Mule deer and energy development-Long-term trends of habituation and abundance.

As the extent and intensity of energy development in North America increases, so do disturbances to wildlife and the habitats they rely upon. Impacts to mule deer are of particular concern because some of the largest gas fields in the USA overlap critical winter ranges. Short-term studies of 2-3 years have shown that mule deer and other ungulates avoid energy infrastructure; however, there remains a common perception that ungulates habituate to energy development, and thus, the potential for a demographic effect is low. We used telemetry data from 187 individual deer across a 17-year period, including 2 years predevelopment and 15 years during development, to determine whether mule deer habituated to natural gas development and if their response to disturbance varied with winter severity. Concurrently, we measured abundance of mule deer to indirectly link behavior with demography. Mule deer consistently avoided energy infrastructure through the 15-year period of development and used habitats that were an average of 913 m further from well pads compared with predevelopment patterns of habitat use. Even during the last 3 years of study, when most wells were in production and reclamation efforts underway, mule deer remained >1 km away from well pads. The magnitude of avoidance behavior, however, was mediated by winter severity, where aversion to well pads decreased as winter severity increased. Mule deer abundance declined by 36% during the development period, despite aggressive onsite mitigation efforts (e.g. directional drilling and liquid gathering systems) and a 45% reduction in deer harvest. Our results indicate behavioral effects of energy development on mule deer are long term and may affect population abundance by displacing animals and thereby functionally reducing the amount of available habitat.

Collaborative practice: development, implementation, and evaluation of a weaning protocol for patients receiving mechanical ventilation.

BACKGROUND: Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort. OBJECTIVE: To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from mechanical ventilation in a medical respiratory intensive care unit. METHODS: The weaning protocol used was a modification of a protocol developed by Ely et al. Modifications included a more aggressive approach in proceeding to the spontaneous breathing trial, inclusion of the Richmond Agitation-Sedation Scale, and documentation of the production of secretions. RESULTS: Implementation of the protocol significantly reduced the duration of mechanical ventilation as measured by 8-hour shifts and ventilator days. Although length of stay in the intensive care unit was not significantly reduced (P = .29), a continuing downward trend occurred, from a mean of 8.6 days before the protocol was implemented to 7.9 days during the last 6 months of data collection (P = .07). CONCLUSIONS: The need to provide efficient care requires the collaboration of all disciplines involved in providing patients' care. The weaning protocol introduced in this study demonstrates the benefits of using a collaborative team to identify best practices and implement them in a practice setting.