Joint environmental and social benefits from diversified agriculture

Agricultural simplification continues to expand at the expense of more diverse forms of agriculture. This simplification, for example, in the form of intensively managed monocultures, poses a risk to keeping the world within safe and just Earth system boundaries. Here, we estimated how agricultural diversification simultaneously affects social and environmental outcomes. Drawing from 24 studies in 11 countries across 2655 farms, we show how five diversification strategies focusing on livestock, crops, soils, noncrop plantings, and water conservation benefit social (e.g., human well-being, yields, and food security) and environmental (e.g., biodiversity, ecosystem services, and reduced environmental externalities) outcomes. We found that applying multiple diversification strategies creates more positive outcomes than individual management strategies alone. To realize these benefits, well-designed policies are needed to incentivize the adoption of multiple diversification strategies in unison.

Mapping the planet's critical areas for biodiversity and nature's contributions to people

Meeting global commitments to conservation, climate, and sustainable development requires consideration of synergies and tradeoffs among targets. We evaluate the spatial congruence of ecosystems providing globally high levels of nature's contributions to people, biodiversity, and areas with high development potential across several sectors. We find that conserving approximately half of global land area through protection or sustainable management could provide 90% of the current levels of ten of nature's contributions to people and meet minimum representation targets for 26,709 terrestrial vertebrate species. This finding supports recent commitments by national governments under the Global Biodiversity Framework to conserve at least 30% of global lands and waters, and proposals to conserve half of the Earth. More than one-third of areas required for conserving nature's contributions to people and species are also highly suitable for agriculture, renewable energy, oil and gas, mining, or urban expansion. This indicates potential conflicts among conservation, climate and development goals.

Climate-driven variation in dispersal ability predicts responses to forest fragmentation in birds

Species sensitivity to forest fragmentation varies latitudinally, peaking in the tropics. A prominent explanation for this pattern is that historical landscape disturbance at higher latitudes has removed fragmentation-sensitive species or promoted the evolution of more resilient survivors. However, it is unclear whether this so-called extinction filter is the dominant driver of geographic variation in fragmentation sensitivity, particularly because climatic factors may also cause latitudinal gradients in dispersal ability, a key trait mediating sensitivity to habitat fragmentation. Here we combine field survey data with a morphological proxy for avian dispersal ability (hand-wing index) to assess responses to forest fragmentation in 1,034 bird species worldwide. We find that fragmentation sensitivity is strongly predicted by dispersal limitation and that other factors-latitude, body mass and historical disturbance events-have relatively limited explanatory power after accounting for species differences in dispersal. We also show that variation in dispersal ability is only weakly predicted by historical disturbance and more strongly associated with intra-annual temperature fluctuations (seasonality). Our results suggest that climatic factors play a dominant role in driving global variation in the impacts of forest fragmentation, emphasizing the need for more nuanced environmental policies that take into account local context and associated species traits.

Catalyzing success in community-based conservation

Efforts to devolve rights and engage Indigenous Peoples and local communities in conservation have increased the demand for evidence of the efficacy of community-based conservation (CBC) and insights into what enables its success. We examined the human well-being and environmental outcomes of a diverse set of 128 CBC projects. Over 80% of CBC projects had some positive human well-being or environmental outcomes, although just 32% achieved positive outcomes for both (i.e., combined success). We coded 57 total national-, community-, and project-level variables and controls from this set, performed random forest classification to identify the variables most important to combined success, and calculated accumulated local effects to describe their individual influence on the probability of achieving it. The best predictors of combined success were 17 variables suggestive of various recommendations and opportunities for conservation practitioners related to national contexts, community characteristics, and the implementation of various strategies and interventions informed by existing CBC frameworks. Specifically, CBC projects had higher probabilities of combined success when they occurred in national contexts supportive of local governance, confronted challenges to collective action, promoted economic diversification, and invested in various capacity-building efforts. Our results provide important insights into how to encourage greater success in CBC.

Mapping the planet's critical natural assets

Sustaining the organisms, ecosystems and processes that underpin human wellbeing is necessary to achieve sustainable development. Here we define critical natural assets as the natural and semi-natural ecosystems that provide 90% of the total current magnitude of 14 types of nature's contributions to people (NCP), and we map the global locations of these critical natural assets at 2 km resolution. Critical natural assets for maintaining local-scale NCP (12 of the 14 NCP) account for 30% of total global land area and 24% of national territorial waters, while 44% of land area is required to also maintain two global-scale NCP (carbon storage and moisture recycling). These areas overlap substantially with cultural diversity (areas containing 96% of global languages) and biodiversity (covering area requirements for 73% of birds and 66% of mammals). At least 87% of the world's population live in the areas benefitting from critical natural assets for local-scale NCP, while only 16% live on the lands containing these assets. Many of the NCP mapped here are left out of international agreements focused on conserving species or mitigating climate change, yet this analysis shows that explicitly prioritizing critical natural assets and the NCP they provide could simultaneously advance development, climate and conservation goals.

Past and recent farming degrades aquatic insect genetic diversity

Recent declines in once-common species are triggering concern that an environmental crisis point has been reached. Yet, the lack of long abundance time series data for most species can make it difficult to attribute these changes to anthropogenic causes, and to separate them from normal cycles. Genetic diversity, on the other hand, is sensitive to past and recent environmental changes, and reflects a measure of a populations' potential to adapt to future stressors. Here, we consider whether patterns of genetic diversity among aquatic insects can be linked to historical and recent patterns of land use change. We collated mitochondrial cytochrome c oxidase subunit I (COI) variation for >700 aquatic insect species across the United States, where patterns of agricultural expansion and intensification have been documented since the 1800s. We found that genetic diversity was lowest in regions where cropland was historically (pre-1950) most extensive, suggesting a legacy of past environmental harm. Genetic diversity further declined where cropland has since expanded, even after accounting for climate and sampling effects. Notably though, genetic diversity also appeared to rebound where cropland has diminished. Our study suggests that genetic diversity at the community level can be a powerful tool to infer potential population declines and rebounds over longer time spans than is typically possible with ecological data. For the aquatic insects that we considered, patterns of land use many decades ago appear to have left long-lasting damage to genetic diversity that could threaten evolutionary responses to rapid global change.

A trait-based framework for predicting foodborne pathogen risk from wild birds

Recent foodborne illness outbreaks have heightened pressures on growers to deter wildlife from farms, jeopardizing conservation efforts. However, it remains unclear which species, particularly birds, pose the greatest risk to food safety. Using >11,000 pathogen tests and 1565 bird surveys covering 139 bird species from across the western United States, we examined the importance of 11 traits in mediating wild bird risk to food safety. We tested whether traits associated with pathogen exposure (e.g., habitat associations, movement, and foraging strategy) and pace-of-life (clutch size and generation length) mediated foodborne pathogen prevalence and proclivities to enter farm fields and defecate on crops. Campylobacter spp. were the most prevalent enteric pathogen (8.0%), while Salmonella and Shiga-toxin producing Escherichia coli (STEC) were rare (0.46% and 0.22% prevalence, respectively). We found that several traits related to pathogen exposure predicted pathogen prevalence. Specifically, Campylobacter and STEC-associated virulence genes were more often detected in species associated with cattle feedlots and bird feeders, respectively. Campylobacter was also more prevalent in species that consumed plants and had longer generation lengths. We found that species associated with feedlots were more likely to enter fields and defecate on crops. Our results indicated that canopy-foraging insectivores were less likely to deposit foodborne pathogens on crops, suggesting growers may be able to promote pest-eating birds and birds of conservation concern (e.g., via nest boxes) without necessarily compromising food safety. As such, promoting insectivorous birds may represent a win-win-win for bird conservation, crop production, and food safety. Collectively, our results suggest that separating crop production from livestock farming may be the best way to lower food safety risks from birds. More broadly, our trait-based framework suggests a path forward for co-managing wildlife conservation and food safety risks in farmlands by providing a strategy for holistically evaluating the food safety risks of wild animals, including under-studied species.

Prioritizing actions: spatial action maps for conservation

Spatial prioritization is a critical step in conservation planning, a process designed to ensure that limited resources are applied in ways that deliver the highest possible returns for biodiversity and human wellbeing. In practice, many spatial prioritizations fall short of their potential by focusing on places rather than actions, and by using data of snapshots of assets or threats rather than estimated impacts. We introduce spatial action mapping as an approach that overcomes these shortfalls. This approach produces a spatially explicit view of where and how much a given conservation action is likely to contribute to achieving stated conservation goals. Through seven case examples, we demonstrate simple to complex versions of how this method can be applied across local to global scales to inform decisions about a wide range of conservation actions and benefits. Spatial action mapping can support major improvements in efficient use of conservation resources and will reach its full potential as the quality of environmental, social, and economic datasets converge and conservation impact evaluations improve.

Global human influence maps reveal clear opportunities in conserving Earth's remaining intact terrestrial ecosystems

Leading up to the Convention on Biological Diversity Conference of the Parties 15, there is momentum around setting bold conservation targets. Yet, it remains unclear how much of Earth's land area remains without significant human influence and where this land is located. We compare four recent global maps of human influences across Earth's land, Anthromes, Global Human Modification, Human Footprint and Low Impact Areas, to answer these questions. Despite using various methodologies and data, these different spatial assessments independently estimate similar percentages of the Earth's terrestrial surface as having very low (20%-34%) and low (48%-56%) human influence. Three out of four spatial assessments agree on 46% of the non-permanent ice- or snow-covered land as having low human influence. However, much of the very low and low influence portions of the planet are comprised of cold (e.g., boreal forests, montane grasslands and tundra) or arid (e.g., deserts) landscapes. Only four biomes (boreal forests, deserts, temperate coniferous forests and tundra) have a majority of datasets agreeing that at least half of their area has very low human influence. More concerning, <1% of temperate grasslands, tropical coniferous forests and tropical dry forests have very low human influence across most datasets, and tropical grasslands, mangroves and montane grasslands also have <1% of land identified as very low influence across all datasets. These findings suggest that about half of Earth's terrestrial surface has relatively low human influence and offers opportunities for proactive conservation actions to retain the last intact ecosystems on the planet. However, though the relative abundance of ecosystem areas with low human influence varies widely by biome, conserving these last intact areas should be a high priority before they are completely lost.

Highly diversified crop-livestock farming systems reshape wild bird communities

Agricultural intensification is a leading threat to bird conservation. Highly diversified farming systems that integrate livestock and crop production might promote a diversity of habitats useful to native birds foraging across otherwise-simplified landscapes. At the same time, these features might be attractive to nonnative birds linked to a broad range of disservices to both crop and livestock production. We evaluated the influence of crop-livestock integration on wild bird richness and density along a north-south transect spanning the U.S. West Coast. We surveyed birds on 52 farms that grew primarily mixed vegetables and fruits alone or integrated livestock into production. Crop-livestock systems harbored higher native bird density and richness relative to crop-only farms, a benefit more pronounced on farms embedded in nonnatural landscapes. Crop-livestock systems bolstered native insectivores linked to the suppression of agricultural pest insects but did not bolster native granivores that may be more likely to damage crops. Crop-livestock systems also significantly increased the density of nonnative birds, primarily European Starlings (Sturnus vulgaris) and House Sparrows (Passer domesticus) that may compete with native birds for resources. Models supported a small, positive correlation between nonnative density and overall native bird density as well as between nonnative density and native granivore density. Relative to crop-only farms, on average, crop-livestock systems exhibited 1.5 times higher patch richness, 2.4 times higher density of farm structures, 7.3 times smaller field sizes, 2.4 times greater integration of woody crops, and 5.3 times greater integration of pasture/hay habitat on farm. Wild birds may have responded to this habitat diversity and/or associated food resources. Individual farm factors had significantly lower predictive power than farming system alone (change in C statistic information criterion (ΔCIC) = 80.2), suggesting crop-livestock systems may impact wild birds through a suite of factors that change with system conversion. Collectively, our findings suggest that farms that integrate livestock and crop production can attract robust native bird communities, especially within landscapes devoted to intensified food production. However, additional work is needed to demonstrate persistent farm bird communities through time, ecophysiological benefits to birds foraging on these farms, and net effects of both native and nonnative wild birds in agroecosystems.

Finding middle ground: Extending conservation beyond wilderness areas

We show that because of methodological improvements, the human modification map detects higher levels of land modification and is more accurate than the human footprint map across the gradient of modification globally. While we agree that protecting the world's least modified lands or wildlands is essential for conservation, we assert that extending conservation actions to better "manage the middle" are urgently needed to ensure healthy functioning ecosystems for people and nature. This article is a commentary on Kennedy et al., 25, 811-826; See also the Commentary on this article by Venter et al., 26, 330-332.

A global synthesis reveals biodiversity-mediated benefits for crop production

Human land use threatens global biodiversity and compromises multiple ecosystem functions critical to food production. Whether crop yield-related ecosystem services can be maintained by a few dominant species or rely on high richness remains unclear. Using a global database from 89 studies (with 1475 locations), we partition the relative importance of species richness, abundance, and dominance for pollination; biological pest control; and final yields in the context of ongoing land-use change. Pollinator and enemy richness directly supported ecosystem services in addition to and independent of abundance and dominance. Up to 50% of the negative effects of landscape simplification on ecosystem services was due to richness losses of service-providing organisms, with negative consequences for crop yields. Maintaining the biodiversity of ecosystem service providers is therefore vital to sustain the flow of key agroecosystem benefits to society.

Mapping global development potential for renewable energy, fossil fuels, mining and agriculture sectors

Mapping suitable land for development is essential to land use planning efforts that aim to model, anticipate, and manage trade-offs between economic development and the environment. Previous land suitability assessments have generally focused on a few development sectors or lack consistent methodologies, thereby limiting our ability to plan for cumulative development pressures across geographic regions. Here, we generated 1-km spatially-explicit global land suitability maps, referred to as "development potential indices" (DPIs), for 13 sectors related to renewable energy (concentrated solar power, photovoltaic solar, wind, hydropower), fossil fuels (coal, conventional and unconventional oil and gas), mining (metallic, non-metallic), and agriculture (crop, biofuels expansion). To do so, we applied spatial multi-criteria decision analysis techniques that accounted for both resource potential and development feasibility. For each DPI, we examined both uncertainty and sensitivity, and spatially validated the map using locations of planned development. We illustrate how these DPIs can be used to elucidate potential individual sector expansion and cumulative development patterns.

We need both natural and energy solutions to stabilize our climate

We respond to concerns raised by Baldocchi and Penuelas who question the potential for ecosystems to provide carbon sinks and storage, and conclude that we should focus on decarbonizing our energy systems. While we agree with many of their concerns, we arrive at a different conclusion: we need strong action to advance both clean energy solutions and natural climate solutions (NCS) if we are to stabilize warming well below 2°C. Cost-effective NCS can deliver 11.3 PgCO2 e yr-1 or ~30% of near-term climate mitigation needs through protection, improved management, and restoration of ecosystems, as we increase overall ambition.

Managing the middle: A shift in conservation priorities based on the global human modification gradient

An increasing number of international initiatives aim to reconcile development with conservation. Crucial to successful implementation of these initiatives is a comprehensive understanding of the current ecological condition of landscapes and their spatial distributions. Here, we provide a cumulative measure of human modification of terrestrial lands based on modeling the physical extents of 13 anthropogenic stressors and their estimated impacts using spatially explicit global datasets with a median year of 2016. We quantified the degree of land modification and the amount and spatial configuration of low modified lands (i.e., natural areas relatively free from human alteration) across all ecoregions and biomes. We identified that fewer unmodified lands remain than previously reported and that most of the world is in a state of intermediate modification, with 52% of ecoregions classified as moderately modified. Given that these moderately modified ecoregions fall within critical land use thresholds, we propose that they warrant elevated attention and require proactive spatial planning to maintain biodiversity and ecosystem function before important environmental values are lost.

A global synthesis of the effects of diversified farming systems on arthropod diversity within fields and across agricultural landscapes

Agricultural intensification is a leading cause of global biodiversity loss, which can reduce the provisioning of ecosystem services in managed ecosystems. Organic farming and plant diversification are farm management schemes that may mitigate potential ecological harm by increasing species richness and boosting related ecosystem services to agroecosystems. What remains unclear is the extent to which farm management schemes affect biodiversity components other than species richness, and whether impacts differ across spatial scales and landscape contexts. Using a global metadataset, we quantified the effects of organic farming and plant diversification on abundance, local diversity (communities within fields), and regional diversity (communities across fields) of arthropod pollinators, predators, herbivores, and detritivores. Both organic farming and higher in-field plant diversity enhanced arthropod abundance, particularly for rare taxa. This resulted in increased richness but decreased evenness. While these responses were stronger at local relative to regional scales, richness and abundance increased at both scales, and richness on farms embedded in complex relative to simple landscapes. Overall, both organic farming and in-field plant diversification exerted the strongest effects on pollinators and predators, suggesting these management schemes can facilitate ecosystem service providers without augmenting herbivore (pest) populations. Our results suggest that organic farming and plant diversification promote diverse arthropod metacommunities that may provide temporal and spatial stability of ecosystem service provisioning. Conserving diverse plant and arthropod communities in farming systems therefore requires sustainable practices that operate both within fields and across landscapes.

Differential matrix use by Neotropical birds based on species traits and landscape condition

There is considerable uncertainty about the role of human-modified habitats in supporting species in fragmented landscapes. This is because few studies sample outside of native habitats in the "matrix." Those that do, often fail to sample landscapes in a way that accounts for the confounding effects of native habitat pattern and species detection biases that can obscure species responses. We employed multi-species hierarchical occupancy models to determine the use of human-modified habitats by Neotropical birds in landscapes that were similar in forest amount and configuration but surrounded by a matrix of agriculture (predominately pasture), bauxite mining (surface mining for aluminum), or suburban development in central Jamaica. We found that the vast majority of bird species used the matrix: with the highest mean occurrences for open-associated, followed by generalist, and last forest-associated species. Migrant species had higher mean occurrences in all matrix types relative to resident species. Contrary to our expectation, mean occurrence for the entire species community, and for forest-associated and migrant species, were highest in bauxite, intermediate in suburban, and lowest in agriculture. Open-associated species had higher occurrences in both bauxite and agricultural matrices, whereas generalist species had higher occurrences in suburban matrices. Additional behavioral observations indicated that Neotropical birds used matrix areas, particularly scattered trees, to acquire food, and secondarily, as movement conduits. Matrix use patterns reflected the differential availability of potential resources and structural connectivity across the three landscape types, but only for those species adapted to open/edge environments and with generalized habitat requirements. Patterns of matrix use by forest specialists reflected the differential levels of degradation of the native forest; thus, we propose that higher matrix use for forest-dependent species may be induced by diminished within-forest resources. These results underscore that effective management of human-modified matrices requires in-depth understanding of the trade-offs between the benefits available in the matrix and the impacts on the disturbance of native habitats.

Bigger is better: Improved nature conservation and economic returns from landscape-level mitigation

Impact mitigation is a primary mechanism on which countries rely to reduce environmental externalities and balance development with conservation. Mitigation policies are transitioning from traditional project-by-project planning to landscape-level planning. Although this larger-scale approach is expected to provide greater conservation benefits at the lowest cost, empirical justification is still scarce. Using commercial sugarcane expansion in the Brazilian Cerrado as a case study, we apply economic and biophysical steady-state models to quantify the benefits of the Brazilian Forest Code (FC) under landscape- and property-level planning. We find that FC compliance imposes small costs to business but can generate significant long-term benefits to nature: supporting 32 (±37) additional species (largely habitat specialists), storing 593,000 to 2,280,000 additional tons of carbon worth $69 million to $265 million ($ pertains to U.S. dollars), and marginally improving surface water quality. Relative to property-level compliance, we find that landscape-level compliance reduces total business costs by $19 million to $35 million per 6-year sugarcane growing cycle while often supporting more species and storing more carbon. Our results demonstrate that landscape-level mitigation provides cost-effective conservation and can be used to promote sustainable development.

High-resolution satellite imagery is an important yet underutilized resource in conservation biology

Technological advances and increasing availability of high-resolution satellite imagery offer the potential for more accurate land cover classifications and pattern analyses, which could greatly improve the detection and quantification of land cover change for conservation. Such remotely-sensed products, however, are often expensive and difficult to acquire, which prohibits or reduces their use. We tested whether imagery of high spatial resolution (≤5 m) differs from lower-resolution imagery (≥30 m) in performance and extent of use for conservation applications. To assess performance, we classified land cover in a heterogeneous region of Interior Atlantic Forest in Paraguay, which has undergone recent and dramatic human-induced habitat loss and fragmentation. We used 4 m multispectral IKONOS and 30 m multispectral Landsat imagery and determined the extent to which resolution influenced the delineation of land cover classes and patch-level metrics. Higher-resolution imagery more accurately delineated cover classes, identified smaller patches, retained patch shape, and detected narrower, linear patches. To assess extent of use, we surveyed three conservation journals (Biological Conservation, Biotropica, Conservation Biology) and found limited application of high-resolution imagery in research, with only 26.8% of land cover studies analyzing satellite imagery, and of these studies only 10.4% used imagery ≤5 m resolution. Our results suggest that high-resolution imagery is warranted yet under-utilized in conservation research, but is needed to adequately monitor and evaluate forest loss and conversion, and to delineate potentially important stepping-stone fragments that may serve as corridors in a human-modified landscape. Greater access to low-cost, multiband, high-resolution satellite imagery would therefore greatly facilitate conservation management and decision-making.

Landscape matrix mediates occupancy dynamics of Neotropical avian insectivores

In addition to patch-level attributes (i.e., area and isolation), the nature of land cover between habitat patches (the matrix) may drive colonization and extinction dynamics in fragmented landscapes. Despite a long-standing recognition of matrix effects in fragmented systems, an understanding of the relative impacts of different types of land cover on patterns and dynamics of species occurrence remains limited. We employed multi-season occupancy models to determine the relative influence of patch area, patch isolation, within-patch vegetation structure, and landscape matrix on occupancy dynamics of nine Neotropical insectivorous birds in 99 forest patches embedded in four matrix types (agriculture, suburban development, bauxite mining, and forest) in central Jamaica. We found that within-patch vegetation structure and the matrix type between patches were more important than patch area and patch isolation in determining local colonization and local extinction probabilities, and that the effects of patch area, isolation, and vegetation structure on occupancy dynamics tended to be matrix and species dependent. Across the avian community, the landscape matrix influenced local extinction more than local colonization, indicating that extinction processes, rather than movement, likely drive interspecific differences in occupancy dynamics. These findings lend crucial empirical support to the hypothesis that species occupancy dynamics in fragmented systems may depend greatly upon the landscape context.

Plasma cortisol and neuropeptide Y in female victims of intimate partner violence

BACKGROUND

The experience of intimate partner violence (physical and sexual violence) has been linked to psychiatric disorders such as posttraumatic stress disorder, yet data on the neuroendocrine profile in this population is sparse. This study sought to examine baseline plasma cortisol and neuropeptide Y (NPY) levels in female victims of intimate partner violence (IPV).

METHODS

Morning plasma samples were collected for cortisol and NPY determination in 22 women with histories of IPV (10 with current PTSD, 12 without current or lifetime PTSD) and 16 non-abused controls.

RESULTS

Mean cortisol levels were significantly lower in IPV subjects compared with controls, but did not distinguish IPV subjects with and without PTSD. There were no significant differences in mean NPY levels between the groups. Neither cortisol nor NPY levels were significantly correlated with PTSD symptoms.

CONCLUSIONS

These preliminary findings suggest that victims of IPV, like women traumatized by childhood abuse, may be characterized by alterations in hypothalamic-pituitary-adrenal axis functioning, however, further study is needed to identify specific stress system disturbances in this group.

Cognitive difficulties and posttraumatic stress disorder in female victims of intimate partner violence

Subjective cognitive complaints of women exposed to intimate partner violence (IPV) and nonabused women were examined using the Cognitive Difficulties Scale (CDS). Cognitive complaints were compared among victims of IPV with a lifetime diagnosis of posttraumatic stress disorder (PTSD) (PTSD+; n=20), victims of IPV without lifetime PTSD (PTSD-; n=21), and a nonabused comparison group (n=22). The results indicated that both the PTSD+ and PTSD- groups had significantly higher levels of self-perceived cognitive difficulties than nonabused women. Furthermore, PTSD symptom severity was found to be positively correlated with self-perceived cognitive difficulties (r=.47). Further research is needed to determine whether cognitive complaints are associated with exposure to IPV, with the subsequent development of PTSD, or with other not yet understood factors. Furthermore, additional work is needed to resolve whether cognitive complaints are accompanied by objective evidence of cognitive dysfunction in victims of IPV.

Meta analysis: effects of interventions on premature infants feeding

Nipple feeding of premature infants presents a challenge to neonatal nurses who are trying to prepare the infants for eventual discharge from the hospital. To determine what empirical evidence there was to support interventions that positively influence feeding performance and feeding efficiency a meta-analysis is presented. The effects of NPO, nasogastric tubes, different nipples, breast versus bottle feeding, gestational age, oral support, oral stimulation, and nonnutritive sucking on volume intake are evaluated. The results suggest that nursing care should: (a) consider the infant's gestational age; (b) maturational ability and development; (c) keep track of and attempt to minimize the length of time an infant is NPO; and (d) provide prefeeding oral stimulation and oral support.

Vitamin A and HIV infection: disease progression, mortality, and transmission

Among HIV-infected individuals, many nutritional factors that influence disease progress, mortality, and transmission are not well understood. Of particular interest is the role of vitamin A. The benefits of vitamin A have been recognized since ancient times by Egyptian physicians who successfully treated night blindness with vitamin A. Contemporary scientists have since recognized the importance of vitamin A and have provided evidence that it may help in repairing damaged mucosal surfaces; what remains unclear, however, is its role during HIV infection. In this review, we examine the evidence provided in both observational studies and randomized controlled trials that assessed the effect of vitamin A during HIV infection.

Randomized controlled trial assessing the effect of vitamin A supplementation on maternal morbidity during pregnancy and postpartum among HIV-infected women

OBJECTIVE

To determine whether low-cost treatment of HIV using vitamin A would be beneficial, we examined the effect of vitamin A supplementation on morbidity of HIV-1 infected women.

METHODS

We conducted a randomized, double blind placebo-controlled trial at King Edward VIII Hospital, in Durban, South Africa. In total, 312 HIV-seropositive pregnant women between 28 and 32 weeks' gestation were recruited into this trial. Patients were randomized to receive placebo or 5,000 IU retinyl palmitate and 30 mg beta-carotene daily. At delivery of their children, patients received placebo or 200,000 IU retinyl palmitate. The main outcome measures were pre- and postnatal report of HIV-related symptoms.

RESULTS

Vitamin A did not confer any significant beneficial effect on the report of either HIV or pregnancy-related symptoms during the pre- or postnatal period.

CONCLUSION

In this study of HIV-infected pregnant women, vitamin A supplementation given in doses designed to decrease mother-to-infant transmission did not result in significant beneficial effect on reported symptoms pre- or postnatally. Further investigation with larger number of participants, tailoring supplementation for specific clinical conditions, outside the context of pregnancy, is required to help clarify the possible clinical benefits of vitamin A.

Television and young Hispanic children's health behaviors

Television viewing patterns in preschool age Hispanic children were studied in order to explore the role of TV in the establishment of early childhood health behaviors. The television viewing habits and patterns of children and parents and parental coviewing, regulation, and encouragement practices were examined. Using the dimensions of regulation and encouragement, four parental typologies were established: laissez-faire, restrictive, promotive, and selective. Children in this study watched television 3-4 hours a day, half of which consisted of viewing adult shows. This amount of time is significantly higher than the guideline of less than 2 hours a day suggested by the American Academy of Pediatrics (AAP). Relationships between television viewing, injury behaviors, risk taking, and acculturation were established and implications for primary care, school, and community health care nursing are discussed.

Antenatal diagnosis of vesicouterine fistula

BACKGROUND

In pregnancy, vesicouterine fistulas usually are diagnosed postpartum after cesarean deliveries.

CASE

An 18-year-old woman, gravida 3, para 2, with two prior cesarean deliveries had pain and apparent rupture of membranes at 23 weeks' gestation. At 26 weeks' gestation, she developed increasing suprapubic pain and irregular contractions. Ultrasonographic findings included a small uterine defect and possible ballooning of membranes into her bladder. Cytoscopy showed ballooning of amnion into the bladder dome. A viable 900-g female infant was delivered by classic cesarean, the fistulous tract was excised, and the rupture sites were repaired.

CONCLUSION

Vesicouterine fistulas might be diagnosed antenatally. With continued contractions and associated uterine rupture, cesarean delivery can be done with excision of the fistulous tract and repair of the rupture sites.

Risk of repetition of a severe perineal laceration

OBJECTIVE

To compare the outcome of subsequent delivery in women with a history of a third- or fourth-degree laceration with outcomes in women without such a history.

METHODS

This retrospective study used a perinatal database and chart review from 1978 to 1995. Only women whose first delivery was at our institution at more than 36 weeks' gestation, vaginal singleton, vertex presentation, and birth weight greater than 2500 g, with a subsequent delivery were included. The women were grouped by presence or absence of a third- or fourth-degree (severe) perineal laceration in their first delivery. The subsequent delivery was analyzed for maternal age, weight, birth weight, gestational age, method of delivery, use of episiotomy, and occurrence of a severe laceration. Comparison of data was by Fisher exact and t tests.

RESULTS

Four thousand fifteen women met our starting criteria. In their first delivery, the average birth weight, use of instrumentation, and episiotomy rate were significantly higher in those women sustaining a severe laceration. When compared with women without a history of severe perineal laceration, women with such a history were at more than twice the risk for another in their subsequent delivery. The women at highest risk (21.4%) were those sustaining a laceration in their first delivery who underwent instrumental vaginal delivery with episiotomy in their subsequent delivery. When episiotomy or instrumental delivery was performed in the second vaginal birth, 52 (11.6%) of 449 women with a history of a severe perineal laceration sustained another, compared with 98 (6.5%) of 1509 without such a history (P < .001, odds ratio 1.9, 95% confidence interval 1.3, 2.7).

CONCLUSION

Women delivering their second baby, and in whom episiotomy or instrumentation is used, are at increased risk of severe perineal laceration compared with women delivery spontaneously.

Risk taking in young Hispanic children

INTRODUCTION

The purpose of this study was to examine risk taking and daring behavior in preschool-age Hispanic children. The study sought to describe aspects of children's personality, behavior, and culture that may inform us of their propensity to take risks that lead to injuries.

METHOD

Forty-five children (4 to 5 years of age) and their parents, drawn from a primary care practice, participated in the study. Instruments completed by the families included the Acculturation Scale. Child Shyness Report, Injury Report, and the Injury Behavior Checklist. Children were interviewed about risk taking and daring behavior using a projective technique (Child Sensation Seeking Profile).

RESULTS

These children, irrespective of gender and socioeconomic status, reported similar rates of daring and risk taking behavior. Injury behaviors were not predicted by personality profiles of shyness or the child's self-report of risk taking and daring behavior. Actual injuries increased with higher levels of acculturation, but children's injury behaviors reported by parents were low in comparison with other populations. Discrepancies were observed between parental perception and report of children's injury behavior and children's expressed preferences in some domains of daring and risky behavior.

DISCUSSION

Primary care providers must consider ethnic differences in rates and causes of injury when developing interventions and injury prevention programs. PNPs can use these findings to better meet the health promotion goals of Healthy Children 2000.

Childhood nutrition

This review focuses on the research in normative nutrition for children aged 2 to 12, published from 1985 to 1996. The chapter uses a primary prevention framework and the Healthy People 2000 (Public Health Service, 1990) objectives to identify and review those areas relevant for childhood health promotion and nursing practice. Current research demonstrates that food intake in early childhood is causally linked to health-related problems later in life, therefore obesity and cardiovascular research are highlighted in this review. Environmental and societal factors affect the nutritional health of children, thus the contribution of the media, poverty, cultural, and family practices are also reviewed. The chapter concludes with a summary of strengths and weaknesses of the body of research and suggestions for a nursing agenda in the area of childhood nutrition.

Intrauterine growth restriction: identification and management

Intrauterine growth restriction (IUGR) is a common diagnosis in obstetrics and carries an increased risk of perinatal mortality and morbidity. Identification of IUGR is crucial because proper evaluation and management can result in a favorable outcome. Certain pregnancies are at high risk for growth restriction, although a substantial percentage of cases occur in the general obstetric population. Accurate dating early in pregnancy is essential for a diagnosis of IUGR. Ultrasound biometry is the gold standard for assessment of fetal size and the amount of amniotic fluid. Growth restriction is classified as symmetric and asymmetric. A lag in fundal height of 4 cm or more suggests IUGR. Serial ultrasonograms are important for monitoring growth restriction, and management must be individualized. General management measures include treatment of maternal disease, good nutrition and institution of bed rest. Preterm delivery is indicated if the fetus shows evidence of abnormal function on biophysical profile testing. The fetus should be monitored continuously during labor to minimize fetal hypoxia.

Risk-taking in preschool children

This study was designed to characterize preschool-age children who engage in daring, risk-taking behaviors. Seventy-four children (39 males, 35 females) and their mothers from a wide range of socioeconomic strata participated. Children who described themselves as high in risk-taking were generally males, had higher accident and injury rates, and had parents whose assessments of their children's risk-taking activities were congruent with their own. Contrary to our expectations, however, risk-taking children did not appear to be more than ordinarily impulsive, which suggests that risk-taking is engaged in contemplatively (i.e., with some caution) by some youngsters and need not result in serious mishaps. Cognitive ability was found to be a codependent predictor of risk-taking for boys. Parents and clinicians will find it useful to know that risk-taking is a multidimensional phenomenon, not a unitary behavior or personality trait and that the Injury Behavior Checklist would be a valuable tool for screening selected populations.

Determination of zafirlukast, a selective leukotriene antagonist, human plasma by normal-phase high-performance liquid chromatography with fluorescence detection

A high-performance liquid chromatographic (HPLC) method was developed for the determination of zafirlukast, a selective peptide leukotriene receptor antagonist, in human plasma. Zafirlukast and the internal standard, ICI 198 707, were extracted from deproteinated plasma samples using large reservoir C18 solid-phase extraction columns and analyzed by normal-phase liquid chromatography with fluorescence detection. The method had a lower limit of quantitation of 0.75 ng/ml and a linear calibration curve in the range of 0.75 to 200 ng/ml. The absolute recovery of zafirlukast was > 90%, and the within-day and between-day relative standard deviations were < 9%. The utility of the method in the characterization of the plasma concentration-time profiles of zafirlukast in clinical studies was demonstrated.

Are children's early emotions antecedents to risk taking?

PURPOSE

To explore the processes by which early emotional experiences affect behavior and to investigate the use of basic development characteristics to guide primary care.

METHOD

A randomized cohort of 74 children from a wide range of socio-economic classes were followed from infancy until 54 months of age. Children were assessed at 2 days, 12, 18 and 54 months by laboratory tests and maternal report.

RESULTS

The personality characteristic of inhibition/shyness appeared to be an enduring trait from infancy through the preschool years. However, findings did not support the view that early personality variables (e.g., avidity, shyness, security) alone predict risk taking during later years.

CONCLUSIONS

Nurses offering safety counseling about risk taking in order to minimize injuries during early childhood should consider personality concepts to be multi-dimensional. Infant and toddler profiles should not be considered solely predictive of later behavior.

Clinical utility of the CERAD word list memory test

The word list memory test from the Consortium to establish a registry for Alzheimer's disease (CERAD) neuropsychological battery (Morris et al. 1989) was administered to 230 psychiatric outpatients. Performance of a selected, age-matched psychiatric group and normal controls was compared using an ANCOVA design with education as a covariate. Results indicated that controls performed better than psychiatric patients on most learning and recall indices. The exception to this was the savings index that has been found to be sensitive to the effects of progressive dementias. The current data are compared and integrated with published CERAD data for Alzheimer's disease patients. The CERAD list memory test is recommended as a brief, efficient, and sensitive memory measure that can be used with a range of difficult patients.

Experience in the design and use of isolator systems for sterility testing

The use of isolator systems for sterility testing is on the increase. Prior to installation and validation careful consideration must be given to the type of barrier to be used, and the design of the facility which will house the barrier system. The validation of these systems requires development and testing of the sterilization cycle. Vapor phase hydrogen peroxide has proven to be efficacious in this application, and examples of sterilization cycle development are presented in this paper. Also of concern is the penetration of sterilant into test articles, media and supplies.

Effects of melatonin on water metabolism and renal function in male Syrian hamsters (Mesocricetus auratus)

The pineal indoleamine, melatonin, has been shown to influence many physiological systems within the mammalian body. Few studies, however, have examined the influence of melatonin on renal function. This study investigated the effects of melatonin on water metabolism and renal function. Young adult male Syrian hamsters were maintained on a long photoperiod (LD 14:10) in metabolic cages. The animals received daily (1700) injections of either control vehicle or 25 micrograms of melatonin for 85 consecutive days. Melatonin administration resulted in significant increases in water consumption and urine production. Water budgets were also significantly influenced by melatonin, as were urinary osmolality, urinary sodium, and potassium concentrations, but urinary calcium concentrations were essentially unaltered. When excretion rates for sodium, potassium, and calcium were calculated, no differences were observed between the vehicle control and melatonin-treated groups. Injections of melatonin also significantly decreased plasma antidiuretic hormone (ADH). These results demonstrate that afternoon injections of melatonin can alter renal function, which may involve direct (i.e., on ADH secretion and/or thirst mechanisms) or indirect (i.e., behavioral) effects.

Technetium carboxylate complexes--III. A new synthetic route to hexakis-(isonitrile) technetium(I) salts

Hexakis(isonitrile)technetium(I) cations have been prepared from carboxylate based technetium starting materials. The following ligands have been employed: t-butyl, n-butyl, cyclohexyl, and benzyl isonitrile. The products have been characterized by u.v.-visible and i.r. spectroscopy, cyclic voltammetry, fast atom bombardment mass spectrometry and electrophoresis.

A formate based precursor for the preparation of technetium complexes

Tc-formate complexes have been prepared by electrolytic, stannous, and borohydride reduction of pertechnetate in formate buffer. Individual Tc-formate complexes were isolated from reaction mixtures with silica bonded phase anion-exchange HPLC. The predominate air stable red Tc-formate complex has a negative charge, an absorption maximum at 536 nm, and a molecular weight between 100 and 300 dalton. The isolated major Tc-formate complex was found to react with isocyanide, diphosphonate, and various nitrogenous ligands. The relevant use of Tc-formate complexes as synthetic precursors to other technetium complexes is seen as being beneficial to the understanding of technetium ligand substitution.