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Since its emergence, devil facial tumour disease (DFTD) has spread throughout most of the geographic range of the Tasmanian devil, causing >90% local population decline, >80% overall decline and cascading effects on the ecosystem. We developed a decision tree to guide research and management of this cancer. The devil–DFTD system gives an opportunity to study a wildlife disease in all stages of existence across the entire geographic range of a natural host. Despite predictions of extinction, devils persist. State–space models show that individuals with higher fitness (the larger, more dominant individuals responsible for most of the biting) are more likely to become infected themselves. Individual-based models in which demographic parameters depend on the size of the tumours carried by individual hosts show that DFTD epidemics operate on a much slower timescale than those of viral or bacterial diseases. Following an initial epidemic peak, the consequences for a general epidemic may be coexistence, even in the absence of evolutionary changes in either host or pathogen. Multiple lines of evidence show that Tasmanian devils are evolving in response to DFTD. Conservation efforts are now shifting from managing for extinction to managing for persistence.
A panel of emergency medicine (EM) leaders endeavoured to define the key elements of leadership and its models, as well as to formulate consensus recommendations to build and strengthen academic leadership in the Canadian EM community in the areas of mentorship, education, and resources.
The expert panel comprised EM leaders from across Canada and met regularly by teleconference over the course of 9 months. From the breadth of backgrounds and experience, as well as a literature review and the development of a leadership video series, broad themes for recommendations around the building and strengthening of EM leadership were presented at the CAEP 2015 Academic Symposium held in Edmonton, Alberta. Feedback from the attendees (about 80 emergency physicians interested in leadership) was sought. Subsequently, draft recommendations were developed by the panel through attendee feedback, further review of the leadership video series, and expert opinion. The recommendations were distributed to the CAEP Academic Section for further feedback and updated by consensus of the expert panel.
The methods informed the panel who framed recommendations around four themes: 1) leadership preparation and training, 2) self-reflection/emotional intelligence, 3) academic leadership skills, and 4) gender balance in academic EM leadership. The recommendations aimed to support and nurture the next generation of academic EM leaders in Canada and included leadership mentors, availability of formal educational courses/programs in leadership, self-directed education of aspiring leaders, creation of a Canadian subgroup with the AACEM/SAEM Chair Development Program, and gender balance in leadership roles.
These recommendations serve as a roadmap for all EM leaders (and aspiring leaders) to build on their success, inspire their colleagues, and foster the next generation of Canadian EM academic leaders.
Laboratory investigations are essential to patient care and are conducted routinely in emergency departments (EDs). This study reports the turnaround times at an academic, tertiary care ED, using root cause analysis to identify potential areas of improvement. Our objectives were to compare the laboratory turnaround times with established benchmarks and identify root causes for delays.
Turnaround and process event times for a consecutive sample of hemoglobin and potassium measurements were recorded during an 8-day study period using synchronized time stamps. A log transformation (ln [minutes + 1]) was performed to normalize the time data, which were then compared with established benchmarks using one-sample t tests.
The turnaround time for hemoglobin was significantly less than the established benchmark (n = 140, t = –5.69, p < 0.001) and that of potassium was significantly greater (n = 121, t = 12.65, p < 0.001). The hemolysis rate was 5.8%, with 0.017% of samples needing recollection. Causes of delays included order-processing time, a high proportion (43%) of tests performed on patients who had been admitted but were still in the ED waiting for a bed, and excessive laboratory process times for potassium.
The turnaround time for hemoglobin (18 min) met the established benchmark, but that for potassium (49 min) did not. Root causes for delay were order-processing time, excessive queue and instrument times for potassium and volume of tests for admitted patients. Further study of these identified causes of delays is required to see whether laboratory TATs can be reduced.
Michael Blyth, Principal Research Officer in the Rural Resources Economics Section of the Bureau of Agricultural Economics,
Andrew McCallum, Research Officer in the Rural Resources Economics Section of the Bureau of Agricultural Economics
The impact of land degradation on the productivity of the land resource has been claimed to be a serious physical problem in agricultural and forestry land uses (see, for example, Balderstone et al 1982, pl35 and Schuster 1979, p1). However, the physical existence of land degradation is not necessarily evidence of an economic problem. To establish whether or not an economic problem exists requires knowledge of the costs and benefits of reducing or preventing degradation, and/or the costs and benefits of reclaiming degraded land.
An individual land user considers the costs of land degradation and other costs of production in a similar fashion. The land user will avoid or prevent land degradation to the point at which private benefits from additional prevention, equal to extra profit generated from increased production, are equal to private costs. However, the full social costs of land degradation may involve external costs, for example, in the form of damage to roads or siltation of waterways. There may also be external benefits in that soil lost from one property may enhance the soil productivity of the property on which it is deposited. There is no general incentive for landowners to consider external costs and benefits. The results of private decision making may thus diverge from those which would occur if full social costs were taken into account.
Public policy response to the existence of land degradation is generally aimed at reducing the external or offsite costs and aligning the private and social costs of production or land use.
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