Juvenile salmon density on marsh surfaces versus within tidal channels

Use of tidal marsh surfaces by juvenile salmon in Pacific Northwest estuaries has generally been ignored by ecologists, engineers and planners involved in salmon habitat restoration. In contrast, fish use of marsh plains has been documented in many other parts of the world. Are Pacific Northwest marshes an exception to the pattern of fish use that is so common elsewhere? For three consecutive years, fish were sampled bi-monthly in tidal channels and on tidal marsh plains of the Skagit Delta to answer this question. Juvenile Chinook and chum salmon, as well as sticklebacks were the most consistently caught and abundant fish in channels and on the marsh surface, but eight other fish species were also found on the marsh surface. While fish densities were much higher in tidal channels than on marsh surfaces, marsh surface area was much greater than channel area, so sticklebacks and juvenile chum were potentially 50% more numerous on the marsh surface than in channels. However, due to their high channel densities, juvenile Chinook were nevertheless more abundant in tidal channels than on the marsh surface; those on the marsh surface amounted to 40% of those in tidal channels. The ratio of marsh surface to channel fish density peaks late in the season for all three fish species, which may be a response to increased prey production over the marsh plain. The substantial use of the marsh surface by juvenile salmon that we observed suggests estuarine habitat restoration for salmon recovery should not neglect the direct value of vegetated marsh plains to juvenile salmon. Tidal marsh habitat for juvenile salmon is more than just tidal channels. Partial habitat restoration that only restores tidal flow to channels and not to adjacent marshes, e.g., using self-regulating tide gates (SRTs), has a direct impact on juvenile salmon habitat use

Assessing tidal marsh vulnerability to sea-level rise in the Skagit Delta

Historical aerial photos, from 1937 to the present, show Skagit Delta tidal marshes prograding into Skagit Bay throughout most of the record, but the progradation rates have been steadily declining and become negative in recent decades, i.e., the marshes have begun to erode. If past trends continue, the marshes will continue eroding despite the large suspended sediment load provided by the river. Within the bay-fringe region between the North and South Fork Skagit River distributaries, an area isolated from direct riverine sediment supply by anthropogenic blockage of historical distributaries, 0.5-m tall marsh cliffs along with concave marsh profiles indicate wave erosion is contributing to marsh retreat. This is further supported by a “natural experiment” provided by rocky outcrops that shelter high marsh in their lee, while being bounded by 0.5-m lower eroded marsh to windward and on either side. GIS analysis of the bay-fringe marsh indicates that relative to modern LIDAR data the seaward edge of the 1972 marsh (its maximal extent) was 15 cm lower in elevation than the 2012 marsh edge; this comparison assumes no change in marsh slope during the last 40 years. Tide gauge data show sea level rose 7.9 ± 4.6 cm during this time, suggesting sea level rise accounts for a substantial portion of the elevation difference, while erosion may have contributed to the rest. Coastal wetlands with high sediment supply are considered resilient to sea level rise, but the Skagit Delta shows this is not necessarily true. A combination of sea level rise and wave-generated erosion may overwhelm sediment supply. Additionally, constructed levees intensify river jet momentum thereby delivering most suspended sediment far offshore where it is unavailable for marsh accretion. Adaptive response to the threat of sea level rise should consider the efficacy of restoring historical distributaries and managed retreat of constrictive river levees to maximize sediment delivery to delta marshes

Introduction

Introduction to the assessing, planning and adapting to climate change Impacts in Skagit River watershed session of the Salish Sea Conference

Health professionals’ perspectives on delivering home and hospital management at diagnosis for children with type 1 diabetes: a qualitative study from the Delivering Early Care in Diabetes Evaluation (DECIDE) trial

Objective: To explore the delivery of home and hospital management at diagnosis of Type 1 diabetes in childhood and any impact this had on health professionals delivering care. Methods: This qualitative study was undertaken as part of the DECIDE randomised controlled trial where participants were individually randomised to receive initiation of management at diagnosis, to home or hospital. Semi-structured telephone interviews were planned with a purposive sample of health professionals involved with the delivery of home and hospital management, to include consultants, diabetes and research nurses, and dietitians from the eight UK centres taking part. The interview schedule focused on their experiences of delivering the two models of care; preferences, impact and future plans. Data were subject to Thematic Analysis. Results: Twenty two health professionals participated, represented by consultants, diabetes and research nurses, and dietitians. Overall, nurses preferred home management and perceived it to be beneficial in terms of facilitating a unique opportunity to understand family life and provide education to extended family members. Nurses described a special bond and lasting relationship that they developed with the home managed children and families. Consultants expressed concern that it jeopardised their relationship with families. Dietitians reported being unable to deliver short bursts of education to families in the home managed arm. All health professionals were equally divided over which was logistically easier to deliver. Conclusions: A hybrid approach, of a brief stay in hospital and early home management, offers a pragmatic solution to the advantages and challenges presented by both systems

The effect of the Talking Diabetes consulting skills intervention on glycaemic control and quality of life in children with type 1 diabetes: cluster randomised controlled trial (DEPICTED study)

Objective To evaluate the effectiveness on glycaemic control of a training programme in consultation skills for paediatric diabetes teams

Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks):a pragmatic randomised controlled trial

SummaryBackgroundMany countries now offer support to teenage mothers to help them to achieve long-term socioeconomic stability and to give a successful start to their children. The Family Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the USA and introduced into practice in England that involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. We aimed to assess the effectiveness of giving the programme to teenage first-time mothers on infant and maternal outcomes up to 24 months after birth.MethodsWe did a pragmatic, non-blinded, randomised controlled, parallel-group trial in community midwifery settings at 18 partnerships between local authorities and primary and secondary care organisations in England. Eligible participants were nulliparous and aged 19 years or younger, and were recruited at less than 25 weeks' gestation. Field-based researchers randomly allocated mothers (1:1) via remote randomisation (telephone and web) to FNP plus usual care (publicly funded health and social care) or to usual care alone. Allocation was stratified by site and minimised by gestation (<16 weeks vs ≥16 weeks), smoking status (yes vs no), and preferred language of data collection (English vs non-English). Mothers and assessors (local researchers at baseline and 24 months' follow-up) were not masked to group allocation, but telephone interviewers were blinded. Primary endpoints were biomarker-calibrated self-reported tobacco use by the mother at late pregnancy, birthweight of the baby, the proportion of women with a second pregnancy within 24 months post-partum, and emergency attendances and hospital admissions for the child within 24 months post-partum. Analyses were by intention to treat. This trial is registered with ISRCTN, number ISRCTN23019866.FindingsBetween June 16, 2009, and July 28, 2010, we screened 3251 women. After enrolment, 823 women were randomly assigned to receive FNP and 822 to usual care. All follow-up data were retrieved by April 25, 2014. 304 (56%) of 547 women assigned to FNP and 306 (56%) of 545 assigned to usual care smoked at late pregnancy (adjusted odds ratio [AOR] 0·90, 97·5% CI 0·64–1·28). Mean birthweight of 742 babies with mothers assigned to FNP was 3217·4 g (SD 618·0), whereas birthweight of 768 babies assigned to usual care was 3197·5 g (SD 581·5; adjusted mean difference 20·75 g, 97·5% CI −47·73 to 89·23. 587 (81%) of 725 assessed children with mothers assigned to FNP and 577 (77%) of 753 assessed children assigned to usual care attended an emergency department or were admitted to hospital at least once before their second birthday (AOR 1·32, 97·5% CI 0·99–1·76). 426 (66%) of 643 assessed women assigned to FNP and 427 (66%) 646 assigned to usual care had a second pregnancy within 2 years (AOR 1·01, 0·77–1·33). At least one serious adverse event (mainly clinical events associated with pregnancy and infancy period) was reported for 310 (38%) of 808 participants (mother–child) in the usual care group and 357 (44%) of 810 in the FNP group, none of which were considered related to the intervention.InterpretationAdding FNP to the usually provided health and social care provided no additional short-term benefit to our primary outcomes. Programme continuation is not justified on the basis of available evidence, but could be reconsidered should supportive longer-term evidence emerge.FundingDepartment of Health Policy Research Programme

Long-Billed Curlew Nest Site Selection and Success in the Intermountain West

Grassland birds have experienced steeper population declines between 1966 and 2015 than any other bird group on the North American continent, and migratory grassland birds may face threats in all stages of their annual cycle. The grassland‐associated long‐billed curlew (Numenius americanus) is experiencing population declines in regional and local portions of their North American breeding range. The nesting period is an important portion of the annual cycle when curlews may face demographic rate limitations from a suite of threats including predators and anthropogenic disturbance. We compared nest sites to random sites within breeding territories to examine nest site selection, and modeled correlates of nesting success for 128 curlew nests at 5 Intermountain West sites. Nest sites were 6 times more likely than random sites to be situated adjacent to existing cowpies. Additionally, curlews selected nest sites with shorter vegetation, and less bare ground, grass, and shrub cover than at random sites within their territories. Nest success varied widely among sites and ranged from 12% to 40% in a season with a mean of 27% for all nests during the 2015 and 2016 seasons. Higher nest success probability was associated with higher curlew densities in the area, greater percent cover of conspicuous objects (cowpies, rocks) near the nest, and higher densities of black‐billed magpies (Pica hudsonia) and American crows (Corvus brachyrhynchos) at the site. We also found increased probability of nesting success with increased distance from a nest to the nearest potential perch in that territory. Given the central role of working lands to curlews in much of the Intermountain West, understanding limitations to nesting success in these diverse landscapes is necessary to guide adaptive management strategies in increasingly human‐modified habitats. We suggest some grazing and irrigation practices already provide suitable nesting conditions for curlews, and others may require only minor temporal shifts to improve compatibility

The Fire and Tree Mortality Database, for Empirical Modeling of Individual Tree Mortality After Fire

Wildland fires have a multitude of ecological effects in forests, woodlands, and savannas across the globe. A major focus of past research has been on tree mortality from fire, as trees provide a vast range of biological services. We assembled a database of individual-tree records from prescribed fires and wildfires in the United States. The Fire and Tree Mortality (FTM) database includes records from 164,293 individual trees with records of fire injury (crown scorch, bole char, etc.), tree diameter, and either mortality or top-kill up to ten years post-fire. Data span 142 species and 62 genera, from 409 fires occurring from 1981-2016. Additional variables such as insect attack are included when available. The FTM database can be used to evaluate individual fire-caused mortality models for pre-fire planning and post-fire decision support, to develop improved models, and to explore general patterns of individual fire-induced tree death. The database can also be used to identify knowledge gaps that could be addressed in future research

Development and Evaluation of a Psychosocial Intervention for Children and Teenagers Experiencing Diabetes (DEPICTED): a protocol for a cluster randomised controlled trial of the effectiveness of a communication skills training programme for healthcare professionals working with young people with type 1 diabetes

Background Diabetes is the third most common chronic condition in childhood and poor glycaemic control leads to serious short-term and life-limiting long-term complications. In addition to optimal medical management, it is widely recognised that psychosocial and educational factors play a key role in improving outcomes for young people with diabetes. Recent systematic reviews of psycho-educational interventions recognise the need for new methods to be developed in consultation with key stakeholders including patients, their families and the multidisciplinary diabetes healthcare team. Methods/design Following a development phase involving key stakeholders, a psychosocial intervention for use by paediatric diabetes staff and not requiring input from trained psychologists has been developed, incorporating a communication skills training programme for health professionals and a shared agenda-setting tool. The effectiveness of the intervention will be evaluated in a cluster-randomised controlled trial (RCT). The primary outcome, to be measured in children aged 4-15 years diagnosed with type 1 diabetes for at least one year, is the effect on glycaemic control (HbA1c) during the year after training of the healthcare team is completed. Secondary outcomes include quality of life for patients and carers and cost-effectiveness. Patient and carer preferences for service delivery will also be assessed. Twenty-six paediatric diabetes teams are participating in the trial, recruiting a total of 700 patients for evaluation of outcome measures. Half the participating teams will be randomised to receive the intervention at the beginning of the trial and remaining centres offered the training package at the end of the one year trial period. Discussion The primary aim of the trial is to determine whether a communication skills training intervention for specialist paediatric diabetes teams will improve clinical and psychological outcomes for young people with type 1 diabetes. Previous research indicates the effectiveness of specialist psychological interventions in achieving sustained improvements in glycaemic control. This trial will evaluate an intervention which does not require the involvement of trained psychologists, maximising the potential feasibility of delivery in a wider NHS context. Trial registration Current Controlled Trials ISRCTN61568050

Factors Influencing the Emergence and Spread of HIV Drug Resistance Arising from Rollout of Antiretroviral Pre-Exposure Prophylaxis (PrEP)

Background: The potential for emergence and spread of HIV drug resistance from rollout of antiretroviral (ARV) pre-exposure prophylaxis (PrEP) is an important public health concern. We investigated determinants of HIV drug resistance prevalence after PrEP implementation through mathematical modeling. Methodology: A model incorporating heterogeneity in age, gender, sexual activity, HIV infection status, stage of disease, PrEP coverage/discontinuation, and HIV drug susceptibility, was designed to simulate the impact of PrEP on HIV prevention and drug resistance in a sub-Saharan epidemic. Principal Findings: Analyses suggest that the prevalence of HIV drug resistance is influenced most by the extent and duration of inadvertent PrEP use in individuals already infected with HIV. Other key factors affecting drug resistance prevalence include the persistence time of transmitted resistance and the duration of inadvertent PrEP use in individuals who become infected on PrEP. From uncertainty analysis, the median overall prevalence of drug resistance at 10 years was predicted to be 9.2% (interquartile range 6.9%-12.2%). An optimistic scenario of 75% PrEP efficacy, 60% coverage of the susceptible population, and 5% inadvertent PrEP use predicts a rise in HIV drug resistance prevalence to only 2.5% after 10 years. By contrast, in a pessimistic scenario of 25% PrEP efficacy, 15% population coverage, and 25% inadvertent PrEP use, resistance prevalence increased to over 40%. Conclusions: Inadvertent PrEP use in previously-infected individuals is the major determinant of HIV drug resistance prevalence arising from PrEP. Both the rate and duration of inadvertent PrEP use are key factors. PrEP rollout programs should include routine monitoring of HIV infection status to limit the spread of drug resistance. © 2011 Abbas et al