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Wildfire risk assessment research has made considerable progress towards estimating the probability of wildfires but comparatively little progress towards estimating the expected consequences of potential fires. One challenge with estimating wildfire consequences has been to identify a common metric that can be applied to consequences measured in different units. In this paper, we use the preferences of representatives of local fire management agencies as the common consequences metric and apply it to a case study in the southern Gulf Islands, British Columbia, Canada. The method uses an expert survey and a maximum-difference conjoint analysis to establish the relative importance of specific fire consequences. A fire with a major potential for loss of life was considered to be about three times worse than major damage to houses and 4.5 times worse than loss of a rare species. Risk ratings were very sensitive to changes in fire consequences ratings. As the complexity of values at risk and number of stakeholders increase, the most efficient allocation of wildfire prevention, protection, and suppression resources becomes increasingly challenging to determine. Thus, as the complexity of stakeholder representation and values at risk increases, we need to pay increasing attention to quantitative methods for measuring wildfire consequences. Resume: La recherche qui porte sur l'evaluation des risques de feu de foret a fait des progres considerables concernant l'estimation de la probabilite des feux de foret mais comparativement peu de progres concernant l'estimation des consequences anticipees de feux potentiels. Un des defis de l'estimation des consequences des feux de foret consiste a identifier une mesure commune applicable aux consequences mesurees avec differentes unites. Dans cet article, nous utilisons les preferences de representants des organismes locaux de gestion du feu comme mesure commune des consequences et nous l'appliquons a une etude de cas dans le secteur sud des Iles Gulf en Colombie-Britannique, au Canada. La methode utilise un sondage aupres des experts et une analyse conjointe pour etablir l'importance relative des consequences du feu. Un feu qui a de fortes possibilites de causer des pertes de vie a ete considere environ trois fois pire que des dommages importants aux habitations et 4,5 fois pire que la perte d'une espece rare. L'estimation des risques etait tres sensible aux changements dans le classement des consequences du feu. A mesure que la complexite des valeurs menacees et le nombre d'intervenants augmentent, il devient de plus en plus difficile de determiner comment allouer le plus efficacement les ressources a la prevention, a la protection et a la suppression des feux de foret. Par consequent, a mesure que la complexite de la representation des intervenants et des valeurs menacees augmente, il faut accorder une attention de plus en plus grande aux methodes quantitatives pour mesurer les consequences des feux de foret. [Traduit par la Redaction], Introduction Forest fires are increasing in both number and size across North America (Westerling et al. 2006). Since 1986, the number of wildfires in the western United States has jumped [...]

Abstract--The recovery of benthic communities inside the western Gulf of Maine fishing closure area was evaluated by comparing invertebrate assemblages at sites inside and outside of the closure four to [...]

Abstract--The northern bluefin tuna (Thunnus thynnus) is a highly mobile apex predator in the Gulf of Maine. Despite current stock assessments that indicate historically high abundance of its main prey, [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.anbehav.2006.06.013 Byline: Andrew B. Cooper, Nathalie Pettorelli, Sarah M. Durant Abstract: Predation plays a key role in shaping mammalian communities through prey killed and through the decisions and choices of both predators and prey. We used an extensive data set from observed hunts of a diurnal large African carnivore, the cheetah, Acinonyx jubatus, in combination with analysis techniques originally developed in the field of economics (discrete choice models) to examine predation decisions within the context of the immediate environment and the reproductive and hunger status of individuals. This is one of the first attempts at an integrated understanding of the suite of ecological and behavioural factors that influence hunting decisions in a large carnivore. The decision of a cheetah to hunt or not was influenced by the abundance of their main prey, the reproductive status of the cheetah and the presence of competitors and predators, but not by the hunger level of the cheetah. Given that the decision to hunt is taken, prey choice is then driven by the time of year, the sex of the predator, the abundance of prey and the presence of competitors. We believe that discrete choice models may provide a new step forward in our ability to understand the decisions that animals make in their natural environment. Author Affiliation: (a) Department of Natural Resources, Institute for the Study of Earth, Oceans and Space, University of New Hampshire, Durham (a ) The Zoological Society of London, Institute of Zoology, Regent's Park, London (a ) Wildlife Conservation Society, International Conservation, U.S.A. (As.) Tanzania Wildlife Research Institute, Arusha, Tanzania Article History: Received 6 February 2006; Revised 21 March 2006; Accepted 28 June 2006 Article Note: (miscellaneous) MS. number: 8840R

Inhaled nitric oxide may be effective in treating patients with sickle cell disease who are having a vaso-occlusive crisis. Sickle cell disease is caused by abnormally shaped red blood cells that can get stuck in small blood vessels. This causes the crisis, which is characterized by great pain. Nitric oxide may help by relaxing the blood vessels and making them larger.

Patients who recover from acute respiratory distress syndrome may still be disabled up to one year later, according to a study of 109 patients. Muscle wasting and weakness were most common, and 6% did not have enough oxygen in their blood. Treatment with corticosteroid drugs was associated with a worse outcome.

Abstract Background Intensive care physicians often must rely on substitute decision makers to address all dimensions of the construct of "best interest" for incapable, critically ill patients. This task involves identifying prior wishes and to facilitate the substitute decision maker's understanding of the incapable patient's condition and their likely response to treatment. We sought to determine how well such discussions are documented in a typical intensive care unit. Methods Using a quality of communication instrument developed from a literature search and expert opinion, 2 investigators transcribed and analyzed 260 handwritten communications for 105 critically ill patients who died in the intensive care unit between January and June 2006. Cohen's kappa was calculated before analysis and then disagreements were resolved by consensus. We report results on a per-patient basis to represent documented communication as a process leading up to the time of death in the ICU. We report frequencies and percentages for discrete data, median (m) and interquartile range (IQR) for continuous data. Results Our cohort was elderly (m 72, IQR 58-81 years) and had high APACHE II scores predictive of a high probability of death (m 28, IQR 23-36). Length of stay in the intensive care unit prior to death was short (m 2, IQR 1-5 days), and withdrawal of life support preceded death for more than half (n 57, 54%). Brain death criteria were present for 18 patients (17%). Although intensivists' communications were timely (median 17 h from admission to critical care), the person consenting on behalf of the incapable patient was explicitly documented for only 10% of patients. Life support strategies at the time of communication were noted in 45% of charts, and options for their future use were presented in 88%. Considerations relevant to determining the patient's best interest in relation to the treatment plan were not well documented. While explicit survival estimates were noted in 50% of charts, physicians infrequently documented their own predictions of the patient's functional status (20%), anticipated need for chronic care (0%), or post ICU quality of life (3%). Similarly, documentation of the patient's own perspectives on these ranged from 2-18%. Conclusions Intensivists' documentation of their communication with substitute decision makers frequently outlined the proposed plan of treatment, but often lacked evidence of discussion relevant to whether the treatment plan was expected to improve the patient's condition. Legislative standards for determination of best interest, such as the Health Care Consent Act in Ontario, Canada, may provide guidance for intensivists to optimally document the rationales for proposed treatment plans.

Abstract Background Communication may affect perceptions of fair process for intensive care unit bed allocation decisions through its impact on the publicity condition of accountability for reasonableness. Methods We performed a qualitative case study to describe participant perceptions of the communication of bed allocation decisions in an 18-bed university affiliated, medical-surgical critical care unit at Sunnybrook and Women's College Health Sciences Centre. Interviewed participants were 3 critical care physicians, 4 clinical fellows in critical care, 4 resource nurses, 4 "end-users" (physicians who commonly referred patients to the unit), and 3 members of the administrative staff. Median bed occupancy during the study period (Jan-April 2003) was 18/18; daily admissions and discharges (median) were 3. We evaluated our description using the ethical framework "accountability for reasonableness" (A4R) to identify opportunities for improvement. Results The critical care physician, resource nurse, critical care fellow and end-users (trauma team leader, surgeons, neurosurgeons, anesthesiologists) functioned independently in unofficial "parallel tracks" of bed allocation decision-making; this conflicted with the official designation of the critical care physician as the sole authority. Communication between key decision-makers was indirect and could exclude those affected by the decisions; notably, family members. Participants perceived a lack of publicity for bed allocation rationales. Conclusion The publicity condition should be improved for critical care bed allocation decisions. Decision-making in the "parallel tracks" we describe might be unavoidable within usual constraints of time, urgency and demand. Formal guidelines for direct communication between key participants in such circumstances would help to improve the fairness of these decisions.