The Impact of Concessioners on Sustainability in and around U.S. National Parks: A Case Study of Grand Teton National Park Concessioners

Concessioners play an important role in park and protected area management by providing visitor services. Historically, concessioners were criticized for their negative impacts on environmental sustainability. However, due to policy changes, technological advances, and shifting market demands, there is a need to reevaluate the role of concessioners in sustainable destination management in and around parks and protected areas. The purpose of this qualitative case study situated in Grand Teton National Park (GTNP), which was guided by social exchange theory, was to explore U.S. national park concessioners’ influence on sustainable development at the destination level from the perspective of National Park Service (NPS) staff, concessioners, and local community members. Sustainability was examined holistically as a multifaceted construct with integrated socioeconomic, cultural, and environmental dimensions. Twenty-three participants completed semistructured interviews. Researchers identified four thematic categories describing concessioners’ influence on sustainability; motivations and barriers to pursuing sustainability initiatives; and situational factors that facilitated concessioners’ sustainability actions. While participants commented on the negative environmental impacts of concessioners and their operations, these data suggest that concessioners were working individually and collaboratively to promote environmental, socioeconomic, and cultural sustainability in and around GTNP. Some concessioners were even described as leaders, testing and driving the development of innovative sustainability policies and practices. These actions were motivated, in part, by contractual obligations and profit generation. However, concessioners also had strong intangible motivators, such as intrinsic values and a strong sense of community, that drove their positive contributions to sustainability. Based on these data, we recommend that those involved in future theoretical and practical work with concessioners acknowledge the importance of both tangible and intangible motivators when attempting to promote higher levels of sustainability achievement and collaboration. This will become increasingly important as land management agencies continue to embrace strategies beyond the traditional “parks as islands” approach to management. Additionally, future work should explore more specifically the role of policy, conceptualizations of sustainability, and private industry sponsorship in promoting concessioners’ contributions to sustainability, especially in collaborative settings. This work is needed to understand if and how these observations generalize to other contexts.

Observed Mass-Scale Call-Response Dynamics Between Public Health Officials and the American Public in the Surging COVID-19 Pandemic Summer 2020

By any objective measure, the United States has mishandled its response to the SARS-CoV-2 and COVID-19 outbreak, with 177,394 deaths and 5,745,721 cases. In the world, there have been some 796,330 deaths and 22,848,030 validated coronavirus cases (with 15,500,447 recovered). The real rates are thought to be 3x – 10x higher given the low access to tests. In this moment, there are multiple epidemics ongoing in the U.S., resulting in massive government and private industry expenditures, disrupted markets, and social roiling. In journalistic coverage and social image sets, the interactive call-response between public health officials and the general American public may be seen in the Summer of 2020 (in a time of phased shutdowns and re-openings and re-closings). This work offers an original content analysis of over 2,431 journalistic articles and 2,224 social images captured July 3, 2020 to understand where the call-response communications broke down and the message got lost at enormous social and personal cost. A sidebar offers an analysis of COVID-19 social memes.

Managing career transitions into post-secondary Learning Designer Jobs: An Australasian perspective

This semi-structured qualitative study maps out the diversity of career paths of Australian and New Zealand (ANZ) learning designers (LDs) and summarises their career advice for those aspiring to be LDs. It identifies that, among the 92 participants, there were many different pathways into the profession both from an academic and from professional backgrounds. It identified that the most common entry points into the postsecondary LD profession come through previously working: as a primary and secondary teacher; in higher education student services, as an English as a Second Language (ESL) professional, a sessional academic seeking job stability; in private industry, such as in film and television and in the area of training and development. Most career transitions into LD were serendipitous, or a natural progression rather than a deliberate and planned process. The study further identified a paucity of LD and associated professions career information in ANZ public domain, which held some back from entering a Learning Design career earlier. This paper concludes with some recommended strategies to address this, to the extent that it is hoped that this paper will aid aspiring LDs in planning their career transitions more effectively.

Canadian Trends and Projections in Prescription Drug Purchases: 2001–2023

Limited data are available to understand costs and trends over time in the Canadian pharmaceutical market across all sectors. To fill this gap, a retrospective time series analysis of annual prescription drug purchases in Canada between 2001 and 2020 was conducted using data from the IQVIA Canadian Drugstore and Hospital Purchases Audit. Spending has grown over the past 2 decades at a steady pace, with annual average growth of 5.3% and 7.1% in the retail and hospital sectors, respectively. Total prescription purchases in 2020 were approximately $32.7 billion, 4.3% higher than in 2019 (3.8% growth in retail, 6.9% in hospital). New approvals of specialty and oncology drugs and generic formulations of the top 25 drugs may influence drug purchases in 2021 to 2023. Overall drug purchases in Canada are projected to continue growing. The forecast for the outpatient sector is continued moderate levels of growth in drug spending (3% to 4%), with higher rates of growth (7% to 8%) in the hospital setting. Action should be taken to curb sustained growth in pharmaceutical spending in Canada. Otherwise, these costs may be shifted to other budgets, private industry, and/or patients.

Lenalidomide Plus Rituximab Chemotherapy for Relapsed or Refractory Indolent B-Cell Non-Hodgkin Lymphomas

Data from 2 randomized controlled trials indicated a statistically significant benefit in progression-free survival and overall survival for patients with follicular lymphoma who received R2 as compared to patients who received rituximab plus placebo or R-CHOP. The frequency of all types of adverse events in patients receiving R2 as compared to rituximab plus placebo or R-CHOP was comparable, but patients receiving R2 experienced more severe adverse events. Two economic analyses concluded that R2 was cost-effective for the treatment of patients with follicular lymphoma as compared to rituximab plus placebo (UK and Dutch contexts). Evidence identified in this review was mostly limited to that describing patients with follicular lymphoma. Most evidence identified in this review was generated with support and/or funding from a private industry pharmaceutical manufacturer.

Improving food security for Labrador Inuit in Nunatsiavut, Labrador: A matter of health equity

Background The current low state of food security amongst Inuit in Canada is influenced by policy choices. Policy actors develop and implement policies, yet few research studies include their perspectives. This study includes policy actors’ perspectives on gaps and areas of improvement for policies that pertain to food security for Labrador Inuit in Nunatsiavut. Nunatsiavut is one of the four Inuit land claim areas in northern Canada making up the Inuit homeland, or Inuit Nunangat. It is situated in northern Labrador in the province of Newfoundland and Labrador, Canada. Methods This qualitative study consisted of key informant interviews conducted from July 2020-December 2020 with policy actors that spanned the Nunatsiavut Government (regional Inuit government), Government of Newfoundland and Labrador (provincial government), the Government of Canada (federal government), non-governmental organizations and private industry. Participants were asked about their role, policy gaps and opportunities for improving policies that pertain to food security in Nunatsiavut. It also included initial insights from emergency food security measures implemented during the first wave of COVID-19 in 2020. Results Fifteen key informant interviews were completed, and three participants provided written responses. The results were reported as per the consolidated criteria for reporting qualitative studies (COREQ): 32–item checklist. Seven participants (39%) stated they developed policy, six participants (33%) stated they both developed and implemented policy and five participants (28%) stated they implemented policy. Seven themes were identified from discussions with policy actors. Policy recommendations to improve food security include improving transportation, social policies, and policy coherence in policy implementation. Five separate themes were identified from discussions on implementing emergency food security measures during the first wave of COVID-19 in Nunatsiavut. These included inadequacy of social policies, hidden poverty among people living in Nunatsiavut and future considerations for post- COVID-19 food security policies. Conclusion The results of this study show that improving food security in Nunatsiavut is a matter of health equity. During COVID-19, these inequities were further highlighted, demonstrating the importance of urgent action. Findings from this study can inform actions to improve existing and future policies that pertain to food security for Labrador Inuit in Nunatsiavut.

Building Information Modelling Usage in Federal Hydropower Design and Construction Management

The use of Building Information Modeling (BIM) is widespread within the engineering and construction industry, with huge strides in both usage and technological advances in the past two decades. The benefits of design collaboration, communication, visualization, and risk mitigation are untold. The U.S. Army Corps of Engineers foresaw the benefits of BIM and began to write policy for its mandatory use across the enterprise in the early 2000s. As BIM technology evolved, the U.S. Army Corps of Engineers has struggled to keep pace with the speed of industry but continue to make improvements to policy and more widespread usage across the enterprise. The MILCON program sees widespread use in the planning and design phases using BIM for visualization, communication, creation of 2D construction drawings, and rough estimating. BIM usage stops short in two major areas of the U.S. Army Corps of Engineers work: hydropower rehabilitation and construction management. Professionals from the U.S. Army Corps of Engineers in design management, hydropower engineering, and construction management all agreed that BIM, utilized and implemented properly, can have a very strong impact in each major field that would improve efficiencies, aid stakeholders in better understanding of complicated design concepts, and realize a more streamlined construction management process for complicated hydropower work. Through literature review and interviews with construction professionals, this research studied how BIM is being used within the U.S. Army Corps of Engineers, specifically within hydropower rehabilitation programs, for design and construction management. This research also focused on how private industry has been and is currently using BIM in construction management, and to correlate how processes used in private industry may be used on hydropower generation unit rehabilitation projects at USACE-owned facilities.

Race and Ethnic Group Dependent Space Radiation Cancer Risk Predictions

Future space missions by national space agencies and private industry, including space tourism, will include a diverse makeup of crewmembers with extensive variability in age, sex, and race or ethnic groups. The relative risk (RR) model is used to transfer epidemiology data between populations to estimate radiation risks. In the RR model cancer risk is assumed to be proportional to background cancer rates and limited by other causes of death, which are dependent on genetic, environmental and dietary factors that are population dependent. Here we apply the NSCR-2020 model to make the first predictions of age dependent space radiation cancer risks for several U.S. populations, which includes Asian-Pacific Islanders (API), Black, Hispanic (white and black), and White (non-Hispanic) populations. Results suggest that male API and Hispanic populations have the overall lowest cancer risks, while White females have the highest risk. Blacks have similar total cancer rates as Whites, however their reduced life expectancy leads to modestly lower lifetime radiation risks compared to Whites. There are diverse tissue specific cancer risk ranking across sex and race, which include sex specific organ risks, females having larger lung, stomach, and urinary-bladder radiation risks, and males having larger colon and brain risks.

Healthcare Activism, Marketization, and the Collective Good

This introductory chapter charts the book’s trajectory by engaging with three interlinked key dynamics of contemporary healthcare—marketization, digitalization, and individualization. It draws on several theoretical frameworks to conceptualize notions of the common, collective, or public good and to consider how healthcare activism may play into defining and defending the collective good when faced with the outlined societal, economic, and scientific dynamics. Presenting contemporary examples from the Covid-19 pandemic, the chapter argues that the way activists define and defend the collective good can only fully be understood by grasping how this good is shaped by other, often more dominant, stakeholders in healthcare: governmental institutions, professional experts, scientists, and private industry—the latter being a focal point of concern for this current volume.

Race and Ethnic Group Dependent Space Radiation Cancer Risk Predictions

Future space missions by national space agencies and private industry, including space tourism, will include a diverse makeup of crewmembers with extensive variability in age, sex, and race or ethnic groups. The relative risk (RR) model is used to transfer epidemiology data between populations to estimate radiation risks. In the RR model cancer risk is assumed to be proportional to background cancer rates and limited by other causes of death, which are dependent on genetic, environmental and dietary factors that are population dependent. Here we apply the NSCR-2020 model to make the first predictions of age dependent space radiation cancer risks for several U.S. populations, which includes Asian-Pacific Islanders (API), Black, Hispanic (white and black), and White (non-Hispanic) populations. Results suggest that male API and Hispanic populations have the overall lowest cancer risks, while White females have the highest risk. Blacks have similar total cancer rates than Whites, however their reduced life expectancy leads to modestly lower lifetime radiation risks compared to Whites. There are diverse tissue specific cancer risk ranking across sex and race, which include sex specific organ risks, female’s having larger lung, stomach, and urinary-bladder radiation risks, and male’s having larger colon and brain risks.