Should tourists care more about invasive species? International and domestic visitors' perceptions of invasive plants and their control in New Zealand.

Tourism has been implicated in the spread of invasive species, not only through physical means but through invasive species being perpetuated in destinations as part of the tourism landscape. This study reports on a survey of 238 domestic and international tourists visiting the south of New Zealand, with a focus on their knowledge of and attitudes to the management of two invasive plants: wild conifers and Russell lupins. Both plants have profound ecological, economic and environmental impacts but are also increasingly a part of the tourist landscapes in the study region. The survey found significant differences between domestic and international visitors in their levels of ecological knowledge about the invasive plants, with domestic visitors having greater awareness. However, there were also significant differences between international visitors according to origin and ethnicity, with Asian visitors showing lower awareness and also lower willingness to support eradication of the invasives, even after being provided information on the ecological impact of the species. Participants also responded differently to the two species, being less willing to support eradication of the attractive Russell lupin, compared to wild conifers. There are implications for management in terms of the messaging that may be required for different visitor groups around invasive species control. The study also points to the challenge of developing support for the management of charismatic plant species such as Russell lupin that are now firmly located within the tourism domain.

Therapy outcome of day treatment for people with anorexia nervosa before and during the COVID-19 pandemic.

OBJECTIVE: The current research aimed to compare clinical outcome measures of two National Eating Disorder (ED) Day Services at the Maudsley Hospital from before the COVID-19 lockdown, when treatment was face to face, with after the lockdown when treatment moved online. METHOD: Clinical outcome measures collected as part of the admission and discharge process were compared from the beginning and end of treatment for patients treated either via face-to-face or online delivery. Twenty-nine patients' data were analyzed (89% of them female, 11% male, 89% from White ethnic backgrounds, 11% from BAME ethnic backgrounds and a mean age of 25.99 years). Additionally, the mean change in outcome measures was also compared between the two groups (pre-lockdown face to face and during lockdown online). RESULTS: Treatment delivered face to face led to significant improvements in body mass index (BMI) but not in Eating Disorder Examination Questionnaire (EDEQ) Global and Work and Social Adjustment Scale (WSAS) Total scores. In contrast, treatment delivered online led to significant improvements in EDEQ Global and WSAS Total scores but not in BMI. Neither one of the delivery modalities created significantly larger mean changes in any of the clinical outcome measures than the other. CONCLUSIONS: Both face-to-face and online delivery of eating disorder day treatment show some success. Suggested improvements for using online delivery of treatment include implementing additional support opportunities, adapting the online format to improve communication and commitment and using a hybrid model of specific face-to-face elements with some online treatment.

Conceptualizing Indigenous Human-Animal Relationships in Aotearoa New Zealand: An Ethical Perspective.

This article considers the complexity and diversity of ethical concepts and beliefs held by Maori, the indigenous people of Aotearoa New Zealand (hereafter New Zealand), relating to animals. A combination of interviews and focus group discussions were conducted with individuals who identify as Maori and were working with wildlife, primarily in an eco-tourism and conservation context. Two main themes emerged from the data: ethical concepts relating to the environment, and concepts relating to the spiritual relationships between people, animals and the environment. These findings highlight that the connections between humans and animals through a Maori lens are nuanced in ways not typically accounted for in Western philosophy. This is of particular importance because of the extent to which standard Western thought is embodied in law and policy related to human treatment of animals and the environment. In New Zealand, relationships and partnerships are informed by Te Tiriti o Waitangi, one of New Zealand's founding documents. Where these partnerships include activities and environments involving human-animal interaction, policy and legislation should account for Maori knowledge, and diverse of thought among different hapu (tribal groups). We conclude by exploring ways of including Maori ethical concepts around animals in general, and wild animals in particular, in law and policy, providing a case study relevant to other bicultural or multicultural societies.

Visualising natural attractions within national parks: Preferences of tourists for photographs with different visual characteristics.

To explore what types of photographs are more helpful means to interpret natural attractions within national parks, this study focused on the relationship between the photographs with different visual characteristics and their perceived visual appeal. A photograph-based Q method was adopted. Results confirmed the visual quality of a photograph was the most important characteristic that determined its perceived attractiveness; those photographs with a high visual quality could successfully attract tourists' attention. The subject also significantly affected the preferences of observers, suggesting an interest-dependent pattern. Using photographs of birds as examples, the participants who were interested in birds were attracted by the photographs of birds rather than those of other subjects. This study provides a better understanding of the effectiveness of photographs for communication. Findings may help researchers, communicators and national park marketers better understand and select appropriate photographs for interpretation within national parks.

A picture is not always worth a thousand words: The visual quality of photographs affects the effectiveness of interpretive signage for science communication.

Photographs are widely used to visualise science. However, the influence of visual quality of photographs on the effectiveness of science communication is often disregarded and seldom tested. This study examines how the visual quality of photographs affects science communication on interpretive signage within Xixi National Wetland Park, China. Results show that a high-quality photograph on the signage significantly increased the following affective and cognitive aspects of communication: (1) a visitor's intention to read the signage, (2) enjoyment of reading the interpretive information, (3) understanding and (4) recall of the information on the signage. This study offers empirical evidence for the benefits of using high-quality photographs to visualise science. To improve the effectiveness of science communication in interpretive products, we argue that the quality of the selected photographs should be considered seriously.

Measuring Clinical Efficacy Through the Lens of Audit Data in Different Adult Eating Disorder Treatment Programmes.

Background: Audit data is important in creating a clear picture of clinical reality in clinical services, and evaluating treatment outcomes. This paper explored the data from an audit of a large national eating disorder (ED) service and evaluated the outcome of inpatient and day treatment programmes for patients with anorexia nervosa (AN) with and without autistic traits. Methods: Four hundred and seventy-six patients receiving treatment for AN at inpatient (IP), day-care (DC) and step-up (SU) programmes were assessed at admission and at discharge on the following measures: autistic traits, body-mass-index (BMI), ED symptoms, depression and anxiety symptoms, work and social functioning, and motivation for change. Outcomes were analyzed first at a within-group level based on change in mean scores and then at an individual level based on the clinical significance of improvement in eating disorder symptoms. Outcomes were compared between patients with high autistic traits (HAT) and low autistic traits (LAT) in each programme. Results: The findings suggest that 45.5% of DC and 35.1% of IP patients showed clinically significant changes in ED symptoms following treatment. Co-occurring high autistic traits positively predicted improvement in ED symptoms in IP setting, but was a negative predictor in DC. In IP, more HAT inpatients no longer met the BMI cut-off for AN compared to LAT peers. In terms of general psychopathology, patients with AN and HAT exhibited more severe depression symptoms, anxiety symptoms and social functioning impairment than their LAT peers, and these symptoms stayed clinically severe after treatment. Conclusions: Patients with AN and hight autistic traits are more likely than their peers with low autistic traits to show weight restoration and improvement in ED systems after inpatient treatment. This reverses in DC, with high autistic trait patients less likely to improve after treatment compared to low autistic trait patients. Our results suggest that inpatient treatment with individualized and structured routine care may be an effective model of treatment for patients with AN and high autistic traits.

A pediatric residency experience with surgical co-management.

BACKGROUND AND OBJECTIVE: Acquisition of knowledge and skills in the care of surgical patients is defined as an essential element of training by the Pediatric Residency Review Committee. The pediatric-surgical comanagement model of care is increasingly utilized, yet its impact on residency training has not been described. The goal of this study was to describe a 5-year experience with a co-management model in a pediatric residency program. METHODS: We describe the planning and implementation of a surgical co-management model in a pediatric residency program and report on case volume and diversity from 2005 to 2010. We assessed the experience of pediatric residents and faculty through rotation evaluations, program leadership meetings, and an anonymous online survey. In the survey, residents rated the value of their exposure on knowledge and skills in selected perioperative domains and their experience with interprofessional teamwork. RESULTS: The volume of co-managed patients increased threefold from 2005 to 2010; most (79%) had concurrent medical conditions, and one-third (36%) were children with special health care needs (CYSHCN). Residents reported that co-management helped them gain knowledge and skills in pain management, fluid and electrolytes, respiratory, and nutritional support, as well as in interprofessional teamwork. Other strengths included greater exposure to CYSHCN and subspecialty faculty, and preparedness for critical care rotations. Challenges included clarity of roles and responsibilities between pediatric and surgery residents and interservice communication. CONCLUSIONS: A surgical co-management model in pediatric residency training presented important opportunities for development of residents' knowledge and skills in perioperative care and interprofessional teamwork.

Space versus Place in Complex Human-Natural Systems: Spatial and Multi-level Models of Tropical Land Use and Cover Change (LUCC) in Guatemala.

The relative role of space and place has long been debated in geography. Yet modeling efforts applied to coupled human-natural systems seemingly favor models assuming continuous spatial relationships. We examine the relative importance of placebased hierarchical versus spatial clustering influences in tropical land use/cover change (LUCC). Guatemala was chosen as our study site given its high rural population growth and deforestation in recent decades. We test predictors of 2009 forest cover and forest cover change from 2001-2009 across Guatemala's 331 municipalities and 22 departments using spatial and multi-level statistical models. Our results indicate the emergence of several socio-economic predictors of LUCC regardless of model choice. Hierarchical model results suggest that significant differences exist at the municipal and departmental levels but largely maintain the magnitude and direction of single-level model coefficient estimates. They are also intervention-relevant since policies tend to be applicable to distinct political units rather than to continuous space. Spatial models complement hierarchical approaches by indicating where and to what magnitude significant negative and positive clustering associations emerge. Appreciating the comparative advantages and limitations of spatial and nested models enhances a holistic approach to geographical analysis of tropical LUCC and human-environment interactions.

Connecting the Dots Between Health, Poverty and Place in Accra, Ghana.

West Africa has a rapidly growing population, an increasing fraction of which lives in urban informal settlements characterized by inadequate infrastructure and relatively high health risks. Little is known, however, about the spatial or health characteristics of cities in this region or about the spatial inequalities in health within them. In this article we show how we have been creating a data-rich field laboratory in Accra, Ghana, to connect the dots between health, poverty, and place in a large city in West Africa. Our overarching goal is to test the hypothesis that satellite imagery, in combination with census and limited survey data, such as that found in demographic and health surveys (DHSs), can provide clues to the spatial distribution of health inequalities in cities where fewer data exist than those we have collected for Accra. To this end, we have created the first digital boundary file of the city, obtained high spatial resolution satellite imagery for two dates, collected data from a longitudinal panel of 3,200 women spatially distributed throughout Accra, and obtained microlevel data from the census. We have also acquired water, sewerage, and elevation layers and then coupled all of these data with extensive field research on the neighborhood structure of Accra. We show that the proportional abundance of vegetation in a neighborhood serves as a key indicator of local levels of health and well-being and that local perceptions of health risk are not always consistent with objective measures.

A collaborative model for inpatient training in a small pediatric residency program.

BACKGROUND: The nationwide decline in pediatric admissions to community hospitals threatens the sustainability of small pediatric residency programs. Little is known about the response of small programs to this challenge. OBJECTIVES: We report on the design and evaluation of an innovative, collaborative model for pediatric inpatient training between an academic community medical center and a children's hospital. METHODS: We describe the operational, academic, and financial features of the model. Outcome measures include patient volume and subspecialty mix, resident and faculty perceptions as reported in an anonymous survey, and Accreditation Council for Graduate Medical Education Residency Review Committee (RRC) review. RESULTS: In 2003, Albert Einstein Medical Center (Einstein) closed its pediatric inpatient unit and established an independent teaching service at St Christopher's Hospital for Children (St Christopher's) in Philadelphia, Pennsylvania. Under the new model, patient volume and subspecialty mix more than tripled. Einstein residents and faculty identified 5 major strengths: level of responsibility and decision making, caring for medically complex children, quality of teaching, teamwork, and opportunity to participate in academic activities at a children's hospital. St Christopher's leadership reported increased volume, no disruption of their residency program, and no dilution of clinical teaching material. The Einstein program was reaccredited by the RRC in 2006 for 2 years and in 2009 for 4 years. CONCLUSION: A collaborative model for inpatient training was successful in maintaining a community hospital-based pediatric residency program. Positive outcomes were documented for the residency program, the parent community hospital, and the collaborating children's hospital.

Development and evaluation of an interactive multimedia clinical skills teaching program designed for the pediatric clerkship.

BACKGROUND AND PURPOSE: We evaluated the physical-examination section of a multimedia program developed to teach infant history and physical-examination skills. METHODS: A total of 71 students participated: one group viewed only the physical-examination section (PX), one the history section (HX), one none of the program (CX). We assessed physical-examination skills by direct observation of medical students performing an abdominal exam and scored using a checklist at baseline, immediately after intervention, and at the end of the pediatric clerkship. We analyzed results using analysis of variance with repeated measures. RESULTS: Baseline scores were PX = 2.5, HX = 2.8. The PX group scored significantly higher immediately postintervention at 6.8 compared to the HX group (3.1). At the end of the clerkship, significant differences between the groups remained. Final group mean scores were PX = 5.5, HX = 4.4, and CX = 2.7. CONCLUSION: The program improved examination skills with attenuation over 6 weeks.