women reported lower comfort with tampons. Increasing EC awareness, self-efficacy, and familiarization with tampons would advance prospects for at-home sample collection for EC testing.
Understanding the impact of the COVID-19 pandemic on paediatric non-COVID-19-related care, as well as patient and caregiver concerns and stressors, is critical for informing healthcare delivery. It was hypothesised that high care disruptions and psychological stress would be observed among paediatric and adult CHD patients in the early phase of the pandemic.
A cross-sectional, international, electronic survey study was completed. Eligible participants included parents of children with acquired or CHD, adults with CHD, or caregivers of adults with CHD.
A total of 1220 participants from 25 countries completed the survey from 16 April to 4 May, 2020. Cardiac care disruption was significant with 38% reporting delays in pre-pandemic scheduled cardiac surgeries and 46% experiencing postponed cardiac clinic visits. The majority of respondents (75%) endorsed moderate to high concern about the patient with heart disease becoming ill from COVID-19. Worry about returning for in-person care was significantly greater than worry of harm to patient due to postponed care. Clinically significant psychological stress was high across the sample including children (50%), adults with CHD (42%), and caregivers (42%).
The early phase of the COVID-19 pandemic contributed to considerable disruptions in cardiac care for patients with paediatric and adult CHD. COVID-19-related fears are notable with potential to impact willingness to return to in-person care. Psychological stress is also very high necessitating intervention. Further study of the impact of delays in care on clinical outcomes is warranted.
Harvest weed seed control (HWSC) may control problematic weeds by decreasing contributions to the weed seedbank. However, HWSC practices will not be effective if plants have shed a great part of their seeds before harvest or if a low proportion of seed production is retained at a height that enables collection during harvest. The seed-shattering pattern of several weed species was evaluated over three growing seasons to determine their potential to be controlled with HWSC in the Pacific Northwest (PNW). The studied weed species were downy brome (Bromus tectorum L.), feral rye (Secale cereale L.), Italian ryegrass [Lolium perenne L. ssp. multiflorum (Lam.) Husnot], and rattail fescue [Vulpia myuros (L.) C.C. Gmel.]. Seed retention at harvest, seed production, and plant height differed among species, locations, and years. Environmental conditions influenced seed-shattering patterns, particularly the time plants started to shatter seeds and the rate of the shattering. Agronomic factors such as herbicide use, interrow space, or crop height/vigor also seemed to affect shattering patterns and seed production, but more specific studies must be conducted to determine their individual effects. Bromus tectorum, L. perenne ssp. multiflorum, and V. myuros had an average seed retention at harvest of less than 50%. In addition, the low seed retention height of V. myuros makes this species a poor candidate for HWSC. Secale cereale had average seed retention at harvest greater than 50%, and seed retention height was greater than 30 cm. The variability of seed retention in different species will make the efficacy of HWSC practices species and environment dependent in PNW winter wheat (Triticum aestivum L.) cropping systems. Harvesting the wheat crop as early as possible will be crucial to the success of HWSC.
Recent studies suggest that close-range blast exposure (CBE), regardless of acute concussive symptoms, may have negative long-term effects on brain health and cognition; however, these effects are highly variable across individuals. One potential genetic risk factor that may impact recovery and explain the heterogeneity of blast injury’s long-term cognitive outcomes is the inheritance of an apolipoprotein (APOE) ε4 allele, a well-known genetic risk factor for Alzheimer’s disease. We hypothesized that APOE ε4 carrier status would moderate the impact of CBE on long-term cognitive outcomes.
To test this hypothesis, we examined 488 post-9/11 veterans who completed assessments of neuropsychological functioning, psychiatric diagnoses, history of blast exposure, military and non-military mild traumatic brain injuries (mTBIs), and available APOE genotypes. We separately examined the effects of CBE on attention, memory, and executive functioning in individuals with and without the APOE ε4 allele.
As predicted, we observed a differential impact of CBE status on cognition as a function of APOE ε4 status, in which CBE ε4 carriers displayed significantly worse neuropsychological performance, specifically in the domain of memory. These results persisted after adjusting for clinical, demographic, and genetic factors and were not observed when examining other neurotrauma variables (i.e., lifetime or military mTBI, distant blast exposure), though these variables displayed similar trends.
These results suggest APOE ε4 carriers are more vulnerable to the impact of CBE on cognition and highlight the importance of considering genetic risk when studying cognitive effects of neurotrauma.
This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
Spinal muscular atrophy (SMA) is characterized by the progressive loss of motor neurons causing muscle atrophy and weakness. Nusinersen, the first effective SMA therapy was approved by Health Canada in June 2017 and has been added to the provincial formulary of all but one Canadian province. Access to this effective therapy has triggered the inclusion of SMA in an increasing number of Newborn Screening (NBS) programs. However, the range of disease-modifying SMN2 gene copy numbers encountered in survival motor neuron 1 (SMN1)-null individuals means that neither screen-positive definition nor resulting treatment decisions can be determined by SMN1 genotype alone. We outline an approach to this challenge, one that specifically addresses the case of SMA newborns with four copies of SMN2.
To develop a standardized post-referral evaluation pathway for babies with a positive SMA NBS screen result.
An SMA NBS pilot trial in Ontario using first-tier MassARRAY and second-tier multi-ligand probe amplification (MLPA) was launched in January 2020. Prior to this, Ontario pediatric neuromuscular disease and NBS experts met to review the evidence regarding the diagnosis and treatment of children with SMA as it pertained to NBS. A post-referral evaluation algorithm was developed, outlining timelines for patient retrieval and management.
Ontario’s pilot NBS program has created a standardized path to facilitate early diagnosis of SMA and initiation of treatment. The goal is to provide timely access to those SMA infants in need of therapy to optimize motor function and prolong survival.
The CDC recommends that consultant pharmacists support antimicrobial stewardship programs (ASPs) in long-term care facilities (LTCFs). We studied CDC-recommended ASP core elements implementation and antibiotic use in LTCFs before and after training consultant pharmacists. Methods: Between August 2017 and October 2017, consultant pharmacists from a regional long-term care pharmacy attended 5 didactic sessions preparing them to assist LTCFs in implementation of CDC-recommended ASP core elements. Training also included creating a process for evaluating appropriateness of all systemic antibiotics and providing prescriber feedback during their monthly mandatory drug-regimen reviews. Once monthly “meet-the-expert” sessions were held with consultant pharmacists throughout the project (November 2017 to December 2018). LTCF enrollment began in November 2017 and >90% of facilities joined by January 2018. After enrollment, consultant pharmacists initiated ASP interventions including antibiotic reviews and feedback using standard templates. They also held regular meetings with infection preventionists to discuss Core Elements implementation and provided various ASP resources to LTCFs (eg, antibiotic policy template, guidance documents and standard assessment and communication tools). Data collection included ASP Core Elements, antibiotic starts, days of therapy (DOT), and resident days (RD). The McNemar test, the Wilcoxon signed-rank test, generalized estimating equation model, and the classic repeated measures approach were used to compare the presence of all 7 core elements and antibiotic use during the baseline (2017) and intervention (2018) year.Results: In total, 9 trained consultant pharmacists assisted 32 LTCFs with ASP implementation. When evaluating 27 LTCFs that provided complete data, a significant increase in presence of all 7 Core Elements after the intervention was noted compared to baseline (67% vs 0; median Core Elements, 7 vs 2; range, 6–7 vs 1–6; P < .001). Median monthly antibiotic starts per 1,000 RD and DOT per 1,000 RD decreased in 2018 compared to 2017: 8.93 versus 9.91 (P < .01) and 106.47 versus 141.59 (P < .001), respectively. However, variations in antibiotic use were detected among facilities (Table 1). When comparing trends, antibiotic starts and DOT were already trending downward during 2017 (Fig. 1A and 1B). On average, antibiotic starts decreased by 0.27 per 1,000 RD (P < .001) and DOT by 1.92 per 1,000 RD (P < .001) each month during 2017. Although antibiotic starts remained mostly stable in 2018, DOT continued to decline further (average monthly decline, 2.60 per 1,000 RD; P < .001). When analyzing aggregated mean, antibiotic use across all sites per month by year, DOT were consistently lower throughout 2018 and antibiotic starts were lower for the first 9 months (Fig. 1C and 1D). Conclusions: Consultant pharmacists can play an important role in strengthening ASPs and in decreasing antibiotic use in LTCFs. Educational programs should be developed nationally to train long-term care consultant pharmacists in ASP implementation.
Funding: Merck & Co., Inc, provided funding for this study.
Disclosures: Muhammad Salman Ashraf and Scott Bergman report receipt of a research grant from Merck.
The inclusion of students with autism spectrum disorder (ASD) is increasing, but there have been no longitudinal studies of included students in Australia. Interview data reported in this study concern primary school children with ASD enrolled in mainstream classes in South Australia and New South Wales, Australia. In order to examine perceived facilitators and barriers to inclusion, parents, teachers, and principals were asked to comment on the facilitators and barriers to inclusion relevant to each child. Data are reported about 60 students, comprising a total of 305 parent interviews, 208 teacher interviews, and 227 principal interviews collected at 6-monthly intervals over 3.5 years. The most commonly mentioned facilitator was teacher practices. The most commonly mentioned barrier was intrinsic student factors. Other factors not directly controllable by school staff, such as resource limitations, were also commonly identified by principals and teachers. Parents were more likely to mention school- or teacher-related barriers. Many of the current findings were consistent with previous studies but some differences were noted, including limited reporting of sensory issues and bullying as barriers. There was little change in the pattern of facilitators and barriers identified by respondents over time. A number of implications for practice and directions for future research are discussed.
OBJECTIVES/GOALS: Healthcare costs for falls are expected to reach nearly 55 billion dollars annually in the US by 2020. Leveraging 911 calls as trigger events to activate fall prevention solutions could transform our ability to identify high-risk individuals and significantly improve fall prevention strategies globally. METHODS/STUDY POPULATION: An innovative pilot program entitled Community-centered Fall Intervention Team (Community FIT). Community FIT that leverages 911 calls, implementation science approaches, community partnerships, and collaboration among multiple healthcare disciplines including physical therapists, community paramedics, physicians, and social service coordinators was used to design and implement a community paramedicine fall intervention program. 911 call reports from February 2016 – August 2019 were analyzed using time series analyses to measure community level outcomes in fall-related calls and transports. RESULTS/ANTICIPATED RESULTS: 224 grab bars were installed free of charge to local residents (averaging approximately $125 per home for modifications).Over an 18-month period, time series analysis indicated an approximate demonstrated a consistent drop in the average fall-related 911 calls per month from 11.6 to 4.5 calls (a change of 61.21%) and a decrease of 58% in the transport rates to the hospital for fall-related 911 calls. 911 referrals to the community paramedicine program have also increased by 83%, demonstrating increased activation of fall prevention strategies with Community FIT. DISCUSSION/SIGNIFICANCE OF IMPACT: Collectively, these pilot study results provide preliminary support for individual and system level improvements in fall prevention by leveraging 911 calls to activate a community medicine fall prevention program. Future studies are needed to determine reach, long-term effectiveness, and sustainability of the program. CONFLICT OF INTEREST DESCRIPTION: Johnson & Johnson Hip Fracture Advisory Board (not related to project submission)
The Federal Trade Commission (FTC) has an important role to play in the governmental oversight of mobile health apps, ensuring consumer protections from unfair and deceptive trade practices and curtailing anti-competitive methods. The FTC’s consumer protection structure and authority is outlined before reviewing the recent FTC enforcement activities taken on behalf of consumers and against developers of mhealth apps. The article concludes with identification of some challenges for the FTC and modest recommendations for strengthening the consumer protections it provides.
To characterize nontuberculous mycobacteria (NTM) associated with case clusters at 3 medical facilities.
Retrospective cohort study using molecular typing of patient and water isolates.
Veterans Affairs Medical Centers (VAMCs).
Isolation and identification of NTM from clinical and water samples using culture, MALDI-TOF, and gene population sequencing to determine species and genetic relatedness. Clinical data were abstracted from electronic health records.
An identical strain of Mycobacterium conceptionense was isolated from 41 patients at VA Medical Centers (VAMCs A, B, and D), and from VAMC A’s ICU ice machine. Isolates were initially identified as other NTM species within the M. fortuitum clade. Sequencing analyses revealed that they were identical M. conceptionense strains. Overall, 7 patients (17%) met the criteria for pulmonary or nonpulmonary infection with NTM, and 13 of 41 (32%) were treated with effective antimicrobials regardless of infection or colonization status. Separately, a M. mucogenicum patient strain from VAMC A matched a strain isolated from a VAMC B ICU ice machine. VAMC C, in a different state, had a 4-patient cluster with Mycobacterium porcinum. Strains were identical to those isolated from sink-water samples at this facility.
NTM from hospital water systems are found in hospitalized patients, often during workup for other infections, making attribution of NTM infection problematic. Variable NTM identification methods and changing taxonomy create challenges for epidemiologic investigation and linkage to environmental sources.
The objective of this systematic review was to evaluate the efficacy of antibiotics to prevent or control colibacillosis in broilers. Studies found eligible were conducted controlled trials in broilers that evaluated an antibiotic intervention, with at least one of the following outcomes: mortality, feed conversion ratio (FCR), condemnations at slaughter, or total antibiotic use. Four electronic databases plus the gray literature were searched. Abstracts were screened for eligibility and data were extracted from eligible trials. Risk of bias was evaluated.
Seven trials reported eligible outcomes in a format that allowed data extraction; all reported results for FCR and one also reported mortality. Due to the heterogeneity in the interventions and outcomes evaluated, it was not feasible to conduct meta-analysis.
Qualitatively, for FCR, comparisons between an antibiotic and an alternative product did not show a significant benefit for either. Some of the comparisons between an antibiotic and a no-treatment placebo showed a numerical benefit to antibiotics, but with wide confidence intervals. The risk-of-bias assessment revealed concerns with reporting of key trial features.
The results of this review do not provide compelling evidence for or against the efficacy of antibiotics for the control of colibacillosis.