Multiple benefits and trade-offs of changes in landscape structure and composition surrounding avocado orchards

Agroecosystems are facing a number of challenges, including declines in biodiversity and associated ecosystem services, emphasizing the need to change the current practices and approaches used within the industry. Ecological intensification, a management strategy that utilizes ecological processes to increase the production of crops while also reducing environmental impacts compared to conventional farming practices, provides a solution to counteract these harmful impacts. The field of landscape ecology provides insight into how ecological intensification practices could be integrated into landscape-level management. This field has found contrasting outcomes in various locations and crops, highlighting the context-specific nature of the interactions between the landscape and ecosystems and the need for tailored approaches to ecological intensification. In this thesis, I contribute to this growing field by exploring the relationship between the landscape and avocado pollinator biodiversity and pest abundance in the Bay of Plenty, which is the primary region for avocado orchards in New Zealand. In Chapter 2, I analyzed how the landscape surrounding avocado orchards impacted various aspects of insect pollinator communities, including species richness, evenness, abundance, biomass and mean body mass. Additionally, in Chapter 3, I investigated the influence of the landscape on the abundance of pest species such as thrips, leafroller, mealy bugs and scale as well as its effects on yield and fruit quality. My synthesized findings show that the dynamics between the landscape and avocado pests and pollinators within agroecosystems are shaped by multiple variables. This thesis also highlights a tradeoff where increasing pollinator abundance is accompanied by higher thrips abundance. Consequently, to balance the control of pests and pollinator conservation, holistic landscape management strategies are crucial. In conclusion, results from my thesis offers valuable insight into the relationship between the landscapes and avocado pests and pollinators in agroecosystems, highlighting the importance of comprehensive landscape management strategies to increase sustainable avocado production. Superviso

Faculty Recital: Sun-Young Gemma Shin, Baroque Violin, Martha Stiehl, Harpsichord/Organ

Kemp Recital Hall October 15, 2017 Sunday Evening 7:00p.m

Ketogenic diets as an adjuvant therapy for glioblastoma (KEATING): a randomized, mixed methods, feasibility study

This is a post-peer-review, pre-copyedit version of an article published in Journal of Neuro-Oncology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11060-020-03417-8Purpose We conducted a feasibility study to investigate the use of ketogenic diets (KDs) as an adjuvant therapy for patients with glioblastoma (GBM), investigating (i) trial feasibility; (ii) potential impacts of the trial on patients’ quality of life and health; (iii) patients’ perspectives of their decision-making when invited to participate in the trial and (iv) recommending improvements to optimize future phase III trials. Methods A single-center, prospective, randomized, pilot study (KEATING), with an embedded qualitative design. Twelve newly diagnosed patients with GBM were randomized 1:1 to modifed ketogenic diet (MKD) or medium chain triglyceride ketogenic diet (MCTKD). Primary outcome was retention at three months. Semi-structured interviews were conducted with a purposive sample of patients and caregivers (n=15). Descriptive statistics were used for quantitative outcomes and qualitative data were analyzed thematically aided by NVivo. Results KEATING achieved recruitment targets, but the recruitment rate was low (28.6%). Retention was poor; only four of 12 patients completed the three-month diet (MCTKD n=3; MKD n=1). Participants’ decisions were intuitive and emotional; caregivers supported diet implementation and infuenced the patients’ decision to participate. Those who declined made a deliberative and considered decision factoring diet burden and quality of life. A three-month diet was undesirable to patients who declined and withdrew. Conclusion Recruitment to a KD trial for patients with GBM is possible. A six-week intervention period is proposed for a phase III trial. The role of caregiver should not be underestimated. Future trials should optimize and adequately support the decision-making of patients

The trouble with a cuddle: Families’ experiences of supervising interactions between children in middle childhood and the family dog

Background: There is growing scientific interest in the benefits for children of interacting with and engaging with domestic dogs. Since the effects of such pairings on the dog are under explored, this study aimed to explore the lived experiences of family units supervising interactions between children in middle childhood (7–12) and the family dog(s). Methods: Ten families with at least one child aged 7–12 years old (mean 8.6, SD 1.6) and a family dog were recruited via social media to participate in whole family unit face-to-face semi-structured interviews. Experience of the effects of child-dog interaction (CDI) on the family dog was explored through discussion and reflections of CDIs, the dog’s responses, and how these were managed. The interviews were recorded and transcribed verbatim, and thematic analysis using a semantic approach was used to construct key themes. Results: All families reported that the most positive CDIs were of mutual play or that the dog freely approached the child with the ability to move away. This dynamic is subsequently referred to as dog freedom of choice (FOC). Most discussed experiences of dog aggression or avoidance of the child when FOC was compromised by close physical contact (CPC) from the child, such as cuddling. In most cases, the caregivers and children within the family unit were aware that the dog did not always enjoy such a CPC. However, interviewees recognised that such awareness did not always lead to cessation of the interaction. Conclusions: While shared play where FOC was supported suggested mutual benefits, CDIs perceived as expressions of affection, for example, hugs towards the family dog, may compromise dog quality of life and raise the risk of dog bites. Furthermore, a caregiver or child with conscious awareness of a dog reacting aversely to compromised FOC is not always a mechanism for ending of the interaction. This may raise questions about the efficacy of education programmes intended to raise the recognition of dog body language to change human behaviour

Health State Values of Deaf British Sign Language (BSL) Users in the UK: An Application of the BSL Version of the EQ-5D-5L

Background: Deaf people experience health inequalities compared to hearing populations. The EQ-5D, a widely used, standardised, generic measure of health status, which is available in over 100 languages, was recently translated into British Sign Language (BSL) and initial validation conducted. Using data from this previous study of the EQ-5D-5L BSL we aimed to assess (1) whether responses to the EQ-5D differed between a sample of Deaf BSL users and the general population (2) whether socio-demographic characteristics and clinical measures were associated with EQ-5D index scores in Deaf BSL users and (3) the impact of psychological distress and depression on health status in Deaf BSL users. Methods: Published population tariffs were applied to the EQ-5D-5L BSL, using the crosswalk methodology, to estimate health state values. Descriptive statistics (mean, SD, 95% CIs) compared Deaf BSL signer participants’ (n = 92) responses to data from the general population. Descriptive statistics and linear regression analyses were used to identify associations between Deaf participants’ EQ-5D index scores, socio-demographic characteristics, physical health and depression. Descriptive statistics compared the BSL index scores for people with psychological distress/depression to those from two cross-sectional, population-based surveys. Results: Using the EQ-5D, Deaf participants had lower mean health-state values (0.78; 95% CI 0.72–0.83; n = 89) than people participating in the 2017 Health Survey for England (0.84; 95% CI 0.83–0.84; n = 7169). Unlike larger studies, such as the Health Survey for England sample, there was insufficient evidence to assess whether Deaf participants’ EQ-5D health state values were associated with their demographic characteristics. Nevertheless, analysis of the BSL study data indicated long-standing physical illness was associated with lower health-state values (ordinary least squares coefficient = − 0.354; 95% CI − 0.484, − 0.224; p < 0.01; n = 82). Forty-three percent of our Deaf participants had depression. Participants with depression had reduced health status (0.67; 95% CI 0.58–0.77; n = 36) compared to those with no psychological distress or depression (0.87; 95% CI 0.61–0.67; n = 36). Conclusions: The study highlights reduced health in the Deaf signing population, compared to the general population. Public health initiatives focused on BSL users, aiming to increase physical and mental health, are needed to address this gap

Head and neck lymphedema and quality of life: the patient perspective.

PurposeHead and neck lymphedema (HNL) is common after head and neck cancer (HNC). This study aimed to explore quality of life (QoL) in patients with HNL to guide the development of a patient-reported QoL measure.MethodsWe conducted semi-structured interviews with 22 HNC survivors with HNL. Interviews explored participants' experiences of living with HNL. Analysis of interview transcripts drew on qualitative content analysis to ensure themes were grounded in patient experience.ResultsTwo main themes were established: "I want to live my life" and "It was like things were short-circuited." These themes encompassed the substantial disruption patients attributed to the HNL and their desire to normalize life.ConclusionsUnderstanding the impact of HNL on individual patients may be critical to optimizing treatment strategies to improve the physical burden of HNL and QoL. This study provides the framework for developing a patient-reported HNL QoL measure.Implications for cancer survivorsThe development of an HNL-specific QoL measure, grounded in the patient perspective, may provide cancer care teams with a tool to better understand HNL's impact on each patient to tailor patient-centered care and optimize QoL outcomes

Frailty Nurse and GP-led models of care in Care Homes: The role of contextual factors impacting Enhanced in Care Homes framework implementation

BACKGROUND: The Enhanced Health for Care homes (EHCH) framework is an innovative response to provide more proactive, preventative approaches to care for residents living in care homes. It involves co-producing a shared vision with primary care. As part of EHCH a UK clinical commissioning group supported GP’s in two localities to implement their preferred delivery approach involving a new Frailty Nurse-led (FN-led) model in care homes alongside an existing General Practitioner-led (GP-led) model. This paper focuses on implementation of the new FN-led model. METHODS: A qualitative study design was adopted. Forty-eight qualitative semi-structured interviews were undertaken across six care home sites in a Northern locality: three implementing the FN-led and three engaged in an existing GP-led model. Participants included residents, family members, care home managers, care staff, and health professionals working within the EHCH framework. RESULTS: Two overarching themes were generated from data analysis: Unanticipated implementation issues and Unintended consequences. Unsuccessful attempts to recruit Frailty Nurses (FN) with enhanced clinical skills working at the desired level (UK NHS Band 7) led to an unanticipated evolution in the implementation process of the FN-led model towards ‘training posts’. This prompted misaligned role expectations subsequently provoking unexpected temporary outcomes regarding role-based trust. The existing, well understood nature of the GP-led model may have further exacerbated these unintended consequences. CONCLUSION: Within the broader remit of embedding EHCH frameworks, the implementation of new FN roles needed to evolve due to unforeseen recruitment issues. Wider contextual factors are not in the control of those developing new initiatives and cannot always be foreseen, highlighting how wider factors can force evolution of planned implementation processes with unintended consequences. However, the unintended consequences in this study highlight the need for careful consideration of information dissemination (content and timing) to key stakeholders, and the influence of existing ways of working

Implementing a whole-school relationships and sex education intervention to prevent dating and relationship violence: evidence from a pilot trial in English secondary schools

Adolescent dating and relationship violence is associated with health harms and is an important topic for sex education. School-based interventions addressing this have been effective in the USA, but schools in England confront pressures that might hinder implementation. We assessed the feasibility of, and contextual enablers/barriers to implementing Project Respect, a whole-school intervention. We conducted a pilot trial with process evaluation in six English secondary schools. Intervention comprised: training; policy-review; mapping and patrolling ‘hotspots’; parent information; help-seeking app; and a curriculum (including student-led campaigns) targeting dating violence. Process evaluation included assessments of fidelity and interviews with the trainer and school staff. Schools delivered training and lessons partially or completely and made parent and app information available. Two schools conducted policy reviews; none patrolled hotspots or implemented campaigns. Implementation was strengthened where staff saw dating violence as a priority. Delivery was undermined where staff were insufficiently involved, lacked time for planning or struggled to timetable lessons, and where new school challenges undermined engagement. School-based health interventions must work to build staff buy-in and ensure they do not overburden schools. Dating and relationship violence might best be addressed in this context as a broader aspect of sex education