The sustainable management of the New Zealand longfin eel : a bioeconomic analysis : a thesis presented in partial fulfilment of the requirements for the degree of Master of Applied Economics at Massey University

Annual recruitment of the New Zealand longfin eel (Anguilla dieffenbachii) has declined by around 75 percent since heavy levels of commercial fishing began in the early 1970s. Longfin eels live in freshwater for many years, sometimes over one hundred, before reaching sexual maturity and migrating to oceanic spawning grounds. Longfin eels are semelparous, in that they die after making only a single reproductive contribution following migration. Late maturation and semelparity render longfin populations extremely sensitive to recruitment overfishing. Consequently, poorly defined property rights and fragmented regulation have permitted multiple user groups, but primarily the commercial fishery, to reduce these stocks to the point of near-collapse. In this research, a deterministic multiple-cohort bioeconomic model is developed and applied to a longfin eel population to investigate sustainable management strategies for the fishery, subject to its biological and economic characteristics. The optimisation framework incorporates density-dependent growth and spawner-recruitment relationships and a delay-difference equation to express the significant lag between the sexual maturity of adults and the vulnerability of corresponding young to the fishery. The model also permits the investigation of alternative weight restrictions and a price that varies with age/size. The model demonstrates the insufficiency of using past harvests to calculate sustainable catch, as done recently for the South Island fishery. The model results also indicate the need for a minimum weight restriction higher than that maintained under the existing regulatory system. The importance of no maximum weight restriction is also identified. Additionally, the model results indicate that there is a significant inverse relationship between the level of exploitation and the annual breeding population, since no harvested eel has ever spawned. The sensitivity of longfin eel populations to recruitment overfishing is greater in reality due to uncertainty, competition among harvesters, price and harvest incentives, and this specie's biology. These factors suggest that the use of any harvest-based regulatory system without significant investment in area closure will fail to protect longfin eel stocks through the recovery and maintenance of spawning biomass. The analysis identifies the need for an integrated management strategy, incorporating area closures, for rebuilding and maintaining spawning biomass, and the use of ITQ management in open fisheries to aid the allocation of fishing rights among users. Efficient management of these open areas requires a higher minimum weight limit than under the current management system, and no maximum weight restriction. The calculation of sustainable harvest levels remains problematic due to poor information; however, active adaptive management may be used to work towards their identification. This approach might be aided by density-dependent growth, which would assist the recovery of populations if sustainable harvest were overestimated. Additionally, spawners from closed populations would help to safeguard against recruitment overfishing during the investigation of sustainable exploitation rates. This integrated policy represents a biologically sound and economically relevant management strategy that has the potential to sustain longfin populations and their harvest indefinitely

Criteria for assessing high-priority drug-drug interactions for clinical decision support in electronic health records

Background: High override rates for drug-drug interaction (DDI) alerts in electronic health records (EHRs) result in the potentially dangerous consequence of providers ignoring clinically significant alerts. Lack of uniformity of criteria for determining the severity or validity of these interactions often results in discrepancies in how these are evaluated. The purpose of this study was to identify a set of criteria for assessing DDIs that should be used for the generation of clinical decision support (CDS) alerts in EHRs. Methods: We conducted a 20-year systematic literature review of MEDLINE and EMBASE to identify characteristics of high-priority DDIs. These criteria were validated by an expert panel consisting of medication knowledge base vendors, EHR vendors, in-house knowledge base developers from academic medical centers, and both federal and private agencies involved in the regulation of medication use. Results: Forty-four articles met the inclusion criteria for assessing characteristics of high-priority DDIs. The panel considered five criteria to be most important when assessing an interaction- Severity, Probability, Clinical Implications of the interaction, Patient characteristics, and the Evidence supporting the interaction. In addition, the panel identified barriers and considerations for being able to utilize these criteria in medication knowledge bases used by EHRs. Conclusions: A multi-dimensional approach is needed to understanding the importance of an interaction for inclusion in medication knowledge bases for the purpose of CDS alerting. The criteria identified in this study can serve as a first step towards a uniform approach in assessing which interactions are critical and warrant interruption of a provider’s workflow

Exploring Breast Cancer Systemic Drug Therapy Patterns in Real-World Data

PURPOSE: To explore medications and their administration patterns in real-world patients with breast cancer. METHODS: A retrospective study was performed using TriNetX, a federated network of deidentified, Health Insurance Portability and Accountability Act-compliant data from 21 health care organizations across North America. Patients diagnosed with breast cancer between January 1, 2013, and May 31, 2022, were included. We investigated a rule-based and unsupervised learning algorithm to extract medications and their administration patterns. To group similar administration patterns, we used three features in k-means clustering: total number of administrations, median number of days between administrations, and standard deviation of the days between administrations. We explored the first three lines of therapy for patients classified into six groups on the basis of their stage at diagnosis (early as stages I-III RESULTS: In early-stage HR+/ CONCLUSION: Although there is a general agreement with the NCCN Guidelines, real-world medication data exhibit variability in the medications and their administration patterns

Consumers׳ perception of the complexity of selected household purchase decisions

This study provides evidence of consumers' perception of the complexity of a variety of product/service decisions in terms of a complexity continuum and indicates how such categorisation is influenced by specific demographic characteristics, specifically gender, age and education level that are predominant in terms of consumer socialisation. A survey which was conducted in a major city and involved 461 respondents. The multiple section structured questionnaire were completed by willing spouses/ partners of participating households. Complexity values were calculated in terms of a specific anchoring product, namely major household appliances. It became evident that the most expensive purchases that households ever make, namely purchasing a home and a car, which were perceived to be the most complex by all while grocery purchase was on the least complex divide of the continuum. Also on the more complex divide of the continuum were service related decisions such as insurance. Particularly noteworthy is the confirmation of significant differences in perceived complexity within product categories that are perceived to be the most- and the least complex by all. This confirms the vulnerability of certain segments of the consumer society and the need for concerted effort to communicate with them in appropriate media and on a level that would enhance informed consumer decision-making. Underlying reasons probably relate to consumers' risk perception and affordability issues that could be explored in future research. Interestingly the findings of the gender comparison shifted the focus to different product categories than those elicited in the age-, income and level of education comparisons. Findings therefore confirm the relevance of demographic characteristics in media communication and consumer facilitation as well as in research. Retailers and marketers should therefore be cognisant of the characteristics of their target markets and be very selective and cautious when identifying communication media.http://www.elsevier.com/locate/jretconserhb201