Alien Registration- Macdonald, Robina A. (Paris, Oxford County)

https://digitalmaine.com/alien_docs/21118/thumbnail.jp

73,401 Hexagons: A Geodiversity Gap Analysis of the Crown of the Continent Ecosystem

The Crown of the Continent Initiative (CCI) is a transboundary collaborative of conservation groups who work to further conservation goals throughout the Crown of the Continent Ecosystem, located in Northwestern Montana and southern British Columbia and Alberta. CCI and their member groups are interested in using geodiversity as a conservation measure in the Crown Ecosystem. First suggested in 1988 (Hunter et al.), geodiversity, or land facets, are typically a combination of abiotic features used as surrogates for the overlying biotic features. Conservation planning often employs an approach of coarse and fine filters, gap analysis, and systematic reserve design to identify where those features are lacking sufficient protection and, in order to fill those deficiencies (Hunter et. al 1988; Margules and Pressey 2000). Recently, there has been renewed interest in land facets for their utility in incorporating climate adaptation into reserve planning. The concept is that by protecting abiotic features that currently host biodiversity, those features will continue to do so into the future, even if the biota they host changes due to climate change (Anderson and Ferree 2010; Beier and Brost 2010). CCI is interested in the land facets currently protected, as well as the applicability of land facets as a conservation measure for planning of future protected areas in the Crown of the Continent. This report reviews the literature associated with systematic conservation planning, the incorporation of climate adaptation into conservation plans, and the use of land facets as a coarse-filter conservation measure. Data sources to apply this research in the Crown are identified and reviewed, and the methodology used to complete a land facet gap analysis in GIS (Geographic Information Systems) is described. Once gaps were identified, Marxan optimization software was used to identify reserve designs that efficiently meet the geodiversity conservation goals. That process is described and the results are summarized. Both the gap analysis and Marxan reserve solutions showed a need for increased protection along the Eastern Slopes and in the southwest Crown. In both the United States and Canada, these areas include a mixture of federally and privately owned land. Given that both analysis methods show broad areas that are not adequately protected, it is suggested that these results may be best used to augment other conservation measures, rather than as a stand-alone measure for setting conservation priorities. This conclusion is supported by current practice of conservationists implementing land facets in their work (Lawler et al. 2015; Anderson et a. 2015)

Impact of Leaders’ Emotional and Cultural Intelligence on Leadership Effectiveness: Mediating Role of Transformational Leadership

For leaders to serve as effective change agents in the organization, significance of leaders’ intelligence cannot be overlooked. Current empirical study was carried out with an intention to investigate the impact of leaders’ emotional and cultural intelligence on leadership effectiveness through the mediating role of transformational leadership as perceived by followers. With the help of questionnaire, data was collected from the employees of private banks of twin cities (Islamabad and Rawalpindi) of Pakistan. A total of 262 responses were entered in SPSS for analyzing data and interpreting results. The mediating, dependent and independent variables were modeled in a path diagram and tested through structural equation modeling (SEM). The findings of the study indicate that transformational leadership fully mediates the relationships of leaders’ emotional and cultural intelligence with leadership effectiveness. The results of the study provide useful insight into the fact that emotionally and culturally intelligent leaders are more effective because they exhibit more transformational leadership style. Theoretical and practical implications of the findings are discussed along with limitations and recommendations for future researc

Depression after Delivery: Risk Factors, Diagnostic and Therapeutic Considerations

Postpartum mood disorders can negatively affect women, their offspring, and their families when left untreated. The identification and treatment of postpartum depression remains problematic since health care providers may often not differentiate postpartum blues from depression onset. Recent studies found potentially new risk factors, etiologies, and treatments; thus, possibly improving the untreated postpartum depression rates. This integrated review examined several postpartum psychiatric disorders, postpartum blues, generalized anxiety, obsessive compulsive disorder, post-traumatic stress disorder, and postpartum psychosis for current findings on prevalence, etiologies, risk factors, and postpartum depression treatments

Responsible participation and housing: restoring democratic theory to the scene

Tensions between individual liberty and collective social justice characterise many advanced liberal societies. These tensions are reflected in the challenges posed for representative democracy both by participatory democratic practices and by the current emphasis on (so-called) responsible participation. Based on the example of ‘community’ housing associations in Scotland, this paper explores these tensions. It is argued that the critique of responsibility may have been over-stated – that, in particular, ‘community’ housing associations offer the basis for relatively more inclusive and effective processes of decision-making than council housing, which relies on the traditional processes and institutions of representative local government for its legitimacy

Effect of azithromycin on incidence of acute respiratory exacerbations in children with HIV taking antiretroviral therapy and co-morbid chronic lung disease: a secondary analysis of the BREATHE trial

Background - In the BREATHE trial weekly azithromycin decreased the rate of acute respiratory exacerbations (AREs) compared to placebo among children and adolescents with HIV-associated chronic lung disease (CLD) taking antiretroviral therapy (ART). The aim of this analysis was to identify risk factors associated with AREs and mediators of the effect of azithromycin on AREs. Methods - The primary outcome of this analysis was the rate of AREs by study arm up to 49 weeks. We analysed rates using Poisson regression with random intercepts. Interaction terms were fitted for potential effect modifiers. Participants were recruited from Zimbabwe and Malawi between15 June 2016 and 4 September 2018. Findings - We analysed data from 345 participants (171 allocated to azithromycin and 174 allocated to placebo). Rates of AREs were higher among those with an abnormally high respiratory rate at baseline (adjusted rate ratio (aRR) 2.08 95% CI 1.10-3.95 p-value 0.02) and among those with a CD4 cell count -2 and participants without baseline resistance to azithromycin. However, there was no statistical evidence for interaction due to low statistical power. Interpretation - These may represent subgroups who may benefit the most from treatment with weekly azithromycin, which could help guide targeted treatment. Funding - There was no funding source for this post hoc analysis

Screening and Treatment for Subclinical Hypertensive Heart Disease in Emergency Department Patients With Uncontrolled Blood Pressure: A Cost‐effectiveness Analysis

ObjectivesPoorly controlled hypertension (HTN) is extremely prevalent and, if left unchecked, subclinical hypertensive heart disease (SHHD) may ensue leading to conditions such as heart failure. To address this, we designed a multidisciplinary program to detect and treat SHHD in a high‐risk, predominantly African American community. The primary objective of this study was to determine the cost‐effectiveness of our program.MethodsStudy costs associated with identifying and treating patients with SHHD were calculated and a sensitivity analysis was performed comparing the effect of four parameters on cost estimates. These included prevalence of disease, effectiveness of treatment (regression of SHHD, reversal of left ventricular hypertrophy [LVH], or blood pressure [BP] control as separate measures), echocardiogram costs, and participant time/travel costs. The parent study for this analysis was a single‐center, randomized controlled trial comparing cardiac effects of standard and intense (<120/80 mm Hg) BP goals at 1 year in patients with uncontrolled HTN and SHHD. A total of 149 patients (94% African American) were enrolled, 133 (89%) had SHHD, 123 (93%) of whom were randomized, with 88 (72%) completing the study. Patients were clinically evaluated and medically managed over the course of 1 year with repeated echocardiograms. Costs of these interventions were analyzed and, following standard practices, a cost per quality‐adjusted life‐year (QALY) less than $50,000 was defined as cost‐effective.ResultsTotal costs estimates for the program ranged from$117,044 to $119,319. Cost per QALY was dependent on SHHD prevalence and the measure of effectiveness but not input costs. Cost‐effectiveness (cost per QALY less than$50,000) was achieved when SHHD prevalence exceeded 11.1% for regression of SHHD, 4.7% for reversal of LVH, and 2.9% for achievement of BP control.ConclusionsIn this cohort of predominantly African American patients with uncontrolled HTN, SHHD prevalence was high and screening with treatment was cost‐effective across a range of assumptions. These data suggest that multidisciplinary programs such as this can be a cost‐effective mechanism to mitigate the cardiovascular consequences of HTN in emergency department patients with uncontrolled BP.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136283/1/acem13122.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136283/2/acem13122_am.pd

Carcass and meat quality traits of Iberian pig as affected by sex and crossbreeding with different Duroc genetic lines

A total of 144 pigs were used to study the effects of sex (barrows or gilts) and terminal sire line (Iberian or three genetic lines of Duroc: Duroc 1, Duroc 2 and Duroc 3) on performance and carcass and meat quality traits. Gilts showed slightly lower average daily gain, shoulder weight and trimming losses, but slightly better primal cuts yields and higher loin weight, while there was no significant effect of sex on meat quality traits or on the fatty acid composition of lard and muscle. There were important differences in performance and in carcass and primal cuts quality traits between pure Iberian pigs and all Iberian × Duroc crossbreeds evaluated, partly due to the lower slaughter weights reached by the formers. The different sire lines showed differences in several traits; Duroc 1 group showed lower backfat thickness and ham and shoulder trimming losses, and higher primal cut yields than Duroc 2 and Duroc 3 groups. Intramuscular fat (IMF) content remained unaffected by crossbreeding, but meat color resulted more intense and redder in crosses from the Duroc 1 sire line. The accumulation of fatty acids in lard was not affected by Duroc sire line, while animals of the group Duroc 2 showed higher levels of monounsaturated fatty acid and lower of polyunsaturated ones in IMF. These results highlight the importance of considering not only performance, but also carcass and meat quality traits when deciding the Duroc sire line for crossbreeding in Iberian pig production

Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy.

BACKGROUND: Management of co-morbidities among persons living with HIV is an emerging priority, which may require additional medication over and above life-long antiretroviral therapy (ART). We explored factors associated with adherence to the trial drug among children and adolescents with perinatally acquired HIV taking antiretroviral therapy (ART) in the Bronchopulmonary Function in Response to Azithromycin Treatment for Chronic Lung Disease in HIV-Infected Children (BREATHE) trial. METHODS: The BREATHE trial recruited 6-19 year olds with perinatally acquired HIV and co-morbid chronic lung disease as measured by FEV1. This two-site trial was individually randomised (1:1), double-blind and placebo-controlled. Participants received a once-weekly weight-based dose of 1-5 tablets of azithromycin (AZM: 250mg) or placebo, taken orally. We used pharmacy dispensing records and count of returned pills to measure adherence to study medication. Logistic regression was used to explore factors associated with adherence coverage. Poisson regression with Lexis expansion for time was used to explore whether adherence modified the effect of azithromycin on the incidence of acute respiratory exacerbation, a secondary outcome of the trial. Trial registration: ClinicalTrials.gov NCT02426112. RESULTS: The 347 participants (median age 15.3, 51% male) consumed 14,622 doses of study medication over 16,220 person-weeks under study. Adherence was higher for those randomised to AZM (73.4%) than placebo (68.4%) and declined over the 48 weeks of the study (Score test for trend <0.02). Those with unsuppressed HIV viral load at baseline had 2.08 (95% CI: 1.19, 3.63) times the odds of non-adherence than those with viral suppression. Differences were also observed between trial sites. CONCLUSION: The majority of children and adolescents tolerated the addition of a once-weekly dose of medication to their pill burden. Barriers in adhering to treatment for co-morbid conditions are likely common to barriers in adhering to ART. Control of co-morbidities will therefore present additional challenges in HIV care

Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy

BACKGROUND : Management of co-morbidities among persons living with HIV is an emerging priority, which may require additional medication over and above life-long antiretroviral therapy (ART). We explored factors associated with adherence to the trial drug among children and adolescents with perinatally acquired HIV taking antiretroviral therapy (ART) in the Bronchopulmonary Function in Response to Azithromycin Treatment for Chronic Lung Disease in HIV-Infected Children (BREATHE) trial. METHODS : The BREATHE trial recruited 6–19 year olds with perinatally acquired HIV and co-morbid chronic lung disease as measured by FEV1. This two-site trial was individually randomised (1:1), double-blind and placebo-controlled. Participants received a once-weekly weightbased dose of 1–5 tablets of azithromycin (AZM: 250mg) or placebo, taken orally. We used pharmacy dispensing records and count of returned pills to measure adherence to study medication. Logistic regression was used to explore factors associated with adherence coverage. Poisson regression with Lexis expansion for time was used to explore whether adherence modified the effect of azithromycin on the incidence of acute respiratory exacerbation, a secondary outcome of the trial. Trial registration: ClinicalTrials.gov NCT02426112. RESULTS : The 347 participants (median age 15.3, 51% male) consumed 14,622 doses of study medication over 16,220 person-weeks under study. Adherence was higher for those randomised to AZM (73.4%) than placebo (68.4%) and declined over the 48 weeks of the study (Score test for trend <0.02). Those with unsuppressed HIV viral load at baseline had 2.08 (95% CI: 1.19, 3.63) times the odds of non-adherence than those with viral suppression. Differences were also observed between trial sites. CONCLUSION : The majority of children and adolescents tolerated the addition of a once-weekly dose of medication to their pill burden. Barriers in adhering to treatment for co-morbid conditions are likely common to barriers in adhering to ART. Control of co-morbidities will therefore present additional challenges in HIV care.The Global Health and Vaccination Research (GLOBVAC) Programme of the Medical Research Council of Norway, the Wellcome Trust, the Medical Research Council (MRC) and the Department for International Development (DFID UK).http://www.plosone.orgdm2022School of Health Systems and Public Health (SHSPH