Psychological distress and PTSD among clinicians in Roma, Lesotho during the COVID-19 pandemic.

BACKGROUND:  Since 2020, the world has been battling the coronavirus disease 2019 (COVID-19) pandemic. The mortality and morbidity at the height of the pandemic sparked generalised fear and uncertainty about the future. Concerns were raised about the psychological impact of the pandemic on workers in healthcare systems globally. This study was conducted to establish the degree of psychological impact of the pandemic on frontline health workers in Lesotho. METHODS:  The study used a quantitative cross-sectional survey design. The Kessler psychological distress screening tool (K-10) and the post-traumatic stress disorder (PTSD) checklist for civilians (PCL-C) were administered to screen for psychological distress among clinical staff at St. Joseph's Hospital in Roma and its four Health Centres. Additional open- and closed-ended questions were added for context. Data were analysed using Fisher's exact tests, Pearson chi-square tests and correlation studies. RESULTS:  Of the 101 participants, 42 (41.6%) scored ≥ 24 on the K-10 scale (95% CI: 32.0% - 51.2%) indicating moderate to severe psychological distress and 32 (31.7%) scored ≥ 50 on the PCL-C checklist suggesting severe PTSD (95% CI: 24.5% - 42.9%). High scores on the K-10 were found more among men than women (17 [37.8%] vs. 4 [7.1%]; p ≤ 0.001). Post-traumatic stress disorder was more in the younger age group (p ≤ 0.03), in those reporting anxiety (p = 0.005) and those with more co-morbidities (p ≤ 0.001). CONCLUSION:  This study revealed the grave psychological impact of the COVID-19 pandemic on frontline clinical health workers in Lesotho.Contribution: These data will assist health leaders and policymakers to implement mental health support interventions for health workers in future.

Integrating herbivore assemblages and woody plant cover in an African savanna to reveal how herbivores respond to ecosystem management.

African savannas are experiencing anthropogenically-induced stressors that are accelerating the increase of woody vegetation cover. To combat this, land managers frequently implement large-scale clearing of trees, which can have a cascading influence on mammalian herbivores. Studies rarely focus on how differences in woody cover influence the herbivore assemblage, making it difficult to assess how aggressive measures, or the lack of management, to counteract increasing woody cover affect the local composition and biodiversity of herbivores. We address this knowledge gap by applying a model-based clustering approach to field observations from MalaMala Game Reserve, South Africa to identify multiple herbivore-vegetation 'configurations,' defined as unique sets of herbivore assemblages (i.e., groups of herbivores) associated with differing woody plant covers. Our approach delineated how tree-clearing influences the distribution and abundance of the herbivore community in relation to surrounding savanna areas, which represent a natural mosaic of varying woody cover. Regardless of season, both intensively managed areas cleared of trees and unmanaged areas with high tree cover contained configurations that had depauperate assemblages of herbivores (low species richness, low abundance). By contrast, habitats with intermediate cover of woody vegetation had much higher richness and abundance. These results have substantial implications for managing African savannas in a rapidly changing climate.

Metabolic heat loss in southern elephant seals (Mirounga leonina) differs with stage of moult and between habitats.

The moult in southern elephant seals (Mirounga leonina) represents an especially energetically demanding period during which seals must maintain high skin temperature to facilitate complete replacement of body fur and upper dermis. In this study, heat flux from the body surface was measured on 18 moulting southern elephant seals to estimate metabolic heat loss in three different habitats (beach, wallow and vegetation). Temperature data loggers were also deployed on 10 southern elephant seals to monitor skin surface temperature. On average, heat loss of animals on the beach was greater than in wallows or vegetation, and greater in wallows than in vegetation. Heat loss across all habitats during the moult equated to 1.8 x resting metabolic rate (RMR). The greatest heat loss of animals was recorded in the beach habitat during the late moult, that represented 2.3 x RMR. Mass loss was 3.6 ± 0.3 kg day-1, resulting in changes in body condition as the moult progressed. As body condition declined, skin surface temperature also decreased, suggesting that as animals approached the end of the moult blood flow to the skin surface was no longer required for hair growth.

The role of self-efficacy and catastrophizing in explaining improvements in disability, pain and fatigue among patients with chronic widespread pain treated with physiotherapy: an exploratory analysis.

OBJECTIVES: Most research exploring the relationship between cognitive factors (catastrophizing and self-efficacy beliefs) and levels of pain, disability and fatigue in patients with chronic widespread pain has been performed in multidisciplinary environments. It is less clear whether these associations are valid in other clinical environments. This study therefore aimed to establish whether changes in cognitive factors were related to changes in pain, disability and fatigue among patients treated in a physiotherapy-led symptom management programme. DESIGN: A longitudinal pre-post treatment study. Regression analyses were performed with change in pain, disability, physical and mental fatigue as the dependent measures. Demographics, change in pain and fatigue (when not dependent variables) and cognitive factors were entered as independent variables. ß values were calculated for the final model. SETTING: Two out-patient physiotherapy departments in Manchester, UK. PARTICIPANTS: Fifty patients with persistent widespread pain. INTERVENTION: A physiotherapist-led symptom management programme. MAIN OUTCOME MEASURES: Disability (Fibromyalgia Impact Questionnaire), Pain (Numeric Pain Rating Scale and Fatigue (Chalder Fatigue Scale) RESULTS: Significant changes in disability, fatigue and cognitive factors were observed after treatment. Changes in self-efficacy beliefs (ß=-0.38, P<0.05) and catastrophizing (ß=0.41, P<0.05) were significantly related to reductions in disability. There was no significant relationship between change in the cognitive variables and change in pain or fatigue. CONCLUSIONS: Self-efficacy beliefs and catastrophizing were important determinants of change in disability, but not pain or fatigue among patients with chronic widespread pain attending physiotherapy. Cognitively-informed physiotherapy appeared to be effective in reducing disability and fatigue and modifying cognitive factors. Such interventions may offer an effective treatment option for patients with chronic widespread pain and future randomised controlled trials are required to fully assess this.

Atypical beta power fluctuation while listening to an isochronous sequence in dyslexia.

OBJECTIVE: Developmental dyslexia is a reading disorder that features difficulties in perceiving and tracking rhythmic regularities in auditory streams, such as speech and music. Studies on typical healthy participants have shown that power fluctuations of neural oscillations in beta band (15-25 Hz) reflect an essential mechanism for tracking rhythm or entrainment and relate to predictive timing and attentional processes. Here we investigated whether adults with dyslexia have atypical beta power fluctuation. METHODS: The electroencephalographic activities of individuals with dyslexia (n = 13) and typical control participants (n = 13) were measured while they passively listened to an isochronous tone sequence (2 Hz presentation rate). The time-frequency neural activities generated from auditory cortices were analyzed. RESULTS: The phase of beta power fluctuation at the 2 Hz stimulus presentation rate differed and appeared opposite between individuals with dyslexia and controls. CONCLUSIONS: Atypical beta power fluctuation might reflect deficits in perceiving and tracking auditory rhythm in dyslexia. SIGNIFICANCE: These findings extend our understanding of atypical neural activities for tracking rhythm in dyslexia and could inspire novel methods to objectively measure the benefits of training, and predict potential benefit of auditory rhythmic rehabilitation programs on an individual basis.

Increased Metabolic Rate of Hauled-Out Harbor Seals (Phoca vitulina) during the Molt.

AbstractHarbor seals (Phoca vitulina) live in cold temperate or polar seas and molt annually, renewing their fur over a period of approximately 4 wk. Epidermal processes at this time require a warm skin; therefore, to avoid an excessive energy cost at sea during the molt, harbor seals and many other pinnipeds increase the proportion of time they are hauled out on land. We predicted that metabolic rate during haul-out would be greater during the molt to sustain an elevated skin temperature in order to optimize skin and hair growth. To examine this, we measured post-haul-out oxygen consumption (V˙O2) in captive harbor seals during molt and postmolt periods. We recorded greater V˙O2 of seals while they were molting than when the molt was complete. Post-haul-out V˙O2 increased faster and reached a greater maximum during the first 40 min. Thereafter, V˙O2 decreased but still remained greater, suggesting that while metabolic rate was relatively high throughout haul-outs, it was most pronounced in the first 40 min. Air temperature, estimated heat increment of feeding, and mass also explained 15.5% of V˙O2 variation over 180 min after haul-out, suggesting that the environment, feeding state, and body size influenced the metabolic rate of individual animals. These results show that molting seals have greater metabolic rates when hauled out, especially during the early stages of the haul-out period. As a consequence, human disturbance that changes the haul-out behavior of molting seals will increase their energy costs and potentially extend the duration of the molt.

Electronic-prescribing tools improve N-acetylcysteine prescription accuracy and timeliness for patients who present following a paracetamol overdose: A digital innovation quality-improvement project.

OBJECTIVES: Prescription error rates and delays in treatment provision are high for N-acetylcysteine (NAC) when prescribed for paracetamol overdose (POD). We hypothesised that an electronic tool which proposed the complete NAC regimen would reduce prescription errors and improve the timeliness of NAC provision. Error rates and delays in the provision of NAC were assessed following POD, before and after the implementation of an electronic prescribing tool. METHODS: The NAC electronic prescribing tool proposed the three NAC infusions (dosed for weight) following entry of the patient's weight. All NAC prescriptions were reviewed during a three-month period prior to and after the tool's implementation. Error rates were divided into dose, infusion volume or infusion rate. Delays in NAC provision were identified using national Emergency Medicine guidelines. RESULTS: 108 NAC prescriptions were analysed for all adult patients admitted to the emergency department of a secondary care hospital in the UK between July-September 2017 and August-October 2018, respectively. There were no differences in the demographics of patients or the seniority of the prescribing clinician before or after the introduction of the electronic tool. The electronic prescribing tool was associated with a decrease in prescribing errors (25% to 0%, p < 0.0071) and an increase in the provision of NAC within recommended times (11.1% to 47.4%, p = 0.029). CONCLUSIONS: An electronic prescribing tool improved prescription errors and the timeliness of NAC provision following POD. Further studies will determine the effect of this on length of stay and the benefit of wider implementation in other secondary care hospitals.

Rapid recovery of ecosystem function following extreme drought in a South African savanna grassland.

Climatic extremes, such as severe drought, are expected to increase in frequency and magnitude with climate change. Thus, identifying mechanisms of resilience is critical to predicting the vulnerability of ecosystems. An exceptional drought (

Cognitive factors are associated with disability and pain, but not fatigue among physiotherapy attendees with persistent pain and fatigue.

OBJECTIVES: Most research exploring the relationship between cognitive factors and pain, disability and fatigue in patients with persistent pain/fatigue has been performed in multi disciplinary environments. It is unclear whether these associations are consistent in other contexts. This study therefore aimed to establish the relationships between these factors in patients with persistent pain/fatigue referred for physiotherapy treatment. DESIGN: Cross-sectional observational study assessing the association between cognitive factors (self-efficacy and catastrophizing) and levels of pain, disability, mental fatigue and physical fatigue in patients with persistent pain/fatigue disorders. Data were analysed using regression analyses. SETTING: Two out-patient physiotherapy departments, Manchester, UK. PARTICIPANTS: 166 patients with persistent pain and fatigue disorders chronic widespread pain, fibromyalgia and chronic fatigue syndrome/myalgic encephalopathy). MAIN OUTCOME MEASURES: Disability was assessed using the Fibromyalgia Impact Questionnaire, whilst mental and physical fatigue were assessed with the sub-scales of the Chalder Fatigue Scale. Pain intensity was measured with a Numeric Pain Rating Scale, self-efficacy with the Chronic Pain Self-efficacy Questionnaire and catastrophizing with the Pain Catastrophizing Scale. RESULTS: Cognitive factors were significantly associated with pain (self-efficacy beliefs ß=-0.30, P<0.05; catastrophizing ß=0.24, P<0.05) and disability (self-efficacy beliefs ß=-0.62, P<0.05), but not fatigue. CONCLUSIONS: Similar associations were observed in patients referred to physiotherapy as to those observed in patients treated in multi disciplinary clinical environments. Self-efficacy beliefs appear to be particularly strong determinants of disability, but exert a lesser influence over pain or fatigue. Targeting self-efficacy may be an effective method to reduce disability in patients with persistent pain and fatigue disorders.

Regular rhythmic primes boost P600 in grammatical error processing in dyslexic adults and matched controls.

Regular musical rhythms orient attention over time and facilitate processing. Previous research has shown that regular rhythmic stimulation benefits subsequent syntax processing in children with dyslexia and specific language impairment. The present EEG study examined the influence of a rhythmic musical prime on the P600 late evoked-potential, associated with grammatical error detection for dyslexic adults and matched controls. Participants listened to regular or irregular rhythmic prime sequences followed by grammatically correct and incorrect sentences. They were required to perform grammaticality judgments for each auditorily presented sentence while EEG was recorded. In addition, tasks on syntax violation detection as well as rhythm perception and production were administered. For both participant groups, ungrammatical sentences evoked a P600 in comparison to grammatical sentences and its mean amplitude was larger after regular than irregular primes. Peak analyses of the P600 difference wave confirmed larger peak amplitudes after regular primes for both groups. They also revealed overall a later peak for dyslexic participants, particularly at posterior sites, compared to controls. Results extend rhythmic priming effects on language processing to underlying electrophysiological correlates of morpho-syntactic violation detection in dyslexic adults and matched controls. These findings are interpreted in the theoretical framework of the Dynamic Attending Theory (Jones, 1976, 2019) and the Temporal Sampling Framework for developmental disorders (Goswami, 2011).

Shining new light on mammalian diving physiology using wearable near-infrared spectroscopy.

Investigation of marine mammal dive-by-dive blood distribution and oxygenation has been limited by a lack of noninvasive technology for use in freely diving animals. Here, we developed a noninvasive near-infrared spectroscopy (NIRS) device to measure relative changes in blood volume and haemoglobin oxygenation continuously in the blubber and brain of voluntarily diving harbour seals. Our results show that seals routinely exhibit preparatory peripheral vasoconstriction accompanied by increased cerebral blood volume approximately 15 s before submersion. These anticipatory adjustments confirm that blood redistribution in seals is under some degree of cognitive control that precedes the mammalian dive response. Seals also routinely increase cerebral oxygenation at a consistent time during each dive, despite a lack of access to ambient air. We suggest that this frequent and reproducible reoxygenation pattern, without access to ambient air, is underpinned by previously unrecognised changes in cerebral drainage. The ability to track blood volume and oxygenation in different tissues using NIRS will facilitate a more accurate understanding of physiological plasticity in diving animals in an increasingly disturbed and exploited environment.

Change in dominance determines herbivore effects on plant biodiversity.

Herbivores alter plant biodiversity (species richness) in many of the world's ecosystems, but the magnitude and the direction of herbivore effects on biodiversity vary widely within and among ecosystems. One current theory predicts that herbivores enhance plant biodiversity at high productivity but have the opposite effect at low productivity. Yet, empirical support for the importance of site productivity as a mediator of these herbivore impacts is equivocal. Here, we synthesize data from 252 large-herbivore exclusion studies, spanning a 20-fold range in site productivity, to test an alternative hypothesis-that herbivore-induced changes in the competitive environment determine the response of plant biodiversity to herbivory irrespective of productivity. Under this hypothesis, when herbivores reduce the abundance (biomass, cover) of dominant species (for example, because the dominant plant is palatable), additional resources become available to support new species, thereby increasing biodiversity. By contrast, if herbivores promote high dominance by increasing the abundance of herbivory-resistant, unpalatable species, then resource availability for other species decreases reducing biodiversity. We show that herbivore-induced change in dominance, independent of site productivity or precipitation (a proxy for productivity), is the best predictor of herbivore effects on biodiversity in grassland and savannah sites. Given that most herbaceous ecosystems are dominated by one or a few species, altering the competitive environment via herbivores or by other means may be an effective strategy for conserving biodiversity in grasslands and savannahs globally.

The processes underpinning reductions in disability among people with chronic neck pain. A preliminary comparison between two distinct types of physiotherapy intervention.

PURPOSE: To establish whether different processes underpin changes in disability in people with neck pain who underwent two types of active physiotherapy intervention. MATERIALS AND METHODS: This study was a sub-analysis of a randomized controlled trial assessing whether the addition of Interactive Behavioral Modification Therapy (a cognitively informed physiotherapy treatment) to a Progressive Neck Exercise Program improved outcome in patients with chronic neck pain. Regression analyses were performed to determine the extent to which demographics, changes in pain, and changes in certain cognitive factors were related to changes in disability. RESULTS: In the progressive neck exercise group, changes in levels of pain intensity were the only factor significantly related to change in disability, explaining 33% of the variance. In the interactive behavioral modification therapy group, changes in pain intensity, and catastrophizing together explained 54% of the variance in change in disability. Only changes in catastrophizing displayed a significant ß value in the final model. CONCLUSIONS: Different processes appear to underpin changes in disability in patients undergoing cognitively informed physiotherapy to those undergoing a primarily exercise-based approach. Implications for rehabilitation Certain cognitive factors are known to be related to levels of disability in patients with chronic neck pain Specifically targeting these factors results in more patients making a clinically meaningful reduction in disability Different processes appear to underpin reductions in disability when people with neck pain are treated with cognitively informed physiotherapy to when treated with exercise alone, which may account for why more patients improve when treated in this manner. Reductions in catastrophizing appear to be particularly important and efforts should be made to assess and treat catastrophic thoughts in people with chronic neck pain.

Acceptance in chronic neck pain: associations with disability and fear avoidance beliefs.

Chronic neck pain can result in significant levels of disability. Physiotherapy treatments often aim to modify cognitive factors and this approach benefits some, but not all, patients. Research from other pain conditions suggests that acceptance may be related to disability; however, it is unclear whether these associations exist in patients with neck pain. Moreover, it is unclear to what extent other cognitive factors are related to acceptance. Feasibly, if these factors are related, existing treatments may already be indirectly modifying acceptance. The aim of this study was therefore to establish the associations between acceptance and disability, and between acceptance and other cognitive factors. Cross-sectional data were collected from 149 patients and regression analyses were carried out. In the first analysis, disability was the dependent variable and the proportion of variance explained by two acceptance subscales (activities engagement and pain willingness) was calculated. In the second analyses, the acceptance subscales were the dependent variables. Measures of pain-related fear, catastrophizing and pain vigilance and awareness were entered as explanatory variables and the proportion of variance explained was calculated. In the first analysis, acceptance explained 18% of variance in disability (P<0.001). In the second analysis, cognitive factors explained 7% (P<0.05) of variance in activities engagement and 58% (P<0.001) of pain willingness. On this basis, treatments that enhance acceptance may reduce disability. Moreover, as cognitive factors were strongly related to pain willingness, but not activity engagement, alternative treatments may be required to maximize acceptance. Further studies are warranted to assess acceptance-based treatments in patients with neck pain.

Are fear of movement, self-efficacy beliefs and fear of falling associated with levels of disability in people with osteoarthritis of the knee? A cross sectional study.

INTRODUCTION: Osteoarthritis of the knee (OAK) can result in significant disability and previous authors have suggested that cognitive and falls-related factors may be significant determinants of function. However, no previous studies have considered the relative influence of these factors when the effects of symptoms related to OAK are also considered. Additionally, it is plausible that falls-related factors exert a greater influence in patients who have previously fallen. METHODS: Fifty-eight patients were recruited from an outpatient physiotherapy department. They completed measures of physical function, pain, stiffness, physical symptoms, fear avoidance, perceived consequences of falling, fear of falling and self-efficacy beliefs. Variables exhibiting significant correlations with disability were entered into a regression model. ß Values were also calculated for the final model to allow the relative contribution of each variable to be established when all variables were considered. Sub-analysis was then performed using only data from patients who had previously fallen, to establish whether cognitive and falls-related factors exerted a stronger influence in this group. RESULTS: Pain, stiffness and joint symptoms significantly explained 75% of the variance in disability. The cognitive and falls-related variables did not significantly explain any additional variance. Only pain and stiffness exhibited significant ß values in the final model. Similar findings were observed in the sub-analysis with the participants who had previously fallen, with only pain and stiffness explaining significant variance (77%) or exhibiting significant ß values. DISCUSSION: The current findings suggested that cognitive and falls-related factors are not significantly related to disability in patients with OAK. By contrast, pain and stiffness were strongly associated with disability. This suggests that targeting cognitive and falls-related factors is unlikely significantly to improve outcome in these patients.

Comparison of three types of exercise in the treatment of rotator cuff tendinopathy/shoulder impingement syndrome: A randomized controlled trial.

OBJECTIVES: To assess the efficacy of three different exercise programmes in treating rotator cuff tendinopathy/shoulder impingement syndrome. DESIGN: Parallel group randomised clinical trial. SETTING: Two out-patient NHS physiotherapy departments in Manchester, United Kingdom. PARTICIPANTS: 120 patients with shoulder pain of at least three months duration. Pain was reproduced on stressing the rotator cuff and participants had full passive range of movement at the shoulder. INTERVENTIONS: Three dynamic rotator cuff loading programmes; open chain resisted band exercises (OC) closed chain exercises (CC) and minimally loaded range of movement exercises (ROM). MAIN OUTCOMES: Change in Shoulder Pain and Disability Index (SPADI) score and the proportion of patients making a Minimally Clinically Important Change (MCIC) in symptoms 6 weeks after commencing treatment. RESULTS: All three programmes resulted in significant decreases in SPADI score, however there were no significant differences between the groups. Participants making a MCIC in symptoms were similar across all groups, however more participants deteriorated in the ROM group. Dropout rate was higher in the CC group, but when only patients completing treatment were considered more patients in the CC group made a meaningful reduction in pain and disability. CONCLUSIONS: Open chain, closed chain and range of movement exercises all seem to be effective in bringing about short term changes in pain and disability in patients with rotator cuff tendinopathy. ISRCTN76701121.

Dynamic habitat corridors for marine predators; intensive use of a coastal channel by harbour seals is modulated by tidal currents.

ABSTRACT: Previous studies have found that predators utilise habitat corridors to ambush prey moving through them. In the marine environment, coastal channels effectively act as habitat corridors for prey movements, and sightings of predators in such areas suggest that they may target these for foraging. Unlike terrestrial systems where the underlying habitat structure is generally static, corridors in marine systems are in episodic flux due to water movements created by tidal processes. Although these hydrographic features can be highly complex, there is generally a predictable underlying cyclic tidal pattern to their structure. For marine predators that must find prey that is often patchy and widely distributed, the underlying temporal predictability in potential foraging opportunities in marine corridors may be important drivers in their use. Here, we used data from land-based sightings and 19 harbour seals (Phoca vitulina) tagged with high-resolution GPS telemetry to investigate the spatial and temporal distribution patterns of seals in a narrow tidal channel. These seals showed a striking pattern in their distribution; all seals spent a high proportion of their time around the narrowest point of the channel. There was also a distinctive tidal pattern in the use of the channel; sightings of seals in the water peaked during the flood tide and were at a minimum during the ebb tide. This pattern is likely to be related to prey availability and/or foraging efficiency driven by the underlying tidal pattern in the water movements through the channel. SIGNIFICANCE STATEMENT: To maximise foraging efficiency, predators often make use of narrow constrictions in habitat to intercept prey using these corridors for movement. In the marine environment, narrow channels may act as corridors, and sightings of predators suggest that they may target these for foraging. Despite this, there is little information on how individual predators use such areas. Here, we investigate how individual harbour seals use a narrow coastal channel subject to strong tidal currents; results showed that seals spent the majority of their time at the narrowest point of the channel foraging during peak tidal currents. This highlights the importance of narrow channels for marine predators and suggests that this usually wide-ranging predator may restrict its geographic range to forage in the channel as a result of increased prey availability and/or foraging efficiency driven by water movements through the narrow corridor.

Corkscrew Seals: Grey Seal (Halichoerus grypus) Infanticide and Cannibalism May Indicate the Cause of Spiral Lacerations in Seals.

Large numbers of dead seals with characteristic spiral lesions have been washing ashore around the North Atlantic over the past two decades. Interactions with ship propellers and shark predation have been suggested as the likely causal mechanisms. However, new evidence points towards a more likely candidate: grey seal predation. An adult male grey seal was observed and recorded catching, killing and eating five weaned grey seal pups over a period of one week on the Isle of May, Scotland. A further 9 carcasses found in the same area exhibited similar injuries. Post mortem analysis of lesions indicated the wound characteristics were similar to each other and in 12 of the 14 carcasses analysed, were indistinguishable from carcasses previously attributed to propeller interaction. We therefore propose that most of the seal carcasses displaying spiral lacerations in the UK are caused by grey seal predation. Cases in other locations should be re-evaluated using the scoring system presented here to identify whether grey seal predation is a major cause of mortality in phocid seals.

Multiple-Pulse Sounds and Seals: Results of a Harbor Seal (Phoca vitulina) Telemetry Study During Wind Farm Construction.

Offshore construction and survey techniques can produce pulsed sounds with a high sound pressure level. In coastal waters, the areas in which they are produced are often also used by seals, potentially resulting in auditory damage or behavioral avoidance. Here, we describe a study on harbor seals during a wind farm installation off southeast England. The study used GPS/global system for mobile communication tags on 23 harbor seals that provided distribution and activity data; the closest range of individual seals to piling varied from 6.65 to 46.1 km. Furthermore, the maximum predicted received levels (RLs) at individual seals varied between 146.9 and 169.4 dB re 1 µPa peak to peak.