Essential requirements for the governance and management of data trusts, data repositories, and other data collaborations.

Introduction: Around the world, many organisations are working on ways to increase the use, sharing, and reuse of person-level data for research, evaluation, planning, and innovation while ensuring that data are secure and privacy is protected. As a contribution to broader efforts to improve data governance and management, in 2020 members of our team published 12 minimum specification essential requirements (min specs) to provide practical guidance for organisations establishing or operating data trusts and other forms of data infrastructure. Approach and Aims: We convened an international team, consisting mostly of participants from Canada and the United States of America, to test and refine the original 12 min specs. Twenty-three (23) data-focused organisations and initiatives recorded the various ways they address the min specs. Sub-teams analysed the results, used the findings to make improvements to the min specs, and identified materials to support organisations/initiatives in addressing the min specs. Results: Analyses and discussion led to an updated set of 15 min specs covering five categories: one min spec for Legal, five for Governance, four for Management, two for Data Users, and three for Stakeholder & Public Engagement. Multiple changes were made to make the min specs language more technically complete and precise. The updated set of 15 min specs has been integrated into a Canadian national standard that, to our knowledge, is the first to include requirements for public engagement and Indigenous Data Sovereignty. Conclusions: The testing and refinement of the min specs led to significant additions and improvements. The min specs helped the 23 organisations/initiatives involved in this project communicate and compare how they achieve responsible and trustworthy data governance and management. By extension, the min specs, and the Canadian national standard based on them, are likely to be useful for other data-focused organisations and initiatives.

Assessing the umbrella value of a range-wide conservation network for jaguars (Panthera onca).

Umbrella species are employed as conservation short-cuts for the design of reserves or reserve networks. However, empirical data on the effectiveness of umbrellas is equivocal, which has prevented more widespread application of this conservation strategy. We perform a novel, large-scale evaluation of umbrella species by assessing the potential umbrella value of a jaguar (Panthera onca) conservation network (consisting of viable populations and corridors) that extends from Mexico to Argentina. Using species richness, habitat quality, and fragmentation indices of ~1500 co-occurring mammal species, we show that jaguar populations and corridors overlap a substantial amount and percentage of high-quality habitat for co-occurring mammals and that the jaguar network performs better than random networks in protecting high-quality, interior habitat. Significantly, the effectiveness of the jaguar network as an umbrella would not have been noticeable had we focused on species richness as our sole metric of umbrella utility. Substantial inter-order variability existed, indicating the need for complementary conservation strategies for certain groups of mammals. We offer several reasons for the positive result we document, including the large spatial scale of our analysis and our focus on multiple metrics of umbrella effectiveness. Taken together, our results demonstrate that a regional, single-species conservation strategy can serve as an effective umbrella for the larger community and should help conserve viable populations and connectivity for a suite of co-occurring mammals. Current and future range-wide planning exercises for other large predators may therefore have important umbrella benefits.

Translating patient safety legislation into health care practice.

BACKGROUND: An independent state agency, the Authority is charged with taking steps to reduce and eliminate medical errors by identifying problems and recommending solutions that promote patient safety. PENNSYLVANIA PATIENT SAFETY REPORTING SYSTEM (PA-PSRS): The Authority implemented PA-PSRS, a mandatory reporting and analysis system for both adverse events and near-misses, among 450 hospitals, birthing centers, and ambulatory surgical facilities. Pennsylvania is the only state to require the reporting of both adverse events and near-misses. THE PATIENT SAFETY ADVISORY: The Patient Safety Advisory is a quarterly publication containing articles about trends in reports submitted to PA-PSRS. The peer-reviewed articles include analysis of and lessons learned from PA-PSRS reports and evidence-based risk reduction strategies based on research in the clinical literature. To complement and reinforce the effectiveness of certain Advisory articles, the Authority has introduced electronic, educational tool kits on its Web site that can be downloaded. They include posters, draft policies, audio-slide presentations for staff training, and other materials related to clinical implementation of patient safety interventions and protocols. SUMMARY AND CONCLUSION: In just over two years, the Authority has developed a program that turns reports into actionable items through the analysis and research of adverse events and near-misses.

Assessing risk for major depression on patients selected for percutaneous transluminal coronary angioplasty: is it a worthwhile venture?

We hypothesized that a prior history of a major depressive disorder would not compromise the efficacy of percutaneous transluminal coronary angioplasty (PTCA), a coronary revascularization procedure, in improving quality of life and health status when comparing patients with no previous history. To determine the utility of screening for risk for depression in heart patients scheduled for PTCA, 190 patients were administered a two-item depressive disorders screener prior to PTCA and the SF-36 and Seattle Angina Questionnaire prior to and 6 months post procedure. Results reveal that while those with no prior history of depression had statistically better quality of life and health status outcomes than those with a probable past depression, (P <.05), the clinically meaningful differences as determined by effect size scores showed that those susceptible to recurrent depression benefited from PTCA as well as, and on some measures better than those with no previous history. Prescreening patients at probable risk for a depression is not a valid or helpful enterprise if the purpose is to develop intervention strategies for improving outcome post PTCA. Screening out patients based on history of depression may in fact lead to an inequitable allocation of resources and have no major benefit in enhancing quality of life and improving health status.

Planning to Save a Species: the Jaguar as a Model.

International conservation planning at the end of the twentieth century is dominated by coarse-filter, supra-organismal approaches to conservation that may be insufficient to conserve certain species such as the jaguar ( Panthera onca). If we are to retain broadly distributed species into the next century, we need to plan explicitly for their survival across their entire geographic range and through political boundaries while recognizing the variety of ecological roles the species plays in different habitats. In March 1999 the Wildlife Conservation Society sponsored a priority-setting and planning exercise for the jaguar across its range, from northern Mexico to northern Argentina. Field scientists from 18 countries reached consensus on four types of information: (1) the spatial extent of their jaguar knowledge, (2) the known, currently occupied range of jaguars, (3) areas with substantial jaguar populations, adequate habitat, and a stable and diverse prey base, and (4) point localities where jaguars have been observed during the last 10 years. During the exercise, these experts also conducted a range-wide assessment of the long-term survival prospects of the jaguar and developed an algorithm for prioritizing jaguar conservation units occurring in major habitat types. From this work, we learned that the known, occupied range of the jaguar has contracted to approximately 46% of estimates of its 1900 range. Jaguar status and distribution is unknown in another 12% of the jaguar's former range, including large areas in Mexico, Colombia, and Brazil. But over 70% of the area where jaguars are thought to still occur was rated as having a high probability of supporting their long-term survival. Fifty-one jaguar conservation units representing 30 different jaguar geographic regions were prioritized as the basis for a comprehensive jaguar conservation program.

RESUMEN: La planeación de la conservación internacional al final del siglo veinte esta dominada por enfoques de grano grueso, supra-organísmicas que pueden ser insuficientes para conservar ciertas especies como el jaguar ( Panthera onca). Si hemos de mantener especies ampliamente distribuidas en el próximo siglo, necesitamos planificar su supervivencia explícitamente en todo su rango geográfico a través de límites políticos al mismo tiempo que se reconozca la variedad de funciones ecológicas de las especies en diferentes hábitats. En marzo de 1999 la Sociedad de Conservación de Vida Silvestre promovió un ejercicio de definición de prioridades y de planeación para el jaguar en todo su rango de distribución, desde el norte de México hasta el norte de Argentina. Científicos de 18 países llegaron a consensos en cuatro tipos de información: (1) la extensión espacial de su conocimiento del jaguar, (2) el rango conocido, actualmente ocupado por el jaguar, (3) áreas con poblaciones importantes, hábitat adecuado y una base de presas estable y diversa y (4) localidades en las que se han observado jaguares durante los últimos 10 años. Durante el ejercicio, estos expertos también hicieron una evaluación de la supervivencia a largo plazo del jaguar en todo su rango y desarrollaron un algoritmo para priorizar unidades de conservación del jaguar en los tipos de hábitat más importantes. De este trabajo, aprendimos que el rango del jaguar conocido y ocupado se ha contraído aproximadamente al 46% de su rango estimado circa de 1900. El estatus del jaguar y su distribución en otro 12% del rango anterior, incluyendo extensas áreas en México, Colombia y Brasil. Sin embargo, más del 70% del área donde se piensa que todavía ocurre el jaguar fue considerada con una alta probabilidad de soportar la supervivencia a largo plazo. Se priorizaron 51 unidades de conservación representando 30 regiones diferentes como la base para un sólido programa de conservación del jaguar.