Orientation of native versus translocated juvenile lesser spotted eagles <i>(Clanga pomarina)</i> on the first autumn migration

The ontogeny of migration routines used by wild birds remains unresolved. Here we investigated the migratory orientation of juvenile lesser spotted eagles (LSE; Clanga pomarina) based on translocation and satellite tracking. Between 2004 and 2016, 85 second-hatched juveniles (Abels) were reared in captivity for release into the declining German population, including 50 birds that were translocated 940 km from Latvia. In 2009, we tracked 12 translocated juveniles, as well as eight native juveniles and nine native adults, to determine how inexperienced birds come to use strategic migration routes. Native juveniles departed around the same time as the adults and six of eight used the eastern flyway around the Mediterranean, which was used by all adults. In contrast, translocated juveniles departed on average 6 days before native LSEs, and five travelled southward and died in the central Mediterranean region. Consequently, fewer translocated juveniles (4/12) than native juveniles (7/8) reached Africa. We conclude that juvenile LSEs have a much better chance of learning the strategic southeastern flyway if they leave at an appropriate time to connect with experienced elders upon departure. It is not clear why translocated juveniles departed so early. Regardless, by the end of the year, most juveniles had perished, whether they were translocated (10/12) or not (6/8). The small number of surviving translocated juveniles thus still represents a significant increase in the annual productivity of the German LSE population in 2009

Achieving the "triple aim" for inborn errors of metabolism: a review of challenges to outcomes research and presentation of a new practice-based evidence framework

Across all areas of health care, decision makers are in pursuit of what Berwick and colleagues have called the “triple aim”: improving patient experiences with care, improving health outcomes, and managing health system impacts. This is challenging in a rare disease context, as exemplified by inborn errors of metabolism. There is a need for evaluative outcomes research to support effective and appropriate care for inborn errors of metabolism. We suggest that such research should consider interventions at both the level of the health system (e.g., early detection through newborn screening, programs to provide access to treatments) and the level of individual patient care (e.g., orphan drugs, medical foods). We have developed a practice- based evidence framework to guide outcomes research for inborn errors of metabolism. Focusing on outcomes across the triple aim, this framework integrates three priority themes: tailoring care in the context of clinical heterogeneity; a shift from “urgent care” to “opportunity for improvement”; and the need to evaluate the comparative effectiveness of emerging and established therapies. Guided by the framework, a new Canadian research network has been established to generate knowledge that will inform the design and delivery of health services for patients with inborn errors of metabolism and other rare diseases.This work was supported by a CIHR Emerging Team Grant (“Emerging team in rare diseases: acheiving the ‘triple aim’ for inborn errors of metabolism,” B.K. Potter, P. Chakraborty, and colleagues, 2012– 2017, grant no. TR3–119195). Current investigators and collaborators in the Canadian Inherited Metabolic Diseases Research Network are: B.K. Potter, P. Chakraborty, J. Kronick, D. Coyle, K. Wilson, M. Brownell, R. Casey, A. Chan, S. Dyack, L. Dodds, A. Feigenbaum, D. Fell, M. Geraghty, C. Greenberg, S. Grosse, A. Guttmann, A. Khan, J. Little, B. Maranda, J. MacKenzie, A. Mhanni, F. Miller, G. Mitchell, J. Mitchell, M. Nakhla, M. Potter, C. Prasad, K. Siriwardena, K.N. Speechley, S. Stocker, L. Turner, H. Vallance, and B.J. Wilson. Members of our external advisory board are D. Bidulka, T. Caulfield, J.T.R. Clarke, C. Doiron, K. El Emam, J. Evans, A. Kemper, W. McCormack, and A. Stephenson Julian. J. Little is supported by a Canada Research Chair in Human Genome Epidemiology. K. Wilson is supported by a Canada Research Chair in Public Health Policy