Love Thy Neighbour: Repatriating Precarious Blackfoot Sites

This paper explores responsibility for the care of significant Blackfoot placesparticularly those situated in the province of present-day Alberta. Examples ofsignificant Blackfoot sites are given and the forces that have destroyed many ofthem are recounted. The story of how Blackfoot were removed from their territory toreserves is narrated and the effect of this on Blackfoot knowledge generation andtransfer is interpreted. The forces that destroyed significant sites, since theBlackfoot removal, are described and present-day stresses on the remaining sites arerelated. Pressure to extend hydrocarbon exploration and drilling into protectedwilderness areas are offered as an example. While current legislative and policyinitiatives in Alberta to mandate the inclusion of Blackfoot perspectives in effortsto preserve and protect heritage sites are laudable, this essay offers repatriationas a model for authentic Blackfoot participation in the care of the remaining sitesand the beings who inhabit them. Repatriation acknowledges that these places areanimate beings with whom humans live. In the Blackfoot view, protecting andpreserving places is not enough. Interdependent relationships, like the one betweenhumans and the places and beings that nourish them, must be nurtured throughunimpeded access, continued use, and ceremonies of renewal such as visiting andexchanging of gifts. While Blackfoot acknowledge that the non-Blackfoot newcomersare here to stay, they continue to imagine a future where all that from which theyhave been dispossessed will be repatriated so that they may meet their sacredresponsibilities to their territory and all the beings who dwell there.Le document de recherche porte sur la responsabilité de la protection des lieuxauxquels les Pieds-Noirs sont attachés, en particulier ceux qui sont situés dans laprovince actuelle de l’Alberta. Les auteurs citent plusieurs lieux en exempleet expliquent comment ceux-ci ont été détruits. Ils racontent comment lesPieds-Noirs ont été déplacés de leur territoire vers les réserves et analysent lesconséquences de cet événement sur la production et le transfert du savoir. Ilsdécrivent les forces qui ont détruit d’autres lieux importants depuis leretrait des Pieds-Noirs et les contraintes qui pèsent actuellement sur les lieux quiexistent encore, notamment l’expansion de la recherche d’hydrocarbureset le forage dans des milieux sauvages. Selon les auteurs, les projets de lois et depolitiques en Alberta qui visent à rendre obligatoire l'intégration du point de vuedes Pieds-Noirs aux activités de conservation et de protection des lieuxpatrimoniaux sont louables, mais ils proposent le rapatriement comme modèle departicipation authentique des Pieds-Noirs à la protection des lieux qui restent etdes êtres qui y habitent. Le rapatriement reconnaît que ces lieux sont des êtresanimés avec lesquels les êtres humains coexistent. Pour les Pieds-Noirs, il nesuffit pas de protéger et de conserver des lieux. Les relations d'indépendance commecelles reliant les êtres humains, les lieux et les êtres qui les nourrissent doiventêtre soutenues par un accès libre, une utilisation continue et des cérémonies derenaissance telles que les visites et les échanges de présents. Les Pieds-Noirsreconnaissent que les nouveaux venus non-Pieds-Noirs sont là pour rester mais ilscontinuent d’imaginer un avenir où tout ce dont on les a dépossédés reviendraau même endroit afin de pouvoir remplir leurs devoirs sacrés envers leur territoireet tous les êtres qui y vivent

Resilience to Stress and Disturbance, and Resistance to Bromus tectorum L. Invasion in Cold Desert Shrublands of Western North America

Alien grass invasions in arid and semi-arid ecosystems are resulting in grass–fire cycles and ecosystem-level transformations that severely diminish ecosystem services. Our capacity to address the rapid and complex changes occurring in these ecosystems can be enhanced by developing an understanding of the environmental factors and ecosystem attributes that determine resilience of native ecosystems to stress and disturbance, and resistance to invasion. Cold desert shrublands occur over strong environmental gradients and exhibit significant differences in resilience and resistance. They provide an excellent opportunity to increase our understanding of these concepts. Herein, we examine a series of linked questions about (a) ecosystem attributes that determine resilience and resistance along environmental gradients, (b) effects of disturbances like livestock grazing and altered fire regimes and of stressors like rapid climate change, rising CO2, and N deposition on resilience and resistance, and (c) interacting effects of resilience and resistance on ecosystems with different environmental conditions. We conclude by providing strategies for the use of resilience and resistance concepts in a management context. At ecological site scales, state and transition models are used to illustrate how differences in resilience and resistance influence potential alternative vegetation states, transitions among states, and thresholds. At landscape scales management strategies based on resilience and resistance—protection, prevention, restoration, and monitoring and adaptive management—are used to determine priority management areas and appropriate actions

Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children

OBJECTIVES: To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD. STUDY DESIGN: A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category. RESULTS: Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P < .0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62). CONCLUSION: Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease

Influence of real-world characteristics on outcomes for patients with methicillin-resistant Staphylococcal skin and soft tissue infections:a multi-country medical chart review in Europe

BACKGROUND: Patient-related (demographic/disease) and treatment-related (drug/clinician/hospital) characteristics were evaluated as potential predictors of healthcare resource use and opportunities for early switch (ES) from intravenous (IV)-to-oral methicillin-resistant Staphylococcus aureus (MRSA)-active antibiotic therapy and early hospital discharge (ED). METHODS: This retrospective observational medical chart study analyzed patients (across 12 European countries) with microbiologically confirmed MRSA complicated skin and soft tissue infections (cSSTI), ≥3 days of IV anti-MRSA antibiotics during hospitalization (July 1, 2010-June 30, 2011), and discharged alive by July 31, 2011. Logistic/linear regression models evaluated characteristics potentially associated with actual resource use (length of IV therapy, length of hospital stay [LOS], IV-to-oral antibiotic switch), and ES and ED (using literature-based and expert-verified criteria) outcomes. RESULTS: 1542 patients (mean ± SD age 60.8 ± 16.5 years; 61.5% males) were assessed with 81.0% hospitalized for MRSA cSSTI as the primary reason. Several patient demographic, infection, complication, treatment, and hospital characteristics were predictive of length of IV therapy, LOS, IV-to-oral antibiotic switch, or ES and ED opportunities. Outcomes and ES and ED opportunities varied across countries. Length of IV therapy and LOS (r = 0.66, p < 0.0001) and eligibilities for ES and ED (r = 0.44, p < 0.0001) showed relatively strong correlations. IV-to-oral antibiotic switch patients had significantly shorter length of IV therapy (−5.19 days, p < 0.001) and non-significantly shorter LOS (−1.86 days, p > 0.05). Certain patient and treatment characteristics were associated with increased odds of ES (healthcare-associated/ hospital-acquired infection) and ED (patient living arrangements, healthcare-associated/ hospital-acquired infection, initiating MRSA-active treatment 1–2 days post cSSTI index date, existing ED protocol), while other factors decreased the odds of ES (no documented MRSA culture, ≥4 days from admission to cSSTI index date, IV-to-oral switch, IV line infection) and ED (dementia, no documented MRSA culture, initiating MRSA-active treatment ≥3 days post cSSTI index date, existing ES protocol). CONCLUSIONS: Practice patterns and opportunity for further ES and ED were affected by several infection, treatment, hospital, and geographical characteristics, which should be considered in identifying ES and ED opportunities and designing interventions for MRSA cSSTI to reduce IV days and LOS while maintaining the quality of care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2334-14-476) contains supplementary material, which is available to authorized users

The U.S. training institute for dissemination and implementation research in health

Abstract Background The science of dissemination and implementation (D&amp;I) is advancing the knowledge base for how best to integrate evidence-based interventions within clinical and community settings and how to recast the nature or conduct of the research itself to make it more relevant and actionable in those settings. While the field is growing, there are only a few training programs for D&amp;I research; this is an important avenue to help build the field’s capacity. To improve the United States’ capacity for D&amp;I research, the National Institutes of Health and Veterans Health Administration collaborated to develop a five-day training institute for postdoctoral level applicants aspiring to advance this science. Methods We describe the background, goals, structure, curriculum, application process, trainee evaluation, and future plans for the Training in Dissemination and Implementation Research in Health (TIDIRH). Results The TIDIRH used a five-day residential immersion to maximize opportunities for trainees and faculty to interact. The train-the-trainer-like approach was intended to equip participants with materials that they could readily take back to their home institutions to increase interest and further investment in D&amp;I. The TIDIRH curriculum included a balance of structured large group discussions and interactive small group sessions. Thirty-five of 266 applicants for the first annual training institute were accepted from a variety of disciplines, including psychology (12 trainees); medicine (6 trainees); epidemiology (5 trainees); health behavior/health education (4 trainees); and 1 trainee each from education &amp; human development, health policy and management, health services research, public health studies, public policy and social work, with a maximum of two individuals from any one institution. The institute was rated as very helpful by attendees, and by six months after the institute, a follow-up survey (97% return rate) revealed that 72% had initiated a new grant proposal in D&amp;I research; 28% had received funding, and 77% had used skills from TIDIRH to influence their peers from different disciplines about D&amp;I research through building local research networks, organizing formal presentations and symposia, teaching and by leading interdisciplinary teams to conduct D&amp;I research. Conclusions The initial TIDIRH training was judged successful by trainee evaluation at the conclusion of the week’s training and six-month follow-up, and plans are to continue and possibly expand the TIDIRH in coming years. Strengths are seen as the residential format, quality of the faculty and their flexibility in adjusting content to meet trainee needs, and the highlighting of concrete D&amp;I examples by the local host institution, which rotates annually. Lessons learned and plans for future TIDIRH trainings are summarized

Cumulative effects of bullying and racial discrimination on adolescent health in Australia

This study examined how cumulative exposure to racial discrimination and bullying victimization influences the health of Australian adolescents (n=2802) aged 10-11 years (19.3% visible ethnic minorities (non-White, non-Indigenous); 2.6% Indigenous) using data from 3 waves (2010-2014) of the nationally representative Longitudinal Study of Australian Children (LSAC). Cumulative exposure to racial discrimination and bullying victimization had incremental negative effects on socioemotional difficulties. Higher accumulated exposure to both stressors across time was associated with increased BMI z-scores, and risk of overweight/obesity. Studies that examine exposure to single risk factors such as bullying victimization or racial discrimination at 1 time point only are likely to miss key determinants of health for adolescents from stigmatized racial/ethnic backgrounds and under-estimate their stressor burden

Resilience to Stress and Disturbance, and Resistance to Bromus tectorum L. Invasion in Cold Desert Shrublands of Western North America

Alien grass invasions in arid and semi-arid ecosystems are resulting in grass–fire cycles and ecosystem-level transformations that severely diminish ecosystem services. Our capacity to address the rapid and complex changes occurring in these ecosystems can be enhanced by developing an understanding of the environmental factors and ecosystem attributes that determine resilience of native ecosystems to stress and disturbance, and resistance to invasion. Cold desert shrublands occur over strong environmental gradients and exhibit significant differences in resilience and resistance. They provide an excellent opportunity to increase our understanding of these concepts. Herein, we examine a series of linked questions about (a) ecosystem attributes that determine resilience and resistance along environmental gradients, (b) effects of disturbances like livestock grazing and altered fire regimes and of stressors like rapid climate change, rising CO₂, and N deposition on resilience and resistance, and (c) interacting effects of resilience and resistance on ecosystems with different environmental conditions. We conclude by providing strategies for the use of resilience and resistance concepts in a management context. At ecological site scales, state and transition models are used to illustrate how differences in resilience and resistance influence potential alternative vegetation states, transitions among states, and thresholds. At landscape scales management strategies based on resilience and resistance—protection, prevention, restoration, and monitoring and adaptive management—are used to determine priority management areas and appropriate actions.Keywords: ecosystem productivity, plant traits, environmental gradients, fundamental and realized niche, management strategies, cheatgrass, state and transition models, altered fire regime

Psoriasis and Hypertension Severity: Results from a Case-Control Study

BACKGROUND: Epidemiologic studies have provided new insights into the association between psoriasis and cardiovascular diseases. Previous population studies have examined hypertension frequency in psoriasis patients. However, the relationship between severity of hypertension and psoriasis has not been characterized. OBJECTIVE: We sought to investigate whether patients with psoriasis have more difficult-to-manage hypertension compared to non-psoriatic hypertensive patients. APPROACH: We performed a case-control study using the University of California Davis electronic medical records. The cases were defined as patients diagnosed with both psoriasis and hypertension, and controls were defined as patients with hypertension and without psoriasis. In this identified population, 835 cases were matched on age, sex, and body mass index (BMI) to 2418 control patients. KEY RESULTS: Treatment with multiple anti-hypertensives was significantly associated with the presence of psoriasis using univariate (p < 0.0001) and multivariable analysis, after adjusting for diabetes, hyperlipidemia, and race (p < 0.0001). Compared to hypertensive patients without psoriasis, psoriasis patients with hypertension were 5 times more likely to be on a monotherapy antihypertensive regimen (95% CI 3.607.05), 9.5 times more likely to be on dual antihypertensive therapy (95% CI 6.68-13.65), 16.5 times more likely to be on triple antihypertensive regimen (95% CI 11.01-24.84), and 19.9 times more likely to be on quadruple therapy or centrally-acting agent (95% CI 10.58-37.33) in multivariable analysis after adjusting for traditional cardiac risk factors. CONCLUSIONS: Psoriasis patients appear to have more difficult-to-control hypertension compared to non-psoriatic, hypertensive patients