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Play, games and sport are a part of the content of physical education (PE), and has been the subject of a longstanding debate among educators internationally and in Scandinavian countries. Play refers to something unstructured and free, while sport is a controlled and managed activity. Drawing on Skovbjerg`s (2021) play theory, this article explores how PE teachers in Norwegian secondary schools structure play as part of their teaching and curriculum. Through class observations and teacher interviews, this study analyzes how teachers use play-based formulas and rules that are similar to games and sports activities in PE classes. Results show that although teachers value play as part of PE, they struggle with building assessment into play-based formulas and breaking free from the structure of sports in PE. These findings inform our discussion on play in PE and how play-based formulas and rules can be integrated with assessment and learning outcomes within a competence-based curriculum.

Abstract Background Accurate assessment of fluid volume and hydration status is essential in many disease states, including patients with chronic kidney disease. The aim of this study was to investigate the ability of a wearable continuous bioimpedance sensor to detect changes in fluid volume in patients undergoing regular hemodialysis (HD). Methods 31 patients with end-stage renal disease were enrolled and monitored with a sensor patch (Re:Balans®) on the upper back through two consecutive HD sessions and the interdialytic period between. The extracellular resistance RE was calculated from multi-frequency bioimpedance measurements and was hypothesized to correlate with the amount of extracted fluid during dialysis. Results Only HD sessions with a positive net fluid extraction were included in the primary analysis. Participants had an increase of 7.5 ± 4.3 Ω (Ohm) in RE during the first HD and 6.2 ± 2.3 Ω during the second HD, and a fluid extraction (ultrafiltration (UF) volume) of 1.5 ± 0.8 L and 1.2 ± 0.6 L, respectively. The relative change in RE during HD correlated strongly with UF volume (r = 0.82, p

Abstract There is a growing interest in using fecal mRNA transcripts as biomarkers for non-invasive detection of colorectal cancer (CRC). The following study compares different RNA extraction and reverse transcription PCR (RT-PCR) methods for mRNA detection in stool and identifies a robust and sensitive protocol. A combination of the Stool total RNA purification kit (Norgen) and the Superscript III one-step RT-PCR kit (Invitrogen) provided high RNA purity and sensitive and consistent mRNA detection, making them well-suited candidates for large-scale studies. We tested the protocol by detecting the mRNA of several immune genes (CXCL1, IL8, IL1B, IL6, PTGS2, and SPP1) in 22 CRCs, 24 adenomatous polyps, and 22 control stool samples. All these inflammatory markers, except for CXCL1, showed a strong association with CRC. Cancer stool samples showed increased levels of IL1B, IL8, and PTGS2 transcripts compared to polyp and control groups. Thus, this work supports the potential use of fecal mRNA as biomarkers for CRC detection.

Coastal aquaculture and local fisheries interact in shared marine environments, influencing each other synergistically and/or antagonistically. Salmon farming, notably with open-net sea cages along the Norwegian coast, attracts wild fish due to increased food availability from uneaten feed, but it also exposes wild fish to farm emissions like waste and toxic chemicals (de-lice treatments, antifouling and medical agents). The attraction behaviour of wild fish can impact fatty acid composition in fish tissues, influenced by the high terrestrial fat content in salmon aquafeed. We study how the Atlantic cod, aggregating around salmon farms in a subarctic fjord in Northern Norway, can be affected, potentially altering their natural diet and fatty acid profiles. Our study compares the muscle-tissue fatty acid compositions of cod caught near aquaculture facilities (impact) versus fish caught in neighbouring fjords (control), and we hypothesise decreased omega-3 fatty acids near farms. The analysis revealed no significant differences in the fatty acid concentrations or categories between the impacted and control fish, challenging our initial expectations. However, differences were found for C18:1(n9)t (elaidic acid), with a higher value in the impacted fish. These findings suggest that salmon farming’s influence on cod’s fatty acid profiles in the flesh (i.e., relevant for the nutritional quality of the fillets that consumers eat) may be limited or minimal despite their aggregative behaviours around farms. The threshold levels of salmon feed consumed by wild cod before it affects the quality and survival of, e.g., sperm or other life stages, are not known and require new investigations. This study underscores the complexity of interactions between aquaculture and wild fisheries, impacting both ecological dynamics and consumer perspectives on seafood quality and health benefits.

Objective: Our primary objectives are to assess whether intraarticular corticosteroid injections are superior to saline injections with regards to thumb base pain after 4 weeks, and to compare the efficacy of steroid injections, saline injections, and an occupational therapy intervention on thumb base pain after 12 weeks in people with painful inflammatory osteoarthritis (OA) of the first carpometacarpal (CMC-1) joint. Design: In this three-armed, double-blind, randomized multicenter trial, 354 participants with painful inflammatory CMC-1 OA from six Norwegian hospitals are recruited. Participants are randomized 1:1:1 to intraarticular steroid or saline injections in the CMC-1 joint or a multimodal occupational therapy intervention. The primary outcomes are thumb base pain measured on a numeric rating scale (NRS, range: 0–10) after 4 weeks and 12 weeks. Key secondary outcomes include synovitis by Magnetic Resonance Imaging (MRI) after 4 weeks and hand function by the Measure of Activity Performance of the Hand (MAP-Hand) questionnaire after 12 and 24 weeks. Other secondary outcomes are synovitis by clinical examination and ultrasound, measures of pain, function, stiffness, and health-related quality of life, and direct and indirect costs. Adverse events are recorded at each visit. The duration of the randomized controlled trial is 24 weeks, followed by an 80-week open-label observational phase to investigate the long-term efficacy and safety of repeated steroid injections and the occupational therapy intervention. Conclusions: The results from this trial will have important clinical implications and influence future guidelines on OA management of the CMC-1 joint. Clinical trial registration: EU-CT 2023-505254-17-00, NCT06084364.

IntroductionThe number of elite female athletes combining athletic careers with mothering has increased during the last decades. Many mother-athletes return to an equal or an even better level of performance postpartum. Despite numerous success stories across a variety of sports, there are currently no mother-athletes in Swedish elite ice hockey. Therefore, the aim of this study was to explore how Swedish elite female ice hockey players perceive challenges associated with initiating and maintaining the mother-athlete role.MethodsQualitative data were collected through semi-structured interviews with 7 elite female ice hockey players (5 prepregnancy and 2 mothers/former athletes) and analyzed using thematic analysis.ResultsThematic analysis revealed three main challenges facing elite female ice hockey players: (a) Making ends meet, (b) A leap in the dark and (c) You can't be what you can't see. Due to these challenges, the participants perceived combining elite ice hockey and mothering as unrealistic. Consequently, they felt forced to either retire from elite sports early or postpone mothering to post career.DiscussionContinued work with improving the financial support and developing clear maternity policies is essential to prevent early dropouts before elite female ice hockey players have reached peak performance. Enabling more players to prolong their athletic careers during pregnancy and postpartum will likely produce more positive mother-athlete role models. Further, keeping more players in the sport for a longer period could help women's ice hockey to develop to its highest optimal quality (e.g., level and competition).

The slow-fast continuum is a commonly used framework to describe variation in life-history strategies across species. Individual life histories have also been assumed to follow a similar pattern, especially in the pace-of-life syndrome literature. However, whether a slow-fast continuum commonly explains life-history variation among individuals within a population remains unclear. Here, we formally tested for the presence of a slow-fast continuum of life histories both within populations and across species using detailed long-term individual-based demographic data for 17 bird and mammal species with markedly different life histories. We estimated adult lifespan, age at first reproduction, annual breeding frequency, and annual fecundity, and identified the main axes of life-history variation using principal component analyses. Across species, we retrieved the slow-fast continuum as the main axis of life-history variation. However, within populations, the patterns of individual life-history variation did not align with a slow-fast continuum in any species. Thus, a continuum ranking individuals from slow to fast living is unlikely to shape individual differences in life histories within populations. Rather, individual life-history variation is likely idiosyncratic across species, potentially because of processes such as stochasticity, density dependence, and individual differences in resource acquisition that affect species differently and generate non-generalizable patterns across species.

An immunosuppressive tumor microenvironment promotes tumor growth and is one of the main factors limiting the response to cancer immunotherapy. We have previously reported that inhibition of vacuolar protein sorting 34 (VPS34), a crucial lipid kinase in the autophagy/endosomal trafficking pathway, decreases tumor growth in several cancer models, increases infiltration of immune cells and sensitizes tumors to anti‐programmed cell death protein 1/programmed cell death 1 ligand 1 therapy by upregulation of C‐C motif chemokine 5 (CCL5) and C‐X‐C motif chemokine 10 (CXCL10) chemokines. The purpose of this study was to investigate the signaling mechanism leading to the VPS34‐dependent chemokine increase. NanoString gene expression analysis was applied to tumors from mice treated with the VPS34 inhibitor SB02024 to identify key pathways involved in the anti‐tumor response. We showed that VPS34 inhibitors increased the secretion of T‐cell‐recruitment chemokines in a cyclic GMP‐AMP synthase (cGAS)/stimulator of interferon genes protein (STING)‐dependent manner in cancer cells. Both pharmacological and small interfering RNA (siRNA)‐mediated VPS34 inhibition increased cGAS/STING‐mediated expression and secretion of CCL5 and CXCL10. The combination of VPS34 inhibitor and STING agonist further induced cytokine release in both human and murine cancer cells as well as monocytic or dendritic innate immune cells. Finally, the VPS34 inhibitor SB02024 sensitized B16‐F10 tumor‐bearing mice to STING agonist treatment and significantly improved mice survival. These results show that VPS34 inhibition augments the cGAS/STING pathway, leading to greater tumor control through immune‐mediated mechanisms. We propose that pharmacological VPS34 inhibition may synergize with emerging therapies targeting the cGAS/STING pathway.

This article discusses the potentials of a/r/tography aka artography against the background of life in an accelerating academia that is increasingly shallow and unfulfilling, and where quality is only indirectly measured using bibliometrics. We find Hartmut Rosa’s concept of resonance to be useful when discussing the values that get lost in such a system. We appreciate the arguments for a slower, deeper, and more collegial way of working. It is where the distractions of ordinary life intersect with the vision of a more profound, qualitative way of working that we make our arguments for an artographic way of being. However, we also identify challenges by drawing on experiences in our own working lives, and specifically our ongoing collaborative research project. Exploring options for navigating around the constraints, we suggest a ‘toolbox’ for how the individual artographer can contribute to making academia a more resonant space. Photo: Markus Tullberg

Introduction and methodsThis study aimed to investigate the motivational processes behind self-regulated learning and performance among 192 soccer players (82 girls) for three age groups (14–16 years old) eligible for the Norwegian national football team. A conditional process model was proposed and tested with achievement goals as mediators between achievement motives on the one hand and coach-reported performance and self-regulated learning on the other hand. The probability of success was examined as a potential moderator in the motivational process.ResultsAs predicted, motives to achieve success directly influenced planning and reflection/evaluation, whereas the influence of the success motive on regulation of effort was explained partly by task- and self-based approach goals. The motive to achieve success was, however, particularly crucial for maintaining these beneficial regulatory processes when the probability of success was found to be from moderate to low. Concerning the avoidance paths, the data supported only some of our original hypotheses. The motive to avoid failure predicted all three types of avoidance-based (task, self, and other) and other-based approach goals but did not contribute to explaining planning, reflection/evaluation, regulation of effort, or performance. There were no significant correlations between motivation variables and coach-reported performance. Moreover, girls were more motivated to avoid failure than boys, while both sexes achieved similar scores for football-specific self-regulated learning, probability of success, achievement goals, and motive to achieve success.DiscussionThe results are discussed considering a hierarchical motivation model.

ObjectiveClear connections have been found between mental processes and performance in elite level football. Yet, few studies have investigated how professional football players’ experience the influence of mental processes on performance.MethodThis study used a qualitative research design and in-depth interview of six Norwegian professional football players at elite level with a mean age of 28, 3 years and represented five professional clubs. The aim of the study was to investigate how they perceived the importance of arousal regulation, mental toughness, and self-confidence, and that of the sport psychologist in developing these skills.ResultsThe results revealed a complex and multifaceted link between mental processes and performance. All players, demonstrate a conscious awareness of how mental processes influence their performance. The use of a sport psychologist in working with mental processes emerges as a crucial factor for developing their mental skills. Another important aspect is the need for increased knowledge about mental training’s effect in elite football. Mental toughness emerges as the most significant mental process for players’ performance because it makes them capable of coping with challenging situations and periods.ConclusionThis study shows that mental processes are important for performing, both related to arousal regulation, and self-confidence, and especially mental toughness. However, mental toughness was also considered a product of age and experience, where older players tend to have experience of more situations that enable them to handle adversity better than younger players. Interestingly, the youngest players seem to be most aware of the use of a sports psychologist.

IntroductionWith the continuous growth of Atlantic salmon (Salmo salar L.) aquaculture, appropriate management of nutrient-rich waste streams from both land- and sea-based production has become increasingly important. Following a circular approach, nutrients contained in aquaculture sludge can be utilized for biomass production of the polychaete Hediste diversicolor. While the potential for upcycling nutrients has been established previously, this study aimed to assess nutrient flows in H. diversicolor fed aquaculture sludge as understanding these will be crucial for optimizing future large-scale production of this species.Materials and methodsWe investigated the effect of low and high feed supply of smolt sludge on the nutrient flows of carbon (C), nitrogen (N), and phosphorus (P) in H. diversicolor on an individual level. Hereby we assessed ingestion, defecation, excretion, respiration, and uptake for growth.Results and discussionNutrient flows differed between the nutrients C, N, and P in the high feed supply group where C uptake for growth was significantly higher than N and P uptake, and N uptake was significantly higher than P uptake. In contrast, no significant differences were observed in the low feed supply group. In the high feed supply group, most of the ingested C, N, and P by H. diversicolor was allocated to uptake for growth (76% C, 83% N, 85% P) with smaller proportions allocated to defecation (7% C, 7% N, 11% P) and respiration/excretion (18% C, 9% N, 5% P). The results from the low feed supply group suggest insufficient nutrient supply as most ingested C was allocated to respiration (84%), while most N was expended on uptake for growth (45%), and ingested P was either taken up for growth (58%) or spent on defecation (34%). Overall, nutrient uptake reflected the smolt sludge composition rather than nutrient requirements for H. diversicolor, which may be a short-term effect and needs to be investigated further. The flow of nutrients was strongly affected by feed supply, as ingestion, defecation, excretion, and uptake for growth were significantly higher in the high feed supply group than in the low feed supply group.

Student teachers have been found to be critical toward the research approaches they learned from their master's-based teacher education programmes. Our aim is to discuss how certain research approaches learnt during a 5-year academic master's level teacher education, may bring student teachers close to practice and provide them with conceptual and practical tools for a thorough understanding of the practice of teaching. The argumentation is based on an elaboration of master's-based teacher education programs in Finland and Norway and the essential characteristics of teachers' work. We elaborate on student teachers' need to understand constative, critical and constructive research approaches. This includes critical approaches such as observations and interviews for understanding and interpretation, and constructive approaches such as action research and lesson studies. Finally, we argue that, through these approaches, student teachers make use of research knowledge in teachers' work with an inquiring orientation as well as develop and change their practice.

BackgroundIn the last decade, a growing body of research has focused on the many aspects and challenges of combining parenthood with elite sport. Although the number of father-athletes is significantly higher than the number of mother-athletes, few studies to date have focused on male athletes’ experiences in a parenting context.AimThe aims of the present study were to explore how father-athlete challenges manifest among elite Nordic skiers in Norway, and to better understand how male athletes balance their priorities as they initiate, maintain, and/or discontinue their athletic career as a father-athlete.MethodsQualitative data were collected through semi-structured interviews with 10 world-class male Nordic skiers in Norway (3 athletes without a child, 4 current father-athletes and 3 former father-athletes) and the content was analyzed using thematic analysis.ResultsFour main stages were identified in the father-athlete transition: (a) Expecting incompatibility (b) Taking the step, (c), The first blow, and (d) Finding the optimal balance. Through these stages the informants expected/had experienced challenges such as performance decline, disturbed sleeping patterns, fear of sickness and role conflicts. To manage these challenges, the father-athletes had developed various strategies to balance their dual roles (e.g., adapting training and competition seasons). Among the benefits, the father-athletes mentioned that they had become more structured, time efficient and ruthless with their priorities, enhanced motivation to train and a better work-life balance.ConclusionThis study offers valuable insights into father-athlete challenges that can be used to support career longevity and work-life balance among male athletes.

Becoming a parent is a vulnerable life transition and may affect parents’ mental health. Depressive symptoms may occur in fathers, as well as mothers, during pregnancy and the postpartum period. The health service is expected to have a family perspective, aiming to support both parents. Despite this goal, mothers traditionally receive more support than fathers. Home visiting programs may provide enhanced guidance for new fathers and increased mental health support. The aim of this study was therefore to assess possible differences in level of depressive symptom in fathers receiving the New Families home visiting program compared with those receiving standard care from the Norwegian Child Health Service. A prospective nonrandomized controlled study with a parallel group design was performed. The Edinburg Postnatal Depression Scale (EPDS) was used to measure depressive symptoms in fathers ( N = 197) at 28 weeks of their partners’ pregnancy (T1), at 6 weeks (T2), and 3 months postpartum (T3), in the intervention and the control group. The results indicate a prevalence of depressive symptoms (EPDS score ≥ 10) in Norwegian fathers of 3.1% at T1, 3.9% at T2, and 2.2% at T3 for the full sample. No significant EPDS score differences were found between the intervention and the control group at six weeks and three months postpartum. This suggests that the intervention had no clear impact on depressive symptoms during this time-period.

Temporal correlations among demographic parameters can strongly influence population dynamics. Our empirical knowledge, however, is very limited regarding the direction and the magnitude of these correlations and how they vary among demographic parameters and species' life histories. Here, we use long-term demographic data from 15 bird and mammal species with contrasting pace of life to quantify correlation patterns among five key demographic parameters: juvenile and adult survival, reproductive probability, reproductive success and productivity. Correlations among demographic parameters were ubiquitous, more frequently positive than negative, but strongly differed across species. Correlations did not markedly change along the slow-fast continuum of life histories, suggesting that they were more strongly driven by ecological than evolutionary factors. As positive temporal demographic correlations decrease the mean of the long-run population growth rate, the common practice of ignoring temporal correlations in population models could lead to the underestimation of extinction risks in most species.

Abstract Background The transition to motherhood is characterized by physical, psychological, social, and relational changes. Quality of life (QoL) changes substantially during this transition. Higher QoL is associated with social support, essential for coping with the challenges and changes of becoming a mother. An early universal home visiting program (New Families) is developed to strengthen and support families. The study aims to evaluate the impact of New Families on first-time mothers’ QoL and to investigate the association between their QoL, social support, and selected possible predictive factors. Methods A prospective non-randomized controlled study with parallel group design. Child Health Services in five city districts of Oslo were matched in intervention and control groups. First-time mothers were allocated based on the residential area and assessed at pregnancy week 28 (N = 228), six weeks postpartum (N = 184), and three months postpartum (N = 167). Measures of the World Health Organization Quality of Life brief, Perinatal Infant Care Social Support Scale, and background variables were collected from October 2018 to June 2020. Multivariate linear regression models were applied to examine intervention impact and assess associations. Results Our data did not reveal a significant association between New Families intervention and the QoL levels of first-time mothers at three months postpartum. Thus, we analyzed the whole sample together. Emotional support was significantly associated with higher QoL levels in the physical health (B = 0.19, 95%CI [0.04 to 0.34]) and social relationships (B = 0.40, 95%CI [0.20 to 0.60]) domains. Appraisal support was significantly associated with higher QoL levels in the psychological (B = 0.34, 95%CI [0.18 to 0.50]) and environment (B = 0.33, 95%CI [0.19 to 0.48]) domains. QoL levels in pregnancy were significantly associated with QoL levels postpartum, showing small to medium effect size (ES = 0.30 to 0.55), depending on the domain. Conclusions Further research, including qualitative interviews, could provide more insights into the impact of New Families on QoL. A positive association between QoL levels in pregnancy and postpartum suggests that postnatal interventions targeting improved QoL could potentially improve postpartum QoL. Emotional and appraisal support seems beneficial for first-time mothers’ QoL and could be provided and facilitated by public health nurses. Trial registration clinicaltrial.gov NCT04162626.

Abstract There is substantial cognitive heterogeneity among patients with schizophrenia (SZ) and bipolar disorders (BD). More knowledge about the magnitude and clinical correlates of performance variability could improve our understanding of cognitive impairments. Using double generalized linear models (DGLMs) we investigated cognitive mean and variability differences between patients with SZ (n = 905) and BD spectrum disorders (n = 522), and healthy controls (HC, n = 1170) on twenty-two variables. The analysis revealed significant case-control differences on 90% of the variables. Compared to HC, patients showed larger intra-individual (within subject) variability across tests and larger inter-individual (between subject) variability in measures of fine-motor speed, mental processing speed, and inhibitory control (SZ and BD), and in verbal learning and memory and intellectual functioning (SZ). In SZ, we found that lager intra -and inter (on inhibitory control and speed functions) individual variability, was associated with lower functioning and more negative symptoms. Inter-individual variability on single measures of memory and intellectual function was additionally associated with disorganized and positive symptoms, and use of antidepressants. In BD, there were no within-subject associations with symptom severity. However, greater inter-individual variability (primarily on inhibitory control and speeded functions) was associated with lower functioning, more negative -and disorganized symptoms, earlier age at onset, longer duration of illness, and increased medication use. These results highlight larger individual differences in patients compared to controls on various cognitive domains. Further investigations of the causes and correlates of individual differences in cognitive function are warranted.

BackgroundColorectal cancer (CRC) is a significant health issue, with notable incidence rates in Norway. The immune response plays a dual role in CRC, offering both protective effects and promoting tumor growth. This research aims to provide a detailed screening of immune-related genes and identify specific genes in CRC and adenomatous polyps within the Norwegian population, potentially serving as detection biomarkers.MethodsThe study involved 69 patients (228 biopsies) undergoing colonoscopy, divided into CRC, adenomatous polyps, and control groups. We examined the expression of 579 immune genes through nCounter analysis emphasizing differential expression in tumor versus adjacent non-tumorous tissue and performed quantitative reverse transcription polymerase chain reaction (RT-qPCR) across patient categories.ResultsKey findings include the elevated expression of CXCL1, CXCL2, IL1B, IL6, CXCL8 (IL8), PTGS2, and SPP1 in CRC tissues. Additionally, CXCL1, CXCL2, IL6, CXCL8, and PTGS2 showed significant expression changes in adenomatous polyps, suggesting their early involvement in carcinogenesis.ConclusionsThis study uncovers a distinctive immunological signature in colorectal neoplasia among Norwegians, highlighting CXCL1, CXCL2, IL1B, IL6, CXCL8, PTGS2, and SPP1 as potential CRC biomarkers. These findings warrant further research to confirm their role and explore their utility in non-invasive screening strategies.

Abstract The house sparrow (Passer domesticus) is a small passerine known to be highly sedentary. Throughout a 30‐year capture–mark–recapture study, we have obtained occasional reports of recoveries far outside our main metapopulation study system, documenting unusually long dispersal distances. Our records constitute the highest occurrence of long‐distance dispersal events recorded for this species in Scandinavia. Such long‐distance dispersals radically change the predicted distribution of dispersal distances and connectedness for our study metapopulation. Moreover, it reveals a much greater potential for colonization than formerly recorded for the house sparrow, which is an invasive species across four continents. These rare and occasional long‐distance dispersal events are challenging to document but may have important implications for the genetic composition of small and isolated populations and for our understanding of dispersal ecology and evolution.

Abstract Harvesting and culling are methods used to monitor and manage wildlife diseases. An important consequence of these practices is a change in the genetic dynamics of affected populations that may threaten their long‐term viability. The effective population size (Ne) is a fundamental parameter for describing such changes as it determines the amount of genetic drift in a population. Here, we estimate Ne of a harvested wild reindeer population in Norway. Then we use simulations to investigate the genetic consequences of management efforts for handling a recent spread of chronic wasting disease, including increased adult male harvest and population decimation. The Ne/N ratio in this population was found to be 0.124 at the end of the study period, compared to 0.239 in the preceding 14 years period. The difference was caused by increased harvest rates with a high proportion of adult males (older than 2.5 years) being shot (15.2% in 2005–2018 and 44.8% in 2021). Increased harvest rates decreased Ne in the simulations, but less sex biased harvest strategies had a lower negative impact. For harvest strategies that yield stable population dynamics, shifting the harvest from calves to adult males and females increased Ne. Population decimation always resulted in decreased genetic variation in the population, with higher loss of heterozygosity and rare alleles with more severe decimation or longer periods of low population size. A very high proportion of males in the harvest had the most severe consequences for the loss of genetic variation. This study clearly shows how the effects of harvest strategies and changes in population size interact to determine the genetic drift of a managed population. The long‐term genetic viability of wildlife populations subject to a disease will also depend on population impacts of the disease and how these interact with management actions.