Management Strategy Evaluation Research Articles

MEXICAN PINK ABALONE (Haliotis corrugata WOOD, 1828) FISHERY MANAGEMENT STRATEGY EVALUATION: A DATA-LIMITED APPROACH

Management procedures (MP) were evaluated to address alternative management of the pink abalone (Haliotis corrugata) fishery in the Mexican Pacific. This assessment utilized the Method Evaluation and Risk Assessment (MERA) platform within the context of management strategy evaluation (MSE). This species has been a crucial component of the abalone fishery in Mexico, with a history dating back to the 19th century. Since 1996, fishery authorities and fishermen have noted a decline in the stock biomass. In response, they implemented various strategies and efforts to address the situation. However, despite these measures, the stock has yet to recover satisfactorily. Eight MP were evaluated, and two corresponded to the status quo (current catch and effort). The simulation results suggest that relying solely on effort-based MP falls short of meeting the management objectives set in the reference points (Biomass and Yield). In contrast, alternative strategies involving different quota allocation strategies (e.g., based on the depletion level) demonstrated superior performance and a higher likelihood of meeting management objectives. Despite incorporating fishery information, the existing management procedures could have performed better in the simulation. Therefore, it is crucial to assess and implement alternative management strategies that are more likely to succeed

Predicting relapsed/refractory disease in childhood hemophagocytic lymphohistiocytosis based on clinical features at diagnosis: A 13-year single-institute retrospective study in Thailand.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease. Relapsed/refractory disease is the main cause of death. This study aims to determine the prognostic indicators for relapsed/refractory disease in childhood HLH (R/R HLH). Infants and children under 18 years of age who were diagnosed with HLH according to HLH-2004 criteria, MAS-HLH criteria for rheumatologic diseases, or H-score undergoing treatment in Chiang Mai University hospital between 2010 and 2022 were included. Demographic data, clinical characteristics, and laboratory parameters were retrospectively reviewed. Out of 86 childhood HLH cases, 30 patients (34.9%) experienced R/R HLH. All patients with primary HLH developed R/R HLH. The most common form of secondary HLH was infection-associated hemophagocytic syndrome (IAHS), comprising 43 cases. Of these, 37.2% had relapsed or refractory disease. Univariable analysis identified several potential risk factors for R/R HLH, including younger age, severe disease status, higher HLH-2004 criteria scores, higher H-scores, overt DIC, higher pSOFA scores, and increased levels of aspartate aminotransferase, total bilirubin, and direct bilirubin. Multivariable logistic regression analysis revealed that a pSOFA score of ≥ 8 and age < 3 years were independent risk factors for R/R HLH, with adjusted odds ratios of 6.35 (95% confidence interval [CI], 1.18-34.19; P = 0.032) and 3.62 (95% CI, 1.04-12.63; P = 0.044), respectively. Children with HLH who have a pSOFA score of ≥ 8, or are younger than 3 years, are at a higher risk of relapsed or refractory disease. Further evaluation of management strategies in this context is warranted.

ALLERGIC CONJUNCTIVITIS IN CHILDHOOD

Allergic conjunctivitis is an eye condition prevalent among children, characterized by inflammation of the conjunctiva resulting from an allergic reaction to substances such as pollen, dust, dust mites and animal dander. This disease is a manifestation of the immune system and causes symptoms such as intense itching, tearing, hyperemia and a sensation of a foreign body in the eyes. The management of allergic conjunctivitis ranges from simple measures, such as frequent eye washing and avoidance of allergens, to the use of medications such as antihistamines, mast cell stabilizers and topical corticosteroids. In childhood, the management of allergic conjunctivitis faces difficulties such as variability in response to treatment and the impossibility of completely avoiding exposure to allergens. The general objective of this study is to evaluate management strategies for allergic conjunctivitis in childhood, with an emphasis on the effectiveness of available treatments and the identification of factors that influence the response to treatment. Specific objectives include analyzing the effectiveness of different treatments, investigating the influence of environmental and individual factors on disease severity and recurrence, and discussing the management of allergic conjunctivitis. This study is relevant as appropriate management of allergic conjunctivitis can prevent complications and improve children’s well-being. Identifying factors that influence response to treatment can contribute to the development of more personalized and effective therapeutic approaches. Recent literature highlights the need to improve education of parents and caregivers about allergic conjunctivitis to ensure appropriate management of the disease. Studies show that understanding the immunological mechanisms underlying the disease is crucial for developing new therapies. Therefore, this research not only adds to scientific knowledge about childhood allergic conjunctivitis, but also provides valuable insights for clinical practice and health policy formulation.

Empirical validation of integrated stock assessment models to ensuring risk equivalence: A pathway to resilient fisheries management.

The Precautionary Approach to Fisheries Management requires an assessment of the impact of uncertainty on the risk of achieving management objectives. However, the main quantities, such as spawning stock biomass (SSB) and fish mortality (F), used in management metrics cannot be directly observed. This requires the use of models to provide guidance, for which there are three paradigms: the best assessment, model ensemble, and Management Strategy Evaluation (MSE). It is important to validate the models used to provide advice. In this study, we demonstrate how stock assessment models can be validated using a diagnostic toolbox, with a specific focus on prediction skill. Prediction skill measures the precision of a predicted value, which is unknown to the model, in relation to its observed value. By evaluating the accuracy of model predictions against observed data, prediction skill establishes an objective framework for accepting or rejecting model hypotheses, as well as for assigning weights to models within an ensemble. Our analysis uncovers the limitations of traditional stock assessment methods. Through the quantification of uncertainties and the integration of multiple models, our objective is to improve the reliability of management advice considering the complex interplay of factors that influence the dynamics of fish stocks.

A scalable big data approach for remotely tracking rangeland conditions

Rangelands, covering half of the global land area, are critically degraded by unsustainable use and climate change. Despite their extensive presence, global assessments of rangeland condition and sustainability are limited. Here we introduce a novel analytical approach that combines satellite big data and statistical modeling to quantify the likelihood of changes in rangeland conditions. These probabilities are then used to assess the effectiveness of management interventions targeting rangeland sustainability. This approach holds global potential, as demonstrated in Mongolia, where the shift to a capitalist economy has led to increased livestock numbers and grazing intensity. From 1986 to 2020, heavy grazing caused a marked decline in Mongolia’s rangeland condition. Our evaluation of diverse management strategies, corroborated by local ground observations, further substantiates our approach. Leveraging globally available yet locally detailed satellite data, our proposed condition tracking approach provides a rapid, cost-effective tool for sustainable rangeland management.

Management strategy evaluation operating model conditioning: a swordfish case study

Evaluation of fish stock status is a key step for fisheries management. Tuna Regional Fisheries Management Organizations (t-RFMOs) are moving towards management strategy evaluation (MSE), a process that combines science and policy and depends on technical aspects, developed by scientists, designed to meet management objectives established by managers and other stakeholders. In the Indian Ocean, the current management advice for swordfish (Xiphias gladius) is based on an ensemble of 24 models considering four areas of uncertainty about the stock dynamics. There is an ongoing MSE process for swordfish, and this paper describes the methodology being applied for the conditioning of the operating model (OM), including model selection and validation. In the MSE, nine sources of uncertainty were considered, each being characterized by 2–3 levels. A partial factorial design was employed to reduce the number of models from a full factorial design to those needed to encompass the overall uncertainty. A selection and validation process was carried out, filtering models that converged, showed good predictive skills, and provided plausible estimates. Overall, the estimated spawning stock biomass (SSB) relative to SSB at maximum sustainable yield (MSY), and fishing mortality (F) relative to FMSY encompasses the estimates of the stock assessment ensemble at the most optimist area of the distribution. The MSE for swordfish is an ongoing process that is expected to provide more robust management advice in the future. Further developments to the OM can still occur, but the methods presented herein can be applied to this, or other species, MSE processes.

Interventional Prospective Studies on Xerostomia in Patients Undergoing Palliative and End-of-Life Care: A Scoping Review.

Patients undergoing palliative care often develop debilitating oral conditions, including xerostomia. These conditions may significantly impact patients' quality of life. Despite the high prevalence and adverse impact of xerostomia, effective management strategies remain unclear. This scoping review was performed to elucidate effective interventions for xerostomia in patients undergoing palliative and end-of-life care. A comprehensive search strategy was employed to identify relevant studies up to August 2023. Full-text primary articles focusing on xerostomia in patients receiving palliative care were included in the review. Eleven articles were selected for analysis, and data were extracted by six reviewers. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Among the 11 studies, interventions ranged from oral care to saliva substitutes and methods to stimulate saliva secretion. The primary method of assessing xerostomia was the performance of subjective evaluations using visual analog scale scores or numerical rating scale scores. Various interventions including oral care regimens, topical treatments, and mixed efficacy outcomes were reported. Notably, only one study directly measured the saliva volume, highlighting a reliance on subjective endpoints in most studies. Although no definitive conclusions can be drawn regarding the most effective intervention, oral care was a preferred option for managing xerostomia in patients undergoing palliative care. Additionally, adjunctive treatments such as ice cubes, saline, and moisturizers showed promise but require further investigation. Objective measures should be incorporated into future intervention trials to complement subjective assessments and provide a comprehensive evaluation of xerostomia management strategies in this patient population.

Real-World Treatment Patterns, Clinical Outcomes, Healthcare Resource Utilization, and Costs in Advanced Hepatocellular Carcinoma in Ontario, Canada.

The therapeutic landscape for aHCC has evolved in recent years, necessitating a comprehensive analysis of treatment patterns, clinical outcomes, HCRU, and costs to contextualize emerging treatments. This study aimed to investigate these outcomes using real-world data from Ontario, Canada. This retrospective cohort study was conducted using linked administrative databases from April 2010 to March 2020. Patients diagnosed with aHCC were included, and their clinical and demographic characteristics were analyzed, as well as treatment patterns, survival, HCRU, and economic burden. Among 7322 identified patients, 802 aHCC patients met the eligibility criteria for inclusion in the study. Treatment subgroups included 1L systemic therapy (53.2%), other systemic treatments (4.5%), LRT (9.0%), and no treatment (33.3%). The median age was 66 years, and the majority were male (82%). The mOS for the entire cohort from diagnosis was 6.5 months. However, patients who received 1L systemic therapy had an mOS of 9.0 months, which was significantly higher than the other three subgroups. The mean cost per aHCC-treated patient was $49,640 CAD, with oral medications and inpatient hospitalizations as the largest cost drivers. The results underscore the need for the continuous evaluation and optimization of HCC management strategies in the era of evolving therapeutic options.

A Review article of pharmacovigilance and studies of clinical research for health care

Pharmacovigilance, the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug- related problems, is intrinsically linked to effective information management. The pivotal role of information in pharmacovigilance encompassing data collection, analysis, and dissemination for optimal patient safety. The foundation of pharmacovigilance lies in robust information system that facilitate the collection of adverse event reports from healthcare professionals, patients, and other stakeholder. The evolution of data sources, emphasizing the integration of electronic health records, wearable devices and real world evidence to enhance the depth and breadth of information available for analysis. Innovative technologies, including artificial intelligence and machine learning, are transforming pharmacovigilance by automating signal detection and predictive modeling. How those tools are utilized to sift through vast datasets, identifying potential safety concerns and aiding regulatory decision-making. Furthermore, the abstract delves into the importance of structured information sharing between regulatory agencies, pharmaceutical companies, healthcare providers. Timely transparent communication of safety information ensure a proactive response to emerging risk and enable the development of effective risk management strategies.The continues evaluation of information management strategies to adapt to the complexities of modern healthcare and pharmaceutical innovation. In essence, this abstract illuminates the symbiotic relationship between pharmacovigilance and information management, showcasing how the effective utilization of diverse and high quality data is fundamental to advancing drug safety practices and safeguarding public health.

Developing management plans for sprat (Sprattus sprattus) in the Celtic Sea to advance the ecosystem approach to fisheries

Sprat are commercially valuable and are an important component of the North-East Atlantic ecosystem as major predators of zooplankton, competitors with herring, and prey for piscivorous fish, marine mammals, and seabirds. Despite this, insufficient information exists for Celtic Seas sprat, one of five North-East Atlantic stocks, to estimate stock status. To ensure the sustainable exploitation of sprat, the health of the Celtic Seas ecosystem, and the wider fisheries sector, we conduct a management strategy evaluation to stress test the current single-species advice framework. The aim is to evaluate whether ecosystem objectives can be achieved under single-species maximum sustainable yield and precautionary advice frameworks. An operating model was conditioned on life history theory and strategic information from ecosystem models. We showed that in-year advice using an empirical rule could achieve management objectives and help balance the trade-offs between fishing activities and ecosystem health. The approach allows ecosystem understanding to be incorporated within existing precautionary and maximum sustainable yield frameworks to provide a robust management framework that can meet multiple objectives despite uncertainty.

The second Irish Helicobacter pylori Working Group consensus for the diagnosis and treatment of Helicobacter pylori infection in adult patients in Ireland.

There has been an increase in resistance to many of the antimicrobials used to treat Helicobacter pylori ( H. pylori ) nationally and internationally. Primary clarithromycin resistance and dual clarithromycin and metronidazole resistance are high in Ireland. These trends call for an evaluation of best-practice management strategies. The objective of this study was to revise the recommendations for the management of H. pylori infection in adult patients in the Irish healthcare setting. The Irish H. pylori working group (IHPWG) was established in 2016 and reconvened in 2023 to evaluate the most up-to-date literature on H. pylori diagnosis, eradication rates and antimicrobial resistance. The 'GRADE' approach was then used to rate the quality of available evidence and grade the resulting recommendations. The Irish H. pylori working group agreed on 14 consensus statements. Key recommendations include (1) routine antimicrobial susceptibility testing to guide therapy is no longer recommended other than for clarithromycin susceptibility testing for first-line treatment (statements 6 and 9), (2) clarithromycin triple therapy should only be prescribed as first-line therapy in cases where clarithromycin susceptibility has been confirmed (statement 9), (3) bismuth quadruple therapy (proton pump inhibitor, bismuth, metronidazole, tetracycline) is the recommended first-line therapy if clarithromycin resistance is unknown or confirmed (statement 10), (4) bismuth quadruple therapy with a proton pump inhibitor, levofloxacin and amoxicillin is the recommended second-line treatment (statement 11) and (5) rifabutin amoxicillin triple therapy is the recommend rescue therapy (statement 12). These recommendations are intended to provide the most relevant current best-practice guidelines for the management of H. pylori infection in adults in Ireland.

Current understanding and management of CAR T cell-associated toxicities.

Chimeric antigen receptor (CAR) T cell therapy has revolutionized the treatment of several haematological malignancies and is being investigated in patients with various solid tumours. Characteristic CAR T cell-associated toxicities such as cytokine-release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are now well-recognized, and improved supportive care and management with immunosuppressive agents has made CAR T cell therapy safer and more feasible than it was when the first regulatory approvals of such treatments were granted in 2017. The increasing clinical experience with these therapies has also improved recognition of previously less well-defined toxicities, including movement disorders, immune effector cell-associated haematotoxicity (ICAHT) and immune effector cell-associated haemophagocytic lymphohistiocytosis-like syndrome (IEC-HS), as well as the substantial risk of infection in patients with persistent CAR T cell-induced B cell aplasia and hypogammaglobulinaemia. A more diverse selection of immunosuppressive and supportive-care pharmacotherapies is now being utilized for toxicity management, yet no universal algorithm for their application exists. AsCAR T cell products targeting new antigens are developed, additional toxicities involving damage to non-malignant tissues expressing the target antigen are a potential hurdle. Continued prospective evaluation of toxicity management strategies and the design of less-toxic CAR T cell products are both crucial for ongoing success in this field. In this Review, we discuss the evolving understanding and clinical management of CAR T cell-associated toxicities.

Including close-kin mark-recapture data in statistical catch-at-age stock assessments and management strategies

Close-kin mark-recapture (CKMR) data can be used on their own to provide estimates of fish spawning stock biomass, adult mortality rate and fecundity-at-age. However, CKMR data can also be integrated directly into a stock assessment. We present a simplified example of integrating CKMR data within the Stock Synthesis assessment framework, and use simulation to evaluate management strategies based on the harvest control rule used to set catch limits for fish stocks off southeast Australia. The simulations are tailored to jackass morwong, Nemadactylus macropterus, a moderately-long lived (up to 46 years) fish species that is believed to have exhibited a regime-shift reduction in recruitment. We identify the sample sizes needed for a CKMR-based management strategy to achieve similar performance to an (optimistically parameterized) catch-per-unit-effort (CPUE)-based approach for this species. A CKMR-based management strategy can perform at least as well as a CPUE-based approach and CKMR data provide information to better estimate parameters such as adult natural mortality. Moreover, CKMR-based management strategies are not subject to the risk associated with CPUE-based approaches related to trends in catchability. The performances of CKMR-based assessment methods and management strategies are likely case-specific, but this paper shows the viability of including CKMR data in next generation stock assessments and harvest control rules.

Directed work-up of select penetrating neck injuries is safe: Hard signs continue to soften

IntroductionManagement of penetrating neck injuries (PNIs) has evolved over time, more frequently relying on increased utilization of diagnostic imaging studies. Directed work-up with computed tomography imaging has resulted in increased use of angiography and decreased operative interventions. We sought to evaluate management strategies after directed work-up, hypothesizing increased use of non-operative therapeutic interventions and lower mortality after directed work-up. MethodsPatients with PNI from 2017 to 2022 were identified from a single-center trauma registry. Demographics, injuries, physical exam findings, diagnostic studies and interventions were collected. Patients were stratified by presence of hard signs and management strategy [directed work-up (DW) and immediate operative intervention (OR)] and compared. Outcomes included therapeutic non-operative intervention [endovascular stent, embolization, dual antiplatelet therapy (DAPT), or anticoagulation (AC)], non-therapeutic neck exploration, length of stay (LOS), and mortality. ResultsOf 436 patients with PNI, 143 (33%) patients had vascular and/or aerodigestive injuries. Of these, 115 (80%) patients underwent DW and 28 (20%) patients underwent OR. There were no differences in demographics or injury severity score between groups. Patients in the DW group were more likely to undergo vascular stent or embolization (p = 0.040) and had fewer non-therapeutic neck explorations (p = 0.0009), compared to the OR group. There were no differences in post-intervention stroke, leak, or mortality. Sixty percent of patients with vascular hard signs and 78% of patients with aerodigestive hard signs underwent DW. ConclusionsDirected work-up in select patients with PNI is associated with fewer non-therapeutic neck explorations. There was no difference in mortality. Selective use of endovascular management, AC and DAPT is safe.

Exploring tradeoffs in southeast United States marine fisheries management using management strategy evaluation

Recreational fishing is the fastest growing sector in industrialized nations and can have substantial impacts on marine fish populations and ecosystems. Commercial objectives are typically characterized by maximizing yield and fishery stability whereas recreational anglers generally prefer sustained access to fishing and the availability of larger fish. Achieving these objectives while balancing tradeoffs between recreational and commercial fishing is essential to effective recreational and mixed-use fisheries management. Balancing multiple sector objectives is of particular concern in the southeast United States (US), where recreational fishing is the dominant source of mortality for marine fish stocks. We developed and applied a size-structured management strategy evaluation (MSE) tool, individually, to two stocks in southeast US Atlantic waters, black sea bass (Centropristis striata), a sedentary reef fish in overfished condition, and cobia (Rachycentron canadum), a migratory coastal pelagic fish, to evaluate the performance and tradeoffs of mixed management procedures against a variety of objectives. Several recreational and commercial objectives were aligned: fishers sought to conserve the stock and maximize catch, which simplified the evaluation of tradeoffs. We tested management procedures over alternate states of recruitment for black sea bass, and natural mortality for cobia. Management procedures that allowed harvest for black sea bass resulted in or risked an overfished status if the current weak recruitment regime continues, but could rebuild with no fishing regardless of recruitment state. Although results were sensitive to uncertainty in recruitment, no management procedures could achieve historic landings for either sector, and only management procedures that reduced effort consistently resulted in a reduced number of dead discards. No management procedures resulted in an overfished status for cobia. Management procedures for cobia generally achieved objectives and were robust to uncertainty in natural mortality. In both case studies, tradeoffs occurred between maximizing catch and season length and maintaining a stronger size structure in the population. This study resulted in a flexible MSE tool with strong potential utility for scoping management procedures that explicitly consider recreational fishing objectives.

Lessons from long-term monitoring of tropical rock lobsters to support fisheries management

Fishery-independent scientific surveys are highly valuable for monitoring lobsters and other fisheries. Yet, there are relatively few long-term monitoring surveys to support the provision of management advice. A number of challenges can prevent the continuity of long-term monitoring series. This paper uses the 35-year continuous annual dive surveys for Australia’s Torres Strait tropical rock lobster (TRL) to overview strengths and limitations of a long-term scientific survey, as well as lessons learnt from having overcome a range of challenges. Fishery-independent surveys are more reliable than fishery-dependent data and are more robust to external shocks such as market drivers and fuel prices. The primary purpose of the surveys is to provide a reliable index of stock abundance together with data to inform on size and age structure, plus model parameters and reference points. Here, we also highlight additional survey benefits including: yielding positive gains relative to cost, facilitating an adaptive management approach that serves as an early warning system, reducing and resolving inter-sector conflicts, reduced frequency of stock assessments, providing data from associated habitat monitoring, improved stakeholder buy-in, utility for development of Operating Models for Management Strategy Evaluation, contribution to achieving certification, contributing to biodiversity agreements and consistent cross-jurisdictional monitoring. We analyse lessons learnt from challenges such as changes in resource management, budget cuts, increased health and safety requirements, maintenance of capability and staff capacity, stakeholder buy-in, need to validate survey results, a pandemic and changing climate. Our experiences highlight why long-term scientific surveys are considered the gold standard for fisheries monitoring and we provide insights for building and maintaining key marine monitoring series.

Experiences in developing empirical harvest strategies for the Indonesian tropical tuna fisheries

Harvest strategies, also referred to as management procedures, are foundational to evidence-based fisheries decision making. Together with closed-loop simulation testing, termed Management Strategy Evaluation, of potential harvest strategies, they are considered to be best practice. However, the use of these approaches is still mostly limited to a small minority of high-value, data-rich stocks in developed economies. The Indonesian tropical tuna fisheries provide a rare real-world experience where formal empirical harvest strategies were being developed for data-limited fisheries within a developing economy as an operational management tool. The Harvest Strategy Framework is a departure from a previously open-access fishery for tropical tuna in Indonesian archipelagic waters. It outlines the necessary actions to operationalize the harvest strategy, including fisheries monitoring, harvest control rules, associated management measures to meet the management objectives, and immediate actions to reduce the levels of catch as a precautionary measure until the harvest strategy is fully implemented. It was developed over a 9-year national consultative process, commencing in 2014 and culminating in the official adoption of the framework in June 2023. This paper outlines key processes and challenges encountered in stakeholder engagement and technical capacity development within the intricate governance context of Indonesia. We argue that the engagement processes have cemented a future direction towards sustainable and best practice fisheries management in Indonesia and the effective co-production process has potential to show the way for other fisheries in coastal developing states who face similar challenges in managing their national and internationally shared stocks.

Evaluations of brand management strategies for luxury goods with a hybrid fuzzy multicriteria decision making model

AbstractThe previous studies on brand attachment (BA) are relatively limited to exploring the relation between the customer's BA and loyalty from the enterprise's perspective. This study employs a hybrid fuzzy multicriteria decision‐making model with a quality function deployment (QFD) and a fuzzy association matrix is used to explore customer BA and the corresponding BA management strategies for enhancing brand loyalty. Results indicate the integration strategy, which comprises the personality, expertise, and kindness of the brand's salespersons and the development of intelligent automobile technology, is used to signal brand value and thereby stimulate customer resonance with the brand.

Development of climate informed management scenarios for fisheries in the eastern Bering Sea

Abstract In recognition of the impact of climate change on marine ecosystems worldwide, integrated research teams have coupled climate change projections with social-ecological models to inform management and evaluate adaptation strategies for the fishing industry and fishing communities. A key step in this process is the selection of scenarios that enable improved adaptation strategies and decision-making through engagements with constituents with diverse interests in the future use of marine resources. This paper presents an approach to selecting and refining climate-informed social-ecological scenarios for groundfish and crab fisheries in the eastern Bering Sea. The approach involved: (a) initial model development to provide worked examples; (b) engagement with stakeholders to seek input on climate-related concerns, priorities, and adaptation options; and (c) establishment of pathways for uptake of climate-informed decision support information into existing management systems. This approach narrowed the range of candidate scenarios, identified pressing climate concerns of constituents, and clarified timelines for scheduling modeling projects to address these concerns. Separating evaluation of management strategies (research modeling) from proposed changes to Fishery Management Plans preserved opportunities for public debate of proposed changes through a well-established regulatory review process. Collectively, these outcomes help to advance the development of a regionally relevant climate-ready harvest policy.

The Evaluation of Drug Management and Improvement Strategies Using the Hanlon Method in the Pharmacy Installation of the Bahteramas Hospital Southeast Sulawesi

Drug management is a drug management cycle which includes these stages as follows: selection, procurement, distribution and use. Ineffectiveness and inefficiency may negatively impact hospitals both medically and economically. This study aims to evaluate drug management in the selection, procurement, distribution and use of drugs at the Bahteramas Hospital, Southeast Sulawesi,&#x0D; with Hanlon method as strategic improvement. This study has done with a descriptive method with data collected retrospectively in 2022 and prospectively, both primary (management record) and secondary (interviews). Results of this study about drug management showed there were 4 indicators that do not comply with standards. Meanwhile, other 10 indicators could comply with the standards. The improvement strategy using the Hanlon method in drug management is to prioritize repairing problems sequentially starting from the average percentage of drug waiting time, suitability of the national formulary and hospital formulary, as well as the percentage of dead stock.