Human-altered environments often challenge native species with a complex spatial distribution of resources. Hostile landscape features can inhibit animal movement (i.e., genetic exchange), while ...other landscape attributes facilitate gene flow. The genetic attributes of organisms inhabiting such complex environments can reveal the legacy of their movements through the landscape. Thus, by evaluating landscape attributes within the context of genetic connectivity of organisms within the landscape, we can elucidate how a species has coped with the enhanced complexity of human altered environments. In this research, we utilized genetic data from eastern chipmunks (Tamias striatus) in conjunction with spatially explicit habitat attribute data to evaluate the realized permeability of various landscape elements in a fragmented agricultural ecosystem. To accomplish this we 1) used logistic regression to evaluate whether land cover attributes were most often associated with the matrix between or habitat within genetically identified populations across the landscape, and 2) utilized spatially explicit habitat attribute data to predict genetically-derived Bayesian probabilities of population membership of individual chipmunks in an agricultural ecosystem. Consistency between the results of the two approaches with regard to facilitators and inhibitors of gene flow in the landscape indicate that this is a promising new way to utilize both landscape and genetic data to gain a deeper understanding of human-altered ecosystems.
Understanding how habitat loss and fragmentation impact genetic variation is a major goal in landscape genetics, but to date, most studies have focused solely on the correlation between intervening ...matrix and genetic differentiation at a single spatial scale. Several caveats exist in these study designs, among them is the inability to include measures of genetic diversity in addition to differentiation. Both genetic metrics help predict population persistence, but are expected to function at differing spatial scales, which requires a multiscale investigation. In this study, we sampled two distinct spatial scales in 31 independent landscapes along a gradient of landscape context (i.e., forest amount, configuration, and types of intervening matrix) to investigate how landscape heterogeneity influences genetic diversity and differentiation in the forest-associated eastern chipmunk (Tamias striatus). Overall, quality of intervening matrix was correlated with genetic differentiation at multiple spatial scales, whereas only configuration was associated with regional scale genetic diversity. Habitat amount, in contrast, did not influence genetic differentiation or diversity at either spatial scale. Based on our findings, landscape effects on genetic variation appears to differ based on spatial scale, the type of genetic response variable, and random variation among landscapes, making extrapolation of results from single scale, unreplicated studies difficult. We encourage landscape geneticists to utilize multiscale, replicated landscapes with both genetic diversity, and differentiation to gain a more comprehensive understanding of how habitat loss and fragmentation influence genetic variation.
This study explored how nonpromotional school changes, a potentially major event for children, were associated with 3 forms of social maladjustment: isolation/withdrawal, affiliation with maladjusted ...peers, and aggression toward peers. Given that school mobility frequently co-occurs with family transitions, the moderating role of these transitions was investigated. These issues were examined in 2 longitudinal samples of U.S. (N = 1,364) and Canadian (N = 1,447) elementary school children. Propensity weighted analyses controlling for premobility individual, family, and friends' characteristics indicated that children who experienced both school and family transitions were at risk of either social withdrawal (in the Canadian sample) or affiliation with socially maladjusted peers (in the U.S. sample). These findings suggest the importance of considering both the social consequences of school mobility and the context in which such mobility occurs.
Examine possible prognostic factors for the persistence of tinnitus after acoustic neuroma resection.
Case series with chart review.
Tertiary academic medical center.
The records of 166 patients who ...underwent acoustic neuroma resection from 2009 to 2014 were reviewed. Patients were asked to complete a survey, including the Tinnitus Handicap Inventory, 1 to 6 years postoperatively.
Of the 53 patients who completed the survey, 17% reported that their tinnitus resolved; 9% reported improvement; 23% reported no change; 43% reported that their tinnitus worsened; and 8% were unsure. Respondents ≥50 years old and those with nonserviceable hearing preoperatively were more likely to report that their tinnitus resolved or improved (P < .01 and P = .02, respectively). Respondents <50 years old and those with serviceable hearing preoperatively were more likely to report that their tinnitus was the same or worse (P < .001 and P = .036, respectively). Respondents with age <50 years, serviceable hearing preoperatively, and residual tumor had a higher average Tinnitus Handicap Inventory score (P = .016, P = .048, and P = .047, respectively). Sex, tumor size, surgical approach, hearing preservation, and cochlear nerve status did not correlate with the prognosis of tinnitus postoperatively. Respondents whose tinnitus resolved postoperatively were more likely to report being "very satisfied" with their care (P = .012).
In this study, 83% of respondents had persistent tinnitus after acoustic neuroma resection. The prognosis of tinnitus was worse for younger respondents, those with serviceable hearing preoperatively, and those with residual tumor postoperatively. Respondents' satisfaction was higher if their tinnitus resolved.
IntroductionContinued nursing education and development can reduce mortality and morbidity of patients and can alleviate the shortage of healthcare workers by training of nurses for high-demand skill ...sets. We reviewed patterns of educational interventions and strategies in initiating behaviour change, improving patient outcomes or knowledge for nurses in low- and middle-income countries (LMICs).MethodsThe study searched the MEDLINE (PubMed), Embase, CINAHL, Google Scholar and Web of Science databases. The study included interventional studies on continued nursing education from 2007 to 2017. Of the 6216 publications retrieved, 98 articles were included and analysed by three independent reviewers.ResultsOf the 98 studies that met inclusion criteria, five were randomised controlled trials, five were qualitative in design and the remaining 88 were quasi-experimental, before-and-after studies. Of these studies, the median sample size of participants was 64, and the majority were conducted in Asia (53.6%). During the 10-year study period, 20.4% was conducted in 2015, the highest proportion, with a general increase in number of studies over time from 2007 to 2017. Main themes that arose from the review included train-the-trainer models, low-dose/high-frequency models, use of multiple media for training, and emphasis on nurse empowerment, strong international partnerships, and the integration of cultural context. Overall, the studies were limited in quality and lacked rigorous study design.ConclusionContinued nursing education in LMICs is essential and effective in improving nurses’ knowledge base, and thus patient outcomes and quality of care. Long-term, randomised studies are needed to understand how training strategies compare in impact on nurses and patients.
Treatment of glenohumeral osteoarthritis Izquierdo, Rolando; Voloshin, Ilya; Edwards, Sara ...
Journal of the American Academy of Orthopaedic Surgeons,
06/2010, Letnik:
18, Številka:
6
Journal Article
Recenzirano
Odprti dostop
This clinical practice guideline is based on a systematic review of published studies on the treatment of glenohumeral osteoarthritis in the adult patient population. Of the 16 recommendations ...addressed, nine are inconclusive. Two were reached by consensus-that physicians use perioperative mechanical and/or chemical venous thromboembolism prophylaxis for shoulder arthroplasty patients and that total shoulder arthroplasty not be performed in patients with glenohumeral osteoarthritis who have an irreparable rotator cuff tear. Four options were graded as weak: the use of injectable viscosupplementation; total shoulder arthroplasty and hemiarthroplasty as treatment; avoiding shoulder arthroplasty by surgeons who perform fewer than two shoulder arthroplasties per year (to reduce the risk of immediate postoperative complications); and the use of keeled or pegged all-polyethylene cemented glenoid components. The single moderate-rated recommendation was for the use of total shoulder arthroplasty rather than hemiarthroplasty. Management of glenohumeral osteoarthritis remains controversial; the scientific evidence on this topic can be significantly improved.
We employed data from a longitudinal investigation of over 1,000 children who participated in Tulsa's universal school-based pre-K program in 2005, and path modeling techniques, to examine the ...contribution of pre-K classroom quality to both kindergarten- and middle-school academic skills. We also examined gender and income-related differences in quality-outcome associations. Both Instructional and Emotional Support in pre-K classrooms, but not Classroom Management, assessed with the Classroom Assessment Scoring System (CLASS), were associated with kindergarten academic skills and, modestly indirectly associated through these immediate impacts, to middle-school test scores. Linear associations were found for Instructional Support whereas nonlinear patterns of association were evident for Emotional Support. Gender and income differences characterized Instructional Support-outcome associations. Results are discussed in terms of implications for improving pre-K quality as one avenue for supporting the ongoing development of academic skills.
Optimizing the management of rotator cuff problems Pedowitz, Robert A; Yamaguchi, Ken; Ahmad, Christopher S ...
Journal of the American Academy of Orthopaedic Surgeons,
06/2011, Letnik:
19, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Of the 31 recommendations made by the work group, 19 were determined to be inconclusive because of the absence of definitive evidence. Of the remaining recommendations, four were classified as ...moderate grade, six as weak, and two as consensus statements of expert opinion. The four moderate-grade recommendations include suggestions that exercise and nonsteroidal anti-inflammatory drugs be used to manage rotator cuff symptoms in the absence of a full-thickness tear, that routine acromioplasty is not required at the time of rotator cuff repair, that non-cross-linked, porcine small intestine submucosal xenograft patches not be used to manage rotator cuff tears, and that surgeons can advise patients that workers' compensation status correlates with less favorable outcomes after rotator cuff surgery.
Research suggests that elementary school absenteeism can contribute to deficits in achievement. It is less clear how the timing and growth in rates of attendance shape early elementary school ...achievement. The present study examined the role of absenteeism in pre-K and early elementary school in the context of third-grade achievement, along with differences based on gender and socioeconomic status. Aims were examined with a sample from an urban school district (N = 854). Overall, attendance rates were stable across early elementary school. Neither initial days attended nor changes over time were significantly associated with reading achievement in third grade for the sample as a whole. Among boys and low-income children, more days attended in pre-K was significantly associated with higher reading scores in third grade. Results are discussed in terms of early elementary attendance policies and practices for working with students who miss days of school.
PDF
