British Columbia

However, such differences between countries may be due more to differences in the medical systems rather than differences in the quality of patient care. The United States has a very different medical environment, partly because of the highly litigious nature of US culture. 2 The fear of being sued may reduce the incidence of hindsight bias3 in US studies, since physicians may order more tests than are strictly necessary, which makes it more difficult for researchers such as Baker and associates to second-guess their decisions.

Abstract:  Although there are many indicators of endangerment (i.e., whether populations or species meet criteria that justify conservation action), their reliability has rarely been tested. Such indicators may fail to identify that a population or species meets criteria for conservation action (false negative) or may incorrectly show that such criteria have been met (false positive). To quantify the rate of both types of error for 20 commonly used indicators of declining abundance (threat indicators), we used receiver operating characteristic curves derived from historical (1938–2007) data for 18 sockeye salmon (Oncorhynchus nerka) populations in the Fraser River, British Columbia, Canada. We retrospectively determined each population's yearly status (reflected by change in abundance over time) on the basis of each indicator. We then compared that population's status in a given year with the status in subsequent years (determined by the magnitude of decline in abundance across those years). For each sockeye population, we calculated how often each indicator of past status matched subsequent status. No single threat indicator provided error-free estimates of status, but indicators that reflected the extent (i.e., magnitude) of past decline in abundance (through comparison of current abundance with some historical baseline abundance) tended to better reflect status in subsequent years than the rate of decline over the previous 3 generations (a widely used indicator). We recommend that when possible, the reliability of various threat indicators be evaluated with empirical analyses before such indicators are used to determine the need for conservation action. These indicators should include estimates from the entire data set to take into account a historical baseline.Resumen:  Aunque existen muchos indicadores de riesgo (i.e., sí las poblaciones o especies cumplen con criterios para justificar acciones de conservación), su confiabilidad ha sido probada pocas veces. Dichos indicadores pueden fallar al identificar que una población o especie cumple con criterios para acciones de conservación (negativo falso) o pueden mostrar incorrectamente que tales criterios se han cumplido (positivo falso). Para cuantificar la tasa de ambos tipos de error para 20 indicadores de declinación de abundancia (indicadores de amenaza) utilizados comúnmente, utilizamos curvas de características de operación de receptores derivadas de datos históricos (1937–2008) de 18 poblaciones de salmón (Oncorhynchus nerka) en el Río Fraser, Columbia Británica, Canadá. Retrospectivamente determinamos el estatus anual de cada población (reflejado en cambios en la abundancia en el tiempo) con base en cada indicador. Posteriormente comparamos el estatus de la población en un año determinado con el estatus de años subsecuentes (determinado por la magnitud de la declinación en abundancia en esos años). Para cada población de salmón, calculamos la frecuencia en que cada indicador de estatus pasado era igual al estatus subsecuente. Ningún indicador de amenaza proporcionó estimaciones de estatus libres de error, pero los indicadores que reflejaron la extensión (i.e., magnitud) de la declinación en abundancia pasada (mediante comparación de la abundancia actual con la abundancia histórica de referencia) tendieron a reflejar de mejor manera el estatus en años anteriores que la tasa de declinación en las 3 generaciones previas (un indicador ampliamente utilizado). Recomendamos que, cuando sea posible, se evalúe la confiabilidad de varios indicadores de amenaza con análisis empíricos antes de que esos indicadores sean utilizados para determinar la necesidad de acciones de conservación. Estos indicadores deben incluir estimaciones a partir del total de datos para considerar una referencia histórica.Resumen:  Aunque existen muchos indicadores de riesgo (i.e., sí las poblaciones o especies cumplen con criterios para justificar acciones de conservación), su confiabilidad ha sido probada pocas veces. Dichos indicadores pueden fallar al identificar que una población o especie cumple con criterios para acciones de conservación (negativo falso) o pueden mostrar incorrectamente que tales criterios se han cumplido (positivo falso). Para cuantificar la tasa de ambos tipos de error para 20 indicadores de declinación de abundancia (indicadores de amenaza) utilizados comúnmente, utilizamos curvas de características de operación de receptores derivadas de datos históricos (1937–2008) de 18 poblaciones de salmón (Oncorhynchus nerka) en el Río Fraser, Columbia Británica, Canadá. Retrospectivamente determinamos el estatus anual de cada población (reflejado en cambios en la abundancia en el tiempo) con base en cada indicador. Posteriormente comparamos el estatus de la población en un año determinado con el estatus de años subsecuentes (determinado por la magnitud de la declinación en abundancia en esos años). Para cada población de salmón, calculamos la frecuencia en que cada indicador de estatus pasado era igual al estatus subsecuente. Ningún indicador de amenaza proporcionó estimaciones de estatus libres de error, pero los indicadores que reflejaron la extensión (i.e., magnitud) de la declinación en abundancia pasada (mediante comparación de la abundancia actual con la abundancia histórica de referencia) tendieron a reflejar de mejor manera el estatus en años anteriores que la tasa de declinación en las 3 generaciones previas (un indicador ampliamente utilizado). Recomendamos que, cuando sea posible, se evalúe la confiabilidad de varios indicadores de amenaza con análisis empíricos antes de que esos indicadores sean utilizados para determinar la necesidad de acciones de conservación. Estos indicadores deben incluir estimaciones a partir del total de datos para considerar una referencia histórica.

During 1997–1999, 32 Woodland Caribou (Rangifer tarandus caribou) were translocated from the Sustut Herd to the Telkwa Mountains in westcentral British Columbia to augment recovery of the Telkwa Caribou Herd. The animals were fitted with radiocollars and located during 1997–2000 to determine selection of habitat features and terrain variables. Six Caribou calves were also collared to determine causes and timing of calf mortality during summer 1999. Defining available habitat for newly translocated animals is often arbitrary and subjective, and we based the analyses on ranks for habitat use and availability as this is less sensitive to the inclusion or exclusion of a questionable resource. This method represents some loss of information but provides indications of the relative importance of various habitat types without classifying any as avoided. High elevation habitat (> 1700 masl) on moderate slopes (16 – 45°) received the highest ranks, as did “warm” (136 – 315°) aspects and f...

Early identification of distinct patterns of child social-emotional strengths and vulnerabilities has the potential to improve our understanding of child mental health and well-being; however, few studies have explored natural groupings of indicators of child vulnerability and strengths at a population level. The purpose of this study was to examine heterogeneity in the patterns of young children's social and emotional health and investigate the extent to which sociodemographic characteristics were associated. Cross-sectional study based on a population-level cohort. All kindergarten children attending public schools between 2004 and 2007 in British Columbia (BC), Canada. 35 818 kindergarten children (age of 5 years) with available linked data from the Early Development Instrument (EDI), BC Ministry of Health and BC Ministry of Education. We used latent profile analysis (LPA) to identify distinct profiles of social-emotional health according to children's mean scores across ...

The formalized nurse practitioner (NP) role in British Columbia is relatively new with most roles implemented in primary care. The majority of primary care is delivered by physicians using the fee-for-service model. There is a shortage of general practitioners associated with the difficulties of recruitment and retention, particularly in rural and remote locations. The uptake of the primary care NP role has been slow due to challenges in understanding the extent of its contributions. This study aims to identify the outcomes associated with the NP role in collaborative primary care practice. Three case studies where NPs were embedded into rural fee-for-service practices were undertaken to determine the outcomes at the practitioner, practice, community, and health services levels. Interviews, documents, and before and after data, were analyzed to identify changes in practise, access, and acute care service utilization. The results showed that NPs affected how care was delivered, parti...

Artificial regeneration of forests through planting requires high quantities of quality seeds for growing vigorous seedlings. These seedlings are raised in nurseries, where germination capacity (GC) and speed are the most important germination parameters. Germination performance is enhanced by prescribing species-specific dormancy-breaking treatments to individual seedlots in bare-root and container nurseries. For most conifer species in British Columbia, the dormancy-breaking treatments and germination conditions have been worked out, but fine-tuning and optimization could improve germination capacity and speed of germination. Implications of inter- and intra-species variations in germination behaviour and seed quality and their influence on the development of unintentional directional selection of specific genotypes are discussed. The potential of molecular and genomics approaches to understand the underlying biology of seed germination-related problems is also discussed.

The subspecies composition of migratory sandhill cranes (Grus canadensis) which stage and winter along the Lower Columbia River in northwest Oregon and southwest Washington is uncertain, but may include all 3 using the Pacific Flyway: lesser (G. c. canadensis), Canadian (G. c. rowani), and greater (G. c. tabida). However, the status of rowani has been debated. During 2001-02, we captured and marked 8 cranes using a noose line trapping technique, and attached Platform Transmitter Terminals (PTTs) to 6 to ascertain locations of their breeding areas, migration corridors and winter sites. Morphometric data were collected for subspecies determination. From measurements and their summer distribution, we conclude that they are likely the intermediate rowani form. Because of their limited numbers, distinct coastal migration path, and habitat issues at breeding, staging, and wintering areas, we recommend that conservation efforts be increased and that they be managed as a unique population. ...

Long-term care facilities (nursing homes) in British Columbia consist of a mix of for-profit, not-for-profit non-government, and not-for-profit health-region-owned establishments. This study assesses the extent to which staffing levels have changed by facility ownership category. With data from Statistics Canada's Residential Care Facilities Survey, various types of care hours per resident-day were examined from 1996 through 2006 for the province of British Columbia. Random effects linear regression modeling was used to investigate the effect of year and ownership on total nursing hours per resident-day, adjusting for resident demographics, case mix, and facility size. From 1996 to 2006, crude mean total nursing hours per resident-day rose from 1.95 to 2.13 hours in for-profit facilities (p = 0.06); from 1.99 to 2.48 hours in not-for-profit non-government facilities (p < 0.001); and from 2.25 to 3.30 hours in not-for-profit health-region-owned facilities (p < 0.001). The a...

Scheduling surgical specialties in a medical facility is a very complex process. The choice of schedules and resource availability impact directly on the number of patients treated by specialty, cancellations, wait times, and the overall performance of the system. In this paper we present a system-wide model developed to allow management to explore trade-offs between OR availability, bed capacity, surgeons’ booking privileges, and wait lists. We developed a mixed integer programming model to schedule surgical blocks for each specialty into ORs and applied it to the hospitals in a British Columbia Health Authority, considering OR time availability and post-surgical resource constraints. The results offer promising insights into resource optimization and wait list management, showing that without increasing post-surgical resources hospitals could handle more cases by scheduling specialties differently.