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IntroductionTraumatic brain injury (TBI) is the leading cause of mortality and long-term disability in young adults. Despite the high prevalence of anaemia and red blood cell transfusion in patients with TBI, the optimal haemoglobin (Hb) transfusion threshold is unknown. We undertook a randomised trial to evaluate whether a liberal transfusion strategy improves clinical outcomes compared with a restrictive strategy.Methods and analysisHEMOglobin Transfusion Threshold in Traumatic Brain Injury OptimizatiON is an international pragmatic randomised open label blinded-endpoint clinical trial. We will include 742 adult patients admitted to an intensive care unit (ICU) with an acute moderate or severe blunt TBI (Glasgow Coma Scale ≤12) and a Hb level ≤100 g/L. Patients are randomly allocated using a 1:1 ratio, stratified by site, to a liberal (triggered by Hb ≤100 g/L) or a restrictive (triggered by Hb ≤70 g/L) transfusion strategy applied from the time of randomisation to the decision to withdraw life-sustaining therapies, ICU discharge or death. Primary and secondary outcomes are assessed centrally by trained research personnel blinded to the intervention. The primary outcome is the Glasgow Outcome Scale extended at 6 months. Secondary outcomes include overall functional independence measure, overall quality of life (EuroQoL 5-Dimension 5-Level; EQ-5D-5L), TBI-specific quality of life (Quality of Life after Brain Injury; QOLIBRI), depression (Patient Health Questionnaire; PHQ-9) and mortality.Ethics and disseminationThis trial is approved by the CHU de Québec—Université Laval research ethics board (MP-20-2018-3706) and ethic boards at all participating sites. Our results will be published and shared with relevant organisations and healthcare professionals.Trial registration numberNCT03260478.

Objective To determine if insertion of rIVCF for PE prophylaxis in high risk trauma patients could result in a clinically meaningful reduction (>24 h) in time that patients are left unprotected from PEs Summary and background data Trauma patients are at high risk for the development of pulmonary embolism (PE). Early pharmacologic PE prophylaxis is ideal, however many patients are unable to receive prophylaxis due to concomitant injuries. Current guidelines are conflicting on the role of prophylactic retrievable inferior vena cava filters (rIVCF) for PE prevention in this patient population, and robust data to guide clinicians is lacking. Methods In this single center, randomized control trial of adult (age > 18 years) trauma patients at high risk for PE by EAST criteria and unable to receive pharmacologic prophylaxis for at least 72 h, we randomized 42 patients to receive a rIVCF or to not have a rIVCF placed. Our primary endpoints were time left unprotected to PE development and feasibility. Results The median patient age was 53 years, with a median Injury Severity Score of 33. Randomization to rIVCF reduced the time left unprotected to PE (Control: 78.2 h [53.6–104]; rIVCF: 25.5 h [9.8–44.6], p = 0.0001). Two pulmonary embolisms occurred in the control group, and one in the rIVCF group. Seven deaths occurred in the control group, and 8 in the rIVCF group. Conclusion This feasibility study demonstrates a clinically meaningful reduction in time left unprotected to PE. Further investigations powered to demonstrate a reduction in PE incidence are required. Level of evidence Level 1 Evidence randomized controlled trial

IntroductionClinically important upper gastrointestinal bleeding is conventionally defined as bleeding accompanied by haemodynamic changes, requiring red blood cell transfusions or other invasive interventions. However, it is unclear if this clinical definition reflects patient values and preferences. This protocol describes a study to elicit views from patients and families regarding features, tests, and treatments for upper gastrointestinal bleeding that are important to them.Methods and analysisThis is a sequential mixed-methods qualitative-dominant multi-centre study with an instrument-building aim. We developed orientation tools and educational materials in partnership with patients and family members, including a slide deck and executive summary. We will invite intensive care unit (ICU) survivors and family members of former ICU patients to participate. Following a virtual interactive presentation, participants will share their perspectives in an interview or focus group. Qualitative data will be analysed using inductive qualitative content analysis, wherein codes will be derived directly from the data rather than using preconceived categories. Concurrent data collection and analysis will occur. Quantitative data will include self-reported demographic characteristics. This study will synthesise the values and perspectives of patients and family members to create a new trial outcome for a randomised trial of stress ulcer prophylaxis. This study is planned for May 2022 to August 2023. The pilot work was completed in Spring 2021.Ethics and disseminationThis study has ethics approval from McMaster University and the University of Calgary. Findings will be disseminated via manuscript and through incorporation as a secondary trial outcome on stress ulcer prophylaxis.Trial registration numberNCT05506150.

Purpose The purpose of this paper is to reflect on competence in the management of government, with a focus on the management of public finances. I also reflect on the role public financial management (PFM) can play in addressing the impact of the coronavirus (COVID-19) pandemic. Design/methodology/approach The approach in this paper is to document my thoughts and opinions on PFM in the context of the COVID-19 pandemic. Findings Competent bureaucrats and sound finances are the key drivers of an effective PFM system that enables and encourages decisions leading to high standards of financial performance and position. Practical implications Although this is purely a personal reflection on the issue covered, it may encourage other academics and practitioners to explore the idea further in various settings across the globe. Originality/value Having devoted my academic and professional career to the field of PFM, this personal, reflective essay considers the role of PFM systems in generating information that leads to better decisions, better financial performance and position and ultimately a greater ability to absorb shocks such as the COVID-19 pandemic.

PurposeThe New Zealand Government has progressively strengthened its balance sheet position since the mid-1990s, other than for the four years immediately following the global financial crisis and the Canterbury earthquakes. This paper describes the nature and the forecast and actual fiscal impacts of the COVID-19 response, and identifies the transparency mechanisms which reveal these impacts. It also expresses a viewpoint on the implications of the COVID-19 response for the future resilience of the Government's fiscal position.Design/methodology/approachThe paper draws on the suite of official budgetary documents to demonstrate both the transparency of the disclosures on the COVID-19 impact and the substance of the forecast and actual fiscal impacts.FindingsThe paper reveals the change in the long-term fiscal aspirations of the New Zealand Government from one of achieving and maintaining a significant net worth buffer, to one which accommodates in the long-term a markedly smaller buffer and lower level of net worth.Originality/valueThe public financial management system in New Zealand is notable for its transparency. The Government's response to the pandemic is used to illustrate the nature and extent of that transparency.

Lignin phenol, pollen, and diatom analyses were performed on dated sediments (13,533–8993 cal yr B.P.) recovered from Fallen Leaf Lake, California. This multiproxy data set constrains the end of the Tioga glaciation in the Lake Tahoe Basin and reconstructs the response of the region’s aquatic and terrestrial ecosystems to climatic changes that accompanied the Younger Dryas, the end of the Pleistocene, and early Holocene warming. From the Pleistocene to the Holocene, lignin concentrations and syringyl/vanillyl (S/V) ratios increased, while cinnamyl/vanillyl (C/V) ratios and the lignin phenol vegetation index (LPVI) decreased, recording the proliferation of woody plant material and, particularly, the expansion of angiosperms as the Tioga glaciation ended and temperatures warmed. This interpretation is constrained by lignin phenol analyses of plant material from Fallen Leaf Lake’s present-day watershed. Complementary palynological analyses show a transition from a gymnosperm-dominated landscape to a more mixed angiosperm-gymnosperm vegetation assemblage that formed as closed canopy forests became more open and grasses and aster colonized meadows. Aquatic flora assemblages, in the form of greater amounts of green algae and greater percentages of diatom phytoplankton, indicate increased levels of lake primary productivity in response to warming. Principal component analysis (PCA) distinctly resolves the Pleistocene from the Holocene diatom flora. The Pleistocene flora is dominated by cyclotelloids and low-mantled Aulacoseira species that are rare in Fallen Leaf Lake today, but common at higher and colder elevations that may resemble the Pleistocene Fallen Leaf Lake. The Holocene diatom flora is dominated by Aulacoseira subarctica.

Canadian donor management practices have not been reported. Our aim was to inform clinicians and other stakeholders about the range of current practices.This prospective observational cohort study enrolled consecutive, newly consented organ donors from August 1 2015 to July 31 2018 at 27 academic and five community adult intensive care units in British Columbia, Alberta, Ontario, and Quebec. Research staff prospectively recorded donor management data. Provincial organ donation organizations verified the organs donated. We formally compared practices across provinces.Over a median collection period of eight months, 622 potential donors were classified at baseline as having neurologic determination of death (NDD donors; n = 403) or circulatory death (DCD donors; n = 219). Among NDD donors, 85.6% underwent apnea testing (rarely with carbon dioxide insufflation), 33.2% underwent ancillary testing, and subsequent therapeutic hypothermia (34-35°C) was rare. Neurologic determination of death donors were more hemodynamically unstable with most having received vasopressin and norepinephrine infusions, with a large majority having received high-dose corticosteroids and intravenous thyroxine. Among DCD donors, 61.6% received corticosteroids, and 8.9% received thyroxine. Most donors did not receive lung-protective ventilation strategies. Invasive procedures after donation consent included bronchoscopy (71.7%), cardiac catheterization (NDD donors only; 21.3%), and blood transfusions (19.3%). Physicians ordered intravenous antemortem heparin for 94.8% of DCD donors. The cohort donated 1,629 organs resulting in 1,532 transplants. Case selection, death determinations, and hormone, nutrition and heparin practices all varied across provinces.These study findings highlight areas for knowledge translation and further clinical research. Interprovincial discrepancies will likely pose unique challenges to national randomized trials.www.clinicaltrials.gov (NCT03114436); registered 10 April, 2017.RéSUMé: OBJECTIF: Les pratiques canadiennes de prise en charge des donneurs n’ont pas été rapportées. Notre objectif était d’informer les cliniciens et autres parties intéressées quant à l’éventail des pratiques actuelles. MéTHODE: Cette étude de cohorte observationnelle et prospective a recruté des donneurs d’organes consécutifs ayant récemment consenti au don entre le 1

IntroductionIn Canada, deceased organ donation provides over 80% of transplanted organs. At the time of death, families, friends or others assume responsibility as substitute decision-makers (SDMs) to consent to organ donation. Despite their central role in this process, little is known about what barriers, enablers and beliefs influence decision-making among SDMs. This study aims to explore the experiences and perspectives of SDMs involved in making decisions around the withdrawal of life-sustaining therapies, end-of-life care and deceased organ donation.Methods and analysisSDMs of 60 patients admitted to intensive care units will be enrolled for this study. Ten hospitals across five provinces in Canada in a prospective multicentre qualitative cohort study. We will conduct semistructured telephone interviews in English or French with SDMs between 6 and 8 weeks after the patient’s death. Our sampling frame will stratify SDMs into three groups: SDMs who were not approached for organ donation; SDMs who were approached and consented to donate and SDMs who were approached but did not consent to donate. We will use two complementary theoretical frameworks—the Common-Sense Self-Regulation Model and the Theoretical Domains Framework— to inform our interview guide. Interview data will be analysed using deductive directed content analysis and inductive thematic analysis.Ethics and disseminationThis study has been approved by the Centre Hospitalier de l’Université de Montréal Research Ethics Board. The findings from this study will help identify key factors affecting substitute decision-making in deceased organ donation, reasons for non-consent and barriers to achieve congruency between SDM and patient wishes. Ultimately, these data will contribute to the development and evaluation of tools and training for healthcare providers to support SDMs in making decisions about organ donation.Trial registration numberNCT03850847.

This article addresses changes to the Public Finance Act that have been proposed in the Public Finance (Wellbeing) Amendment Bill or are being considered for future legislative or administrative action. It discusses these changes in the context of the State Sector Act. The interrelationship between the two pieces of legislation is described, as are the implications of proposed changes to the Public Finance Act. These changes include requirements for the specification of objectives for wellbeing (outcomes) in the budget process and reporting of wellbeing by the Treasury at least every four years. Changes also include, potentially, greater flexibility in the nature of appropriations and the selection of the services that will be provided within an appropriation, as well as legislative support for the public service to operate in a more ‘joined-up’, innovative and collaborative way. The article identifies as a strength of the proposed changes to the Public Finance Act and the State Sector Act that they maintain consistency between the two acts, but also identifies the risk of replacing one one-size-fits-all system with a different one-size-fits-all system, and considers a ‘two-track’ public management system as an alternative.

Background Clinical trials management can be studied using project management theory. The CYCLE pilot randomized controlled trial (RCT) was conducted to determine the feasibility of a future rehabilitation trial of early in-bed cycling in the intensive care unit (ICU). In-bed cycling is a novel intervention, not typically available in ICUs. Implementation of this intervention requires personnel with specialized clinical expertise caring for critically ill patients and use of the in-bed cycle. Our objective was to describe the implementation and conduct of our pilot RCT using a project management approach. Methods We retrospectively reviewed activities, timelines, and personnel involved in the trial. We organized activities into four project management phases: initiation, planning, execution, and monitoring and controlling. Data sources included Methods Centre documents used for trial coordination and conduct, and the trial data set. We report descriptive statistics as counts and proportions and also medians and quartiles, and we summarize the lessons learned. Results Seven ICUs in Canada participated in the trial. Time from research ethics board and contracts submission to first enrolment was a median (first quartile, third quartile) of 185 (146, 209) and 162 (114, 181) days, respectively. We trained 128 personnel on the CYCLE pilot RCT protocol, and 80 (63%) completed trial-related activities. Four sites required additional training after start-up due to staff turnover and leaves of absence. Over 15 months, we screened 864 patients: 256 were eligible and 66 were enrolled. Despite an 85% consent rate, 74% (190/256) of eligible patients were not randomized, largely (80% [152/190]) due to physiotherapist availability. Thirteen percent of recruitment weeks were lost due to physiotherapist staffing shortages. We highlight five key lessons learned: (1) prepare and anticipate site needs; (2) communicate regularly; (3) proactively analyse and act on process measure data; (4) develop contingency plans; (5) express appreciation to participating sites. Conclusions Our analysis highlights the scope of relevant activities, rigorous training and monitoring, number and types of required personnel, and time required to conduct a multicentre ICU rehabilitation intervention trial. Our lessons learned can help others interested in implementing complex intervention trials, such as rehabilitation. Trial registration ClinicalTrials.gov, NCT02377830. Registered prospectively on 4 March 2015. Electronic supplementary material The online version of this article (10.1186/s13063-019-3634-7) contains supplementary material, which is available to authorized users.

12034 Background: In a growing number of jurisdictions, oncology patients may choose euthanasia or physician-assisted suicide (EPAS). A 2016 systematic review reported that 75% of U.S. and over 70% of Dutch and Belgian EPAS cases involved oncology patients. In the Netherlands and Belgium, the percentage of deaths among oncology patients via EPAS has been increasing. We investigated the incidence and risk factors for EPAS and EPAS requests in oncology patients. Methods: A systematic review was performed following PRISMA guidelines. PubMed, Embase and Cochrane databases were searched for articles from January 2000 to April 2020. Search terms were related to suicide, euthanasia, assisted dying, assisted death, right to die, mercy killing, and cancer. Eligible studies reported incidence and/or risk factors for EPAS/EPAS request based on at least 50 oncology patients. Eligibility for inclusion was independently reviewed by two authors, with discrepancies adjudicated by a third. Data obtained included: study type, country, cancer diagnosis, number of eligible patients, inclusion criteria, follow-up length, incidence of EPAS or EPAS request, and odds ratios (OR) for risk factors for EPAS and EPAS request. ORs and p values were extracted from studies whenever possible and were otherwise calculated based on the data provided using chi-squared test. Results: The search strategy identified 6519 results. 25 abstracts were selected for full-text review and 10 studies were included for analysis. All studies reported incidence of EPAS/EPAS request and 6 studies reported risk factors for EPAS/EPAS request. Six studies were from the Netherlands, 3 from Belgium, and 1 from Canada. Inclusion period for studies spanned from 1996 to 2018. Half of the included studies were prospectively conducted. Incidence of EPAS in cancer patients ranged from 7% to 15% and EPAS requests ranged from 8% to 27%. Factors significantly associated (p

Millennial-scale shifts in aridity patterns have been documented during the Holocene in the western United States, yet the precise timing, severity, and regional extent of these shifts prompts further study. We present lake sediment core data from Fallen Leaf Lake, a subalpine system at the southern end of the Lake Tahoe basin for which 80% of the contemporary inflow is derived from snowpack delivered by Pacific frontal storm systems. A high quality age model has been constructed using 14C ages on plant macrofossils, 210Pb, and the Tsoyowata tephra datum (7.74–7.95 cal kyr BP). One core captures the transition from the Late Tioga-younger Dryas glaciolacustrine package to laminated opaline clay at 11.48 cal kyr BP. Early Holocene sedimentation rates are relatively high (∼1.9 mm/year) and cooler winter temperatures are inferred by the presence of pebbles interpreted to be transported out into the lake via shore ice. There is a geochemically distinct interval from ∼4.71 to 3.65 cal kyr BP that is interpreted as a late Holocene neopluvial, characterized by depleted δ13C and lower C:N that point to reduced runoff of terrigenous organic matter, increased winter precipitation, and increased algal productivity. The largest Holocene signal in the cores occurs at the end of the neopluvial, at 3.65 cal kyr BP, and marks a shift into a climate state with variable precipitation, yet is overall more arid than the neopluvial. This new climate state persists for ∼3 ka, until the Little Ice Age. Low sedimentation rates (0.5 mm/year), the homogeneous opaline sediment, and steadily increasing contributions of terrestrial vs. algal organic matter in these cores suggest that the lowstand state of Fallen Leaf Lake may have been the norm from 3.65 to 0.55 cal kyr BP, punctuated by short term high precipitation years or multi-year intervals capable of rapid short duration lake level rise. Fallen Leaf Lake is strongly influenced by changes in winter precipitation and temperature, manifested largely by the geochemical proxies, and highlights unique advantages of subalpine lakes in regional paleoclimate reconstructions.

I study the provision of information as an incentive instrument in a continuous-time sender-receiver model. The sender observes a persistent, evolving state and sends signals over time to the receiver, who sequentially chooses public actions which affect the welfare of both players. I solve for the sender's optimal dynamic information policy in closed form. Under this policy, the sender provides information gradually, contingent on the receiver's past actions. I show that the sender can implement this policy by truthfully reporting the realized state with a delay that shrinks over time.

We introduce a model of probabilistic verification in a mechanism design setting. The principal verifies the agent's claims with statistical tests. The agent's probability of passing each test depends on his type. In our framework, the revelation principle holds. We characterize whether each type has an associated test that best screens out all the other types. In that case, the testing technology can be represented in a tractable reduced form. In a quasilinear environment, we solve for the revenue-maximizing mechanism by introducing a new expression for the virtual value that encodes the effect of testing.

Introduction Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury. Vasopressors preferentially vasoconstrict blood vessels that supply non-vital organs and capacitance vessels, thereby mobilising the unstressed blood volume. Used as fluid-sparing adjuncts, these drugs can complement resuscitative measures by correcting hypotension without diluting clotting factors or increasing the risk for tissue oedema. Methods and analysis We will identify randomised control trials comparing early resuscitation with vasopressors versus placebo or standard care in adults following traumatic injury. Data sources will include MEDLINE, EMBASE, CENTRAL, clinical trial registries and conference proceedings. Two reviewers will independently determine trial eligibility. For each included trial, we will conduct duplicate independent data extraction and risk of bias assessment. We will assess the overall quality of the data for each individual outcome using the GRADE approach. Ethics and dissemination We will report this review in accordance with the PRISMA statement. We will disseminate our findings at critical care and trauma conferences and through a publication in a peer-reviewed journal. We will also use this systematic review to create clinical guidelines (http://www.magicapp.org), which will be disseminated in a standalone publication. Trial registration number CRD42016033437.

GC × GC-TOF-MS was applied to investigate the molecular diversity of CuO-oxidized, trimethylsilyl (TMS) derivatized DOM isolated from Lake Tahoe’s main tributary, the Upper Truckee River (UTR), California. Many (4789) chromatographic peaks were resolved in a single sample at a signal/noise (S/N) ratio of 10 or greater and > 300 (> 6%) were assigned discrete structures. Mapping the two dimensional elution time space revealed 8 homologous series defined by successive CH 2 additions. Series of other compounds related to one another by OCH 3 and OH substitutions were also assigned. Elucidation of the retention time (RT) displacements affected by these molecular transformations guided the discovery of novel compounds as well as those that had previously escaped detection within DOM, including a suite of lignin-derived cyclobutane photodimers. Analysis of RT shifts among sets of benzene polycarboxylic acid (BPCA) isomers revealed the second chromatographic dimension to strongly retain sterically strained isomers, providing a basis for assigning groups of isomers that were otherwise unassignable. The heightened chromatographic resolution also revealed a substantial and hitherto analytically inaccessible diversity of isomers, which appear to be uniquely resolved with the method, but which would fall outside the analytical window of other high resolution MS methods, such as Fourier transform ion cyclotron resonance MS (FT-ICR-MS). The study likely represents the most comprehensive compound-specific elucidation of any natural OM (NOM) sample to date.

Clinical trials management can be studied using project management theory. The CYCLE pilot randomized controlled trial (RCT) was conducted to determine the feasibility of a future rehabilitation trial of early in-bed cycling in the intensive care unit (ICU). In-bed cycling is a novel intervention, not typically available in ICUs. Implementation of this intervention requires personnel with specialized clinical expertise caring for critically ill patients and use of the in-bed cycle. Our objective was to describe the implementation and conduct of our pilot RCT using a project management approach.We retrospectively reviewed activities, timelines, and personnel involved in the trial. We organized activities into four project management phases: initiation, planning, execution, and monitoring and controlling. Data sources included Methods Centre documents used for trial coordination and conduct, and the trial data set. We report descriptive statistics as counts and proportions and also medians and quartiles, and we summarize the lessons learned.Seven ICUs in Canada participated in the trial. Time from research ethics board and contracts submission to first enrolment was a median (first quartile, third quartile) of 185 (146, 209) and 162 (114, 181) days, respectively. We trained 128 personnel on the CYCLE pilot RCT protocol, and 80 (63%) completed trial-related activities. Four sites required additional training after start-up due to staff turnover and leaves of absence. Over 15 months, we screened 864 patients: 256 were eligible and 66 were enrolled. Despite an 85% consent rate, 74% (190/256) of eligible patients were not randomized, largely (80% [152/190]) due to physiotherapist availability. Thirteen percent of recruitment weeks were lost due to physiotherapist staffing shortages. We highlight five key lessons learned: (1) prepare and anticipate site needs; (2) communicate regularly; (3) proactively analyse and act on process measure data; (4) develop contingency plans; (5) express appreciation to participating sites.Our analysis highlights the scope of relevant activities, rigorous training and monitoring, number and types of required personnel, and time required to conduct a multicentre ICU rehabilitation intervention trial. Our lessons learned can help others interested in implementing complex intervention trials, such as rehabilitation.ClinicalTrials.gov, NCT02377830 . Registered prospectively on 4 March 2015.

IntroductionSurvivors of critical illness frequently exhibit acute and chronic neurological complications. The underlying aetiology of this dysfunction remains unknown but may be associated with cerebral ischaemia. This study will use near-infrared spectroscopy to non-invasively quantify regional cerebral oxygenation (rSO2) to assess the association between poor rSO2during the first 72 hours of critical illness with delirium severity, as well as long-term sensorimotor and cognitive impairment among intensive care unit (ICU) survivors. Further, the physiological determinants of rSO2will be examined.Methods and analysisThis multicentre prospective observational study will consider adult patients (≥18 years old) eligible for enrolment if within 24 hours of ICU admission, they require mechanical ventilation and/or vasopressor support. For 72 hours, rSO2will be continuously recorded, while vital signs (eg, heart rate) and peripheral oxygenation saturation will be concurrently captured with data monitoring software. Arterial and central venous gases will be sampled every 12 hours for the 72 hours recording period and will include: pH, PaO2, PaCO2, and haemoglobin concentration. Participants will be screened daily for delirium with the confusion assessment method (CAM)-ICU, whereas the brief-CAM will be used on the ward. At 3 and 12 months post-ICU discharge, neurological function will be assessed with the Repeatable Battery for the Assessment of Neuropsychological Status and KINARM sensorimotor and cognitive robot-based behavioural tasks.Ethics and disseminationThe study protocol has been approved in Ontario by a central research ethics board (Clinical Trials Ontario); non-Ontario sites will obtain local ethics approval. The study will be conducted under the guidance of the Canadian Critical Care Trials Group (CCCTG) and the results of this study will be presented at national meetings of the CCCTG for internal peer review. Results will also be presented at national/international scientific conferences. On completion, the study findings will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03141619

Ocean fronts with accumulated biomass and organic matter may be significant sites of enhanced microbial activity. We sampled a frontal region (the A-Front) separating oligotrophic and mesotrophic water masses within the California Current Ecosystem (CCE) to assess the influence of frontal hydrography on several microbial parameters. Samples for heterotrophic bacterial, viral and flagellate abundance, dissolved and particulate carbon and nitrogen, transparent particles and bacterial carbon production were collected at 6 depths from the surface to 100 m with 5‐9 conductivity/temperature/depth casts along a 26-km northerly transect across the front. Relative to adjacent oligotrophic and mesotrophic waters, the frontal transition displayed peaks in the mean estimates of cell-specific bacterial carbon and bulk bacterial production, particulate organic carbon and particulate organic nitrogen concentrations, and the abundance and size of transparent particles. Bacterial carbon production increased 5-fold northward from oligotrophic waters to the frontal zone, in agreement with an increase in the frequency of dividing cells, but bacterial abundance was lower than at adjacent stations. This may be partially explained by high chlorophyll, elevated virus:bacteria ratios and low nanoflagellate grazer abundance at the front. Our data suggest that CCE fronts can facilitate intense biological transformation and physical transport of organic matter, in sharp contrast to adjacent low productivity waters, and harbor dynamic microbial populations that influence nutrient cycling.

The sovereign debt crisis has emphasized the seriousness of the results of poor financial management and financial reporting. Financial reporting failure in the private sector earlier this century led to dramatic action. Although there have been widespread reporting failures in the public sector , there have been very few strong calls for action. This article looks at what is being done internationally to ensure high-quality accounting by governments, particularly solutions from the accounting profession.

As the current sovereign debt crisis engulfing Europe broadens and threatens to bring down more governments and lead the world into another, potentially very serious, economic slowdown, minimal commentary and public debate has focused on a fundamental problem, and the need to address it. That problem is the deficient – and sometimes fraudulent – accounting practices employed by many governments around the world. A major shortcoming of many governments has been highlighted by the crisis – that is, the poor quality of public financial management and the lack of public accountability. And, while robust public-sector financial management would not alone solve the crisis, it is clear that the problems presented by the crisis will not be solved without it. Shareholders, debt providers and regulators of publicly listed companies would not tolerate for a minute the poor levels of reporting and disclosure evidenced by governments. Yet while governments recognise the need to impose stringent regulations on companies accessing funds from the public, many – indeed most – make little or no effort to meet such high standards in their own reporting. This is despite the fact that governments seek to raise hundreds of billions – indeed trillions – of dollars from the public. Improved financial reporting, disclosure and financial management of the public sector cannot be achieved until there is recognition that the incentives faced by politicians promote decision-making that works contrary to the public interest and appropriate institutional reforms are implemented.