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Citizen science is becoming very useful in surveying and monitoring biodiversity. Within the European Union LIFE medCLIFFS project, a network of volunteers has been established for the detection and long-term monitoring of invasive plant species that threaten the endemic flora of Mediterranean cliffs in north-eastern Spain. Through iNaturalist, volunteers record various data along a series of 1 km transects. Based on the ca. 700 observations collected by volunteers in 2023 (the first year of the project), a simple and visually-attractive methodology for assessing the recorded populations has been developed. This method classifies populations into one of three population dynamics categories: (1) propagative behavior (i.e., populations with seedlings or young plants but lacking senescent or dead individuals); (2) senescent behavior (i.e., showing senescent/dead plants but lacking seedlings/juveniles); and (3) a mixed behavior (i.e., containing both). This methodology, whose outputs are easily interpretable as heatmaps, allows the collection of large datasets on invasive plants by citizen scientists, with two main purposes: (1) knowing which species are most concerning based on simple, straightforward observations of their population dynamics; and (2) identifying which regions of the study area are more problematic and, thus, where management efforts should be directed.
A natural population of Vriesea friburgensis var. paludosa was genetically and demographically characterized. Four selected enzymatic systems were used. In total, 10 allozymic loci were analysed. The proportion of polymorphic loci was 70% and the number of alleles per locus was 2.3· The mean observed and expected heterozygosities were 0.234 and 0.226, respectively. An excess of heterozygotes was revealed by the value of the fixation index (—0.035). These indices showed the presence of high levels of genetic diversity in the population studied. A demographic survey revealed almost six times more vegetative than sexually reproductive plants. Reproductive plants were found only in clusters. The genetic diversity exhibited by this population, associated with vegetative as well as sexual propagation, resulting in clusters or colonies, would allow the employment of a sustainable management strategy for species conservation as well as its exploitation as an ornamental.
Giant coronary artery aneurysms are rare but potentially fatal complications of Kawasaki disease. The lack of evidence-based recommendations on their management and treatment cause guidelines and practices to differ. We aimed to assess these variations.
Methods:
An anonymous online survey regarding surveillance, imaging, pharmacological management, and interventional practices was distributed among 134 physicians attending to Kawasaki disease patients worldwide. A p-value of <0.05 was deemed significant.
Results:
The majority (60%) of respondents were general paediatric cardiologists, and 29% interventional specialists. The average years in practice was 15 ± 9.6. Physicians from Asia had the most experience with giant coronary artery aneurysms. American practitioners preferred combining anticoagulants with aspirin. Beta-blockers and statins were more likely used in teenagers versus younger children. Cardiac catheterisation was most (52%) chosen for coronary surveillance in patients with echocardiogram anomalies, followed by Coronary CT-angiography. The indications for coronary intervention were split among respondents, regardless of geographic region or experience. The preferred treatment of coronary stenosis was percutaneous intervention (69%) versus bypass surgery. For thrombosis, thrombolytics (50%) were preferred over percutaneous (39%) and surgical (11%) interventions. Most (92%) preferred intervening in young children in a paediatric facility but were split between a paediatric and adult facility for older children. Most chose combined management by adult and paediatric specialists for either age-scenarios (70, 82%).
Conclusion:
As identified by our study, the lack of large studies and evidence-based recommendations cause uncertainty and ambivalence towards certain treatments. International collaborative efforts are needed to provide more robust evidence in the management of these patients.
Yellow and knotroot foxtail are two common weed species infesting turfgrass and pastures in the southeastern region of the United States. Yellow and knotroot foxtail share morphological similarities and are frequently misidentified by weed managers, thus leading to confusion in herbicide selection. Greenhouse research was conducted to evaluate the response of yellow and knotroot foxtail to several turfgrass herbicides: pinoxaden (35 and 70 g ai ha−1), sethoxydim (316 and 520 g ai ha−1), thiencarbazone + dicamba + iodosulfuron (230 g ai ha−1), nicosulfuron + rimsulfuron (562.8 g ai ha−1), metribuzin (395 g ha−1), sulfentrazone (330 g ai ha−1), sulfentrazone + imazethapyr (504 g ai ha−1), and imazaquin (550 g ai ha−1). All treatments controlled yellow foxtail >87% with more than 90% reduction of the biomass. By comparison, only sulfentrazone alone controlled knotroot foxtail 90% and completely reduced aboveground biomass. Sethoxydim (520 g ai ha−1), metribuzin, and imazaquin controlled knotroot foxtail >70% at 28 d after application. In a rate response evaluation, nonlinear regression showed that yellow foxtail was approximately 8 times more susceptible to pinoxaden and 2 times more susceptible to sethoxydim than knotroot foxtail based on log (WR50) values, which were 50% reduction in fresh weight. Our research indicates that knotroot foxtail is more difficult to control across a range of herbicides, making differentiation of these two species important before herbicides are applied.
Over the last decade, we have gained a better understanding of impulse control disorder in Parkinson’s disease (PD-ICD), a medication complication in PD. Researchers were aware of its complexity and took efforts to learn more about its diagnostic and treatment possibilities. Nevertheless, clinical management for it is currently neglected. We conducted a narrative overview of literature published from 2012 to October 2023 on various aspects of clinical management for PD-ICD. A potential “susceptibility-catalytic-stress” model in the development of PD-ICD was proposed and a profile encoding predictors for PD-ICD was created. Based on these predictors, some methods for prediction were recently developed for better prediction, such as the polymorphic dopamine genetic risk score and the clinic-genetic ICD-risk score. A variety of treatment options, including dose reduction of dopamine receptor agonists (DAs), DAs removal, DAs switch, and add-on therapy, are investigated with inconsistent reports. Based on current findings, we developed a clinical management model prototype centered on prevention, consisting of prediction, prevention, follow-up and monitoring, therapy, and recurrence prevention, for clinical reference, and further proposed 4 key clinical management principles, including standardization, prediction centered, persistence, and whole course.
Understanding the relationships between cetaceans and their environment is crucial for conservation. This study examined humpback whales in Bahía de Banderas, Mexico, identifying key calving habitats. From 2018 to 2023, 1066 sightings were recorded, including 242 mother–calf groups, 109 mating groups, and 715 other groups. Spatial analysis revealed a non-random distribution; both the Kruskal–Wallis and Wilcoxon–Mann–Whitney tests detected significant differences (P < 0.05) in site preferences. Calving mothers favoured habitats with a mean depth of 59 m and a distance of 2 km from the coast, while mating groups preferred locations at 126 m and 4 km, and other groups chose areas at 149 m and 4 km. All groups were found in relatively flat areas around 2° seafloor slope. A dispersion test indicated a significant relationship between the location of calving mothers and environmental factors. K-means clustering showed 83.6% of calving mothers' sightings at depths less than 40 m and 2 km from the coast. Ensemble species distribution models identified three critical calving areas: one large area (261.8 km2) along the north coast and two smaller areas (9.5 and 5.4 km2) at the southern end of the bay. This study highlights Bahía de Banderas as a vital breeding habitat for humpback whales, providing insights for conservation strategies to protect calving grounds during the breeding season.
Anthropogenic-mediated climate change is expected to negatively affect pest management in agriculture. Hence, we investigated the oviposition, immature mortality, and developmental processes of Spodoptera species (Spodoptera exigua (Hübner) and Spodoptera litura (Fabricius)) under different temperatures (20, 25, and 30°C) and relative humidity (RH) (30–35, 50–55, 70–75, and 90–95%) conditions. For fecundity, mouths of each Spodoptera species were released into a rectangular box whose inner walls were covered with a sheet of white paper for each combination of temperature and RH. The mouths were kept inside the box to deposit eggs for 72 h. Temperature and RH significantly affected the fecundity, with the maximum number of eggs laid in 70–75% at 30°C. The highest egg and larval mortalities were recorded in 30–35 and 90–95% RH, respectively. Temperature and RH greatly affected the developmental period (egg–adult) and adult emergence rate. The rapid development was recorded in 70–75% RH at 30°C. Higher number of adults was found with an increase in temperature and RH. Adult longevity was significantly higher in 70–75% RH at 20°C. Based on the present study's findings, temperature and RH had an individual apparent effect on the developmental processes of Spodoptera species instead of an interactive effect. Therefore, there is need for an in-depth study of the influence of several climatic factors, including CO2, on the developmental modality and demographic changes of Spodoptera species to assess the impacts of climatic components and the sustainable development of management strategies.
Following the contemporary debate surrounding two alternative perspectives on compliance – enforcement and management – this article suggests an analysis through the lens of the rule of law crisis. Specifically, the financial and techno-managerial strategy developed by the EU for the indirect protection of the rule of law relies on mechanisms that combine characteristics from both the enforcement and management approaches. This article will identify these mechanisms, namely the European Semester, the Conditionality regulation, the European Structural Investment Funds and the Recovery and Resilience Facility, in order to determine their nature, features, and tools for ensuring compliance with the rule of law. The hypothesis of this article relies on the idea that the EU’s tools are characterised by a mismatch between the causes of the identified problems and the chosen solutions. Considering that the deployment of the above measures has not re-established compliance, the EU strategy toes between inducing rule conformity on the one hand and deterring rule of law violations on the other. However, it seems that only the former can restore the rule of law, as the latter is considered ill-equipped to reverse or at least halt instances of backsliding. This mismatch explains why the Justice Scoreboard, the Framework, and the Review Cycle with its Annual Report have not made any difference, and more generally, why management strategies are unfit for dealing with deliberate backsliding.1
This chapter is a guide to taking on a first consultant post in forensic psychiatry, a guide to supervising trainee doctors in forensic psychiatry and an overview of advice from a group of senior clinical directors in forensic psychiatry across multiple jurisdictions. It is designed to offer informal advice to consultant forensic psychiatrists on a wide range of issues that pertain to clinical practice and management that is rarely contained in textbooks.
Gloria HY Wong, The University of Hong Kong,Bosco HM Ma, Hong Kong Alzheimer's Disease Association,Maggie NY Lee, Hong Kong Alzheimer's Disease Association,David LK Dai, Hong Kong Alzheimer's Disease Association
Alzheimer’s Disease International highlighted in 2016 the role of primary care in dementia. With overly specialised healthcare systems and stretched specialist workforce, dementia is currently under-diagnosed and under-managed. While various service models have been trialled in different parts of the world, several barriers remain; among them are a lack of a gatekeeping role for primary care in highly stretched healthcare systems and a perception that primary care is of a lower quality. In this chapter, we briefly review and outline the possible roles of primary care, including the gatekeeping role, based on the concepts and practices of task-shifting and task-sharing in dementia care. Examples of primary care models in dementia are given, followed by a basic overview of the work-up, diagnosis, and management related to simple, uncomplicated Alzheimer’s disease in line with gatekeeping and task-shifting/sharing. With this background, we then move on to the rationales and evidence of integrated health and social care services, with an example of community primary care-based integrated health and social care services, from which the cases provided in this book were drawn.
Edited by
Allan Young, Institute of Psychiatry, King's College London,Marsal Sanches, Baylor College of Medicine, Texas,Jair C. Soares, McGovern Medical School, The University of Texas,Mario Juruena, King's College London
Mood disorders are associated with dysfunction in a broad range of neurocognitive domains and processes. Deficits have been reported to occur in symptomatic states (depression, [hypo]mania) as well as in remission, negatively impacting psychological well-being and impairing social and occupational functioning. Multiple studies have investigated the potential of pharmacological and nonpharmacological (psychological, behavioural and neurostimulatory) interventions for the amelioration or prevention of neurocognitive impairments. In this chapter, we present an overview of these approaches. We focus particularly on their underlying mechanisms of action and discuss the relative advantages of each approach.
This chapter provides details of the viruses and other organisms that are more severe in immunocompromised patients (HIV, CMV, EBV, HSV, VZV, HHV6, HHV7, HHV8, adenoviruses, influenzaviruses, parainfluenzaviruses, RSV, SARS-CoV-2, HBV, HEV, polyomaviruses, papillomaviruses, parvovirus, T gondii). It gives details of symptoms, diagnosis, treatment and strategies for reducing the risk of severe symptoms.
This chapter details the epidemiology, route of spread, prevalence, incubation period and at-risk groups relating to human adenoviruses. It gives information on symptoms, laboratory diagnosis, treatment, prophylaxis and infection control.
Giant coronary aneurysm with ventricular fistula is rare. Due to the limited data from randomised clinical trials, therapeutic strategies for coronary aneurysms predominantly rely on on case series and anecdotal evidences. Reporting cases that provide practical experience in managing these aneurysms is therefore crucial. In this article, we report a rare case of a successful surgical management for a thrombosed giant left coronary aneurysm with right ventricular fistula, which is larger than any previously reported cases.
Since the first edition was published in 2009, there have been significant advances in diagnostics and management of viral infections, as well as newly discovered viruses such as SARS-CoV-2 and Zika virus. This new edition provides up-to-date information on the key developments in clinical and diagnostic virology, especially molecular diagnosis, with guidance on new molecular and bedside tests. Effective antiviral treatments and novel combinations of treatments recently introduced are covered in depth. Infection control precautions and pandemic preparedness are discussed, with a focus on recent outbreaks. As with the first edition, coverage is succinct and practical with easily accessible information in algorithms and tables, and standardised chapter layouts organised from A to Z. This is an ideal introduction to complex topics for healthcare trainees, as well as a handy and easily accessible reference for more experienced hospital clinicians and primary care physicians.
Dementia is a syndrome associated with an ongoing decline of brain function. It is common among older in-patients. Hospital admissions tend to be due to comorbid conditions rather than the dementia itself. Falls, infections, poor nutrition, dehydration, and delirium affect the length of stay and the functioning of patients with dementia. Without a timely diagnosis of the dementia and its associated clinical features, patients can experience adverse outcomes, which cause care home admissions instead of a discharge home. This chapter discusses the epidemiology, risk factors, assessment, and treatment of dementia in a general hospital setting.
Alasdair MacIntyre’s critique of managerial capitalism is well known, with some arguing that MacIntyrean thought is antithetical to contemporary capitalist business. Nevertheless, substantial efforts have been taken to demonstrate how different business activities constitute MacIntyrean practices, which points to an incoherence at the heart of MacIntyrean business ethics scholarship. This article proposes a way of bridging these perspectives, suggesting a reimagined MacIntyrean approach to business that is thoroughly ‘practice-led.’ A detailed comparison of accounting and management shows that while neither are practices in ‘good order,’ they differ in significant ways: where management does not meet the criteria for a MacIntyrean practice, accounting is a ‘distorted’ practice. This leads to a categorisation of practice-led business activity, whereby the traditional tasks of management are subsumed, shared or subordinated to practices and practitioners. Insights on how this can be implemented are drawn from the ‘communities of practice’ literature and a consideration of professions.
Long-term urinary catheters are problematic and burdensome for patients, carers and health services. Nursing practice to improve the management of long-term urinary catheters has been held back by a lack of evidence to support policy and practice. Little is known about who uses a catheter long term and the resources and costs needed for their management. Understanding these costs will help to target innovations to improve care. There have been no substantial innovations to urinary catheters or their management recently and no publications to characterise users and costs.
Aim:
To describe long-term catheter users and explore catheter-related service use and costs in England.
Methods:
Descriptive information on the characteristics of catheter users and their use of services was obtained from: General Practice records (n = 607), district nursing records (n = 303), questionnaires to patients (n = 333) and triangulated, 2009–2012. Annual service costs (British pounds 2011) were computed.
Findings:
Most catheter users (59.6%) were men, nearly three-quarters (71.2%) were over 70 years and 60.8% used a urethral catheter. Women tended to be younger than men and more likely to use a suprapubic catheter. The services used most frequently over 12 months were general practitioner (by 63.1%) and out of hours services (43.0%); 15.5% accessed Accident and Emergency services for urgent catheter-related care. Hospital use accounted for nearly half (48.9%) of total health service costs (mainly due to inpatient stays by 13.6% of participants); catheter supplies/medications were next most costly (25.7%). Half of all costs were accounted for by 14.2% of users. The median annual cost of services used was £6.38, IQR: £344–£1324; district nursing services added approximately a further £200 per annum.
Conclusions:
Finding better ways to reduce catheter problems (e.g. blockage, infection) that cause unplanned visits, urgent or hospital care should be a priority to improve quality of life for long-term catheter users and reduce health service expenditure.
Entanglement in static fishing gear is the largest cause of non-natural mortality for minke whales (Balaenoptera acutorostrata) in Scottish waters. To mitigate whale entanglement, one priority is to identify areas where the risk of entanglement is consistently high. Sightings data for minke whales and creel fleets were collected by the Hebridean Whale and Dolphin Trust, during vessel line transect surveys conducted between 2008 and 2014. Habitat modelling was used to relate survey, environmental, and temporal variables to the co-occurrence of minke whales and creels in coastal waters of western Scotland. This revealed that minke whale occurrence was related to depth, peaking around 70 m. Using predictive habitat modelling, the overlap between minke whale habitat and the creel fishery was measured as risk of entanglement. A method was developed to quantify the consistency of risk over the seven-year time period. This allowed for the identification of areas where there had been a consistently low, medium, or high risk of entanglement from 2008 to 2014. The three areas with a consistent high risk of entanglement were identified: Inner Sound and Sound of Raasay, east of North and South Uist, and north of The Small Isles. The method presented here could be used to guide management to areas where mitigation efforts will be the most consistently effective over time.