Can We Learn in the Sandbox Together?: Interprofessional Case Conferences as Facilitation Tools

Duke Medicine utilized interprofessional case conferences (ICCs) from 2008-2012 with the objective of modeling and facilitating development of teamwork skills among diverse health profession students, including physical therapy, physician assistant, medical doctor and nursing. The purpose of this publication was to describe the operational process used to develop and implement the ICCs and measure the success of the ICCs in order to shape future work. The ICCs were offered to develop skills and attitudes essential for participation in healthcare teams. Students were facilitated by faculty of different professions to conduct a comprehensive historical assessment of a standardized patient (SP), determine pertinent physical and lab assessments to undertake, and develop and share a comprehensive management plan. Cases included patient problems that were authentic and relevant to each professional student in attendance. The main barriers to implementation are outlined and the focus on the process of working together is highlighted. Evaluation showed high satisfaction rates among participants and the outcomes from these experiences are presented. The limitations of these results are discussed and recommendations for future assessment are emphasized. The ICCs demonstrated that students will come together voluntarily to learn in teams, even at a research-focused institution, and express benefit from the collaborative exercise.

North Sea Ecosystem: Status Report

The North Sea is a dynamic large marine ecosystem which is bordered by a dense coastal population, contains a productive oil and gas province, has a dense shipping network and has one of the most productive fisheries in the world. An assessment of the state of health of the North Sea was initiated in 1987 as part of a developing series of international initiatives at Ministerial level to address concerns over the impact of these activities on the marine ecosystem. Four North Sea Ministerial Conferences (1984, 1987, 1990, 1995) and an Intermediate Ministerial Meeting (1993) have been held to date to develop a harmonized approach to the sustainable management of the North Sea. In 1988 at the request of Ministers a North Sea Task Force was established to co-ordinate work leading to the production of a Quality Status Report (QSR) on the North Sea in December 1993. In recognition of the large geographical and ecological diversity exhibited, a sub-regional approach was adopted and a total of 13 sub-regional assessment reports were produced to a common protocol. The Task Force established a five-year plan to co-ordinate research, monitoring and modelling and other special topics in the preparations for the QSR. As part of this exercise a ‘Monitoring Master Plan’ was drawn up to provide for the first time reliable spatial information on the distribution of chemical contaminants and biological effects throughout the North Sea. The Task Force was a unique structure in international collaboration with a fixed remit that ended in December 1993. It was successful in bringing together many diverse organisations with interests in the North Sea and co-ordinated to a tight timetable the production of the QSR. The experiences gained are now being applied to the whole north east Atlantic under a new OSPAR Convention and have wide application to other Large Marine Ecosystems.

Costs and benefits to European shipping of ballast-water and hull-fouling treatment: Impacts of native and non-indigenous species

Maritime transport and shipping are impacted negatively by biofouling, which can result in increased fuel consumption. Thus, costs for fouling reduction can be considered an investment to reduce fuel consumption. Anti-fouling measures also reduce the rate of introduction of non-indigenous species (NIS). Further mitigation measures to reduce the transport of NIS within ballast water and sediments impose additional costs. The estimated operational cost of NIS mitigation measures may represent between 1.6% and 4% of the annual operational cost for a ship operating on European seas, with the higher proportional costs in small ships. However, fouling by NIS may affect fuel consumption more than fouling by native species due to differences in species’ life-history traits and their resistance to antifouling coatings and pollution. Therefore, it is possible that the cost of NIS mitigation measures could be smaller than the cost from higher fuel consumption arising from fouling by NIS.

Assessing the Impact of Shipping Vessel Noise on Humpback Whales

The ocean is a hub of noise. Bioacoustic noise, noise from precipitation and wind, and noise from oceanic shelf slides and other geologic processes have occurred consistently as marine species have evolved over time. However, with the discovery of oceanic oil and gas reserves, submarine systems, ship propulsion and the emergence of global trade, anthropogenic sources of sound have added significant quantities of sound to the oceanic system. Shipping has been found to be the largest input of low-frequency anthropogenic noise and Humpback Whales (Megaptera novaengliae), known to be the most vocal marine species, have an auditory sensitivity that falls within the range of frequencies emitted by shipping vessels. As Humpback Whales are heavily dependent on vocalizations, for reasons relatively unconfirmed, a better understanding of why they sing and how their communication is being impacted by vessel noise is critical. Evaluating existing literature both on Humpback behavior and communication, the mechanics of their communication, sound emissions from modern ships, oceanic sound transmission, and studies regarding Humpback's exposure to other sources of low-frequency anthropogenic noise, it is clear that more research is needed to draw any causational conclusions between vessel noise and detrimental impacts on Humpback Whales. With a projected increase in global consumption and vessel traffic, there is an urgent need for further research exploring shipping noise impacts and behavioural alterations of Humpbacks. Existing research has shown changes in Humpback communication when exposed to low-frequency sonar noise, however few studies have been conducted on their communication when in close proximity to shipping vessels. In order for the impacts to be properly assessed, preliminary understanding of humpback communication, their auditory thresholds and more studies between vessel noise exposure and Humpback Whale behavior must be conducted.