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Articles by K. Wells
Total Records ( 2 ) for K. Wells
  M Schoenbaum , B Butler , S Kataoka , G Norquist , B Springgate , G Sullivan , N Duan , R. C Kessler and K. Wells
 

Context  Concerns about mental health recovery persist after the 2005 Gulf storms. We propose a recovery model and estimate costs and outcomes.

Objective  To estimate the costs and outcomes of enhanced mental health response to large-scale disasters using the 2005 Gulf storms as a case study.

Design  Decision analysis using state-transition Markov models for 6-month periods from 7 to 30 months after disasters. Simulated movements between health states were based on probabilities drawn from the clinical literature and expert input.

Setting  A total of 117 counties/parishes across Louisiana, Mississippi, Alabama, and Texas that the Federal Emergency Management Agency designated as eligible for individual relief following hurricanes Katrina and Rita.

Participants  Hypothetical cohort, based on the size and characteristics of the population affected by the Gulf storms.

Intervention  Enhanced mental health care consisting of evidence-based screening, assessment, treatment, and care coordination.

Main Outcome Measures  Morbidity in 6-month episodes of mild/moderate or severe mental health problems through 30 months after the disasters; units of service (eg, office visits, prescriptions, hospital nights); intervention costs; and use of human resources.

Results  Full implementation would cost $1133 per capita, or more than $12.5 billion for the affected population, and yield 94.8% to 96.1% recovered by 30 months, but exceed available provider capacity. Partial implementation would lower costs and recovery proportionately.

Conclusions  Evidence-based mental health response is feasible, but requires targeted resources, increased provider capacity, and advanced planning.

  A Cockburn , A. H Dalziell , C. J Blackmore , M. C Double , H Kokko , H. L Osmond , N. R Beck , M. L Head and K. Wells
 

Female superb fairy-wrens Malurus cyaneus initiate extragroup fertilizations by forays to the territory of preferred males, just before sunrise, 2–4 days before egg laying. Over a prolonged breeding season, males advertise their availability to foraying females by singing during the dawn chorus. Here, we show that 1) males commence dawn advertisement at the same time of the year regardless of their quality or status; 2) subordinate males advertise by singing in close proximity to the dominant, or by using the dominant's song perch, despite inevitable punishment; 3) low-quality dominants and their helpers sing from the boundary of their own territory, which increases their proximity to attractive neighboring dominants; 4) each spatial cluster of males use a common dialect of a song that is implicated in extragroup choice, despite the ability of individual males to sing several dialects; and 5) there is leakage of paternity to lower-quality helpers and neighbors as a result of their "satellite" behavior. Collectively, these data suggest that Wagner's hidden lek hypothesis (Wagner RA, 1998. Hidden leks: sexual selection and the clustering of avian territories. In: Parker PG, Burley NT, editors. Avian reproductive tactics: female and male perspectives. Ornithological Monographs No. 49. Allen Press. p. 123–145) can be extended to birds that defend year-round all-purpose territories and that mating induced by parasitic behavior of low-quality satellites can be one explanation for polyandry in birds.

 
 
 
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