Adaptive management is an approach to recurrent decision making in which uncertainty about the decision is reduced over time through comparison of outcomes predicted by competing models against observed values of those outcomes. The National Wildlife Refuge System (NWRS) of the U.S. Fish and Wildlife Service is a large land management program charged with making natural resource management decisions, which often are made under considerable uncertainty, severe operational constraints, and conditions that limit ability to precisely carry out actions as intended. The NWRS presents outstanding opportunities for the application of adaptive management, but also difficult challenges. We describe two cooperative programs between the Fish and Wildlife Service and the U.S. Geological Survey to implement adaptive management at scales ranging from small, single refuge applications to large, multi-refuge, multi-region projects. Our experience to date suggests three important attributes common to successful implementation: a vigorous multi-partner collaboration, practical and informative decision framework components, and a sustained commitment to the process. Administrators in both agencies should consider these attributes when developing programs to promote the use and acceptance of adaptive management in the NWRS.
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http://dx.doi.org/10.1016/j.jenvman.2010.10.065 | DOI Listing |
Herz
January 2025
Herzzentrum Leipzig, Universitätsklinik für Kardiologie, Strümpellstr. 39, 04289, Leipzig, Deutschland.
Coronary artery disease (CAD) is the leading cause of death worldwide. Acute coronary syndrome (ACS) encompasses a spectrum of diagnoses ranging from unstable angina pectoris to myocardial infarction with and without ST-segment elevation and frequently presents as the first clinical manifestation. It is crucial in this scenario to perform a timely and comprehensive assessment of patients by evaluating the clinical presentation, electrocardiogram and laboratory diagnostics using highly sensitivity cardiac troponin in order to initiate a timely and risk-adapted continuing treatment with immediate or early invasive coronary angiography.
View Article and Find Full Text PDFClin Transl Oncol
January 2025
Medical Oncology Department, Hospital del Mar, Parc de Salut Mar, Spanish Group for Breast Cancer Research (GEICAM), Barcelona, Spain.
Therapeutic decision-making for older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer highlights the importance of a comprehensive geriatric assessment (CGA). This assessment considers the functional status, comorbidities, and relevant conditions of the patient, and allows for an estimation of life expectancy, but it does not facilitate individualized treatment plans. There are also other challenges to consider related to the cardiac toxicity of the treatments and the under-representation of older patients in clinical trials.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong.
: Transitional attachment objects, such as blankets, play a critical role in childhood by helping children manage separation anxiety and regulate emotions. Although attachment to these objects often decreases as children grow older, it may persist into adulthood and influence emotion regulation and stress responses. Their influence on emotion regulation in adulthood remains uncertain.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Internal Medicine I-Discipline of Medical Semiology I, Department V, Center of Advanced Research in Cardiology and Hemostasology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.
The SARS-CoV-2 virus infection, the most severe pandemic in recent human history, found healthcare systems around the world more or less unprepared. Adjusting to this challenge involved changes in the daily routines of healthcare systems, as well as the patients, once again highlighting the importance of primary care (family physician or general practitioner). In the context of the COVID-19 pandemic, the family doctor in Romania played a crucial role in patient management, rapidly adapting to the changes and challenges imposed by the state of emergency.
View Article and Find Full Text PDFInt J Rheum Dis
January 2025
Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Background: Right ventricular (RV) failure is a well-recognized pivotal prognostic factor of adverse outcomes in pulmonary artery hypertension (PAH), while RV dilation provides significant implications for adaptive or maladaptive changes. PAH is a predominant cause of mortality among patients with connective tissue disease (CTD). This study aims to elucidate the prognostic significance of RV morphology, as assessed by echocardiography (ECHO), in with CTD associated with PAH (CTD-PAH).
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