ABSTRACT
BACKGROUND: The British Virgin Islands and the US Virgin Islands, two island groups located in the Caribbean archipelago, hold unique plant diversity and high endemism. Until recently, Solanum conocarpum was considered a rare plant species endemic to the island of St. John in the US Virgin Islands. Ongoing botanical surveys in this region are revealing new populations and refining our understanding of the distribution of these narrow endemic plant species. The objective of this paper is to assess the conservation status of S. conocarpum, including a review of its geographic range, population numbers, threats and conservation actions needed for its long-term survival. NEW INFORMATION: In this paper, we present new occurrences for S. conocarpum, extending its geographic range to a new island, Tortola and new territory, the British Virgin Islands. Despite this range expansion, this species is evaluated as Endangered (EN), based on Criteria B1b(iii,v)+2b(iii,v)+C2a(i), according to the IUCN Red List Categories and Criteria. The extent of occurrence (EOO = 46 km2) and area of occupancy (AOO = 20 km2) are highly restricted. On St. John (US Virgin Islands), the historically recorded individuals at Reef Bay, Europa Ridge and Sabbat Point are now considered extirpated due to disturbance from development compounded by invasive species, as well as the impact of feral ungulates and drought stress. These threats are impacting the species across the whole island of St. John and contributing to a continuing decline of suitable habitat, despite the island being a National Park. On the island of Tortola, the species occurs on unprotected lands subject to development and habitat modification and decline by feral ungulates. Based on these threats acting separately across the two islands, two locations were defined. The estimated total number of mature individuals ranges between 150 and 250, with the largest subpopulation at Nanny Point in the US Virgin Islands, containing 108 mature individuals. Conservation action, focused on protecting this species' habitat, is urgently needed.
ABSTRACT
Background Fiscally responsible utilization of anticancer treatments is necessary to combat their continually increasing cost. Dose rounding is one strategy that has been explored to minimize cost and waste without losing clinical effectiveness. Objectives To determine if dose rounding chemotherapy agents is a feasible cost-containment strategy at an institution with a small oncology clinic. Methods This study is a retrospective chart review of all body surface area dosed parenteral chemotherapy prescribed for an oncological diagnosis over a 12-month period (1 October 2015-30 September 2016). Chemotherapy doses were rounded down by 5%. Doses for patients with metastatic diagnoses were also rounded down by 10%. Rounded doses were evaluated for a potential decrease in vial size. Cost was represented as dollar/milligram of drug. Potential for drug waste minimization was also calculated. Results There were 877 total doses of chemotherapy administered to 70 unique patients throughout the 12-month duration of the study. When doses were rounded down by 5%, 140 doses qualified for a decrease in vial number. The potential for cost savings was $22,849 with 83,802 mg saved from wastage. A 10% decrease resulted in the reduction of vials for 248 doses, a potential savings of $30,911 with 129,011 milligrams saved. The targeted agents accounted for the majority of savings, $16,920 of the $22,849 with 5% rounding and $20,086 of the $30,911 with 10% rounding. Conclusion Dose rounding has the potential to be an effective cost-containment strategy in low volume oncology clinics.
