Conservation and management of Canada’s polar bears (Ursus maritimus) in a changing Arctic1This review is part of the virtual symposium “Flagship Species – Flagship Problems” that deals with ecology, biodiversity and management issues, and climate impacts on species at risk and of Canadian importance, including the polar bear (Ursus maritimus), Atlantic cod (Gadus morhua), Piping Plover (Charadrius melodus), and caribou (Rangifer tarandus)

Canada has an important responsibility for the research, conservation, and management of polar bears ( Ursus maritimus Phipps, 1774) because the majority of polar bears in the world occur within the nation’s borders. Two fundamental and recent changes for polar bears and their conservation have arisen: (1) the ongoing and projected further decline of sea-ice habitat as a result of climate change and (2) the implementation of aboriginal land claims and treaties in Canada’s North. Science has documented empirical links between productivity of polar bear population and sea-ice change. Predictive modeling based on these data has forecast significant declines in polar bear abundance and distribution of polar bears. With the signing of northern land claims and treaties, polar bear management in Canada has integrated local aboriginal participation, values, and knowledge. The interaction of scientific and local perspectives on polar bears as they relate to harvest, climate change, and declining habitat has recently caused controversy. Some conservation, management, and research decisions have been contentious because of gaps in scientific knowledge and the polarization and politicization of the roles of the various stakeholders. With these ecological and governance transitions, there is a need to re-focus and re-direct polar bear conservation in Canada.

Escherichia coli O157:H7: etiology, clinical features, complications, and treatment

In recent years, Escherichia coli (E. coli) O157:H7 has developed into an emerging cause of foodborne illness. It has been identified as the leading cause of post-diarrheal hemolytic-uremic syndrome (HUS) and acute renal failure in infancy and childhood. This article examines, the etiology, clinical features, complications, and treatment of this illness. Prevention strategies are also presented as well as a disaster management case study.

Clinical practice guidelines for maintaining adequate iron status with intravenous iron dextran in hemodialysis patients

While oral iron can be used to manage iron stores in some hemodialysis patients, most require intravenous iron supplementation. Maintenance of iron balance in these patients is critical, since patients with end stage renal disease often suffer from anemia caused by inadequate production of red blood cells and iron deficiency resulting from chronic blood loss. Using guidelines that include maintenance dosing ensures sustained adequate iron stores and maximizes the effects of rHuEPO therapy. Easy-to-administer clinical practice guidelines for repletion and maintenance of iron stores are presented here.

Drug resistant organisms and their implications for the outpatient dialysis setting

Ever since antibiotics have been used to combat infection, resistance to them has also developed. The elderly and immunosuppressed populations found in today's dialysis facility comprise a group at risk for acquiring infection caused by drug resistant organisms. By utilizing antibiotics prudently and developing infection control strategies based on the disease/organism epidemiology, mode of transmission and individualized needs of the patient as well as the care setting, the proliferation of drug resistant organisms may be curtailed.

The high prevalence of unsafe sexual behaviors among acute psychiatric inpatients. Implications for AIDS prevention

We conducted a study to determine the prevalence and sociodemographic distribution of unsafe sexual behaviors among psychiatric inpatients and to investigate an association between crack cocaine use and these behaviors. Two hundred thirty-nine patients admitted to two Philadelphia hospitals during a 12-month period were interviewed to obtain a detailed sexual history and substance abuse history. A history of multiple sex partners was reported by 42.6% of male patients and 13.0% of female patients (p < .01). A history of receptive anal intercourse in the past 6 months was reported by 11.6% of females and 2.1% of males (p < .05). Only about half the study subjects who were sexually active reported ever using a condom during the past 6 months. Crack cocaine use among males and cocaine use among females was statistically significantly associated with a history of having sex with a high risk partner. This study draws attention to the role of crack cocaine and other types of cocaine in the spread of human immunodeficiency virus infection in this population and the need for intensive acquired immunodeficiency syndrome prevention programs on inpatient psychiatric units.

A modeling approach to hospital location for effective marketing

This paper develops a mixed integer linear programming model for locating health care facilities. The parameters of the objective function of this model are based on factor rating analysis and grid method. Subjective and objective factors representative of the real life situations are incorporated into the model in a unique way permitting a trade-off analysis of certain factors pertinent to the location of hospitals. This results in a unified approach and a single model whose credibility is further enhanced by inclusion of geographical and demographical factors.

Calcitriol injection for the management of renal osteodystrophy

The introduction of synthetically produced calcitriol in the early 1970s was an important contribution to the prevention and treatment of renal bone disease. However, despite the efficacy and the availability of oral calcitriol many dialysis patients continued to develop secondary hyperparathyroidism (Norris, 1991). Effective treatment was often impossible in patients with osteitis fibrosa because even low oral doses of calcitriol could cause hypercalcemia (Andress, Norris, Coburn, Slatopolsky, & Sherrad, 1989). From 1981 to the present, numerous studies have been conducted that have demonstrated intravenous calcitriol as being more effective and having several advantages over the oral route of administration, particularly in patients with poor compliance and those with a tendency to develop hypercalcemia.

Factor structure of the SCL-90-R: is there one?

A review of the literature on the factor structure of the Symptom Check List-90-R (SCL-90-R) and its precursors makes evident the many problems inherent in this clinical assessment tool as a measure of independent dimensions of symptom distress, particularly in psychiatric patients. The many versions of the Symptom Check List are evaluated on several criteria (e.g., factor stability, factor loadings, proportion of variance, etc.). It is concluded that interpreting nine dimensions for clinical purposes is highly questionable. It is perhaps still a better measure of general distress as was intended in its original version approximately three decades ago.