National survey of pediatric services available in US emergency departments

BACKGROUND: Children account for nearly 20% of all US emergency department (ED) visits, yet previous national surveys found that many EDs lack specialized pediatric care. In response, a 2001 joint policy statement recommended resources needed by EDs for effective pediatric emergency care delivery. We sought to update and enhance previous estimates of pediatric services available in US EDs. METHODS: We administered a telephone survey to a 5% random sample (n = 279) of all US EDs from the 2007 National Emergency Department Inventory-USA. The survey collected data on local capabilities (including typical management of three clinical scenarios) and prevalence of a coordinator for pediatric emergency care. We used descriptive statistics to summarize data. Multivariable logistic regression was used to examine the association between survey respondent and ED characteristics as well as the presence of a coordinator for pediatric emergency medicine. RESULTS: Data were collected from 238 hospitals (85% response rate). A minority of hospitals had pediatric departments (36%) or intensive care units (12%). The median annual number of ED visits by children was 3,870 (interquartile range 1,500–8,800). Ten percent of hospitals had a separate pediatric ED; only 17% had a designated pediatric emergency care coordinator. Significant positive predictors of a coordinator were an ED pediatric visit volume of ≥1 patient per hour and urban location. Most EDs treated only mild-to-moderate cases of childhood bronchiolitis and asthma exacerbation (77% and 65%, respectively). Less than half (48%) of the hospitals reported the ability to surgically manage a child with acute appendicitis. CONCLUSION: We found little change in pediatric emergency services compared to earlier estimates. Our study results suggest a continued need for improvements to ensure access to emergency care for children

Incorporating industry based dredge surveys into the assessment of sea scallops, Placopecten magellanicus

Cooperative research utilizing industry vessels represents a viable approach to acquire the data necessary to meet the increasing needs associated with the modern management of marine resources. This dissertation addresses a variety of topics associated with the integration of commercial vessels into the stock assessment of the sea scallop, Placopecten magellanicus. In this study we evaluate the efficacy of utilizing industry vessels with respect to topics that range from rotational closed area survey design, sampling gear evaluation as well as an experiment that broadens the scale of the traditional use of industry vessels in this fishery and provides data to support the use of commercial vessels for surveying sea scallops resource wide. The first paper presents a methodology to evaluate candidate sampling designs for closed area surveys. We simulated scallop populations within a closed area based upon both empirical data and an analysis of the autocorrelation structure of the scallops in that area. From the simulated realizations of the scallop abundance and distribution, three different sampling designs at three levels of sampling were evaluated with respect to bias and accuracy of both mean abundance and variance of the sample mean. The second and third papers take advantage of the ability of commercial vessels to simultaneously tow two dredges. Based on this ability, in the second paper, we estimate the size selectivity of the currently mandated New Bedford Style sea scallop dredge. In addition to estimating the size selective characteristics of this piece of gear, we also estimate the efficiency of the dredge. Both measures are important with respect to correctly estimating the exploitable biomass of sea scallops in rotational sea scallop closed areas. The third paper again used paired data to evaluate the relative changes in the performance of the NMFS sea scallop survey dredge. We utilize a Generalized Linear Mixed Modeling (GLMM) approach to analyzing these data with the goal of characterizing any structural changes in the performance of the dredge that is used to survey both specifically scallop closed areas as well as the entire resource via the annual NMFS time series since the 1970\u27s. The final paper broadens the scale of the utilization of industry vessels and calibrates two of these platforms to the NMFS annual sea scallop survey. We evaluated four separate vessel gear combinations relative to the R/V Albatross IV, throughout the range of the U.S. sea scallop resource and present information to either utilize these vessels to conduct the survey, or at least form a link to a future platform. The results in this dissertation demonstrate that industry vessels represent a feasible option for the collection of sea scallop stock assessment information and present both methods and current information to facilitate their use. These approaches are especially applicable for sea scallops, where the management for this species embraces the spatial characteristics of the underlying population and crafts appropriate management strategies

A Comparison of Size Selectivity and Relative Efficiency of Sea Scallop Trawls and Dredges

Virginia Institute of Marine ScienceMaster of Science (M.Sc.

Final Report An Assessment of Sea Scallop Abundance and Distribution in the Georges Bank Access Areas and Surrounds

For the sea scallop, Placopecten magellanicus, the concepts of space and time have emerged as the basis of an effective management tool. The strategy of rotational area management has aided in the sustainability of the resource. Since 2003 with the adoption of Amendment 10 to the Fishery Management Plan (FMP), rotational area management has provided a mechanism to protect juvenile scallops from fishing mortality by closing areas based on scallop abundance and observed length distributions. Approximately half of the sea scallop industry’s current annual landings are attributed to areas under this rotational harvest strategy. While this represents a management success, it also highlights the extent to which landings and management are dependent on the effective implementation of this strategy. The continued prosperity of scallop spatial management is dependent on both periodic and large incoming year classes, as well as a mechanism to delineate the scale of a recruitment event and subsequently monitor the growth and abundance of these scallops over time. Current and accurate information related to the abundance and distribution of adult and juvenile scallops is essential for managers to respond to changes in resource subunits, especially as the resource is being managed at finer-spatial scales. Acknowledging the importance of accurate, timely, and meaningful information necessary to meet the management challenges, the Virginia Institute of Marine Science (VIMS) conducted a stratified random survey of the Georges Bank (GB) Closed Area I (CAI) and Closed Area II (CAII), as well as the southern flank south of CAII in the summer of 2020 and 2021. The primary objective of these surveys was to assess the abundance and distribution of sea scallops in this area, culminating with spatially explicit annual estimates of total and exploitable biomass by Scallop Area Management Simulator (SAMS) Area. Secondary project objectives for each survey year included: 1. Finfish bycatch species composition and catch rates, 2. Scallop biological sampling (length:weight relationship, disease, product quality, and shell samples for ageing) and 3.Sea scallop dredge performance (commercial and survey dredges)

Development and implementation of a high precision resource wide dredge survey of the Mid-Atlantic scallop resource are: Final Report

The sea scallop fishery is currently the most valuable single species fishery in the United States. Part of this success stems from a hybrid management strategy that incorporates a spatial component (rotational closed areas) with traditional fishery management approaches. While much recent attention has focused on the success of closed areas (e.g. Elephant Trunk Closed Area), production from open areas had enabled scallop landings to remain high and relatively stable over the past few years. Regardless of the management approach, timely and accurate information related to scallop distribution and biomass is critical for the effective management of the resource. This data need is essential for both the rotational access areas and the areas open to general fishing under day-at-sea (DAS) control