Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia

NatureScot Commissioned Report 741: Black Grouse Conservation In Southern Scotland

Black grouse in southern Scotland have declined in both numbers and range, with the Scottish Black Grouse Biodiversity Action Plan Steering Group identifying this area as a priority area for conservation action. Recent studies from north Perthshire have identified the importance of retaining heather moorland habitats within a forest-moorland landscape mosaic. The remaining moorland habitats in southern Scotland may be at risk from increased afforestation driven by government policy to expand woodland cover, changes in farming practice, wind farm developments and reductions in grouse moor management. To effectively conserve black grouse in southern Scotland, information on how the scale andquality of moorland habitats influences black grouse numbers and distribution are required.In this report we explored long term trends in black grouse numbers from shooting bag records. We assessed habitat composition within lek ranges of occupied leks and assessed the effect of habitat variables and moorland management on lek size. Similarly, we explored temporal changes from a sample of sites surveyed between 1989-99 and again 2006-12.We also considered how scale and management of moorland habitat patches influence occupancy. Main findings Black grouse are in long term decline in the region. Shooting bag records illustrate that the numbers of birds shot per km2 peaked in 1910 and then declined. By the 1980s they were infrequently harvested. Recent lek surveys showed a 64% decline between 1989-99 and 2006-12. Heather moorland was present within all occupied lek ranges. Leks were a median 110m from heather moorland, with the majority situated on acid grassland habitats. Twice as many males attended leks in areas where gamekeepers were employed and driven red grouse shooting was practised. Moorland patches occupied by black grouse were 25 times larger than unoccupied patches. We found 90% of males to be associated with six moorland patches, with the Moorfoot Hills and Tweedsmuir Hills patches supporting 62% of males. Only one large moorland patch larger than 100km2, the Lammermuirs Hills, was unoccupied. To effectively conserve black grouse in southern Scotland a landscape-scale strategic approach is required. The fundamental objectives of this will be to secure and protect core populations associated with the larger moorland patches, prior to instigating measures to increase population size and the connectivity with other patches in the landscape