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Afessa B: Triage of patients with acute gastrointestinal bleeding for intensive care unit admission based on risk factors 9 menopause discharge purchase fosamax 70 mg fast delivery. Krag M women's health center jacksonville fl discount 35 mg fosamax with visa, Perner A women's health clinic yonkers generic fosamax 70 mg with amex, Wetterslev J menopause underarm odor discount fosamax 35mg mastercard, Moller M: Stress ulcer prophylaxis in the intensive care unit: is it indicatedfi Acta Anaesthesiol Scand 2013; 57:835-47 a 4-factor prothrombin complex concentrate in patients on vitamin K antagonists presenting with major bleeding: a 5. Kuipers E, et al: International consensus assessment after acute upper gastrointestinal haemorrhage. Factors resulting in a reduced incidence of stress gastritis in vessel in her transverse colon. Colonoscopy is unsuccessful due to the presence of large amounts of blood and stool in the colon. The patient remains hypotensive despite aggressive resuscitation and correction of coagulopathy. The goal of nutrition in the critically ill patient is to improve the increased morbidly and mortality, outcome by preserving lean body mass and avoiding the negative consequences prolonged hospital stay, poor immune of malnourishment. The goal of this chapter is to provide a basic framework for critical • the goal of critical care nutrition is to care nutrition and highlight the challenges that the clinician will face. Definition • Enteral nutrition is always preferred to parenteral nutrition unless contraPatient Case: indicated. Initial fiuid resuscitation is carried out and he is threatening complication from intubated for potential airway compromise due to suspected inhalation injury. There are three basic categories of macronutrients total body weight or body weight < 90% ideal i. Simplified daily caloric estimations can be based on a illness patient’s weight and estimated stress level. Increased morbidity and mortality confounding variables (air leaks, supplemental oxygen, ii. Primarily used in critically ill, mechanically ventilated degrees centigrade, Ve=minute ventilation in L/min patients g. Total calorie need = 178411(A)+5(kg)+244(M)+239(T) patients with certain underlying disease processes. Calories provided from dextrose containing solutions and and pneumonia lipid based medications should be taken into account b. Inconsistency of outcomes and diversity in patient populations prevent routine use of glutamine, arginine i. Re-evaluation is often necessary as energy expenditure patients requiring enteral nutrition postoperatively changes 4. Step 5: Trace Elements, Vitamins, and Other Additives mortality in multi-system organ failure patients (5) and should not be routinely added. Trace elements (selenium, zinc and copper) and vitamins reduce mortality in a small cohort of burn patients. After numerous attempts, you are only able to get the nasoduodenal feeding tube into the patient’s stomach. Dose adjustments should be considered in renal you feed into the patient’s stomachfi Reserved for patients who require long term enteral cholecystokinin, gastrin, and bile salts access iii. Initiation of enteral feeding goal versus starting at 25cc/hr and advancing to goal as quickly as tolerated (q2h advances by 25cc/hr) i. In high nutritional risk patients or patients projected to more constipation require at least 72 hours of mechanical ventilation, enteral ix. Tolerance of Enteral Feeding receive enteral nutrition until fully resuscitated and stabilized i. Patient complaints of pain, gastric distention, vomiting, reduced fiatus, radiographic evidence of ileus v. Monitoring gastric residual volume for tolerance of tube feeding is controversial vi. Not monitoring residual gastric volumes during enteral feeding does not lead to more pneumonia (7), vii. In absence of other signs of feeding intolerance, should not hold tube feedings unless gastric residual 1. Compared low volume enteral feeds: 30% goal volume is greater than 500cc (1) calories (10-20cc/hr) for six days then advanced to a. The appropriate time frame to start parenteral nutrition remains controversial if a patient is not malnourished prior i. Late parenteral nutrition (8 days) has been shown to be mortality associated with fewer complications than early initiation (48 hours). Risk of systemic infection is much higher days, and reduced duration of renal replacement ii. Liver complications include transaminitis, cholestasis, therapy steatosis, steatohepatitis, fibrosis, and cirrhosis 2. Using the Fick equation, the amount of oxygen After 10 days on the ventilator, he is medically stable such that he consumed per minute is calculated. Respiratory quotient is calculated tachypneic and develops a mild respiratory acidosis necessitating a. What nutritional factors may be playing into the dificulty weaning from the ventilator and how b. Several nutrition scales used to calculate the nutritional these conditions status of patients. Parameters used include laboratory values (albumin, due to increased carbon dioxide production prealbumin, etc. As feeds are initiated, there is an increase in serum insulin 256 levels which shifts phosphate intracellularly and leads to a 3. Hypophosphatemia with serum levels < 1mg/dL analysis of randomized controlled trials. Altered mental status including gait disturbances and Trial of Glutamine and Antioxidants in Critically Ill Patients. Reignier J, Mercier E, Le Gouge A, et al: Efiect of Not Monitoring Residual Gastric Volume on Risk of Ventilator References: Associated Pneumonia in Adults Receiving Mechanical 1. Mc Clave S, et al: Guidelines for the Provision and Assessment Ventilation and Early Enteral Feeding: A Randomized Control of Nutrition Support Therapy in the Adult Critically Ill Patient. A gastric residual of 200cc has been aspirated and there are no other signs of feeding intolerance. After beginning to provide nutritional support to a chronically malnourished patient, he develops confusion and dyspnea. Diagnosis: Two out of the following three criteria must be present for diagnosis Key Points: of acute pancreatitis: 1) acute-onset upper abdominal pain 2) serum lipase and/or • Most patients presenting with acute amylase greater than three times the upper limit of normal 3) imaging findings, pancreatitis have mild disease. Severe critical illnesses including diabetic ketoacidosis, trauma, intracranial hemorrhage, acute pancreatitis carries a mortality ruptured abdominal aortic aneurysm, and renal failure. Patient Case: Enteral nutrition is preferred to A 54 year-old man with a history of alcohol abuse presents to the emergency parenteral nutrition. For this Serum lipase has higher specificity for acute pancreatitis reason, guidelines recommend deferring imaging for at least compared with serum amylase. Identifying etiology: Identification of the etiology of acute pancreatitis will guide appropriate treatment and could prevent recurrent episodes. Many drugs have been implicated in acute pancreatitis; the most well-established are 6-mercaptopurine, azathioprine, and didanosine. Classification: the Revised 2012 Atlanta Classification Pancreatic necrosis appears as areas of low enhancement (white arrow) defines three categories of acute pancreatitis: mild, moderately severe, and severe. Mild pancreatitis carries a low mortality rate proposed to identify patients at risk of developing severe (0. The clinical usefulness of these scoring systems has pancreatitis is defined by organ failure lasting more than 48 hours been questioned, (2) and guidelines recommend close monitoring and carries a mortality of nearly 30%. Initial management: Initial management of acute pancreatitis includes appropriate triage, fiuid resuscitation, analgesia, and initiation of nutrition. Hypovolemia in acute pancreatitis results from vomiting, anorexia, third spacing and insensible losses. Guidelines difier in their recommendations for fiuid quantity, ranging from 250 cc/hour to up to 10 ml/kg/hour. Enteral nutrition is believed to reduce the risk of be harmful in acute pancreatitis.

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High incidence of invasive group A Streptococcus disease caused by strains of uncommon emm types in Thunder Bay pregnancy low blood pressure proven 35 mg fosamax, Ontario women's health of niagara generic fosamax 70mg mastercard, Canada women's health research institute buy 70mg fosamax mastercard. The 2008 Canadian Listeriosis outbreak: a result of knowledge ignored McMaster University Medical Journal pregnancy 4 weeks ultrasound purchase fosamax 35mg line. Public health notice update outbreak of Listeria infections linked to packaged salad products produced at the Dole processing facility in Springfield, Ohio [Internet]. Predicting the speed of tick invasion: an empirical model of range expansion for the Lyme disease vector Ixodes scapularis in Canada. Factors affecting Reportable Diseases in Ontario (1991-2016) 99 2012;49(2):457-64. Climate change and the potential for range expansion of the Lyme disease vector Ixodes scapularis in Canada. Population-based passive tick surveillance and detection of expanding foci of blacklegged ticks Ixodes scapularis and the Lyme disease agent Borrelia burgdorferi in Ontario, Canada. Spatiotemporal dynamics and demographic profiles of imported Plasmodium falciparum and Plasmodium vivax infections in Ontario, Canada (1990-2009):e76208. Coxiella burnetti (Q fever) abortion storms in goat herds after attendance at an annual fair. Seroprevalence of Coxiella burnetii in selected populations of domestic ruminants in Newfoundland. Towards tuberculosis elimination: an action framework for low-incidence countries. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2009, 2005, 2001, 1997, 1992, 1987 by Saunders, an imprint of Elsevier Inc. Lexicographer/Content Strategist: Sean Webb Content Development Specialist: Gabriela Benner Publishing Services Manager: Patricia Tannian Senior Project Manager: Carrie Stetz Design Direction: Paula Catalano Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 Preface this seventh edition of Dorland’s Dictionary of Medical Acronyms & Abbreviations (formerly Jablonski’s) is the second edition to be published since the original author, Stanley Jablonski, passed away. The book has been very well received over the years, and the author’s enthusiasm and love of medical vocabulary, even vexingly obscure abbreviations, are evident in its pages. The task of maintaining this volume now remains with the developer of Dorland’s dictionaries, who is well aware of the tradition of excellence associated with this dictionary. Although responsibility for updating the dictionary has changed, the content remains the familiar, convenient resource that has served users well for more than two decades. The print book retains its format of boldface abbreviations followed by run-in meanings, which enables it to encompass as many entries as larger, more cumbersome books while remaining an easy-to-handle size. The listings for organizations have been updated: new ones have been added; name changes have been incorporated; outdated names have been cross-referenced to new ones (or dropped, when thoroughly obsolete). The abbreviations and acronyms are presented alphabetically, and well over one thousand new additions and changes have been made. Also new to this edition is a section presenting acronyms and abbreviations that should not be used because they may be mistaken for other abbreviations or terms and carry with them a danger of being misconstrued. The new editor of Dorland’s Dictionary of Medical Acronyms & Abbreviations would like to express his appreciation for the work that has been handed down from the previous editors and Mr. Jablonski, and looks forward to continuing to maintain the book’s high standards going forward. Because new acronyms and abbreviations are constantly being coined, this volume can never really be complete. If you do not fnd an acronym or abbreviation, or a defnition that you are searching for, we invite you to submit your suggestions for the next edition. Implantable DefbrilA/V ampere/volt; arteriovenous lators [trial]; Angiography vs. Intravascular Av average; avoirdupois Ultrasound Directed Coronary Stent PlaceaV abvolt ment [trial]; Antiarrhythmics vs. Chirurgfailure; congenital hepatic fbrosis; congesiae Doctor] tive heart failure; Crimean hemorrhagic fever chirug surgical [Lat. Bolus Alcongenital nephrotic syndrome; cutaneous teplase Trial; Continuous Infusion vs. Internal Mammary Artery for sis; systemic infammatory disease Single Left Anterior Descending Arterial Les. Directional CoroS&T science and technology nary Atherectomy Randomized Trial; St. Flow-chart summary of recommendations Additional information in the form of supplementary materials can be found online at. Implications Grade* Patients Clinicians Policy Level 1 Most people in your situation would Most patients should receive the the recommendation can be evaluated ‘‘We recommend’’ want the recommended course of action recommended course of action. Level 2 the majority of people in your situation Different choices will be appropriate for the recommendation is likely to require ‘‘We suggest’’ would want the recommended course different patients. Each patient needs substantial debate and involvement of action, but many would not. B Moderate the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Guideline development followed an explicit process of evidence review and appraisal. The guideline contains chapters on definition, risk assessment, evaluation, prevention, and treatment. Limitations of the evidence are discussed and specific suggestions are provided for future research. We also thank the Evidence of evidence to make a grade 1 or 2 recommendation, in Review Team members and staff of the National Kidney general, there is a correlation between the quality of overall Foundation who made this project possible. As a consequence the distal tubules and dence suggests that acute, relatively mild injury to the kidney collecting ducts become fully permeable to water. Concenor impairment of kidney function, manifest by changes in trating mechanisms in the inner medulla are also aided urine output and blood chemistries, portend serious clinical by low fiow through the loops of Henle and thus, urine 1–5 consequences. Traditionally, most reviews and textbook volume is minimized and urine concentration maximized chapters emphasize the most severe reduction in kidney (4500 m Osmol/kg). Conversely, when the tubules are function, with severe azotemia and often with oliguria or injured, maximal concentrating ability is impaired and urine anuria. It has only been in the past few years that moderate volume may even be normal. Intact tubular function, best overall index of kidney function in health and disease. These conditions will result in rapid and include the untoward effects of decreased kidney function irreversible damage to the kidney and require prompt such as volume overload, retention of uremic compounds, recognition and management. Distal nephron involvement in these to be associated with even worse outcome as compared to animal experiments is minimal, unless medullary oxygena11 milder reductions. Indeed these Although urine output is both a reasonably sensitive authors correctly point out that the term ‘‘acute tubular functional index for the kidney as well as a biomarker of necrosis does not accurately refiect the morphological 12 tubular injury, the relationship between urine output and changes in this condition’’. For example, oliguria to describe a clinical situation in which there is adequate may be more profound when tubular function is intact. More recently, investigators have emphasized the role of endothelial dysfunction, coagulation abnormalities, systemic infiammation, endothelial dysfunction, and oxidative stress in causing renal injury, particularly in the setting of 14,15 sepsis. For example, patients with arterial catastrophes (ruptured aneurysms, acute dissection) can suffer prolonged periods of warm ischemia just like animal models. The term ‘‘acute kidney injury/impairment’’ has been 18 proposed to encompass the entire spectrum of the syndrome crush syndrome. Rather than focusing exclusively 7,20,21 on patients with renal failure or on those who receive dialysis lead to mortality rates from 15–60%.

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The ways in which a risk assessment improves patient and staff safety depend on the type of risk assessment and whether it can directly or indirectly protect patients and staff breast cancer 5k topeka ks fosamax 70 mg visa. A safety risk assessment that involves a process women's health clinic qld order fosamax 35mg online, such as storing sharps at the bedside womens health 40-60 cheap fosamax 35 mg without prescription, can eliminate a possible patient or workplace injury pregnancy in fallopian tubes purchase fosamax 70 mg without a prescription. A medical equipment risk assessment may reveal that use of a particular device is related to increased infection rates and could result in patient harm if not addressed. The actions are spelled out in accreditation standards detailed in Chapter 2 (not included). Using Risk Assessments to Improve Efficiency Just because organizations have processes in place does not mean that those processes are efficient. Many times organizations engage in activities in a particular way just because they have always done them that way. By conducting risk assessments, organizations can identify processes that are inefficient and ineffective and determine potential ways to improve efficiency, accuracy, and appropriateness. Using Risk Assessments to Identify Training Issues Risk assessments can also be used as valuable training tools because they identify hazards, build awareness about potentially negative situations, and suggest resolutions to those situations. Organizations also use risk assessments to guide their education programs, because they show areas where further education is needed to achieve safe delivery of care. For example, the infection prevention and control risk assessment may identify the need for further staff training on hand hygiene or on protocols, such as elevating the head of the bed for patients on ventilators. Such an assessment could identify gaps in staff knowledge and areas that need improvement. Public Reporting of Infection Rates and Selected Infections and Organisms the rising interest in and requirements for transparency of infection control data and regulations for reporting of infection rates are causing organizations to look carefully at their processes for data collection, validation, and analysis. Infection prevention and control professionals are working to develop enhanced systems to meet the requirements. Accomplishing the Expanded Functions of Infection Prevention the infection prevention and control professional’s role has expanded to include patient safety, emergency management, more risk management, and other responsibilities, but frequently a corresponding increase in resources to support these requirements has not occurred. The Movement to Target Zero Infections Infection prevention and control professionals have always worked to achieve the lowest level of infection possible. Recent research has demonstrated that it is possible to reduce infections in much greater measure than previously thought possible. Infection prevention and control professionals are working diligently in collaboratives or in single organizations or systems to improve patient safety with reduced infection rates. Increasing Visibility and Requirements for Infection Prevention Programs Infection prevention and control has become more visible in recent years. Consumers are more knowledgeable, and influential consumer advocate groups have emerged; technology has made information more available; legislators are creating more requirements; accrediting organizations are developing more directive standards and recommendations; payers are eliminating payment for some infections; and the media’s interest has driven change. Using Risk Assessments to Develop Hypotheses Risk assessments also can be used to evaluate questions or situations in which no clear answer is apparent. Typically, the actions of health care organizations are guided by regulations, best practices, lessons learned, and so forth; however, situations may occur in which no such tools exist. A risk assessment can help probe for information about a question or situation and identify potential solutions. It can help organizations make an educated guess and at least start down the road toward a solution. Source: Soule B: A Risk-Based Approach to Infection Prevention: Creating an Infection Prevention and Control Plan. So, the safety manager conducts a risk assessment to ascertain the potential risks associated with storing sharps at the bedside and also the potential benefits to staff. After weighing the pros and cons, the safety manager decides to allow the storage of sharps at the bedside but determines the issue will need to be closely monitored. If any incidents occur because a patient, child, or visitor accesses these unsecured sharps, this process will change immediately. The organization documents the process through the minutes of the safety committee. By using a proactive risk-assessment process, the organization is able to address a question confidently, knowing that all the positives and negatives associated with that question have been considered. Consider the following examples: • Malaria in the southeast United States • Hantavirus in the southwest United States • Legionella in the southern United States • West Nile, widespread from east to west in United States • Nosocomial cholera, measles, hepatitis B, and infectious diarrhea in developing nations • Tuberculosis in parts of Africa, Asia, Latin America, and the Middle East • Viral haemorrhagic fevers in Africa • Methicillin-resistant Staphylococcus aureus in the United States and the Mediterranean region Using Risk Assessments to Justify a Need Almost all organizations must contend with limited resources. Risk assessments focus attention on a need and its consequences and provide a clear solution to address that need. The Consequences of Not Performing Risk Assessments Ultimately, if organizations do not perform risk assessments adequately, the inaction can lead to serious consequences. Failing to address infection risks can have other more immediate effects for individual patients. For example, a patient who needs a central line and acquires a health care-associated bloodstream infection via the central line would, at least, require a longer period of treatment with antibiotics, possibly within the hospital, and, at worst, might die of the infection or other causes exacerbated by the infection. In the case of Clostridium difficile– associated diarrhea, a reasonably healthy person hit by this disease might be forced to stay a bit longer in the hospital; however, an elderly person might require prolonged nursing home care and may never regain his or her previous state of health. The Joint Commission standard, which is discussed in detail in Chapter 2 (not included), states that “the organization identifies risks for acquiring and transmitting infections. The team should remember to consider events that might occur but are not fully known or understood. Examples of such events include an influenza pandemic or an outbreak of an infection of unknown etiology. Review the current literature to learn about new science, studies, and outbreaks that should be considered as potential risks to the organization. Or the assessments can be as simple as drawing a line down the middle of a piece of paper and listing the pros of a project or process on one side and the cons on the other. Documentation can be very useful in the risk-assessment process because it helps establish the steps involved in the process and records the results in a consistent manner (see Figure 1-2, page 17 [not included]). Documentation also helps maintain consistency in the risk-assessment process, so that every time a particular type of risk assessment is conducted, this is done the same way. For example, if a surveyor is assessing compliance during an on-site survey and sees a questionable activity, such as storing sharps at the bedside, the organization can prove to the surveyor it conducted a proactive risk assessment and considered the possible hazards associated with the issue. By providing the documentation, the organization can show its work and help the surveyor understand the organization’s approach. The risk assessment should serve as the basis for developing written goals and measurable objectives for the infection control program. In other words, the assessment is the foundation of every organization’s infection prevention plan. It gives specific guidance on developing an infection prevention and control plan. Limiting the transmission of infections associated with the use of medical equipment, devices, and supplies. When determining the goals, organizations may want to look at the mission statement for the year as a starting point. The emphasis should be on using resources wisely to address the risks that have the most serious potential for harm. By linking goals to the highest priorities identified in the risk assessment, an organization is moving from knowing about potential problems to working to prevent them. The main focus for each goal is a measurable objective, an action plan, and an evaluation process to determine if the objective has been met. Joint Commission International Standards were excerpted from Joint Commission International Accreditation Standards for Hospitals, 4th Edition. Other measures designed to limit exposure to pathogens include the following: Airborne infection isolation rooms: Also called negative pressure isolation rooms, these are patient-care rooms designed for one patient that 2 are used to isolate individuals who may have an airborne infectious disease. Waterborne pathogens precautions: Organizations should take steps to ensure their facility’s water supply does not become contaminated, including water in cooling towers, domestic hot and cold water systems, and aerosolizing water systems. For example, health care organizations report 600 to 1,300 water-related Legionella pneumophila infections every year. The Joint Commission recommends organizations work with design professionals who adhere to American Society of Heating, Refrigerating, and Air-Conditioning Engineers and American Institute of Architects guidelines. Limiting Transmission of Infections Associated with Procedures Minimizing the risk of transmitting infections associated with procedures is a crucial component of the goal-setting process. Invasive procedures such as surgery, for example, carry significant infection risks. Surgical site infections have been shown to compose up to 20% of all of healthcare-associated infections. An October 2008 report addressed state reporting programs and individual hospital initiatives to reduce these deadly infections, and a report released in April 2008 urged the U.

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Although radio telemetry has long been the standard technology used to womens health center 90042 buy generic fosamax 70 mg on line collect data on local or long-range migratory movements among a wide variety of species menstrual overflow buy generic fosamax 35mg on line, including some bats menstrual hormone chart generic fosamax 35 mg visa, the mass of the transmitters has limited the size of the animals to womens health 042013 discount 70mg fosamax with visa which they can be applied (Wikelski et al. Thus telemetry studies in small bats have been limited by the size of available devices. Transmitters depend on a signal-emitting device (the radio transmitter), which is attached to the target animal, usually via a collar or harness (Figure 7. Radio transmitters vary in range, but typically signals can be detected over about 1 or 2 km, as long as they are unobstructed. Signals can be heard for longer distances when animals are tracked from higher elevations, depending on the length of the antenna, location of the animal, size of the transmitter and other environmental characteristics that may attenuate the signal. The frequency of the tone emitted by the receiver changes according to the distance between the transmitter and the antenna. Antennae can be hand-held or mounted on a vehicle, boat or aeroplane (Michener and Walcott, 1966). Each radio telemetry unit can be set to emit signals of a specific frequency, and receivers can switch among frequencies so that a scientist can track multiple animals at the same time. Radio telemetry is very useful for locating animals to a particular location, such as a tree or burrow, as long as the animals are not out of the transmitter’s range. Some of the most extensive data sets on local and long-range movements of bats come from Australian studies describing the migratory movements and foraging behaviour of Old World fruit bats of the genus Pteropus (Eby, 1991; Palmer and Woinarski, 1999; Tidemann et al. Pteropus species are gregarious, forming roosting colonies of varying sizes, depending on the habitat (Pierson and Rainey, 1992; Hall and Richards, 2000; Kunz and Jones, 2000). Radiotelemetry studies of Australian Pteropus species show that individuals may fiy up to 50 km each night to forage (Palmer, Price and Bach, 2000). Australian fiying foxes occupy large home ranges, and are generally seasonally nomadic, fiying hundreds of kilometres per week as part of their normal movement patterns, often in response to local food availability (Nelson, 1965; Eby 1991; Tidemann et al. Integrated sensors can be used to corroborate location findings, such as sea-surface temperature for albatrosses (Shaffer et al. Movement and migration tracks are reconstructed using the best location data, with established error rates (classes of 3, 2, 1 and 0), which are subjectively evaluated using ecological knowledge about the study species. Home range analysis can be performed by using multiple techniques and combining data from multiple individuals (Figure 7. Temporal, spatial, seasonal and statistical analyses are also possible, including evaluation of the potential role of bats in transmitting diseases to other locations or species. This usually requires that the receiver and datalogger are within approximately 500 m although it is possible to recover data from longer distances if the receiver is located at a higher altitude than the 156 Investigating the role of bats in emerging zoonoses animal wearing the logger. Four bats captured and released at a large permanent colony in southwestern Peninsular Malaysia spent significant amounts of time roosting and foraging in Sumatra, Indonesia as well as Malaysia. Two bats (Bat 3 and 4) captured and released at the same colony flew in different directions following release, then reunited in southern Thailand approximately four months later. These studies illustrate the high mobility and multinational habitat use of this species, as well as the potential for connectivity among spatially distant colonies Source: Epstein, 2009: No. The use of telemetry to understand bat movement and ecology 157 transmitter determines the longevity of the device battery and the frequency or timing of the equipment for collecting geographic locations. More recently, telemetry has become an important tool for epidemiologists’ understanding of the host range and movement of chiropteran and other bat species that can be reservoirs or transmission vectors for a variety of pathogens. When considering the use of telemetry devices on bats, the following should be taken into consideration: t What hypothesis will be testedfi Scientists should consult the device’s manufacturer and carefully consider the impact that any attached device may have on the welfare of the study animal. All study protocols using telemetry devices should be reviewed by an institutional animal care and use or equivalent committee, which must include a bat telemetry expert to ensure the ethically appropriate use of the equipment. The following are important welfare considerations: Is the mass of the device < 5 percent of the animal’s body massfi A few additional considerations should be taken into account when using telemetry with bats rather than other animals. Solar-powered devices require exposure to sunlight, and bats’ colonial nature and often tightly packed roosting behaviour may obscure solar cells on a device, preventing adequate recharging during the day. Bats often groom each other or fight, making antennae vulnerable to chewing or other damage that may destroy transmitter functionality. Some bat species roost in trees over water; if transmitters fall off they may not be recoverable. Each technology and attachment technique has advantages and disadvantages, and scientists should carefully consider the questions they wish to answer through telemetry. Load carrying and maneuverability in an insectivorous bat – a test of the 5-percent rule of radio-telemetry. Intra-Mediterranean migrations of loggerhead sea turtles (Caretta caretta) monitored by satellite telemetry. The urban crowd: Foraging ecology of Eidolon helvum from the non-migratory subpopulation in Accra, Ghana. Seasonal movements of gray-headed fiying-foxes, Pteropus-Poliocephalus (Chiroptera, Pteropodidae), from 2 maternity camps in northern New South Wales. Wild birds and avian infiuenza: An introduction to applied field research and disease sampling techniques. Migration routes and wintering locations of broad-winged hawks tracked by satellite telemetry. Use of satellite telemetry to identify common loon migration routes, staging areas and wintering range. Identifying critical foraging habitats of the green turtle (Chelonia mydas) along the Pacific coast of the Baja California peninsula, Mexico. Foraging behaviour of the black fiying-fox (Pteropus alecto) in the urban landscape of Brisbane, Queensland. Monitoring the long-distance movement of wildlife in Asia using satellite telemetry conservation biology in Asia. Kathmandu, Nepal, Society for Conservation Biology Asia Section and Resources Himalaya Foundation. Genetic assignment methods for the direct, real-time estimation of migration rate: a simulation-based exploration of accuracy and power. Foraging ecology of the black fiying fox (Pteropus alecto) in the seasonal tropics of the Northern Territory, Australia. Seasonal roosts and foraging movements of the black fiying fox (Pteropus alecto) in the Northern Territory: resource tracking in a landscape mosaic. In Pacific Island Flying Foxes: Proceedings of an International Conservation Conference. First application of satellite telemetry to track African straw-coloured fruit bat migration. Transboundary conservation: An ecoregional approach to protect neotropical migratory birds in South America. Assigning birds to wintering and breeding grounds using stable isotopes: lessons from two feather generations among three intercontinental migrants. An evaluation of the accuracy of kernel density estimators for home range analysis. Global positioning system and associated technologies in animal behaviour and ecological research. Philosophical Transactions of the Royal Society B-Biological Sciences, 365(1550): 2163-2176. Going wild: what a global small-animal tracking system could do for experimental biologists. Newmana At the global level, health care for people and animals, including wildlife, needs to move away from its current approach of hopping from one pandemic risk to the next, to adopt a more holistic view, based on an understanding of the drivers of disease emergence and the preventive measures that secure the health of people, livestock, wildlife and the environment. This approach will require further education about the interdependency of human, animal, wildlife and ecosystem health, accompanied by political, national and financial commitment to shift priority towards measures that prevent disease transmission across sectors and borders. One of the greatest challenges associated with such an effort is the ability to balance the needs of people, wildlife and domestic animals in the face of limited natural resources and increasing global population, resource consumption and demand for livestock-based protein. Education can help this process, but behaviour must also be modified, and neither scientific knowledge nor education alone will lead to changes in human behaviour and decision-making at the global level. There is need to demonstrate how individuals’ decisions and people’s lives in urban, suburban and rural areas depend on ecological health and ecosystem services. Change will require the integration of scientific research with educational outreach and consideration of cultural dimensions and local priorities.

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