The influence of habitat alteration is widespread, but the impact of climate cannot continue to be discounted.

In Dickie et al. (2024), we contrasted the effects of climate and habitat alteration on white-tailed deer density, recognizing the role of both these factors. Barnas et al.'s (2024) critique raised concerns about data transformations, model overfitting, and inference methods, but our analysis demonstrates that these criticisms are either unfounded or align with our original conclusions. We reaffirm that while both climate and habitat alteration contribute to deer densities, management decisions cannot ignore the strong role of climate, which is only predicted to increase in coming decades.

Habitat alteration or climate: What drives the densities of an invading ungulate?

Anthropogenic habitat alteration and climate change are two well-known contributors to biodiversity loss through changes to species distribution and abundance; yet, disentangling the effects of these two factors is often hindered by their inherent confound across both space and time. We leveraged a contrast in habitat alteration associated with the jurisdictional boundary between two Canadian provinces to evaluate the relative effects of spatial variation in habitat alteration and climate on white-tailed deer (Odocoileus virginianus) densities. White-tailed deer are an invading ungulate across much of North America, whose expansion into Canada's boreal forest is implicated in the decline of boreal caribou (Rangifer tarandus caribou), a species listed as Threatened in Canada. We estimated white-tailed deer densities using 300 remote cameras across 12 replicated 50 km2 landscapes over 5 years. White-tailed deer densities were significantly lower in areas where winter severity was higher. For example, predicted deer densities declined from 1.83 to 0.35 deer/km2 when winter severity increased from the lowest value to the median value. There was a tendency for densities to increase with increasing habitat alteration; however, the magnitude of this effect was approximately half that of climate. Our findings suggest that climate is the primary driver of white-tailed deer populations; however, understanding the mechanisms underpinning this relationship requires further study of over-winter survival and fecundity. Long-term monitoring at the invasion front is needed to evaluate the drivers of abundance over time, particularly given the unpredictability of climate change and increasing prevalence of extreme weather events.

Feasibility study of a sensor-based autonomous load control exercise training system for COPD patients.

Decision support systems (DSSs) which are able to automatically supervise and control physical exercise training of patients affected by chronic obstructive pulmonary disease (COPD) are regarded as a novel method to promote rehabilitation. The objective of our research work for this paper was to evaluate the feasibility of a rule-based DSS for autonomous bicycle ergometer training of COPD patients. Load control is based on real-time analysis of sensor parameters oxygen saturation and heart rate. Ten COPD patients have participated in a study, performing altogether 18 training sessions. On average, 7.4 rules were fired in each training session. Four sessions had to be stopped for different reasons. The average ergometer training load ranged between 31 and 47 W. The average percentage of heart rate in or lower than the intended target zone was 45.9 and 41.6%, respectively. The average patient-perceived Borg value was 12.6±2.4. Patients reported a high satisfaction for the automatically controlled training. With the help of the DSS, patients may change their training place from a rehabilitation center to their own homes. More studies are needed to assess long-term clinical and motivational effects of the DSS in home environment.

Smart Glasses in Nursing Training - Redundant Gadget or Precious Tool? A Pilot Study.

INTRODUCTION: Heavy workloads in nursing care and high employee turnover call for efficient methods to support on-the-job training. Within the Witra Care project - aiming to develop mobile technologies to support knowledge transfer between experienced and inexperienced nurses - the objective was to investigate the feasibility and perceived usefulness of advanced smart glasses for an exemplary, specific activity in nursing training - preparation of a surgical instrument table in an operating room. METHODS: Four trainee nurses performed different tasks using speech-command operated smart glasses within an operating room setting and were asked for their expectations towards this technology, their experiences and perceptions. RESULTS: All tasks could be achieved by the trainee nurses, and the overall perception was that the technology is supportive and helpful. DISCUSSION: Our results indicate interest in new wearable technologies for supporting training in nursing care. Limitations include small sample size, selection bias and several technical issues such as speech recognition accuracy or short battery lifetime. More research is necessary to evaluate the usefulness and usability of advanced wearable devices for supporting knowledge transfer and training in nursing care.

Developing a mobile application for recording learning experiences in nursing practice.

OBJECTIVE: In complex clinical on-the-job training a seamless and target-oriented incorporation is crucial to assure a good medical care. The reliable transmission of specific and relevant facts, besides education knowledge, is a key factor to ensure sustainable quality in care processes. MATERIALS AND METHODS: We present the clinical field study WITRA care. A possible way to capture hidden clinical care knowledge with assistance of mobile devices will be described. RESULTS: Basic functions to collect learning experiences with mobile devices as well as a secure and confidential manner to support a reliable transmission procedure in the hospital network area are implemented. A user experience questionnaire and a semi-standardized interview illustrate first positive acceptance evaluations and time-saving effects. DISCUSSION AND CONCLUSION: With mobile devices, tacit knowledge gaps can be tapped in a clinical care unit. The study provided first insights and proved its feasibility in general. However, advanced problems and questions arose and will be considered in the future.

Multimodal activity monitoring for home rehabilitation of geriatric fracture patients--feasibility and acceptance of sensor systems in the GAL-NATARS study.

BACKGROUND: Demographic change will lead to a diminishing care workforce faced with rising numbers of older persons in need of care, suggesting meaningful use of health-enabling technologies, and home monitoring in particular, to contribute to supporting both the carers and the persons in need. OBJECTIVES: We present and discuss the GAL-NATARS study design along with first results regarding technical feasibility of long-term home monitoring and acceptance of different sensor modalities. METHODS: Fourteen geriatric participants with mobility-impairing fractures were recruited in three geriatric clinics. Following inpatient geriatric rehabilitation, their homes were equipped with ambient sensor components for three months. Additionally, a wearable accelerometer was employed. Technical feasibility was assessed by system and component downtimes, technology acceptance by face-to-face interviews. RESULTS: The overall system downtime was 6%, effected by two single events, but not by software failures. Technology acceptance was rated very high by all participants at the end of the monitoring periods, and no interference with their social lives was reported. DISCUSSION AND CONCLUSIONS: Home-monitoring technologies were well-accepted by our participants. The information content of the data still needs to be evaluated with regard to clinical outcome parameters as well as the effect on the quality of life before recommending large-scale implementations.

Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies--outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL).

Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human-machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific "GAL technology", providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL's highly inter- and multidisciplinary aspects, with respect to research into GAL's application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing such a large project. Overall it can be stated that, from our point of view, the GAL research network has been run successfully and has achieved its major research objectives. Since we now know much more on how and where to use AAL technologies for new environments of living and new forms of care, a future focus for research can now be outlined for systematically planned studies, scientifically exploring the benefits of AAL technologies for senior citizens, in particular with respect to quality of life and the quality and efficiency of health care.