The impact of fertility preservation on the timing of breast cancer treatment, recurrence, and survival.

BACKGROUND: Many young women with breast cancer undergo fertility preservation (FP) before cancer treatment. This study examined the impact of FP on breast cancer outcomes. METHODS: The authors performed a retrospective cohort study of 272 women aged 20 to 45 years with newly diagnosed stage 0 to III breast cancer who underwent an FP consultation between 2005 and 2017. Among these women, 123 (45.2%) underwent FP (fertility preservation-positive [FP+]). The remaining 149 women did not undergo FP (fertility preservation-negative [FP-]). RESULTS: The characteristics at enrollment were similar with the exception of ethnicity (FP+, 87.8% White; FP-, 67.8% White; P = .002) and BRCA status (FP+, 27.7% BRCA+; FP-, 15.5% BRCA+; P = .021). The median follow-up was approximately 4 years. Women who underwent FP had longer times to first treatment (FP+, 37 days; FP-, 31 days; adjusted hazard ratio [aHR], 0.74; confidence interval [CI], 0.56-0.99) and neoadjuvant chemotherapy (FP+, 36 days; FP-, 26 days; aHR, 0.41; CI, 0.24-0.68) and from surgery to adjuvant chemotherapy (FP+, 41 days; FP-, 33 days; aHR, 0.58; CI, 0.38-0.90). Adjusted 3- and 5-year invasive disease-free survival (IDFS) rates were comparable between the 2 groups (3-year IDFS: FP+, 85.4%; FP-, 79.4%; P = .411; 5-year IDFS: FP+, 73.7%; FP-, 67.1%; P = .288). Similarly, no difference in overall survival (OS) was observed between the 2 groups (3-year OS: FP+, 95.5%; FP-, 93.5%; P = .854; 5-year OS: FP+, 84.2%; FP-, 81.4%; P = .700). CONCLUSIONS: FP after a breast cancer diagnosis delays the time to treatment by a small amount, but this delay does not lead to inferior IDFS or OS.

Survey design for broad-scale, territory-based occupancy monitoring of a raptor: Ferruginous hawk (Buteo regalis) as a case study.

Given the uncertain population status of low-density, widely-occurring raptors, monitoring changes in abundance and distribution is critical to conserving populations. Nest-based monitoring is a common, useful approach, but the difficulty and expense of monitoring raptor nests and importance of reliable trend data to conservation requires that limited resources are allocated efficiently. Power analyses offer a helpful tool to ensure that monitoring programs have the ability to detect trends and to optimize financial resources devoted to monitoring. We evaluated alternative monitoring designs for raptors to identify appropriate survey effort to detect population trends. We used data collected from a territory-occupancy study of ferruginous hawks throughout Wyoming to guide simulations and evaluate the ability to detect trends in occupancy rates. Results suggest that greater gains in precision of trend estimation may be achieved through the addition of more sites and not more visits; statistical power was ≥80% when monitoring lasted 20 years and population declines were 20%; and probability of detection affected statistical power less than rates of population decline. Monitoring at least 150 sites for 20 years would provide reasonable estimates of trend in occupancy given certain rates of detection and occupancy, but only for population declines of 20%. Removal sampling did not result in substantial changes of any metrics used to evaluate simulations, providing little justification for employing the standard design if territory occupancy is the variable of interest. Initial rates of territory occupancy may be biased high, a problem inherent to many studies that monitor territory occupancy. We explored the effects of lower rates of initial occupancy on the ability to detect trends. Although we present data from a study of ferruginous hawks, our simulations can be applied to other raptor species with similar life history and population dynamics to provide guidance for future trend estimation of territory occupancy.

Predicting above-ground density and distribution of small mammal prey species at large spatial scales.

Grassland and shrub-steppe ecosystems are increasingly threatened by anthropogenic activities. Loss of native habitats may negatively impact important small mammal prey species. Little information, however, is available on the impact of habitat variability on density of small mammal prey species at broad spatial scales. We examined the relationship between small mammal density and remotely-sensed environmental covariates in shrub-steppe and grassland ecosystems in Wyoming, USA. We sampled four sciurid and leporid species groups using line transect methods, and used hierarchical distance-sampling to model density in response to variation in vegetation, climate, topographic, and anthropogenic variables, while accounting for variation in detection probability. We created spatial predictions of each species' density and distribution. Sciurid and leporid species exhibited mixed responses to vegetation, such that changes to native habitat will likely affect prey species differently. Density of white-tailed prairie dogs (Cynomys leucurus), Wyoming ground squirrels (Urocitellus elegans), and leporids correlated negatively with proportion of shrub or sagebrush cover and positively with herbaceous cover or bare ground, whereas least chipmunks showed a positive correlation with shrub cover and a negative correlation with herbaceous cover. Spatial predictions from our models provide a landscape-scale metric of above-ground prey density, which will facilitate the development of conservation plans for these taxa and their predators at spatial scales relevant to management.

Re-Occupancy of Breeding Territories by Ferruginous Hawks in Wyoming: Relationships to Environmental and Anthropogenic Factors.

Grassland and shrubland birds are declining globally due in part to anthropogenic habitat modification. Because population performance of these species is also influenced by non-anthropogenic factors, it is important to incorporate all relevant ecological drivers into demographic models. We used design-based sampling and occupancy models to test relationships of environmental factors that influence raptor demographics with re-occupancy of breeding territories by ferruginous hawks (Buteo regalis) across Wyoming, USA, 2011-2013. We also tested correlations of territory re-occupancy with oil and gas infrastructure-a leading cause of habitat modification throughout the range of this species of conservation concern. Probability of re-occupancy was not related to any covariates we investigated in 2011, had a strong negative relationship with cover of sagebrush (Artemisia spp.) in 2012, was slightly higher for territories with artificial platforms than other nest substrates in 2013, and had a positive relationship with abundance of ground squirrels (Urocitellus spp.) that was strong in 2012 and weak in 2013. Associations with roads were weak and varied by year, road-type, and scale: in 2012, re-occupancy probability had a weak positive correlation with density of roads not associated with oil and gas fields at the territory-scale; however, in 2013 re-occupancy had a very weak negative correlation with density of oil and gas field roads near nest sites (≤500 m). Although our results indicate re-occupancy of breeding territories by ferruginous hawks was compatible with densities of anthropogenic infrastructure in our study area, the lack of relationships between oil and gas well density and territory re-occupancy may have occurred because pre-treatment data were unavailable. We used probabilistic sampling at a broad spatial extent, methods to account for imperfect detection, and conducted extensive prey sampling; nonetheless, future research using before-after-control-impact designs is needed to fully assess impacts of oil and gas development on ferruginous hawks.

Dynamics of a recovering Arctic bird population: the importance of climate, density dependence, and site quality.

Intrinsic and extrinsic factors affect vital rates and population-level processes, and understanding these factors is paramount to devising successful management plans for wildlife species. For example, birds time migration in response, in part, to local and broadscale climate fluctuations to initiate breeding upon arrival to nesting territories, and prolonged inclement weather early in the breeding season can inhibit egg-laying and reduce productivity. Also, density-dependent regulation occurs in raptor populations, as territory size is related to resource availability. Arctic Peregrine Falcons (Falco peregrinus tundrius; hereafter Arctic peregrine) have a limited and northern breeding distribution, including the Colville River Special Area (CRSA) in the National Petroleum Reserve-Alaska, USA. We quantified influences of climate, topography, nest productivity, prey habitat, density dependence, and interspecific competition affecting Arctic peregrines in the CRSA by applying the Dail-Madsen model to estimate abundance and vital rates of adults on nesting cliffs from 1981 through 2002. Arctic peregrine abundance increased throughout the 1980s, which spanned the population's recovery from DDT-induced reproductive failure, until exhibiting a stationary trend in the 1990s. Apparent survival rate (i.e., emigration; death) was negatively correlated with the number of adult Arctic peregrines on the cliff the previous year, suggesting effects of density-dependent population regulation. Apparent survival and arrival rates (i.e., immigration; recruitment) were higher during years with earlier snowmelt and milder winters, and apparent survival was positively correlated with nesting season maximum daily temperature. Arrival rate was positively correlated with average Arctic peregrine productivity along a cliff segment from the previous year and initial abundance was positively correlated with cliff height. Higher cliffs with documented higher productivity (presumably indicative of higher-quality habitat), are a priority for continued protection from potential nearby development and disturbance to minimize population-level impacts. Climate change. may affect Arctic peregrines in multiple ways, including through access to more snow-free nest sites and a lengthened breeding season that may increase likelihood of nest success. Our work provides insight into factors affecting a population during and after recovery, and demonstrates how the Dail-Madsen model can be used for any unmarked population with multiple years of abundance data collected through repeated surveys.

The enhanced Aussie Optimism Positive Thinking Skills Program: The relationship between internalizing symptoms and family functioning in children aged 9-11 years old.

The family context plays a critical role in the health of the child. This was the first study to examine the usefulness of the General Functioning subscale of the Family Assessment Device (FAD-GF) in assessing family functioning and its relationship to internalizing symptoms in school-aged children aged between 9 and 11 years of age. Eight hundred and forty-seven year 4 and 5 students from 13 schools (607 intervention students, and 240 control students) participated in the Aussie Optimism Positive Thinking Skills Program (AO-PTS) - a universal school-based program targeting internalizing symptoms. Students rated how 'healthy' they perceived their family to be at pre-test and at 6-months follow-up. Although some aspects of validity and reliability could be improved, results indicated that perceptions of family functioning at pre-test were predictive of internalizing symptoms at the 6-months follow-up. The FAD-GF therefore showed promise as a potential measure of family functioning for children as young as 9 years old. Regardless of children's pre-test levels of perceived family functioning, no intervention effects were found on the anxiety and depression scales; this finding suggests that child perceptions of family functioning may act as a general protective factor against internalizing symptomology.

Sexual and gender-based violence in the European asylum and reception sector: a perpetuum mobile?

BACKGROUND: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and discusses determinants for 'Desirable Prevention'. METHODS: Applying community-based participatory research, we conducted an SGBV knowledge, attitude and practice survey with residents and professionals in eight European countries. We conducted logistic regression using mixed models to analyse the data in R. RESULTS: Of the 562 respondents, 58.3% reported cases of direct (23.3%) or peer (76.6%) victimization. Our results indicate that when men were involved, it most likely concerned sexual perpetration (adjusted odds ratio [aOR]: 4.09, confidence interval [CI]: 1.2; 13.89) and physical victimization (aOR: 2.57, CI: 1.65; 4), compared with females, who then rather perpetrated emotional violence (aOR: 1.85, CI: 1.08; 3.13) and underwent sexual victimization (aOR: 7.14, CI: 3.33; 16.67). Compared with others, asylum seekers appeared more likely to perpetrate physical (aOR 7.14, CI: 4; 12.5) and endure socio-economic violence (aOR: 10, CI: 1.37; 100), whereas professionals rather bore emotional (aOR: 2.01, CI: 0.98; 4.12) and perpetrated socio-economic violence (aOR: 25.91, CI: 13.41; 50.07). When group perpetration (aOR: 2.13, CI: 1.27; 3.58) or victimization (aOR: 1.84, CI: 1.1; 3.06) occurred, it most likely concerned socio-economic violence. CONCLUSION: Within the European asylum reception sector, residents and professionals of both sexes experience SGBV victimization and perpetration. Given the lack of prevention policies, our findings call for urgent Desirable Prevention programmes addressing determinants socio-ecologically.

Impact of delayed diagnosis and treatment in clinically isolated syndrome and multiple sclerosis.

Multiple sclerosis (MS) is a progressive inflammatory disease with several possible clinical courses; before the development of definite MS, some patients may have clinically isolated syndrome (CIS), which is a single attack of neurological symptoms caused by inflammation or demyelination. Disease-modifying treatments (DMTs) have been extensively used for the management of MS, resulting in improvements in the clinical presentation and decreases in MS-associated neurological damage. Earlier initiation of DMT in the course of MS is associated with better outcomes. For patients with CIS, initiation of interferon-beta or glatiramer acetate treatment after an initial clinical event indicative of MS has been associated with delays in the progression to clinically definite MS as well as improvements in measures of neurological damage via magnetic resonance imaging. The initiation of treatment for patients with CIS should be considered, and nurses play a vital role in educating patients about the risks of conversion to MS and the benefits of early DMT.

Self-efficacy and health status improve after a wellness program in persons with multiple sclerosis.

PURPOSE: To determine if an intensive wellness program for persons with MS results in improved self-efficacy, quality of life (QOL), or physical activity outcomes. METHODS: 129 subjects participated in one of seven 4-day interdisciplinary educational wellness programs throughout the United States. This intervention was based on the philosophy that health management is important to disease management. The program consisted of psychological and physiological evaluations, lectures and workshops. Before the intervention and after at 1, 3 and 6 months, self-efficacy (MS Self-Efficacy Scale, MSSE, control), health related QOL (SF-36) and physical activity (Physical Activity Scale for Persons with Physical Disabilities, PASAID) was assessed. RESULTS: Improvements were noted at 1, 3 and 6 months post-intervention. Those present at 6 months included, MSSE, role physical, vitality and mental health scales of the SF-36. PASAID did not change. Improvements were independent of disability (EDSS). CONCLUSION: A 4-day multidisciplinary educational wellness program can result in improvement in self-efficacy and health-related QOL in persons with MS and can be stable up to at least 6 months. Improvements do not depend on degree of disability.

Meta-analysis of avian and small-mammal response to fire severity and fire surrogate treatments in U.S. fire-prone forests.

Management in fire-prone ecosystems relies widely upon application of prescribed fire and/or fire surrogate (e.g., forest thinning) treatments to maintain biodiversity and ecosystem function. Recently, published literature examining wildlife response to fire and fire management has increased rapidly. However, none of this literature has been synthesized quantitatively, precluding assessment of consistent patterns of wildlife response among treatment types. Using meta-analysis, we examined the scientific literature on vertebrate demographic responses to burn severity (low/moderate, high), fire surrogates (forest thinning), and fire and fire surrogate combined treatments in the most extensively studied fire-prone, forested biome (forests of the United States). Effect sizes (magnitude of response) and their 95% confidence limits (response consistency) were estimated for each species-by-treatment combination with two or more observations. We found 41 studies of 119 bird and 17 small-mammal species that examined short-term responses (< or =4 years) to thinning, low/moderate- and high-severity fire, and thinning plus prescribed fire; data on other taxa and at longer time scales were too sparse to permit quantitative assessment. At the stand scale (<50 ha), thinning and low/moderate-severity fire demonstrated similar response patterns in these forests. Combined thinning plus prescribed fire produced a higher percentage of positive responses. High-severity fire provoked stronger responses, with a majority of species possessing higher or lower effect sizes relative to fires of lower severity. In the short term and at fine spatial scales, fire surrogate forest-thinning treatments appear to effectively mimic low/moderate-severity fire, whereas low/moderate-severity fire is not a substitute for high-severity fire. The varied response of taxa to each of the four conditions considered makes it clear that the full range of fire-based disturbances (or their surrogates) is necessary to maintain a full complement of vertebrate species, including fire-sensitive taxa. This is especially true for high-severity fire, where positive responses from many avian taxa suggest that this disturbance (either as wildfire or prescribed fire) should be included in management plans where it is consistent with historic fire regimes and where maintenance of regional vertebrate biodiversity is a goal.

Healthcare reform: maternity service provision in Ireland.

The objective of this article is to explore recent and proposed future developments in maternity service provision in Ireland in the context of health policy reform. Ireland is experiencing an unprecedented demand for maternity services with in excess of 75,000 births in 2009, the highest since the 1970s when Ireland experienced a 'baby boom'. A further 10% rise is projected for 2010. This demographic change has placed increased demands on an already over-stretched maternity service. Despite more than a decade of economic success the health service has remained in constant crisis with many commentators arguing it has worsened rather than improved since the reform process was instigated in 2001 [1]. Reform of maternity services has begun and this article presents two case studies to demonstrate the regional variations in maternity provision in a country which has a national health service and a national Maternity and Infant Care Scheme. It shows what developments have occurred and what direction maternity services are likely to go in the next decade. The two regions under scrutiny are the North East Health Services Executive (NEHSE) and the Greater Dublin Area (GDA). The former illustrates important developments which have occurred in the NEHSE as a result of the Maternity Services Task Force (2002-2010) and argues that there are important learning outcomes not only for the GDA which is the subject of the latter case study but also for the development of maternity services nationally.

Recognizing nonadherence in patients with multiple sclerosis and maintaining treatment adherence in the long term.

CONTEXT: Patients with multiple sclerosis (MS) face many challenges. One significant challenge is long-term adherence to disease-modifying therapy (DMT). Four of the 6 currently available DMTs involve self-injection, and all cause adverse events of varying degrees of severity. Although effective, the benefit of DMTs is difficult to determine on an immediate basis. Healthcare providers must play a major role in recognizing nonadherence and identifying strategies to promote adherence. EVIDENCE ACQUISITION: We conducted a literature search of the MEDLINE database using the search terms "adherence" and "multiple sclerosis" to gather data from relevant studies investigating adherence among patients with MS. EVIDENCE SYNTHESIS: Barriers to maintaining treatment adherence in patients with MS include forgetting the medication, injection anxiety, perceived lack of efficacy, coping with adverse events, and issues with complacency and treatment fatigue. An open and honest healthcare provider-patient relationship is a core element in maintaining motivation and adherence in patients with MS. In addition, continuous education and consistent reinforcement of the value of treatment are essential strategies in the maintenance of treatment adherence. Other strategies to promote adherence include management of treatment expectations and minimization of adverse events. CONCLUSIONS: The chronic nature of MS makes treatment adherence challenging in patients with long-standing disease. Patients and healthcare providers need to work together to establish open lines of communication and a trust-based therapeutic relationship to ensure that patients have the knowledge and skills they need to adhere to long-term MS therapy.

Avifaunal responses to fire in southwestern montane forests along a burn severity gradient.

The effects of burn severity on avian communities are poorly understood, yet this information is crucial to fire management programs. To quantify avian response patterns along a burn severity gradient, we sampled 49 random plots (2001-2002) at the 17351-ha Cerro Grande Fire (2000) in New Mexico, USA. Additionally, pre-fire avian surveys (1986-1988, 1990) created a unique opportunity to quantify avifaunal changes in 13 pre-fire transects (resampled in 2002) and to compare two designs for analyzing the effects of unplanned disturbances: after-only analysis and before-after comparisons. Distance analysis was used to calculate densities. We analyzed after-only densities for 21 species using gradient analysis, which detected a broad range of responses to increasing burn severity: (I) large significant declines, (II) weak, but significant declines, (III) no significant density changes, (IV) peak densities in low- or moderate-severity patches, (V) weak, but significant increases, and (VI) large significant increases. Overall, 71% of the species included in the after-only gradient analysis exhibited either positive or neutral density responses to fire effects across all or portions of the severity gradient (responses III-VI). We used pre/post pairs analysis to quantify density changes for 15 species using before-after comparisons; spatiotemporal variation in densities was large and confounded fire effects for most species. Only four species demonstrated significant effects of burn severity, and their densities were all higher in burned compared to unburned forests. Pre- and post-fire community similarity was high except in high-severity areas. Species richness was similar pre- and post-fire across all burn severities. Thus, ecosystem restoration programs based on the assumption that recent severe fires in Southwestern ponderosa pine forests have overriding negative ecological effects are not supported by our study of post-fire avian communities. This study illustrates the importance of quantifying burn severity and controlling confounding sources of spatiotemporal variation in studies of fire effects. After-only gradient analysis can be an efficient tool for quantifying fire effects. This analysis can also augment historical data sets that have small samples sizes coupled with high non-process variation, which limits the power of before-after comparisons.

The parathyroid/pituitary variant of multiple endocrine neoplasia type 1 usually has causes other than p27Kip1 mutations.

CONTEXT: One variant of multiple endocrine neoplasia type 1 (MEN1) is defined by sporadic tumors of both the parathyroids and pituitary. The prevalence of identified MEN1 mutations in this variant is lower than in familial MEN1 (7% vs. 90%), suggesting different causes. Recently, one case of this variant had a germline mutation of p27(Kip1)/CDKN1B. OBJECTIVE: The objective was to test p27 in germline DNA from cases with tumors of both the parathyroids and pituitary. DESIGN: Medical record review and sequence analysis in DNA were performed. SETTING: This study involved an inpatient and outpatient referral program for cases of endocrine tumors. PATIENTS: Sixteen index cases had sporadic tumors of two organs, both the parathyroids and the pituitary. There were 18 additional index cases with related features of familial tumors. Five subjects were normal controls. No case had an identified MEN1 mutation. INTERVENTIONS: Clinical status of endocrine tumors was tabulated. Sequencing of germline DNA from index cases and control cases for the p27 gene was performed by PCR. MAIN OUTCOME MEASURES: Endocrine tumor types and their expressions were measured, as were sequence changes in the p27 gene. RESULTS: Tumor features were documented in index cases and families. One p27 germline single nucleotide change was identified. This predicted a silent substitution of Thr142Thr. Furthermore, there was a normal prevalence of heterozygosity for a common p27 polymorphism, making a large p27 deletion unlikely in all or most of these cases. CONCLUSIONS: The MEN1 variant with sporadic parathyroid tumors, sporadic pituitary tumor, and no identified MEN1 mutation is usually not caused by p27 germline mutations. It is usually caused by as yet unknown process(es).

Molecular pathology of the MEN1 gene.

Multiple endocrine neoplasia type 1 (MEN1), among all syndromes, causes tumors in the highest number of tissue types. Most of the tumors are hormone producing (e.g., parathyroid, enteropancreatic endocrine, anterior pituitary) but some are not (e.g., angiofibroma). MEN1 tumors are multiple for organ type, for regions of a discontinuous organ, and for subregions of a continuous organ. Cancer contributes to late mortality; there is no effective prevention or cure for MEN1 cancers. Morbidities are more frequent from benign than malignant tumor, and both are indicators for screening. Onset age is usually earlier in a tumor type of MEN1 than of nonhereditary cases. Broad trends contrast with those in nonneoplastic excess of hormones (e.g., persistent hyperinsulinemic hypoglycemia of infancy). Most germline or somatic mutations in the MEN1 gene predict truncation or absence of encoded menin. Similarly, 11q13 loss of heterozygosity in tumors predicts inactivation of the other MEN1 copy. MEN1 somatic mutation is prevalent in nonhereditary, MEN1-like tumor types. Compiled germline and somatic mutations show almost no genotype/phenotype relation. Normal menin is 67 kDa, widespread, and mainly nuclear. It may partner with junD, NF-kB, PEM, SMAD3, RPA2, FANCD2, NM23beta, nonmuscle myosin heavy chain II-A, GFAP, and/or vimentin. These partners have not clarified menin's pathways in normal or tumor tissues. Animal models have opened approaches to menin pathways. Local overexpression of menin in Drosophila reveals its interaction with the jun-kinase pathway. The Men1+/- mouse has robust MEN1; its most important difference from human MEN1 is marked hyperplasia of pancreatic islets, a tumor precursor stage.

Rethinking cognitive function in multiple sclerosis: a nursing perspective.

Cognitive impairment is a common problem in multiple sclerosis (MS); up to 65% of patients exhibit some neuropsychological dysfunction during the course of their disease. It is a major contributing factor to unemployment, accidents, impairment of daily functioning, and loss of social activity in those affected by MS. The areas of cognition typically impaired are memory, attention, information processing, executive functions, and visuospatial skills. Cognitive dysfunction is independent of disease duration and level of disability; cognitive decline may begin in the earliest stages of MS before patients become even mildly disabled. Structural brain imaging studies show a positive correlation between the extent of brain atrophy and cognitive dysfunction. Despite its prevalence in MS, cognitive dysfunction often goes undiagnosed or is misdiagnosed as depression, stress, stubbornness, lack of intelligence, or psychosis. Because nurses play such an important role in the care of patients with MS, they are in a position to identify patients with cognitive dysfunction, educate patients and their families on ways to cope with cognitive deficits, and counsel patients on available treatment options. Practical guidelines help nurses identify and care for cognitively impaired MS patients.

Effects of experimental food supplementation on movements of juvenile northern goshawks (Accipiter gentilis atricapillus).

Food availability is thought to strongly influence the leaving phase of natal dispersal in animals with condition-dependent dispersal. We conducted a food supplementation experiment to determine the influence of extra food on the onset of dispersal and early dispersal movement patterns of 42 radio-tagged northern goshawks (Accipiter gentilis atricapillus) from 28 broods in north-central New Mexico during 1992 and 1993. We randomly assigned half of the broods each year as treatments and the other half as controls. Treatment broods were given supplemental food from hatching (late April) until mid-October. Control broods received the same visitation rate but no food. Birds were located approximately every 2 days from fledging until mid-October in 1992 and 1993. Timing of fledging and independence were not affected by the treatment. However, extra food significantly influenced post-fledging movements of juvenile goshawks. During the late fledgling-dependency period (>65 days of age until independence) control birds were located in the natal area (<2 km from nest tree) more frequently than supplemented birds. This pattern reversed after independence (approximately 82 days of age) when supplemented birds were located more frequently in the natal area than controls. After independence the control birds were never located in the natal area and by the end of September in both years the controls had all left the study area (study area boundaries were approximately 25 km from nest tree). Supplemented birds were never located outside of the study area for the duration of the experiment. We conclude that the control birds dispersed out of the study area and the supplemented birds remained. Since the experimentally fed juveniles remained near a known food source and the controls did not, our study demonstrates that food availability influences at least the first 4 months of post-fledging movement patterns in this population. These results also suggest individuals base dispersal decisions on knowledge of their environment at a local scale, which can influence juvenile recruitment.