Addressing Cumulative Effects through an Indigenous-led Assessment Process.

Cumulative effects assessments are often expected to include an analysis of environmental and social effects despite a relative lack of clarity around how include a broad spectrum of social and cultural impacts. In Canda, these expectations are evolving in part in response to the need to consider the impacts of development on Indigenous communities, and the emergence of Indigenous-led Led Impact Assessment. Led by a team from the Tŝilhqot'in National Government and the University of British Columbia's Centre for Environmental Assessment Research, this project explored how to improve processes for assessing cumulative effects drawing from an Indigenous-led approach.

Professional Burnout and Career Choice Regret in Urology Residents.

Purpose Of Review: High rates of professional burnout and career choice regret among urology residents may increase professional dissatisfaction, shorten career longevity, and exacerbate urology workforce shortages. Understanding the prevalence of and risk factors for burnout may help develop interventions.

Recent Findings: Up to 48% of contemporary U.

Insights from First Nations, Government and Industry Leaders on Criteria for Successful Impact Benefit Agreements.

Over the past decade, British Columbia, Canada's westernmost province, has begun developing liquified natural gas (LNG) mega projects that can transport Canadian resources to foreign markets across the Pacific region. These projects have gained significant profile due to high-level debates over their environmental, social and economic impacts. While LNG projects are required to undergo environmental impact assessment procedures, there is growing recognition of the need to ensure that positive social, economic and environmental impacts are fairly distributed to local communities.

Initial Experience and Clinical Assessment of the Karl Storz FLEX-XC1 Single-Use Flexible Ureteroscope.

Introduction: The Karl Storz FLEX-XC1 is a novel single-use flexible ureteroscope that uses the same videographics platform as its reusable digital counterpart. We evaluated the technical performance of the FLEX-XC1 in its initial clinical use.

Methods: We reviewed a series of consecutive ureteroscopy procedures performed by 2 endourologists using the FLEX-XC1 for indications for which we typically use a single-use device: total stone burden > 15 mm or > 10 mm in the lower pole, anticipated case duration > 60 minutes, bilateral procedure, or upper tract urothelial cancer procedures.

OECD Case Studies of Integrated Regional and Strategic Impact Assessment: What Does 'Integration' Look Like in Practice?

Increasingly, protocols for assessing the impacts of land-uses and major resource development projects focus not only on environmental impacts, but also social and human health impacts. Regional and Strategic Environmental Assessment (RSEAs) are one innovation that hold promise at better integrating these diverse land-use values into planning, assessment, and decision-making. In this contribution, a realist review methodology is utilized to identify case studies of "integrated RSEA"-those which are strategic, have a regional assessment approach, and seek to integrate environmental, community and health impacts into a singular assessment architecture.

Assessing the Cumulative Social Effects of Projects: Lessons from Canadian Hydroelectric Development.

Cumulative effects assessments are often expected to include an analysis of cumulative social effects to people, their communities, and livelihoods caused by resource development projects and land use activities. Understanding cumulative social effects is important for decisions about prospective resource development projects, but there has been limited attention devoted to how to complete such an assessment. This paper critically examines how cumulative effects frameworks are applied to social impacts during environmental assessments.

From Project Impacts to Strategic Decisions: Recurring Issues and Concerns in Wind Energy Environmental Assessments.

Wind energy is among the fastest-growing renewable energy source. Although not as controversial as fossil fuel-based energy projects, wind energy projects can be contested. Understanding common environmental assessment issues surrounding wind energy projects is important for addressing the transaction costs for renewable energy projects.

Successful application of pharmacogenomic testing in the evaluation and management of a patient with human immunodeficiency virus and disseminated histoplasmosis.

Objectives: To demonstrate the successful use of pharmacogenomic testing to specifically tailor antifungal treatment to the phenotype of a patient with human immunodeficiency virus (HIV) and disseminated histoplasmosis who had clinical progression while on itraconazole and subsequently had insufficient therapeutic drug levels of voriconazole.

Case Summary: We present the case of a patient with HIV and disseminated histoplasmosis with a persistently elevated serum Histoplasma capsulatum antigen and subtherapeutic levels of voriconazole. Pharmacogenomic testing revealed he was a CYP2C19 rapid metabolizer, thus explaining his persistent, subtherapeutic levels of voriconazole and prompting a change in therapy.

Primary prostatic squamous cell carcinoma.

Primary prostate squamous cell malignancies are rare and very aggressive. A 65-year-old man presented to our institution with clinical and radiographic findings concerning for advanced prostatic malignancy. Surgical pathology of the tumor revealed poorly differentiated carcinoma with squamous differentiation, and histopathological markers were positive for markers of squamous differentiation negative for all urothelial and prostatic markers.

A case of traumatic penile fracture with simultaneous rupture of both corpora cavernosa and complete urethral transection.

Penile fracture is a rare injury to the penis caused by blunt trauma. The presence of urethral injuries sustained during fracture is less than 10%, but very few cases involve complete circumferential urethral transection. We present a case of a patient who presented with traumatic penile fracture involving bilateral corporal cavernosa injury and complete urethral transection.

Incidental Findings on Brain MRI in People with HIV Infection.

Background: Incidental findings are a well-known complication of imaging studies done for both diagnostic and research purposes. Little is known about the rates and types of incidental findings found on brain MRI in patients with HIV infection, who may be at risk for HIV-Associated Neurocognitive Disorders (HAND).

Methods: The parent study included 108 adults with HIV infection and 125 demographically-matched uninfected controls who completed MRI and neuropsychological testing.

Water Quality Monitoring to Support Cumulative Effects Assessment and Decision Making in the Mackenzie Valley, Northwest Territories, Canada.

Project proponent- and government-led environmental monitoring are required to identify, understand, and manage cumulative effects (CE), yet such monitoring initiatives are rarely mutually supportive. Notwithstanding the need for a more integrated and complementary approach to monitoring, monitoring efforts are often less effective than intended for addressing CE. This paper examines current monitoring programs in the Mackenzie Valley, Northwest Territories, Canada, based on 7 attributes: consistency, compatibility, observability, detectability, adaptability, accessibility, and usability.

A precise measurement of the magnetic field in the corona of the black hole binary V404 Cygni.

Observations of binary stars containing an accreting black hole or neutron star often show x-ray emission extending to high energies (>10 kilo--electron volts), which is ascribed to an accretion disk corona of energetic particles akin to those seen in the solar corona. Despite their ubiquity, the physical conditions in accretion disk coronae remain poorly constrained. Using simultaneous infrared, optical, x-ray, and radio observations of the Galactic black hole system V404 Cygni, showing a rapid synchrotron cooling event in its 2015 outburst, we present a precise 461 ± 12 gauss magnetic field measurement in the corona.

A template for integrated community sustainability planning.

This article describes a template for implementing an integrated community sustainability plan. The template emphasizes community engagement and outlines the components of a basic framework for integrating ecological, social and economic dynamics into a community plan. The framework is a series of steps that support a sustainable community development process.

Integrated ecological and regional planning in a rapid-growth setting.

Toronto is among the fastest-growing urban regions in North America. Regional efforts to preserve rural landscapes and remnant habitat have had variable success. In the 1990s, significant conflict emerged over proposals to build large housing developments on portions of the Oak Ridges Moraine, a 160-km stretch of environmentally sensitive land along the city's northern edge.