88,788 results

  • Indwelling Catheter Care: Areas for Improvement

    Hernandez, MA

    Conference paper
    Massey University

    Objectives: To describe perioperative nurses' current attitude and indwelling catheter management practices, To analyse and identify areas of indwelling catheter care practice that require improvement in the light of existing evidence-based guidelines. Research Question: What areas of indwelling catheter care experience of perioperative nurses in a tertiary public hospital require improvement in the light of existing evidence-based guidelines? Design: A qualitative research design using focus group discussions was utilised to answer the research question. The focus group discussions explored the perioperative staff nurses' attitude and indwelling catheter care experience and facilitated the identification of areas of practice that can be further improved in the light of existing evidence. Setting: Two perioperative wards of a public tertiary hospital located in Auckland, New Zealand Participants: A convenience sample of staff nurses (n=13) from two perioperative wards were invited to participate in the focus group discussions. Study participation was voluntary, with utmost respect for human dignity and autonomy. Methods: A qualitative approach utilising focused group discussions was done to gain insight into the nurses' attitude and indwelling catheter care experience. Thirteen (n = 13) nurses participated in the focus groups. Two focus groups were formed to facilitate the management of interviews. Seven nurses participated in the first focus group, whereas six participated in the second. The focus group discussions were organised on different dates to accommodate as many participants as possible without compromising patient care or safety. An interview prompt sheet was utilised as a guide in the focus group discussions which took approximately 45 minutes to complete. The proceedings were audio-recorded, transcribed and made accessible only to the researcher with due respect to confidentiality of information. Results: The results of the two focus groups discussions were combined and four key themes were established, namely: preparation for catheter management, Nursing skills and knowledge, current clinical practice and catheter management resources. The focus groups revealed that the nurses did not always feel confident towards indwelling catheter management due to their lack of preparation or catheter care training. There was evidence of diversity in training and feelings of not being prepared properly during their undergraduate training due to the teaching method utilised, the time allotted for the training, the focus of the training itself and the lack of opportunity to practice catheter management skills to prevent CAUTI. These relate to feelings of insufficiency with regard to catheter care knowledge and lack of confidence with regard to catheter management skills. Diversity and deficiency in undergraduate education can be one of the reasons why nurses' practices vary thereby affecting the quality of patient care. Despite these challenges, nurses cope with the task by being resourceful and by asking colleagues for support. There are also recommendations to standardise in-service training programmes and organisational policies and procedures; and, to revisit undergraduate nursing programmes to emphasise infection prevention and control. The findings also suggest that nurses perceive catheter management as task-oriented, with the decision to insert, re-insert and remove a catheter being heavily reliant on doctors. There is, however, a growing recognition among nurses that they also make important patient care decisions. The existence of organisational protocols such as those related to catheter removal empowers nurses to make important nursing decisions. Revisiting organisational protocols also help nurses feel more confident in performing procedures. Nurses want to advocate for their patients' safety, thus increased confidence and empowerment facilitates nurses' assertion of evidence-based practices to minimise risks and improve their patient's condition. Finally, nurses also expressed awareness of the importance of catheter care documentation. However, there is an apparent discrepancy in what the nurses expressed as recognition of the importance of documentation and actual documentation of patient care as evidenced by variability in actual documentation and failure to relate assessment findings with the patient's health status. Standardised documentation of patient assessment and catheter status is recommended to improve the quality of documentation in relation to nursing assessment. Current clinical practice is characterised by collaborative care. While nurses were perceived to be mainly responsible for catheter insertion, maintenance and removal, doctors also need support in terms of recognising the unnecessary presence of a patient's catheter. Nurses expressed that cognitively able patients play a role in catheter care. This makes patient care in the current research setting unique because of nurses' perception of patient involvement. Nurses perceive that they are responsible for educating and empowering patients to actively participate in their care. Catheter care also involves advocating for the patient's interests. Nurses feel vulnerable and fear going against their patient's preference when faced with circumstances that require ethical decision-making. Nurses are aware that in patient centred care, the patient's moral, cultural and religious values need to be considered. Thus, nurses overcome this feeling of concern by maintaining an open communication with the patient. Nurses also identified their gender as a barrier to catheter care due to unwritten, agreed rules of behaviour that guide clinical practice. To remove this barrier without compromising patient preference, a standardised organisational policy on catheterisation has been recommended. Nurses also reported clinical practises that puts patient's safety at risk and indicated poor knowledge and hence clinical practice. A multi-pronged approach in educating and addressing practice discrepancies has been recommended to improve nurses' knowledge and practise. Overall, clinical practice related to catheter care requires nursing skills, decision-making, critical thinking and a complete grasp of ethical principles. Finally, with regard to catheter management resources, nurses are aware that organisational policies on catheter management are available intranet, although some have concerns with locating it. Ease of access to policies and consistency with day to day workflow can potentially enhance nursing care. Support from colleagues also proves to be valuable when nurses cannot access policies. The nurses also reported that the existence of policies on catheter removal helped standardise the process itself and guided nurses in their decisions. For those who found the organisational policy not suitable for various types of patients, their expertise in the use of the nursing process and collaborative care helped them arrive at important decisions and interventions. Decision-support tools were recommended to be utilised as these facilitate decisions regarding deviations from specific organisational guidelines. While organisational policies facilitate decisions and nursing care, these do not replace nurses' knowledge and skills in providing quality patient care. Conclusion: There are various areas in catheter care that can be improved further. These include: diversity in catheter care practise of which some may be of concern to patient safety; variability in actual documentation of care and failure to relate assessment findings with the patient's health status; heavy reliance on doctors for the decision to insert, re-insert and remove a catheter; gender as a barrier to catheter care due to unwritten, agreed rules of behaviour that guide clinical practice; and difficulty in accessing organisational policies. Nurses have identified recommendations to address these concerns. These include: standardisation of in-service training programmes and organisational policies and procedures without compromising patient preference; standardisation of documentation of patient assessment and catheter status; empowerment of nurses through evidence-based protocols; multi-pronged approach in the delivery of in-service education; creation of policies that are consistent with day to day workflow and are easy to access; and utilisation of decision-support tools that address deviations from specific organisational guidelines.

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  • What Works to Improve Staff Compliance with Multi-drug Resistant Organism (MDRO) Screening

    Hernandez, MA

    Conference paper
    Massey University

    What Works to Improve Staff Compliance with Multi-drug Resistant Organism (MDRO) Screening Monina H. Gesmundo, MN (Honours), PGDip HSc (Merit), PGCert Tertiary Teaching, BSN, RN, RM, CNS School of Nursing, Massey University, Auckland, New Zealand Purpose of the presentation: To present the evaluation of the effect of multi-modal interventions on the staff MDRO admission screening compliance rate in various departments of a tertiary public hospital in New Zealand Target Audience: The target audience of this presentation are staff nurses, nurse educators, nurse managers, quality improvement advisers and infection control practitioners who are keen to identify interventions that work in improving staff compliance to MDRO admission screening Objective: To evaluate the effect of multi-modal interventions on the staff MDRO admission screening compliance rate in various departments of a tertiary public hospital Research question: What is the effect of multi-modal infection prevention and control interventions on the staff MDRO admission screening compliance rate in various departments of a tertiary public hospital? Design: A retrospective review of monthly MDRO admission screening audits was done to compare the compliance rate before and after multi-modal interventions were implemented. The audit was conducted in the care of older people and elective surgical department of a public tertiary hospital in Auckland, New Zealand from December 2010 to November 2014. Setting: Two departments of a public tertiary hospital in Auckland, New Zealand Methods: Monthly MDRO admission screen audits were done in a representative ward of each department for the purpose of quality improvement. Audits were conducted by generating a monthly list of patients who were eligible to be screened for MDRO on admission to the ward. Twenty patients were randomly selected from the monhtly list for a specified period of time to evaluate whether nurses screened them for MDRO within 24 hours of admission. Eligibility to be screened is based on the criteria published in the organisational policy for MDRO management. Nursing staff compliance rate with the MDRO admission screen policy was computed using frequency and percentage. Multi-modal interventions focusing on the nursing staff were implemented by the infection control practitioner. Interventions include: monthly MDRO admission screen compliance audits, regular reporting of audit result, feedback with regard to missed screens, regular education sessions with the nursing staff and staff encouragement from both the infection control practitioner and nurse manager. Compliance rates were reported to the charge nurse managers on a monthly basis through an e-mail. Compliance rates of greater than 90% were celebrated and reinforced, whereas a drop in the compliance rate or a compliance rate of < 90% was followed up with the nurse manager. Regular 10-15 minute-education sessions during staff handovers were done by the infection control practitioner to present the audit results, to provide input, to answer queries and to encourage the staff to do better. Nurse managers also encourage staff to improve screening compliance rate. Data analysis utilized Microsoft Excel Software in quantitative data collation and encoding. MDRO admission screen audits were presented using descriptive statistics such as frequency, percentage, mean, median and mode. Standard deviation was used to show data variability. T-test was utilized to test for a significant difference in the overall compliance rate before and after the multi-modal interventions were introduced. T-test is a parametric procedure of testing the difference in group means. The level of significance was set at P < 0.05 to identify a significant difference in the compliance rate. Results: Results show that the MDRO admission screen compliance rate in the two departments were variable. The average compliance rate from October, 2012 to November, 2014 in the elective surgical department is 85.75% compared to 75.91% from December, 2010 to September, 2012 (Table 1). Table 1.MDRO admission screen compliance at the elective surgical department Surgical Department Before* After** Mean 75.90909091 Mean 85.75 Number of patient records audited 1670 Number of patient records audited 2058 Number of monthly audits completed 22 Number of monthly audits completed 24 *Period coverage is from December, 2010 to September, 2012 **Period coverage is from October, 2012 to November, 2014 In the care of older people department, results show that the MDRO admission screen compliance was also variable. The average MDRO admission screen compliance rate from August, 2013 to October, 2014 is 96.80% compared to 83.84% from December, 2010 to July 2013 (Table 2). Variability in the compliance may be due to patient acuity, staff mix, thorough history-taking of the patient, review of previous admissions, completeness of handover, staff knowledge of the organisational policy, staff motivation to adhere to organisational policy and availability of staff support. Table 2.MDRO admission screen compliance at the health of older people department Health of Older People Before*** After**** Mean 83.83870968 Mean 96.8 Number of patient records audited 2599 Number of patient records audited 1452 Number of monthly audits completed 31 Number of monthly audits completed 15 *** Period coverage is from December, 2010 to July 2013 ****Period coverage is from August, 2013 to October, 2014 Statistical analysis of the overall MDRO admission screening compliance rate before and after the interventions showed a significant difference (P < 0.05) in the compliance rate in both departments. A two-sample T-test with unequal variance was utilized in the statistical analysis given the variability in the screening rate and count. Table 3 provides a summary of the statistical testing done. The last column shows that there is a significant difference in the compliance rate in the surgical department (P < 0.009) and the care of older people department (P < 0.00003) Table 3.Descriptive summary of statistical testing of the MDRO admission screen compliance rate before and after the interventions Departments Before After T-Test (P < 0.05) Number of Audits Mean Compliance Rate Number of Audits Mean Compliance Rate Surgical Department 22 75.91 24 85.75 0.009324379 Care of Older People 31 83.84 15 96.80 0.000036141 Conclusion: The multi-modal interventions addressed to nurses had a significant impact on the MDRO admission screening compliance rate in various departments of a tertiary public hospital. While various factors may affect the staff MDRO admission screening compliance rate, the rate could be kept at a high level through regular audits, regular reporting of audit result, regular education sessions and consistent staff encouragement.

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  • BRIEF COMMUNICATION: The current state of the New Zealand goat industry

    Carr, AJ; schreurs, N; Lopez-Villalobos; thomas, D

    Conference paper
    Massey University

    Goat farming in New Zealand has a lower profile compared to dairy, sheep and beef systems. The goat industry is small in New Zealand (Stafford & Prosser, 2016) and there has been limited consideration of the potential for the industry to expand (Shepard & O’Donnell, 1979). The environmental and commodity market constraints currently impacting pastoral systems in New Zealand provide an opportunity for the goat industry to have a greater economic contribution to New Zealand’s agricultural production. In New Zealand, goats are farmed for milk, meat and fibre production and also act as a mechanism for controlling excess pasture growth, enhancing clover in mixed pasture and controlling weeds (Batten, 2014). The aim of this paper was to present an overview of the goat industry to provide background knowledge for consideration when deciding the direction of the goat industries in New Zealand. As part of the overview, farmers, processors and industry bodies were contacted to obtain an estimate of the number and location of goats farmed in New Zealand. Although some of the sources of information for the goat industry are not perfect, this research is an attempt to bring together information that has not been consolidated in nearly 40 years (Shepard & O’Donnell, 1979) and was achieved as part of a three-part study with companion papers being produced (Lopez-Lozano et al. 2017; Smith et al. 2017). Information from this study were used in conjunction with the value of the goat industry (Lopez-Lozano et al. 2017) to project the potential of the New Zealand goat industry (Smith et al. 2017).

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  • UK Degree Apprenticeships a Year in Review – A focus on the digital & technology solutions professional degree apprenticeship at Manchester Metropolitan University.

    Goodyer, JE

    Report
    Massey University

    false

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  • Nitrogen decisions for cereal crops: a risky and personal business, 2016 International Nitrogen Initiative Conference

    Farquharson, R; Chen, D; Yong, L; Liu, D; Ramilan, T

    Conference paper
    Massey University

    Cereal crops principally require Nitrogen (N) and water for growth. Fertiliser economics are important because of the cost at sowing with expectation of a financial return after harvest. The production economics framework can be used to develop information for ‘best’ fertiliser decisions. But the variability of yield responses for rainfed production systems means that fertiliser decisions are a risky business. How do farmers make such decisions, and can economics give any guidance? Simulated wheat yield responses to N fertiliser applications show tremendous variation between years or seasons. There are strong agronomic arguments for a Mitscherlich equation to represent yield responses. Plots of the 10th, 50th and 90th percentiles of yield response distributions show likely outcomes in ‘Poor’, ‘Medium’ and ‘Good’ seasons at four Australian locations. By adding the prices for Urea and wheat we predict that the ‘best’ decisions vary with location, soil, and (sometimes) season. We compare these predictions with typical grower fertiliser decisions. Australian wheat growers understand the yield responses in their own paddocks and the relative prices, so they are making relevant short-term fertiliser decisions. These are subjective or personal decisions. Myanmar smallholders grow rice and maize in the Central Dry Zone, with relatively low levels of fertiliser and low crop yields. They have pre-existing poverty, high borrowing costs and are averse to risky outcomes. A Marginal Rate of Return (MRR) analysis with a hurdle rate of 100% is illustrated for the Australian locations, and this approach will be tested in Myanmar.

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  • Ionically cross-linked alginate hydrogels as drug delivery systems for analgesics in broiler chickens : thesis presented in partial fulfilment of the requirement for the degree of Masters of Science in Chemistry at Massey University, Palmerston North, Manawatu, New Zealand

    Booty, Samuel James

    Thesis
    Massey University

    Treating birds with analgesic drugs requires continuous injections of near lethal concentrations to maintain the therapeutic dose in the blood plasma. This is due to birds having higher metabolic rates than mammals. Therefore, there is a need to develop drug delivery systems that can control and slow down the release of analgesics in birds. This study was designed to analyse the sustained release of the model analgesics, sodium salicylate and sodium aspirin, from ionically cross-linked alginate hydrogels, in in vitro and in vivo experiments using broiler chickens as the model bird. Analgesic loaded hydrogels separated into two layers, unlike the homogeneous blank hydrogels. This was labelled as the separation effect. Swelling studies indicated the absence of the insoluble cross-linked alginate material in the hydrogels where the separation effect occurred, with most of the hydrogels dissolving back into the medium. The highest equilibrium swelling percentage achieved in the loaded hydrogels was 68 %. In comparison, the highest equilibrium swelling percentage in the blank hydrogels was 622 %. In vitro drug release profiles showed that the hydrogels released up to 100% of the sodium salicylate within 3.33 hours. In contrast, the hydrogels containing sodium aspirin released only 35 % of the encapsulated drug. Hydrogels containing a drug concentration of 150 mg/mL were injected into the model birds at a dose rate of 150 mg/Kg. No chicken reacted negatively to the hydrogel injection. In vivo results indicate sustained release of the model analgesic from the hydrogels compared to the release from the aqueous solutions of the drug. The effective concentration for an analgesic effect of sodium salicylate was maintained by the group injected with an aqueous solution of sodium salicylate 18 hours after the injection. The groups injected with the hydrogel with the maximum calcium chloride content saw the largest sustained release, with the plasma concentration of sodium salicylate remaining over the effective concentration for up to 36 hours after the injection. Keywords: Sodium salicylate, sodium aspirin, hydrogel, analgesia, sustained release, broiler chicken.

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  • Patronage, photography and politics: The influence of Archduchess Isabella on design transformation of an aesthetic

    Heffernan, S

    Conference paper
    Massey University

    Aristocratic woman played an important role disseminating design, notably, Archduchess Isabella in the Austro-Hungarian Empire. Her influence on aesthetics and production of peasant inspired design was considerable at the turn of the nineteenth century. A member of the wealthiest branch of the Habsburg family, she lived on vast modern, well equipped, mechanised estates in Hungary. Significantly, the brightly coloured costumes of the BÈllye estate's Sok·c Slav immigrants from the south attracted her attention. She developed social and economic concerns for aspects of peasant life. She was ambitious, had a feel for politics and worked to provide opportunities for rural women to gain income. She promoted education and embroidery training initiatives that drew support of the Austro-Hungarian government. Another motivating factor was the impact of the Austro-Hungarian exhibition embroideries in a special pavilion at the Paris Women's Arts Handicrafts Exhibition in 1892. The same year Home Industries were established for women to learn embroidery and sell designs both at home and abroad. Isabella and her family wore CÌfer Home Industry designs and as a skillful photographer she promoted the CÌfer school in the Sunday Journal in 1898. Later, in 1902 Norman and Stacey's Tottenham Court Road Emporium sold Home Industry dress. This paper highlights Isabella's influence on peasant inspired dress including rare unpublished and published photographs to reveal her political influence on dress aesthetics, production, materials and use.

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  • Smoothing the path to transition

    Emerson, L; Kilpin, K; Feekery, AJ

    Report
    Massey University

    This report is the key project output from a two-year, $200,000 TLRI-funded PAR research project centred on exploring the perceived academic literacy gap in the transition from secondary to tertiary learning contexts. The research adopted an academic literacy pedagogy to connect writing and critical thinking with disciplinary knowledge development, rather than a writing skills pedagogy often adopted in academic preparation courses and learning support centres, which tends to focus on structural element of writing. The project sought to understand the academic learning demands and teaching practices in Year 13 and first year university courses, and, through the recognition of key elements of difference in approaches to teaching academic literacy, develop ways to bridge the expectation gap, thereby smoothing the transition into tertiary learning demands. Key interventions were developed to familiarise secondary teachers and students to tertiary learning demands and expectations via university visits and collaborative exploration of academic literacy and IL opportunities inherent in NCEA unit standards and assessments. The research identified key pressures on secondary teachers, particularly the perceived accountability pressure of NCEA achievement, and a lack of strategic instruction centred on academic literacy, and particularly IL, which emerged as a key element for further investigation in secondary schools. The TLRI fund is a highly contested research fund, with an emphasis on partnerships between teachers and researchers to improve educational outcomes for learners.

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  • Measuring bacterial denitrifier genes distributions and abundances in New Zealand dairy-grazed pasture soils.

    Jha, N; Deslippe, J; Saggar, S; Tillman, R; Giltrap, D

    Conference paper
    Massey University

    false

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  • High resolution monitoring of nitrate in agricultural catchments – a case study on the Manawatu River, New Zealand

    Burkitt, LL; Jordan, P; Singh, R; Elwan, A

    Report
    Massey University

    false

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  • Protecting Civilians in an Urban Conflict Lessons Learned from Australia’s Deployment Following the Timor Leste Crisis 2006-2007

    Powles, AR; Cox, B

    Report
    Massey University

    The protection of civilians in urban conflict environments is a dynamic of contemporary peacekeeping operations which has received far less attention than it deserves. Urban zones are fast becoming the new territories of conflict and violence and this, what has been termed, the “new military urbanism”, is recognised within contemporary military doctrine1 as a defining feature of modern warfare and armed conflict. However, inadequate consideration of the implications of urban epicentres of conflict on the protection of civilians has been given in the context of peacekeeping operations. The specific characteristics and dynamics of violence generated by an urban environment create unique challenges for the protection of civilians and have considerable implications for how peacekeepers implement protection of civilian mandates.

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  • Counting the spanning trees of the 3-cube using edge slides

    Tuffley, CP

    Journal article
    Massey University

    We give a direct combinatorial proof of the known fact that the 3-cube has 384 spanning trees, using an "edge slide" operation on spanning trees. This gives an answer in the case n=3 to a question implicitly raised by Stanley. Our argument gives a bijective proof of the n=3 case of a weighted count of the spanning trees of the n-cube due to Martin and Reiner.

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  • Analysing historical trends in breast cancer biomarker expression: a feasibility study (1947-2009).

    Krieger, N; Habel, L; Waterman, PD; Shabani, M; Ellison-Loschmann, L; Achacosa, NS; Acton, L; Schnitt, SJ

    Journal article
    Massey University

    false

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  • Towards a comprehensive global approach to prevention and control of NCDs

    McKee, M; Haines, A; Ebrahim, S; Lamptey, P; Barreto, ML; Matheson, D; Walls, HL; Foliaki, S; Jaime Miranda, J; Chimeddamba, O; Garcia-Marcos, L; Vineis, P; Pearce, N

    Journal article
    Massey University

    Published

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  • Objective Measures for the Assessment of Post-Operative Pain in Bos indicus Bull Calves Following Castration

    Musk, GC; Jacobsen, S; Hyndman, TH; Lehmann, HS; Tuke, SJ; Collins, T; Gleerup, KB; Johnson, CB; Laurence, M

    Journal article
    Massey University

    false

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  • Comparative PIV and LDA studies of Newtonian and non-Newtonian flows in an agitated tank

    Story, A; Jaworski, Z; Simons, MJH; Nowak, E

    Journal article
    Massey University

    false

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  • Identification of genes and genomic islands correlated with high pathogenicity in Streptococcus suis using whole genome tiling microarrays

    ZHANG, JI

    Journal article
    Massey University

    false

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  • Factors Influencing the Dairy Trade from New Zealand

    Shadbolt, NM; Apparao, D

    Journal article
    Massey University

    false

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  • Female song occurs in songbirds with more elaborate female coloration and reduced sexual dichromatism

    Webb, W; Brunton, DH; Aguirre, JDAVID; Thomas, D; Valcu, M; Dale, J

    Journal article
    Massey University

    Elaborate plumages and songs in male birds provide classic evidence for Darwinian sexual selection. However, trait elaboration in birds is not gender-restricted: female song has recently been revealed as a taxonomically-widespread trait within the songbirds (oscine Passerines), prompting increased research into likely functions and social/ecological correlates. Here we use phylogenetically-informed comparative analysis to test for an evolutionary association between female song and plumage color elaboration in songbirds. If there is an evolutionary trade-off between signaling modes, we predict a negative correlation between acoustic and visual elaboration. This trade-off hypothesis has been commonly proposed in males but has mixed empirical support. Alternatively, if song and plumage have similar or overlapping functions and evolve under similar selection pressures, we predict a positive correlation between female song and female plumage elaboration. We use published data on female song for 1023 species of songbirds and a novel approach that allows for the reliable and objective comparison of color elaboration between species and genders. Our results reveal a significant positive correlation between female colorfulness and female song presence. In species where females sing, females (but not males) are on average more colorful—with concomitantly reduced average sexual dichromatism. These results suggest that female plumage and female song likely evolved together under similar selection pressures and that their respective functions are reinforcing. We discuss the potential roles of sexual vs. social selection in driving this relationship, and the implications for future research on female signals.

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  • Complete Genome Sequences of Cluster A Mycobacteriophages BobSwaget, Fred313, KADY, Lokk, MyraDee, Stagni, and StepMih

    Hendrickson, HL; Silander, OK; Freed, N; Kagey, J

    Journal article
    Massey University

    false

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