Fourth Annual Report: 2007 Pre-Construction Eelgrass Monitoring and Propagation for King County Outfall Mitigation

King County proposes to build a new sewer outfall discharging to Puget Sound near Point Wells, Washington. Construction is scheduled for 2008. The Point Wells site was selected to minimize effects on the nearshore marine environment, but unavoidable impacts to eelgrass (Zostera marina) beds are anticipated during construction. To mitigate these impacts and prepare for post-construction restoration, King County began implementing a multiyear eelgrass monitoring and restoration program in 2004, with the primary goal of returning intertidal and shallow subtidal habitat and eelgrass to pre-construction conditions. Major program elements related to eelgrass are (a) pre-construction monitoring, i.e., documenting initial eelgrass conditions and degree of fluctuation over 5 years prior to construction, (b) eelgrass transplanting, including harvesting, offsite propagating, and stockpiling of local plants for post-construction planting, and (c) post-construction planting and subsequent monitoring. The program is detailed in the Eelgrass Restoration and Biological Resources Implementation Workplan (King County 2006). This report describes calendar year 2007 pre-construction activities conducted by Pacific Northwest National Laboratory (PNNL) for King County. Activities included continued propagation of eelgrass shoots at the PNNL Marine Sciences Laboratory (MSL) in Sequim, Washington, and monitoring of the experimental harvest plots in the marine outfall corridor area to evaluate recovery rates relative to harvest rates. In addition, 490 eelgrass shoots were also harvested from the Marine Outfall Corridor in July 2007 to supplement the plants in the propagation tank at the MSL, bringing the total number of shoots to 1464. Eelgrass densities were monitored in four of five experimental harvest plots established in the Marine Outfall Corridor. Changes in eelgrass density were evaluated in year-to-year comparisons with initial harvest rates. A net increase in eelgrass density from 2004 post-harvest to 2007 was observed in all plots, despite density decreases observed in 2006 in all plots and at most harvest rates. Eelgrass densities within individual subplots were highly variable from year to year, and the change in density in any interannual period was not related to initial 2004 harvest rate. Harvest rates of neighboring subplots did not appear to affect subplot eelgrass density (Woodruff et al. 2007). Three years post-harvest, eelgrass shoot densities were not significantly different from pre-harvest shoot densities at any harvest level. Additional plans are being discussed with King County to harvest all eelgrass from the construction corridor and hold in the propagation tanks at the MSL for post-construction planting. Under this plan, plants that would have been lost to construction will be held offsite until construction is completed. This strategy reduces and possibly eliminates the need to harvest eelgrass from donor beds located south of the construction area, allowing them to remain undisturbed. However, if eelgrass is harvested from donor beds, the monitoring of eelgrass growth at different harvest rates should help determine an optimum harvest rate that supports rapid recovery of donor eelgrass beds

The Impact of Cultural Environment on Entry-Level Auditors’ Abilities to Perform Analytical Procedures

We focus on the impact of three of Hofstede’s cultural dimensions, power distance, uncertainty avoidance, and individualism, on the results of analytical procedures conducted by entry-level auditors in Mexico and the U.S. Analytical procedures are ideal for this research as they require auditors to use professional judgment and appropriate levels of professional skepticism, abilities related to all three cultural characteristics. We find no other study investigating the impact of culture on the application of auditing procedures similar across the studied cultures. We find cultural characteristics do not affect the participants’ abilities to predict income statement balances, but they may influence the ability to predict changes in balance sheet accounts. We also find culture is associated with differences in risk assessments. Our results indicate that participants rarely differentiate accounts that change according to expectation from those that change contrary to expectation, but rather alter their risk assessments to match the direction of balances that increase or decrease

Eelgrass donor sites: potentially overlooked impacts of restoration in Puget Sound

Eelgrass (Zostera marina) is an important habitat in the Salish Sea and restoration efforts are being undertaken around the region to increase eelgrass abundance and resilience. Eelgrass restoration is typically performed by transplanting whole shoots or dispersing viable seeds collected from reproductive shoots to a site. Most of the restoration efforts in the Pacific Northwest utilize whole shoots harvested from donor meadows and transplanted into restoration areas, but little work has been done to look at the impacts of the harvest on the donor stock. In response to the lack of existing data for Puget Sound, Washington Department of Natural Resources and Pacific Northwest National Laboratory’s Marine Sciences Laboratory conducted a controlled harvest experiment in two regions of the Salish Sea at sites associated with ongoing restoration activities. These meadows were harvested under different pressure (i.e., different percentage of plants taken from 0 to 50%) using traditional harvesting techniques. The meadows were then monitored for two years for changes in density. The results indicated that the eelgrass meadows were surprisingly resilient to all levels of harvest under ideal conditions and in small harvest areas. Interpretation and implications of these results will be discussed, as well as potential considerations for choosing potential donor sites for future restoration efforts

Third Annual Report: 2006 Pre-Construction Eelgrass Monitoring and Propagation for King County Outfall Mitigation

King County proposes to build a new sewer outfall discharging to Puget Sound near Point Wells, Washington. Construction is scheduled for 2008. The Point Wells site was selected to minimize effects on the nearshore marine environment, but unavoidable impacts to eelgrass (Zostera marina) beds are anticipated during construction. To mitigate for these impacts and prepare for post-construction restoration, King County began implementation of a multi-year eelgrass monitoring and restoration program in 2004, with the primary goal of returning intertidal and shallow subtidal habitat and eelgrass to pre-construction conditions. Major program elements are a) pre-construction monitoring, i.e., documenting initial eelgrass conditions and degree of fluctuation over 5 years prior to construction, b) eelgrass transplanting, including harvesting, offsite propagating and stockpiling of local plantstock, and post-construction planting, and c) post-construction monitoring. The program is detailed in the Eelgrass Restoration and Biological Resources Implementation Workplan (King County 2006). This report describes calendar year 2006 pre-construction activities conducted by Pacific Northwest National Laboratory (PNNL) in support of King County. Activities included continued propagation of eelgrass shoots and monitoring of the experimental harvest plots in the marine outfall corridor area to evaluate recovery rates relative to harvest rates. Approximately 1500 additional shoots were harvested from the marine outfall corridor in August 2006 to supplement the plants in the propagation tank at the PNNL Marine Sciences Laboratory in Sequim, Washington, bringing the total number of shoots to 4732. Eelgrass densities were monitored in the five experimental harvest plots established in the marine outfall corridor. Changes in eelgrass density were evaluated in year-to-year comparisons with initial harvest rates. Net eelgrass density decreased from 2004 post-harvest to 2006 in all plots, despite density increases observed in 2005 in some plots and at some harvest rates. Eelgrass densities within individual subplots were highly variable from year to year, and the change in density in any interannual period did not correlate to the initial 2004 harvest rate. Continued monitoring should help project managers determine an optimum harvest rate that supports rapid recovery of donor eelgrass beds

Recommendations for Emerging Good Practice and Future Research in Relation to Family and Caregiver Health Spillovers in Health Economic Evaluations:A Report of the SHEER Task Force

BackgroundOmission of family and caregiver health spillovers from the economic evaluation of healthcare interventions remains common practice. When reported, a high degree of methodological inconsistency in incorporating spillovers has been observed.AimTo promote emerging good practice, this paper from the Spillovers in Health Economic Evaluation and Research (SHEER) task force aims to provide guidance on the incorporation of family and caregiver health spillovers in cost-effectiveness and cost-utility analysis. SHEER also seeks to inform the basis for a spillover research agenda and future practice.MethodsA modified nominal group technique was used to reach consensus on a set of recommendations, representative of the views of participating subject-matter experts. Through the structured discussions of the group, as well as on the basis of evidence identified during a review process, recommendations were proposed and voted upon, with voting being held over two rounds.ResultsThis report describes 11 consensus recommendations for emerging good practice. SHEER advocates for the incorporation of health spillovers into analyses conducted from a healthcare/health payer perspective, and more generally inclusive perspectives such as a societal perspective. Where possible, spillovers related to displaced/foregone activities should be considered, as should the distributional consequences of inclusion. Time horizons ought to be sufficient to capture all relevant impacts. Currently, the collection of primary spillover data is preferred and clear justification should be provided when using secondary data. Transparency and consistency when reporting on the incorporation of health spillovers are crucial. In addition, given that the evidence base relating to health spillovers remains limited and requires much development, 12 avenues for future research are proposed.ConclusionsConsideration of health spillovers in economic evaluations has been called for by researchers and policymakers alike. Accordingly, it is hoped that the consensus recommendations of SHEER will motivate more widespread incorporation of health spillovers into analyses. The developing nature of spillover research necessitates that this guidance be viewed as an initial roadmap, rather than a strict checklist. Moreover, there is a need for balance between consistency in approach, where valuable in a decision making context, and variation in application, to reflect differing decision maker perspectives and to support innovation

Turning the Tide: Five Years of Achieving the Dream in Community Colleges

In 2004, Lumina Foundation for Education launched “Achieving the Dream: Community Colleges Count,” a national initiative aimed at improving success among community college students, particularly low-income students and students of color. Now encompassing more than 130 institutions in 24 states and the District of Columbia, Achieving the Dream helps community colleges build a “culture of evidence” by using student records and other data to examine students’ performance over time and to identify barriers to academic progress. From there, community colleges are expected to develop intervention strategies designed to improve student outcomes; conduct further research on student progress; and bring effective programs to scale. As a result, it is anticipated that colleges will see measurable improvements over time in student outcomes, including increased progress through developmental education and college-level “gatekeeper” (introductory) courses, grades, persistence, and completion of credentials

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification