Environmental and economic impacts of retrieved abandoned, lost, and discarded fishing gear in Southwest Nova Scotia, Canada.

Abandoned, lost, and discarded fishing gear (ALDFG), negatively impacts marine environments. Managing ALDFG in Atlantic Canada is challenging due to knowledge gaps on loss rates, locations, data availability/accuracy, impacts, and regulatory barriers for retrieval. This study removed ALDFG in Southwest Nova Scotia in collaboration with local fishers (with local knowledge and practical ALDFG removal expertise), government, non-profit organizations, and academia. A total of 29,298 kg of ALDFG was retrieved, including 24,630 kg using towed grapples covering ~3986 km of seafloor and 4668 kg from shorelines (comprising, 68 % lobster traps and 12 % dragger cable by weight). Traps ranged from <1 to 37 years old (median, 10 years). Traps continued to catch target and non-target species with 25 species released, including 652 individual lobsters (82 % were market-sized) and 57 fish (42 were species-at-risk). Based on estimated 2 % trap losses, annual commercial losses from ALDFG were $155,836 CAD in Lobster Fishing Area 34.

Lean Implementation for Graduating Optimally Controlled Stable Type 2 Diabetics from Endocrine Specialty Clinic Back to Primary Care.

INTRODUCTION: Endocrine specialty clinics (SCs) are occupied by a high percentage of stable follow-up patients, limiting access to new patients with greater needs. AIM: Feasibility project to improve access to diabetes SC by reducing the number of stable optimally controlled follow-up type 2 diabetic patients. SETTING: M Health Fairview (MHFV), a hybrid network of University of Minnesota academic and Fairview Health community hospitals and clinics with affiliated providers. PROGRAM DESCRIPTION: A team-based lean methodology quality improvement graduation program including medical assistants, nurses, physicians, and a compact with primary care (PC) was used to identify within the Endocrine clinic population the graduation-eligible optimally controlled stable type 2 diabetic patients, acclimate them to the graduation concept, engage in shared decision-making, and transition them back to PC with a warm hand-off and graduation certificate. PROGRAM EVALUATION: Seventeen percent (58/341) of eligible patients with optimally controlled diabetes graduated by 6 months, ranging between 0 and 83% per week. DISCUSSION: The innovation and feasibility of opening SC access through the use of a team-based graduation program to transfer stable diabetes patients back to their home clinic was demonstrated. This innovation has the potential to support health system triage of new patients to limited access specialty care.

"I've Got the Energy to Change, But I Haven't Got the Energy for This Kinda Therapy": A Qualitative Analysis of the Motivations Behind Democratic Therapeutic Community Drop-Out for Men With Sexual Convictions.

Prison-based democratic therapeutic communities (TCs) provide an alternative to mainstream prison, where prisoners can work on psychological difficulties and address offending behavior. Research demonstrates TCs are effective at reducing reoffending rates for residents who stay in therapy 18+ months, and those who drop out of TCs offend at a significantly higher rate than those who complete therapy. Thus, it is important to reduce attrition in TCs. No research has yet explored the explanations for TC drop out offered by those with sexual convictions. The present study uses Interpretive Phenomenological Analysis to qualitatively explore the accounts of men with sexual convictions (n = 7) who dropped out of a TC in a UK prison. Results highlight that issues surrounding external responsivity, therapeutic relationships, and treatment readiness were salient in the participants' accounts of drop out. This research has implications for TCs seeking to better understand and address attrition of people with sexual convictions.