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Although they can be specific for each region or country order genuine tadalis sx on line, they should contain broadly similarcan be specific for each region or country cheap 20mg tadalis sx mastercard, they should similar components cheap 20 mg tadalis sx. Financial plans Ensuring that you have sufficient funds to finance your disease management strategy is of criticalEnsuring that you have sufficient funds to finance your disease management strategy is of critical importance as any delay in obtaining finances will hinder the speed of response to an emergencyimportance as any delay in obtaining finances will hinder the response to an emergency disease outbreak cheapest generic tadalis sx uk. The rapid implementation of disease control activities will ultimately reduce thedisease outbreak. The rapid implementation of disease control activities will ultimately reduce thedisease outbreak. The rapid implementation of disease control activities will ultimately reduce the overall cost of the disease control campaign. Criteria should be agreed for the release of funds, for example, when an outbreak has been identified or the presence of disease is strongly suspected, when effective control and/or elimination of the disease is possible and when there are approved plans to implement such measures. If the funding and resources of a disease management strategy is limited in a country or area, potential international donor sources should be identified (e. It may be wise to include procedures for applying for funding from various ‘back-up’ sources in the financial plan. If possible, funds for compensation of wetland stakeholders who have incurred financial losses as a result of disease control activities should also be included where this is national policy. Resource plans It is important to make an inventory which lists all the resources that will be needed during a disease outbreak, including capacity of personnel (their qualifications, expertise and experience) and equipment (quantities, specifications and locations). This should be compared with an inventory list of existing resources and any deficiencies should be rectified. All staff should be thoroughly trained in their roles, duties and responsibilities, and a contingency plan should allow for ‘back-up’ staff [►Section 3. Legislation A contingency plan should include information on legislation and regulations that may or may not give permissions to conduct various disease prevention and control activities, in the event of an outbreak at or around your site. This should include information about the compulsory notification of certain animal diseases and may also include authorisations for the declaration of infected areas and disease control zones, movements of animals and people, the destruction and safe disposal of infected or potentially infected animals and objects, compensation for those financially affected by disease control activities and authorisation for any other relevant activities. Simulation exercises It is important to ensure that your contingency plan is practically achievable and for this, simulation exercises should be carried out in advance of their implementation. Lessons learnt from such exercises should be used to further refine and improve your contingency plan. These exercises are essential for building effective teams, ensuring that there are adequate resources and for training staff [►Section 3. Disease outbreak scenarios should be realistic and real data should be used if possible. Each stage of an outbreak response may need to be tested before a full-scale disease scenario is attempted. Changing circumstances may require that a contingency plan be updated to retain its effectiveness in preventing and controlling disease. The effectiveness of a contingency plan in preventing and/or controlling a disease in a wetland should be thoroughly evaluated after a disease outbreak response has ended, and recommendations for improvement should be incorporated where necessary. Risk analysis as a component of animal disease emergency preparedness planning, Chapter 3. Exotic animal disease contingency framework plan: covering exotic notifiable animal diseases of livestock. Chapter 4, Field manual of wildlife diseases: general field procedures and diseases of birds. The specific actions required to reduce risks associated with these diseases should be identified within risk assessments [►Section 3. More generally, ‘healthy habitat management’ and reducing stressors at a site will benefit disease prevention and/or control [►Section 3. Additionally, following standardised protocols for releasing and moving animals into, within and out of wetlands will help to mitigate disease risks [►Section 3. It is important that wetland managers identify stressor risks within their site and the broader catchment/landscape, and understand that these may change over time. Once these factors are identified, they can be managed and/or their impact mitigated, as appropriate. Disease zoning (although challenging in wildlife and/or aquatic systems) can help control some infectious diseases through the delineation of infected and uninfected zones defined by sub-populations with different disease status. Buffer zones separating infected and uninfected zones may consist of physical barriers, an absence of hosts, an absence of disease vectors or only immune hosts e. Appropriate levels of surveillance are required to accurately define zones and for prevention of disease spread to occur, the movements of animals between zones needs to be restricted. The movement of infected animals to new areas and populations represents the most obvious potential route for introduction of new/novel infections. The risk of transmission and spread of disease can be minimised by conducting risk assessments and following certain standardised national and international guidelines and regulations for moving, relocating and/or releasing animals. A disease risk analysis should be conducted for any translocations for conservation purposes. Biosecurity in wetlands refers to the precautions taken to minimise the risk of introducing infection (or invasive alien species) to a previously uninfected site and, therefore, preventing further spread. Infectious animal diseases are spread not only through movement of infected hosts but also their products e. Constructed treatment wetlands can assist greatly in reducing risks from contaminated wastewaters. Where possible, biosecurity measures should be implemented routinely as standard practice whether or not an outbreak has been detected. A regional/supra-national approach to biosecurity is important for trans-boundary diseases, particularly those where domestic and international trade are considered as important pathways for disease spread, e. If wetland stakeholders understand the principles and value of biosecurity and what measures to take, this will encourage the development of an everyday ‘culture’ of biosecurity which can help disease prevention and control. Implementing biosecurity measures in the natural environment can be extremely challenging, particularly in aquatic systems, and although eliminating risk will be impossible, a substantial reduction in risk may be achievable, particularly where several complementary measures are employed. Stressors may not in themselves cause disease but their effects can be subtle and can influence disease dynamics and the likelihood of a disease outbreak. Stressors can be additive or synergistic, working together to shift the balance between health and disease within individual hosts or populations. Consequently, stressors at wetland sites should be identified and managed to reduce disease susceptibility. Identification of potential stressors requires a thorough knowledge of the site and a reasonable understanding of the biology and ecology of the animal species present. It is important to periodically re-assess the stressors at a given site as they may change over time. Nutrition: malnutrition (deficiency, excess or imbalance of nutrients) of animals may result in increased disease susceptibility. Consideration can be given to providing supplementary high quality food and/or water, although artificial provisioning brings its own disease risks (e. Human disturbance: ideally this should be reduced/kept to a minimum where possible, especially at sensitive times in the life cycles of wildlife, at times when other stressors are known to occur or when risks of disease outbreaks are high. Zoning human activities such as recreation and agriculture may also be of value in managing human disturbance. Predators: depending on the management priorities of a site, measures could be considered to minimise stress from predators (e. Interspecific and intraspecific competition: depending on the management priorities of a site, measures could be considered to reduce competition from other animals (e. Extreme weather and other environmental perturbations: during periods of extreme potential stress (e. For example, a voluntary ban on shooting activities during extended periods of cold weather may be advisable. Such actions need to be the subject of advance agreement amongst site managers and other stakeholders. Common Eider Somateria mollissima mortality in the spring and winter of 1999/2000 in the Wadden Sea. Although debatable, there is evidence to suggest the 1999/2000 mass mortality of common eider ducks in the Wadden Sea was due to nutritional stress and simultaneous heavy parasite loads.

With progressive ripeness of foods discount tadalis sx 20 mg with visa, there is a decrease in starch and an increase in free sugar content buy 20 mg tadalis sx with visa. Although the glycemic response of diabetics is distinctly higher than that of healthy individuals generic tadalis sx 20 mg with mastercard, the relative response to different types of mixed meals is similar (Indar-Brown et al 20mg tadalis sx fast delivery. For instance, coingestion of dietary fat and protein can some- times have a significant influence on the glucose response of a carbohydrate- containing food, with a reduction in the glucose response generally seen with increases in fat or protein content (Gulliford et al. For instance, it is important that the incremental area, rather than the absolute area, under the blood glucose curve be measured (Wolever and Jenkins, 1986). The breakdown of starch begins in the mouth where salivary amylase acts on the interior α-(1,4) linkages of amylose and amylopectin. The digestion of these linkages continues in the intestine where pancre- atic amylase is released. Amylase digestion produces large oligosaccharides (α-limit dextrins) that contain approximately eight glucose units of one or more α-(1,6) linkages. The microvilli of the small intestine extend into an unstirred water layer phase of the intestinal lumen. When a limit dextrin, trisaccharide, or disaccharide enters the unstirred water layer, it is rapidly hydrolyzed by enzymes bound to the brush border membrane. These limit dextrins, produced from starch digestion, are degraded by glucoamylase, which removes glucose units from the nonreducing end to yield maltose and isomaltose. Maltose and isomaltose are degraded by intestinal brush border disaccharidases (e. Maltase, sucrase, and lactase digest sucrose and lactose to monosaccharides prior to absorption. Intestinal Absorption Monosaccharides first diffuse across to the enterocyte surface, followed by movement across the brush border membrane by one of two mecha- nisms: active transport or facilitated diffusion. The intestine is one of two organs that vectorially transports hexoses across the cell into the bloodstream. The mature enterocytes capture the hexoses directly ingested from food or produced from the digestion of di- and polysaccharides. The resultant gradient results in the cotransport of one molecule each of sodium and glucose. The driving force for glucose transport is the glucose gradient and the energy change that occurs when the unstirred water layer is replaced with glucose. In this type of transport, called facili- tated diffusion, glucose is transported down its concentration gradient (from high to low). Absorbed sugars are transported throughout the body to cells as a source of energy. The concentration of glucose in the blood is highly regulated by the release of insulin. Most of the glucose-1-phosphate derived from galactose metabolism is converted to glycogen for storage. The glyceraldehyde can be con- verted to glycolytic intermediary metabolites that serve as precursors for glycogen synthesis. Glyceraldehyde can also be used for triacylglycerol synthesis, provided that sufficient amounts of malonyl coenzyme A (CoA) (a precursor for fatty acid synthesis) are available. In muscle, glucose is metabolized anaerobically to lactate via the glycolytic pathway. After the consumption of carbohydrates, fat oxida- tion is markedly curtailed, allowing glucose oxidation to provide most of the body’s energy needs. In this manner, the body’s glucose and glycogen content can be reduced toward more normal concentrations. Glucose can be synthesized via gluconeogenesis, a metabolic pathway that requires energy. Gluconeogenesis in the liver and renal cortex is inhibited via insulin following the consumption of carbohy- drates and is activated during fasting, allowing the liver to continue to release glucose to maintain adequate blood glucose concentrations. Glucose can also be converted to glycogen (glycogenesis), which contains α-(1-4) and α-(1-6) linkages of glucose units. Glycogen is present in the muscle for storage and utilization and in the liver for storage, export, and maintenance of blood glucose concentrations. Glycogenesis is activated in skeletal muscle by a rise in insulin concentration following the consumption of carbohydrate. In the liver, glycogenesis is activated directly by an increase in circulating glucose, fructose, galactose, or insulin concentration. Following glycogenolysis, glucose can be exported from the liver for maintenance of normal blood glucose concentrations and for use by other tissues. A limited amount of carbohydrate is converted to fat because de novo lipogenesis is generally quite minimal (Hellerstein, 1999; Parks and Hellerstein, 2000). This finding is true for those who are obese, indi- cating that the vast majority of deposited fat is not derived from dietary carbohydrate when consumed at moderate levels. Based on the metabolic functions of insulin discussed above, the ingestion of carbohydrate produces an immediate increase in plasma insulin concentrations. This immediate rise in plasma insulin concentra- tion minimizes the extent of hyperglycemia after a meal. The effects of insulin deficiency (elevated blood glucose concentration) are exemplified by type 1 diabetes. Individuals who have type 2 diabetes may or may not produce insulin and insulin-dependent muscle and adipose tissue cells may or may not respond to increased insulin concentrations (insulin resis- tant); therefore, circulating glucose is not effectively taken up by these tissues and metabolized. Clinical Effects of Inadequate Intake The lower limit of dietary carbohydrate compatible with life appar- ently is zero, provided that adequate amounts of protein and fat are con- sumed. However, the amount of dietary carbohydrate that provides for optimal health in humans is unknown. There are traditional populations that ingested a high fat, high protein diet containing only a minimal amount of carbohydrate for extended periods of time (Masai), and in some cases for a lifetime after infancy (Alaska and Greenland Natives, Inuits, and Pampas indigenous people) (Du Bois, 1928; Heinbecker, 1928). Caucasians eating an essentially carbohydrate-free diet, resembling that of Greenland natives, for a year tolerated the diet quite well (Du Bois, 1928). However, a detailed modern comparison with populations ingesting the majority of food energy as carbohydrate has never been done. It has been shown that rats and chickens grow and mature success- fully on a carbohydrate-free diet (Brito et al. It has also been shown that rats grow and thrive on a 70 percent protein, carbohydrate-free diet (Gannon et al. Azar and Bloom (1963) also reported that nitrogen balance in adults ingesting a carbohydrate-free diet required the ingestion of 100 to 150 g of protein daily. The ability of humans to starve for weeks after endogenous glycogen supplies are essentially exhausted is also indicative of the ability of humans to survive without an exogenous supply of glucose or monosaccharides convertible to glucose in the liver (fructose and galactose). However, adaptation to a fat and protein fuel requires considerable metabolic adjustments. The only cells that have an absolute requirement for glucose as an oxidizable fuel are those in the central nervous system (i. The central nervous system can adapt to a dietary fat-derived fuel, at least in part (Cahill, 1970; Sokoloff, 1973). Also, the glycolyzing cells can obtain their complete energy needs from the indirect oxidation of fatty acids through the lactate and alanine-glucose cycles. In the absence of dietary carbohydrate, de novo synthesis of glucose requires amino acids derived from the hydrolysis of endogenous or dietary protein or glycerol derived from fat. Therefore, the marginal amount of carbohydrate required in the diet in an energy-balanced state is condi- tional and dependent upon the remaining composition of the diet. Never- theless, there may be subtle and unrecognized, untoward effects of a very low carbohydrate diet that may only be apparent when populations not genetically or traditionally adapted to this diet adopt it. Of particular concern in a Western, urbanized society is the long-term consequences of a diet sufficiently low in carbohydrate such that it creates a chronically increased production of β-hydroxybutyric and acetoacetic acids (i. The concern is that such a diet, deficient in water- soluble vitamins and some minerals, may result in bone mineral loss, may cause hypercholesterolemia, may increase the risk of urolithiasis (Vining, 1999), and may affect the development and function of the centra1 ner- vous system. It also may adversely affect an individual’s general sense of well being (Bloom and Azar, 1963), although in men starved for an extended period of time, encephalographic tracings remained unchanged and psychometric testing showed no deficits (Owen et al. The latter is required for hypoglycemic emergencies and for maximal short-term power production by muscles (Hultman et al.

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Take the whites of eggs40 and mix them with water in which pennyroyal and hot herbs of this kind have been cooked discount tadalis sx online mastercard, and with a new linen cloth dipped ¶a order tadalis sx 20mg with visa. Et nota quod prius abluenda est bene cum eademi aqua calida cum qua fuerint ista distemperata cheap tadalis sx 20 mg on-line. Accipe gallas purchase tadalis sx 20mg mastercard, rosas, sumac, plantaginem, consolidam maio- rem, bolum armenicum, alumen,a chimoleam, ana unciam. On Treatments for Women  in it, place it in the vagina two or three times a day. And note that prior to this the vagina ought to be washed well with the same warm water with which these things were mixed. Having ground it, dis- solve it with rainwater, and with a linen or cotton cloth place it in the vagina in the above-mentioned manner. Let the woman sit in water where there have been cooked marsh mallows and pennyroyal, and she will be freed. For Swelling of the Face [] For sudden swelling of the face, a fumigation of hot water alone suffices. Ad hoc facimusb ma- turatiuum de malua et maluauisco, absinthio, arthimesia, et auxungia, et cum caputc apparuerit,d contere nucleose et appone. Et sif non rumpitur cum flebo- tomo aperiatur, et exprimeg parum in principio ne subita euacuatione malum fiat, et inpone licinium singulis diebus bis uel ter, illinitum cum uitello oui. Istis facimus pannum in uino intinctum in quob bullierint folia mirtilli, uelc ipsa herba ueld ipsi mirtilli. On Treatments for Women  On Pain of the Breasts [] For pain of the breasts caused by milk, we should mix clay with vinegar and make a plaster; this diminishes the pain and constricts the milk. On Lesions of the Breasts [] There are some women who have lesions in the breasts. For this we make a maturative from marsh mallow and mayweed, wormwood, mugwort, and animal grease, and when the head [of the lesion] appears, grind together nuts and apply them. And if it does not rupture let it be opened with a lancet, and press out a little in the beginning lest by a sudden evacuation it becomes bad, and each day apply a piece of lint twice or three times smeared with egg yolk. For this cleans every fistula and makes it become necrotic, as long as it is not between any bones. On Foul-Smelling Sweat [] There are some women who have sweat that stinks beyond measure. For these we prepare a cloth dipped in wine in which there have been boiled leaves of bilberry, or the herb itself or the bilberries themselves. Accipe pulegium, policariam, quatuor frondes lauri, et bullianta in aqua, et facias eam sedere in aqua ista, et postb fac de omni- bus fumigium. On Treatments for Women  On Swelling of the Vagina [] For swelling of the vagina. Take pennyroyal, fleabane, and four fronds of laurel, and boil them in water, and you should make her sit in this water, and afterward make a fumigation from all these [herbs]. For Antlike Itching and Itch-Mites [] For antlike itches and itch-mites wherever they might be in the body, especially in the face and on the forehead, we mix grain with wine, and with a powder of frankincense applied in the manner of a plaster, we place it on the [afflicted] spot. On Pain of the Eyes [] For pain of the eyes, take marsh mallow, the herb of violets, tips of bramble, dried roses, vervain, and sermountain. OnW eboftheEye [] If there is a web in the eye, take conch and frankincense and burn them. Take two parts of aloe, and as much frank- incense and plaster of Paris as of the aloe; pulverize them finely and prepare them with fresh animal grease and anoint the place. On Cancer of the Nose [] For cancer of the nose, take lungwort, sage, Greek tar, wild garlic, and ‘‘blacking,’’ that is, earth of the countryside,45 and pulverize them all equally. Et cum exierit de balneo, pista maluam,e arthimesiam, camphoram, et eas pistatas in olla calefacias, et informa magdaleones cum oleo laurino uelf pulegino pauco, et suppone. Tunc accipe tribu- los marinos et coque in aqua marina uelb salsa, et [vb] fumiga pedes sepe, et post fumigium cum fomentumc erit tepidum, lauabis pedes. Postea accipe semen urtice et cornu cerui, et da puluerem inde factum ad bibendum cum uino. Afterward, grind root of delicate willow and root of madder, and give the juice to the patient with wine. Cook all these herbs in water thoroughly, and make the patient sit in it up to her breasts. And when she exits from the bath, pound marsh mal- low, mugwort, and camphor, and warm these pounded things in a pot, and make lozenges with laurel oil or a little pennyroyal oil, and insert them as a suppository. On Swelling of the Feet [] Sometimes it happens that the feet are swollen due to pain of the womb. Then take sea brambles and cook them in sea- or saltwater, and fumigate the feet often. And after the fumigation, when the mixture has become lukewarm, you will wash the feet. Afterward, take nettle seed and buck’s-horn plantain, and give a powder made of this to drink with wine. Accipe paleam auenea et combure in cineres, post apponatur aqua calida quantum patiens sustinere poterit, et intus teneat pedes quous- que infrigidentur. Accipe pinguedinem anguillarum recentium que apparet post decoctionem illarum, et [rb] succum caprifolii, et barbe Iouis, et ouorum formicarum plenam palmam, tere et cola,b et hec omnia simulc cum oleo misceanturd et decoquantur. On Treatments for Women  [On Cutting the Umbilical Cord] [] When the umbilical cord of the child is cut, you should say as follows, holding the stump extended: ‘‘Jesus Christ is dead, he was pierced by the lance, and he took no thought of any ointment or of his pain or of any unguent. On Itch-Mites of the Hands and Feet [] For extracting the worm from the hands and the feet, that is, the itch- mite, which in English is called degge,47 take a heated brick and any kind of vessel full of water, and afterward let henbane seed be placed upon the burning brick. And let the patient hold her feet above the smoke, and you will see the worms falling into the water just like hairs. Afterward let there be applied water as warm as the patient is able to stand it, and let her leave her feet there until they have become cold. Then let it be strained so that none of the water remains, and let the ashes be squeezed well so that the water goes out, and let them be separated bit-by-bit, and there will be found worms just like threads [extracted] by the smoke of the henbane. And in water as hot as she is able to stand it let the limb of the patient be placed, and the worms will come out; afterward let the place be healed just like any other wound. Take the fatty residue of fresh eels which appears after cooking them, and juice of honeysuckle, and houseleek, and a palmful of ants’ eggs; grind them and strain them. After the cooking, let vinegar be added to it so that it might be the more penetrating, or wine as suffices. And pour it into the healthy ear and stop up the afflicted one, and let [the patient] lie upon the ¶a. Hec omnia coquanturb in uino forti uel ueteri, et fomentabis bis uel ter in die,c et easd herbas pista et misce cum melle et bulliat; istud cum uino inductum superpone. Accipe pulegium, origanum, nepitam, lauri frondes uel grana,68 et maluas, in aqua fac bullire, et inde patientem fomenta. Post accipe gariofilum, spicam nardi, nu- cem muscatam, galangam,e et fiat fumigium, et per embotum fumum recipiat. Deinde triferam magnam uelf pocionem sancti Pauli in modum auellane cum bombaceg superpone. And make him for a little while lie on the healthy ear, and again upon the af- flicted one. Take an apple and hollow it out and place in on the ear, and if there is any worm, it will come out. Take marsh mallow, wormwood, vervain, marsh mallow,48 henbane, mugwort, and cabbages. Let all these be cooked in strong or old wine, and you will foment [the testicles] two or three times a day. And grind these herbs and mix them with honey and boil them; apply this with wine. Also, when ground in wine and cooked in honey [and] placed upon tumors of the face, it softens, matures, and attenuates them. On Pain of the Womb [] Pain of the womb happens from miscarriage, [or] sometimes before that time from retention of the menses. Take pennyroyal, oregano, catmint, fronds of laurel or its grains, and marsh mallows, make them boil in water and then foment the patient. Afterward, take clove, spikenard, nutmeg, and galangal, and let a fumigation be made, and let her receive the smoke through a funnel.

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Ensuring that the infected area is free of susceptible animals for an appropriate period of time cheap tadalis sx 20mg overnight delivery. The most appropriate use of this approach at a wetland site would be for the rapid elimination of a disease in livestock generic tadalis sx 20 mg otc. Lethal methods include dispatch by firearm or captive-bolt purchase tadalis sx no prescription, the use of gaseous buy tadalis sx no prescription, biological or injectable agents. Stamping out may often be a cost-effective approach to disease control in livestock in an emergency situation, as in appropriate circumstances (e. As with all disease strategies, the scientific feasibility, and health, ethical, social and economic costs and benefits of stamping out and lethal intervention should be carefully evaluated before it is selected as a disease control strategy. Lethal intervention has been used for disease control in wildlife, but in wetland sites this may not be consistent with conservation objectives. Hence, the potential costs and benefits of lethal interventions need to be considered carefully. This requires some knowledge of the likely behavioural and demographic responses of host populations to lethal control as these can result in complex outcomes in terms of disease control. However, implementation at the level of individual hosts requires the availability of adequate diagnostic tools, and at the population level it is important to be able to accurately identify the target population. Lethal interventions of invasive alien species or pests is likely to be consistent with conservation objectives but, nevertheless, a sound understanding of the response of the target population is required prior to intervention to help predict impacts. Control, elimination, eradication and re-emergence of infectious diseases: getting the message right. These programmes form some of the most fundamental aspects of managing diseases in wetlands and should be included in all wetland disease management strategies. Successful communication relies upon establishing a regular dialogue between wetland stakeholders and disease control authorities. A ‘culture’ of disease management can only be developed if: a broad range of wetland stakeholders (e. Such programmes should be integrated into all wetland disease management strategies. Programmes should aim to inform wetland stakeholders of the basic principles of healthy habitat management, thus reducing the risk of a disease outbreak. Communication strategies should aim to make stakeholders aware of the nature and potential consequence of animal disease and of the benefits gained from prevention and control measures. They should ultimately encourage people to take the recommended courses of action in preventing and controlling a disease outbreak. Awareness raising campaigns should emphasise the importance of early warning systems and of notifying and seeking help from the nearest government animal and/or human health official as soon as an unusual disease outbreak is suspected. Selection of the appropriate message, the messenger and the method of delivery is critical for successful communication. A strategy, written in ‘peacetime’ for dealing with the media can increase likelihood of successful outcomes from this relationship maximising potential benefits and minimising potential negative impacts. Simulation exercises and testing of contingency plans are a valuable method for training. Snail fever integrated control and prevention project in Tongxing Village of Wucheng Township, Yongxiu County of Jiangxi Province, P. Such programmes are one of the most critical aspects of managing disease in wetlands, and engender a ‘bottom-up’ approach. A ‘culture’ of disease management can only be developed if a broad range of wetland stakeholders participate in these programmes. Target audience Communications and awareness raising materials should be targeted at those likely to affect potential for disease emergence, those likely to be affected by disease or come into contact with it, and to those whose activities may influence its prevalence and spread, such as local authorities, people living in ‘high risk’ areas, farmers and livestock owners and traders. Each different group is a specific audience and communications need to be tailored appropriately. The message It is important to consider the intended audience for your message when writing/determining its content. Be mindful of the key purpose of the message whilst considering your target audience’s education, socio-economic status, current knowledge and experience of the issue/disease, age, language, culture and geographic location. Given the multiple benefits of disease control, there can be an element of rallying the community to a common cause, ideally involving local community groups, key land users and farming organisations where appropriate. Messages need to be communicated clearly and simply and with credibility, accuracy, consistency and speed. An effective message should be: repeated come from a trusted, credible and legitimate source be specific to the event being experienced, and offer a positive course of action. Materials and services Messages can be communicated using various materials and services. These include signs, printed materials, the internet, media coverage, public service announcements, national campaigns, audio conferences, seminars and workshops. Ways should be considered for the audience to submit information or ask questions too, for instance by giving a phone number or email address: they may be your eyes and ears on the ground. It is valuable to find out how a target audience likes to receive information, such as, online, on the radio, on a notice board, in the newspaper. Communicating through sources trusted by the target audience can heighten the credibility of, and attention to, messages. Engaging the public in disease control: the public information sign on a trail in Victoria, Australia, outlines the problem, provides a positive course of action and provides contact information for further communication. The media The media, such as television, radio, newspapers and online news sources, can help get a message to a large number of people quickly and easily. Developing partnerships or good relationships with local or national media can reduce potential for misunderstanding. Ideally, selected personnel should receive media training and be designated spokespersons on behalf of an organisation involved with managing disease, to effectively convey information before, during and after an outbreak or other problem. A community task force that includes health, environmental, civic and business concerns can be valuable in reaching various segments of society and in developing a common message. Community outreach activities should encourage community mobilisation whereby groups take part in actions to prevent and control an outbreak, e. Target audience research Knowing different audiences is critical to putting communication plans into practice. Attitudes to disease management measures may vary considerably by region or section of society. Previous experience with disease prevention and control measures will affect the acceptability of future efforts. Target audience research can identify local attitudes, motivations, barriers to ‘change’, and opportunities to promote desired behaviours. Surveys assessing knowledge, understanding, attitude and practice levels can be of particular value - ideally combining qualitative and quantitative methods. Evaluations, including lessons learned, should be conducted, whenever possible, to measure the efficacy of communications in achieving their aims, and adjustments made accordingly. Emergency communications for a disease outbreak Emergency communications are inevitably focused on managing for the worst case scenario. Above all, a communication plan is a resource of information for those that need it and should be integrated into the overall wetland disease management strategy. All relevant wetland stakeholders, disease control authorities, spokespersons and communications professionals should be involved (e. Crisis Communication: this is used when there is an unexpected disease outbreak and there is a need to quickly communicate about that crisis to wetland stakeholders and the wider public. Issues Management Communication: this is used with the knowledge of an impending crisis and, therefore, the opportunity to choose the timing of the communication to the wetland stakeholders and the wider public. Risk Communication: this is used to prepare people for the possibility of a disease outbreak and to provide appropriate steps to prevent an outbreak and mitigate for its impacts. There will be stages to every outbreak and communication must also evolve with each stage. The following cycle demonstrates the likely stages of an outbreak: Precrisis Initial Maintenance Resolution Evaluation Be prepared. Document lessons consensus about the risk information to those Honestlyexamine learned. Provide emergency Listen to stakeholder Persuade the public courses of action and audience to support public (including how/whereto feedback, and correct policy and resource get more information).