Misunderstanding the ''nature'' of co-management: a geography of regulatory science and indigenous knowledges (IK).

Governments, NGOs, and natural scientists have increased research and policy-making collaborations with Indigenous peoples for governing natural resources, including official co-management regimes. However, there is continuing dissatisfaction with such collaborations, and calls for better communication and mutual learning to create more ''adaptive'' co-management regimes. This, however, requires that both Western and Indigenous knowledge systems be equal participants in the ''co-production'' of regulatory data. In this article, I examine the power dynamics of one co-management regulatory regime, conducting a multi-sited ethnography of the practices of researching and managing one transnational migratory species, greater white-fronted geese (Anser albifrons frontalis), who nest where Koyukon Athabascans in Alaska, USA, practice subsistence. Analyzing the ethnographic data through the literatures of critical geography, science studies and Indigenous Studies, I describe how the practice of researching for co-management can produce conflict. ''Scaling'' the data for the co-management regime can marginalize Indigenous understandings of human­ environment relations. While Enlightenment-based practices in wildlife biology avoid ''anthropomorphism,'' Indigenous Studies describes identities that operate through non-modern, deeply imbricated human­nonhuman identities that do not separate ''nature'' and ''society'' in making knowledge. Thus, misunderstanding the ''nature'' of their collaborations causes biologists and managers to measure and research the system in ways that erase how subsistence- based Indigenous groups already ''manage'' wildlife: by living through their ethical commitments to their fellow beings. At the end of the article, I discuss how managers might learn from these ontological and epistemologicaldifferences to better ''co-produce'' data for co-management.

Indigenous studies speaks to environmental management.

This article describes the increasing connections between the fields of Indigenous studies and environmental management and examines some of the ways that an Indigenous studies perspective can guide thinking about environmental management. Indigenous groups have been involved in the management of environmental and natural resources on their lands since time immemorial. Indigenous groups have also become increasingly involved in Western practices of environmental management with the advent of co-management institutions, subsistence boards, traditional ecological knowledge forums, and environmental issues affecting Indigenous resources. Thus, it is an important time for scholarship that explores how Indigenous groups are both shaping and being affected by processes of environmental management. This article summarizes key findings and themes from eight papers situated at the intersection of these two fields of study and identify means by which environmental managers can better accommodate Indigenous rights and perspectives. It is the authors' hope that increased dialog between Indigenous studies and environmental management can contribute to the building of sustainable and socially just environmental management practices.

Participatory and Spatial Analyses of Environmental Justice Communities' Concerns about a Proposed Storm Surge and Flood Protection Seawall.

In response to increasing threats from sea-level rise and storm surge, the City of Charleston, South Carolina, and the US Army Corps of Engineers (USACE) propose constructing a seawall around the Charleston peninsula. The proposed seawall will terminate close to lower wealth, predominantly minority communities. These communities are identified as environmental justice (EJ) communities due to their history of inequitable burdens of industrial and urban pollution and proximity to highways and US Environmental Protection Agency (EPA) designated Superfund sites. The present study documents community concerns and opinions related to the proposed seawall, existing flooding problems, and other issues. The project was guided by knowledge co-production and participant-observation approaches and included interviews with community members, collection of locality-specific data, GIS mapping to visualize key issues, development of an ArcGIS Story Map, and participation in public meetings. Community concerns are reported in the voices of community members and fell into eight major themes: community connections, drainage, impacts of road infrastructure, displacement, increasing vulnerability, sense of exclusion and isolation, mistrust of government, and civic engagement. Community members were significantly engaged in the study and are the owners of the results. As one of the first US East Coast cities pursuing major structural adaptation for flooding, Charleston is likely to become a model for other cities considering waterfront protection measures. We demonstrate the importance of meaningful engagement to ensure that climate adaptation will benefit all, including marginalized communities, and have as few unintended negative consequences as possible. Bringing more people to the table and creating vibrant, long-term partnerships between academic institutions and community-based organizations that include robust links to governmental organizations should be among the first steps in building inclusive, equitable, and climate resilient cities.

Contemporary autochthonous human Chagas disease in the USA.

Chagas disease is a leading cause of non-ischemic cardiomyopathy in Latin America and an infection of emerging importance in the USA. Recent studies have uncovered evidence of an active peridomestic cycle in southern states, yet autochthonous transmission to humans has been rarely reported. We conducted a systematic review of the literature and public health department reports to investigate suspected or confirmed locally acquired cases of Chagas in the USA. We found 76 cases of contemporary suspected or confirmed locally acquired Chagas disease, nearly ten times the case counts cited in the prior 50 years of scientific literature. Shared risk factors among cases include rural residence, history of hunting or camping, and agricultural or outdoor work. The results of this review suggest that the disease burden and risk of autochthonous Chagas infection is potentially higher in the USA than previously recognized.

Limitations of an optimum sustainable population or potential biological removal approach for conserving marine mammals: Pacific walrus case study.

Decision rules are the agreed-upon points at which specific management interventions are initiated. For marine mammal management under the U.S. Marine Mammal Protection Act (MMPA), decision rules are usually based on either a numeric population or biological-removal approach. However, for walrus and other ice-associated pinnipeds, the inability to reliably assess population numbers or biological removals highlights a significant gap in the MMPA, particularly when the Arctic environment is rapidly changing. We describe the MMPA's ecosystem-based management goals, and why managers have bypassed these goals in favor of an approach that depends upon numerical population assessment. We then revisit the statute's primary goals in light of current knowledge about the Pacific walrus ecosystem and new developments in environmental governance. We argue that to monitor and respond to changes in the walrus ecosystem, decision rules should be based on scientific criteria that depend less on the currently-impractical goal of accurately enumerating population size and trends, or removals from that population. Rather, managers should base decisions on ecological needs and observed ecological changes. To implement this approach would require an amendment to the MMPA that supports filling the gap in management with achievable decision rules. Alternatively, walrus and other ice-associated pinnipeds will remain largely unmanaged during a period of profound environmental change.

Informing the Content and Composition of the CCM Certification Examination: A National Study From the Commission for Case Manager Certification: Part 2.

PURPOSE: The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas of case management practice, meaning the work performed by case managers in various care settings and across diverse professional disciplines. PRIMARY PRACTICE SETTING(S): The national study covered case management practices and work settings across the full continuum of health care. METHODOLOGY AND SAMPLE: This cross-sectional descriptive study used the practice analysis method and online survey research design. The study employed a purposive sample of case managers, in which 52,370 individuals received an invitation to volunteer to participate. Data collection completed over a 4-week period resulted in 7,668 useable survey responses (nearly a 15% response rate). RESULTS: The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as was highlighted in Part I of the two-part article series on the role and function study. The results of the study informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination. This work assures the CCM continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The role and function study keeps the CCM credentialing examination evidence-based and maintains its validity for evaluating competency of case managers. Findings can be used to develop programs and curricula for the training and education of case managers. The study instrument also can be used for further research of case management practice.

What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

PURPOSE: The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. PRIMARY PRACTICE SETTING(S): The national study covered all case management practices and/or work settings across the full continuum of health care. METHODOLOGY AND SAMPLE: This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). RESULTS: The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

Pain management: screening and assessment of pain as part of a comprehensive case management process.

PURPOSE/OBJECTIVE: Pain management, episodic and chronic, is a major issue in health care today, affecting more than 76 million people across care-delivery settings from acute care to rehabilitation, workers' compensation to primary care. As a result, professional case managers occupy an important role within an interdisciplinary care team to address pain as part of a comprehensive case management process, from intake and assessment through care delivery and transitions of care. PRIMARY PRACTICE SETTING: Pain management, as part of the comprehensive case management process, is applicable across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with clients and their support systems. FINDINGS/CONCLUSIONS: The prevalence of pain across the care continuum, affecting individuals at various stages of an individual's lifecycle, raises the importance of acute and chronic pain assessments as part of the overall case assessment. In addition to screening for pain, case management assessments must look for signs of depression, as well as the potential for abuse/misuse of opioid medications, which is an alarming public health threat. Given their clinical expertise, their roles as advocates, their ability to conduct a comprehensive client/patient assessment, and their expertise in using tools such as motivational interviewing, professional case managers-and particularly those who are board certified-occupy a central role in pain management as part of a patient-centered approach. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Case managers must understand the impact of both pain and pain medications on the client's daily functions, from a health and safety perspective. Pain management should be examined through the lens of professional case management, and what a competent case manager can do to advocate for clients who are experiencing pain, whether acute or chronic, while facilitating the sharing of information among various members of an interdisciplinary care team and coordinating care.