Empirical evidence of chaos, or complex behavior, in ecosystems is scarce, presumably due to high system-level noise and/or the rarity of conditions necessary for complex behavior to arise. An alternative explanation might be that complex behavior is fragile and readily suppressed by disturbances that are common in many ecosystems. Here we investigated the role of disturbance frequency and magnitude on complex behavior and focused on population succession trajectories in a plankton system. Because of its prominence in aquatic ecology, we used hydraulic flushing and nutrient loading as disturbances. Our findings from numerical modeling exercises and laboratory microcosm experiments using natural plankton assemblages indicated that one aspect of complex behavior, divergence of nearby trajectories, was suppressed when the magnitude and periodicity of hydraulic flushing and nutrient loading were large. In other words, complex succession became determinable. Divergence of nearby trajectories was relatively robust, however, because pulses of not less than 85% of the total inflow were required to suppress this behavior. Our numerical findings also revealed that large hydraulic disturbances could introduce to the system another aspect of complex behavior, aperiodic succession.
This study was a collaboration between Western public health researchers and Suriname indigenous communities. The question asked was “how can Western researchers effectively engage traditional indigenous communities in Suriname, South America, in public health research”. The approach used a combination of Participatory Action Research methods in which “Western” researchers became participating observers in an indigenous-led research initiative. The Wayana communities of Puleowime (Apetina) and Kawemhakan (Anapayke) defined a single objective: determine for themselves whether they are at risk from exposure to mercury (Hg) contamination. Community members collected hair samples for analysis. Hair samples were analyzed using a portable Hg analyzer. Individual, community and hazard quotient indices were used to quantify risk. Results showed the Wayana were at a high lifetime risk of adverse effects from exposure to Hg. This study showed that the community-led approach is an effective way Westerners can engage indigenous communities and address serious public health threats. While factors that appealed to indigenous communities were identified, obstacles inherent to Western research methodology were also encountered.
The indigenous Wayana community of Puleowime (Apetina) in Suriname is susceptible to the effects of mercury because they consume large amounts of fish compared to mainstream communities. Small-scale and artisanal gold mining activities occur at numerous sites in eastern and southeastern Suriname placing the Wayana at risk from exposure to mercury released into the environment. A previous community-led risk assessment study showed that the Wayana were at a high lifetime risk of adverse effects from exposure to mercury. Subsequent to this earlier study, the residents of Puleowime requested assistance in a community-led follow-up research project to determine for themselves whether there were health impacts associated with exposure to mercury contamination. Neurotoxic effects consistent with methylmercury exposure were documented in an exposed population through a battery of neurological tests. Although the specific motor and cognitive batteries were not exactly the same, similar associations were observed between neurologic impairment and hair mercury concentrations compared to other studies in the Amazonia region where mean hair mercury levels were in the subacute range.
This project showed that a democratic approach to science does not automatically compromise the orderly search for answers. Specifically, our experience in Kwakoegron suggests that the collaborative relationship that emerges by empowering an indigenous community to initiate its own research projects, and address the needs it identifies, can contribute positively to the risk assessment process. This project showed that when Kwakoegron was acknowledged as an equal partner, the risk assessment process led to an open exchange of information and an intervention plan that was both pragmatic and acceptable in the context of the community's unique social and cultural needs.
Background We developed a practice-based learning and improvement (PBLI) curriculum to address important gaps in components of content and experiential learning activities through didactics and participation in systems-level quality improvement projects that focus on making changes in health care processes. Methods We evaluated the impact of our curriculum on resident PBLI knowledge, self-efficacy, and application skills. A quasi-experimental design assessed the impact of a curriculum (PBLI quality improvement systems compared with non-PBLI) on internal medicine residents' learning during a 4-week ambulatory block. We measured application skills, self-efficacy, and knowledge by using the Systems Quality Improvement Training and Assessment Tool. Exit evaluations assessed time invested and experiences related to the team projects and suggestions for improving the curriculum. Results The 2 groups showed differences in change scores. Relative to the comparison group, residents in the PBLI curriculum demonstrated a significant increase in the belief about their ability to implement a continuous quality improvement project (P = .020), comfort level in developing data collection plans (P = .010), and total knowledge scores (P < .001), after adjusting for prior PBLI experience. Participants in the PBLI curriculum also demonstrated significant improvement in providing a more complete aim statement for a proposed project after adjusting for prior PBLI experience (P = .001). Exit evaluations were completed by 96% of PBLI curriculum participants who reported high satisfaction with team performance. Conclusion Residents in our curriculum showed gains in areas fundamental for PBLI competency. The observed improvements were related to fundamental quality improvement knowledge, with limited gain in application skills. This suggests that while heading in the right direction, we need to conceptualize and structure PBLI training in a way that integrates it throughout the residency program and fosters the application of this knowledge and these skills.
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